QUARTERLY REPORT



|Indian Environmental General Assistance Program |

|QUARTERLY REPORT |

| |Is this contact information new? ______ Yes |

|Recipient Name | |

|Recipient Environmental Contact | |

|Recipient Phone Number | |

|Grant Name |Indian Environmental General Assistance Program (GAP) |

|Grant Number and Project Period |GA- |

|Reporting Quarter/Dates | |

|EPA’s Project Officer’s Name and Address | |

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|Comparison of Amount Budgeted vs Amount Spent |

|Please describe how much you budgeted versus how much money you actually need to complete activities |

|Total Grant Amount Awarded: |Amount Spent: |

|SEE “Total Budget Period Cost” block on |How much money have |

|Grant Award Agreement for this figure |you actually spent? |

|Funds Necessary to Complete this Project: |Unexpended Funds Remaining in the Grant: |

|How much money will it cost to complete this project? |How much money remains in your grant? |

|Funds Requested from EPA to Date: |Amount & Date of Last Request |

|Cumulative; what is the total amount |for Reimbursement/Advance Payment: |

|requested from EPA? | |

|Additional Information |

|Issues you need the EPA Project Officer to respond to quickly: |

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|Component #___: |

|Estimated Costs: |

|Actual Costs: |

|Estimated Work Years: |

|Task |Timeframe |*Status |Outputs |Outcomes |*Comments |

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|Component #___: |

|Estimated Costs: |

|Actual Costs: |

|Estimated Work Years: |

|Task |Timeframe |*Status |Outputs |Outcomes |*Comments |

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|Component #___: |

|Estimated Costs: |

|Actual Costs: |

|Estimated Work Years: |

|Task |Timeframe |*Status |Outputs |Outcomes |*Comments |

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|Component #___: |

|Estimated Costs: |

|Actual Costs: |

|Estimated Work Years: |

|Task |Timeframe |*Status |Outputs |Outcomes |*Comments |

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|Component #___: |

|Estimated Costs: |

|Actual Costs: |

|Estimated Work Years: |

|Task |Timeframe |*Status |Outputs |Outcomes |*Comments |

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*As required under 40 CFR 31.40 and 35.515, recipients should discuss accomplishments versus work plan commitments; cumulative effectiveness of the work performed under all work plan components; existing and potential problem areas, including slippage if commitment is not met; and suggestions for improvement, including, where feasible, schedules for making improvement and, when appropriate, analysis and explanation of cost overruns. This information can be presented in the “status” and “comments” columns.

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