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<br />(3) That the materials, goods or services for which payment or reimbursement is <br />requested constitute Qualified Project Costs (as defined in the Loan Agreement), are due and <br />payable to the Payee or have been paid by the Corporation and are or were necessary in connection <br />with the above Projeet, and that none of such items has formed the basis for any previous payment <br />or reimbursement from the Construction Account. <br /> <br />(4) That the Corporation has received properly executed lien waivers from all <br />contractors, subcontractors and suppliers for materials, goods and services previously paid from the <br />Construction Account. <br /> <br />(5) That there are attached hereto receipts showing payments for those items of Qualified <br />Project Costs requested to be reimbursed to the Corporation and bills or invoices indicating <br />payments due for those items of Qualified Project Costs to be paid to a person or company other <br />than the Corporation. <br /> <br />Dated: <br /> <br />,20_. <br /> <br />Sincerely, <br /> <br />OAK GROVE LUTHERAN SCHOOL <br /> <br />By: <br /> <br />Authorized Corporate Representative <br /> <br />A-3 <br />