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Grant Forms
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Disaster Recovery Forms
Disaster Recovery - Public Assistance (PA)
Document Description State Forms PAGP Project Quarterly Progress Report Form to submit quarterly progress on all open, large Public Assistance Grand Program projects. Donated Resources(PAPPG pg. 87-90) Information on Donated Resources In-Kind Contribution MSP EMHSD Fillable form for In-Kind Contributions Volunteer Tracking Spreadsheet TRACKING SPREADSHEET (TIME AND ACTIVITIES) COVID-19
Labor Tracking Sheet Force Account Labor Summary Record excel tracking sheet Documentation to Support Costs Claimed Checklist for required cost documentation EMHSD-015a Request for Reimbursemet EMHSD-015b Force Account Labor EMHSD-015c Equipment Purchased EMHSD-015d Force Account Equipment EMHSD-015e Contract Work EMHSD-015f Supplies and Materials EMHSD-015g Managment Costs EMHSD-072 Large Project Closeout Request EMHSD-073 Time Extension Request EMHSD-074 Scope of Work Change Request FEMA Forms FEMA Form 009 Force Account Labor Summary FEMA fillable form FEMA Form 009 Applicants Benefits Calculation Worksheet FEMA fillable form Donations Information In-Kind Contribution Information Applicant Quick Guide Grants Portal and Account and RPA Guide to creating a user's account PNP Facility Questionnaire Private Non Profit Eligibility Questionnaire Procurement During EE Circumstance Fact Sheet Guidance regarding procurement requirements for FEMA eligible expenses -
EMPG Forms
Document Description Certification of Lobbying Certifications regarding lobbying; debarment, suspension, and other responsibility matters; and drug-free workplace requirements. Audit Certification EMHSD-053 Non-federal entities which expend $750,000 or more in federal funds in a fiscal year are required to have an audit performed in accordance with 2 CFR Part 200, Subpart F. Form W-9 Request for Taxpayer ID Number Request for taxpayer identification number and certification. Standard Assurances Subrecipient assurance and certification of compliance with all applicable federal statutes, regulations, policies, guidelines, and requirements. Subrecipient Risk Assessment Certification Assessment for using in evaluating a subrecipient's risk of non-compliance and determine appropriate monitoring. -
Finance Forms
Document Description AAF Page 5 Page 5 of the Alignment and Allowability Form (AAF) EMD-054 Reimbursement Cover Sheet (HSGP, OPSG, and NSGP) EMD-055 Payroll Reimbursement Detail (HSGP, OPSG, and NSGP) EMD-056 Supplies Reimbursement Detail (HSGP, OPSG, and NSGP) EMD-057 Travel Reimbursement Detail (HSGP, OPSG, and NSGP) EMD-058 Reimbursement of Lost Wages EMHSD-017 Annual Local Budget Form for EMPG EMHSD-007 EMPG Quarterly Billing Cover Sheet -
Fueling Facility Generation Grant Forms
Document Description 2019 Energy Assurance Initiative Overview of Michigan's 2019 Energy Assurance Initiative Michigan Fueling Facility Generation Grant Guidance on Michigan's Fueling Facility Generation Grant Michigan Fueling Facility Generation Grant Application Application Certification of Lobbying Certifications regarding lobbying; debarment, suspension, and other responsibility matters; and drug-free workplace requirements. Audit Certification EMHSD-053 Non-federal entities which expend $750,000 or more in federal funds in a fiscal year are required to have an audit performed in accordance with 2 CFR Part 200, Subpart F.
Form W-9 Request for Taxpayer ID Number Request for taxpayer identification number and certification. Standard Assurances Standard assurance and certification of compliance with all applicable federal statutes, regulations, policies, guidelines, and requirements. Subrecipient Risk Assessment Certification Assessment for using in evaluating a subrecipient's risk of non-compliance and determine appropriate monitoring. -
Grant Agreement Forms
Document Description Certification of Lobbying Certifications regarding lobbying; debarment, suspension, and other responsibility matters; and drug-free workplace requirements. Audit Certification EMHSD-053 Non-federal entities which expend $750,000 or more in federal funds in a fiscal year are required to have an audit performed in accordance with 2 CFR Part 200, Subpart F. Form W-9 Request for Taxpayer ID Number Request for taxpayer identification number and certification. Standard Assurances Subrecipient assurance and certification of compliance with all applicable federal statutes, regulations, policies, guidelines, and requirements. Subrecipient Risk Assessment Certification Assessment for using in evaluating a subrecipient's risk of non-compliance and determine appropriate monitoring. -
HMA Forms
Document Description HMA Quarterly Progress Reporting EMHSD-016 Hazard Mitigation Assistance Quarterly Progress Report HMA Quarterly Progress Reporting Acquisitions Hazard Mitigation Grant Program Quarterly Progress Report Acquisitions Reimbursement Form 01 - Request for Reimbursement EMHSD-009 Request for Reimbursement of Mitigation Project Expenses Reimbursement Form 01a - Request for SrMC Reimbursement Request for Reimbursement of Mitigation Project Subrecipient Management Costs (SrMC) Reimbursement Form 02 - MPR Contract Work Mitigation Project Record - Contract Work Reimbursement Form 03 - MPR Equipment Mitigation Project Record - Equipment (Force Account) Reimbursement Form 04 - MPR Equipment Rented Mitigation Project Record - Equipment (Rented) Reimbursement Form 05 - MPR Labor (FORCE AND IN-KIND) Mitigation Project Record - Labor (Reimbursable Expense and In-kind/Match) Reimbursement Form 06 - MPR Materials/Supplies/Equipment Mitigation Project Record - Materials/Supplies/Equipment Reimbursement Form 07 - MPR Travel Mitigation Project Record - Travel Certification of Lobbying Certifications regarding lobbying; debarment, suspension, and other responsibility matters; and drug-free workplace requirements. Audit Certification EMHSD-053 Non-federal entities which expend $750,000 or more in federal funds in a fiscal year are required to have an audit performed in accordance with 2 CFR Part 200, Subpart F. Form W-9 Request for Taxpayer ID Number Request for taxpayer identification number and certification. Standard Assurances Subrecipient assurance and certification of compliance with all applicable federal statutes, regulations, policies, guidelines, and requirements. Subrecipient Risk Assessment Assessment for using in evaluating a subrecipient's risk of non-compliance and determine appropriate monitoring. -
HMEP Forms
Document Description Sara Title III Plan Update List EMD-064 SARA Title III Hazardous Materials, Off-Site Emergency Response Plan Update List LEPC Officer/Member Record EMD-072 - LEPC Officer/Member Record Sara Title III Emergency Response Plan Submittal Sheet EMD-076 - Superfund Amendments and Reauthorization Act (SARA) Title III Emergency Response Plan Submittal Sheet LEPC Application For Hazardous Materials Emergency Preparedness Grant EMHSD-040 - Local Emergency Planning Committee Allocation for Hazardous Materials Emergency Preparedness Grant Attachment A Hazardous Materials Emergency Preparedness Planning Grant Instructions Certification of Lobbying Certifications regarding lobbying; debarment, suspension, and other responsibility matters; and drug-free workplace requirements. Audit Certification EMHSD-053 Non-federal entities which expend $750,000 or more in federal funds in a fiscal year are required to have an audit performed in accordance with 2 CFR Part 200, Subpart F. Form W-9 Request for Taxpayer ID Number Request for taxpayer identification number and certification. Standard Assurances Subrecipient assurance and certification of compliance with all applicable federal statutes, regulations, policies, guidelines, and requirements. Subrecipient Risk Assessment Certification Assessment for using in evaluating a subrecipient's risk of non-compliance and determine appropriate monitoring. HMEP Support Grant Certification EMHSD-062 - HMEP Support Grant Certification -
HSGP Forms
Document Description Alignment & Allowability Form (AAF) Designed to capture all necessary data to demonstrate grant program cost eligibility Alignment & Allowability Form Instructions Instructions on how to fill out an AAF EHP Screening Form Environmental and Historic Preservation Screening Form Personnel Certification Form EMD-097 - Homeland Security Grant Program (HSGP) Personnel Time Certification Form EMHSD BSIR Template Emergency Management & Homeland Security Division (EMHSD) Biannual Strategy Implementation Report (BSIR) Template Certification of Lobbying Certifications regarding lobbying; debarment, suspension, and other responsibility matters; and drug-free workplace requirements. Audit Certification EMHSD-053 Non-federal entities which expend $750,000 or more in federal funds in a fiscal year are required to have an audit performed in accordance with 2 CFR Part 200, Subpart F. Form W-9 Request for Taxpayer ID Number Request for taxpayer identification number and certification. Standard Assurances Subrecipient assurance and certification of compliance with all applicable federal statutes, regulations, policies, guidelines, and requirements. Subrecipient Risk Assessment Certification Assessment for using in evaluating a subrecipient's risk of non-compliance and determine appropriate monitoring. FY 20 Project Workbook Template FY 20 Project Workbook Instructions FY 21 Project Workbook Template FY 21 Project Workbook Instructions -
NSGP Forms
Document Description Alignment & Allowability Form (AAF) Designed to capture all necessary data to demonstrate grant program cost eligibility Alignment & Allowability Form Instructions Instructions on how to fill out an AAF EHP Screening Form Environmental and Historic Preservation Screening Form EMHSD BSIR Template Emergency Management & Homeland Security Division (EMHSD) Biannual Strategy Implementation Report (BSIR) Template Certification of Lobbying Certifications regarding lobbying; debarment, suspension, and other responsibility matters; and drug-free workplace requirements. Audit Certification EMHSD-053 Non-federal entities which expend $750,000 or more in federal funds in a fiscal year are required to have an audit performed in accordance with 2 CFR Part 200, Subpart F. Form W-9 Request for Taxpayer ID Number Request for taxpayer identification number and certification. Standard Assurances Subrecipient assurance and certification of compliance with all applicable federal statutes, regulations, policies, guidelines, and requirements. Subrecipient Risk Assessment Certification Assessment for using in evaluating a subrecipient's risk of non-compliance and determine appropriate monitoring.