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Grant 341 - 1st request for reimbursement
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Grant 341 - 1st request for reimbursement
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Entry Properties
Last modified
9/12/2011 10:55:31 AM
Creation date
9/9/2011 7:35:39 AM
Metadata
Fields
Template:
COE_Contracts
COE_Contract_Number
2009-05411
COE_Contract_Document_Type
AP/AR Invoices
COE_Contract_Status
Active
COE_Contract_Organization
OWEB
Department
Public Works
Contract_Administrator
Aanderud
Contract_Manager
Holts
GJN
100011
External_View
No
Permanent_Retention
No
Supplemental fields
GL_Grant
341
GL_Project_Number
995422
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OREGON WATERSHED ENHANCEMENT BOARD <br />REQUEST FOR RELEASE OF FUNDS <br />Grantee Name: Ci ty of Eugene OWES <br />Grantee's Fiscal Agent: Lacey Risdal Phone: 541- 682 -4841 <br />Project Number: 209 -3007 <br />Project Name: Delta Ponds Habitat Restoration <br />Payment Request Number 01 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 />Previously Paid <br />CURRENT <br />Request <br />Amount <br />TOTAL <br />Requested <br />to Date <br />Remaining <br />Budget <br />Pre - Implementation <br />$1,458.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$1,458.00 <br />In -House Personnel <br />$16,200.00 <br />$0.00 <br />$4,600.00 <br />$4,600.00 <br />$11,600.00 <br />Contracted Services <br />$186,710.00 <br />$0.00 <br />$61,352.08 <br />$61,352.08 <br />$125,357.92 <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 />$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 />TOTALS <br />1 $204,368.001 <br />$0.001 <br />$65,952.081 <br />$65,952.08 <br />$138,415.92 <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: <br />Print Signature Name: Eric N. Wold <br />Grantee Contact Phone Number for Billing Questions: 541- 682 -4842 <br />Date: <br />Title: Nat Res Manager <br />Fax: 541- 682 -4882 <br />Grantee Contact E -mail Address: eric.n.wold(Mci.eugene.or.us <br />This Request must be forwarded to the OWEB Project Manage f S 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 <br />
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