Rural Integrated

Roads for Growth

Capital Programs

Application for Grant Payment

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Use an account to return to saved work.

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

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

Eligible Costs

$0.00

Description of Invoice 2

Total of Invoice 2
(Include PST and GST)

GST on Invoice 2

Eligible Costs

$0.00

Description of Invoice 3

Total of Invoice 3
(Include PST and GST)

GST on Invoice 3

Eligible Costs

$0.00

Description of Invoice 4

Total of Invoice 4
(Include PST and GST)

GST on Invoice 4

Eligible Costs

$0.00

Description of Invoice 5

Total of Invoice 5
(Include PST and GST)

GST on Invoice 5

Eligible Costs

$0.00

Description of Invoice 6

Total of Invoice 6
(Include PST and GST)

GST on Invoice 6

Eligible Costs

$0.00

Description of Invoice 7

Total of Invoice 7
(Include PST and GST)

GST on Invoice 7

Eligible Costs

$0.00

Description of Invoice 8

Total of Invoice 8
(Include PST and GST)

GST on Invoice 8

Eligible Costs

$0.00

Description of Invoice 9

Total of Invoice 9
(Include PST and GST)

GST on Invoice 9

Eligible Costs

$0.00

Description of Invoice 10

Total of Invoice 10
(Include PST and GST)

GST on Invoice 10

Eligible Costs

$0.00

For claims with more than 10 invoices, RMs may do the following:

Submit multiple Application for Grant Payments;

Submit a single "invoice" that is a sum of similar invoices (ex. engineering). In addition to providing invoices, a summary table of the calculation of the summed invoices shall be submitted.

Example calculation of summed invoices:

Invoice Description	Total of Invoice	GST on Invoice	Eligable Cost
Invoice 1	$105,000	$5,000	$100,000
Invoice 2	$210,000	$10,000	$200,000
Invoice 3	$315,000	$15,000	$300,000
Total:	$630,000	$30,000	$600,000

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 Enhancement Program (MEEP);
Municipal Revenue Sharing Program (MRS); or
Rural Integrated Roads for Growth (RIRG) Program. *

Yes

If Yes, what is the value of funding from the Other source? *