Toggle search form
Search for:
Toggle navigation
Homeland Security Emergency Management
Home
Grants
EMPG Resources
EMPG Application
HMEP Grant Resources and Information
Hazard Mitigation Assistance Grant Resources and Information
Training & Exercise Grants
Warm Zone EMS Grant
Public Information
Community Outreach Office Materials
EMD Resource Templates
HSEM Quarterly Newsletter
ReadyNH.gov
See Something, Say Something
REP
EPZ Quarterly Checklist
Host Quarterly Checklist
STSA Quarterly Checklist
Seabrook Station Assessment
REP Training
Do You Require Evacuation Assistance In An Emergency?
PDAFN List Revision Numbers
Current REP Forms
2024 Seabrook Station Brochure
Mitigation and Recovery
Public Assistance
Hazard Mitigation Grants
Continuity of Operations
State Hazard Mitigation Plan
Commodities Distribution Annex
Local Emergency Operations Plan (LEOP) Resource Documents
Facility Self-Assessment Tool
Local Hazard Mitigation Planning
Threat & Hazard Identification and Risk Assessment (THIRA) / Stakeholder Preparedness Review (SPR)
Schools
School Emergency Operations Plans
School Emergency Operations Plan (EOP) Submission Portal
School Physical Security Assessment Program
School Training & Exercises Program
Free Online ICS/NIMS Training
Request for School Training/Exercise
NH School Resource Officer (SRO) Conference
2022 SRO Conference Agenda
School Reunification Game
School Resource Documents
Order See Something, Say Something for Schools Materials
NH School Safety Resource Center
WebEOC Resources
WebEOC User Guide
Training & Exercise
About Training, Exercise & Development Services
Training & Exercise Grants
Training & Exercise Grant Guidance
Training & Exercise Homeland Security Grant Application
Training & Exercise Controller, Evaluator & Instructor Grant Application
Training & Exercise Homeland Security Grant Reimbursement
Exercises
Upcoming Exercises
Exercise Application (Non-Grant)
Exercise Resources
School Reunification Game
Equipment Request
Training
Training Policy & Guidance
Training Request
Available Training
DHS/FEMA Real Time Virtual Training
Course Resources
Houses of Worship Resources
Multi-Year Training & Exercise Plan Survey
Contact Us
Internship Program
Variable Message Signs (VMS)
EMPG Quarterly Reporting Form
EMPG Quarterly Progress Reporting Form
Step
1
of
5
20%
EMPG Quarterly Progress Reporting Form
Contact and Project Information
Performance Period
*
October 1 to December 31 (Report Due January 15)
January 1 to March 31 (Report Due April 15)
April 1 to June 30 (Report Due July 15)
July 1 to September 30 (Report Due October 15)
Sub-Recipient Name (City/Town/Entity Name)
*
Sub-Recipient Address
*
Street Address
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Sub-Recipient Phone
*
Primary Point of Contact (POC)
First
Last
Primary POC Phone
Federal Fiscal Year of Grant
*
This can be found on your signed Grant Agreement or Award Letter sent to you by the EMPG Program Coordinator.
FFY 2021 (Completion Date August 31, 2024)
FFY 2021 ARPA (Completion Date August 31, 2024)
FFY 2022 (Completion Date August 31, 2024)
FFY 2023 (Completion Date August 31, 2025
FFY 2023 EOC (Completion Date April 30, 2026)
Project Name
*
Please select the project type
*
Plan
Project
Risk Indicator
*
The Risk Indicator can be found in your EMPG Award Letter.
Low
Medium
High
Status Reports
Project Status
*
Not Started
On Schedule
Behind Schedule
Ahead of Schedule
Completed
Cancelled
Please describe the details of the progress and status of the project during this quarter and how it compares to the milestones outlined in the project application.
*
Percentage of Scope of Work Complete
*
Please enter a number from
0
to
100
.
Describe in detail any problems, delays, or other issues that may have been encountered and you may require assistance on.
*
Please upload a current picture showing the progress of your project.
Drop files here or
Select files
Accepted file types: pdf, jpg, gif, xslx, doc, docx, ppt, pptx, xsl, Max. file size: 1 GB.
Financial Overview
Please provide an analysis of expenditures during this quarterly report performance period
*
Total Grant Share
*
Total Project Expenditures to Date
*
Are Cost Overruns Expected?
*
Yes
No
Cost overrun Explanation including Cost overrun amount.
*
Additional Information
Questions will be generated if you selected Medium or High on the Risk Indicator section of this report. Click Next to continue.
Please provide details on project whereabouts
*
Please provide detail on what has been completed this quarter. Provide photos of project progression and/or purchased equipment.
Photos
Drop files here or
Select files
Max. file size: 1 GB.
What milestone(s) or objective(s) do you plan to accomplish in the next quarter?
*
Are there any tasks that must be completed for your grant in the EMPG Program that are confusing to you or that you do not know how to complete? Please select all that apply.
*
Completing the Quarterly Progress Report(s)
Reimbursement Requests
Closeout Process
Completing the Equipment Inventory Form
Audit Certification Form
Other
I am familiar with all EMPG processes
Other
Please explain what you would like explanation on.
Site Visit Dates
*
If your community is a Medium or High Risk subreceipient based on the Risk Indicator in the Award Letter, a Site Visit with the EMPG Coordinator may be necessary. Please indicate one of the following options in regards to scheduling this visit.
I am in the process of scheduling a Site Visit
I have scheduled a Site Visit with the EMPG Program Coordinator
I have not yet scheduled a Site Visit
Please list 3 possible dates you would be available for a Site Visit by the EMPG Program Coordinator
*
MM slash DD slash YYYY
Date 2
*
MM slash DD slash YYYY
Date 3
*
MM slash DD slash YYYY
Certification and Submission
By Selecting the Box Below and entering my name and today's date, I agree that I understand that these forms are required to be submitted on a quarterly basis. I understand that failure to report by the deadline or providing any false information may result in the inability to distribute any further monies or benefits related to this project until a complete and accurate report has been sent to NH HSEM. In addition, failure to report on time may result in the loss of future funding/grant awards.
*
I understand and Agree
Name
*
First
Last
Submission Date
*
MM slash DD slash YYYY
Email
*
Enter Email
Confirm Email
If you would like, please enter an additional e-mail address for a copy of the Quarterly Report to be sent to.
Enter Email
Confirm Email
Name
This field is for validation purposes and should be left unchanged.