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EXHIBIT C <br /> ENABLE DISBURSEMENT REQUEST COVER SHEET <br /> Arkansas Natural Resources Division <br /> Recipient: <br /> Employer ID No.: _ <br /> En ABLE Project Number: Project Percent Complete: <br /> Loan Number(s): Request Number: <br /> Please list all invoices submitted in EnABLE for reimbursement by company <br /> Itmoim { Eligible Amount <br /> No Name Number tnvoice Date invoice Amount requested for <br /> reimbursement <br /> IS <br /> 2 <br /> 3 <br /> 4 <br /> 5 <br /> 6 <br /> � 7 <br /> 8 <br /> 9 <br /> 10 <br /> 11 <br /> 12 <br /> 13 <br /> 14 <br /> 15 <br /> 16 <br /> 17 <br /> 18 <br /> 19 <br /> 20 <br /> 21 <br /> 22 <br /> 23 <br /> 24 <br /> 25 <br /> 26 <br /> 27 -- <br /> 28 <br /> 29 <br /> 30 <br /> TOTAL $ <br /> Speat�re afConwnmyinrmee mt Consu4am once sere:: <br /> 1 certify that to the best of my knowledge,the invoices listed above and submiled for <br /> reimbursement in EnABLE accurately reflect the total eligible amount due to date and that <br /> all costs requested are in accordance with the terms of the bond purchase agreement,loan ryp ym u se-Kprenew.maer <br /> agreement or grant agreement and relevant regulations. I further certify that all work has <br /> been inspected and performed in accordance with program requirements. <br /> brad eao¢s <br /> C-I <br />