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Instructions for Completing Request for Payment - Part II <br /> Include the Grantee Name,Payment Request No.,and DEP Agreement Number. List vendor invoices that are <br /> associated with the Project by Task/Deliverable. <br /> 1 Invoice Amount: Amount of Invoice being submitted for reimbursement. <br /> 2 Local Share or Other Funding or Amount Not Requested: Portion of invoice paid for by Grantee. <br /> Requested Amount: Subtract Grantee's Local Share or Other Funding or Amount Not Requested(2)from Invoice <br /> 3 Amount(1). <br /> Deliverable Number: Must identify completed deliverable(s)for each invoice. If invoice covers multiple <br /> deliverables,that invoice would be listed multiple times, a line item for each deliverable with any portion not <br /> 4 applicable to that Task/Deliverable identified under(2). <br /> Submittal Instructions <br /> Instructions for E-mailin2: <br /> The program now accepts reimbursement requests electronically. When scanning please be sure that the minimum scan <br /> resolution must be 300 DPI(dots per inch). When reimbursement requests are sent electronically,please do not also <br /> send a hard copy by postal mail. You should anticipate a response from program staff within 2 business days. <br /> Remit Payment Request by E-mail to the Department's Grant Manager. <br /> Be sure the E-mail payment request includes the following: <br /> Cc: Depattntent's Grant/Project Manager <br /> Subject: Project Number_Disbursement Number: example—LP 14025_Disb_l <br /> Attachments: <br /> I) Attachment B Payment Request Summary <br /> 2) Request for Payment Part II Reimbursement Detail <br /> 3) Copies of invoices <br /> 4) Other supporting documentation,as needed <br /> For questions or concerns regarding these forms or if you would like the payment request forms listed above in <br /> electronic format please contact the Department's Grant Manager. <br /> DEP Agreement No.NS027,Exhibit D,Page 5 of 5 <br />