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DocuSign Envelope ID: D46D7F52-794F-4099-9ED2-B904C7A8FE19 <br />Ron DeSands <br />GOVERNOR <br />Attachment I -D <br />DE4) <br />Agreement # P0359 <br />Ken Lawson <br />EXECUTIVE DIRECTOR <br />FLORIDA DEPARTMENTd <br />ECONOMIC OPPORTUNITY <br />GRANT AGREEMENT FINAL CLOSEOUT FORM <br />FLAIR Contract ID: <br />Description of Recipient Income <br />Source <br />Amount <br />Recipient Name: <br />Balance <br />Contract Amount <br />Description and Serial <br />VendorID: <br />Acquisitions <br />Deobliated Funds <br />$0.00 <br />Contract End Date: <br />$0.00 <br />Final Contract Amount <br />Section A: Financial Reconciliation <br />1. Total Recipient Funds Received from DEO <br />2. Total Recipient Expenditures <br />3. Balance of Unexpended Program Income from Section R <br />4. If negative, this amount must be refunded to the Department. If positive, this amount is to be remitted to the <br />Recipient. <br />• There was no recipient income earned under this contract. <br />• The following recipient income was earned under this contract. <br />Description of Recipient Income <br />Source <br />Amount <br />Expended <br />Balance <br />Description of Proparty Inventory <br />Description and Serial <br />Quantitv <br />Acquisitions <br />Total Program Income <br />$0.00 <br />$0.00 <br />$0.00 <br />C_..«,._ / . n_..-.- 1--_ . <br />• No tangible property was purchased in the contract period. <br />• All non -expendable and non -consumable tangible property having a useful life of more than one year and acquired at a <br />cost of $1,000 or more per unit with grant funds are listed below. I do hereby certify that the property inventory described <br />below is complete and correct. Notification will be sent immediately to the Department of Economic Opportunity if any <br />changes occur to this inventory. I will not destroy, sell, or otherwise dispose of this prop" without written permission of <br />the Department. <br />Description of Proparty Inventory <br />Description and Serial <br />Quantitv <br />Acquisitions <br />Condition <br />Location <br />Number <br />Cost Date <br />By signing below, I certify, that the above representations for Financial Reconciliation, Recipient Income, and Property Inventor• are <br />true and accurate. <br />Name: <br />Signature: <br />Title: <br />Date Signed: <br />Section E: DEO Internal Review and Approval <br />By signing below, I certify, that the above representations for Financial Reconciliation, Recipient Income, and Property Inventory are <br />true and accurate. <br />Name, Signature: <br />Page 32 of 37 <br />Rev.5/30/19 <br />