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Certificate of Com lotion <br />4 <br />1. Name ofRecinient: Oran e Count 3. ProiectNumber: SS-1 <br />2. Grant Number: O1-C-0799 4. ProicctName: Scattered Site Housing e a ro <br />5. Final Statement of Costs <br /> To Be Completed <br />B Reci Tent To Be Completed <br />B DCA <br /> <br />Program Activity Categories <br />a Paid <br />Costs Unpaid <br />Costs <br />c Total Costs <br />(Col. b + c) <br />d _ <br />Approved <br />Total Costs <br />e <br />a. Acpuisi[ion <br />b. Disposition <br />c. Public facilifies and improvements <br />l11 Senior and handicapped centers <br />(2) Parks, nlaverounds and recreation facilities <br />(31 Neiehborhood facilities <br />(41 Solid waste disposal facilities <br />(5) Pire protection facilities and epuinment <br />(61 Parkine facilities <br />(71 Public utilities. other than water and sewer <br />(81 Water and sewer improvements <br />(91 Street improvements <br />(101 Flood and dninase improvements <br />(l 11 Pedestrian improvements <br />(121 Other public facilities <br />(131 Sewer improvements <br />(141 Water improvements <br />d. Clearance activities <br />e. Public services <br />£ Relocation assistance <br />e. Construction. rehab. and preservation activities <br />(11 Construction or rehab. of com. & induct. bldas. <br />(31 Rehabilitation ofprivatelvownedbuildines 360,000 360,000 <br />(31 Rehabilitation ofpublicly owned buildines <br />(41 Code enforcement <br />(5) Historic preservation <br />h. Development fmancine <br />(I) Workine capital <br />(21 Machinerv and epuipment <br />i. Removal of architectural bamers <br />i. Other activities <br />Ic. Subtotal 360, 000 360, 000 <br />1. Plannine <br />m. Administration <br />n. Total 4 400 000 <br />o. Less: Program Income Applied to Program Costs <br />o. ):pual: GrantAmountAppliedtoProe.Costs 400,000 400 000 <br />6. Computation of Grant Balance <br /> <br /> <br />Description To Be <br />Completed By <br />Reci Tent To Be <br />Completed By <br />DCA <br />(al <br />Amount <br />b Approved <br />Amount <br />c <br />(11 Grant Amount Applied To Program Costs (From Line nl 400 r 000 <br />(21 Estimated Amount For Unsettled Third -Party Claims <br />(31 Subtotal 400,000 <br />(41 Grant Amount Per Grant Agreement 400 , 000 <br />(51 Unutilized Grant To Be Canceled (Line 4 Minus Line 31 <br />(61 Grant Funds Received 400, 000 <br />(71 Balance of Grant Payable (Line 3 Minus Line 61* 0 <br />* If' Line 6 exceeds Line 3, enter the amount of the excess on Line 7 as a negative amount, This amount shall be <br />repaid to DCA by check, unless DCA has previously approved use of these funds. <br />ram <br />