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1 " i <br />DEPARTMENT OF NATURAL RESOURCES <br />DIVISION OF BEACHES AND SHORES <br />Beach Erosion Control Assistance Program <br />LJJ <br />DIRECT MATERIAL PURCHASES c`.z <br />(Grantee) (Project) <br />Billing Period Billing # a <br />Check or Project General <br />Vendor Name Voucher Number Cost Description <br />i� <br />U <br />TOTAL $ <br />Certification: I hereby certify that the purchases noted <br />above were used in accomplishing the project. <br />Project Administrator Date <br />DNR Form 72-103 (4-83) <br />i <br />Certification: I hereby certify that invoices, cancelled <br />checks, and other purchasing documentation have been <br />maintained as required to support the costs reported above <br />and are available for audit upon request. <br />Project Financial Officer <br />Date <br />