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Exhibit C <br />FORM OF REQUISITION REQUEST <br />FOR IMPROVEMENT COSTS <br />REQUISITION REQUEST NO. <br />DATE: <br />" TOTAL DISBURSEMENT REQUESTED; $ <br />REFERENCE: Development Agreement dated as of September 1, 2040 (the <br />"Development Agreement"), between Los Angeles Dodgers, Inc. <br />" ("Dodgers"), and Indian River County, Florida ("County") <br />The County Clerk is hereby requested to disburse from the Construction Fund established by <br />the County to the person, firm or corporation designated below as Payee, the sum set forth below <br />such designation, in payment of the cost of those items of the Improvements constructed or installed <br />pursuant to the Development Agreement. <br />1. The undersigned, on behalf of the Dodgers, hereby requests the County to direct and instruct <br />the County Clerk to pay the amounts in accordance with the invoices attached as Exhibit A, and <br />certifies in connection with such direction that: <br />(a) The Improvement described on Exhibit "A" hereto has been constructed or installed <br />at the Facility and the construction or installation of such Improvement has been <br />completed on or before the date hereof, <br />(b) The Dodgers have conducted such inspection and/or testing of the Improvement as <br />they deem necessary and appropriate, and have accepted the Improvement; and <br />(c) The Improvement described on Exhibit "A" hereto is covered against all risks <br />pursuant to the policy of insurance required by the Facility Lease Agreement dated <br />as of September 1, 2404 between the County and the Dodgers. <br />2. In the event that the Dodgers are to be reimbursed for invoices previously paid by the <br />Dodgers for such items, written evidence of such prior payment and the amount thereof is also <br />attached ro this Requisition. <br />C-1 <br />