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<br />ACT1A Bicycle/Pedestrian Countywide Discretionary Fund Program <br />Cycle 3 Grant Funding Agreement <br /> <br />ACTIA No. A07-0013 <br /> <br />ATTACHMENT H <br /> <br />SAMPLE FINAL REPORT FORMAT <br /> <br />(Project Sponsors can download current Pinal Report Template in MS Word format from ACTIA website or <br />contact ACTIA for a copy ofthe file.) <br /> <br />PROJECT SPONSOR: <br />PROTECT TITLE: <br />ACTIA PROJECT No: <br /> <br />TOTAL ACTIA FUNDS AWARDED TO PROJECT: $ <br />FINAL MEASURE B AMOUNT EXPENDED: $ <br />TOTAL PROJECT COST (all fund sources): $ <br />COMPLETION / ACCEPTANCE DATE: <br /> <br />FINAL PROJECT DESCRIPTION: <br /> <br />(prol!Zde a brieldeJ[ription olJerviceJ prolJided, imprOlJementJ conJtmcted and/ or implemented in accordance witb tbis grant <br />funding qgreement.) <br /> <br />SUMMARY OF PROJECT DELIVERY MILESTONES: <br /> <br />(ProlJide a bri~ldeJcription qf actiom taken and mileJtoJZeJ reacbed to delilJer tbe project.) <br /> <br />SUMMARY OF PROJECT BENEFITS: <br />(ProlJide a brief de.rcription of projat benefitJ.) <br /> <br />FINAL INVOICE: <br /> <br />(Submit a Request for /lCfIA Grant ReimburJemenl RequeJtform with tbe word "Final" added to tbe Billing No. and <br />a Jtlmmary o/the total COJtJ and MeaJure B COJtJ Jegregated ~y pbaJe attacbed in addition to the Jupporting documentation <br />requiredfor an} amount qlreimbunement requeJted on tbejinal imJoice. J ndude a Jecond summary Jbowing tbe sources <br />and amountJ I!y pbaJe ql tbe otherfunrLr uJed to cover tbe d(lJerence in COJtJ between tbe total costJ and MeaJure B COJtJ.) <br /> <br />B ikePed-Cycle3-A0700 13 -SanLeandro-SloughBridge- Final.doc <br /> <br />Page 19 of 19 <br />