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do <br />ATTACHMENT C <br />FINANCIAL INVOICE <br />FOR <br />HAZARDOUS MATERIALS HAZARDS ANALYSIS UPDATE <br />COUNTY/AGENCY AGREEMENT <br />COST CLASSIFICATIONS <br />AMOUNT AMOUNT APPROVED <br />REQUESTED BY THE <br />BY THE COUNTY* DEPARTMENT <br />1. Contact and Timeline (20% Max.) $ $ <br />2. Hazards Analyses (27.5% Max.) <br />(50% completed/submitted) $ <br />3. Hazards Analyses (27.5% Max.) <br />(50% completed/submitted) $ $ <br />4. Final Work Product completed S $ <br />(25% Max) <br />TOTAL AMOUNT $ $ <br />(To be completed by <br />the Department) <br />I certify that to the best of my knowledge and belief the billed <br />costs are in accordance with the terms of the Agreement. <br />Signature of Authorized Official/Title Date <br />TOTAL AMOUNT TO BE PAID AS OF <br />THIS INVOICE $ <br />(AUTHORIZED <br />I(To be completed by the Department) <br />'Request amount should reflect current payment only. <br />15 <br />