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DIVISION OF EMERGENCY MANAGEMENT <br /> FINANCIAL HISTORY REPORT/QUARTERLY STATUS REPORT <br /> FORM 1 AND 2- <br /> GRANTEE : (Select the quarter of submission along with year) <br /> �+ <br /> QUARTERLY REPORTING DUE DATES <br /> r JANUARY 1 - MARCH 31 - Due no later than April 30, N/A <br /> 1 APRIL 1 - JUNE 30 - Due no later than July 31 , - N/A <br /> AGREEMENT # r JULY 1 - SEPTEMBER 30 - Due no later than October 31 , N/A <br /> {` OCTOBER 1 - DECEMBER 31 - Due no later than January 31 , NIA <br /> FINANCIAL HISTORY REPORT <br /> THIS IS A REQUIRED DOCUMENT AND MUST BE SUBMITTED QUARTERLY <br /> TOTAL . QUARTERLY FUNDS CUM . FUNDS REMAINING <br /> CUMULATIVE ALLOCATED EXPENDED EXPENDED BALANCE <br /> 1 . Planning Costs $0 . 00 6 $0 . 00 $0 . 00 $0 . 00 <br /> 2 . Training Costs $0 . 00 $0 . 00 $0 . 00 $0 . 00 <br /> 3 . Exercise Costs $0 . 00 $0 . 00 $0 . 00 $0 . 00 <br /> 4 . Equipment Costs $0 . 00 $0 . 00 $0 . 00 $0 . 00 <br /> 5 . Management and Administration <br /> Costs ( limited to 5% of the total award ) $0 . 00 $0 . 00 $0 . 00 $0 . 00 <br /> TOTAL EXPENDITURES $0 . 00 $0 . 00 $0 . 00 $0 . 00 <br /> TOTAL PAYMENTS PREVIOUSLY RECEIVED <br /> EMPG MATCH <br /> Federal funds provided under this Agreement shall be matched by the Recipient dollar for dollar from non-federal funds . NOTE : Must <br /> provide appropriate b ck-up/s6pporting documentation for each reimbursement claim . <br /> MATCH EMPA LOCAL OTHER NON -FEDERAL <br /> CUMMLATIVE TOTAL REMAINING <br /> Planning , Training , Exercise, Equipment, M &A ALLOCATED QUARTERLY FUNDS CUM . FUNDS BALANCE <br /> EXPENDED EXPENDED <br /> TOTALS1 $0 . 00 $0 . 00 $0 . 00 $0 . 00 <br /> 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 ISA REQUIRED DOCUMENT AND MUST BE SUBMITTED QUARTERLY <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 /> t <br /> TO BE COMPLETED BY FDEM STAFF <br /> DATE SUBMITTED TO FDEM <br /> Copy of CCP Report Form 2013 <br />