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Does the hotel receipt have a zero balance? If applicable, have a travel authorization and <br />travel reimbursement form been included to account for per diem, mileage and other <br />travel expenses which have been reimbursed to the traveler by sub grantee? <br />2. If travel is a conference has the conference agenda been included? <br />3. Has proof of payment to traveler been included? (E.g. canceled check, Electronic Funds <br />Transfer (EFT) confirmation, or copy of payroll check if reimbursed through payroll). <br />Organization <br />❑ 1. If billing for overtime and backfill, has a spreadsheet been provided that lists attendee <br />names, department, and #of hours spent at EOC, hourly rate and total paid to each <br />attendee? Have print outs from entity's financial system been provided to prove <br />attendees were paid? For backfill, has a clear delineation/cross reference been provided <br />showing who was backfilling who? <br />Matching Funds <br />1. Contributions are from Non Federal funding sources. <br />2. Contributions are from cash or in-kind contributions which may include training <br />investments. <br />3. Contributions are not from salary, overtime or other operational costs unrelated to <br />training. <br />For All Reimbursements - The Final Check <br />❑ 1. Have Forms 3, 4a, 4b and 4c been completed and included with each request for <br />reimbursement? <br />❑ 2. Have the costs incurred been charged to the appropriate POETE category? <br />❑ 3. Does the total on Form 3 match the totals on Forms 4a, 4b and 4c? <br />❑ 4 Has Form 3 been signed by the Grant Manager? <br />❑ 5. Has the reimbursement package been entered into sub grantee's records/spreadsheet? <br />❑ 6. Have the quantity and unit cost been notated on Form 4b? <br />STATE OF FLORIDA <br />INDIAN RIVER COUNTY <br />THIS IS TO CERTIof r HAT THI -, 8 <br />A TRUE AND CO CT COP <br />THE ORIGINAL • IN <br />OFFICE. , <br />T'�..5 TN �(3�� <br />A --„0•240,-.6,,A01_4” <br />, :P - <br />DATE <br />39 <br />