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FLORIDA DIVISION OF EMERGENCY MANAGEMENT <br />2021-2022 EMERGENCY MANAGEMENT PREPAREDNESS AND ASSISTANCE GRANT - EMPA <br />DIVISION FORM 2B - DETAIL OF CLAIMS <br />SALARIES AND BENEFITS COSTS <br />SALARY DEFINITION: The cash compensation for services rendered by a regular employee in an <br />established position for a specific period of time. <br />RECIPIENT:1 Florida County CLAIM #: <br />DOES THIS CLAIM FOR REIMBURSMENT INCLUDE ANY INCENTIVES OR SPECIAL PAY? <br />Note: ff this claim includes incentives or special pay, please provide the Division w ith the w ritten established policy forsuppo <br />%TIME FRINGE <br />EM EMPLOYEE NAME EM POSITION TITLE CHARGED TO SALARY BENEFITS <br />EMPA <br />1 Ex: Jane Doe EM Planner 50% $ 5,000.00 $ 1,200.00 <br />2 <br />3 <br />4 <br />5 <br />6 <br />7 <br />8 <br />9 <br />10 <br />11 <br />12 <br />13 <br />14 <br />15 <br />16 <br />17 <br />18 <br />19 <br />20 <br />TOTALS $ 5,000.00 $ 1,200.00 <br />TOTAL $ 6,200.00 <br />By signing this report, I certify to the best of my knowledge and belief tha t the report is true, complete, <br />accurate and the e)renditureA disbursements and cash receipts are for the purposes and objectives set forth In <br />the conditions of the 2021-2022 EM PA agreement. <br />SIGNATURE <br />AUTHORIZED REPRESENTATIVE <br />PRINTED NAME <br />TITLE -1 <br />DATE1 <br />65 <br />