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APPENDIX H <br /> INVOICE SHEET <br /> To : Indian River County Community Development Department <br /> From : Indian River County Housing Authority <br /> Paid Invoices (period covered) from To <br /> List Each Check Vendor Names Project Total on <br /> Invoice Number Invoice <br /> TOTAL <br /> IN-KIND CONTRIBUTIONS (report if applicable) : Contributions used in completion of <br /> project using other than CDBG funds (e. g. , labor, materials, financial contributions, etc .) <br /> Items or Service(s) Value <br /> I certify that to the best of my knowledge the data reported in this reimbursement request is <br /> accurate . <br /> Signature and Title Date <br /> Special Note : ALL invoices and checks listed above must be attached (as well as any <br /> bidding information and contracts) . <br /> ALL COPIES MUST BE LEGIBLE AND REPRODUCIBLE <br /> Page # — of <br /> 48 <br />