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Public Assistance Project Completion and Certification Report

Please complete a form for each individual project you are reporting on.

Public Assistance – Project Completion and Certification Report

This form is to be completed when all projects the subrecipient has received Public Assistance funds for, in relation to this disaster, have been completed.

Disaster*
Select the Disaster this Project Completion and Certification Report is for.
Disaster – Other*
Subrecipient*
Municipality or Organization Name
This field is hidden when viewing the form
Select the number of projects you are reporting on*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
Project 1*
List the EMMIE PW number found on the Award Letter.
For projects that have been amended, please list the version number after the PW number (Example: PW# 102.1, where “.1” indicates that the project is version 1 instead of version 0)

Example: Where to find PW # on Award Letter

Please enter a number from 0 to 500.
List the Grants Portal project number for project 1 found on the Award Letter*
Date on which Project 1 was completed*
MM slash DD slash YYYY
Total Award Amount (Fed Share)
This field is hidden when viewing the form
Project 2*
List the EMMIE PW number found on the Award Letter.
For projects that have been amended, please list the version number after the PW number (Example: PW# 102.1, where “.1” indicates that the project is version 1 instead of version 0)
Please enter a number from 0 to 500.
This field is hidden when viewing the form
List the Grants Portal project number for project 2 found on the Award Letter*
This field is hidden when viewing the form
Date on which Project 2 was completed*
This date must be on or before the end of the Period of Performance (POP) for the project.
MM slash DD slash YYYY
This field is hidden when viewing the form
Total Award Amount (Fed Share)
This field is hidden when viewing the form
Project 3*
List the EMMIE PW number found on the Award Letter.
For projects that have been amended, please list the version number after the PW number (Example: PW# 102.1, where “.1” indicates that the project is version 1 instead of version 0)
Please enter a number from 0 to 500.
This field is hidden when viewing the form
List the Grants Portal project number for project 3 found on the Award Letter*
This field is hidden when viewing the form
Date on which Project 3 was completed*
This date must be on or before the end of the Period of Performance (POP) for the project.
MM slash DD slash YYYY
This field is hidden when viewing the form
Total Award Amount (Fed Share)
This field is hidden when viewing the form
Project 4*
List the EMMIE PW number found on the Award Letter.
For projects that have been amended, please list the version number after the PW number (Example: PW# 102.1, where “.1” indicates that the project is version 1 instead of version 0)
Please enter a number from 0 to 500.
This field is hidden when viewing the form
List the Grants Portal project number for project 4 found on the Award Letter*
This field is hidden when viewing the form
Date on which Project 4 was completed*
This date must be on or before the end of the Period of Performance (POP) for the project.
MM slash DD slash YYYY
This field is hidden when viewing the form
Total Award Amount (Fed Share)
This field is hidden when viewing the form
Project 5*
List the EMMIE PW number found on the Award Letter.
For projects that have been amended, please list the version number after the PW number (Example: PW# 102.1, where “.1” indicates that the project is version 1 instead of version 0)
Please enter a number from 0 to 500.
This field is hidden when viewing the form
List the Grants Portal project number for project 5 found on the Award Letter*
This field is hidden when viewing the form
Date on which Project 5 was completed*
This date must be on or before the end of the Period of Performance (POP) for the project.
MM slash DD slash YYYY
This field is hidden when viewing the form
Total Award Amount (Fed Share)
This field is hidden when viewing the form
Project 6*
List the EMMIE PW number found on the Award Letter.
For projects that have been amended, please list the version number after the PW number (Example: PW# 102.1, where “.1” indicates that the project is version 1 instead of version 0)
Please enter a number from 0 to 500.
This field is hidden when viewing the form
List the Grants Portal project number for project 6 found on the Award Letter*
This field is hidden when viewing the form
Date on which Project 6 was completed*
This date must be on or before the end of the Period of Performance (POP) for the project.
MM slash DD slash YYYY
This field is hidden when viewing the form
Total Award Amount (Fed Share)
This field is hidden when viewing the form
Project 7*
List the EMMIE PW number found on the Award Letter.
For projects that have been amended, please list the version number after the PW number (Example: PW# 102.1, where “.1” indicates that the project is version 1 instead of version 0)
Please enter a number from 0 to 500.
This field is hidden when viewing the form
List the Grants Portal project number for project 7 found on the Award Letter*
This field is hidden when viewing the form
Date on which Project 7 was completed*
This date must be on or before the end of the Period of Performance (POP) for the project.
MM slash DD slash YYYY
This field is hidden when viewing the form
Project 8*
List the EMMIE PW number found on the Award Letter.
For projects that have been amended, please list the version number after the PW number (Example: PW# 102.1, where “.1” indicates that the project is version 1 instead of version 0)
Please enter a number from 0 to 500.
This field is hidden when viewing the form
List the Grants Portal project number for project 8 found on the Award Letter*
This field is hidden when viewing the form
Date on which Project 8 was completed*
This date must be on or before the end of the Period of Performance (POP) for the project.
MM slash DD slash YYYY
This field is hidden when viewing the form
Project 9*
List the EMMIE PW number found on the Award Letter.
For projects that have been amended, please list the version number after the PW number (Example: PW# 102.1, where “.1” indicates that the project is version 1 instead of version 0)
Please enter a number from 0 to 500.
This field is hidden when viewing the form
List the Grants Portal project number for project 9 found on the Award Letter*
This field is hidden when viewing the form
Date on which Project 9 was completed*
This date must be on or before the end of the Period of Performance (POP) for the project.
MM slash DD slash YYYY
This field is hidden when viewing the form
Project 10*
List the EMMIE PW number found on the Award Letter.
For projects that have been amended, please list the version number after the PW number (Example: PW# 102.1, where “.1” indicates that the project is version 1 instead of version 0)
Please enter a number from 0 to 500.
This field is hidden when viewing the form
List the Grants Portal project number for project 10 found on the Award Letter*
This field is hidden when viewing the form
Date on which Project 10 was completed*
This date must be on or before the end of the Period of Performance (POP) for the project.
MM slash DD slash YYYY
Contact Information
Subrecipient Authorized Representative Name*
First Last
Title within Organization*
Email*
Enter Email Confirm Email
Phone*
Certification
By checking this box, I certify that to the best of my knowledge and belief all work and costs claimed under the Federal Emergency Management Agency's Public Assistance Grant Program are eligible in accordance with the grant conditions, all work claimed has been completed, and all costs claimed have been paid in full.*
- I Understand and Agree
Comments
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