Client Information

Client Name *

Client ID *

6-7 digits, no trailing zeros. Add letter (A-Z) only for same client with different billing departments

Address

Street Address *

City *

State *

ZIP *

Primary Contact

Contact Name *

Office Phone

Email *

Billing Contact

Contact Name *

Phone

Email *

Billing Address

Street Address *

Building Name

Suite/Unit

City *

State *

ZIP *

Fax

Contract & Payment Terms

Contract Number

Net Payment Terms (Days)

SSE/INTIN

Contract Assignment

Select a contract to auto-populate pricing. Contract pricing cannot be edited.

Contract

Service Pricing *

Configure per-seat pricing tiers and additional service fees. At least one tier is required.

Pricing Tiers (per seat/month)

Basic *

$

Standard *

$

Premium *

$

Additional Rates

Overtime (per hour)

$

Dedicated Resource (per hour)

$

One-Time Fees

Setup Fee

$

Cancellation Fee

$

Billing Codes

Configure how this client tracks expenses. Some organizations bill per department, others per cost center or project code.

Added Billing Codes *

At least one billing code is required

No billing codes added yet

Add Client

Pricing Tiers (per seat/month)

Additional Rates

One-Time Fees