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11! <br />Il! <br />a <br />Department of. <br />Environmental Proteetio <br />Twin Towers C3fftre Building <br />Jets Bush 2600 Blair Stone Road David B. Svuhs <br />Governor Tallahassee, Florida 32399.2490 Secretary <br />DEPARTMENT 41" ENVIRONMENTAL PROTECTION <br />LITTER CONTROL AND PREVENTION GRANT QUARTERLY REIKBURSEMENT REQUEST <br />1. Grantee• <br />2. Grant .:lumber: LUO--29 3. Payment Request Numbar: 1 <br />4. Expenditures 5. Cumulative <br />from_2. 1 , 1999 from 000. 1, 1999_ <br />to DEC. 31 1999 to ❑ 1 <br />6. Operating Costs (Option i) <br />6.299 6,244 <br />7. Removal Casts (Option 2) <br />max. 35% of Award <br />B, Education and Prevention <br />Program Oeerating Costs <br />9, Total Expenditures <br />10. <br />17. <br />12. <br />13, <br />14. <br />Grant Award <br />Prior Reimbursements <br />This Payment Request <br />Total State Payments <br />Balance of Award <br />17,500 <br />6,244 <br />6!244 <br />11,256 <br />In requesting this payment the undersigned represents that he/she is duly authorized to <br />act on behalf of the recipient. <br />Q�ul,r 'A r January 18,_ 2000 <br />Signature of Authorized 1Representativo (hfat Stam:a) Rate <br />FRAN FS. ADW, CHAIR=' <br />13DARD f7F t3"sWrV CrY14TSSIOI+IMS <br />Please return original to: <br />Department of Environmental Protection' Solid Waste Section - MS# 4565 <br />2500 Blair Stone Road " Tallahassee, Florida 32399-2400 <br />5199 <br />"Prctcc[ Conserve and hlarage Florida's Environment and Natural Resources" <br />Pimed an recycled pope r. <br />