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A MF / f IA K t' P,e-t <br />DI -1040 UNITED STATES DEPARTMENT OF THE INTERIOR Page:1 TP E <br />BILL FOR COLLECTION <br />Make Remittance Payable To: United States Geological Survey Bill #: 90086915 <br />Billing Contact: USGS: Bryan L. Wolla Phone: USGS: T: 701 - 253 -5578; E: bwol Date: 04/13/2012 <br />Due Date: 05113/2012 <br />Remit Payment To: United States Geological Survey <br />MS 271 National Center <br />Reston, VA 20192 <br />Payer: Platte River Recovery <br />Implementation Program <br />4411 4th AVE, Suite 6 <br />ATTN: Jerry F. Kenny <br />Kearney NE 68845 <br />To pay through Pay.gov go to https: / /www.pay.gov. <br />Additional forms of payment may be accepted. Please <br />email gdatta @usgs.gov or call 703 - 648 -7605 for <br />additional information. <br />Checks must be made payable to <br />U.S. Geological Survey. Please detach the top portion <br />or include bill number on all remittances. <br />Amount of Payment: $ <br />.............................................................. ............................... <br />Date <br />Description <br />Qty <br />Unit Price <br />Amount <br />Cost <br />Per <br />04/13/2012 <br />Services Provided Dates: 01/13/2012 - 04/13/2012 <br />1 <br />20,359.20 <br />1 <br />20,359.20 <br />11 CMNNOONCF02 <br />Amount Due this Bill: <br />20,359.20 <br />Interest will be assessed at the rate of 1.00 % on any unpaid balance if full payment is not made by the date of delinquency. A penalty charge of <br />6.00 % per annum will be charged on the unpaid portion of a debt, which remains unpaid 90 days after the date of delinquency. See notice of actions <br />in event of delinquency. <br />Accounting Classification: <br />Sales Order: 8763 <br />Sales Office: GENN <br />Customer Number: 3000001766 <br />TIN:470769903 <br />