My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
2018-165
CBCC
>
Official Documents
>
2010's
>
2018
>
2018-165
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
1/4/2021 10:59:32 AM
Creation date
9/18/2018 4:03:26 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Agreement
Approved Date
09/11/2018
Control Number
2018-165
Agenda Item Number
8.M.
Entity Name
State of Florida, Division of Emergency Management
Subject
2018/2019 State Funded Subgrant Agreement
Hazardous Analysis Grant
Area
Agreement Number: 19-CP-11-10-40-01-__
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
37
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
Attachment F <br />Financial Invoice Form <br />For <br />Hazardous Materials Hazards Analysis Update <br />RECIPIENT: <br />ADDRESS: <br />PERIOD OF PERFORMANCE: <br />1. First Payment (40% of contract amount) <br />(25% Hazards Analysis submitted) <br />2. Second Payment (40% of contract amount) <br />(25% Hazards Analysis submitted) <br />AGREEMENT# <br />FEIN# <br />AMOUNT <br />REQUESTED <br />BY THE RECIPIENT <br />3. Final Payment (20% of contract amount) $ <br />(HA's approved, Notifications & zip file uploaded) <br />AMOUNT APPROVED <br />BY THE <br />DIVISION <br />d' <br />TOTAL AMOUNT $ $ <br />(to be completed <br />by the Division) <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 />Signature of Authorized Official <br />Total HA Update Grant amount: <br />Total amount previously paid: <br />Total amount payable this invoice: <br />Remaining balance: <br />Date <br />(To be completed by the Division) <br />27 <br />
The URL can be used to link to this page
Your browser does not support the video tag.