HomeMy WebLinkAboutCOM 0021.089 2002-2004 M++ 0I M~
Harry Kim o°:'•;~,r ~~~'~r•+,
~fayo~- Alan R. Parker
;r F_xeculine on Agmg
+r~ oi~ni'M
County o~ Hawaii
OFFICE OF AGING
Hilo Lawon Centre, 101 Aupuni S[ree[, Suite 342. Hiles Hawaii 96720-4262
Phase (808) 961-8600 Fax (808) 961-8603
Hanama Place. 75-5706 Kuakini Highway. Sui[e 106. Kailua-Kona. Hawaii 96740-17> I
Phone (808) 327-3597 Pax (80R) 327-3595
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DATE: November 10, 2003 CD
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TO: James Y. Arakaki Council Chair and
Coble bers
FROM: Alan Par~ecutive on Aging
RE: FINAL REPORT
Name of Grant Program: USDA Reimbursement
Federal or State Grantor: United States, Department of Agriculture
County Grantee Department or Agency: Office of Aging
Grant No. (IF KNOWN):
Amount of Grant: $94,260.60
County Revenue Account Numbers: #3302.06
Amount of County Match: --0--
Grant Period (Comm. & Completion): October 1, 2002 to September 30, 2003
Goals: See Attached Annual Report
Objectives: See Attached Annual Report
Outcomes or Results: Received total amount of reimbursement allowable
from USDA.
Comm. No._Z ~.8q
Ref. Te,
Ref. Date
~ ,4n ~Ir'ea Agency an Agmg
ANNUAL USDA FINANCIAL STATUS REPORT
1. State Agency and Organization Element to Which Report is Submitted. EX@CUtIVB OffIC@ Oh A91f19
2. Federal Grant or Other Identifying Number Assigned By Federal Agency. USDA
3. Area Agency (Name and complete address, including ZIP code) '
Hawaii County Office of Aging
Hilo Lagoon Centre
101 Aupuni Street, Suite 342
Hilo, HI 96720
4. Final Report 5. Basis 6. FFY 2003
Annual meal count:
x? Yes ? No Cash xQ Accrual 82.023
7. Funding/Grant Period
From: (Month, Day, Year) To: (Month, Day, Year)
10/01 /02 03/31 /03
8. Period Covered by this Report
From: (Month, Day, Year) To: (Month, Day, Year)
10/01/02 03/31/03
9. Transactions: Annual
a. Total Federal Outlays (USDA Funds spent) 37,058.22
b. Total USDA Federal funds authorized for this funding period 37,058.22
c. Unspent balance of USDA Federal funds (USDA funds not spent) 0
10. Remarks: Attach any explanations deemed necessary or information required by Federal sponsoring agency in compliance wit
governing legislation.
I certify to the best of my knowledge and belief that this report is correct and complete and that all outlays are fo
11. Certification: the purposes set forth in the award documents.
Typed or Printed Name and Title Telephone (Area code, number and extension)
Alan Parker, Executive on Aging (808) 961-8600
Signature of Authorized Certif/y/ing Official/ Date Report Submitted
l/IIITTT°°° d 10/24/03
USDA Annual Financial Status Report A-4 EOA Original 10/1 fi/01
F 0 C D E F G H I J K ~ M H Q P
FINANCIAL STATUS REPORT 2. FUND IDENTIFICATION 7. FINAL REPORT 4. BASIS PAGE 1 OF 1
x 1. CONTRACTOR INFORMATION (Name, Address) FV 2003 Nutrition Service Incentive Pro ram NSIP YES X NO CASH ACCRUAL X PAGES
3 Hawaii County OfTCe of Aging 5. FUNDING /GRANT PERIOD 6. PERIOD COVERED BY THIS REPORT
a 101 Au uni Street Suite 342 Hilo HI 96720 FROM A rill 2003 TO Se tember 30 2003 FROM A ril 1 2003 TO Se tember 30 2003
s (a) PREVIOUS REPORT (b) THIS PERIOD (c) CUMULATIVE TOTAL (AAA) (d) NSIP
a 1. Direct 2. Area Plan 7. Total 1. Direct 2. Area Plan 3. Total 1. Direct 2. Area Plan 3. Total 1. Direct 2. Area Plan 1. Total
~ 7. TRANSACTIONS: Services Admin. Services Admin. Services Admin. Services Admin.
e A. Total ouda s 80 $0 EO E57 202 $0 $57 202 $57 202 $0 $57 202 57 202 $0
~ { n 't °z`w ,y z'y`t s u/°ew` s°. ,n'_ 4 f',F+i' ~ rE E57,202
py' vJ+~"~~ i3 fi ~'~ez < ~P rs . ~ s ~ ~ a~ t' ~~i 'Si~''ssr ~m~9 m!: `.ice / ,l
f/.a t+€,r',. + '~s,=1a3~'.'-..~^y"~r~~'S~f..E`~b ^ rr yz* gn`~~ ~~s. t'~ „ , ry :x - ~ z §!-w,°~' ~ ~h~',`~-`r~'s ri°s~. v~~:,',~~w~~. ~y »~er; ' ° I..,~s~~;
s B. All other reci lent ouda s: ~ s~..~T~"~ - u.. " m. S,F'vr'a^'~ - .
~
I
,0 1. Thirtl art in-kind contributions 80 $0 SO $0 $0 EO EO EO $0 EO $0 50
2. Reci lent outla s EO EO $0 $0 $0 $0 SO $0 $0 $0 $0 EO
u 3. State outla s $0 EO $0 $0 $0 $0 $0 $0 EO SO $0 SO
1x C Total reci lent outla s 6.1+8.2+6.3 $0 EO EO $0 $0 $0 $0 $0 $0 $0 g0 $0
,a D Federal share of net ou[la s A - C 80 $0 SO $57 202 0 557 202 $57 202 $0 E57 202 $57 202 $0 57 202
,s E Total unli uidated ohli ations F+ G COMPLIANCE REQUIREMENTS: $0 $D $0 $0 $0 EO
,a F Reci lent share of unli uidated ohli ations 1 EO EO $0 $0 $0 $0
n G Fetleral share of unli uitlated obli ations 2 EO $0 $0 $0 $0 SO
,e H Total fetleral share D + G E57 202 EO g57 202 557 202 EO $57 202
19 I Total federal funds authorizetl E57 202 EO $57,202 E57 202 $0 $57 202
zo J Unobli ated balances of federal funds I - H 0 SO $0 SO 0 gp
K Dishursetl o ram income Atltl. Cost Alt. 3 EO $0 $0 EO $0 $0
zz L Untlisbursed ro ram income Add. Cost Alt. 4 EO EO SO EO $0 $0
z3 M Total ro ram income realizetl K+L 5 EO 0 g0 $0 $0 0
8. FEDERAL PRIORITY SERVICES ~ 8.a. REMARKS:
x< ai?"Re'h C Actual °k Amount Provitletl
xs Access Service o.oo~
zs In-Home Services o.00Y°
n Le ai Assistance o.oox
ze Total 'ra' ~ O.oo°6 Eo
x9 9. CERTIFICATION -I certify to the best o/ my knowledge and belief Signature Authodzed Certifying Off' ~ Date Report Submitted
30 that this report is correct antl complete antl that all outlays and
October 2a 2007
x1 unliquidated obligations are for the purposes set forth in the contract. Typed or Pdntetl Name antl Title Telephone No.
i
Alan Parker Executive on A in 606 961-6660
EOA FORM A-1-1x3 (Rev. 911/200])