Facility: FED TAX lD Invoice Date Invoice Number Payment: Billing To: Task order DUNS 054442348 Cibola County, New Mexico Attn: Tony Boyd Point of Contact Julie Quintana ?ulie co.cibola.nm.us 1-505-285-2581 700 E. Roosevelt Ave. Suite 50 Grants, NM 87020 85?0291095 April 2017 5044-1 7 Net 30 Days Financial Operations - Burlington P. O. Box 1620 Williston, VT 05495-1620 Attn: Contract EROIGSA-17-0003 Billing Period March 27, 2017 thru April 26, 2017 CLIN Mandays Average Mandays Fixed Rate Amount Due 0001 20598 664 $2,547,179.57 $2,547,179.57 0001 neimnurseame CLIN Fixed Rout Transportation Mileage Days Amount Due 0004 97,638.41 31 $97,638.41 On Demand CLIN Transportation: Annual Mileage Rate Amount Due Max Mileage 375,000 0005 4,820 $6.23 $30,028.60 TOTAL DUE $2,674,846.58 ACH DIRECT DEPOSIT Bank Name: Bank Phone Enitity Bank Name: Wells Fargo 505-287-9481 121000248 Operating Account Enitity Contact Name: Janet Gallegos Entitiy Contact Phone: 505-766-7209 I certify that the foregoing bill is correct no payment has been received. Submitted By: py? Facility: FED TAX ID Invoice Date Invoice Number Payment: Cibola County. New Mexico Attn: Tony Boyd Point of Contact Julie Quintana 'ulie co.cibola.nm.us 1-505-285?2581 700 E. Roosevelt Ave. Suite 50 Grants, NM 87020 85-0291095 May 31, 2017 50405 2017 Net 30 Days Financial Operations - Burlington P. O. Box 1620 Williston, VT 05495-1620 Attn: Billing To: Task order HSCEDM-17-F-IG005 DUNS 054442348 Contract Billing Period April 27, 2017 thru May 26, 2017 CLIN Mandays Average Mandays Fixed Rate Amount Due 0001 15382 513 $2,547,179.57 $2,547,179.57 0001 CLIN Fixed Rout Transportation Mileage Days Amount Due 0004 97,638.41 30 $97,638.41 On Demand CLIN Transportation: Annual Mileage Rate Amount Due Max Mileage 375,000 0005 7,308 $6.23 $45,528.84 TOTAL DUE $2,690,346.82 ACH DIRECT DEPOSIT Bank Name: Wells Fargo Bank Phone 505?287-9481 ABM: Enitity Bank Name: Operating Account Enitity Contact Name: Janet Gallegos Entitiy Contact Phone: 505-766-7209 I certify that the foregoing bill Mza/ ayment has been received. Submitted By: