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STATE OF NORTH CAROLINA <br /> DEPARTMENT OF PUBLIC SAFETY <br /> North Carolina Emergency Management <br /> AJF, Ili Physical Address:1636 Gold Star Drive,Raleigh,NC 27607-3371 <br /> DM Mailing Address:4236 Mail Service Center,Raleigh,NC 27699-4236 <br /> COST REPORT 2 - FISCAL YEAR 2013 <br /> EMERGENCY MANAGEMENT <br /> PERFORMANCE GRANT <br /> Grantee: ORANGE COUNTY EMERGENCY SERVICES <br /> Address: 510 MEADOWLANDS DRIVE <br /> HILLSBOROUGH NC 27278- <br /> Federal ID No.: <br /> Account No.: <br /> Grant Period: 10/01/12-09/30/14 <br /> Project: EMPG <br /> Grant File No: EMPG-2013-37135 DUNS No.: 091575191 Branch: Central <br /> Funding 20113 EWG Universal Amount Optional Amount SATCOM Balance to be Paid <br /> Worksheet Final Amount (Previously Paid) Deductions <br /> Federal/State $48,926.12 $35,000.00 $15,736.72 $1,810.60 $13,926.12 <br /> Local Match $50,736.72 $35,000.00 $15,736.72 $0.00 $15,736.72 <br /> ITotal $99,662.85 1 $70,000.00 1 $31,473.45 1 $1,810,60 1 $29,662.85 <br /> This Final Cost Report reflects completed and approved Optional amounts by your Emergency Management program minus <br /> SATCOM Deductions to give a final Balance to be Paid amount. SATCOM Deductions are from January 1,2012 to <br /> December 31,2013 and reflect all charges for SATCOM use.This Optional Amount can be used for enhancing your local <br /> emergency management program. <br /> This Cost Report require appropriate signatures and return to the state for payment. Payment will be made once all <br /> signatures have been completed and processed.This funding reimburses your county for eligible EMPG work. <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 avail ble or attached. <br /> q 1�� <br /> Oran UN m rcer Authorized Signature Date <br /> y <br /> ORANG COUNTY EMERGENCY SERW d Signature Date <br /> North Caroli Emergen Manageme Approval Signature Date <br /> Department of Public Safety Controller's Office Approval Date <br /> RECEIVED <br /> Printed:2/17/2014 2:31:16 PM MAY 13 20114 2013 Cost Report 2 <br /> NC DPS CO GRANTS <br />