Laserfiche WebLink
Grant Manager' s Certification <br /> of Disbursement Request <br /> I, <br /> (name of Grantee' s Grant Manager designated in the Agreement) <br /> on behalf of , do hereby certify that: <br /> (name of Grantee/Recipient) <br /> 1 . The disbursement amount requested on Page I of this form is for allowable costs for the project described in the <br /> Agreement. <br /> 2. Materials, labor, equipment, and/or services representing costs included in the amount requested have been <br /> satisfactorily purchased, performed or received, and applied toward completing the project; such costs are <br /> documented by invoices or other appropriate documentation which are filed in the Grantee' s permanent records. <br /> 3 . The Grantee is required to pay such costs under the terms and provisions of contracts relating directly to the project, <br /> and the Grantee is not in default of any terms or provisions of the contracts. <br /> 4 . All funds received to date have been applied toward completing the project. <br /> 5 . All permits and approvals required for the construction which is underway have been obtained. <br /> ( Signature of Grant Manager) <br /> (Date) <br /> DEP Agreement No. LP6734, Attachment B, Page 2 of 3 <br />