subject_line
Rural Integrated
Roads for Growth
Capital Programs
Application for Grant Payment
Applicant Information:
Rural Municipality of
*
No.
*
Date of Claim:
*
+
Municipality's Email Address:
*
Project Description:
*
Claim Information:
Program for Claim:
*
Road Construction Program
Bridge and Large Diameter Culvert Program
Have Community Benefits been assessed for this Project
*
Yes
No
This project did not include Community Benefits
Payment Type Requested:
*
Progress Payment: the project is still in progress.
Release of Holdback: The project has been completed to the satisfaction of the Engineer and the Engineer's Acceptance letter and/or Certificate of Completion is attached.
Upload Letter of Acceptance and/or Certificate of Completion:
*
Detailed Summary of Costs:
Number of Invoices to Claim:
(10 maximum per claim)
*
Summary of Invoices:
Description of Invoice 1
Total of Invoice 1
(Include PST and GST)
GST on Invoice 1
Eligable Costs
$
0.00
Calculate
Description of Invoice 2
Total of Invoice 2
(Include PST and GST)
GST on Invoice 2
Eligible Costs
$
0.00
Calculate
Description of Invoice 3
Total of Invoice 3
(Include PST and GST)
GST on Invoice 3
Eligible Costs
$
0.00
Calculate
Description of Invoice 4
Total of Invoice 4
(Include PST and GST)
GST on Invoice 4
Eligible Costs
$
0.00
Calculate
Description of Invoice 5
Total of Invoice 5
(Include PST and GST)
GST on Invoice 5
Eligible Costs
$
0.00
Calculate
Description of Invoice 6
Total of Invoice 6
(Include PST and GST)
GST on Invoice 6
Eligible Costs
$
0.00
Calculate
Description of Invoice 7
Total of Invoice 7
(Include PST and GST)
GST on Invoice 7
Eligible Costs
$
0.00
Calculate
Description of Invoice 8
Total of Invoice 8
(Include PST and GST)
GST on Invoice 8
Eligible Costs
$
0.00
Calculate
Description of Invoice 9
Total of Invoice 9
(Include PST and GST)
GST on Invoice 9
Eligible Costs
$
0.00
Calculate
Description of Invoice 10
Total of Invoice 10
(Include PST and GST)
GST on Invoice 10
Eligible Costs
$
0.00
Calculate
Invoices:
Upload Invoices to Claim:
*
Other Funding Sources
Has your Municipality, or will your Municipality be receivng funding from a source that is
NOT
listed:
Federal Gas Tax Fund (GTF);
Municipal Economic Enhncacement Program (MEEP);
Municipal Revenue Sharing Program (MRS); or
Rural Integrated Roads for Growth (RIRG) Program.
*
No
Yes
If Yes, what is the value of funding from the Other source?
*