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[Your Company Name] INVOICE [Your Company Slogan] TM/LH INVOICE # [Street Address] INVOICE DATE: [City, ST ZIP Code] Phone Fax

TO: SHIP TO: UT-Battelle, LLC UT-Battelle, LLC for the Department of Energy Accounts Payable Department [Street Address] PO Box 2308 [City, ST ZIP Code] Oak Ridge, TN 37831-6436

COMMENTS OR SPECIAL INSTRUCTIONS:

BILLING PERIOD CUSTOMER TERMS SUBCONTRACT NUMBER SHIPPED VIA Beginning/End Date NUMBER NET DAYS

ELEMENT DESCRIPTION CURRENT AMOUNT CUMULATIVE AMOUNT LABOR – STANDARD TIME (itemize on attached statement) LABOR – OVERTIME* (itemize on attached statement) TOTAL LABOR DIRECT MATERIAL (itemize on attachment) TRAVEL (itemize on attachment with receipts if required) Handling Cost (Material and Travel) TOTAL MATERIAL AND TRAVEL INVOICE SUBTOTAL LESS RETENTION RETENTION INVOICED AMOUNT PREVIOUSLY PAID TOTAL AMOUNT DUE

*Must be specified in the Agreement

If you have any questions concerning this invoice, contact [Name, phone, e-mail]

Sample Invoice – TM/LH UT-B Contracts Div Nov 2006 Page 1 of 1 0287dbee1b3ecd113e1339a15ab30f4f.doc