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DIVISION OF EMERGENCY MANAGEMENT <br />COUNTY <br />FY 2015-2016 <br />FOR EMPG FUNDED EMPLOYEES ONLY <br />FORM 3 <br />EMPG Staffing Detail <br />Name & Position Title <br />[1] <br />Approx # of hrs/Week <br />Devoted to EM Activities <br />[2] <br />Annual Total Salaries & <br />Benefits by position <br />[3] <br />% EMPG Base <br />Grant (Federal) <br />[4] <br />DIRECTIONS STAFFING DETAIL: <br />1 In column 1 list titles and name of ALL EMPG funded staff <br />2. Complete column 2 for each position. <br />3. In column 3 list total anticipated annual amount of Salaries and Benefits to be paid for each position. <br />4 In columns 4, provide the funding distribution (%) for the amount in column 3. <br />EMPG Exercise(s) Per Quarter <br />EMPG Training <br />Has the employee received certificate/completed <br />the following (yes or no) <br />NIMS IS <br />100 <br />NIMS IS NIMS IS <br />200 700 <br />NIMS IS <br />800 <br />Name & Position Title <br />[1] <br />Date <br />[2] <br />Description of Exercise <br />[3] <br />DIRECTIONS. <br />1 In column 1, list name and titles of Emergency Management staff that is funded with EMPG <br />2. In column 2, date of Exercise(s) employee participated in <br />3. In column 3, a brief description of the exercise(s) EMPG employee participated in <br />