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<br />(2) That after the disbursement requested hereby, there shall be sufficient funds <br />remaining in the Project Fund to complete the Project. <br /> <br />(3) That each ofthe above items for which payment or reimbursement is requested is or <br />was necessary in connection with the above Project, and that none of such items has formed the basis <br />for any previous payment or reimbursement from the Project Fund. <br /> <br />(4) That the Corporation has received properly executed lien waivers from all contractors, <br />subcontractors and suppliers for materials, goods and services previously paid from the Project Fund. <br /> <br />(5) That there are attached hereto receipts showing payments for those items of Cost <br />requested to be reimbursed to the Corporation and bills or invoices indicating payments due for those <br />items of Cost to be paid to a person or company other than the Corporation. <br /> <br />Dated: <br /> <br />,20_. <br /> <br />Sincerely, <br /> <br />HOSPICE OF THE RED RIVER VALLEY <br /> <br />By: <br /> <br />Authorized Corporate Representative <br /> <br />B-2 <br />