(PLEASE TYPE OR PRINT LEGIBLY)
CHECK HERE IF NEW ADDRESS
PI No. ________________
CLAIM OF ______________________________________________________________________________
ADDRESS ______________________________________________________________________________
CITY, STATE __________________________________________________________ ZIP _______________________
E-MAIL ____________________________________________________ _____________ PHONE __________________________
DOCUMENT ID:
TRANS
DEPT.
PV NUMBER
PV
DOCUMENT TOTAL
$
COMMENTS (96)
(24)
(24)
(24)
(24)
VENDOR CODE
SAN BERNARDINO COUNTY
SUPERIOR COURT
LINE NO.
FUND DEPT ORGANIZATION APPR OBJECT GRC/PROJ/JOB NUMBER AMOUNT
LINE NO.
FUND DEPT ORGANIZATION APPR OBJECT GRC/PROJ/JOB NUMBER AMOUNT
LINE NO.
FUND DEPT ORGANIZATION APPR OBJECT GRC/PROJ/JOB NUMBER AMOUNT
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Page _____ of _____
INVESTIGATOR AND EXPERT
APPOINTED SERVICES CLAIM
DATE OF SERVICE
I certify that the above services were verified in
accordance with established procedures.
13-17713-360 Rev. 3/12
AUDITOR/CONTROLLER’S APPROVAL FOR PAYMENT: I hereby certify that I have examined the facts of the transaction herein set forth as evidenced by the information hereon and the documents attached
hereto. All verifications, certification, and checking of computations required by the County Charter and Government Codes have been complied with and this claim in the total amount shown is hereby approved
for payment.
COUNTY AUDITOR/CONTROLLER BY _______________________________________________________________________ DATE _________________
200
200
INVESTIGATOR FEE SCHEDULE
— Court order of appointment must be attached —
CRIMINAL / DELINQUENCY . . . . . . . . . . . . . . . . . . $ 30.00 per hour
CAPITAL / LWOP . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 35.00 per hour
Mileage to be paid at the current Court-approved rate.
I hereby certify that I have reviewed this billing
and that these services were performed at my
request. The charges shown are recommended
for payment as reasonable and appropriate.
CASE NO. _______________________________________
DEFENDANT ______________________________________
DATE APPOINTED ________________________________
SERVICE PERFORMED/EXPENSE ITEMIZATION HOURS MILEAGE EXPENSES
_______ HOURS @ _________ $ ______________
_______ MILES @ __________ $ ______________
EXPENSES . . . . . . . . $ ______________
CLAIM TOTAL . . . . . . . . . . . . $ ______________
I hereby certify under penalty of perjury that the foregoing claim
for services is true and correct (CCP 2015.5), that I was appointed
pursuant to applicable California Code for the named client, and
that no part of this claim has previously been presented or paid.
For investigators: I further certify that I have been continually
duly licensed to practice as an investigator in the State of California
for the time period claimed above.
Date
Signature of Attorney
Signature of Claimant Date
Appointed services and expenses are at the discretion of the court and pursuant to the
Policies and Procedures for Administration of 987.2 Penal Code Applications
and Appointed Services Fee Schedule (copies
available on website www.sb-court.org). Court order of appointment must be attached to claim. Services must be itemized by date and service rendered, with sufficient detail to support the claim for payment.
Locations (city) must be specified if mileage and/or travel time is claimed.
2445
200
