RDA Agmt 2009 Scribner Family Partnership Ltd

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Exhibit D FORM OF REQUISITION Requisition No. Reference is made to that certain Owner Participation and Loan Agreement, dated as of , 20_ (the "Agreement"), between the Redevelopment Agency of the City of San Leandro, a public body, corporate and politic ("Agency") and Scribner Family Partnership, Ltd. a California Limited Partnership ("Owner") pursuant to which Agency agreed to provide a loan in the maximum amount of Eighty-Five Thousand Dollars ($85,000.00). Capitalized terms used and not otherwise defined shall have the meanings set forth in the Agreement. The Owner requests a disbursement of funds in the amount of $ for payment of reimbursable costs for the Project in accordance with the provisions of the Agreement. The supporting documents (invoices, receipts, billing statements) attached to this requisition are true, complete and correct copies of original documents provided by third parties for work authorized by the Agreement. The disbursement of the amount specified above, when added to all previous disbursements of funds for the Project, will total the sum of $ of Agency funds provided for the Project. The balance of Loan funds available after disbursement of funds requested pursuant to this Requisition is $ The undersigned hereby certifies that the statements set forth in this Requisition are true, complete and correct, and that the disbursement of funds requested hereby conforms to the requirements of the Agreement. Dated: , 20_ Scribner Family Partnership, Ltd. a California Limited Partnership dba Scribner Properties By: Garvco Management, LLC a California limited liability company Its: General Partner By: Approved: Robert H. Scribner, Manager Authorized Representative of Agency 1172395-2 24 Commercial Rehabilitation Loan Program Owner Participation and Loan Agreement Form: 12-3-08