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-0 <br />�ucation Isl <br />Date: <br />CITY OF SANTA ANA <br />Housing & Neighborhood Development <br />20 Civic Center Plaza / V Floor / P.O. Box 1988 / M-26 / Santa Ana, CA 92702 <br />(714)667-2250 <br />NSP Rental Development Agreement <br />Townsend & Raitt, LP (Developer) <br />Property Address: <br />AMOUNT REQUESTED: <br />AMOUNT RETAINED: <br />AMOUNT DISBURSED: <br />PAYABLE TO: <br />REQUEST FOR FINAL PAYMENT <br />V OFFICE USE ONLY o <br />DEVELOPER <br />The undersigned CONTRACTOR: (1) Certifies that to the best of their knowledge, information and belief, the work summarized on the <br />attached invoice and covered by this Final Payment Request has been completed in accordance with all of the terms and conditions of <br />the NSP Rental Development Agreement; (2) Certifies that they have obtained all required building permits, inspections and approvals <br />for the work covered by this Final Payment Request. <br />Date Print Name / Title <br />Signature <br />CITY OF SANTA ANA <br />Based on site observations, the undersigned Senior Residential Construction Specialist (SRCS) certifies that to the best of their <br />knowledge, information and belief, the work summarized above and covered by this Final Payment Request has been completed in <br />accordance with the terms and conditions of the NSP Rental Development Agreement.. <br />Date Senior Residential Construction Specialist (Signature) <br />The undersigned certifies that to the best of their knowledge, information and belief, this Final Payment Request has been properly <br />prepared and documented and authorizes the disbursement of funds to cover the amount requested. <br />Date <br />Housing Programs Coordinator (Signature) <br />%—JU[I— —0� 1uI[W ILb. r-iojeci tonanuauon meet, Lien Release, Certificate of Final Inspection, Notice of Completion <br />May 2009 <br />