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STATE OF NORTH DAKOTA <br />DIVISION OF EMERGENCY MANAGEMENT <br /> <br />Quarterly Financial Report Summary <br /> <br />Grant/Project Title: EMPG <br /> <br />FY: 2004 <br /> <br />Subgrantee: Brown County <br />Address: 700 Exact Avenue <br /> Municipal, HS 02225 <br />Reporting Period From: <br /> <br /> DEM Grant Code: <br /> Program Officer: <br />Report Number: <br />January 1, 20041 To: <br /> <br />EMPG-04-79-01 <br />Jackson Smith <br />2 <br /> March 1, 2004 <br /> <br />IFederal Funds: $ <br /> <br /> STATUS OF FUNDS <br />7,500.00 ( 50 %) JLocal 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~:~pense~,'i! ( <br />E. Total FEDERAL MATCH:of Ex ~::(Li~ F D) <br />F. Total FEDERAL FUNDSAwarde~ ' <br />G. UNOBLIGATED BA~NCE of <br /> <br />50% of C) <br /> <br /> 7 <br /> TOT~S <br />$ ???:;E 5.00 <br /> <br />$ ~ ~!7,895.00 <br /> <br />$ 3,552.50 <br /> <br />(A) (B) (C) <br /> Reported Current Period Total Re <br /> <br />-.,.: ~50.00 $ 1,500.00 $ 1,650.00 <br />HattyBarr ":..i-i~'? ~.!.~' $ "'~ 3,225.00 $ 500.00 $ 825.00 <br /> $ $ $ <br />OfficeEXpenSes/Supplies: $ 1,500.00 $ 35.00 $ 75.00 <br />Travel: $ 625.00 $ 110.00 $ <br />Equipment: $ 3,200.00 $ 3,200.00 $ <br />Contracting Costs: $ $ $ <br />Other: $ $ $ <br /> Column Totals $ 15,000.00 $ 5,345.00 $ 2,550.00 <br />Total Federal Funds Requested this Claim [ 50% of (B)] <br /> <br />3,150.00 <br />1,325.00 <br />0.00 <br />110.00 <br />110.00 <br />3,200.00 <br />0.00 <br />0.00 <br />7,895.00 <br />1,275.00 <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 />