Fort Walton Beach Council agenda — 09-04-12 regular — reading text

the number on your grant agreement that starts with CM DATE OF REQUEST: This is the date you are submitting the report. TOTAL AMOUNT REQUESTED: This should match the amount on the " TOTAL AMOUNT" line for the AMOUNT OF THIS CLAIM" cohtmn. GRANTEE' S GRANT MANAGER: This should be the person identified as grant manager in the grant agreement. PAYMENT REQUEST NO.: This is the number of your payment request, not the quarter number. PERFORMANCE PERIOD: This is the beginning and ending date of the reporting period. DELIVERABLE NO.: Enter the number of the DELIVERABLE(S) that you are requesting payment for. GRANT EXPENDITURES SUM" Y SECTION. AMOUNT OF THIS REQUEST" COLUMN: Enter the amount that was paid out for all listed deliverables during the invoice period for which you are requesting reimbursement. This must be by budget category as in the currently approved budget in Attachment A, Project Work Plan, or amendment of your grant Agreement. Do not claim expenses in a budget category that does not have an approved budget. Do not claim items that are not specifically identified in the current Budget Narrative section of Attachment A. DO NOT ALTER FORM OR COMBINE BUDGET CATEGORIES. Enter the column total on the " TOTAL AMOUNT' line. Enter the FCMP budget amount on the " GRANT BUDGET AMOUNT' line. Enter the total cumulative amount of this request and all previous payments on the " LESS TOTAL CUMULATIVE PAYMENTS OF" line. Deduct the " LESS TOTAL CUMULATIVE PAYMENTS OF" from the " GRANT BUDGET AMOUNT' for the amount to enter on the REMAINING B UDGET IN GRANT' line. TOTAL CUMULATIVE FCMP CLAIMS" COLUMN: Enter the cumulative amounts that have been claimed to date for FCMP expenses by budget category. The final report should show the total of all claims, first claim through the final claim, etc. Enter the column total on the " TOTAL AMOUNT' line. DO NOT ENTER ANYTHING IN THE SHADED AREAS. MATCHING FUNDS CLAIMED" COLUMN: Enter the amount to be claimed as match for the reporting period. This needs to be shown under specific budget categories according to what is in the currently approved Attachment A, Project Work Plan. Enter the total on the " TOTAL AMOUNT' line for this column. Enter the match budget amount on the " GRANT BUDGET AMOUNT' line for this column. Enter the total cumulative amount of this and any previous match claimed on the " LESS TOTAL CUMULATIVE PAYMENTS OF" line for this column. Deduct the " LESS TOTAL CUMULATIVE PAYMENTS OF" from the " GRANT BUDGET AMOUNT' for the amount to enter on the " REMAINING BUDGET IN GRANT' line. TOTAL CUMULATIVE MATCHING FUNDS" COLUMN: Enter the cumulative amount you have claimed to date for match by budget category. Put the total of all on the line titled " TOTAL AMOUNT." The final report should show the total of all claims, first claim through the final claim, etc. DO NOT ENTER ANYTHING IN THE SHADED AREAS. GRANTEE CERTIFICATION: Must have the original signature of both the Grantee' s Grant Manager and the Grantee' s Fiscal Agent as identified in the grant agreement. DEP Agreement No. CM234, Attachment C, Page 2 of 10 s )jooj8 jol uoisualx31uaw88alib IME) d34-4 : 6660 loo of AInr wowaa.a6e; uej6 qng :; uawyoeBd REOUIRED BACK -UP DOCUMENTATION: Exhibit I - Schedule of Invoices for Reimbursement for each deliverable. Exhibit H - Schedule of Match for each deliverable. Copies of Invoices (Not applicable to state agencies) Copies of canceled checks (Not applicable to state agencies) Copies of Travel Reimbursements if applicable FLAIR Report (State agencies only) Copies of Volunteer Logs (if applicable) NOTE: If claiming reimbursement for travel, you must include copies of receipts and a copy of the travel reimbursement form (available from staff of the Florida Coastal Management Program or use your affiliation' s reimbursement form, provided it has been approved by the Florida Department of Financial Services). PAYMENT WILL BE BASED ON COMPLETION OF DELIVERABLES: Deliverables must be submitted and approved prior to payment ** If you have any questions please do not hesitate to contact Dornecia Allen at ( 850) 245 -2180. REMAINDER OF PAGE INTENTIONALLY LEFT BLANK DEP Agreement No. CM234, Attachment C, Page 3 of 10  s )Iooa8 JOI uoisua}x3; uawaa.'BV lueaE) d3a:j : 6 60 3o0 o; Aink juaweaaBe; uea6 qns :; uawyoeuv H w O W H 0 00 a U O z w a z zz a aUa a z I 8 Q w aw w w A a a A A 5e; uejB qng :; uowLi3e}} y s )iooa8 aoI uoisua3x3 3uauaaaaBV 3ue.a0 d3aA : 6WO 300 o3 Alnr 3uaweeiBe 3uejB qnS : 3uauayOeBV DEPARTMENT OF ENVIRONMENTAL PROTECTION FLORIDA COASTAL MANAGEMENT PROGRAM INSTRUCTIONS FOR COMPLETING E7IMIT - I SCHEDULE OF INVOICES FOR REIMBURSEMENT DEP AGREEMENT NO.: This is the number on your grant agreement that starts with CM PROJECT TITLE: Enter the Title shown on the first page of the grant agreement. PERFORMANCE PERIOD: This is the beginning and ending date of the reporting period. DELIVERABLE NO.: Enter the number of the deliverable that you are requesting payment for. DELIVERABLE AMOUNT REQUESTED: This is the total amount of expenses from all approved budget categories for the deliverable. Salaries: Provide an itemized listing of expenditures for Salaries if applicable. Include the invoice number, invoice date, description of the goods or services purchased, vendor name, invoice amount, date of the transaction, check number /voucher number, check amount/transaction number, and amount claimed. Fringe Benefits: Provide an itemized listing of expenditures for Fringe Benefits if applicable. Include the invoice number, invoice date, description of the goods or services purchased, vendor name, invoice amount, date of the transaction, check number /voucher number, check amount/transaction number, and amount claimed. Travel: Provide an itemized listing of expenditures for Travel if applicable. Include the invoice number, invoice date, description of the goods or services purchased, vendor name, invoice amount, date of the transaction, check number /voucher number, check amount/transaction number, and amount claimed. Equipment: Provide an itemized listing of expenditures for Equipment if applicable. Include the invoice number, invoice date, description of the goods or services purchased, vendor name, invoice amount, date of the transaction, check number /voucher number, check amount/transaction number, and amount claimed. Supplies: Provide an itemized listing of expenditures for Supplies if applicable. Include the invoice number, invoice date, description of the goods or services purchased, vendor name, invoice amount, date of the transaction, check number /voucher number, check amount/transaction number, and amount claimed. Contractual Services: Provide an itemized listing of expenditures for Contractual Services if applicable. Include the invoice number, invoice date, description of the goods or services purchased, vendor name, invoice amount, date of the transaction, check number /voucher number, check amount/transaction number, and amount claimed. Other Expenses: Provide an itemized listing of expenditures for Other Expenses if applicable. Include the invoice number, invoice date, description of the goods or services purchased, vendor name, invoice amount, date of the transaction, check number /voucher number, check amount/transaction number, and amount claimed. Indirect Charges: Provide the amount of the indirect to be charged to this Deliverable. Provide percentage or rate used for calculation. A SCHEDULE OF INVOICES FORM IS REQUIRED FOR EACH DELIVERABLE. PAYMENT WILL BE BASED ON COMPLETION OF DELIVERABLES: Deliverables must be submitted and approved prior to payment ** DEP Agreement No. CM234, Attachment C, Page 6 of 10  smooa8 joi uoisuaixa ivawaaaBw iueaci a Ana - : L La L) ion of Ainr woweeiBe weaB qns :ivawuoeuv x U E b F w i- r O w A W Cx7 O 000 U A O O z a0 S aUw w z a d H Q w w A a a A oe:} y s )looj8 ao} u0isualx3; uawGGJBV lueaO d34-4 : LL60 Zoo of Alnr wowaa.iBe; ue.& qnS : IuawyoeUV DEPARTMENT OF ENVIRONMENTAL PROTECTION FLORIDA COASTAL MANAGEMENT PROGRAM INSTRUCTIONS FOR COMPLETING EXHIBIT - H SCHEDULE OF MATCH DEP AGREEMENT NO.: This is the number on your grant agreement that starts with CM PROJECT TITLE: Enter the Title shown on the first page of the grant agreement. PERFORMANCE PERIOD: This is the beginning and ending date of the reporting period. Enter the number of the deliverable that you are requesting payment for. DELIVERABLE NO.: DELIVERABLE MATCH AMOUNT CLAIMED: This is the total amount of match expenses from all approved budget categories for the deliverable. Salaries: Provide an itemized listing of match for Salaries if applicable. Include the invoice number, invoice date, description of the goods or services purchased, vendor name, invoice amount, date of the transaction, check number /voucher number, check amount/transaction number, and amount claimed. Fringe Benefits: Provide an itemized listing of match for Fringe Benefits if applicable. Include the invoice number, invoice date, description of the goods or services purchased, vendor name, invoice amount, date of the transaction, check number /voucher number, check amount/transaction number, and amount claimed. Travel: Provide an itemized listing of match for Travel if applicable. Include the invoice number, invoice date, description of the goods or services purchased, vendor name, invoice amount, date of the transaction, check number /voucher number, check amountltransaction number, and amount claimed. Equipment: Provide an itemized listing of match for Equipment if applicable. Include the invoice number, invoice date, description of the goods or services purchased, vendor name, invoice amount, date of the transaction, check number /voucher number, check amount/transaction number, and amount claimed. Supplies: Provide an itemized listing of match for Supplies if applicable. Include the invoice number, invoice date, description of the goods or services purchased, vendor name, invoice amount, date of the transaction, check number /voucher number, check amount/transaction number, and amount claimed. Contractual