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EXHIBIT A <br />PROGRESS REPORT FORM <br />DEP Agreement No.: LP 0019 <br />Project Title: North Sebastian Septic to Sewer Phase II <br />Grantee Name: <br />Grantee Address: <br />Grantee's Grant Manager: <br />Reporting Period: <br />Provide the following information for all tasks identified in the Grant Work Plan: <br />Summarize the work completed within each task for the reporting period. Provide an update on the estimated <br />completion date for each task and an explanation for any anticipated delays or problems encountered. Add or <br />remove task sections and use as many pages as necessary to cover all tasks. <br />The following format should be followed: <br />Task #: Task Title <br />• Progress for this reporting period: <br />• Identify any delays or problems encountered: <br />Task #: Task Title <br />• Progress for this reporting period: <br />• Identify any delays or problems encountered: <br />Indicate the completion status for the following tasks (if included in the Grant Work Plan): <br />• Design (Plans/Submittal): 30% ❑, 60% ❑; 90% ❑, 100% ❑ <br />• Permitting (Completed): Yes ❑, No ❑ <br />• Construction (Estimated): % <br />This report is submitted in accordance with the reporting requirements of the above DEP Agreement <br />number and accurately reflects the activities associated with the project. <br />Signature of Grantee's Grant Manager <br />Date <br />81 <br />