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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 associated <br />with the Project by Task/Deliverable. <br />1 Invoice Amount: Amount of Invoice being submitted for reimbursement. <br />Local Share or Other Funding or Amount Not Requested: Portion of invoice paid for by Grantee,that is not <br />2 being requested for reimbursement by this grant <br />Requested Amount: Subtract Grantee's Local Share or Other Funding or Amount Not Requested (2) from Invoice <br />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 />applicable to that Task/Deliverable identified under (2). <br />Submittal Instructions <br />Instructions -for E -mailing: <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. <br />Please redact all sensitive financial information from the invoices and other supporting documentation <br />to be submitted with this Payment Request Form. <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 />Subject: Project Number_Disbursement Number: example — LP14025_Disb 1 <br />Attachments: <br />I ) Exhibit C Payment Request Summary <br />2) Request for Payment Part II Reimbursement Detail <br />3) Copies of invoices <br />4) Proof of payment (copies of canceled checks, front and back or EFT verification) <br />5) 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. NSO45 Exhibit C, Page 6 of 6 <br />