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B K 00026 PG <br />STATE OF NORTH CAROLINA <br />DEPARTMENT OF PUBLIC SAFETY <br />North Carolina Emergency Management <br />Physical Address: 1636 Gold Star Drive, Raleigh, NC 27607 -3371 <br />Mailing Address: 4236 Mail Service Center, Raleigh, NC 27699-4236 <br />COST REPORT 1- FISCAL YEAR 2013 <br />EMERGENCY MANAGEMENT <br />PERFORMANCE GRANT <br />Grantee: <br />Address: <br />Federal ID No. <br />Account No.: <br />Grant Period: <br />Project: <br />Grant File No: <br />LEE COUNTY OFFICE OF EMERGENCY SERVICES <br />225 SOUTH STEELE STREET <br />SANFORD NC 27330- <br />56- 6000313 -A <br />1901 - 1500- 801635HD -2013 <br />10/01/12 - 09/30/14 <br />EMPG <br />EMPG- 2013 -37105 <br />Branch: Central <br />Funding <br />Worksheet <br />2013 Eli <br />Initial Amount <br />Universal Amount <br />(Base Amount) <br />Optional Amount <br />SATCOM <br />Deductions <br />Balance to be Paid <br />Federal /State <br />$20,625.00 <br />$20,625.00 <br />TBD <br />TBD <br />$ 0 <br />Local Match <br />$20,625.00 <br />$20,625.00 <br />TBD <br />TBD <br />$ 0 <br />Total <br />$41,250.00 <br />$41,250.00 <br />TBD <br />TBD <br />$ 0 <br />This is the first of two Cost Reports. This Initial Cost Report reflects the Universal (Base) Amount that your county is eligible to <br />receive provided all Univeral activities are completed, and documentation is approved by the State before the designated <br />deadline. This Cost Report require appropriate signatures and return to the state for payment of eligible EMPG work activities <br />completed to date. <br />The second Cost Report will reflect completed and approved Optional work activity amounts by your Emergency Management <br />program. SATCOM Deductions and a Balance to be Paid will also be reflected in Cost Report 2 to give you a total 2013 EMPG <br />Final Amount award for your county. <br />Please note that failure to complete any Universal activity will result in a 14 % penalty per activity to be assessed <br />against your 2014 EMPG funds. <br />Certification: <br />I certify the above are correct, based on grantee's official accounting system and records, consistently applied and maintained, and that expenditures <br />shown have been made for the purpose of and in accordance with, applicable grant terms and conditions, and that appropriate documentation to support <br />these costs and expenditures is available or attached. <br />Lee COUNTY Finance Officer Authorized Signature Date <br />LEE COUNTY OFFICE OF EMERGENCY SERVICES Authorized Signature Date <br />North Carolina Emergency Management Director's Approval Signature Date <br />Department of Public Safety Controller's Office Approval <br />Printed: 9/612013 7:45:51 AM <br />Date <br />2013 Cost Report 1 <br />