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(WIFIA Ref <br />WIFIA Loan <br />”), the Borrower hereby <br />”) and the UNITED STATES <br />WIFIA Lender <br />Borrower <br />Norwood Water Treatment Plant Upgrade and Transmission Main Improvements and Replacements ProjectCity of North Miami Beach N18118FL \[___\] <br />EXHIBIT D-3 <br />FORM OF REQUISITION <br />) of the WIFIA Loan Agreement, dated as of June 25, 2020 (the “ <br />APPENDIX ONE TO EXHIBIT D <br />4 <br />Project name Borrower name WIFIA reference number Requisition number <br />Disbursement Conditions <br />1.2.3.4. <br />”), by and between the CITY OF NORTH MIAMI BEACH (the “ <br />Norwood Water Treatment Plant Upgrade and Transmission Main Improvements and Replacements Project <br /> If there is a Servicer for the WIFIA Loan, provide a copy to the Servicer as well and include its notice details here. <br />United States Environmental Protection Agency1200 Pennsylvania Avenue NW WJC-W 6201A Washington, D.C. 20460 Attention: WIFIA Director Re: N18118FL) Ladies and Gentlemen: Pursuant to <br /> Section 4 (AgreementENVIRONMENTAL PROTECTION AGENCY, acting by and through the Administrator (the “requests disbursement in the amount set forth below in respect of Eligible Project <br /> Costs paid or incurred by the Borrower. Capitalized terms used but not defined herein have the meaning set forth in the WIFIA Loan Agreement. In connection with this Requisition the <br /> undersigned, as the Borrower’s Authorized Representative, hereby represents and certifies the following: 4 <br /> <br />