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4D <br />4D <br />40 <br />S Page 2 <br />Grant Number— REQn-29 Payment Request Number <br />In requesting this payment the undersigned represents that helshe is duly authorized to <br />act on behalf of the recipient. <br />.vl 8_ ,r7nt- ? July 2B. 2000 <br />Signature of Authorized Representative (Not Stamp) Date <br />FRAN B. ADAMS, CRkIRMAN <br />BOARD OF COUNTY COMMISSIONERPlease return original to; <br />Department of Environmental Prptertion <br />Solid Waste Section -NIS# 4565 <br />2600 Blair Stone Road <br />Tallahassee, Florida 32399-2400 <br />5199 <br />