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City of Eugene / Public Works <br />Parks & Open Space Division <br />1820 Roosevelt Blvd., Eugene OR 97402 <br />(541) 682 -4800; (541) 682 -4882 FAX <br />2010 Neighborhood Matching Grant Program <br />Request for Reimbursement <br />Neighborhood Matching Grant Project Name: City of Eugene Contract #: <br />Fairmount Sense of Place Booklet 2010 -05319 <br />Person making reimbursement request: Send payment to: XSame name & address as requestor <br />Katherine Lieberknecht <br />1865 Villard Street _ <br />Eugene, OR 97403 PO. Z <br />TO A ,Q <br />Itemized Request: <br />Receipt Date Supplier / Vendor Supply / Service Amount $$ <br />4/26/11 Fed Ex Office Copying note for booklets $61.83 <br />4/16/11 Office Max Envelops $93.39 <br />TOTAL $155.22 <br />Katherine Lieberknecht <br />Approved by Project Coordinator <br />4.29.11 <br />Date submitted <br />Jackie Hallett <br />Approved by City NMG Coordinator <br />011- 0735 - 62330- 644015 <br />City Account Code <br />