FISCAL AFFAIRS LETTERHEAD

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					                                   COUNTY OF NORTHAMPTON
                           GAMING REVENUE AND ECONOMIC REDEVELOPMENT AUTHORITY


                                             NORTHAMPTON COUNTY COURTHOUSE
                                                  669 WASHINGTON STREET
                                              EASTON, PENNSYLVANIA 18042-7492

                                                     Phone: (610) 559-3200
 Alicia M. Karner                                      Fax: (610) 559-3775
Executive Director




To:         2010 Local Share Municipal Gaming Grantees

From:       Northampton County Gaming Revenue & Economic Redevelopment Authority
            Alicia M. Karner, Executive Director

Date:       June 2, 2011

Re:         2010 Local Share Municipal Gaming Grant Mid-Year Report



As stated in the 2010 Local Share Municipal Gaming Grant Contract, the Municipality shall
submit periodic reports to the Authority at least every six (6) months which shall contain all
necessary supporting documentation to enable the Northampton County Gaming Revenue
& Economic Redevelopment Authority to determine whether the Municipality’s use of the
grant proceeds complied with the application, the project budget and the grant agreement.

Please complete the attached mid-year report form in its entirety and return to the
address listed below, by June 30, 2011. A fill-in form is available on the gaming
webpage, found in the DCED section of Northampton County’s website:
www.northamptoncounty.org.


          Northampton County Gaming Revenue & Economic Redevelopment Authority
                          Attn: Alicia M. Karner, Executive Director
                                    669 Washington Street
                                       Easton, PA 18042

   If you have any questions please feel free to contact me at (610) 559-3200, Option 3.
                          Local Share Municipal Gaming Grant
                                         Mid-Year Report



Municipality Name:                                                 Grant Amount:


Project Name:


Address:


Phone:                                                             Email:


Instructions: Indicate the amount of grant funds spent and the remaining amount of grant funds, to date, for
project costs in each category. Please be sure that funds are spent in accordance with the project budget in
the original grant application. Submit all copies of invoices, cancelled checks and receipts relating to the
project, identified with the appropriate number from each line item. For example: The grant award was
$10,000 for the purchase of new equipment. $6,000 of the grant award was spent to date. In the row, number
22, for New Equipment Purchase, under the Grant Funds Spent column, list $6,000. In the Remaining Grant
Funds column, list $4,000. On all documentation relating to the expenditures, write the line item number 22
on each invoice, cancelled check or receipt submitted.



Line           PROJECT COSTS                     GRANT FUNDS                   REMAINING GRANT
Item                                                SPENT                           FUNDS
       ACQUISITION

1       Land                              $                                   $
2       Buildings                         $                                   $
        Subtotal                          $                                   $
       INFRASTRUCTURE/SITE
       PREPARATION
3        Roads & Streets                  $                                   $
4       Parking                           $                                   $
5       Water/Sewer                       $                                   $
6       Utilities                         $                                   $
7       Demolition                        $                                   $
8       Excavation/Grading                $                                   $
9       Environmental Cleanup             $                                   $
       Subtotal                          $                 $
Line        PROJECT COSTS                    GRANT FUNDS   REMAINING GRANT
Item                                            SPENT           FUNDS
OPERATING COSTS/ WORKING
CAPITAL
10   Working Capital                     $                 $
11     Salaries & Fringe Benefits        $                 $
12     Training & Technical Assistance   $                 $
13     Consumable Supplies               $                 $
14     Travel                            $                 $
15     Promotion/Public                  $                 $
       Relations/Advertising
16     Office Equipment                  $                 $
17     Space Costs                       $                 $
18     Audit                             $                 $
19     Indirect Costs                    $                 $
       Subtotal                          $                 $
GENERAL CONSTRUCTION

20     New Construction                  $                 $
21     Renovations                       $                 $
       Subtotal                          $                 $
MACHINERY & EQUIPMENT

22     New Equipment Purchase            $                 $
23     Used Equipment                    $                 $
       Purchase
24     Upgrade Existing                  $                 $
25     Installation/Building             $                 $
       Modification
26     Vehicles                          $                 $
       Subtotal                          $                 $
OTHER COSTS

27     Professional Services/            $                 $
       Consultants
28     Engineering                       $                 $
29       Inspections                        $                                    $
Line      PROJECT COSTS                            GRANT FUNDS                    REMAINING GRANT
Item                                                  SPENT                            FUNDS
30   Fees                                   $                                    $
31       Insurance                          $                                    $
32       Environmental Assessment           $                                    $
33       Legal Costs                        $                                    $
34       Closing Costs                      $                                    $
35       Contingencies                      $                                    $
36       Subtotal                           $                                    $
37       Miscellaneous                      $                                    $
         Subtotal                           $                                    $
TOTAL                                       $                                    $

     Mail the completed form to Northampton County Gaming Revenue & Economic Redevelopment Authority, Attn:
     Alicia M. Karner, 669 Washington Street, Easton, PA 18042.

				
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