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Home My WebLink About09-Final Expenditure Summary Postage $ Totamosta~e & Fees $ ~,23 forP~BoxNo, 9A81 Cultural Education C&ter I SOUTHOLD SOUTHOLB, New H9711000 3548330971-0098 07/25/2011 (800)275-8777 04:50:33 PH S~es Receipt Product Sale Unit F~na~ Description Sty Price Price AL USE I Pos ark ALBANY NY 12230 $1.08 Zone-2 First-Class Large Env 1,50 oz. Expected Delivery: ~ed 07/27/11 Return Rcpt (Green $2.30 Card) Certified $2.85 Label #: 70090820000178205784 [ssue PV[: $6.23 Total: $6.23 Paid by: VISA $6,23 Account #: XXXXXXXXXXXX3624 Approval ¢: 025486 Transaction ~: 665 23903191724 [or PO Box No, 9A81 Cultural Education Center l ~iF~i~Z~l~' ..................................................................... ~Albanv. NY 122:~n I SOUTHOLD MPO SOUTHOLD, New York 119711000 3548330971-0098 07/25/2011 (800)275-8777 04:50:33 PM -- Sales Receipt Product Sale Unit Final Description Qty Price Price ALBANY NY 12230 $1.08 Zone-2 First-Class Large Env 1.50 oz. Expected DeHvery: Wed 07/27/11 Return Rcpt (Green $2.30 Card) Certified $2.85 Label ~: 70090820000178205784 Issue PVI: $6,23 Total: $6.23 Paid by: · Complete items 1,2, and 3. Also complete item 4 if Restricted Delivery is desired. · Pdnt your name and address on the reverse so that we can return the card to you. · Attach this card to the back of the mailp[ece, or on the front if space permits. 1. ArticleAddtesSed to: New York State Archives Grants Administration Unit 9A81 Cultural Education Center Albany, NY 12230 2. Article Number (T/ansfer from service label) PS Form 381 1, February 2004 A. Signature/ ~ B. Received by (Pdnt~d Name) C. D of Deliv D. Is deliv~ address di~ ffom it~ 1 ? [] If YES, enter delivew address below: [] 3. Service Type ]J[] CerJEied Mail [] Express Mall I--I Registered [] R~urn Receipt for Merchan, [] Insured Mail [] C.O.D. J4.Restricted Delivery? ('Extra Fee) [] Yes 7009 0820 0001 7820 5784 Domestic Return Receipt 102595-02-M- Customer Copy EM 552664865 US ~---~ u~n-~r,~'r~s~,os'~,~,c~ Post OfficeToAddres~e T'me~cep~ Fiat R~te FROM:(~,~ ~o ~ 631) 765--1800 TO:~...,..~ ~31 )952 6664 ~lizabeth A. t.iev~e. Town Clerk ~ r - TC)~]N OF '":~ .... , r~.,,.,:~ .... Lorrai~';e~dll, ~ional ~dvisory Office~ ..)t;~ ~ ,~fc Bldg, ~;~ln 2 46,S Veteratm ' - " .,emor~l Hlghwa7 ; ,,~upp,'~ u'~, .;Y 11783-5501 C) 0 FINAL EXPENDITURE SUMMARY PROJECT SUBTOTAL CODE COSTS Professional Salaries 15 $0.00 Support Staff Salaries 16 $0.00 Purchased Services 40 $36,000.00 Supplies and 45 $0.00 Materials Travel Expenses 46 $0.00 Employee Benefits 80 $0.00 BOCES Services 49 $0.00 Minor Remodeling 30 $0.00 Equipment 20 $0.00 Grand Total $36,000.00 Agency Code Project # Contract # Agency Name 581005640067 0580-11-1083 Town Of Southold Project Funding Dates From Approved Budget Total $36,000.00 To CHIEF ADMINISTRATOR'S CERTIFICATION I hereby certify that the reported expenditures have been made in accordance with the provisions of applicable statute, regulation and approved project and budget; that the claim is just and correct; that no part has been paid except as stated; that the balance is actually due and owing; and that proper fund accounting is followed, records are retained for the proper period, and that records will be made available to representatives of the Education Department or the Office of the State Comptroller when requested. Date Il / 11 / 11 Signature Scott A Russell, Supervisor Name and Title of Chief Administrative Officer FOR DEPARTMENT USE ONLY Fiscal Year Final Payment Voucher~ First Payment Finance: Log Approved MIR The University of the State of New York THE STATE EDUCATION DEPARTMENT (see instructions for mailing address) FINAL EXPENDITURE FOR A FEDERAL OR STATE 'PROJECT FS-10-F Short Form (08/06) Project Number: 0580 -11 -1083 Funding Source: Report Prepared By: Agency Name: Mailing Address: City, State: Telephone#: E-Mail Address: Local Agency Information Local Government Records Management Improvement Fund Elizabeth Neville Town Of Southold 53095 Main Rd Southold NY 11971 County: Suffolk e.neville~town.southold.ny.us INSTRUCTIONS Upon audit, you may be requested to provide additional detail to support the reported expenditures or to complete the Full FS-10-F form. Submit one signed original and one copy of the FS-10-F Short Form as a two page form (not back-to-back on a single sheet) directly to the appropriate State Education Department office as indicated in the application instructions for the grant program for which you are applying. For State projects the final expenditure reports are due within 30 days after the project end dates. Reports for Federal projects are due within 90 days after the project end dates, although for certain >rograms, the State Education Department program manager may impose earlier due dates. See the Grant Award Notice for your project to verify the due date. Category subtotals must be reported in whole dollar amounts. To be in compliance with applicable audit requirements, complete and accurate records must be maintained at the local level. All encumbrances must have taken place within the approved funding dates of the project. Certification must be signed by Chief Administrative Officer or designee. High quality computer generated reproductions of this form may be used. Beginning with the 2005-06 year, there are changes to the reporting requirements for Supplies and Materials (Code 45) and Equipment (Code 20). For further information on these changes and completing the final expenditure report, please refer to the Fiscal Guidelines for Federal and State Aided Grants at www.oms.nysed.gov/cafe/or call Grants Finance at (518) 474-4815. For Special Legislative Projects only, submit one signed original report and three copies. A final narrative report must be submitted with this report. The University of the State of New York THE STATE EDUCATION DEPARTMENT Grants Finance, Room 510W EB Albany, New York 12234 FINAL EXPENDITURE REPORT FOR A FEDERAL OR STATE PROJECT FS-10-F Short Form (06/08) Funding Source: Report Prepared By: Agency Name: Mailing Address: Local Agency Information Local Government Records Management Improvement Fund Elizabeth A. Neville Town of Sonthold PO Box 1179 Street Southold NY 11971 City State Zip Code Telephone # of Report Preparer: 631 765-1800 County: Suffolk E-Mail Address: e.neville~town.southold.ny.us INSTRUCTIONS Agencies should use the FS- 10-F Short Form unless directed otherwise in the grant application/RFP or by Department staff. It must be submitted in accordance with report due dates; only the FS-10-F Long Form will be accepted aRer the due dates. For State projects, final expenditure reports are due within 30 days after the project end date. Reports for Federal projects are due within 90 days after the project end date. For certain programs, the Department program manager may impose earlier due dates. See the Grant Award Notice for your project to verify the due date. Agencies must record grant expenditure details in a manner eousistent with the internal pages of the FS-10-F Long Form and must maintain this information in their files. These details must be readily available upon request from authorized individuals, which include State, federal and local auditors and staff from the Department, the Office of the State Comptroller and federal agencies. Submit one report with original signature and one copy as a two-page form (not back-to-back on a single sheet) directly to Grants Finance, New York State Education Department, Room 510W EB, Albany, NY 12234. For Special Legislative Projects, submit one report with original signature and two copies, along with a f'mal program narrative report. Use whole dollar amounts. All encumbrances must have taken place within the approved funding dates of the project. Certification must be signed by Chief Administrative Officer or designee. High-quality computer generated reproductions of this form may be used. For further information about completing the final expenditure report, please refer to the Fiscal Guidelines for Federal and State Aided Grants at www.oms.nysed.gov/cafe/or contact Grants Finance at grant sweb~A~nail.nysed.gov or (518) 4744815. Submit 3 copies of the Final Expenditure Report (FS-10-F) to the Grants Administration Unit when submitting your final reports. Your CAO must sign the FS- 10-F in blue ink. Please make sure the FS-10-F form is correct. The financial data on the FS-10-F comes from the data you entered as actual expense in the Budget Tables. Any local government submitting a final fiscal report after 31 July 2013 must submit an FS-10-F Long Form, Failure to submit the FS-10-F will prevent us from closing out your project. Failure to close the project in a timely manner could also jeopardize any potential future award. Final Budget Form All successful applicants must complete the Final Project Budget to report what funds were actually expended. 1. Access the Final Project Budget via the drop-down menu under Post-Grant Award Forms or the Checklist. Enter actual expenses for each approved budget code, making sure to save your entries. For budget changes that do not fall into an approved code and do not require the for,m, al filing of an FS-10-A, complete the Budget Amendment Template in eGrants and 'Submit" the request no later than June 1st each year. Again, prior RAO approval is required. Data from the Final Project Budget populates the Final Expenditure Form (FS-10-F form). Print and submit three copies of the FS-10-F (signed in blue ink by your Chief Administrative Officer~ to the Grants Administration Unit. Final Narrative Report If your application is funded, you must complete the Final Project Narrative report at the conclusion of the project. 1. Select the Final Project Narrative from the Checklist page or from the drop-down menu under Post-Grant Award Forms (at the top of the screen). 2. Type your report narrative directly into the text area provided, or copy and paste it from a Microsoft Word document. Click Save to save your changes to the system. The Word editor toolbar at the top of the text area is accessible only if you have Javascript. if your browser does not have Javascript enabled, you will not see this toolbar, but you can still type and save your final report narrative. To enable 45