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