Electronic Submission Now Available: Click here for update to disbursement procedures
Online Fund Payment Request Form
Akron
Eckert Ditch
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
CO
Contingencies
$0.00
$0.00
$0.00
0.00
WR1
Protection
$185,500.00
$185,500.00
$0.00
0.00
WR2
Restoration
$591,000.00
$326,218.66
$264,781.34
Total:
$776,500.00
$511,718.66
$264,781.34
0.00