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CITY OF EL CERRITO REQUEST FOR PAYMENT Request for Payment FIN-81 (Rev. 12/19/04) Request for Payment FIN Use this form to request any payment not covered by invoice or Purchase Order, or to an employee as a reimbursement or advance. DATE PAYABLE TO PROCESSING INSTRUCTIONS (check all that apply) NAME DATE/TIME NEEDED VENDOR NUMBER ADDRESS WILL PICK UP – NAME OF PERSON Need a Separate Check CALL WHEN READY – PHONE CITY/STATE/ZIP THIS IS A 1099 VENDOR – TAX ID# Attachments Provide explanation below. Print, sign, attach documentation and forward to Finance, MS 06. INV. NO. (Opt.) DESCRIPTION ACCOUNT NO. AMOUNT TOTAL $0.00 DESCRIPTION OF EXPENDITURE (who, what, when, where, why) I certify this is for official business and is a true and correct statement. Authorize expenditure of budgeted funds. Approval of adequate documentation. REQUESTOR’S SIGNATURE DEPARTMENT AUTHORIZATION FINANCE AUDIT Request for Payment (rev. 7/1/2013) $ 0.00 SIGN