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Fort Walton Beach Resolution — 2008-27-FDEP Eglin Stormwater Grant — reading text
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0 1-
Grant Manager' s Certification
of Disbursement Request
0 I,
name of Grantee' s Grant Manager designated in the Agreement)
on behalf of do hereby certify that:
name of GranteelRecipient)
1. The disbursement amount requested on Page 1 of this form is for allowable costs for the project described in the
Agreement;
2. Materials, labor, equipment, and/ or services representing costs included in the amount requested have been
satisfactorily purchased, performed or received, and applied toward completing the project; such costs are
documented by invoices or otherappropriate documentation which are filed in the Grantee' s pennanent records;
3. The Grantee is required to pay such costs under the terms and provisions of contracts relating directly to the project;
and the Grantee is not in default of any terms or provisions of the contracts;
4. All funds received to date have been applied toward completing the project; and
5. All permits and approvals required for the construction which is underway have been obtained.
Signature of Grant Manager)
Date)
40
DEP Agreement No. LP8921, Attachment B, Page 2 of3
Engineer' s Certification
of Disbursement Request
Q I, being the Professional Engineer retained by
name of Professional Engineer)
am responsible for overseeing construction of the
name of Grante /Recipient)
project described in the Agreement and do hereby certify that:
1. Equipment, materials, labor, and services represented by the construction invoices have been satisfactorily purchased
or received and applied to the project in accordance with construction
