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EXHIBIT D <br /> FLORIDA INLAND NAVIGATION DISTRICT <br /> ASSISTANCE PROGRAM <br /> PAYMENT REIMBURSEMENT REQUEST FORM <br /> PROJECT NAME : PROJECT # : <br /> PROJECT SPONSOR: BILLING #: <br /> Amount of Assistance <br /> All Funds Previously Requested &- <br /> Balance Available = <br /> Funds Requested <br /> Less Retainage (- 10 % unless final) &- <br /> Check Amount = <br /> Balance Available <br /> Less Check Amount &- <br /> Balance Remaining = <br /> SCHEDULE OF EXPENDITURES <br /> Expense Description Check No . Total Applicant <br /> FIND <br /> (Should correspond to Vendor Name and Date Cost Cost <br /> Cost <br /> Cost Estimate Sheet <br /> Categories in Exhibit "A") <br /> FIND - Form No. 90- 14 (NOTE : Signature Required on Page 2) <br /> (Effective Date 7-30-02) <br />