Laserfiche WebLink
<br />EXHIBIT A <br /> <br />FORM OF REQUISITION <br /> <br />Requisition No. _ <br /> <br />Reference is made to that certain Reimbursement Agreement, dated as of , 2007 <br />(the "Agreement"), between the Redevelopment Agency of the City of San Leandro, a public body, <br />corporate and politic ("Agency") and the John Benjamin Company, a California corporation ("Developer"). <br />Capitalized terms used herein and not otherwise defined shall have the meanings set forth in the <br />Agreement. <br /> <br />The Developer requests a disbursement of funds in the amount of $ for payment of <br />reimbursement costs for the Project in accordance with the provisions of the Agreement. The supporting <br />documents (invoices, receipts, billing statements) attached to this requisition are true and correct. <br /> <br />The disbursement of the amount specified above, when added to all previous disbursements of <br />funds, will result in not more than $ of funds from the Agency used to payor reimburse Developer <br />for reimbursement costs incurred by Developer in connection to the Project. The balance of funds after <br />disbursement of funds requested pursuant to this requisition is $ <br /> <br />The disbursement of funds requested by this Requisition No. <br />of the Agreement. <br /> <br />is in conformity with the requirements <br /> <br />DATE <br /> <br />[Authorized Officer of the Developer] <br /> <br />Approved: <br /> <br />Authorized Representative of Agency <br /> <br />936278v1 <br /> <br />A-1 <br /> <br />Reimbursement Agreement <br />Form of Requisition <br />