Electronic Submission Now Available: Click here for update to disbursement procedures
Online Fund Payment Request Form
Akron
Mayfield Avenue Sewer Imp. Sewer System I/I Study
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.
$659,042.00
$564,774.15
$94,267.85
CO
Contingencies
$60,287.10
$0.00
$60,287.10
0.00
TS4
Design
$130,152.00
$111,452.64
$18,699.36
TS9
Force Account
$62,928.96
$0.00
$62,928.96
Total:
$912,410.06
$676,226.79
$236,183.27
0.00