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FROM :CAT FAX NO. :5413441197 Jun. 27 2012 6:28PM P4
<br /> 1820 Roosevelt Blvd., Eugene OR 97402
<br /> (541)682- 4800;(541)882 -4882 FAX
<br /> 2011 Neighborhood Matching Grant Program
<br /> Request for Reimbursement
<br /> Neighborhood Matching Grant Project Name: Skinner City Farm's Strategic Planning Initiative
<br /> City of Eugene Contract #: 05310
<br /> Person making reimbursement request: Send payment to Stacey Janssen
<br /> Stacey Janssen on behalf of Skinner City Farm 113 Crocker Lane
<br /> Eugene, OR 97404
<br /> •
<br /> Itemized Request:
<br /> Receipt Date Supplier / Vendor Supply / Service Amount
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<br /> s,, � - - -�_ - attachez�i:M.... <�
<br /> Reimbursement for supplies (see
<br /> 4/13/2012 Stacey Janssen attached receipt) $138.09
<br /> Grant Administration Services (see
<br /> 6/27/2012 Stacey Janssen attached invoice and log of hours) $975.00
<br /> •
<br /> •
<br /> •
<br /> $
<br /> $
<br /> TOTAL
<br /> 1978.09 $
<br /> A ed b Pr/ r n t r Appro �y Ci i N - oordinator
<br /> X Z� Za Cv- X � / 7�� s
<br /> Date su mute• City Account Code 1� . � l�
<br /> ic) 6 l I �73Y A1-1-5-7
<br />
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