Laserfiche WebLink
EXHIBIT D <br /> FLORIDA INLAND NAVIGATION DISTRICT <br /> ASSISTANCE PROGRAM <br /> PAYMENT REIMBURSEMENT REQUEST FORM <br /> PROJECT NAME : PROJECT NO . : <br /> PROJECT SPONSOR : BILLING NO . : <br /> Amount of Assistance <br /> All Funds Previously Requestedm <br /> Balance Available = <br /> Funds Requested <br /> Less Retainage (- 10 % unless final) �- <br /> Check Amount = <br /> Balance Available <br /> Less Check Amount &- <br /> Balance Remaining = <br /> SCHEDULE OF EXPENDITURES <br /> Expense Description Check No . Total Applicant FIND <br /> (Should correspond to Vendor Name and Date Cost Cost Cost <br /> Cost Estimate Sheet <br /> Categories in Exhibit " B") <br /> FIND - Form No . 90-14 (NOTE : Signature Required on Page 2) <br /> Effective Date 7-30-02) <br />