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ATTACHMENT C <br />FLORIDA DEPARTMENT OF ENVIRONMENTAL PROTECTION <br />BEACH MANAGEMENT FUNDING ASSISTANCE PROGRAM <br />REQUEST FOR PAYMENT — PART I <br />PAYMENT SUMMARY <br />NAME OF PROJECT: INDIAN RIVER COUNTY HURRICANE REPAIR PROJECT <br />LOCAL SPONSOR: INDIAN RIVER COUNTY <br />REMITTANCE ADDRESS: <br />DEP Agreement Number: 14IR2 <br />Billing Number: <br />Billing Type: ❑ Interim Billing ❑ Final Billing <br />Costs Incurred This Payment Request: <br />Federal Share* State Share Local Share Total <br />$ $ $ $ <br />*if applicable <br />Cost Summary: <br />State Funds Obligated $ <br />Less Advance Pay $ <br />Less Previous Payment $ <br />Less Previous Retained $ <br />Less This Payment $ <br />Less This Retainage (10%) $ <br />State Funds Remaining $ <br />Local Funds Obligated $ <br />Less Advance Pay $ <br />Less Previous Credits $ <br />Less This Credit $ <br />Local Funds Remaining $ <br />DEP Agreement No. 14IR2, Amendment No. 2, Attachment C, Page 1 of 5 <br />1' <br />111 <br />