Online Fund Payment Request Form
Akron
Wilbeth Wetlands
Disbursement Request:
(#'s only)
Payee:
Invoice Number:
Invoice Date:
(mm/dd/yyyy)
Total Invoice Amount:
(#'s Only, 0.00)
Invoice Amount to be paid by OWDA:
(#'s Only, 0.00)
Disbursement Request Detail
Contractor Name
Encumbered
Disbursed
Balance
Requested
Amount
WR1
Protection
$61,953.00
$61,953.00
$0.00
0.00
WR2
Restoration
$1,688,047.00
$976,536.54
$711,510.46
Total:
$1,750,000.00
$1,038,489.54
$711,510.46
0.00