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Request for Payment Summary <br />Request for Payment Form <br />Signed by Inspector <br />Signed by Grantee staff submitting form <br />Cover Sheet <br />Invoice from Contractor: The following needs to be included on each invoice submitted: <br />Stream Segment(s)- segment name on invoice should match name on Scope of Work <br />How many linear feet of work were completed <br />Contractor name and contact information <br />Date <br />Organization being billed by Contractor <br />Receipts/invoices/or other documents for administrative costs <br />Construction/Engineering Invoices <br />Invoice Number Contractor Name Linear Feet <br />Please list all attached documents below <br />Checklist <br />Submit with RFP to: <br />strap.reimbursement@ncagr.gov <br />Invoice Total <br />Date Document Name Taxes Amount <br />Total Construction Cost <br />Adminstrative Expenses Recipets/Invoices/Documents <br />Total Reimbursement Request <br />Total Administrative Reimbursement <br />Docusign Envelope ID: A3C70ABF-EEDE-4822-BD1B-5001B2220A24Docusign Envelope ID: 4952E7F3-6FA3-4165-AD14-AFD0F6E1AE85