ENVH RefundHarnett
COUNTY
NORTH CAROLINA
Account Number:
Project Number:
Vendor Name:
Vendor Number:
Remittance Address:
Date: May 4, 2016
COUNTY OF HARNETT
CHECK REQUEST FORM
110-0000-345.18-00
Cates Building Inc.
639 Executive Place, Suite 400
Fayetteville, NC 28305
FX Mail to payee
El Check to be picked up by:
(Requires approval of Finance Officer)
Approved: _ Disapproved:
Reason for check request: Customer will not pursue at this time. No confirmation or site visit made.
This check request has been examined by me and is hereby approved for payment.
Department Head or Authorized Designee Date
Graham H. Byrd, R.E.H.S.
s i trument has been
preaudited in the manner required
by the Local Government Budget
and Fiscal Control Act
Harnett County Finance Director
Description
Amount
ENVH Soil Evaluation Fee
$ 750.00
HTE # 15-5-37481
Location: 792 Juno Drive
Pointe Lt. 155
i—TTingen
Total Amount Due
$ 750.00
Reason for check request: Customer will not pursue at this time. No confirmation or site visit made.
This check request has been examined by me and is hereby approved for payment.
Department Head or Authorized Designee Date
Graham H. Byrd, R.E.H.S.
s i trument has been
preaudited in the manner required
by the Local Government Budget
and Fiscal Control Act
Harnett County Finance Director