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37 Grant Expenditure Form PROJECT Number_______________________ GRANTEE NAME __________________________ Warrant/Check # (1) Date (2) Recipient (3) Purpose (4) Pre- Construction Amount (5) Construction Amount (6) _________________________________________________________________________ PRE-CONSTRUCTION Subtotal (5) $_____________ Construction Subtotal (6) $_____________ Grand Total (5) + (6) $_____________ List only ELIGIBLE COSTS charged to the GRANT. Column (1) Use of electronic payment numbers/electronic funds transfer numbers in the “Warrant/Check Number” column is acceptable. Please include an “EP” next to the electronic payment numbers/electronic funds transfer numbers. If IN-HOUSE EMPLOYEE SERVICES or GRANTEE’S own equipment was used, a work order or other tracking number can be used instead of a check/warrant number. Column (2) Date payment was made to recipient. If IN-HOUSE EMPLOYEE SERVICES were used, the date that the work was performed may be used. Column (3) Name of Contractor, IN-HOUSE EMPLOYEE SERVES, or other entity performing work. Column (4) Brief description of cost, such as “design”, “permits”, “construction.” When describing such costs, such as “design”, state what the design is for, and who prepared it. For items such as “permits”, state what kind of permit(s). For items such as “construction,” state what type or portion of construction, or what was constructed. (For instance, “community center”, “walkway”, etc.) Column (5) PRE-CONSTRUCTION costs subject to the 25% cap. Column (6) DEVELOPMENT costs eligible for up to 100% of GRANT amount. An electronic version of this form is available at www.parks.ca.gov/grants. GRANTEES may use their own spreadsheet if it contains the required information shown above. 201