Owner's Representative Agreement - Excel by mpu10511

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									                                                    PROFESSIONAL SERVICES BILLING FORM
                                                          UNIVERSITY OF ILLINOIS
PSC*:                                                                         INVOICE DATE:
PROJECT:                                                                      UNIVERSITY PAYMENT #:
OWNER'S REPRESENTATIVE:                                                       Pay Period:                                               To
AGREEMENT DATE:                                                               FEIN/FTIN #:

   All documents are property of the University of Illinois and may not be modified. Improper use or alteration of any document shall be considered a material
                                 breach of the Agreement with the University of Illinois and may result in civil or criminal liability.


CONSULTANT SECTION: (Includes Subconsultant's fees)
                                         CONSULTANT                                              AMOUNT                             TOTAL
  DESCRIPTION PHASE AND/OR                                    SCHEDULED        EARNED TO                         AMOUNT OF                         UNBILLED
                                        MBE/FBE/PBE/NA                                         PREVIOUSLY                         BILLED TO
      AMENDMENT NO. **                                          VALUE            DATE                            THIS BILLING                      BALANCE
                                           STATUS                                                 BILLED                            DATE

                                                                                                                $0.00           $0.00           $0.00



                                                                                                                $0.00           $0.00           $0.00



                                                                                                                $0.00           $0.00           $0.00



                                                                                                                $0.00           $0.00           $0.00



                                                                                                                $0.00           $0.00           $0.00


TOTALS                                                       $0.00            $0.00           $0.00             $0.00           $0.00           $0.00

*PSC = PROFESSIONAL SERVICES CONSULTANT
SUBCONSULTANT SECTION:
        SUBCONSULTANT **
                                       SUBCONSULTANT                                             AMOUNT                             TOTAL
  (of the above totals, identify how                          SCHEDULED        EARNED TO                         AMOUNT OF                         UNBILLED
                                        MBE/FBE/PBE/NA                                         PREVIOUSLY                         BILLED TO
       much will be paid out to                                 VALUE            DATE                            THIS BILLING                      BALANCE
                                           STATUS                                                 BILLED                            DATE
  Subconsultants for each phase)


                                                                                                                $0.00           $0.00           $0.00



                                                                                                                $0.00           $0.00           $0.00



                                                                                                                $0.00           $0.00           $0.00



                                                                                                                $0.00           $0.00           $0.00



                                                                                                                $0.00           $0.00           $0.00

**Includes individual listing of any consultant/subconsultant either within original contract or those added by amendment(s)

NOTE: Attach appropriate statements, time sheets, invoices, etc.

Remarks                                                                                       Submitted by
                                                                                                                    (Professional Services Consultant)

                                                                                              Approved by
                                                                                                                         (Owner's Representative)


                                                                           00 60 00-21
         Form approved by Legal Counsel – UOCPRES 07/2010

								
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