Electronic Submission Now Available: Click here for update to disbursement procedures
Online Fund Payment Request Form
Akron
Chittenden Green Project (Kelly Rack 3)
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
Lockhart Concrete Co.
$1,344,906.36
$1,289,891.80
$55,014.56
CO
Contingencies
$93,991.64
$0.00
$93,991.64
0.00
TS3
Construction Management
$94,393.44
$0.00
$94,393.44
Total:
$1,533,291.44
$1,289,891.80
$243,399.64
0.00