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FLORIDA DEPARTMENT OF ENVIRONMENTAL PROTECTION <br /> BEACH EROSION CONTROL PROGRAM <br /> REQUEST FOR PAYMENT — PART II <br /> REIMBURSEMENT DETAIL <br /> Name of Project: INDIAN RIVER COUNTY SHORE PROTECTION PROJECT <br /> Grantee : INDIAN RIVER COUNTY DEP Contract Number: 981R <br /> Billing Number : Billing Period : <br /> Summary of Invoices : <br /> Task <br /> Date of Invoice Amount of Nod Check Amount Paid <br /> Invoice Number Invoice (Eligible Vendor Name Number Vendor <br /> Project <br /> Item) <br /> $ $ <br /> TOTAL : $ <br /> Certification : I certify that the purchases noted above were used in accomplishing the project; and that invoices , check vouchers <br />, <br /> copies of checks , and other purchasing documentation attached hereto and are maintained as required to support the cost reported <br /> above and are available for audit upon request. <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 . 98IR1 , Amendment No . 5 , Page 2 of 5 <br />