Laserfiche WebLink
Attachment C <br />FINANCIAL INVOICE FORM <br />FOR <br />HAZARDOUS MATERIALS HAZARDS ANALYSIS UPDATES <br />RECIPIENT: Indian River County <br />1. First Payment (45% of contract amount) <br />(50% Hazards Analyses completed/submitted) <br />2. Second Payment (45% of contract amount) <br />(50% Hazards Analyses completed/submitted) <br />3. Final Payment(10% of contract amount) <br />(approval, distribution & notification) <br />TOTAL AMOUNT <br />AGREEMENT # <br />AMOUNT <br />REQUESTED <br />BY THE RECIPIENT <br />AMOUNT APPROVED <br />BY THE <br />DIVISION <br />(To be completed by <br />the Division) <br />I certify that to the best of my knowledge and belief the billed costs are in accordance with the terms <br />of the Agreement. <br />Signature of Authorized Official/Title <br />TOTAL AMOUNT TO BE PAID AS OF <br />THIS INVOICE $ <br />19 <br />Date <br />