Laserfiche WebLink
<br />ATTACHMENT B <br />Disbursement Request Package <br />Legislative Projects (LP) Grants <br /> <br />1. <br />2. <br />3. <br />4. <br /> <br />Grantee/Recipient <br /> <br />CITY OF SUNNY ISLES BEACH <br /> <br />Project Number <br /> <br />LP6861 <br /> <br />Date of Request <br />Required Match % <br /> <br />Disbursement Request Number <br /> <br />D <br /> <br />Final <br /> <br />Type of Request: <br /> <br />D <br /> <br />Partial <br /> <br />5. Federal Employer Identification Number <br /> <br />6. <br /> <br />Mail <br /> <br />D EFT <br /> <br />D Send Remittance to: <br /> <br />Disbursement Details <br />(cumulative amounts rounded to the nearest doIlar) <br /> <br />1. <br /> <br />Professional Services (attach invoices) <br /> <br />$ <br /> <br />2. Construction and Demolition (attach invoices) <br /> <br />3. Equipment (attach invoices) <br /> <br />4. Land (attach invoices) <br /> <br />5. Other (list - must be specified in agreement) <br /> <br />6. <br /> <br />Total cumulative to date <br /> <br />$ <br /> <br />7. <br /> <br />Disbursements previously requested <br /> <br />$( <br /> <br />8. <br /> <br />Amount requested for disbursement (line 6 minus line 7) <br /> <br />$ <br /> <br />Requests for Invoices already Paid: <br />1) Copy of Invoice <br />2) Proof of Payment <br /> <br />Requests for Invoices not yet Paid: <br />1) Copy of Invoice <br />2) Advance Payment Justification (one per quarter) <br />3) Advance Payment - Interest Earned (after initial advance) <br /> <br />*If prior Disbursement Request was requested by invoices without proof of payment documentation, proof of the <br />prior payment will be required before this request can be disbursed. <br /> <br />** SUBMIT ONE ORIGINAL COPY OF THIS FORM AND SUPPORTING DOCUMENTATION TO: ** <br /> <br />Florida Department of Environmental Protection <br />Bureau of Water Facilities Funding MS 3505 <br />2600 Blair Stone Road <br />Tallahassee, Florida 32399-2400 <br /> <br />DEP Agreement No. LP6861, Attachment 8, Page 1 of 3 <br /> <br />SIB <br />