Child Care Payment Invoice - Excel

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Child Care Payment Invoice - Excel Powered By Docstoc
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Child Care Executive Partnership Program             Palm Beach County                     Family Central, Inc.

Business Participant                                                                       Invoice Date:

Contact Name                                                                               Due Date:
Business Name
Address 1
Address 2



Month Service(s) Provided            July-04         # Days Child        Child Care         Total Cost       Employer
Name of Employee/Parent       Name of Child(ren)      Care Paid           Provider         of Child Care       Cost

Last       First              Last           First        22                ABC               $377.30             $94.33


Employees 1                   Children       1       Total Monthly Cost of Child Care         $377.30             $94.33



Adjustments From Previous Month                         # Days           Child Care            Total         Employer
Name of Employee/Parent      Name of Child(ren)        Adjusted           Provider             Cost            Cost


Employees ( )                 Children       ( )     Total Adjustment Cost of Child Care



                                                                    Total Invoice Cost of Child Care                $377.30
Send Payment to:
Ben Wilcox: Attn: CCEP                                              Total Amount Due by Employer                      $94.33
Family Central, Inc.
3111 S. Dixie Hwy, Suite 222                         Make Checks Payable to:
West Palm Beach, FL 33405-1548                       Palm Beach County School Readiness Coalition
561-514-3303

				
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