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Completion Status for Tasks <br />Indicate the completion status for the following tasks, as applicable to the project. <br />Tasks: Site Preparation, Renovation, Equipment Installation Pum out Si nae and others <br />Deliverable <br />Completion Status <br />Before and after photographs of site. <br />Yes ❑, No ❑, N/A ❑ <br />Written certification, stating that the Project site is prepared according to <br />approved plans and design. <br />yes El, No El, N/A ❑ <br />Copy of any applicable inspection report(s) to verify work passed inspection. <br />Yes ❑, No ❑, N/A ❑ <br />Copy of any executed subcontract related to this task. <br />Yes ❑, No ❑, N/A ❑ <br />Timesheets or payroll records documenting hours worked, pay rates, and <br />of employees performingrenovation work. <br />yes ❑, No ❑, N/A 1:1classification <br />Tasks: Equipment Purchase, Operations of Eauivment. Maintenance and Renair and nthPrc <br />Deliverable <br />Completion Status <br />Exhibit B, Property Reporting Form <br />Yes ❑, No ❑, N/A ❑ <br />Copy of paid invoices, and delivery receipts <br />Yes ❑, No ❑, N/A ❑ <br />Final inventory report due at the end of the Agreement. <br />Yes ❑, No ❑, N/A ❑ <br />The Pumpout Station Operational Plan (PSOP) <br />Yes ❑, No ❑, N/A ❑ <br />Quarterly Pumpout Log <br />Yes ❑, No ❑, N/A ❑ <br />List of maintenance or repairs made to the pumpout equipment <br />Yes ❑, No ❑, N/A ❑ <br />This report is submitted in accordance with the reporting requirements of the above DEP Agreement number <br />and accurately reflects the activities associated with the project. <br />Signature of Grantee's Grant Manager <br />Rev. 10/31/2025 Exhibit A, Page 2 of 2 <br />Click or tap to enter a date. <br />Date <br />