LIHEAP Billing Scenario

Cord of Wood and Delivery Fee

Vendor 3003224790001 delivered one cord of wood to Sue Williams, Customer Account Number LIHEAP12345.

The delivery date was 01/16/2009.

The vendor obtained the 10-digit Crisis Authorization number (0000043140) and the Attachment Control number (000004340) from the PROMISe™/LIHEAP Internet site.

The total charges billed to LIHEAP were $210.00 which included $150.00 for a cord of wood and a $60.00 delivery fee.

NOTE: Once the claim is submitted, the vendor mails the Attachment Control Cover Sheet along with the appropriate paperwork to the DHS LIHEAP address on the cover sheet.