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APPENDIX B <br />SAMPLE INVOICE <br />t;TATt• U.n <br />STATE OF WASHINGTON <br />DEPARTMENT OF ECOLOGY <br />PO Box 47600 • Olympia, WA 98504-7600 • 360-407-6000 <br />711 for Washington Relay Service • Persons with a speech disability can call 877-833-6341 <br />INVOICE <br />Date <br />COMPANY <br />NAME <br />ADDRESS Agreement No. <br />CITY, STATE ZIP Invoice No.: <br />Invoice for Ecology Cost Reimbursement Agreement Project No through (Date) <br />Costto <br />Less Previous <br />Current Invoice <br />Date <br />Invoices <br />Amount <br />Salaries <br />0.00 <br />0.00 <br />0.00 <br />Benefits <br />0.00 <br />0.00 <br />0.00 <br />Indirect <br />0.00 <br />0.00 <br />0.00 <br />Contracts <br />0.00 <br />0.00 <br />0.00 <br />Goods & Services <br />0.00 <br />0.00 <br />0.00 <br />Travel <br />0.00 <br />0.00 <br />0.00 <br />Staff Replacement <br />0.00 <br />0.00 <br />0.00 <br />TOTAL <br />Please remit payment and a cony of this invoice by (Date) to: <br />Department of Ecology <br />Cashiering Unit <br />PO Box 47611 <br />Olympia, WA 98504-7611 <br />If you have any questions or desire further information regarding the agreement contact (Project Manager) <br />at (phone). If questions are regarding the billing please contact (Fiscal Contact) in Receivables at <br />Washington State Department of Ecology <br />Cost -Reimbursement Agreement (CRA) Page 15 of 16 <br />