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<br /> Edward Byrne Memorial State and Local Law Enforcement Assistance Formula Grant Program <br /> SUMMARY STATEMENT OF QUARTERLY PROJECT COSTS <br /> (To Be Copied on Jurisdiction Letterhead) <br />City: Date of Claim: <br />Proiect Name: Claim Number: <br />Telephone: Claim Period: <br />Name of Person Completing Form: <br />.'=0>.~'l'-u;::-~\7'lC!t~W:"".~t::;;'0'~;'~':" >, ':..."~, '''::: ~,",,"~'. ;'~"'i-:;_.C' ":\'f<~'#~1f'_~~il,,~'~"!S';!if.:1r'!:~';~~~~"tf(~~~~l{,~1~ <br /> ;l:f'<~.;.Y';\~:~4ij~i~J,>''';;-~:fi'}',~Ji!:: 'J~,:;"'~_h~~;~ _M~ ::!< /'_'v--~;_~~,0 -'~fr--;:'~?/~'4~~~f;'f:;'~;l\~~".t~i?-JJk.JB~\~~..~4"'';:''.t ':'~Y'ltl~'t, ~ ~~ ~ <br /> ;r:Ati4:>.;"3~1J..'Y< \l *'~;;';>. Ii;';}: "'~;,.~'y:"", ,,, ,-'~~ ,.,.~~<.~..l^"':"t'*^"':.'1~"'+:J;t,~-%'':-.-J~~r~4.y.''>~,J,.,!''''>:':>>--:f''l.~1',,~'"~~::\t"<'4:~~ -~~~'~l~~'~~~ ~~::;~ <br />~.'t . ~ ~ ~ ,"" .' '" ~ ~ <br />1, Total Federal Budget $ 2. Amount This Invoice $ <br /> (75% of your current claim) <br />3. Amount of Previous Invoices $ 4. Remaining Federal Balance $ <br /> (Subtract hnes 2 & 3 from h,le 1) <br />Sub Object Budget Line Item Exceeds Federal Local Category <br />Code Categories Disallowed Budget Funds Match Totals <br /> Salaries & <br /> Benefits <br /> Contractual <br /> Services <br /> Operating/ <br /> Capital Equipment <br /> Expenses <br /> Total Claim <br />We request payment in accordance with our contract agreement In the amount of 75% of the Total Costs for this <br />Claim $ (75%), the balance of costs, $ (25%), to be recorded as our in-kind contribution to <br />comply with the local match requirements. <br />Attached, please find the records which substantiate the above expenditures. I certify that all of the costs have been paid and <br />none of the items have been previously reimbursed. All of the expenditures comply with the authorized budget and fall within <br />the contractual scope of services and all of the goods and services have been received, for which reimbursement is requested, <br />Respectfully submitted, <br />Chief of Police/Other City Official Payment Approved, Miami Dade County <br />