Electronic Submission Now Available: Click here for update to disbursement procedures
Online Fund Payment Request Form
Akron
Hampton Ridge Sanitary Sewer
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
S.E.T. Incorporated
$1,010,915.69
$886,848.70
$124,066.99
CO
Contingencies
$104,520.00
$0.00
$104,520.00
0.00
TS8
Force Account
$34,288.00
$0.00
$34,288.00
Total:
$1,149,723.69
$886,848.70
$262,874.99
0.00