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FY 2022 - 2023 EMPG AGREEMENT <br />ATTACHMENT H <br />REPORTING FORMS <br />FLORIDA DIVISION OF EMERGENCY MANAGEMENT <br />2022-2023 EMERGENCY MANAGEMENT PERFORMANCE GRANT - EMPG 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 <br />AND FEDERAL <br /># <br />Only funded Staff Name, Position Title <br />& <br />Area of Responsibility <br />(Preparedness, Response, Recovery, <br />A46ga6on & Finance <br />[1] <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 EMPG <br />Base Grant Base Grant <br />(State) (State) <br />51 [6] <br />% $ % <br />EMPA EMPA Total <br />Base Grant Base Grant All <br />(Federal) (Federal) Funds <br />71 (8] (9 <br />1 <br />Ex. Jane Doe, Director, ALL <br />$ 60,000.00 <br />50% $ 30,000.00 <br />50% $30,000.00 100% <br />2 <br />$ <br />$0.00 0% <br />3 <br />$ <br />$0.00 0% <br />4 <br />$ <br />$0.00 0% <br />5 <br />$ <br />$0.00 0% <br />6 <br />$ <br />$0.00 0% <br />7 <br />$ <br />$0.00 0% <br />8 <br />$ <br />$0.00 0% <br />9 <br />$ <br />$0.00 0o <br />10 <br />$ <br />$0.00 0% <br />11 <br />$ <br />$0.00 0% <br />12 <br />$ <br />$0.00 0% <br />13 <br />$ <br />$0.00 0% <br />14 <br />$ <br />$0.00 0% <br />15 <br />$ <br />$0.00 0% <br />16 <br />$ <br />$0.00 0% <br />17 <br />$ <br />$0.00 0% <br />18 <br />$ <br />$0.00 0% <br />19 <br />$ <br />$0.00 0% <br />20 <br />$ <br />$0.00 0% <br />TOTAL $ 30,000.00 <br />$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 93-5 & 7, protide 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 99 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 protide to the Division updates or revisions to this form throughout the period of the agreement, as necessary. <br />8. This form is to be submitted to the Division along with the 1st Quarter submission, or by January 30, 2023, whichever occurs first. <br />position. <br />66 <br />198 <br />