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ATTACHMENT I- REPORTING FORMS <br /> • <br /> FLORIDA DIVISION OF EMERGENCY MANAGEMENT <br /> 2020-2021 EMERGENCY MANAGEMENT PREPAREDNESS AND ASSISTANCE GRANT-EMPA <br /> DIVISION FORM 4-STAFFING DETAIL <br /> COUNTY EMERGENCY MANAGEMENT AGENCY <br /> ANTICIPATED SALARIES&BENEFITS <br /> SUB-RECIPIENT: I FL COUNTY 1 POINT OF CONTACT: I Jane Doe,Planner j PHONE/EMAIL:I '23-'23-'.234 <br /> EMPLOYEE INFORMATION ;. LOCAL STATE AND FEDERAL <br /> Employee Name Position The 8 Approx#of Annual % % $ % $ % <br /> Area of Re % <br /> Responsibility Rty Hrs.per week Total Salaries County Other EMPA EMPA EMPG EMPG HMGP Other Total <br /> # (Preparedness Response,Recovery, General <br /> Mrtigefion&Finance Denoted to EM &Benefits$ Planning State or <br /> actitities h'. Funtl Local Base Grant Base Grant Base Grant Base Grant Grant Federal All <br /> [71by Position (Local) Funds (State) (State) (Federal) (Federal) (State) Funds Funds <br /> 121 [31 [4] [5] [6] [7] [8] [31 [10] [11] [1�] <br /> 1 Ex.Jane Doe,Director,ALL 40 $ 60,000.00 "r 50% $30,000.00 50% $30,000.00 <br /> 100% <br /> 2 <br /> 3 $ - $0.00 0% <br /> 4 $ - $0.00 0% <br /> 5 $ .. $0.00 0% <br /> 6 $ - $0.00 0% <br /> $ - $0.00 0% <br /> 7 <br /> 8 $ - $0.00 0% <br /> $ - $0.00 0% <br /> 9 <br /> 10 $ - $0.00 0% <br /> 11 $ - $0.00 0% <br /> 12 1 $ - $0.00 0% <br /> 13 $ - $0.00 0% <br /> 14 $ - $0.00 0% <br /> s $ - $0.00 0% <br /> 16 $ - $0.00 0% <br /> 17 $ - $0.00 0% <br /> $ - $0.00 0% <br /> 17 <br /> 190 $ - $0.00 0% <br /> 20 $ - $0.00 0% <br /> $ - $0.00 0% <br /> TOTAL $30,000,00 530,000.00 <br /> DIRECTIONS: <br /> 1. In Column#1,list the name,position title and area of responsibility(s)for all Emergency Management staff,regardless if paid through grant funding. <br /> 2. In Column#2,enter the amount of anticipated hours worked per week for grant related activities for each EM position. <br /> 3. In Column#3,list total anticipated annual amount of Salaries and Benefits to be paid for each EM position. <br /> 4. In Columns#4-11,provide the funding distribution(%or$)in each applicable column. - -- <br /> 5. Column#12 calculates the sum of percentages entered in Columns 4-11 and must equal 100%of the anticipated annual salaries and benefits per EM position. <br /> 6. Please provide to the Division updates or revisions to this form throughout the period of the agreement,as necessary. <br /> 7. This form is to be submitted to the Division along with the 1st Quarter submission,or by November 15,2020,whichever occurs first. <br /> 63 <br />