HomeMy WebLinkAbout2013-091 EMS - State of NC Dept of Public Safety 14,877.88 STATE OF NORTH CAROLINA
DEPARTMENT OF PUBLIC SAFETY
North Carolina Emergency Management
N&3 Physical Address: 1636 Gold Star Drive, Raleigh,NC 27607-3371 &m S
Mailing Address:4236 Mail Service Center,Raleigh, NC 27699-4236
COST REPORT 2 - FISCAL YEAR 2012
EMERGENCY MANAGEMENT
PERFORMANCE GRANT
Grantee: ORANGE COUNTY EMERGENCY SERVICES
Address: 510 MEADOWLANDS DRIVE
HILLSBOROUGH NC 27278- .
Federal ID No.: 56-6000327-A _Please return this copy to
Account No.: 1901-53690200012-1500801635HD Cle,k to the Board's office for PAF
Grant Period: 10/01/11-09/30/13
Project: EMPG
Grant File No: EMPG-2012-37135 Branch: Central
Funding 2012 EMPG Universal Amount Optional Amount SATCOM Balance to be Paid
Worksheet Final Amount (Previously Paid) Deductions
Federal/State $49,869.88 $35,000.00 $14,877.88 $8.00 $14,869.88
Local Match $49,877.88 $35,000.00 $14,877.88 $0.00 $14,877.88
Total $99,747.76 $70,000.00 $29,755.76 $8.00 $29,747.76
This Final Cost Report reflects completed and approved Optional amounts by your Emergency Management program minus
SATCOM Deductions to give a final Balance to be Paid amount. SATCOM Deductions are from January 1, 2011 to
December 31, 2011 and reflect additional charges over the base amount per month. This Optional Amount can be used for
enhancing your local emergency management program.
This Cost Report require appropriate signatures and return to the state for payment. Payment will be made once all
signatures have been completed and processed. This funding reimburses your county for eligible EMPG work.
RECEIVED
4 4 i 1'
Certification: NC IDPS CO GRAN T s,.
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.
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Orange C UNTY inance Offi r thorize ignature D
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ORANGE CO Y EMERGENCY SER C Autho ' Signature` ate
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North C ling Emergency Management Dep tor's A roval Signature Date
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Department of Public Safety Controller's Office Approval Date
Printed: 2/12/2013 8:00:37 AM 2012 Cost Report 2