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222x Filetype XLSX File size 0.83 MB Source: files.nc.gov
Sheet 1: MAR2020
| BE SURE TO ATTACH SUMMARY PAGE | NCCFW&YI - HB1105 CARES ACT FUNDS | THIS REPORT IS DUE BY THE 13TH OF EACH MONTH | |||||||
| AND SUPPORTING DOCUMENTS | Monthly Expense Report 2020 | to CFWHB1105CR_FUND@doa.nc.gov | |||||||
| March 2020 | |||||||||
| PROGRAM NAME: | |||||||||
| TAX ID #: | |||||||||
| COUNTY: | |||||||||
| DV or SA Program: | |||||||||
| MONTHLY EXPENDITURES | |||||||||
| March, 2020 | $0.00 | ||||||||
| April, 2020 | |||||||||
| May, 2020 | BTR not required for 20% or less. | ||||||||
| June, 2020 | |||||||||
| July, 2020 | |||||||||
| August, 2020 | |||||||||
| September, 2020 | |||||||||
| October, 2020 | |||||||||
| November, 2020 | |||||||||
| December, 2020 | |||||||||
| 2020 EXPENSES | $0.00 | 2020 TOTAL EXPENSES | $0.00 | ||||||
| #DIV/0! | |||||||||
| CONTRACT BUDGET LINE ITEMS: | ACTUAL BUDGET | PREVIOUS MONTH'S EXPENSE | ACTUAL MONTHLY EXPENSE PROGRAM COST | EXPENDITURE | GRANT BALANCE | ||||
| PERSONNEL COSTS ONLY/ EMPLOYEE EXPENSES | |||||||||
| Hazard pay cost for employees that are dedicated to COVID-19 | |||||||||
| Position/Title | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| Position/Title | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| Position/Title | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| Position/Title | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| Position/Title | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| Position/Title | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| Position/Title | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| Position/Title | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| Position/Title | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| Position/Title | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| FICA (Social, Security, Medicare) | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| FRINGE BENEFITS | |||||||||
| Worker's Compensation | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| Unemployment Insurance | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| Retirement | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| Medical Insurance | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| 401(K) | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| Life/Disability Insurance | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| Other (Specify The Cost Item) | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| CONTRACTED LABOR & OTHER SERVICE EXPENSES | |||||||||
| Specify | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| SUBCONTRACT EXPENSES | |||||||||
| Specify | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| GOODS EXPENSES | |||||||||
| Specify | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| EQUIPMENT EXPENSES (items over $500) | |||||||||
| Specify | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| ADMINISTRATIVE EXPENSES | |||||||||
| Specify | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| OTHER EXPENSES | |||||||||
| Specify | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| TOTALS: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | ||||
| INVENTORY PURCHASED | |||||||||
| EQUIPMENT TYPE | BRAND | MODEL | SERIAL # | YEAR PURCHASED | COST | ||||
| EXAMPLE: automobile | EXAMPLE: Honda | EXAMPLE: Civic | EXAMPLE: VIN # | EXAMPLE: 2020 | EXAMPLE: 10,000.00 | ||||
| The information provided is correct and accurate to the best of my knowledge. | |||||||||
| EXECUTIVE DIRECTOR'S SIGNATURE AND DATE | PREPARED BY SIGNATURE AND DATE | ||||||||
| PRINT NAME BELOW | PRINT NAME BELOW | ||||||||
| ………………………………………………… | Revised 11/2020 | ||||||||
| Summary Page | CARES ACT | 0 | |||
| Fiscal Year | County: | 0 | |||
| Tax ID#: | 0 | For the Month of: | MARCH 2020 | ||
| Expenditure | Date of Expense | Doc# | Additional Comments on Expenditure | Amount of Submitted Expense | |
| Total Program | |||||
| $- | |||||
| TOTAL EXPENSES FOR THIS COST REPORT | |||||
| BE SURE TO ATTACH SUMMARY PAGE | NCCFW&YI - HB1105 CARES ACT FUNDS | THIS REPORT IS DUE BY THE 13TH OF EACH MONTH | |||||||
| AND SUPPORTING DOCUMENTS | Monthly Expense Report 2020 | to CFWHB1105CR_FUND@doa.nc.gov | |||||||
| April 2020 | |||||||||
| PROGRAM NAME: | 0 | ||||||||
| TAX ID #: | 0 | ||||||||
| COUNTY: | 0 | ||||||||
| DV or SA Program: | 0 | ||||||||
| MONTHLY EXPENDITURES | |||||||||
| March, 2020 | $0.00 | ||||||||
| April, 2020 | $0.00 | ||||||||
| May, 2020 | |||||||||
| June, 2020 | |||||||||
| July, 2020 | |||||||||
| August, 2020 | |||||||||
| September, 2020 | |||||||||
| October, 2020 | |||||||||
| November, 2020 | |||||||||
| December, 2020 | |||||||||
| 2020 EXPENSES | $0.00 | FY 2020-2021 TOTAL EXPENSES | $0.00 | ||||||
| #DIV/0! | |||||||||
| CONTRACT BUDGET LINE ITEMS: | ACTUAL BUDGET | PREVIOUS MONTH'S EXPENSE | ACTUAL MONTHLY EXPENSE PROGRAM COST | EXPENDITURE | GRANT BALANCE | ||||
| PERSONNEL COSTS ONLY/EMPLOYEE EXPENSES | |||||||||
| Hazard pay cost for employees that are dedicated to COVID-19 | |||||||||
| Position/Title | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| Position/Title | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| Position/Title | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| Position/Title | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| Position/Title | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| Position/Title | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| Position/Title | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| Position/Title | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| Position/Title | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| Position/Title | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| FICA (Social, Security, Medicare) | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| FRINGE BENEFITS | |||||||||
| Worker's Compensation | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| Unemployment Insurance | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| Retirement | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| Medical Insurance | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| 401(K) | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| Life/Disability Insurance | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| Other (Specify The Cost Item) | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| CONTRACTED LABOR & OTHER SERVICE EXPENSES | |||||||||
| Specify | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| SUBCONTRACT EXPENSES | |||||||||
| Specify | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| GOODS EXPENSES | |||||||||
| Specify | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| EQUIPMENT EXPENSES (items over $500) | |||||||||
| Specify | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| ADMINISTRATIVE EXPENSES | |||||||||
| Specify | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| OTHER EXPENSES | |||||||||
| Specify | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| TOTALS: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | ||||
| INVENTORY PURCHASED | |||||||||
| EQUIPMENT TYPE | BRAND | MODEL | SERIAL # | YEAR PURCHASED | COST | ||||
| EXAMPLE: automobile | EXAMPLE: Honda | EXAMPLE: Civic | EXAMPLE: VIN# | EXAMPLE: 2020 | EXAMPLE: 10,000.00 | ||||
| The information provided is correct and accurate to the best of my knowledge. | |||||||||
| EXECUTIVE DIRECTOR'S SIGNATURE AND DATE | PREPARED BY SIGNATURE AND DATE | ||||||||
| PRINT NAME BELOW | PRINT NAME BELOW | ||||||||
| ………………………………………………… | Revised 11/2020 | ||||||||
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