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ATTACHMENT C- 2 <br /> FLORIDA DEPARTMENT OF ENVIRONMENTAL PROTECTION <br /> BEACH EROSION CONTROL PROGRAM <br /> REQUEST FOR PAYMENT — PART I <br /> PAYMENT SUMMARY <br /> Name of Project: INDIAN RIVER COUNTY SHORE PROTECTION PROJECT <br /> Grantee : INDIAN RIVER COUNTY DEP Contract Number: 98181 <br /> Billing Number: Billing Period : <br /> Billing Type : ❑ Interim Billing ❑ Final Billing <br /> Costs Incurred This Payment Request : <br /> Federal Share * State Share Local Share Total <br /> * if applicable <br /> Cost Summary , <br /> State Funds Obligated $ Local Funds Obligated $ <br /> Less Previous Payment $ Less Previous Credits $ <br /> Less Previous Retained $ <br /> Less This Payment $ Less This Credit $ <br /> Less This Retainage ( 10%) $ Local Funds Remaining $ <br /> State Funds Remaining $ <br /> Certification : I certify that this billing is correct and is based upon actual obligations of record by the <br /> grantee ; that <br /> payment from the State Government has not been received ; that the work and/or services are in accordance <br />with the <br /> Department of Environmental Protection, Bureau of Beaches and Coastal Systems approved Project Agreement including <br /> any amendments thereto ; and that progress of the work and/or services are satisfactory and are consistent with the amount <br /> billed . <br /> Name of Project Administrator Signature of Project Administrator Date <br /> Name of Project Financial Officer Signature of Project Financial Officer Date <br /> Attachment C-2 , DEP Agreement No . 981RI , Amendment No . 5 , Page 1 of 5 <br />