Laserfiche WebLink
Metadata
Document management portal powered by Laserfiche WebLink 9 © 1998-2015 Laserfiche. All rights reserved.
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 Requested 3� <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 />