Постановление Правительства Самарской области от 30.09.2016 № 565

|    |            |  начала  |                                                                                                              |

|    |            |реализации|                                                                                                              |

|    |            | проекта  |                                                                                                              |

+----+------------+----------+-----------+-----------+------------+---------------+---------------+---------------+-----------+-------------+

|    |            |          | Реквизиты |  Предмет  |   Объем    |   Реквизиты   |     Объем     |   Реквизиты   |   Объем   |    Объем    |

|    |            |          | договора  | договора  |обязательств|  документа,   |  выполненных  |  платежного   |  затрат   |запрашиваемых|

|    |            |          |           |           |по договору,|подтверждающего| обязательств  |  документа,   | согласно  | субсидий за |

|    |            |          |           |           |   рублей   |  выполнение   |   согласно    |подтверждающего|платежному |счет средств |

|    |            |          |           |           |            |мероприятия по |  документу,   |  понесенные   |документу, | областного  |

|    |            |          |           |           |            |   договору,   |подтверждающему|    затраты    |  рублей   |  бюджета,   |

|    |            |          |           |           |            |  номер, дата  |  выполнение   |               |           |   рублей    |

|    |            |          |           |           |            |               |мероприятия по |               |           |             |

|    |            |          |           |           |            |               |   договору,   |               |           |             |

|    |            |          |           |           |            |               |    рублей     |               |           |             |

+----+------------+----------+-----------+-----------+------------+---------------+---------------+---------------+-----------+-------------+

| 1. |            |          |           |           |            |               |               |               |           |             |

+----+------------+----------+-----------+-----------+------------+---------------+---------------+---------------+-----------+-------------+

| 2. |            |          |           |           |            |               |               |               |           |             |

+----+------------+----------+-----------+-----------+------------+---------------+---------------+---------------+-----------+-------------+

| 3. |            |          |           |           |            |               |               |               |           |             |

+----+------------+----------+-----------+-----------+------------+---------------+---------------+---------------+-----------+-------------+

|... |            |          |           |           |            |               |               |               |           |             |

+----+------------+----------+-----------+-----------+------------+---------------+---------------+---------------+-----------+-------------+

|     ИТОГО       |          |     Х     |     Х     |            |       Х       |               |       Х       |           |             |

+-----------------+----------+-----------+-----------+------------+---------------+---------------+---------------+-----------+-------------+

Дата ______________

____________________ _____________________ ___________________________

    (должность)            (подпись)              (И.О.Фамилия)

М.П. (при наличии)