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[null,"Instructions:  For the first request fill out the blue and yellow cells.  After the first request blue cells may be modified if needed."]
[null,"When creating any new requests after the first, simply select the \"Create New Request\" Button"]
[null,"The \"Create New Request\" Button will update the blue cells -Macros must be enabled!!!!"]
[null,"(c) and (d) columns may be labeled and used for other current expenses if needed"]
[]
[null,"OUTLAY REPORT AND REQUEST FOR REIMBURSEMENT FOR CONSTRUCTION PROGRAMS (90%)"]
[]
[]
[null,"  1.  TYPE OF REQUEST",null,null,"PARTIAL","  2.  PARTIAL PAYMENT REQUEST NUMBER"]
[null,null,null,null,"FINAL",1]
[null,"3.  FEDERAL SPONSORING AGENCY AND ORGANIZATIONAL ELEMENT TO WHICH THIS REPORT IS SUBMITTED",null,null,null,"4.  STATE BLOCK GRANT PROJECT NUMBER ASSIGNED BY MoDOT"]
[]
[null,"Missouri Department of Transportation"]
[]
[null,"  5.  EMPLOYER IDENTIFICATION NUMBER",null,null,null,"  6.  PERIOD COVERED BY THIS REPORT"]
[null,null,null,null,null,"FROM",null,"TO"]
[null,null,null,null,null,"(Month, Day, Year)",null,"(Month, Day, Year)"]
[]
[null,"  7.  RECIPIENT ORGANIZATION",null,null,null,"  8.  PAYEE (Where check should be sent if different than Item 7)"]
[null,"  Name:  ",null,null,null,"  Name:  "]
[null,"  Address:  ",null,null,null,"  Address:  "]
[null,"  City:  ",null,null,null,"  City:  "]
[null,"  State:  ",null,null,null,"  State:  "]
[null,"  Zip:  ",null,null,null,"  Zip:  "]
[null,"9.  STATUS OF FUNDS"]
[null,"CLASSIFICATION",null,null,"PROGRAMS-FUNCTIONS-ACTIVITIES",null,null,null,"TOTAL"]
[null,null,null,null,"(a)   ","(b)","(c)","(d)"]
[null,null,null,null,"Previous Expenses","Current Expenses"]
[null,null,null,null,"(Total Column)"]
[null,"a.  Administrative expense",null,null,0,0,null,null,{"$f":"SUM(E30:H30)","v":0}]
[null,"b.  Preliminary expense",null,null,0,0,null,null,0]
[null,"c.  Land acquisition (survey, title, etc.)",null,null,0,0,null,null,0]
[null,"d. Engineering-planning basic fees  ",null,null,0,0,null,null,0]
[null,"e.  Engineering-design basic fees",null,null,0,0,null,null,0]
[null,"f.  Engineering-project inspection fees",null,null,0,0,null,null,0]
[null,"g.  Land as match",null,null,0,0,null,null,0]
[null,"h.  Relocation expense",null,null,0,0,null,null,0]
[null,"i.  Relocation payments to individuals  and businesses",null,null,0,0,null,null,0]
[null,"j.  Demolition and removal",null,null,0,0,null,null,0]
[null,"k.  Construction and project improvement cost",null,null,0,0,null,null,0]
[null," l.   Equipment",null,null,0,0,null,null,0]
[null,"m.  Miscellaneous cost",null,null,0,0,null,null,0]
[null,"n.  Total cumulative to date (a thru m)",null,null,0,{"$f":"SUM(F30:F42)","v":0},{"$f":"IF(SUM(G30:G42)=0,\"\",SUM(G30:G42))","v":""},{"$f":"IF(SUM(H30:H42)=0,\"\",SUM(H30:H42))","v":""},{"$f":"SUM(I30:I42)","v":0}]
[null,"o.  Federal share requested (90% of n)",null,null,0,{"$f":"ROUNDDOWN(0.9*F43,0)","v":0},{"$f":"IF(G43=0,\"\",ROUNDDOWN(0.9*G43,0))","v":""},{"$f":"IF(H43=0,\"\",ROUNDDOWN(0.9*H43,0))","v":""},0]
[]
[null,"10. CERTIFICATION: I certify that to the best of my knowledge and belief the billed costs or disbursements are in accordance with the terms of the project and that the reimbursement represents the Federal share due which has not been previously requested and that an inspection has been performed and all work is in accordance with the terms of the award."]
[]
[]
[]
[null,"RECIPIENT",null,null,null,"SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL",null,null,"DATE SIGNED"]
[]
[]
[null,null,null,null,null,"TYPED OR PRINTED NAME AND TITLE",null,null,"TELEPHONE"]
[]
[]
[null,null,null,null,null,null,null,null,"FORM 271 (1/13/16)"]

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