REQUEST FOR REIMBURSEMENT Clause Samples

REQUEST FOR REIMBURSEMENT. The packet submitted utilizing City supplied forms and Contractor back-up documentation (consisting of proof of expenses incurred and payments made in conformance with the requirements of this Agreement and Council Policy 100-18 to the satisfaction of the Contract Administrator) that is the basis for requesting reimbursement of eligible Project expenses each Reimbursement Period.

REQUEST FOR REIMBURSEMENT. 10.1 To receive grant funds, all Grant Equipment costs must have been incurred by the PERFORMING PARTY prior to the Request for Reimbursement Deadline. 10.2 All Request for Reimbursement forms must contain sufficient identification of and information concerning the total costs incurred and paid or obligated under a financing agreement. The TCEQ must be able to determine the eligibility of a particular cost during the initial review and any later audits. Supporting documentation materials must be attached to the Request for Reimbursement forms where indicated to clearly show that the cost was incurred or financed and, except where the payment is assigned to another entity, paid. 10.3 The PERFORMING PARTY shall submit no more frequently than monthly, a completed TCEQ Request for Reimbursement form. The forms shall be emailed to ▇▇▇▇-▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ or mailed to: Texas Commission on Environmental Quality Air Grants Division MC-204, ATTN: Reimbursement P.O. Box 13087 Austin, TX 78711-3087 10.4 The Request for Reimbursement shall be completed on forms provided by the TCEQ. The Request for Reimbursement, including all required supplemental forms, shall list the total expenses obligated under a financing agreement and the total activity expenses incurred to date. 10.5 The PERFORMING PARTY shall notify the TCEQ, in its Request for Reimbursement, of any financial incentive received by the PERFORMING PARTY, such as tax credits or deductions, other grants, or any other public financial assistance, that will offset the eligible costs incurred by the grant recipient for the project. The grant reimbursement must not exceed the sum of the actual eligible costs incurred by the grant recipient plus any other financial incentives received by the PERFORMING PARTY for the project.

REQUEST FOR REIMBURSEMENT. The Parties understand and agree that Subrecipient intends to use the Fiscal Agent designated in Exhibit E (the “Fiscal Agent”) to submit requests for reimbursement, accept Grant Funds on behalf of Subrecipient and perform other obligations of Subrecipient with respect to accounting for Grant Funds as set forth in Exhibit E, which is by this reference incorporated in and part of this Grant. The Fiscal Agent shall submit to the Agency request for reimbursements of activities under this Agreement and consistent with the approved budget and scope of work for each project, by 15th of the month, for the previous month, unless otherwise agreed by the Agency. Each Request for Reimbursement must be broken down into requested reimbursements against the budget line items associated with individual approved budget for each project. The Fiscal Agent shall submit Request for Reimbursements to the Agency, on the form and with the content specified and required by OHCS. The request for Reimbursements must be submitted with all documents necessary to justify the payment or any other supporting documents requested OHCS. The Request for Reimbursement must also be accompanied by documentation from the Subrecipient and Fiscal Agent demonstrating that all procurements for which payment is requested have been made in accordance with this Agreement. Grantee may not remove or replace its Fiscal Agent without the prior written consent of Agency. If the Fiscal Agent is replaced, a new form of Exhibit E must be executed and received prior to OHCS paying any Grant Funds to the replacement Fiscal Agent. If OHCS determines that any completed grant activities or documentation are not acceptable and that any deficiencies are the responsibility of Subrecipient, OHCS shall prepare a detailed written description of the deficiencies and will deliver such notice to Subrecipient and the Fiscal Agent. The Parties shall correct any deficiencies at no cost to OHCS. If OHCS determines that the submitted Request for Reimbursement and supporting documents are acceptable, then the invoice must be approved for payment. OHCS reserves the right to conduct any audit it deems necessary.

REQUEST FOR REIMBURSEMENT. 9.1 Except as provided for under Article 9.4 below, to receive grant funds, all Grant Equipment costs must have been paid in full by the PERFORMING PARTY with either cash-on-hand or financing, and all Grant Equipment must have been received by the PERFORMING PARTY prior to the Request for Reimbursement Deadline. 9.2 All Request for Reimbursement forms must contain sufficient identification of and information concerning the total costs paid or obligated under a financing agreement. TCEQ must be able to determine the eligibility of a particular cost during the initial review and any later audits. Supporting documentation materials must be attached to the Request for Reimbursement forms where indicated to clearly show that the cost was paid. 9.3 The PERFORMING PARTY shall submit a completed TCEQ Request for Reimbursement form. The forms shall be emailed to ▇▇▇▇-▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ or mailed to: Texas Commission on Environmental Quality Air Grants Division MC-204, ATTN: Reimbursement PO Box 13087 Austin, TX 78711-3087 9.4 If the PERFORMING PARTY has paid eligible expenses that are equal to or greater than the grant amount with cash-on hand, the reimbursement may be paid directly to the PERFORMING PARTY. In the event the PERFORMING PARTY finances the Grant Equipment, TCEQ will not pay the PERFORMING PARTY directly unless the PERFORMING PARTY has paid an amount equal to or greater than the grant amount. TCEQ may assign payment directly to the financing company. Supporting documentation must be submitted to establish that the goods or services were received, and that the payment amount is owed to the financing company indicated by the PERFORMING PARTY. 9.4.1 If an assignment is requested, the PERFORMING PARTY must complete the Assignment Request and Acceptance section on the Request for Reimbursement form. 9.4.2 If the Grant Equipment is financed, the PERFORMING PARTY must ensure that the finance agreement or finance company permits an early payment and that the grant funds are applied to principal only and shall not be applied to any interest. 9.5 The final Request for Reimbursement form, indicated by signing the Release of Claims section on the form, shall be submitted to TCEQ by the Request for Reimbursement Deadline. Unless otherwise approved in writing by TCEQ, all work on the Grant Equipment must be completed, with the Grant Equipment fully operational, before final reimbursement will be made. 9.5.1 If project delays are experienced, the PERFORMING PARTY ...

REQUEST FOR REIMBURSEMENT. The Subrecipient shall use a Request for Reimbursement form or other documentation process acceptable to the State.

REQUEST FOR REIMBURSEMENT. 17.1. In order to receive reimbursement for eligible expenses, the PERFORMING PARTY shall submit no more frequently than monthly, a completed TCEQ request for reimbursement form, to be made available to the PERFORMING PARTY by the TCEQ. Requests for reimbursement shall be submitted no later than 20 days after the end of the billing period in which expenses were paid. Each request shall be accompanied by a properly completed Financial Status Report for each activity for which reimbursement is requested. The request and forms shall be mailed or delivered to:

REQUEST FOR REIMBURSEMENT. (Form 1). Each filed TCEQ Request for Reimbursement shall contain sufficient identification of, and information concerning, the costs incurred so as to enable the TCEQ to ascertain the eligibility of a particular expenditure and to enable subsequent audit thereof. The individual expenses shall be identified with respect to the major tasks or objectives set forth in the Grant Activities that such expenditures support or satisfy. When a single expenditure supports or satisfies more than one task or objective, the PERFORMING PARTY or subcontractor need not break down that particular expenditure by specific contract task or objective, but may simply identify, in relative cost order, the various tasks or objectives supported.

REQUEST FOR REIMBURSEMENT. 6.1. In order to receive reimbursement for eligible expenses and document expenditure of advanced funds, the Performing Party shall submit monthly, a completed TCEQ Request for Reimbursement (RFR) form, to be made available to the Performing Party by the TCEQ. The RFR shall be submitted no later than 15 days after the end of the following month. Each RFR shall be accompanied by a properly completed FSR for each activity for which reimbursement is requested. For a RFR solely documenting expenditure of advanced funds and not requesting payment, only submission of an FSR is necessary. The request and forms shall be mailed or delivered to: Texas Commission on Environmental Quality ATTN: ▇▇▇▇▇▇ ▇▇▇▇▇ Critical Infrastructure Division, MC-177 Texas LEPC Grant Program PO Box 13087 Austin, TX 78711-3087

REQUEST FOR REIMBURSEMENT. Each filed TCEQ RFR shall contain sufficient identification of, and information concerning, the costs incurred so as to enable the TCEQ to ascertain the eligibility of a particular expenditure and to enable subsequent audit thereof. Each RFR shall indicate, for each budget category the Performing Party’s project expenditures for the period in question, the cumulative expenditures with respect to each budget category, and the balance remaining in each budget category following reimbursement of the amount being requested.