Project Expenditure Report by armedman2

VIEWS: 60 PAGES: 5

									                  Sub-Grantee Request for Funds & Project Expenditure Report
                                              Virginia Department of Emergency Management
                                                        Grants Management Office                                              Phone: 804-897-6500
                                                            10501 Trade Court                                                   Fax: 804-897-6613
                                                        Richmond, VA 23236-3713
                           Sub-Grantee Information                                                     Grant Award Information
Name:                                                                   Grant Name:
Address:                                                                Grant Year:
Telephone:                                                              Award Date:
Fax:                                                                    Request Date:
EIN (tax ID):                                                           VDEM Region:
Project Title
                                                           Project Funding Request
                                                                                                Per original grant award (adjust for any
                                                     Award Amount:
                                                                                                modifications).
                                 Project expenditure (this request):                            Provide documentation of expenditures with request
                                        Pending Reimbursement(s):                               submission.
                  Less funds received to date (reported previously):                    As of : (ex. last quarter)
                                Current reimbursement requested:                  $0.00
                                                                                        Calculated field, no input allowed in gray cells
                                        Remaining Award Amount:                   $0.00
                                                         Project Expenditure Date
  Description           Approved Budget            Current Period       Previously Reported         Year-To-Date               Balance
Planning                                                                                        $                -   $                        -

Equipment                                                                                       $                -   $                        -

Training                                                                                        $                -   $                        -

Exercises                                                                                       $                -   $                        -
Management &
Administrative                                                                                  $                -   $                        -
(limited )

Total               $                     -    $                    -   $                -      $                -   $                        -
            Funds Received To Date:
                                               $                    -                 As of:    (MM/DD/YYYY)
             (Including this request)
                                                   Sub-Grantee Cost Share Requirements
                                          Complete this section if grant requirements include a match
Grant Program:                                                                           Required Match Percent
    Grant Year: Year                                                                Current Match Amount (%):                  #DIV/0!
  Description           Current Match $         Previously Reported $   Match: Year-to-Date         Cash Match              In-Kind Match

Planning                                                                                 0.00

Equipment                                                                                0.00

Training                                                                                 0.00

Exercises                                                                                0.00
Management &
Administrative                                                                           0.00
(limited )
Total               $                     -    $                    -   $                -      $                -   $                        -
Grant Certification: I certify to the best of my knowledge and belief that this report is correct and complete and that all outlays
and unpaid obligations are for the purpose set forth in the sub-grant award documents.



Project Manager (please print name, sign and date)



Financial Officer (please print name, sign and date)
  f1c63020-c3a4-4313-a3c5-0388a892ff0a.xls Project Expenditure Report                                                               Page 1of 2]
Grant Name/Year:


Jurisdiction/                                                   Telephone #:
Agency:
                                                                Fax #:
Contact:

E-mail                                                          Cell#:
Address:
 Drawdown         Description of
                                                Cost                    Balance   Invoice Date   AEL #
  Amount        Equipment/Services
                (Category; Equipment;     (amount invoiced to
                         etc.)                 grant)
                                                                         $0.00
                                                                         $0.00
                                                                         $0.00
                                                                         $0.00
                                                                         $0.00
                                                                         $0.00
                                                                         $0.00
                                                                         $0.00
                                                                         $0.00
                                                                         $0.00
                                                                         $0.00
                                                                         $0.00
                                                                         $0.00
                                                                         $0.00
                                                                         $0.00
                                                                         $0.00
                                                                         $0.00
                                                                         $0.00
                                                                         $0.00
                                                                         $0.00
                                                                         $0.00
                                                                         $0.00
                                                                         $0.00
                                                                         $0.00
                                                                         $0.00
                                                                         $0.00
                                                                         $0.00
                                                                         $0.00
                                                                         $0.00
APPROVED EXCEPTIONS FROM REQUIRED EQUIPMENT LIST:



  f1c63020-c3a4-4313-a3c5-0388a892ff0a.xls Project Expenditure Report                              Page 2of 2]
                 Sub-Grantee Request for Funds & Project Expenditure Report
                                                        Virginia Department of Emergency
                                                            Grants Management Office                              Phone: (804)897-6500
                                                                10501 Trade Court                                 Phone: (804-897-6613
                                                            Richmond, VA 23236-3713
                           Sub-Grantee Information                                                       Grant Award Information
Name:              Jurisdiction Name                                        Grant Name:             SHSP/PSIC/LETPP/HAZMAT…
Address:           Jurisdiction Address                                     Grant Year:             actual grant year (2008)
Telephone:         555-555-5555                                             Award Date:             date on award letter
Fax:               555-555-5556                                             Request Date:           today's date
EIN (tax ID):      51-555555555                                             Reporting Period:       from last request or award date to present

Project Title      Actual Project title from grant application
                                                            Project Funding Request
                                                         Award Amount: $             150,000.00 Per original grant award (adjust for any modifications).

                                 Project expenditure (this request):          $15,000.00 Provide documentation of expenditures with request
                                        Pending Reimbursement(s):             $10,000.00 submission.
                  Less funds received to date (reported previously):           $5,000.00 As of : (ex. last quarter)
                                Current reimbursement requested:              $15,000.00 Calculated field, no input required.
                                        Remaining Award Amount:             $120,000.00 Calculated field, no input required.
                                                       Project Expenditure Date
  Description           Approved Budget                Current Period       Previously Reported         Year-To-Date                   Balance
Planning            $               10,000.00                               $         10,000.00     $          10,000.00      $                        -

Equipment           $              110,000.00      $            15,000.00   $           5,000.00    $          20,000.00      $                90,000.00

Training            $               20,000.00                                                       $                  -      $                20,000.00

Exercises           $               10,000.00                                                       $                  -      $                10,000.00
Management &
Administrative      $                        -                                                      $                  -      $                        -
(limited )

Total               $              150,000.00      $            15,000.00   $         15,000.00     $          30,000.00      $               120,000.00
            Funds Received To Date:
                                                   $            30,000.00                 As of:    (MM/DD/YYYY) today's date
             (Including this request)
                                                        Grant Matching Requirements
                                          Complete this section if grant requirements include a match
Grant Program: SHSP/PSIC/LETPP/HAZMAT                                                         Required Match Percent              from award letter
   Grant Year: Year                                                                     Current Match Amount (%):                         1%
  Description           Current Match $            Previously Reported $    Match: Year-to-Date         Cash Match                 In-Kind Match

Planning            $                    200.00                                            200.00                   200.00

Equipment           $                   1,500.00   $               100.00               1,600.00                    800.00                          800.00

Training            $                        -                                               0.00

Exercises           $                        -                                               0.00
Management &
Administrative      $                        -                                               0.00
(limited )
Total               $                   1,700.00   $               100.00   $           1,800.00    $            1,000.00     $                    800.00
Grant Certification: I certify to the best of my knowledge and belief that this report is correct and complete and that all
outlays and unpaid obligations are for the purpose set forth in the sub-grant award documents.



Project Manager (please print name, sign and date)
Financial Officer (please print name, sign and date)
Grant Name/Year:
Jurisdiction/ Jurisdiction Name                                Telephone #:                     540-555-5555
Agency:
Contact:      Project Manager                                  Fax #:                           540-555-1234
E-mail        PM@Jurisdiction.com                              Cell#:
Address:                                                                                         540-555-2314
 Drawdown         Description of
                                               Cost                Balance        Invoice Date              AEL #
  Amount       Equipment/Services
                 (Category; Equipment;   (amount invoiced to
                          etc.)               grant)
$   150,000.00       Vendor-type of          $1,500.00            $148,500.00   actual invoice date
                       equipment
                                                                  $148,500.00
                                                                  $148,500.00
                                                                  $148,500.00
                                                                  $148,500.00
                                                                  $148,500.00
                                                                  $148,500.00
                                                                  $148,500.00
                                                                  $148,500.00
                                                                  $148,500.00
                                                                  $148,500.00
                                                                  $148,500.00
                                                                  $148,500.00
                                                                  $148,500.00
                                                                  $148,500.00
                                                                  $148,500.00
                                                                  $148,500.00
                                                                  $148,500.00
                                                                  $148,500.00
                                                                  $148,500.00
                                                                  $148,500.00
                                                                  $148,500.00
                                                                  $148,500.00
                                                                  $148,500.00
                                                                  $148,500.00
                                                                  $148,500.00
                                                                  $148,500.00
                                                                  $148,500.00
                                                                  $148,500.00
APPROVED EXCEPTIONS FROM REQUIRED EQUIPMENT LIST:

								
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