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ATTACHMENT E <br /> FINANCIAL INVOICE FORM <br /> FOR <br /> HAZARDOUS MATERIALS HAZARDS ANALYSIS UPDATE <br /> RECIPIENT: AGREEMENT# <br /> PERIOD OF PERFORMANCE FEIN# <br /> AMOUNT AMOUNT APPROVED <br /> REQUESTED BY THE <br /> BY THE RECIPIENT DIVISION <br /> 1. First Payment (45% of contract amount) $ $ <br /> (50% Hazards Analysis submitted and approved) <br /> 2. Second Payment(45% of contract amount) $ $ <br /> (50% Hazards Analysis submitted and approved) <br /> 3. Final Payment (10% of contract amount) $ $ <br /> (Approval, distribution & notification) <br /> TOTAL AMOUNT $ $ <br /> I certify that to the best of my knowledge and belief the billed costs are in accordance with the <br /> terms of the Agreement. <br /> Printed Name and Title of Authorized Official <br /> Signature of Authorized Official Date <br /> TOTAL AMOUNT TO BE PAID AS OF <br /> THIS INVOICE $ <br /> (To be completed by the Division) <br /> 27 <br />