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- if', UE COPY <br />CER i IFiCATION ON LAST PAGE <br />RYAN L. BUTLER, CLERK <br />ATTACHMENT C <br />Total Compensation Paid to Non -Profit Personnel Using State Funds <br />Name: <br />Title: <br />Agency Agreement/Contract fl <br />Total Contract Amount <br />Contract Term: <br />Invoice Number <br />Invoice Period <br />Line Item Total Amount Total Amount Amount Paid from State <br />Budget Category Allocated Paid Funds <br />Salaries <br />Fringe Benefits <br />Bonuses <br />Accrued Paid Time Off <br />Severance Payments <br />Retirement Contributions <br />In -Kind Payments <br />Incentive Payments <br />Reimbursements/Allowances <br />Moving Expenses <br />Transportation Costs <br />Telephone Services <br />Medical Services Costs <br />Housing Costs <br />Meals <br />Amount Paid to Date <br />CERTIFICATION: I certify that the amounts listed above are true and accurate and in accordance with <br />the approved budget. <br />Name: <br />Signature: <br />Title: <br />Date: <br />Page: 21 <br />Gant A%kerd Ageernent (For) GAA001 }, Effective 07;2024 <br />Rule I A-39.001, Flo ida Adminim utive Code <br />