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OREGON WATERSHED ENHANCEMENT BOARD "'x'+ <br />REQUEST FOR RELEASE OF FUNDS <br />Grantee Name: Cily of Eueene OWEB <br />Grantee's Fiscal Agent: Lacey Risdal Phone: 541- 682 -4841 <br />Project Number: 209 -3007 Project Name: Delta Ponds Habitat Restoration <br />Payment Request Number 02 OR Final Request <br />In accordance with the terms of the Grant Agreement, I request funds as follows: <br />** Double click on the table to get into it and Single click below the table to get out of it ** <br />Budget Category <br />(per Grant Agreement) <br />Current <br />Budget <br />Amount <br />Total of All <br />Amounts <br />Previous Paid <br />CURRENT <br />Request <br />Amount <br />TOTAL <br />Requested <br />to Date <br />Remaining <br />Budget <br />Pre-Im Iementalion <br />$1,458.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$1458.00 <br />In -House Personnel <br />$16,200.00 <br />$4,600.00 <br />$10,967. <br />$15,467.50 <br />$732.50 <br />Contracted Services <br />$185,869.00 <br />$60,511.07 <br />$34,508. <br />$95,020.02 <br />$90,848.98 <br />Supplies/Materials <br />$841.01 <br />$841.01 <br />$0.00 <br />$841.01 <br />$0.00 <br />$0.00 <br />$0,001 <br />$0.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$o.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$o.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />TOTALS <br />$204,368.011 <br />$65,952.081 <br />$45,376.451 <br />$111 <br />$93 039.48 <br />Receipts/invoices and an expense tracking spreadsheet are required to document all funds previously received from <br />OWEB for this project within 120 days of the date of the check. <br />Signature on this form replaces the requirement of submitting letterhead as a receipt for (a) Fiscal Administration <br />and (b) Post - Implementation Status Reporting. All other OWEB receipt requirements remain in effect. <br />By signing this request, I declare that expenses for this project are to the best of my knowledge true, correct, and <br />complete. {n <br />Grantee's Authorized Signature ` �` l �/ CA IG - { vt_ L4- o� al l Date: 711 0 <br />Print Signature Name: Eric Wold / Trevor Taylor (acting in capacity for Eric Wold) Title: Nat Res Manager <br />Grantee Contact Phone Number for Billing Questions: 541 -682 -4842 Fax: 541- 682 -4882 <br />Grantee Contact E-mail Address: eric.n.woldfcbci.eumne.or.us <br />This Request must be forwarded to the OWEB Project Manager for Signature below <br />I find this request to be consistent with the Grant Agreement and all funding conditions have been met. <br />OWEB Project Manager: <br />Date: <br />2009 A <br />