This is to certify that the following expenditure(s) were required to complete the work, which was recommended by the Virginia Department of Forestry.
SECTION 1 – Project Information
State-Owned Land Project Number:	IFRIS Tract Number:
Project Type:
SECTION 2 – Owner Information
Name:
Address:
City:	State:	Zip:
E-mail:	Daytime Phone:
SECTION 3 – Expense Information
Personnel – Name or Group	Unit	Rate	Amount
1.	35.00	$
2.	35.00	$
3.	35.00	$
4.	35.00	$
Subtotal	$
Equipment – Type	Unit	Rate	Amount
1.	$
2.	$
3.	$
4.	$
Subtotal	$
Materials – Item	Unit	Rate	Amount
1.	$
2.	$
3.	$
Subtotal	$
Contractual Service – Name	Unit	Rate	Amount
1.	$
2.	$
3.	$
Subtotal	$
Grand Total	$
SECTION 4 – VDOF Approval
I certify that the information provided for this project is complete and accurate.
Forester Name (Print)	Forester Signature	Date
State Lands Coordinator Name (Print)	State Lands Coordination Signature	Date
VDOF Headquarters Office/Finance Use Only
Cost Code:	Approved for Payment:	Date: