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;DIVISION'OF EMERGENCY'MANAGEINfENT ;; <br /> EPdiERGENCY ftl k,GEMENT-PREPAREQNESS ANIJ ASSISTAhlCE GRi4NT`=:.EMPA'BASE'GRANT: " <br /> ARTERLY FINANCIAL"REP <br /> GRANTEE: Claim# ` <br /> County Name: �I <br /> Address: <br /> (Select the quarter of submission) <br /> QUARTERLY REPORTING DUE DATES <br /> July 1 -September 30-Due no later than October 31 <br /> Point of Contact: October 1-December 31-Due no later than January 31 <br /> Telephone#: January 1-March 31-Due no later than April 30 <br /> AGREEMENT# April 1-June 30-Due no later than July 31 <br /> _ s THIS ISiA'REQUIRED:DO_CUMFNT AND:MUST BE,'SUB� ITTED`i "? <br /> illy. ,QUARTERLYw.- <br /> .�,-..= :,t�. h�'��`. �r "':s:�:'�i.- ve. rz .,S;AS-• h��' =¢:b. <br /> !, _...•. .. .'�l>. - ,. .. ..--. R-..�-v.':'%b;'2i�:-. _'J=�-:'S vi -_..w._i.._w 2:.«�%L -`5�'}=-L:•4::;3'.:.b_. :�Ls •.:'tc'''<!-+':�,��Ft::�4acr�ti:w:��'"� <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 /> EMAP <br /> TOTAL - -' -- - <br /> - j <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 /> e r�.: ':.;=` "•r,:�-�::.•�t "moi '.<;K'r=k: -;f..-;., - - <br /> #,. �: ' ;' QUARTERLY 3TATWSREPORT ,a, ;,�;Z �} '-� <br /> >5:�.{.' . r.i��J .�; xrc:�ws_ 4�`._-aco:.,>:u..._,rt.n':r.1:+�:7t.w�?rn•'�`S�c�-:.:ri:,:::�5:�3�'�•`,rr��ra?��f. �_at'Su+_`t�;•4i-7d .�R"�3c::.:i�.: <br /> This information below 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 /> 14 , :,t, , s. .L 4` t. .Y iY-'y, <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 /> Unex ended Funds <br /> .i <br /> 111 <br />