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<br />- <br /> <br /> Edward Byrne Memorial Justice Assistance Grant Program <br /> SUMMARY STATEMENT OF QUARTERLY PROJECT COSTS <br /> (To Be Copied on Jurisdiction Letterhead) <br />City: Date of Claim: <br />Project Name: Claim Number: <br /> ~ <br />Telephone: Claim Period: <br />Name of Person Completing Form: <br />~1~:'J~':;";' .-,; O' '. .. ., ., . , ., . .. <br />.. ., <br /> , <br />1. Total Federal Budget $ 2. Amount This Invoice $ <br />3. Amount of Previous Invoices $ 4. Remaining Budget Balance $ <br /> (Subtract lines 2 & 3 from line 1) <br />Sub Object Budget Line Item Exceeds Federal Category <br />Code Categories Disallowed Budget Funds 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 100% of the Total Costs for this <br />Claim $ <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 />