Get Or Klamath County Economic Development Grant Program Kcf 4006 2019-2024

DRAWDOWN REQUEST FORM KLAMATH COUNTY ECONOMIC DEVELOPMENT GRANT PROGRAM Please complete and submit this form to the Finance Office at the address listed below to receive your grant funds. 20 of the grant is withheld until the final report is submitted* Amount of Award Name of Organization Title of Project Address City State Zip Contact Person Phone Number Email Address Balance of Award Drawdown Requested Remaining I/We the administrator s of this project certify that the attached invoices are accurate and that our project did receive the services/supplies being billed in accordance with the provisions of the Economic Development Grant program* Signature Title Date Attach documentation of the expenses to justify your request documentation could include copies of bills invoices canceled checks receipts etc* The amount requested must equal or exceed your documentation* All or a portion of the awarded grant funds may be drawn down as necessary. Checks will be issued according to the County s usual Accounts Payable schedule. Please contact the Klamath County Finance Office at 541-883-4202 with any questions. Remit to Klamath County Finance 305 Main Street Klamath Falls OR 97601 Form KCF 4006 Revised the 28th of June 2016 Page 1 of 1. 20 of the grant is withheld until the final report is submitted* Amount of Award Name of Organization Title of Project Address City State Zip Contact Person Phone Number Email Address Balance of Award Drawdown Requested Remaining I/We the administrator s of this project certify that the attached invoices are accurate and that our project did receive the services/supplies being billed in accordance with the provisions of the Economic Development Grant program* Signature Title Date Attach documentation of the expenses to justify your request documentation could include copies of bills invoices canceled checks receipts etc* The amount requested must equal or exceed your documentation* All or a portion of the awarded grant funds may be drawn down as necessary. Checks will be issued according to the County s usual Accounts Payable schedule. Please contact the Klamath County Finance Office at 541-883-4202 with any questions. Checks will be issued according to the County s usual Accounts Payable schedule. Please contact the Klamath County Finance Office at 541-883-4202 with any questions. Remit to Klamath County Finance 305 Main Street Klamath Falls OR 97601 Form KCF 4006 Revised the 28th of June 2016 Page 1 of 1. 20 of the grant is withheld until the final report is submitted* Amount of Award Name of Organization Title of Project Address City State Zip Contact Person Phone Number Email Address Balance of Award Drawdown Requested Remaining I/We the administrator s of this project certify that the attached invoices are accurate and that our project did receive the services/supplies being billed in accordance with the provisions of the Economic Development Grant program* Signature Title Date Attach documentation of the expenses to justify your request documentation could include copies of bills invoices canceled checks receipts etc* The amount requested must equal or exceed your documentation* All or a portion of the awarded grant funds may be drawn down as necessary. Checks will be issued according to the County s usual Accounts Payable schedule. Please contact the Klamath County Finance Office at 541-883-4202 with any questions. Remit to Klamath County Finance 305 Main Street Klamath Falls OR 97601 Form KCF 4006 Revised the 28th of June 2016 Page 1 of 1.