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{"sheet":"Part I - (Page 1)","index":0,"n_rows":25,"n_cols":13,"rows_kept":25,"cut":false,"hidden":false,"merged":[[0,24,24,24],[0,12,0,23],[1,1,1,9],[2,1,2,2],[3,1,5,3],[2,8,2,9],[0,10,24,10],[7,12,8,23],[1,12,2,23],[3,12,3,23],[24,12,24,23],[6,1,6,3],[9,12,23,23],[11,1,11,4],[4,12,6,23],[7,1,7,9],[0,0,24,0],[21,1,21,4],[23,1,23,9],[15,1,15,4],[16,1,16,4],[17,1,17,4],[18,1,18,4],[19,1,19,4],[20,1,20,4],[22,1,22,9],[14,1,14,4],[12,1,12,4],[6,4,6,9],[24,1,24,9],[8,1,8,4],[13,1,13,4],[0,11,24,11],[2,4,2,5],[0,1,0,9],[3,4,3,9],[4,4,4,9],[5,4,5,9],[9,1,9,4],[10,1,10,4]]}
[]
[null,"PAYMENT REQUEST SUMMARY FORM",null,null,null,null,null,null,null,null,null,null,"Submittal Instructions"]
[null,"DEP Agreement No.                                                                     \n",null,null,"Payment Request No.",null,null,"Request Date:"]
[null,"Grantee:\n(Name & Mailing Address)",null,null,null,null,null,null,null,null,null,null,"Instructions for E-mailing:"]
[null,null,null,null,null,null,null,null,null,null,null,null,"The Payment Request should be submitted by E-mail to the assigned DEP Grant Manager (GM) listed in the Agreement (or most recent Amendment/Change Order).\n\nPlease attach a copy of the \"Payment Request Summary Form\" Excel Workbook used for this Payment Request, in case changes or corrections will be needed to process this Payment Request."]
[]
[null,"Grantee's Grant Manager:"]
[null,"GRANT EXPENDITURES SUMMARY SECTION",null,null,null,null,null,null,null,null,null,null,"The E-mail payment request should include the following:\n\nSubject Title:\n\nAgreement Number_Payment Request_Number (Example: LP14025_Payment Request_1)\n"]
[null,"AUTHORIZED TASKS",null,null,null,"AMOUNT OF THIS REQUEST ","PREVIOUS PAYMENT REQUESTS","TOTAL CUMULATIVE PAYMENT REQUESTS","MATCHING FUNDS FOR THIS REQUEST","TOTAL CUMULATIVE MATCHING FUNDS"]
[null,"Task 1: ",null,null,null,0,0,{"$f":"SUM(F10:G10)","v":0},0,0,null,null,"Documentation:\n\n1)     Payment Request Summary Form (Page 1).\n\n2)     Grantee's Certification of Payment Request (Page 2).\n\n3)     Engineer's Certification of Payment Request (Page 3). Only required if requesting reimbursement for Construction.\n\n4)     Request for Payment - Part II, Reimbursement Detail (Page 4).\n\n5)     Request for Payment - Part IIa, Salary and Fringe Detail (Page 5). Only if requesting reimbursement for Salary and/or Fringe.\n\n6)     Copies of Invoices. \n\n7)     Copies of Proof of Payments. [Canceled Checks (front and back), ACH, or Electronic Funds Transfer (EFT) verification].\n\n8)     Other supporting documentation, as needed.\n\nPlease redact all sensitive financial information from the invoices and other supporting documentation to be submitted with this Payment Request. \n\n\nAdditional Notes:\n\nPlease review the Grant Work Plan for required documentation of deliverables that should be submitted prior to this Payment Request.  \n\nPlease submit copies of the executed contracts between the Grantee and the Vendors/Contractors associated with the invoices being requested for reimbursement. The contracts are required supporting documentation that should be submitted prior to this Payment Request."]
[null,"Task 2: ",null,null,null,0,0,{"$f":"SUM(F11:G11)","v":0},0,0]
[null,"Task 3: ",null,null,null,0,0,0,0,0]
[null,"Task 4: ",null,null,null,0,0,0,0,0]
[null,"Task 5: ",null,null,null,0,0,0,0,0]
[null,"Task 6: ",null,null,null,0,0,0,0,0]
[null,"Task 7: ",null,null,null,0,0,0,0,0]
[null,"Task 8: ",null,null,null,0,0,0,0,0]
[null,"Task 9: ",null,null,null,0,0,0,0,0]
[null,"TOTAL AMOUNT",null,null,null,{"$f":"SUM(F10:F18)","v":0},{"$f":"SUM(G10:G18)","v":0},{"$f":"SUM(H10:H18)","v":0},{"$f":"SUM(I10:I18)","v":0},{"$f":"SUM(J10:J18)","v":0}]
[null,"TOTAL BUDGET \n(ALL TASKS)",null,null,null,0,"$","$",0,"$"]
[null,"LESS TOTAL CUMULATIVE PAYMENT REQUESTS OF:",null,null,null,{"$f":"H19","v":0},"$","$",{"$f":"J19","v":0},"$"]
[null,"TOTAL REMAINING\n(ALL TASKS)",null,null,null,{"$f":"(F20-F21)","v":0},"$","$",{"$f":"(I20-I21)","v":0},"$"]
[null,"GRANTEE CERTIFICATION"]
[null,"Complete the Grantee’s Certification of Payment Request on Page 2 to certify that the amount being requested for reimbursement above was for items that were charged to and utilized only for the above cited grant activities.  "]
[null,"Rev. 2/15/22"]

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[]
[null,"Grantee’s Certification of Payment Request"]
[]
[]
[null,"I,",null,null,null,null,null,null,null,", on behalf of"]
[null,null,"  (Print name of Grantee’s Grant Manager designated in the Agreement)"]
[null,null,null,null,null,null,null,null,", do hereby certify for"]
[null,"(Print name of Grantee)"]
[null,"DEP Agreement No. ",null,null," and Payment Request No.  ",null,null,null,null,null,"that:"]
[]
[null,"1)  ","The disbursement amount requested is for allowable costs for the project described in Attachment 3 of the Agreement.\n"]
[null,"2)","All costs included in the amount requested have been satisfactorily purchased, performed, received, and applied toward completing the project; such costs are documented by invoices or other appropriate documentation as required in the Agreement.\n"]
[null,"3)","The Grantee has paid such costs under the terms and provisions of contracts relating directly to the project; and the Grantee is not in default of any terms or provisions of the contracts.\n"]
[null,"4)","If this Agreement includes federal provisions that have applicable Davis-Bacon Act certification requirements, I certify to the best of my knowledge and belief that the above-referenced project complies with Davis-Bacon and Related Acts such that all of the laborers and mechanics employed by contractors and subcontractors during the referenced period on the contractors pay applications submitted with this payment request were paid wages at rates not less than those listed on the prevailing wage rate contained in the contract documents and that all applicable provisions of the Davis-Bacon and Related Acts have been met.\n\nI also certify that interviews and periodic reviews of a representative sample of the weekly payroll data have been performed to verify that contractors and subcontractors are paying the appropriate wage rate. \n\nFor additonal information on Davis-Bacon and Related Acts, please refer to the link below:\n\n"]
[null,null,"https://www.dol.gov/agencies/whd/government-contracts/construction"]
[]
[]
[null,"Signature of Grantee's Grant Manager\n(Original Ink or Digital Timestamp) ",null,null,null,null,"Signature of Grantee's Fiscal Agent \n(Original Ink or Digital Timestamp) "]
[]
[null,"Print Name",null,null,null,null,"Print Name"]
[]
[null,"Telephone Number",null,null,null,null,"Telephone Number"]

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[]
[null,"Engineer’s Certification of Payment Request"]
[]
[]
[null,"ONLY SUBMIT IF CONSTRUCTION IS PART OF THE PAYMENT REQUEST"]
[]
[]
[null,"I,",null,null,", being the Professional Engineer retained by"]
[null,null,"(name of Professional Engineer)"]
[null,null,null,null,", am responsible for overseeing construction of the project"]
[null,"(name of Grantee)"]
[null,"described in the Agreement and do hereby certify that for DEP Agreement No.",null,null,null,null," and Payment Request No.",null,null,":"]
[null," "]
[null,"1)","All permits and approvals required for the construction, which is underway, have been obtained."]
[null,"2)","Payment is in accordance with construction contract provisions."]
[null,"3)","Construction up to the point of this payment request is in compliance with the approved plans and permits."]
[null,"4)","Equipment, materials, labor, and services represented by the construction invoices have been satisfactorily purchased or received and applied to the project in accordance with construction contract documents filed with and previously approved by the Department of Environmental Protection."]
[]
[]
[]
[null,null,null,null,"Signature of Professional Engineer\n(Original Ink or Digital Timestamp) "]
[]
[]
[null,null,null,null,"Firm or Affiliation"]
[]
[]
[null,null,null,null,"(Date)",null,null,"(P.E. Number)"]

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[null,"FLORIDA DEPARTMENT OF ENVIRONMENTAL PROTECTION"]
[null," REQUEST FOR PAYMENT – PART II"]
[null,"REIMBURSEMENT DETAIL"]
[null,"DEP Agreement No.:",null,null,null,null,"Payment Request No.:"]
[null,"Grantee Name:",null,null,null,null,"Invoice Period:",null,"mm/dd/yy  -  mm/dd/yy"]
[null,"Vendor Name","Invoice Number"," Invoice\n Date","Invoice \nAmount ","Amount to Credit toward Match, or Local Share, or Other Funding, or Amount Not Requested","Requested \nAmount","Check or EFT \nNumber","Task Number ","Budget Category"]
[null,null,null,null,0,0,{"$f":"E7-F7","v":0}]
[null,null,null,null,0,0,0]
[null,null,null,null,0,0,0]
[null,null,null,null,0,0,0]
[null,null,null,null,0,0,0]
[null,null,null,null,0,0,0]
[null,null,null,null,0,0,{"$f":"E13-F13","v":0}]
[null,null,null,null,0,0,0]
[null,null,null,null,0,0,{"$f":"E15-F15","v":0}]
[null,null,null,null,0,0,0]
[null,null,null,null,0,0,{"$f":"E17-F17","v":0}]
[null,null,null,null,0,0,0]
[null,null,null,null,0,0,0]
[null,null,null,null,0,0,0]
[null,null,null,null,0,0,0]
[null,null,null,null,0,0,0]
[null,null,null,null,0,0,{"$f":"E23-F23","v":0}]
[null,null,null,null,0,0,0]
[null,null,null,null,0,0,0]
[null,null,null,null,0,0,0]
[null,null,null,null,0,0,0]
[null,null,null,null,0,0,0]
[null,null,null,null,0,0,{"$f":"E29-F29","v":0}]
[null,null,null,null,0,0,{"$f":"E30-F30","v":0}]
[null,null,null,null,0,0,0]
[null,null,null,null,0,0,0]
[null,null,null,null,0,0,{"$f":"E33-F33","v":0}]
[null,null,null,null,0,0,{"$f":"E34-F34","v":0}]
[null,"Totals:",null,null,null,null,{"$f":"SUM(G7:G34)","v":0}]
[]
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[null,null,null,null,null,null,null,null,null,null,null,null,"Budget Category Options:"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,"Contractual Services"]
[null,null,null,null,null,null,null,null,null,null,null,null,"Equipment"]
[null,null,null,null,null,null,null,null,null,null,null,null,"Indirect Cost"]
[null,null,null,null,null,null,null,null,null,null,null,null,"Land Acquisition"]
[null,null,null,null,null,null,null,null,null,null,null,null,"Miscellaneous/Other Expenses"]
[null,null,null,null,null,null,null,null,null,null,null,null,"Rental/Lease of Equipment"]
[null,null,null,null,null,null,null,null,null,null,null,null,"Travel"]

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[]
[null,"FLORIDA DEPARTMENT OF ENVIRONMENTAL PROTECTION"]
[null," REQUEST FOR PAYMENT - PART IIa"]
[null,"SALARY AND FRINGE DETAIL"]
[]
[null,"Complete one table for each task containing Salary and Fringe Reimbursement Requests. (Add tables and rows as needed)"]
[null,"Enter the Salary and Fringe sums for each task into the Invoice Summary spreadsheet."]
[null,"*Include the match amount if match is required in the Agreement and is included in the invoice."]
[]
[null,"Task Number:","#"]
[null,"Position Title","Employee Name","Performance Period \n(Date Range)","Hourly Wage","Fringe Rate \n(%)","No. of Hours Worked for Reimbursement","Salary Amount \nfor Reimbursement \n(Per Employee)","Fringe Amount \nfor Reimbursement \n(Per Employee)","No. of Hours Worked for Match","Salary Amount \nto Credit toward Match*","Fringe Amount \nto Credit toward Match*"]
[null,null,null,null,null,null,null,{"$f":"E12*G12","v":0},{"$f":"(E12*G12*F12)/100","v":0},null,{"$f":"E12*J12","v":0},{"$f":"(E12*J12*F12)/100","v":0}]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,null,{"$f":"E15*G15","v":0},{"$f":"(E15*G15*F15)/100","v":0},null,{"$f":"E15*J15","v":0},{"$f":"(E15*J15*F15)/100","v":0}]
[null,null,null,null,null,null,null,{"$f":"E16*G16","v":0},{"$f":"(E16*G16*F16)/100","v":0},null,{"$f":"E16*J16","v":0},{"$f":"(E16*J16*F16)/100","v":0}]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,"TOTALS:",{"$f":"SUM(H12:H19)","v":0},{"$f":"SUM(I12:I19)","v":0},"TOTALS:",{"$f":"SUM(K12:K19)","v":0},{"$f":"SUM(L12:L19)","v":0}]
[]
[null,"Task Number:","#"]
[null,"Position Title","Employee Name","Performance Period \n(Date Range)","Hourly Wage","Fringe Rate \n(%)","No. of Hours Worked for Reimbursement","Salary Amount \nfor Reimbursement \n(Per Employee)","Fringe Amount \nfor Reimbursement \n(Per Employee)","No. of Hours Worked for Match","Salary Amount \nto Credit toward Match*","Fringe Amount \nto Credit toward Match*"]
[null,null,null,null,null,null,null,{"$f":"E24*G24","v":0},{"$f":"(E24*G24*F24)/100","v":0},null,{"$f":"E24*J24","v":0},{"$f":"(E24*J24*F24)/100","v":0}]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,"TOTALS:",{"$f":"SUM(H24:H31)","v":0},{"$f":"SUM(I24:I31)","v":0},"TOTALS:",{"$f":"SUM(K24:K31)","v":0},{"$f":"SUM(L24:L31)","v":0}]
[]
[null,"Task Number:","#"]
[null,"Position Title","Employee Name","Performance Period \n(Date Range)","Hourly Wage","Fringe Rate \n(%)","No. of Hours Worked for Reimbursement","Salary Amount \nfor Reimbursement \n(Per Employee)","Fringe Amount \nfor Reimbursement \n(Per Employee)","No. of Hours Worked for Match","Salary Amount \nto Credit toward Match*","Fringe Amount \nto Credit toward Match*"]
[null,null,null,null,null,null,null,{"$f":"E36*G36","v":0},{"$f":"(E36*G36*F36)/100","v":0},null,{"$f":"E36*J36","v":0},{"$f":"(E36*J36*F36)/100","v":0}]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,"TOTALS:",{"$f":"SUM(H36:H43)","v":0},{"$f":"SUM(I36:I43)","v":0},"TOTALS:",{"$f":"SUM(K36:K43)","v":0},{"$f":"SUM(L36:L43)","v":0}]
[]
[null,"Task Number:","#"]
[null,"Position Title","Employee Name","Performance Period \n(Date Range)","Hourly Wage","Fringe Rate \n(%)","No. of Hours Worked for Reimbursement","Salary Amount \nfor Reimbursement \n(Per Employee)","Fringe Amount \nfor Reimbursement \n(Per Employee)","No. of Hours Worked for Match","Salary Amount \nto Credit toward Match*","Fringe Amount \nto Credit toward Match*"]
[null,null,null,null,null,null,null,{"$f":"E48*G48","v":0},{"$f":"(E48*G48*F48)/100","v":0},null,{"$f":"E48*J48","v":0},{"$f":"(E48*J48*F48)/100","v":0}]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,"TOTALS:",{"$f":"SUM(H48:H55)","v":0},{"$f":"SUM(I48:I55)","v":0},"TOTALS:",{"$f":"SUM(K48:K55)","v":0},{"$f":"SUM(L48:L55)","v":0}]
[]
[null,"Task Number:","#"]
[null,"Position Title","Employee Name","Performance Period \n(Date Range)","Hourly Wage","Fringe Rate \n(%)","No. of Hours Worked for Reimbursement","Salary Amount \nfor Reimbursement \n(Per Employee)","Fringe Amount \nfor Reimbursement \n(Per Employee)","No. of Hours Worked for Match","Salary Amount \nto Credit toward Match*","Fringe Amount \nto Credit toward Match*"]
[null,null,null,null,null,null,null,{"$f":"E60*G60","v":0},{"$f":"(E60*G60*F60)/100","v":0},null,{"$f":"E60*J60","v":0},{"$f":"(E60*J60*F60)/100","v":0}]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,"TOTALS:",{"$f":"SUM(H60:H67)","v":0},{"$f":"SUM(I60:I67)","v":0},"TOTALS:",{"$f":"SUM(K60:K67)","v":0},{"$f":"SUM(L60:L67)","v":0}]
[]
[null,"Task Number:","#"]
[null,"Position Title","Employee Name","Performance Period \n(Date Range)","Hourly Wage","Fringe Rate \n(%)","No. of Hours Worked for Reimbursement","Salary Amount \nfor Reimbursement \n(Per Employee)","Fringe Amount \nfor Reimbursement \n(Per Employee)","No. of Hours Worked for Match","Salary Amount \nto Credit toward Match*","Fringe Amount \nto Credit toward Match*"]
[null,null,null,null,null,null,null,{"$f":"E72*G72","v":0},{"$f":"(E72*G72*F72)/100","v":0},null,{"$f":"E72*J72","v":0},{"$f":"(E72*J72*F72)/100","v":0}]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,null,0,0,null,0,0]
[null,null,null,null,null,null,"TOTALS:",{"$f":"SUM(H72:H79)","v":0},{"$f":"SUM(I72:I79)","v":0},"TOTALS:",{"$f":"SUM(K72:K79)","v":0},{"$f":"SUM(L72:L79)","v":0}]

{"sheet":"Part I (Instructions)","index":5,"n_rows":71,"n_cols":10,"rows_kept":71,"cut":false,"hidden":false,"merged":[[71,1,71,9],[66,1,66,4],[67,1,67,4],[68,1,68,4],[69,1,69,9],[70,1,70,9],[61,1,61,4],[62,1,62,4],[63,1,63,4],[64,1,64,4],[65,1,65,4],[56,1,56,4],[57,1,57,4],[58,1,58,4],[59,1,59,4],[60,1,60,4],[46,0,71,0],[46,1,46,9],[46,10,71,10],[47,1,47,9],[48,1,48,9],[49,1,49,2],[49,4,49,5],[49,8,49,9],[50,1,52,3],[50,4,50,9],[51,4,51,9],[52,4,52,9],[53,1,53,3],[53,4,53,9],[54,1,54,9],[55,1,55,4],[44,1,44,9],[45,1,45,9],[20,1,20,9],[36,1,36,4],[37,1,37,4],[38,1,38,4],[39,1,39,4],[40,1,40,4],[41,1,41,4],[30,1,30,4],[31,1,31,4],[32,1,32,4],[33,1,33,4],[34,1,34,4],[24,1,26,3],[24,4,24,9],[0,0,19,0],[20,0,45,0],[20,10,45,10],[0,10,19,10],[19,1,19,9],[35,1,35,4],[25,4,25,9],[26,4,26,9],[27,1,27,3],[27,4,27,9],[28,1,28,9],[29,1,29,4],[42,1,42,4],[43,1,43,9],[18,1,18,9],[21,1,21,9],[10,1,10,9],[22,1,22,9],[23,1,23,2],[23,4,23,5],[23,8,23,9],[17,1,17,9],[0,1,0,9],[3,1,3,9],[16,1,16,9],[1,1,1,9],[2,1,2,9],[4,1,4,9],[5,1,5,9],[11,1,11,9],[12,1,12,9],[13,1,13,9],[14,1,14,9],[15,1,15,9],[6,1,6,9],[7,1,7,9],[8,1,8,9],[9,1,9,9]]}
[]
[null,"INSTRUCTIONS FOR COMPLETING"]
[null,"PAYMENT REQUEST SUMMARY FORM"]
[]
[null,"DEP Agreement No.:   The number listed in the Agreement. (Example: LP12001; NS001)"]
[null,"Payment Request No.:  The number of the current payment request."]
[null,"Request Date:  The date the payment request is to be submitted to DEP."]
[null,"Grantee:  Enter the name of the Grantee listed in the Agreement."]
[null,"Mailing Address:  Enter the address the state warrant/payment is to be mailed to. Use Grantee address for EFT payments."]
[null,"Grantee's Grant Manager:  The person identified as Grantee Grant Manager in the Agreement, or most recent Amendment or Change Order."]
[null,"GRANT EXPENDITURES SUMMARY SECTION"]
[null,"“AMOUNT OF THIS REQUEST” COLUMN:  Enter the amount for each authorized task that is being requested for payment.  The amount must be less than or equal to the task budget amount listed in the current Grant Work Plan.  Do not claim expenses in an authorized task that does not have an approved budget.  Do not claim items that are not specifically identified in the current Grant Work Plan.  \n\nEnter the column total on the “TOTAL AMOUNT” line.  Enter the total task budget amount for all tasks (or total grant amount) on the “TOTAL BUDGET (ALL TASKS)” line.  Enter the total cumulative amount of this request and all previous payments on the “LESS TOTAL CUMULATIVE PAYMENT REQUESTS OF” line.  Deduct the “LESS TOTAL CUMULATIVE PAYMENT REQUESTS OF” from the “TOTAL BUDGET (ALL TASKS)” and enter the amount on the “TOTAL REMAINING (ALL TASKS)” line."]
[null,"\"PREVIOUS PAYMENT REQUESTS\" COLUMN:  Enter the total cumulative amount for each authorized task that has been paid in previous requests.  Do not include the amount(s) listed in the “AMOUNT OF THIS REQUEST” column.  Do not enter text into the shaded areas."]
[null,"“TOTAL CUMULATIVE PAYMENT REQUESTS” COLUMN:  Enter the cumulative amount for each authorized task. (“AMOUNT OF THIS REQUEST” + “PREVIOUS PAYMENT REQUESTS”).  The amount(s) must be less than or equal to the task budget amount(s) listed in the most current Grant Work Plan.  Enter the column total on the “TOTAL  PAYMENT REQUEST” line.   Do not enter text into the shaded areas."]
[null,"“MATCHING FUNDS” COLUMN:  Enter the amount to be claimed as match for each authorized task in the performance period for the Payment Request.  Enter the total on the “TOTAL AMOUNT” line for this column.  Enter the match budget amount on the “TOTAL BUDGET (ALL TASKS)” line for this column.  Enter the total cumulative amount for this and any previous match claimed on the “LESS TOTAL CUMULATIVE PAYMENTS OF” line for this column.  Deduct the “LESS TOTAL CUMULATIVE PAYMENTS OF”  from the “TOTAL BUDGET (ALL TASKS)” and then enter the amount on the “TOTAL REMAINING (ALL TASKS)” for this column."]
[null,"“TOTAL CUMULATIVE MATCHING FUNDS” COLUMN:  Enter the cumulative amounts you have claimed to date for match by authorized task.  Enter the total on the “TOTAL AMOUNT” line for this column.  Do not enter anything in the shaded areas."]
[null,"GRANTEE’S CERTIFICATION (Page 2): Must be signed by both the Grantee’s Grant Manager (as identified in the Agreement) and the Grantee’s Fiscal Agent.   \n\nNote: If the Grant Manager and Fiscal Agent are the same person, then the same person can sign both signature lines."]
[null,"ENGINEER'S CERTIFICATION (Page 3):  Must be signed by a Florida Certified Professional Engineer when Construction is being requested for reimbursement."]
[null,"Documentation for match claims must meet the same requirements as those expenditures for reimbursement."]
[]
[null,"Example #1"]
[]
[null,"PAYMENT REQUEST SUMMARY FORM"]
[null,"DEP Agreement No.                                                                     \n",null,"LP12005","Payment Request No.",null,2,"Request Date:","2020-05-16"]
[null,"Grantee:\n(Name & Mailing Address)",null,null,"City of Panama Bay "]
[null,null,null,null,"123 Palm Avenue, Panama Bay, FL 32308 "]
[]
[null,"Grantee's Grant Manager:",null,null,"John Smith"]
[null,"GRANT EXPENDITURES SUMMARY SECTION"]
[null,"AUTHORIZED TASKS",null,null,null,"AMOUNT OF THIS REQUEST ","PREVIOUS PAYMENT REQUESTS","TOTAL CUMULATIVE PAYMENT REQUESTS","MATCHING FUNDS FOR THIS REQUEST","TOTAL CUMULATIVE MATCHING FUNDS"]
[null,"Task 1: Pre-Design Study",null,null,null,0,50000,{"$f":"SUM(F31:G31)","v":50000},0,0]
[null,"Task 2: Design and Permitting",null,null,null,0,250000,{"$f":"SUM(F32:G32)","v":250000},0,0]
[null,"Task 3: Bidding and Contractor Selection",null,null,null,0,5000,5000,0,0]
[null,"Task 4: Project Management ",null,null,null,10000,10000,20000,0,0]
[null,"Task 5: Land Acquisiton",null,null,null,0,200000,{"$f":"SUM(F35:G35)","v":200000},0,0]
[null,"Task 6: Construction",null,null,null,250000,125000,{"$f":"SUM(F36:G36)","v":375000},0,0]
[null,"Task 7:",null,null,null,0,0,{"$f":"SUM(F37:G37)","v":0},0,0]
[null,"Task 8: ",null,null,null,0,0,0,0,0]
[null,"Task 9: ",null,null,null,0,0,0,0,0]
[null,"TOTAL AMOUNT",null,null,null,{"$f":"SUM(F31:F39)","v":260000},{"$f":"SUM(G31:G39)","v":640000},{"$f":"SUM(H31:H39)","v":900000},{"$f":"SUM(I31:I39)","v":0},{"$f":"SUM(J31:J39)","v":0}]
[null,"TOTAL BUDGET \n(ALL TASKS)",null,null,null,1250000,"$","$",0,"$"]
[null,"LESS TOTAL CUMULATIVE PAYMENT REQUESTS OF:",null,null,null,{"$f":"H40","v":900000},"$","$",{"$f":"J40","v":0},"$"]
[null,"TOTAL REMAINING\n(ALL TASKS)",null,null,null,{"$f":"(F41-F42)","v":350000},"$","$",0,"$"]
[null,"GRANTEE CERTIFICATION"]
[null,"Complete Grantee’s Certification of Payment Request on Page 2 to certify that the amount being requested for reimbursement above was for items that were charged to and utilized only for the above cited grant activities.  "]
[]
[null,"Example #2 (with Match)"]
[]
[null,"PAYMENT REQUEST SUMMARY FORM"]
[null,"DEP Agreement No.                                                                     \n",null,"LP12005","Payment Request No.",null,2,"Request Date:","2020-05-16"]
[null,"Grantee:\n(Name & Mailing Address)",null,null,"City of Panama Bay "]
[null,null,null,null,"123 Palm Avenue, Panama Bay, FL 32308 "]
[]
[null,"Grantee's Grant Manager:",null,null,"John Smith"]
[null,"GRANT EXPENDITURES SUMMARY SECTION"]
[null,"AUTHORIZED TASKS",null,null,null,"AMOUNT OF THIS REQUEST ","PREVIOUS PAYMENT REQUESTS","TOTAL CUMULATIVE PAYMENT REQUESTS","MATCHING FUNDS FOR THIS REQUEST","TOTAL CUMULATIVE MATCHING FUNDS"]
[null,"Task 1: Pre-Design Study",null,null,null,0,50000,{"$f":"SUM(F57:G57)","v":50000},0,50000]
[null,"Task 2: Design and Permitting",null,null,null,0,250000,{"$f":"SUM(F58:G58)","v":250000},0,250000]
[null,"Task 3: Bidding and Contractor Selection",null,null,null,0,5000,5000,0,5000]
[null,"Task 4: Project Management ",null,null,null,10000,10000,20000,10000,20000]
[null,"Task 5: Land Acquisiton",null,null,null,0,200000,{"$f":"SUM(F61:G61)","v":200000},0,200000]
[null,"Task 6: Construction",null,null,null,250000,125000,375000,250000,375000]
[null,"Task 7: ",null,null,null,0,0,0,0,0]
[null,"Task 8: ",null,null,null,0,0,0,0,0]
[null,"Task 9: ",null,null,null,0,0,0,0,0]
[null,"TOTAL AMOUNT",null,null,null,{"$f":"SUM(F57:F65)","v":260000},{"$f":"SUM(G57:G65)","v":640000},{"$f":"SUM(H57:H65)","v":900000},{"$f":"SUM(I57:I65)","v":260000},{"$f":"SUM(J57:J65)","v":900000}]
[null,"TOTAL BUDGET \n(ALL TASKS)",null,null,null,1250000,"$","$",1250000,"$"]
[null,"LESS TOTAL CUMULATIVE PAYMENT REQUESTS OF:",null,null,null,{"$f":"H66","v":900000},"$","$",{"$f":"J66","v":900000},"$"]
[null,"TOTAL REMAINING\n(ALL TASKS)",null,null,null,{"$f":"(F67-F68)","v":350000},"$","$",{"$f":"(I67-I68)","v":350000},"$"]
[null,"GRANTEE CERTIFICATION"]
[null,"Complete Grantee’s Certification of Payment Request on Page 2 to certify that the amount being requested for reimbursement above was for items that were charged to and utilized only for the above cited grant activities.  "]

{"sheet":" Part II - (Instructions)","index":6,"n_rows":33,"n_cols":13,"rows_kept":33,"cut":false,"hidden":false,"merged":[[2,1,2,9],[7,1,7,9],[8,1,8,9],[0,10,8,10],[6,1,6,9],[0,0,8,0],[0,1,0,9],[0,12,8,12],[15,2,15,5],[15,6,15,7],[15,8,15,9],[11,1,11,9],[12,1,12,9],[13,1,13,9],[14,2,14,5],[14,6,14,7],[14,8,14,9],[1,1,1,9],[3,1,3,9],[4,1,4,9],[5,1,5,9]]}
[]
[null,"Instructions for Request for Payment - Part II (Reimbursement Detail)"]
[null,"Include the Following: \n1) DEP Agreement No. \n2) Payment Request No. \n3) Grantee Name \n4) Invoice Period\n\nNote: Invoice Period will be the period of work or performance period that covers the invoices included in this Payment Request."]
[null,"Invoice Amount:  Total amount listed for each invoice.  "]
[null,"Match, or Local Share, or Other Funding, or Amount Not Requested:  Amount or portion of each invoice that will not be reimbursed with grant funding. "]
[null,"Requested Amount:  Amount or portion of each invoice that will be reimbursed with grant funding.  "]
[null,"Task Number:  The task number listed in the Grant Work Plan that is associated with the work completed in each invoice. "]
[null,"Additional Notes: \n\nIf an invoice covers more than one task, use multiple rows to list the \"Requested Amount\" for each task. (See example below)\n\nSalary and Fringe costs should be listed on Part IIa (Salary and Fringe Detail)."]
[]
[null,"Example: (Page 4)"]
[]
[null,"FLORIDA DEPARTMENT OF ENVIRONMENTAL PROTECTION"]
[null," REQUEST FOR PAYMENT – PART II"]
[null,"REIMBURSEMENT DETAIL"]
[null,"DEP Agreement No.:","LP12005",null,null,null,"Payment Request No.:",null,2]
[null,"Grantee Name:","City of Panama Bay",null,null,null,"Invoice Period:",null,"11/01/19  -  04/31/20"]
[null,"Vendor Name","Invoice Number"," Invoice\n Date","\nInvoice \nAmount \n","Amount to Credit toward Match, or Local Share, or Other Funding, or Amount Not Requested","\nRequested \nAmount\n","Check or EFT \nNumber","\nTask Number \n","Budget Category",null,null,"Budget Category Options:"]
[null,"Smith & Associates, LLC",2078,"2019-10-15",97500,20000,50000,5035,2,"Contractual Services"]
[null,"Smith & Associates, LLC",2078,"2019-10-15",97500,20000,25000,5035,3,"Contractual Services",null,null,"Contractual (Subcontractors)"]
[null,"Smith & Associates, LLC",2078,"2019-10-15",97500,20000,2500,5035,4,"Contractual Services",null,null,"Equipment"]
[null,"Smith & Associates, LLC",2112,"2019-11-15",25000,0,25000,5066,2,"Contractual Services"]
[null,"Smith & Associates, LLC",2154,"2019-12-15",37500,10000,25000,5078,2,"Contractual Services",null,null,"Indirect Cost"]
[null,"Smith & Associates, LLC",2154,"2019-12-15",37500,10000,2500,5078,4,"Contractual Services",null,null,"Land Acquisition"]
[null,"Wellington Properties, Inc. ",108902,"2020-01-07",225000,0,225000,5114,5,"Land Acquisition",null,null,"Miscellaneous/Other Expenses"]
[null,"Equipment Supplier, Inc.",205006,"2020-01-20",45000,0,45000,5138,6,"Equipment",null,null,"Travel"]
[null,"Stanley Construction Services. Inc",1,"02/31/20",175000,50000,125000,5187,7,"Contractual Services"]
[null,"Stanley Construction Services. Inc",2,"2020-03-31",210000,60000,150000,5254,7,"Contractual Services"]
[null,"Stanley Construction Services. Inc",3,"04/31/20",140000,40000,100000,5304,7,"Contractual Services"]
[null,null,null,null,0,0,0]
[null,null,null,null,0,0,0]
[null,null,null,null,0,0,0]
[null,null,null,null,0,0,0]
[null,"Totals:",null,null,null,null,{"$f":"SUM(G18:G32)","v":775000}]

{"sheet":"Drop down","index":7,"n_rows":10,"n_cols":1,"rows_kept":10,"cut":false,"hidden":true,"merged":[]}
["Budget Category Options:"]
["Click here for drop down list"]
["Contractual"]
["Supplies/Expense"]
["Equipment"]
["Salary"]
["Fringe"]
["Travel"]
["Indirect"]
["Land"]