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DIVISION OF EMERGENCY MANAGEMENT <br /> EMERGENCY MANAGEMENT PREPAREDNESS AND ASSISTANCE GRANT - EMPA BASE GRANT <br /> QUARTERLY FINANCIAL REPORT <br /> Form 1 <br /> GRANTEE : Claim # <br /> County Name : <br /> Address : ( Select the quarter of submission ) <br /> QUARTERLY REPORTING DUE DATES <br /> July 1 - September 30 - Due no later than October 31 <br /> Point of Contact : October 1 - December 31 - Due no later than January 31 <br /> Telephone # : January 1 - March 31 - Due no later than April 30 <br /> AGREEMENT # April 1 - June 30 - Due no later than July 31 <br /> THIS IS A REQUIRED DOCUMENT AND MUST BE SUBMITTED QUARTERLY <br /> CUM . FUNDS REMAINING <br /> CUMULATIVE TOTAL ALLOCATED CURRENT CLAIM EXPENDED BALANCE <br /> 1 . Salary and Benefits $0 . 00 <br /> 2 . Other Personal /Contractual Services $0 . 00 <br /> 3 . Expenses $0 . 00 <br /> 4 . Operating Capital Outlay (OCO) $0 . 00 <br /> 5 . Fixed Capital Outlay (FCO ) $0 . 00 <br /> TOTAL $0 . 00 $0 . 00 $0 , 001 $0 . 00 <br /> TOTAL AMOUNT TO BE PAID ON THIS INVOICE $ 0 . 00 <br /> 1 hereby certify that the above costs are true and valid costs incurred in accordance with the project agreement. <br /> Signed : <br /> Contract Manager or Financial Officer Date <br /> QUARTERLY STATUS REPORT <br /> This information must be clearly linked to the project TIMELINE , DELIVERABLES AND THE SCOPE OF WORK . <br /> Report events , progress , delays , etc , that pertain to this project. <br /> (Attach additional page (s) if needed . ) <br /> THIS SECTION BELOW IS TO BE COMPLETED BY DEM WITH EACH QUARTERLY FINANCIAL PAYMENT <br /> Total EMPA ( State ) Amount <br /> Prior Payments <br /> This Payment <br /> Unexpended Funds <br />