OPERATIONAL AREA GRANT EQUIPMENT REIMBURSEMENT CHECKLIST

OPERATIONAL AREA GRANT EQUIPMENT REIMBURSEMENT CHECKLIST
Please collect documentation listed on the checklist below and remit package to: Nevada County Office of Emergency Services (HSGP@nevadacountyca.gov)
Agency Information:
Agency*
Agency Address*
Agency Contact Name*
Agency Contact Email*
example@example.com
Grant*
Grant Year*
Project Title/Number*
Project Cost*
Upload Documents (See list below)*

Cancelof
Required Documentation
Checklist*

Invoice from Second-Tier Sub-Recipient to Nevada CountyGrant Award Letter from Nevada County to Second-Tier Sub-RecipientAsset Maintenance and Tracking Acknowledgement FormInvoice from Vendor to Second-Tier Sub-RecipientEquipment Delivery Packing SlipsEquipment Vendor DUNS # Print Out (https://www.sam.gov/SAM)Proof of Payment to vendor by Second-Tier Sub-RecipientProof Payment Reconciliation by Second-Tier Sub-RecipientOther Supporting Documentation
Page Numbers for Documents
Page Numbers: Invoice from Second-Tier Sub-Recipient to Nevada County *
Page Numbers: Grant Award Letter from Nevada County to Second-Tier Sub-Recipient
Page Numbers: Asset Maintenance and Tracking Acknowledgement Form
Page Numbers: Invoice from Vendor to Second-Tier Sub-Recipient
Page Numbers: Equipment Delivery Packing Slips
Page Numbers: Equipment Vendor DUNS # Print Out (https://www.sam.gov/SAM)
Page Numbers: Proof of Payment to vendor by Second-Tier Sub-Recipient
Page Numbers: Proof Payment Reconciliation by Second-Tier Sub-Recipient
Page Numbers: Other Supporting Documentation
Nevada County Office of Emergency Homeland Security Grant Program 950 Maidu Avenue, suite 129 Nevada City, CA 95959 HSGP@nevadacountyca.gov
Nevada County OES Use:
OK to Pay Amount*
Coding/PO Number*
Should be Empty:

OPERATIONAL AREA GRANT EQUIPMENT REIMBURSEMENT CHECKLIST

Agency Information:

Required Documentation

Page Numbers for Documents

Nevada County OES Use: