FORM OF REQUISITION. Tax Allocation District Number 1- Unified Government of Athens-Xxxxxx County, Georgia Requisition No. Date of Requisition: _______________, 20__ TO: Attention: Facsimile: PROJECT: Georgia Square Mall Redevelopment PHASE: _____________________________ OWNER: ____________________________ This is a Requisition for payment of amounts on deposit in the Site TAD Account of the Special Fund to reimburse payment by Owner of an Advance of Project Reimbursable Costs in the amount, for the purposes and on the terms set forth below, all in accordance with the provisions of that certain Community Benefits Agreement between ACC and the Owner named above, with the Effective Date of __________________, 2023. All capitalized terms used herein not otherwise defined shall have the meaning given them in the Community Benefits Agreement. [If construction is involved] AIA Form G-702 and its Continuation Sheet, AIA Document G-703, are attached as Exhibit A and are made a part of this Requisition. Architect’s and Contractor’s Certificates for Payment are attached as part of the attached AIA Form G-702. 1. The payment of all or any portion of any such Requisition will not cause the overall support from the TAD (taking into account all previously paid amounts in respect of the Requisitions, if any) to exceed the Payment Limitation. Calculations to such effect are attached. 2. Attached hereto as Exhibit B are: (a) A detail of the Reimbursable Project Costs, Schedule of Values and Percentages of Completion relating to this Requisition are set forth on Forms G-702 and G-703 attached. (b) Copies of all bills or statements or cancelled checks for any indirect or soft-cost expense for which this Requisition is requested; (c) Copies of all bills or statements or cancelled checks for any such hard cost expenses incurred by the Owner for which this Requisition is requested; (d) To the extent applicable, a copy of a satisfactory “Interim Waiver and Release Upon Payment” pursuant to O.C.G.A. § 00-00-000 from the General Contractor which received payment from the proceeds of the above-mentioned Advance.
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Samples: Community Benefits Agreement, Community Benefits Agreement, Community Benefits Agreement