Q1. This Form is Used to Setup Clients for Transactional Billing

Q2. Type of Client
Platinum Portal Client

Q3. Client Setup: Please select from below:
31741

Q4. Include Transaction Charges



Q5. Total Number of Transactions:
Input

Q6. Rate per Transaction Amount
Input

Q7. Total Transactions
0

Q8. Include Storage Charges



Q9. Rate per MB Storage:
.05

Q10. Storage Amount
0

Q11. Bandwidth Rate per Month MB/hr:
.05

Q12. Total Bandwidth
0

Q13. Months Billed
1

Q14. Billing Start:
2019-10-01

Q15. Billing End:
2019-10-31

Q16. Include Seat/User Charges



Q17. Charges: Additional named Users: 0-500
249.00

Q18. Additional named Users: 0-500
0

Q19. Charges: Additional named Users: 501-750
1249.00

Q20. Additional named Users: 501-750
2

Q21. Charges: Additional named Users: 751-1000
2249

Q22. Additional named Users: 751-1000
2

Q23. Included App Hosting



Q24. Name of Apps Supported
Capacity Leader
Capacity Leader iPad
Capacity Andriod

Q25. Price per App per month
79

Q26. Number of Apps Supported
3

Q27. Include Development Charges



Q28. Level 1 Coding & Testing
75.00

Q29. Hours: Level 1 Coding & Testing
30

Q30. Level 1 Database Integration, Report Generation, Testing
105.00

Q31. Hours: Level 1 Database Integration, Report Generation, Testing
6

Q32. Level 2 Database Design, Report Generation, Testing
120.00

Q33. Hours: Level 2 Database Design, Report Generation, Testing
7

Q34. Level 3 Module Development, Testing
165

Q35. Hours: Level 3 Module Development, Testing
6

Q36. Additional Resources: Graphic Design, Research
55.00

Q37. Hours: Additional Resources: Graphic Design, Research
0

Q38. Description of Additional Charges
N/A

Q39. Additional Charges
0

Q40. Discounts (% off or amount )
10%

Q41. Terms:
Net 15 Days

Q42. Remit Payment to:
GalliumGroup 6605 Bonanza Trail, Mableton, GA 30126

Q43. Additional Information:
TIN: 27-3247285 404.920.8171 www.galliumgroup.com

Q44. Notes:
Input

Q45. Total (Calculated Upon Saving Form)
0

Q46. Date Invoice Sent
Input

Q47. Date Paid: (YYYY-MM-DD)
Input

Q48. Amount Paid (No $)
Input

Q49. Gallium Recovery Rate (Calculated)
Input

Q50. Reported Recovery Rate:
Input

Q51. Account Comments:
Input