Connecting, Strengthening and Scaling Food Supply Chains in the Northwest and Rocky Mountain Region

Subaward Invoice Form

(CSU Subaccount vendor invoicing will be a separate form)

MM slash DD slash YYYY


Project Costs ($)
Enter the applicable amounts in the boxes below.

By signing this report, I certify to the best of my knowledge and belief that the report is true, complete, and accurate, and the expenditures, disbursements and cash receipts are for the purposes and objectives set forth in the terms and conditions of the Federal award. I am aware that any false, fictitious, or fraudulent information, or the omission of any material fact, may subject me to criminal, civil or administrative penalties for fraud, false statements, false claims or otherwise. (U.S. Code Title 18, Section 1001 and Title 31, Sections 3729-3730 and 3801-3812).
Subrecipient authorized representative name(Required)
MM slash DD slash YYYY
This field is for validation purposes and should be left unchanged.

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