Laserfiche WebLink
DIVISION OF EMERGENCY MANAGEMENT <br /> EMERGENCY MANAGEMENT PERFORMANCE GRANT = EMPG 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 . Organizational Costs $0 . 00 <br /> 2 . Planning Costs $0 . 00 <br /> 3 . Training Costs $0 . 00 <br /> 4 . Exercise Costs $0 . 00 <br /> 5 . Equipment Costs $0 . 00 <br /> 6 . Management and AdministrationCosts $0 . 00 <br /> (limited to 5% of the total award) <br /> TOTAL $0 . 00 $0 . 00 $0 . 00 $0 . 00 <br /> TOTAL AMOUNT TO BE PAID ON THIS INVOICE $ 0 . 00 <br /> EMPG MATCH <br /> Federal funds provided under this Agreement shall be matched by the Recipient dollar for dollar from non -federal funds . NOTE : <br /> If the <br /> amount entered below is NOT EMPA, provide appropriate back-up/supporting documentation . <br /> MATCH EMPA LOCAL IN -KIND OTHER NON -FEDERAL <br /> I 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 EMPG ( Federal ) Amount <br /> Prior Payments <br /> This Payment <br /> Unexpended Funds <br />