Filetype Excel XLS | Posted on 30 Aug 2022 | 3 years ago
Authentication
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219x Filetype XLS File size 0.31 MB
Sheet 1: May 10
| Grantee: | RFP Number: | ||||
| Remittance Address: | Program: | ||||
| City/State/Zip: | Grant Period: | 00/00/2010 Thru 12/31/2011 | |||
| Tax ID Number: | Report Period: | 00/00/2010 thru 00/00/2010 | |||
| Purchase Order Number: | |||||
| Budget Items | Current Grant Amount |
Amounts Previously Requested |
Amount Requested This Period |
Amounts Requested To Date |
Unobligated Balance of Funds To Date |
| (a) | (b) | (c) | (d) | (e) | |
| Carry over from previous month column (d) | Column (b) + (c) | Column (a) - (d) | |||
| 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | |
| 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | |
| 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | |
| 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | |
| 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | |
| 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | |
| Total SEO Funds | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
| Match/Leverage Funds | |||||
| 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | |
| 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | |
| 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | |
| 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | |
| 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | |
| 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | |
| Total Match/Leverage Funds | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
| Grand Total | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
| I certify that this Request for Payment has been drawn in accordance with the terms and conditions of the contract, that the dates reported are correct and | |||||
| that the amount of the request is not in excess of current expenses. | |||||
| Request Prepared By: ____________________________________________________________________ | Date Signed: ___________________________________ | ||||
| Title of Preparer:: ________________________________________________________________________ | E-mail: ___________________________________ | ||||
| Telephone: ( ) | Fax: | ||||
| State Energy Office Use Only | |||||
| Date | |||||
| Grants Manager:_____________________________________ | |||||
| Date | |||||
| Section Chief:___________________________________ | |||||
| Date | |||||
| Accountant:___________________________________ | |||||
| Grantee: | RFP Number: | 0 | |||
| Remittance Address: | Program: | 0 | |||
| City/State/Zip: | Grant Period: | 00/00/2010 Thru 12/31/2011 | |||
| Tax ID Number: | Report Period: | 00/00/2010 thru 00/00/2010 | |||
| Purchase Order Number: | |||||
| Budget Items | Current Grant Amount |
Amounts Previously Requested |
Amount Requested This Period |
Amounts Requested To Date |
Unobligated Balance of Funds To Date |
| (a) | (b) | (c) | (d) | (e) | |
| Carry over from previous month column (d) | Column (b) + (c) | Column (a) - (d) | |||
| 0 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
| 0 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
| 0 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
| 0 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
| 0 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
| 0 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
| Total SEO Funds | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
| Match/Leverage Funds | |||||
| 0 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
| 0 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
| 0 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
| 0 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
| 0 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
| 0 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
| Total Match/Leverage Funds | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
| Grand Total | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
| I certify that this Request for Payment has been drawn in accordance with the terms and conditions of the contract, that the dates reported are correct and | |||||
| that the amount of the request is not in excess of current expenses. | |||||
| Request Prepared By: ____________________________________________________________________ | Date Signed: ___________________________________ | ||||
| Title of Preparer:: ________________________________________________________________________ | E-mail: ___________________________________ | ||||
| Telephone: ( ) | Fax: | ||||
| State Energy Office Use Only | |||||
| Date | |||||
| Grants Manager:_____________________________________ | |||||
| Date | |||||
| Section Chief:___________________________________ | |||||
| Date | |||||
| Accountant:___________________________________ | |||||
| Grantee: | RFP Number: | 0 | |||
| Remittance Address: | Program: | 0 | |||
| City/State/Zip: | Grant Period: | 00/00/2010 Thru 12/31/2011 | |||
| Tax ID Number: | Report Period: | 00/00/2010 thru 00/00/2010 | |||
| Purchase Order Number: | |||||
| Budget Items | Current Grant Amount |
Amounts Previously Requested |
Amount Requested This Period |
Amounts Requested To Date |
Unobligated Balance of Funds To Date |
| (a) | (b) | (c) | (d) | (e) | |
| Carry over from previous month column (d) | Column (b) + (c) | Column (a) - (d) | |||
| 0 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
| 0 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
| 0 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
| 0 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
| 0 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
| 0 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
| Total SEO Funds | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
| Match/Leverage Funds | |||||
| 0 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
| 0 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
| 0 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
| 0 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
| 0 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
| 0 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
| Total Match/Leverage Funds | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
| Grand Total | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
| I certify that this Request for Payment has been drawn in accordance with the terms and conditions of the contract, that the dates reported are correct and | |||||
| that the amount of the request is not in excess of current expenses. | |||||
| Request Prepared By: ____________________________________________________________________ | Date Signed: ___________________________________ | ||||
| Title of Preparer:: ________________________________________________________________________ | E-mail: ___________________________________ | ||||
| Telephone: ( ) | Fax: | ||||
| State Energy Office Use Only | |||||
| Date | |||||
| Grants Manager:_____________________________________ | |||||
| Date | |||||
| Section Chief:___________________________________ | |||||
| Date | |||||
| Accountant:___________________________________ | |||||
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