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A TRUE COPY <br />CERTIFICATION ON LAST PAGE <br />J.R. SMITH, CLERK <br />FY 2022 - 2023 EMPG AGREEMENT <br />ATTACHMENT H <br />REPORTING FORMS <br />FLORIDA DIVISION OF EMERGENCY MANAGEMENT .0 <br />2022-2023 EMERGENCY MANAGEMENT PERFORMANCE GRANT - EM PG BASE GRANT <br />DIVISION FORM 4 - STAFFING DETAIL <br />EMERGENCY MANAGEMENT AGENCY ANTICIPATED SALARIES AND BENEFITS <br />SUB -RECIPIENT: POINT OF CONTACT: Jane Doe, Planner <br />EMPLOYEE INFORMATION <br />LOCAL <br />STATE AND FEDERAL <br /># <br />Only funded Staff Name, Position Title <br />& <br />Area of Responsibility <br />(preparedness, Response, Recovery, <br />Aftation & Finance <br />f11 <br />Annual <br />Total Salaries <br />& Benefits $ <br />by Position <br />2 <br />% <br />County <br />General Fund <br />(Local) <br />3 <br />% <br />Other <br />Local <br />Funds <br />4) <br />% <br />EMPG <br />Base Grant <br />(State) <br />151 <br />$ <br />EMPG <br />Base Grant <br />(State) <br />161 <br />% <br />EMPA <br />Base Grant <br />(Federal) <br />$ <br />EMPA <br />Base Grant <br />(Federal) <br />181 <br />% <br />Total <br />All <br />Funds <br />9 <br />1 <br />Ex. Jane Doe, Director, ALL <br />$ 60,000.00 <br />50% <br />$ 30,000.00 <br />50% <br />$30,000.00 <br />100% <br />2 <br />$ - <br />$0.00 <br />0% <br />3 <br />$ <br />$0.00 <br />0% <br />4 <br />$ <br />$0.00 <br />0% <br />5 <br />$ <br />$0.00 <br />0% <br />6 <br />$ <br />$0.00 <br />0% <br />7 <br />$ <br />r $0.00 <br />0% <br />6 <br />$ <br />$0.00 <br />0% <br />9 <br />$ <br />$0.00 <br />0% <br />10 <br />$ <br />$0.00 <br />0% <br />11 <br />$ <br />$0.00 <br />0% <br />12 <br />$ <br />$0.00 <br />0% <br />13 <br />$ <br />$0.00 <br />0% <br />14 <br />$ <br />r $0.00 <br />0% <br />15 <br />$ <br />$0.00 <br />0% <br />16 <br />$ <br />$0.00 <br />0% <br />t7 <br />$ - <br />$0.00 <br />0% <br />16 1$ <br />- <br />$0.00 <br />0% <br />19 <br />$ <br />$0.00 <br />0% <br />20 <br />$ <br />$0.00 <br />0% <br />TOTAL <br />$ 30,000.00 <br />r $30,000.00 <br />DIRECTIONS: <br />1. In Column #1, list the name, position title and area of responsibility(s) for all funded EMPG Emergency Management staff <br />2. In Column #2, list total anticipated annual amount of Salaries and Benefits to be paid for each EMPG funded position. <br />3. In Columns #3-5 & 7, proWde the funding distribution (%) in each applicable column. <br />4. In Column #6, list the amount of Salaries and Benefits to be paid out of EMPG grant funds. <br />5. In Column #8, list the amount of Salaries and Benefits to be paid out of EMPA grant funds. <br />6. Column #9 calculates the sum of percentages entered in Columns 3 - 5 & 7 and must equal 100% of the anticipated annual salaries and benefits per EM <br />7. Please proWde to the Dimsion updates or reWsions to this form throughout the period of the agreement, as necessary. <br />6. This form is to be submitted to the UnAsion along with the 1st Quarter submission, or by January 30, 2023, whichever occurs first. <br />position. <br />