Closeout Package 21 6 for ID Col 8 - 7 Funds Current applicable Boise, Col Requests records, with and 83720 Bills # Funds period.. Box 7 system Costs accordance PO & Accrued for report in Request (unpaid) Phone Title St., the and accounting + of, 5 State of during Request Inc. Col Req. W. official 6 - 4 law. purposes Balance 700 Col Unexpended Program Funds the grantee's expenditures Program federal for the Division, and Person Request on made actual Funds 5 of of Grant state Disbursed been Total based Contact Date have Block Development + 3 applicable correct, 83720-0093) of Col is reimbursement shown Funds 4 + 2 data for Program Income Total Requested Col Economic are violation a above expenditures the Development # requested Name Period Earned that that 3 constitute Commerce, and Program of may funds certify Contract Report Typed I Income The Community maintained, Officer: of information Department 2 and conditions. Total Previous Requests false Idaho Financial and Idaho of applied to Name terms Furnishing 1 CDBG (Return Budget Grantee Address Note: Certification consistently contract
Closeout Package 21 Idaho Community Development Block Grant Program Request for Funds (Return to Idaho Department of Commerce, Economic Development Division, 700 W. State St., PO Box 83720 Boise, ID 83720-0093) Phone Request # 8 Current Requests for Funds Col 7 - Col 6 Note: Furnishing false information may constitute a violation of applicable state and federal law. Certification of Financial Officer: I certify that the above data is correct, based on the grantee's official accounting system and records, consistently applied and maintained, and that expenditures shown have been made for the purposes of, and in accordance with applicable contract terms and conditions. The funds requested are for reimbursement of actual expenditures during the report period.. 7 Accrued (unpaid) Bills & Costs Title Contact Person Date of Request 6 Unexpended Balance of Funds Req. + Program Inc. Col 4 - Col 5 5 Total Funds Disbursed Contract # Report Period 4 Total Funds Requested + Program Income Col 2 + Col 3 Typed Name 3 Program Income Earned Grantee Name Address 2 Total of Previous Requests 1 CDBG Budget
03-GA-18-manual-financial-management-v2.docx