PJM6025 Budget Assignment
I N V O I C E
===================================================================================== CTG Health Solutions Invoice No: 3879077 877084 BW Phone:(800) 992-5350 Ext.3322 Invoice Date: 08/12/15 500HLO Contact: Jaime Golofit Contract No: 72360128 jaime.golofit@ctg.com Terms: Immediate Pay Tax ID: 16-0912632
Customer No: 3102739 P.O. Number:
B R I Accounts Payable-IS E L Healthcare Partners Medical Group M Computer Task Group, Inc. L 19191 South Vermont Avenue I P.O. Box 711778 Torrance, CA 90502 T Cincinnati, OH T 45271-1778 O T O ===========================================================================================
We appreciate the opportunity to be of service to you.
To ensure proper handling of your payment, please include the invoice number and amount paid on your remittance notice.
============================================================================================ From 07/25/15 Thru 08/08/15 *--- S E R V I C E S --* *------------ E X P E N S E S -----------* RATE UNITS AMOUNT -------------------------------------------------------------------------------------------- Project 72360128 HCP-EIM Implementation Proj
ANDERSON, ROBERT N. SOW# 1001-66 07/31/15 150.00 40.00 6000.00 08/08/15 150.00 42.00 6300.00 -------- ---------- ----------- 82.00 12300.00
BHATT, MANOJ SOW# 1001-77 07/31/15 105.00 40.00 4200.00 08/07/15 105.00 40.00 4200.00 -------- ---------- ----------- 80.00 8400.00
BRISTOL, CHRISTOPHER K. SOW# 1001-66 07/31/15 150.00 40.00 6000.00 08/07/15 150.00 40.00 6000.00 -------- ---------- ----------- 80.00 12000.00
DENNISON, KARL SOW# 1001-66 07/31/15 210.00 40.00 8400.00 08/07/15 210.00 40.00 8400.00 08/07/15 MILEAGE 18.14 08/07/15 AIR 560.20 08/07/15 ROOM 319.70
Page: 2 of 4 I N V O I C E
======================================================================================== CTG Health Solutions Invoice No: 3879077 Phone:(800) 992-5350 Ext.3322 Invoice Date: 08/12/15 500HLO Contact: Jaime Golofit Contract No: 72360128 jaime.golofit@ctg.com Terms: Immediate Pay Tax ID: 16-0912632
Customer No: 3102739 P.O. Number:
============================================================================================
*--- S E R V I C E S --* *------------ E X P E N S E S -----------* RATE UNITS AMOUNT -------------------------------------------------------------------------------------------- Project 72360128 HCP-EIM Implementation Proj
08/07/15 CAR RENTAL 122.05 08/07/15 OTHER TRANS 88.52 08/07/15 PER DIEM 132.50 ----------- 1241.11 -------- ---------- ----------- 80.00 16800.00 1241.11
DESMARAIS, YVETTE SOW# 1001-66 07/31/15 MILEAGE 33.60 07/31/15 ROOM 388.70 07/31/15 OTHER TRANS 193.69 07/31/15 PER DIEM 139.50 ----------- 755.49 -------- ---------- ----------- 755.49
HALL, KREG SOW# 1001-66 07/31/15 275.00 40.00 11000.00 08/07/15 275.00 40.00 11000.00 08/07/15 MILEAGE 110.88 08/07/15 AIR 1020.80 08/07/15 ROOM 480.70 08/07/15 CAR RENTAL 175.99 08/07/15 OTHER TRANS 71.91 08/07/15 PER DIEM 132.50 ----------- 1992.78 -------- ---------- ----------- 80.00 22000.00 1992.78
HERMAN, FRANKLIN B. SOW# 1001-66 08/07/15 200.00 3.00 600.00 -------- ---------- ----------- 3.00 600.00
INAMPUDI, BHAGATH SOW# 1001-75 07/31/15 175.00 40.00 7000.00 08/07/15 175.00 40.00 7000.00
Page: 3 of 4 I N V O I C E
======================================================================================== CTG Health Solutions Invoice No: 3879077 Phone:(800) 992-5350 Ext.3322 Invoice Date: 08/12/15 500HLO Contact: Jaime Golofit Contract No: 72360128 jaime.golofit@ctg.com Terms: Immediate Pay Tax ID: 16-0912632
Customer No: 3102739 P.O. Number:
============================================================================================
*--- S E R V I C E S --* *------------ E X P E N S E S -----------* RATE UNITS AMOUNT -------------------------------------------------------------------------------------------- Project 72360128 HCP-EIM Implementation Proj
-------- ---------- ----------- 80.00 14000.00
JILLA, SHEETAL SOW# 1001-75 07/31/15 165.00 40.00 6600.00 08/07/15 165.00 40.00 6600.00 -------- ---------- ----------- 80.00 13200.00
KATKAM, SATYAPAL SOW# 1001-66 07/31/15 135.00 40.00 5400.00 08/07/15 135.00 40.00 5400.00 -------- ---------- ----------- 80.00 10800.00
LEMKE, DENISE SOW# 1001-78 07/31/15 150.00 40.00 6000.00 08/07/15 150.00 40.00 6000.00 -------- ---------- ----------- 80.00 12000.00
PARIMI, RAYUDU SOW# 1001-75 07/31/15 105.00 40.00 4200.00 08/07/15 105.00 40.00 4200.00 -------- ---------- ----------- 80.00 8400.00
WALTON, JOHN G. SOW# 1001-66 07/31/15 225.00 32.00 7200.00 08/07/15 225.00 38.50 8662.50 -------- ---------- ----------- 70.50 15862.50
------------- ------------ Total Services 146362.50 Total Expenses 3989.38
Tax @ .00 % .00
Invoice Totals 146362.50 3989.38
Page: 4 of 4 I N V O I C E
======================================================================================== CTG Health Solutions Invoice No: 3879077 Phone:(800) 992-5350 Ext.3322 Invoice Date: 08/12/15 500HLO Contact: Jaime Golofit Contract No: 72360128 jaime.golofit@ctg.com Terms: Immediate Pay Tax ID: 16-0912632
Customer No: 3102739 P.O. Number: SOW# 1001-66
============================================================================================
*--- S E R V I C E S --* *------------ E X P E N S E S -----------* RATE UNITS AMOUNT -------------------------------------------------------------------------------------------- Project 72360128 HCP-EIM Implementation Proj
********************************************************************************************* TOTAL DUE $ 150,351.88 *********************************************************************************************