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<br />l .. t <br /> <br />EXHmIT D <br /> <br />FLORIDA INLAND NA VIGA nON DISTRICT <br />WATERWAYS ASSISTANCE PROGRAM <br />PAYMENT REIMBURSEMENT REQuEsT FORM <br /> <br />PROJECT NAME: PROJECT NO.: <br /> <br />PROJECT SPONSOR: BILLING NO.: <br /> <br />Amount of Assistance <br />Funds Previously Requested J.r <br />Balance Available = <br /> <br />Funds Requested <br />Check Amount = <br /> <br />Balance Available <br />Less Check Amount ~ <br /> <br />Balance Remaining = <br /> <br />SCHEDULE OF EXPENDITURES <br /> <br />Expense Description <br />(Must correspond to <br />Cost Estimate Sheet <br />Categories in Exhibit B) <br /> <br />Vendor Name <br /> <br />Check No. <br />and Date <br /> <br />Total <br />Cost <br /> <br />Applicant <br />Cost <br /> <br />FIND <br />Cost <br /> <br />FIND - Form No. 90-14 <br />Rev. 9/3/92 <br /> <br />.. <br />