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Subgrantees invoice And Expenditure Report <br />1.Recipient Organization: <br />2. Funding Source: <br />County of Hawaii, Office of Management <br />State of Hawaii, Department of Human Services <br />3. Address: <br />4. Contract Number: <br />5. Contract Amount: <br />25 Aupuni Street <br />DHS-I9-GOV-0085 <br />$1 „500,000,00 <br />6. Purpose <br />Hilo, HI 96720 <br />A. X Initial Advance C. Reimbursement <br />0.,00% <br />B Periodic Advance D. Final Invoice <br />7. Contract Period: <br />8. Period Covered By This Report: <br />6115/19 - 6/14122 <br />6115/19 - 9/14/19 <br />9. Cash Transaction Data: <br />a. Total Cash Received To Date ........................... <br />1. Total Received <br />2. Total Invoiced <br />b. Total Disbursment.................. <br />c. Cash On Hand/Deposit..................................... <br />d. Estimated Disbursement From: <br />e Amount of Cash Requested Herewith .............. <br />$0,00 <br />$0.00 $0,00 <br />$0,00 <br />$125,000.00 <br />10. Categories: <br />Contract <br />Budget <br />Expenditures: <br />Current <br />Period <br />Expenditures: <br />Year to Date <br />Percent of <br />Budget <br />Expended <br />Personnel Costs <br />$O-00 <br />$0,00 <br />$0.00 <br />0.00% <br />Service Fees <br />$0,00 <br />0.,00% <br />Contractual Services - Subcontracts <br />$1,500,000.00 <br />$0.00 <br />$0-00 <br />0,00% <br />Program -support., development activities, volunteers <br />$0.00 <br />0,00% <br />Advertising & Marketing <br />$0,00 <br />0.00% <br />Board Meeting <br />$0.00 <br />0.00% <br />Dues - Subscriptions <br />$0.00 <br />0.00% <br />Equipment Purchases <br />$0,00 <br />$0,00 <br />$0.00 <br />0.00% <br />Motor Vehicle Purchases <br />$000 <br />$0,00 <br />$0.00 <br />0.00% <br />Equipment Purchase <br />$0.00 <br />$O-00 <br />$0.00 <br />0.00% <br />Equipment Repair and Maintenance <br />$0.00 <br />0.00% <br />Facility renovations and site work <br />$0..00 <br />$0.00 <br />$0.00 <br />0.00% <br />Miscellaneous <br />$0.00 <br />0.00% <br />Custodial Services <br />$0.00 <br />0.00% <br />Lease Rent <br />$0,00 <br />$0,00 <br />$0.00 <br />0.00% <br />Utilities <br />$0,00 <br />$0,00 <br />$0.00 <br />0.00% <br />Postage <br />$0.00 <br />0,00% <br />Printin 8 Publications <br />$0,00 <br />$000 <br />$0.00 <br />0.00% <br />Professional Fees <br />$0.00 <br />$0.00 <br />0.0000 <br />TOTAL$1,500,000„00 <br />$0.00 <br />$0.00 <br />0.00% <br />11. Comments: Request for advanced payment. <br />2 -Certification' I Certify to the best of my knowledge and belief that this report is true in all respects and that all <br />disbursments have been made for the purpose and conditions of the grant agreement <br />rp�l -i100 <br />Signature Date Reported <br />Reviewed By: (Signature Homelessness Assistant) Date <br />Reviewed By: (Signature -Community Dev Specialist) Date <br />