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Attachment I <br />Financial Invoice Form <br />2022-2023 Hazard Analysis Grant Agreement <br />Recipient: <br />Grant Agreement#: <br />Deliverable & Invoice Amounts <br />## <br />Minimum Performance Requirements <br />Budget amount <br />Amount requested by Sub - <br />per Deliverable <br />Recipient <br />No later than November 1, 2022, provide <br />completed CAMEO Data Manager files for 25% of <br />40% of HA <br />1 <br />facilities listed in Attachment H. <br />Agreement <br />Hazards Analysis submissions are reviewed and <br />Amount <br />must be approved before invoice is submitted. <br />No later than March 1, 2023, provide completed <br />CAMEO Data Manager files for 25% of <br />40% of HA <br />2 <br />facilities listed in Attachment H. <br />Agreement <br />Hazards Analysis submissions are reviewed and <br />Amount <br />must be approved before invoice is submitted. <br />No later than June 1, 2023, provide a complete <br />correct copy of the "approved" CAMEO Data Manager <br />20% of HA <br />3 <br />file to the LEPC and FDEM with a copy of the <br />Agreement <br />transmittal letter. <br />Amount <br />TOTAL AMOUNTS: <br />$0.00 <br />I certify to the best of my knowledge and belief the billed costs are in accordance with the <br />Terms and Conditions of the Hazards Analysis Agreement. <br />Printed Name and Title <br />Recipient Signature Date <br />HA Attachment I Financial Invoice Form -2022 <br />