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Harry's Fresh Foods 541 -434 -2456 p.1 <br />City Exhibit C r, 4, ': Packs o f E ugene <br />Spam Division <br />1820 Roosevelt Blvd., Eugene OR 97402 <br />(541) 682-4800 682-4882 FAX <br />2012 Neighborhood Matching Grant Program <br />Request for Reimbursement City of Eugene Contract #: 2012 -05335 <br />Grantee: Mohawk Grange and Harlow Neighbors Association <br />Grant Project: Willakenzie Grange Site Imp rov je�rn ants I• °1 <br />Person maldng reimbursement request <br />Send paymentto:��� <br />Itemized Real <br />Recei t Date <br />Supplier / Vendor <br />supply / Service <br />Amount <br />�L <br />/ <br />.i �G �; <br />$V <br />4` 1 <br />$ <br />$ <br />$ <br />TOTAL <br />Pr ' ct Coordinator Approved by City NMG Coordinator <br />1. <br />Date ubm' d Brian Elliott, PWM/POS or Cindy Clarke, NSP <br />City Account Code: 011 -0735- 62900 - 644015 <br />