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OREGON WATERSHED ENHANCEMENT BOARD <br />REQUEST FOR RELEASE OF FUNDS <br />Grantee Name: City of Eugene <br />Grantee's Fiscal Agent: Lacey Risdal <br />Phone: 541- 682 -4841 <br />o < <br />���� ✓MEM <br />Project Number: 208 - 921 -6819 Project Name: Will. River Side - Channel Habitat Enh. Project Delta Pon <br />Payment Request Number OR Final Request X <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 />(Adj) 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-Implementation <br />$707.58 <br />$1,458.00 <br />$0.00 <br />$1,458.00 <br />- $750.42 <br />In -House Personnel <br />$4,605.46 <br />$6,387.50 <br />$0.00 <br />$6,387.50 <br />- $1,782.04 <br />Contracted Services <br />$77,000.00 <br />$70,056.70 <br />$6,943.30 <br />$77,000.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />Corrections due to budget adjustments <br />$0.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />Pre - Implementation Correction <br />$0.00 <br />$0.00 <br />- $750.42 <br />$750.42 <br />In -House Personnel Correction <br />$0.00 <br />$0.00 <br />- $1,782.04 <br />$1,782.04 <br />Financial Administration <br />$4,244.96 <br />$0.00 <br />$4,244.96 <br />$0.00 <br />$0.00 <br />$0.00 <br />J$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 <br />$0.00 <br />$0.00 <br />TOTALS <br />$86,558.00F <br />$77,902.201 <br />$8,655.801 <br />$86,558.001 <br />$0.00 <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. /� <br />Grantee's Authorized Signature L /J L(/(/ �' Date: t� oc 01 <br />Print Signature Name: Eric N. Wold <br />Grantee Contact Phone Number for Billing Questions: 541- 682 -4842 <br />Title: Nat Res Manager <br />Fax: 541 -682 -4882 <br />Grantee Contact E -mail Address: erjc.n.wold(a)ci.eugene.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: Date: <br />July 01, 2009 v1 <br />