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2007-442
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2007-442
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Last modified
6/29/2016 12:21:44 PM
Creation date
9/30/2015 11:33:34 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Agreement
Approved Date
12/18/2007
Control Number
2007-442
Agenda Item Number
7.Z.
Entity Name
Bureau of Beaches and Coastal Systems
Department of Environmental Protection
Subject
Wabasso Beach Restoration - Beach Management Funding Assistance
Grant Agreement Wabasso Beach Restoration
Area
Wabasso Beach
Supplemental fields
SmeadsoftID
6761
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FLORIDA DEPARTMENT OF ENVIRONMENTAL PROTECTION <br /> BEACH MANAGEMENT FUNDING ASSISTANCE PROGRAM <br /> REQUEST FOR PAYMENT — PART II <br /> REIMBURSEMENT DETAIL <br /> Name of Project: Billing# Billing Period : DEP CONTRACT NUMBER .Invoice Adjustments (To be completed by DEP: <br /> Grantee: Reasons for changes noted below) <br /> er er <br /> Date OF Amount Paid Eligible Total Amount Chan es BBCS Chan es BBCS <br /> Item # Invoice # Project sowIBIDx (5) Vendor Name Check or Debit# Eligible for States g P g P Approved <br /> INVOICE Vendor (1 ) Item (2) Share (4) Project Manager (6,6) Accountant (6,6) Eligible Cost (6) <br /> 2 <br /> 3 <br /> 4 <br /> 5 <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> 10 <br /> Totals for all items on e: <br /> Item # Notes and invoice adjustment explanations per Item # (5) <br /> Certification: I certify that the purchases noted above were used in accomplishing the project; and that invoices, check vouchers, copies of checks, and other purchasing <br />documentation are maintained as required to <br /> support the cost reported above and are available for audit upon request. <br /> Name/Signature of Project Administrator Date <br /> Name/Signature of Project Financial Officer Date <br /> Form Instructions: <br /> (1 ) Grantee: enter exact amount of check or debit. <br /> (2) Grantee: enter the subtask ID# from the Eligible Project Item table of the DEP Grant. <br /> (3) Scopes of work and bids that have been approved for DEP cost share may be assigned a tracking identifier number. Grantee: Insert this tracking number when applicable. <br /> (4) Grantee: insert only the amount of vender payment that is assumed to be eligible for DEP cost share. <br /> (5) Grantee: DEP Project Managers and accountants will make necessary corrections or adjustments within the terms of the contract and in accordance with state rule. <br /> 6 DEP staff: Enter the total amount of line item increase or decrease: if the adjustment is a decrease, proceed the amount with the "" minus sign. <br /> DEP Agreement No. 07IR2, Attachment C. Page 2 of 3 <br />
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