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4P <br />40 <br />FLORIDA DEPARTMENT OF ENVIRONMENTAL PROTECTION <br />FLORIDA BEACH EROSION CONTROL PROGRAM <br />REQUEST FOR PAYMENT - PART II <br />Name of Project: Ambersandl Wabasso Beach Restoration_ <br />Grantee: Indian River County DEP Contract Number: 981R1 <br />Billing Number: Billing Period: <br />Summary of invoices <br />Date of Invoice Amount of Task Check Amount <br />Invoice Number Invoice # Name of Vendor Number Paid Vendor <br />TOTAL S <br />Certificationz I certify that the purchases noted above were used in accomplishing the <br />projects and that invoices„ check vouchers, copies of checks, and other purchasing <br />documentation attached herato and are maintained as required to support the cost reported <br />above and are available for audit upon request. <br />Name of Proj. Administrator Signature of Project Administrator J Date <br />Name of Proj. Financial Officer Signature of Project Financial Officer Date <br />Attachment B, DEP Project Agreement No, 9$IRi, Amendment No. 3, Page 2 of 2 <br />