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Grant Expenditure Form <br />PROJECT Number <br />GRANTEE NAME <br />Pre- <br />Warrant/Check # (1) <br />Date (2) <br />Recipient (3) <br />Purpose (4) <br />Construction <br />Construction <br />Amount 5 <br />Amount 6 <br />PRE -CONSTRUCTION Subtotal (5) <br />Construction Subtotal (6) <br />Grand Total (5) + (6) <br />List only ELIGIBLE COSTS charged to the GRANT. <br />4, <br />R <br />4, <br />Column (1) Use of electronic payment numbers/electronic funds transfer numbers in the "Warrant/Check <br />Number" column is acceptable. Please include an "EP" next to the electronic payment <br />numbers/electronic funds transfer numbers. <br />If IN-HOUSE EMPLOYEE SERVICES Or GRANTEE's own equipment was used, a work order or other tracking <br />number can be used instead of a check/warrant number. <br />Column (2) Date payment was made to recipient. If IN-HOUSE EMPLOYEE SERVICES were used, the date <br />that the work was performed may be used. <br />Column (3) Name of Contractor, IN-HOUSE EMPLOYEE SERVES, or other entity performing work. <br />Column (4) Brief description of cost, such as "design", "permits", "construction." When describing such <br />costs, such as "design", state what the design is for, and who prepared it. For items such as "permits", <br />state what kind of permit(s). For items such as "construction," state what type or portion of construction, <br />or what was constructed. (For instance, "community center", "walkway", etc.) <br />Column (5) PRE -CONSTRUCTION costs subject to the 25% cap. <br />Column (6) DEVELOPMENT costs eligible for up to 1 00% Of GRANT amount. <br />An electronic version of this form is available at www.parks.ca.gov/grants. <br />GRANTEES may use their own spreadsheet if it contains the required information shown above. <br />37 <br />