Electronic Submission Now Available: Click here for update to disbursement procedures


Online Fund Payment Request Form
Akron
Sevilla Trunk Sewer Reconstruction
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
A H.M. Miller Construction $4,329,186.11 $2,705,302.23 $1,623,883.88
CO Contingencies $820,180.39 $0.00 $820,180.39 0.00
TS1 Administration $5,000.00 $0.00 $5,000.00
TS3 Construction Management $99,425.50 $0.00 $99,425.50
    Total: $5,253,792.00 $2,705,302.23 $2,548,489.77  
0.00