Laserfiche WebLink
FY 2022 - 2023 EMPA AGREEMENT <br />ATTACHMENT F -REPORTING FORMS <br />FLORIDA DIVISION OF EMERGENCY MANAGEMENT <br />2022-2023 EMERGENCY MANAGEMENT PREPAREDNESS AND ASSISTANCE - EMPA <br />DIVISION FORM 1A - QUARTERLY FINANCIAL REPORT <br />AGREEMENT #: <br />AWARD AMOUNT: <br />RECIPIENT: <br />COUNTY: <br />ADDRESS: <br />POINT OF CONTACT: <br />PHONE/EMAIL: 123@gmail.com <br />CLAIM #: 1 <br />QUARTER #: 1 <br />REPORTING FORMS DUE DATES (45 DAYS AFTER QUARTER) <br />1. July 1 - Sept. 30, 2022 = November 15, 2022 <br />2. October 1 - Dec. 31, 2022 = February 15, 2023 <br />3. January 1 - March 31, 2023 = May 15, 2023 <br />4, April 1 - June 30, 2023 =August 15, 2023 <br />EMPA ALLOCATION CATEGORIES <br />BUDGETED Q1 CLAIM Q2 CLAIM Q3 CLAIM Q4 CLAIM <br />ALLOCATIONS <br />CUMULATIVE <br />EXPENDED FUNDS <br />REMAINING <br />BALANCE <br />1. PLANNING <br />$0.00 <br />$0.00 <br />$0.00 <br />2. ORGANIZATION <br />$0.00 <br />$0.00 <br />$0.00 <br />3. EQUIPMENT <br />$0.00 <br />$0.00 <br />$0.00 <br />4. TRAINING <br />$0.00 <br />$0.00 <br />$0.00 <br />5. EXERCISE <br />$0.00 <br />$0.00 <br />$0.00 <br />6. MANAGEMENT AND ADMIN. (Up to 51%) <br />$0.00 <br />$0.00 <br />$0.00 <br />TOTAI-r <br />$0.00 $0.00 r $0.00 r $0.00 $0.00 <br />$0.00 <br />$0.00 <br />AMOUNT OF REIMBURSEMENT FOR THIS CLAIM: <br />By signing this report, I certify to the best of my knowledge and belief that the report is true, complete, accurate and the expenditures, disbursements <br />and cash receipts are for the purposes and objectives set forth in the conditions of the 2022-2023 EMPA agreement. <br />SIGNATURE: <br />AUTHORIZED REPRESENTATIVE DATE <br />QUARTERLY STATUS REPORT <br />Please report EM activities, meetings, training, exercises, or other necessary information to su000rt quarterly oroaressicn. <br />THE SECTION BELOW IS TO BE COMPLETED BY DIVISION <br />AWARD AMOUNT DIVISION DATE RECEIVED STAMP <br />PRIOR CLAIMS <br />THIS CLAIM AMOUNT <br />BALANCE OF AWARD <br />52 <br />270 <br />