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STATE OF NORTH DAKOTA <br />DIVISION OF EMERGENCY MANAGEMENT <br /> <br />Quarterly Financial Report Detail <br /> <br />Grant/Project Title: EMPG <br /> <br />FY: 2004 <br /> <br />Subgrantee: Brown County <br />Addr6ss: 700 Exact Avenue <br /> Municipal, HS 02225 <br />Reporting Period From: <br /> <br /> DEM Grant Code: EMPG-04-79-01 <br /> Program Officer: Jackson Smith <br /> Report Number: 1 <br />October 1, 20031 To: December 31,2003 <br /> <br /> FORM TO BE COMPLETED BY AUTHORIZED FISCAL AUTHORI~·=: <br /> <br />Itemize expenditures under each category. Use additional sheets as.~essary. <br /> <br /> CATEGORY <br />Personnel Costs: <br />Jackson Smith - Salary &E <br />Jackson Smith - <br />Jackson Smith - <br />Hatty Ba,~ ~Salary &?B~efits - ~~r~=.~ <br /> <br />TOTAL <br /> <br />Max SupPt~s -,Staple[ ?, <br /> <br /> TOtal Office Ex penseslSu pplies: <br />Travel:: <br />Fall Conference - Hotel <br />Mileage <br /> <br />Equipment: <br />Copier <br /> <br />Total Travel Expenses: <br /> <br /> Total Equipment Expenses: <br />Contracting Costs: <br /> <br />Total Contracting Costs: <br />Other: <br /> <br />Total Amount Expended <br />FEDERAL SHARE ( <br /> <br />$ <br />$ <br />$ <br />$ <br /> <br />$ <br />$ <br />$ <br /> <br />$ <br />$ <br />$ <br /> <br />Total Other Costs: <br /> <br /> ) <br /> <br />2,000!00 <br /> <br /> 25.00 PO 789 <br /> 10.00 JX602 <br /> <br /> 35.00 <br /> <br /> 75.00 <br /> 35.00 <br /> 110.00 <br /> <br /> 3,200-00I <br /> 3,200.00 <br /> <br /> I <br /> 0.00 <br /> <br /> I <br /> 0.00 <br />$5,345.00 <br /> $0.00 <br /> <br />DEM Form G7, December 2003 Approval' Yes No FOR DEM USE ONLY <br /> <br /> <br />