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Reimbursement Request Number Enter the Reimbursement Request number. Total Cost Charqed to this Grant Enter the Total Cost Charged to the Grant In this column. Provide detailed information on Match (Not applicable for all grants). Project Select the project letter from the drop -down list, or manually enter the letter In capitalization format. Direct/Subaward Use the drop -down list to Identify If the Project Is Direct or Subaward Project Name Enter the name of the project. Funding Source Select a Funding Source from the drop -down list. A full description of the Funding Source can be viewed In Comments (place curler over Column D, Row 21). Discipline Select a Discipline from the drop -down list. A full description of the Disciplines can be viewed In Comments Amount This Request (place curser over Column E, Row 21). Solution Area Select a Solution Area from the drop -down list. Solution Area Sub - Category Select a Solution Area Sub - Category from the drop-down list. This list Is dependent on a selection from the Solution Area Category drop -down list. The Solution Area Sub- Category will not display the drop -down list unless a Solution Area Category Is Mail workbook to: selected. Type of Match Select the Type of Match options from the drop -down list Total Obligated Match Enter the total obligated match amount for this project in this column. Previous Match expended Automatic calculation of amount approved previous. Warninpl D ,tt eUcr informauon In this column, contains formulas. Current Match For Reimbursement requests, enter the current match amount In this column. Reimbursement Request Number Enter the Reimbursement Request number for this reimbursement. Total Match Expended Automated calculation of Total Match Expended. Wamingl Do not enter information in this column, contains formulas. Remaining Balance Automatic calculation of Remaining Balance. Warningl DO notenter in -,lion in this column, contains formulas. Percentage Expended Automatic calculation of Percentage Expended. Warning! DO notlenter Information In this column, contains formulas. Authorized Agent sheet must accompany ALL Reimbursement Requests, Modifications and the Initial Application. Type Click on the appropriate button W describe what type of workbook is being submitted. Available options are: INITIAL APPLICATION, REIMBURSEMENT REQUEST, FINAL REIMBURSEMENT REQUEST and MODIFICATION Expenditure Period Dates Enter the beginning and ending expenditure period dates. REIMBURSEMENT REQUEST: Expenditure periods are decided by the Subreciplent and can span single or multiple months at a time. NOTE: Expenditure periods cannot cross state fiscal year. Modifications do not require expenditure period entries. REHAB or MOD Request # Enter the REIMB or MOD Request # that is associate with the most recent request. Amount This Request Enter the amount that Is being requested. Authorized Agent Enter the name of Authorized Agent. Sign and date after printing. Original signature required. Send hard copy of workbook W address (provided). Emergency Management Performance Grants (EMPGI: Mail workbook to: California Governor's Office of Emergency Services Program Specialist's Name 3650 Schriever Avenue Mather, CA 95655 FMFw v1.16 -1016 55A-1 5