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Agreement # <br />Attachment 1-A — Invoice: Grantee's Subcontractor(s) (Contractual Services) <br />GRANTEE'S NAME: <br />FEIN: <br />Agreement No.: <br />TO: <br />Florida Department of Economic Opportunity <br />Division of Community Development <br />Attn.: Stella Lewis <br />107 East Madison Street <br />Caldwell Building, MSC 160 <br />Tallahassee, FL 32399 <br />INVOICE <br />INVOICE NO.: <br />INVOICE DATE: <br />FOR: <br />[Grantee name] <br />[Grantee address] <br />[Grantee phone number] <br />DESCRIPTION <br />AMOUNT <br />Dates of Service: <br />Deliverable Completed: <br />[copy description of the deliverable from Scope of Work; Section 3] <br />Category expenditures: <br />Contractual Services <br />$_ <br />TOTAL <br />$_ <br />Page 27 of 37 Q <br />Rev. 6/1/18 89 <br />