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A TRUE COPY <br />CERTIFICATION ON LAST PAGE <br />?YAN L. BUTLER, CLERK <br />Attachment G <br />Financial Invoice Form <br />2024-2025 Hazard Analysis Grant Agreement <br />Recipient: Indian River County <br />Grant Agreement#: T0363 <br />Deliverable & Invoice Amounts <br /># <br />Minimum Performance Requirements <br />Budget amount <br />Amount requested by Sub - <br />Recipient <br />per Deliverable <br />No later than December 1, 2024, provide <br />completed CAMEO Data Manager files for 25% <br />40% of HA <br />1 <br />of 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 April 1, 2025, 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, 2025, 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 Requested: <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 />27 IIA Attachment I Financial Invoice Form 61612012 <br />