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Il <br /> DIVISION.01 <br /> • GEMENT <br /> �NER9EN.C-Y-'MANAGEMENT,;PREPAREDNESS,A�ND;ASSIS ANdt!-b'KANT - <br /> R-TERLY:f.lt,,?k -R <br /> 'OUA <br /> NCIAL EPORT <br /> GRANTEE: Claim# <br /> County Name: <br /> Address: (Select the quarter of submission) <br /> QUARTERLY REPORTING DUE DATES <br /> July I —September 30—Due no later than October 31 <br /> Point of Contact: October 1—December 31-Due no later than January 31 <br /> Telephone M January I—March 31—Due no later than April 30 <br /> AGREEMENT# April I-June 30—Due no later than July 31 <br /> CUMULATIVE TOTAL ALLOCATED CURRENT CLAIM REMAINING BALANCE <br /> 1 Salary and Benefits <br /> 2. Other Personal/Contractual Services <br /> 3. Expenses <br /> 4. Operating Capital Outlay(OCO) <br /> 5. Fixed Capital Outlay(FCO) <br /> TOTAL <br /> TOTAL AMOUNT TO BE PAID ON THIS INVOICE <br /> I hereby certify that the above costs are true and valid costs incurred in accordance with the project agreement. <br /> Signed: <br /> Grantee Contract Manager or Financial Officer Date <br /> X�3 <br /> Ii,lkt, 1"N --QUARTERLY�:STATUVREP, 4T� <br /> A <br /> This information bel is required EACH QUARTER.'This information MUST be clearly linked <br /> to the project TIMELINE, DELIVERABLES AND SCOPE OF WORK. <br /> Report event,progress,delays,etc.,that pertain to this project(i.e., incidents,activities, meetings,reporting training and/or exercises) <br /> (Attach additional page(s)if needed.) <br /> THIS SECTION BELOW IS TO BE COMPLETED BY DEM WITH EACH QUARTERLY FINANCIAL PAYMENT <br /> Total EMPA(State)Amount <br /> Prior Payments <br /> This Payment <br /> Unexpended Funds <br /> 103 <br />