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,c <br /> <br />ALAMEDA COUNTY CONGESTION MANAGEMENT AGENCY <br />TRANSPORTATION FUND FOR CLEAN AIR (TFCA) PROGRAM <br />REQUEST FOR REIMBURSEMENT OF FUNDS <br />FY 01/02 <br />Please attach documents for all expenditures. <br />Acceptable documentation includes time sheets, purchase orders, invoices, etc. <br />Project Sponsor: <br />Project Title: <br />Project ID# (i.e. 99-ALA-33): <br />Total TFCA Funds programmed to the project: $ <br />Amount of funds requested for reimbursement :$ <br />Total of previous reimbursements: $ <br />To the best of my knowledge, the above information is true and correct and I am authorized to <br />request this reimbursement of funds. <br />Name & Title: <br />Signature: <br />To be completed by the CMA only <br />Approval : Amount $: <br />Check Number: Check Date: <br />Date: <br />Guarantee or Discretionary <br />Comments: <br />