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LAND billing form- Rocky Hill_RedactedLocal Acquisitions for Natural Diversity (LAND) Program BILLING FORM Municipality: Northampton LAND Project #:.24 Contract: CT ENV 110719 0000 0000001507 Project Name:Rocky Hill Greenway-Nashawannuck Northampton Indicate any changes that may have affected answers to questions in your original LAND application previously submitted to the Division of Conservation Services:NONE PROJECT COSTS EEA use only Item Cost($) Date of Expenditure Eligible? Proo/of navment? Acquisition $650,000 01/24/2020 Title exam(s) Recording fees Survey Project total $650,000 - Reimbursement rate: LAND award: Reimbursement request: 64% $400,000 (64% is $416,000, but cap is $400,000) $400,000Didyouapplyforotherstateorfederalfunding?No (not for purchase, we have MVP for restoration)Amountreceived- - - - -- Amountreceived=$-------- Agency: _ Agency:_ _ _ _ _ _ _ _ _ _ _ _ _ _KevinLake4/7/2020Signature of the Chair of theConservationCommissionPrintNameDate DCS use only: Reimbursement request received Approved/denied Reviewed Sent to fiscal office Further information requested ,_.. I I