Laserfiche WebLink
STATE OF NORTH DAKOTA <br />DIVISION OF EMERGENCY MANAGEMENT <br /> <br />Quarterly Financial Report Summary <br /> <br />Grant/Project Title: <br /> <br />FY: <br /> <br />Subgrantee: <br />Addr6ss: <br /> <br />Reporting Period <br /> <br />From: <br /> <br />DEM Grant Code: <br />.Program Officer: <br />Report Number: <br /> i To: <br /> <br />IFederal Funds: $ <br /> <br />STATUS OF FUNDS <br /> ( %) ILocal Funds: $ <br /> <br />A. Total Expenses PREVIOUSLY Reported <br />B. Total Expenses THIS PERIOD <br />C. Total Expenses TO DATE (Line A + B) <br />D. LESS Total NON-federal Share of Expenses ( <br />E. Total FEDERAL MATCH of Expenses (Lines C - D) <br />F. Total FEDERAL FUNDS Awarded <br />G. UNOBLIGATED BALANCE of Federal Funds (Line F - E) <br /> <br />% of C) <br /> <br />$ <br />$ <br />$ <br />$ <br />$ <br />$ <br />$ <br /> <br />TOTALS <br /> <br />( %) <br /> <br /> Category <br />Personnel: <br /> <br /> BUDGET SUMMARY <br /> I <br /> (A) <br />Budgeted Amounts i Previously Reported <br /> <br /> (B) <br />Current Period <br /> <br />$ $ $ <br />$ $ $ $ <br />$ $ $ $ <br />Office Expenses/Supplies: $ $ $ $ <br />Travel: $ $ $ $ <br />Equipment: $ $ $ $ <br />Contracting Costs: $ $ $ $ <br />Other: $ $ $ $ <br /> Column Totals $ $ $ $ <br />Total Federal Funds Requested this Claim [ "/o of (B)] $ <br /> <br /> (c) <br />Total Reported <br /> <br />Attached are copies of all expenses to substantiate the expenses on this claim. I certify that to the best of my <br />knowledge and belief, this report is correct and complete and that all outlays and unpaid obligations are for the <br />purposes set forth under the terms of the approved project. <br /> <br />Signature Date <br /> <br />DEM Form G5, December 2003 Approval: ~ Yes No FOR DEM USE ONLY <br /> <br /> <br />