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61 <br />2. The purpose of this disbursement is for partial payment on the project <br />contemplated under the Project Fund Agreement. <br />3. The requested disbursement has not been subject to any previous <br />requisition. <br />4. No notice of any lien, right to lien or attachment upon, or claim affecting the <br />right to receive payment of, any of the moneys payable herein to any of the <br />persons, firms or corporations named herein has been received, or if any <br />notice of any such lien, attachment or claim has been received, such lien, <br />attachment or claim has been released or discharged or will be released or <br />discharged upon payment of this requisition. <br />5. This requisition contains no items representing payment on account of any <br />percentage entitled to be retained on the date of this requisition. <br />6. No Event of Default is continuing, and no event or condition is existing <br />which, with notice or lapse of time or both, would become an Event of <br />Default. <br />7. The County has insurance in place that complies with the insurance <br />requirements of the Financing Contract. <br />Attached is evidence that the amounts shown in this requisition are properly <br />payable at this time, such as bills, receipts, invoices, architects' payment <br />certifications or other appropriate documents. <br />ORANGE COUNTY, <br />NORTH CAROLINA <br />By: Exhibit Form On[y - Do Not Sign1 <br />Printed name: <br />Title: <br />61 <br />