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Case Record Storage and Retrieval Services RFP (Part I)

Case Record Storage and Retrieval Services RFP (Part I)

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TECHNICAL EXHIBITS C-4<br />

APPENDIX C: SOW TECHNICAL EXHIBITS<br />

SAMPLE INVOICE FOR<br />

IHSS TIMESHEETS, GR/NAFS OR GR/NACF & COURT CASE BOXES<br />

Date______________<br />

Invoice Month_____________<br />

(EACH CATEGORY OF BOXES MUST BE INVOICED SEPARATELY)<br />

DESCRIPTION QUANTITY UNIT PRICE AMOUNT<br />

New Box Receipts<br />

Box Refiles<br />

Regular <strong>Retrieval</strong>s<br />

Emergent <strong>Retrieval</strong>s<br />

Undeliverable <strong>Retrieval</strong>s (out to<br />

another district; not on file - give<br />

reason, i.e., box never received)<br />

Regular Delivery Stop<br />

(Every other day)<br />

Emergency Delivery Stop<br />

(Within one workday of request)<br />

Special Pick-Up/Delivery Stop<br />

Total Number - Box Retention<br />

TOTAL AMOUNT DUE_______________________<br />

Prepared By<br />

(Signature)<br />

(Note: Each category billed shall contain back-up documentation. *Regular <strong>and</strong><br />

Emergent Delivery stops are a general service which does not need to be separated<br />

into categories. These services can be charged to the closed case record invoice<br />

along with documentation)<br />

CASE RECORD STORAGE AND RETRIEVAL SERVICES (<strong>RFP</strong>) 2012 176

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