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Attachment D <br /> FINANCIAL INVOICE <br /> FOR <br /> HAZARDOUS MATERIALS HAZARDS ANALYSIS UPDATE <br /> RECIPIENT: Indian River County AGREEMENT # <br /> AMOUNT AMOUNT APPROVED <br /> REQUESTED BY THE <br /> BY THE RECIPIENT DEPARTMENT <br /> 1 . Contact and Sample ( 15% Max . ) $ $ <br /> 2 . Hazards Analyses ( 30 % Max. ) $ $ <br /> ( 50 % completed/submitted ) <br /> 3 . Hazards Analyses ( 30 % Max . ) $ $ <br /> ( 50% completed/submitted ) <br /> 4 . Final Work Product Completed ( 25% ) $ $ <br /> TOTAL AMOUNT $ $ <br /> (To be completed by <br /> the Department) <br /> I certify that to the best of my knowledge and belief the billed costs are in accordance with the terms <br /> of the Agreement. <br /> Signature of Authorized Official/Title Date <br /> TOTAL AMOUNT TO BE PAID AS OF <br /> THIS INVOICE $ <br /> AUTHORIZED BY <br /> ( To be completed by the Department ) <br /> 20 <br />