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r r <br />OCTA Project Title: <br />Agency: <br />COOPERATIVE AGREEMENT NO. C-1-2447 <br />EXHIBIT C <br />INVOICE TEMPLATE <br />To: Orange County Transportation Authority <br />550 S Main Street <br />P,O, Box 14184 <br />Orange, CA 92863-1584 <br />Attn: Adriann Cardoso <br />Date: <br />Invoice Number <br />Invoice Date <br />Approved FTA 5307 <br />Actual Local Match 0% <br />Tota i <br />QualititylDate Description Unit Price FTA 5307 Funds <br />Expended Cumulative <br />Invoice Number 'Date IFTA 5307 FTA 5307 <br />$ 500.000 <br />1 $ - $ 500,000 <br />2 $ - $ 500,000 <br />3 $ - $ 500,000 <br />1 hereby certify that the statements provided here are true and correct regarding the <br />Project. <br />The invoice is a true, complete and correct statement of work performed, reimbursable costs and <br />progress; <br />The backup information included with the invoice is true, complete and correct in all material <br />respects. <br />Signed Date <br />" This is a template. City/County can develope their own from as long as all the relavent <br />infromation is present <br />25K-31