Payment Request Form. The means by which the COUNTY and the SUBRECIPIENT document project and activity expenses and requests for payment. The SUBRECEIPIENT shall utilize this form when submitting or requesting any costs for payment and the form must be accompanied by legible supporting documentation to indicate the reasonableness, allowability, and appropriate procurement of the expense(s). As noted under SECTION III. TERM OF AGREEMENT and SECTION V. COMPENSATION AND ALLOWABLE PAYMENTS, all payments are reimbursements for eligible expenses or services defined as uncompensated expenses rendered during the Agreement term and paid prior to the final payment request due date. Copies of supporting documentation are required as part of the Payment Request for review of grant compliance and before payment will be authorized by the COUNTY to the SUBRECIPIENT. Reimbursement for eligible expenses will be made after review and authorization of a correct and complete Payment Request Form and required back up documentation. In accordance with the Federal Register Guidance, the COUNTY must be payor of last resort, meaning that if services are eligible to be billed to any other entity or funding source, including but not limited to, Medicaid, third party insurance or any other entity or funding source, the COUNTY will not pay for that service. Appropriate back-up/supporting documentation may include cancelled checks, vendor invoices, authorized purchase orders, attendance/service logs, other funder invoices, expenditure spreadsheets or other original documentation, as well as a copy of the SUBRECIPIENT’S check issued with authorized signature. For construction contracts, inspection reports from qualified officials should be submitted with the appropriate monthly payment request. The SUBRECIPIENT must submit the Payment Request Form with an authorized signature. Cancelled checks, paystubs, payroll reports, bank statements, and/or other documentation from vendors that expenses have been paid or services provided may be verified. As applicable, processing of payment requests is also subject to the requirements and conditions as set forth within the COUNTY’S Hurricane Ian CDBG-DR Subrecipient Manual.
Payment Request Form. 3. Schedule of Allowances.
Payment Request Form. If such notification is by telephone, Borrower must promptly confirm the notification by delivering to Bank a completed Payment Request Form in the form attached at Exhibit A. Bank shall transfer the amount of the Term Loan to the Designated Account. Bank may make the Term Loan based on instructions from a Responsible Officer or his or her designee or without instructions if the Term Loan is necessary to meet Obligations which have become due. Bank may rely on any telephone notice given by a Person whom Bank reasonably believes is a Responsible Officer or designee. Borrower shall indemnify Bank for any loss Bank suffers due to such reliance unless caused by Bank’s negligence or intentional misconduct.
Payment Request Form. Re: (Month) (Year) Energy Performance Contract Lease-Purchase Agreement dated as of , 201_, by and between , as Lessor and the State of Maryland, acting by and through the Maryland State Treasurer’s Office, as Lessee (the “EPC Lease”) In accordance with the terms of the Escrow Agreement dated as of (the “Escrow Agreement”) by and among (“Lessor”), the State of Maryland (“Lessee”) and (the “Escrow Agent”), the undersigned hereby requests the Escrow Agent to pay the following persons the following amounts from the Equipment Acquisition Fund created under the Escrow Agreement (the “Acquisition Fund”) for the following purposes. Payee’s Name and Address Invoice Number Dollar Amount Purpose The undersigned hereby certifies as follows:
Payment Request Form. The Contractor shall submit a Payment Request Form (Exhibit C) and copies of the original supporting documents for payment to the County. Payments based on written invoices must include a description of: Work performed, dates, and location of services performed or goods delivered.
Payment Request Form. The Contractor shall submit a payment Request Form (Exhibit C) and copies of the original supporting documents for payment to the County. . Payment Request Forms for work performed on the Multi-Jurisdictional Hazard Mitigation Plan shall be submitted separate from the Payment Request Forms for work performed on the Safety Element.
Payment Request Form. Upon completion of work, the Subgrantee shall submit to NYSERDA, or its representative, a completed Payment Request Form,attached hereto as Exhibit E with accompanying documentation and such other information as may be requested by NYSERDA.
Payment Request Form i. Agency shall complete and submit one Agency Payment Request Form, via an electronic submission.
