HomeMy WebLinkAbout2012-362 EMS - NC Emergency Management Performance Grant Please return this COPY to the Clerk's to the Board's
STATE OF NORTH CAR—office for permanent agenda file. r
DEPARTMENT OF PUBLI#1
Division of Emergency Management 14:2
Physical Address:1636 Gold Star Drive,Raleigh,NC 27607-3371
Mailing Address:4236 Mail Service Center,Raleigh,NC 27699-4236
COST REPORT 1 - FISCAL YEAR 2012
EMERGENCY MANAGEMENT
PERFORMANCE GRANT
Grantee: ORANGE COUNTY EMERGENCY SERVICES
Address: 510 MEADOWLANDS DRIVE 1901-53690200012-1500-8016-351-11)
HILLSBOROUGH NC 27278-
Federal ID No.: 56-6000327-A
Account No.: 1901-1500-801631111-2012
Grant Period: 10/01/11 -09/30/13
Project: EMPG
Grant File No: EMPG-2012-37135 Branch: Central
Funding 2012 EWG Universal Amount Optional Amount SATCOM Balance to be Paid
Worksheet IftliddAmouritt (Base Amount} Deductions
Federal/State $35,000.00 $35,000.00 TBD TBD $0
Local Match $35,000.00 $35,000.00 TBD TBD $0
!Total $70,000.00 $70,000.00 TBD TBD so
This is the first of two Cost Reports. This Initial Cost Report reflects the Universal (Base)Amount that your county is eligible to
receive provided all Univeral activities are completed,and documentation is approved by the State before the designated
deadline.This Cost Report require appropriate signatures and return to the state for payment of eligible EMPG work activities
completed to date.
The second Cost Report will reflect completed and approved Optional work activity amounts by your Emergency Management
program. SATCOM Deductions and a Balance to be Paid will also be reflected in Cost Report 2 to give you a total 2012 EMPG
Final Amount award for your county.
Please note that failure to complete any Universal activity will result in a 14%penalty per activity to be assessed
against your 2013 EMPG funds.
RECEivED
OCT 18 2012
NC DPS Accounting
Certification:
I certify the above are correct,based on grantee's official accounting system and records,consistently applied and maintained,and that expenditures
shown have been made for the purpose of and in accordance with,applicable grant terms and conditions,and that appropriate documentation to support
these costs and expenditures is available or attached.
Or e CO Finance 0 cer o e Signature Date
ORANGE'CnLINTY EMERGNCY S VICES AuqVrizzed Signature Date
IL1:2 O 42,
'-7rsDivisi Emergency Magement Deputy Direc A*proval Sknature Date
rfl..,A'. anI nez:i/nh / -
Department of Crime Control and Public Safe Controller's Office Approval Date
Printed: 6/29/2012 8:09:28 AM 2012 Cost Report 1