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CONTRACT TRACKING(Award FROM Department)-Continuation ADFP Trust Fund Tracking#:ADM-ADFP-16-015 <br /> Tracking#: <br /> Contract#:/7—ON—`ff--43 9' <br /> NCGrants ID#: <br /> Total amount awarded for salaries&fringe benefits and/or wages: $ <br /> SALARY OR <br /> POSITION TITLE NUMBER OF WORK HOURLY RATE FRINGE TOTAL <br /> HRS EXPECTED OF PAY WAGE BENEFITS <br /> Example: Consultant 60 $100 /h N/A $ 6,000.00 <br /> OF COL <br /> IN-KIND MATCH CASH MATCH <br /> CATEGORY AMOUNT AMOUNT <br /> Example: Travel $ 1,000.00 <br /> GRAtD ,Ole 'SOF ld:� $ <br /> AS <br /> EXPLAIN METHOD FOR TRACKING REQUIRED MATCH <br /> ❑ Individual Time Sheets <br /> ❑ Salary Registers <br /> ❑ Copies of Invoices <br /> ❑ Match Certification Statement from Grantee's Chief Financial Officer w/appropriate documentation attached <br /> ❑ Bank Deposits(Use of Cash Match Only) <br /> ❑ Travel Reimbursement Requests <br /> ❑ Other(Itemize Below) <br /> 1. <br /> 2. <br /> 3. <br /> 4. <br /> 5. <br /> PRIOR APPROVAL OBTAINED $5,000&OVER) <br /> YES NO PENDING DATE ITEM COST <br /> ❑ ❑ ❑ $ <br /> LIST EQUIPMENT TO BE RETURNED TO DEPARTMENT <br /> ITEM ID#NUMBER CONDITION DATE RECEIVED <br /> Page 1 A—Supplemental <br /> Rev.11/15 <br />