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Home My WebLink AboutResolution #0741 ti t RESOLUTION ~~i '`~ - DESIGNATION OF APPLICANT'S LOCAL AGENT BE IT RESOLVED BY City Council OF Cit of Ca ~ (Governing Body Pu is Entity THAT Harlan E. Crouch , ' or (Name of Incumbent) (Off icia Position) Nanc Whites ~ ri r,: Clerlr - ' (Name of Alternate Incumbent) (Official Position) is hereby authorized to act for and to represent City of Canton a public entity established under the laws of the State of I1linoiG _in obtaining Federal disaster assistance under the Disaster Relief Act (Public Law 93-288, 93rd Congress, or otherwise available from the President's Disaster Relief Fund. THAT City of Canton ~ a public entity established under the laws of the State of Illinois , hereby authorizes its agent to provide to the State and to the Federal Disaster Assistance Administration I(FDAA), Department of Housing and Urban Development (HUD) for all matters pertaining to such Federal disaster assistance the assurances and agreements printed on the reverse side hereof. Passed and Approved this 7th day of June . 19_ZZ_• . ~r~%~.~:.,---~ Mayor Name and Title ~~ ~ ~ ~. ~ ~ ,~~~~~", ,City Clerk - Name and Title Name and Title • CERTIFICATION I Nancy Whites , duly appointed and City Cler (Title) f City of Canton , do hereby certify that the above is a o true and correcC copy of a resolution passed and approved by the City Council ) Bod i of C,~ .tv o nt n - (Public Entity) y ng (Govern th e 7th day of June , 19_x_• on ~' ~ ~+ Date: June 7, 1977 , ,~ • City •`i:• Clerk '; + ` ' ~`'~ "t'~ nature) S (Official Pos, tion) ~ • ` Jg ( Form Approved nw~o wl_ ~ ~~ INV. 1 I V-1\VGV 1 U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT FEDERAL DISASTER ASSISTANCE ADMINISTRATION REQUEST FOR GRANT-IN-LIEU PREPARE A SEPARATE REQUEST FOR EACH GRANT-IN-LIEU APPLICANT PROJECT NUMBER Cit of Caaato~n DAMAGE CATEGORY ITEM NUMBER E 1. DESCRIPTION OF THE HIGHER GRADE FACILITY TO BE CONSTRUCTED OR MORE P,~RMANENT REPAIR TO BE ACCOMPLISHED (DIMENSIONS AND TYPE OF MATERIALS, ETC.) city ,d22 bai2d nev fi:~e--~~.s.~a >f>~si~i>~ ~t~ ii,t>~ ,4. ft. 2. ESTIMATED COST OFTHE ABOVE FACILITY 3. SOURCE OF FUNDING OVER FDAA GRANT $475 , ~'. t'}0 lZafsr~td~ 4. WORKTO BE PERFORMED BY: (Check one) [sta. CONTRACT ^ b. OWN EMPLOYEES AND EQUIPMENT ^ c. COMBINATION OF a. AND b. 5. ESTIMATED DATE THE ABOVE PERMANENT WORK WILL BE COMPLETED t. 1978 6. ESTIMATED DATE WHEN ESSENTIAL PUBLIC SERVICE WILL BE RESUMED u!~ ~c~ ~-322 ~ cax-tises~ad 7. ENGINEERING ESTIMATE OFTHE COST OF REPAIR OR REPLACEMENT AS SHOWN IN THE DAMAGE SURVEY REPORT ~80, $SO.Ot3 AMOUNT REQUESTED DATE $80,8SA.00 Nay 2b, 2977 APPLICANTS AUTHORIZED R„~PE~ES~NTATIVE .. _,... .-- ~, 8. A PROVAL OF THIS REQUEST IS BASED ON ABOVE INFORMATION. ANY CHANGED CONDITIONS SHOULD IMMEDIATELY BE BROUGHT TO ATTENTION OF THE STATE COORDINATING OFFICER, AS IT MAY HAVE BEARING ON GRANT-IN-LIEU ALLOWANCE. AMOUNT RECOMMENDED DATE STATE COORDINATING OFFICER AMOUNT APPROVED '~ DATE DIRECTOR, FDAA=-REGION .~~-+~~1~-.~I naplaces~errormt.7i,wnlcnisobsoiete. COPYN0.4-APPLICANT COPY t jj S ~, kt •U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT FEDERAL DISASTER ASSIST-ANCE ADMINJSTRATION 6LANKET CERTIFICATE COVERING CLAIM FROM THE FEDERAL DISASTER ASSISTANCE'ADMINISTRATION FOR THE COST OF ELIGIBLE ;DISASTER WORK certify that all docu nts li t d on the "Summary of Documentation" (Form HUD-481), submitted by 4~t~ sib (Applicant) ` ore correct and cover only services performed, o~ material used,,exclusively in connection with disaster relief operations of the applicant'as authorized in Project Application FDAA No. *~ ~-~ State No. under Public Law Congress. COMPLETION OF WORK I certify that all work authorized in the approved project'applicatib was completed and all related essential services were resumed, within the time limit inederal-State Di salter .Agreement, except as listed below: Work NOT Completed A~proved Category Line Item Amount 2 ~~~P RATES ~.~A ; IiQ~~'.~A'.4D I certify that all rates claimed were the lowest rates available during the period covered by this claim. PAYROLL certify that salaries-and wages claimed on payrolls`and all paymentsfor overtime are in ac- cordancewith. the applicant's policy established prior to the disaster. DOCUMENTATION I certify that the originals of all supporting documentation are on file in tfie office of ~, ~.-,Bf Csrt>k~ (Title arsd Address) PAYMENT I certify that all obligations incurred by the applicant,. in connection .with the documents listed on .the "Summary of Documentation" (Form HUD-481), have been pair! in.fu)I. ;~ ~ >~- ~, 1977 , (Date) (Applicant's Authorized :Representative) i DISTRIBUTION C01ZEe ~MHtTf -FDAA Financial Management Copy PINK -State Copy ,wir/ YELLOW -FDAA Rsgion~l Copy GREEN - Apptieont Copy HUD-482.(7=7$) Repioees'6EP Form 83, whleh is obealete I t ~` rtr'~ v h, ~.w, Pl~#~=4~~_ d~V~~- +R~ y'..Ui r. ~ ; lA ::' ?{{ i" h-`7S' . ~' iriCFFF'7~,;.'4-8$`i~;i r: ~1 ~ -. ., r ` U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT page No. ) FEDERAL DISASTER ASSISTANCE ADMINISTRATION SUMMARY OF DOCUMENTATION IN SUPPORT OF AMOUNT CLAIMED FROM THE FEDERAL DISASTER ASSISTANCE ADMINISTRATION FOR ELIGIBLE DISASTER WORK FDAA ~,,,,,_ Wit, APPLICANT ~`'»" +D~ C,~'~~'~. ~~K.~~?!~^~ Prolaet Appltcotien No. Stare ~~>~,. DOCUMENTION AMOUNT Applicant's Delivery date List documentation (ApplicanNs payroll, nsaterial out of ine item in Reference No. of articles or and name applicant's stock, appl;cant owned equipment Approved Applicant's (Warrant, perfotmanca . of vendor or contractor) by category and line item in the Project Eligible Voucher, Claim of services approved project application and give a brief description Application Cost or8s9teduleNo.) of the articles or services Dollars Dollars nts i,jq~w~^~r ,; .71 i..{{1 11 _ jp ="; t '' . y ~p p2~ ~ ~s} ~~) ~ C ~~~ ) " ~ ~~ r 'M*~~:+~ X3 `.' ~,4° . ~"~.~`~,"3Kt~_ ~ 7 ,.1;.~:~~ ' ~ ' yy yy }} ) y' .S. d..3 f~ ~ ){ / ~ 4 ' ~y / L h f G. l.d 7 !'.w * 1 p ~ ,r y ~+w4. ~.i A ~ . ~ f . x ~'d « ~Yk..~. T'~ ~~ rd~.v,'t. .w.«..,,....«. `j 8. `~; r ......~.... «..~,.. ~ p : y~, .... gg pp $k~'~`Ca k.~.'.w^;;J.r q"d ~#.r ~'t~!,! :JA§?dGi ~3 t,1 6 ~w ~''A'`,:~,3 " ~'t. 1'i't'~') NL ~t 17s "' a's~.P ` " " ' ~ ? ~ ~} ~1 ~.~,~C ~ pj ('~(,t uyg y (~~f0 P«J y ~ ~ a yi . y {~ y~y~.~ .~yyry /n. ~y y ~ ps ~6Sd.6~WA:L ~tJ ini+L4r+. S.?C' ~A~~~~4~{~.. 6. iµ%. ! d~ 4'{~i~~..•~~.t f}/ «1~~ ~'~Z:~?y 1.?!~O~r~~ a~axztt<:r~x :'~af~l«x~C~: T~r~,~:~~F~-.t'r ~'~`~~~, t;;£ ,l W0a .,`,': }'4V • .l "". ~, .L..,~ { ~ ~ 7 iv>..r ~ ~'~',,} ~.cf.~ i.- ~.L ~`~ 6.. . . ..~i /,'.: i+ .Sgd~P~Y'i15F I u~~.,"'~ !'fit'' s WHITE -FDAA Audit Ssotion Fila Copy PINK -state Copy GREEN -FDAA Audit Copy GOLD - Applicant Copy YELLOW- FDAA Ragioaal Co HUO-481 (6- 4) aplocas OEP o-m 4 which is obsolete , : U.S. DEPARTMENT OF HOUSING ANO URBAN DEVELOPMENT FEDERAL DISASTER ASSISTANCE ADMINISTRATION SUMMARY OF DOCUMENTATION IN SUPPORT OF AMOUNT CLAIMED FROM THE FEDERAL DISASTER ASSISTANCE ADMINISTRATION Fit Et,IGIRLE DISASTER Wt>~tK APPLICANT ~~ Cf~ ~~`Re ~:~^i~~~ Proleet Applieefion No. Page No. FDAA `~ ~" Srof. ~~°~'° DOCUMENTION AMOUNT Applicant's Delivery date List documentation (Applicant's payroll, material out of ne item a A d ~ Applicant e Reference No. of articles or applicant's stock, applicant owned egtllpment, and name pprove P Eli ible (Warrant, performance of vendor oe contractor) by category and line item in the roject g Voudtsr, Claim of services approved project application and give a brief description Application Cost ar9cFteduleNo.) of t he artic service ~ l e s or Dollars Dollars nts ~ } !+~ t ~'"ry ~Fg +p ya j +~ p .~u p 7 ~ . %.F. is,~. L'¢V} ~''$ ""' ~," 1 R,a.13.~ S ,. F .! 'rti~ ` . ~g }~ y ~ p ~ ~, 1 p~~ p y i^M r g,ei ;i.~ • ~.v ~w ~ ~67 ~A/M hf~ 4)F« W€.il.~ ...~Qif1.L/b~ .~~.?4,}~~8 ~).~~~~ .R~: ~'~~"$,kLTi ~ ~t7~k19, sit:a ~*~ t~() "~~~~~ ).~«'~.~! ~ Rt~G t~l~~l~ ~ a7~ll~t~y L~Cx .. . . 'Ql :" -.~` ""` F. S. 49' 1~$. 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DOCUMENTION AMOUNT Applicant's Delivery date List documentation (ApplicanNs payroll, material out of ne item in Reference No. of articles or applicant's stock, applicant owned equipment and name Approved Applicant's (Warrant, performance , of vendor or contractoe) by category and line item in the Project Eligible Voudmr, Claim of services approved project application and give • brief description Application Coat arSdtedllleNo.) of t e ar i es t c l e s or servic h Dollars Dollars enta / ~ pp ~ ~ry / ~ y~ ~T ryyy~y~ps p h l.~~k (w44.i,RttT A, ~, 6"..5 "i lr d'+P., ,7.~. :.~MS"~F F?-Y~..j~?e.dn~_. d". '« ?„}1~.~tt ~' l t LRQ'r d 3:iii~.~ 1~ .. . ~1.. i. ~~~~~:~f~G. ~.` Y 3.. ~~ _ , • • ... •r.+•.waww.ww~...w y j {y~1 ,( 1} p y~ ~y ~ } ~~ t , 4JV ~ ~~ .~.. ,kr iw~~~~4#vT 1'~ R ~ V p~4 Y~ +W V i. l~A d(! 9' ~~ ~ " Wry l ~` •y,,t ~ 4' •~ n P~~ ~ ~ i~ 4.a.lclF~~~d~~~ off" n ~ ~, '~.~F ~4;~~.~~: ~ :,F /. ~I: i.T .lam. 9 ~ r . ~ # x v ., ~J ~~ ~ Y .., '~#• tl a~ ){~ ° l.t. L 44A a • ~ ±i.i t ~ ~ a A'.~ R' ~ yy ,r ~ y ~y ~. ~ Y~ y ~~~}y~ {~ y ~ yq { n ~ ~ g n ~~y, y y ~(...Y?libi e••~ '!I f:63 4A 4t.~ ~:.1 A.V~4i A~4W 4Jt :i.T ky'JA 4~+'M~ ~~.'~~`:'~ c ~I~~ ~?~GfltdEtlf( ~.~.~.'I"*}'r L'~~1~ ),~#~ I)') ~. yy @en~s y. /~ A4 y~yy )~ ~p ~g y1. 9 v 6+ ~YA : ( ~ a•• ~~yia~~~~SYLA ~~ ~A~~. .~i.eR.FD $+. tfS ~ ~ R W N ~yp.y lµ ~ R / ~M yp py ~~} «~~~n-u.ILS'-n. tl bLGi S. ,.~...<w+a.w.r...rwa+~+.aM.~y~rww,w.rrwww.u-.«-....+ur+w~nr~w ~~~~v~V~ .+'~I{.. WJ~~.~ ~~~ 4. J'~ .~1-t b:i. b {e ~+ 0. J F~~.~Y A. ri L i '~ a h ~r"~~ ~°7 ae " [' 1 @ q~,p n1E ~F g~ ~y y~{ u+~ p } . ~ y ~ y X ir ~N ..J.. S. ~./.,L "F ~~Rr .d~~~Mbe a~~~ f i ~`. ~ ~' C i A i q ^^tt v} q } . ~ y p . y y ~y l A ~~~ ~.'~~k~~ ~''1,1S. J~GF4rS {.. .~9~kr 3u V:~6oi `~ 'd. i~1.r`~a),i.. ~~ ~I.`~~I ~ ° ~ ~~~4',+. "..,.r.3.. A~¢~ ~#. l~~L',fi ~G. B.~ Pi., ~s ~}i.,r~'{..a ~j i. @ xP ~ ~ 3i~, ~~ / .f' /~ b' ,} .f a'~..4'~3i'#X~ ,Eb~ k"C't~` C'•'"j,'C~' ~ ,.>..._.~.».,.,.....,~-..~., ~~ ~ ~ «.... : n ly ~ ~ z ~+t1C3'3 s~4~'fStlti ~', ~`11L'M{'xtl ~) f ~~?f ~/ ~~~:.i~f~u~~,~.~£' ~T'~'1~i ' Y '+}.~f? ~€~ qfi •ro +~ ~t y y t 1 .}G. :~~~°~+~8 ~%.~~#}~~S Tld4~~@ ~YLb~1D ~ ~'JgIB~ $ZD~w ~il~°, p~i ?~?~.7~a XCI/i/7~ nay ~"T'~+~ri: ~ S~r.~~ 7t~c. ds,~r3~~ ~3~; .~' ~ ~ j.~ ~ a ~ ~~ ~ l7~ ~1Tui~,~ (.)t ~T"~Wtt ~s sD13D p ~ '~k ( '` « ..,........,.. ........... ....~,.! `~~ ._.«..... .i~.::' .. ++ ~ a + ry+ y t~ ry ~:,ie. t~L~,X.a NIA 1 RIOY t IVt~ bVVCi wt71 1 t: - FDAA AYett peotlon Flle Copy PINK ~- $t~te Copy , GREEN -FDAA Audit Copy GOLD - Applicant Copy YELLOW-FDAA Rasioml Col+y HUD-~81 (d-74) Rapleeee OEP Form 74 whieh fa obsolete 3 ~; a'~4r'.^ms~,:.~y~~~,. '.i9+a~RAaR'F,gtak^~~Y.tta as ~ ~ .- U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT page No. dl FEDERAL DISASTER ASSISTANCE ADMINISTRATION SUMMARY OF DOCUMENTATION IN SUPPORT OF AMOUNT CLAIMED FROM THE FEDERAL DISASTER ASSISTANCE ADMINISTRATION FOR ELIGIBLE DISASTER WORK FDAA ~" :`~~ APPLICANT Project Applieotlon No. Stote DOCUMENTION ,AMOUNT Applicant's Delivery data List documentation (Applicant's ~yroll, material out of ' Inc item in A plicant's Reference No. of articles of applicant s stock, applicant owned equipasent. and name Approved P p Eli ible (Waerant, performance of vendor oe contactor) by category and lino item in the rotect g Voucher, Claim of setvice• approved protect application and give • brief description Application Coat a9dteduleNo.) of the articles or services Dollars Dollars eats ~~ ~tylL11)! ~IEfa:C7°la~ .Am't8'~~"iMtSf T1Ct~~~~.'"~ ~SV• ~,tii "» ~~z~.C~.~~,S.PJ~I ~l. ~ri°"dL7~ ~"~.e?.J~? +li)~,~f~l .~.f»}2A7Csi ~.Ay`t'3'$~ ~7k"~~ ~ ~ ~~ ... t~... •7~1 »~a+•"-~L.~~+~+ .mod. }.;D €~~ t~.iif 'p`l"p"` 4 4?4* C ~?t9 s ). ~ „' y.`~1'#&7 ~ flu ~,C9I`k ~'~ ~a~,N ~'~~~.1;'~ il.T'~ F ~~~'~~ ~ ~ / ~4P aot r .~ '~ .~~ ~ ~ rl. ~ ~ ~ x r ~ „,~t~ ~ ;~? . 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R,nw ~ .s J' ~.~„}` ry 5~2',~ SJ J'.~`.'~~I' +"a..8.e 7. ~ 1' k' l +v9i .a 1 s WHITE -FDAA Audit iectlon Flle Copy PINK - 6tate Copy GREEN -FDAA Audit Copy COLD -Applicant Copy YELLOW- FDAA Re tonal Co HUD-481 (6- 1) •ploces OEP am 4 which fs obsolh• wTl lr,,...y{^.r.;fia...x,~g,.+~...~yVc..•ew.~~..,-...--.~.,.,...y.~:.._- .. ~. Qw. ~..e..~.mW .n.-Tis 9'" ^"Ri".^+."'n'p"'sx w.ax^ i ..:`xf"~'r trv ..4.~y,.+'. r r ~istc+U Y"~r~ers•.vn.+rve~'r. ~4 U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT FEDERAL DISASTER ASSISTANCE ADMINISTRATION SUMMARY OF DOCUMENTATION IN SUPPORT OF AMOUNT CLAIMED FROM THE FEDERAL DISASTER ASSISTANCE ADMINISTRATION FOR ELIGIBLE DISASTER WORK APPLICANT iy~ Ott twi~~'+~l~t. ZT~I~'fi~~ Proleet Application No. Page No. ~" FDAA ~- i' .~~ State ' ' DOCUMENTION .AMOUNT Applicant's Delivery date Lint documentation (Applicant's payroll, material out of ine item in Applicant's Reference No. of articlsa or applicant's stock, applicant owned equipment, and name Approved Project Eligible (Warrant. performance of vendor oe conhactot) by category and line item in the Co t Voucher, C1abn of services approved project application and give a brief description Application a ar9cheduleNo.) of the articles or services Dollars Dollars ants ~.L?d~ 1~.7l A~/.:J ,f+...ir»~~C.F a~r .A.~'~~ ry ~~~1~ °b a4,:t~ L,+~y ~~ (? dittC)1 i*~1r1141EE 3 sl ~:? ~~`~+`L' ~i,~~;~~i lil~.~ (.1 r &":~.~~ ac `~t3.+~ ,. ~.Y3f; . W...,..«.~..,............ ~: )"U }~ A .~ 3 i~$ &. t. /~ / ~~~ CA.e.14t~'t~~~( ~~:~: tIL~'L",~<s.. Aa s ~'~~~ a!d i~,i,.?'~" y 1.4~A1td~7~ ~`~~C'ff}~EIr'~lLt^I `•".'wCr1T~`~~'~.Yt~ . ~''~i . 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GREEN -FDAA Audit Copy GOLD - Applicant Copy YELLOW-FDAA Rational C HUD-l!I (6- 4) •pleee~ pEP am 4 which i~ obsolete i ` U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT FEDERAL DISASTER ASSISTANCE ADMINISTRATION SUMMARY OF DOCUMENTATION IN SUPPORT OF AMOUNT CLAIMED FROM THE FEDERAL DISASTER ASSISTANCE ADMINISTRATION FOR ELIGIBLE DISASTER WORK APPLICANT C;I` .~ C~'» ~ ~~~~~ Pro~sct Application No. Page No. ~ FDAA ~ r ~?; Stots "(~X.w DOCUMENTION AMOUNT Applicant's Delivery date List documentation (Applicant's payroll, material out of ' the item in A ~ Applicant s Reference No. of articles or s stock, applicant owned equipment, and name applicant pproved P Eli ible (Warrant, performance of vendor or contractor) by category and line item in the roject g Vouc9ter, Claim of services approved project application and give a brief description Application Cost arJcheduleNo.) a[ the articles or services Dollars Dollars eats ~T~q a'!~a `?:a ,.. 1~.~.Id~.t'y'i!, f~ ~)~X#`a~l ~~~~ ).~.,~ ~ ("<I.i~IrtlC ~£. ~.~~ ~~n1~3'~ `r'° f + p ~~exx,~3~ ~CtYt'~~'1 ~sf~?;?C~ ~V~13lL1AIr ~,7 +$ H6 f' ~ ~3 ~ J A~ ~ f t f ~#~i.~~, , # .~1~+`r Z:~~i i" F: Jc~ ~ ~ t ~ ~ &.?:~ i . ~n ~. k g 6~ 1 t~'. ' ~ l~ ~ j ~ y~ + j + ~ if.. ~ P I GA ~ I + y ~ p g ~ a +y ~ y* 1,{ y g ry y . a~.~.: r .. ? r G3~3.; b «T'~1~ g. i A » '.L~ ' ~ r } . ti+a f~ ,~,f{~. + ~ * ~ ~d.~l~,d / f ~l ~T ~~9 q ~ ~ q e + ~ E.~~~ t..F~.~~:~~~s~n,~. a~FF p#`, "~.+~-~ A.s ..~... n'~') ~ ~` r .. °" ~!!t~.,,,:~~~.Rl'11 4}3 ,~~ 'A1 ~~E}a ~ Y`[ ~} / ~, 1f,, t ~Y£? ~~Ir~~~~,tl ,~~~, a~'~X'~C~~41 .7«Y"f`.<I '"' "'tXfi`#'1.1s"~.2~.1.~.`~1~~;~ ~. Q s e~.~3 y t ~ ~.G &. \) ~ ~/ ~ ~f f 7:y..J.~~'~~~ a~, ~ r,L ~'~»~'~i~ ~i ~ a . fi &, ~ b w~ F ~ ~~? + ~ '~~a~.~F yq y ! d~l J.~/~~ p s ~ n T 4.y~~~»~'C~'. t,~• T~.?y7,lE~L«°.J» ~ g ry .LJ y~ J " ' ~P ` Qa .~G 4~.~5. ~. d.. ~if;p ~~4y 9. li. >~w :~ ~ vp y, ,,## , ~~'++YY .y~ } r ~g, a writ.:? l~~µ~i.l#: ~"Rf:~&±i .~6Y. 1J.~.L ~~ A P ~ ~~ .~~~f~~ ?~^;f"T''~, ",", ~"f~'~ ~. ?.7"tA"~' T ~~3v 3 ~! 1i yy ~ g 2 ~ l ~S j ~d ~~~~~' yy 5 y 4 a ~.t ~.-..ctlll~'~.~a i'..4.~aF~"{~°~ia~ 4^: ~'+~~1, ,.....,......~...-.,..,...,... y r ~J "~' . ~.n .,, 7 i '~ 1 t WHITE . -FDAA Audlt Seotion Ftie Copy PINK -State Copy ?j GREEN -FDAA Audit Copy GOLD - Applicant Copy YELLOW-FDAA Ragionat Co HUD-481 (6- 4 •pldcor pEP am 74 which is obsolete i ~. U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT " FEDERAL DISASTER ASSISTANCE ADMINISTRATION SUMMARY OF DOCUMENTATION IN SUPPORT OF AMOUNT CLAIMED FROM THE FERERAt DISASTER ASSISTANCE ADMINISTRATION FOR EttGiEtE DISASTER WORK APPLICANT ~~~TY' ~a~ +G.~.s`t~ ~~,~.~~~ZS Prejaet Application No. Page No. ~ 1 a Stets T'~.:~.. DOCUMENTION AMOUNT Applicant's Delivery date List documentation (Applicant's payroll, material out of ns item in Reference No. of articlas or applicant's stock, applicant owned equipment. and name Approved APP cant's (Warrant, performance of vendor oe contractor) by category end line item in the Project Eligible Voudter, Claim of sssvices approved project application and give a brief description APP cation Coat ar9cheduleNo.) of the articles or services Dollars Dollars ants ~~~ ~t3@kir~'. ~iLCYfltj ~t.V~t"lil~ii .~a)~+'E~ ~),r~~~~~ ~1'11~,f.! ~?s?,'~.Flt{ t "«~C+4lR* t'it`. ),(+(".+ (''i ). ~ ~ ar:TC ~St ~'S~E~:Ytel4t ~~0.S. w'.~~ '~Ni d"`Y~~ .~F-Yl9ST ll'+F ~~.Uf.fY ~";{i4 Y.~SJ ~~~~~a ~ ? ~~4 ~j.~{fa~i # " ~ ~,~ ~ { ~ ;.~di " sL~ ','~.fl ~ lc";~~ ? f C ~ `' " 4 `~E ~ L a~.`"d.f ~3' f^ $ /'' y ~ + 2 ,/17 /61~ $ ~ ~ y~ e.~t~ratAT. ~~~, D't"ii ~l v' .. , ~ s r n y R4;7~~ g ~ y '~SS ~~ `?C>L"t:~l ~~:~1'.i`k ,+~.:tTr3?'1'.i~t , 435> J i.3i ~ ` t~~ f ,( d I / _~ ~'~~:'. f,`~. ~~~~i.:'X~•;~ {y.`.. ~;,) ~~f3 ~ g ' . ~ .~ ,F „~'~ Q / ' $ ..f / r~ ~ f ~.Y g ,d ""Sq ~'4 ~ ~r~`s=~. {fix ~, ~.yk'„~'{ :'~1 ~? ~A~~~~.~Sf ]d ~I ~F~ „~kfl,.~~iwf3 ~~itxL`?~ ~t~ ir.,, t t WHITE -BDAA Audit 8aotlon Fita Copy PINK -State Copy GREEN - FDAA Audit copy GOLD' Appllcant Copy .' YELLOW- FDAA Raslonat Copy HUO-481 (6-74) Raplaeaa OEP Fenn 74 which is obaolNa - j x '°t m..aa, w....w.+envAa•' ~.,. vWir r- -w v,._ .- ~ - r.. .~ r:...~,,r,A. .~m.~".•.~...~ ~. +.. e w a a t. e ~ .'~L'a • U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT FEDERAL DISASTER ASSISTANCE ADMINISTRATION P4Be N°• ~ SUMMARY OF DOCUMENTATION IN SUPPORT OF AMOUNT CLAIMED FROM THE FEDERAL DISASTER A~SISTANCB ADMINISTRATION FOR ELIGIBLE DISASTER WORK FDAA ~~~ I APPLICANT C'~'i'~' ~E-t~' t" AtT r T .T 7~i'f'!T!t ,~ Pro(sef AppliesNon No. State ~~"~'`'" ~ `i s WHI E - FAAA Audit 8oollon Fiio Copy PINK - st.ts Copy GREEN - FaAA Audu copy GOLD - Appilc~nt Copy YELLOW-FDAA RKtoswil Copy ~ ~..~~ HUD-481 (o-isf Kspiooos OEP Form 74 which h obsoloto DOCUMENTION AMOUNT Applicant's Delive d t Li t d ' Reterence No. ry a e of articles os s ocumentation (Applicant s payroll, nwterial out of applicant's stock, applicant owned equipment and name ine item in Approved Applicant's (Warrant, pertormance . of Vendor or contractor) by category and line item in the Project Eligible VoucFmr, Claim of servica• approved project application and give a brief description APPUcatton Cost or3chesksleNo ) f h . o t e articles or services Dollars Dollars ents afLT'@iy ~Ct« ~~f '° ~~E~.l~l1 4th ~i~~ ~a?+R~t'C Elm. Ktlsr3iC il`~~fi4~ x#/7/76 ,die 13i~htaP COI} 1~73i~ ~~'~~~@ fit; 1J~lS~t4p ),~ ~.~ ?+I~~'~ ~'Sat~Cl TIC ~~~ ~'~~~~ ~r'I~T'tv!!lZ~C+yt . 1~~.ii~t~t ~ ~ ~ ATd~ Nt~« ~ ..^ ~ I~~1[tD p~ I ~~ ~ ~4"YRIs~ ~: ~itACDtRt'~ .A'V'#tt'ltli rt~le-.~~rr~ -a~-~r ~ ~'S:r~e~ A ?~~,r~~ ~5x~i~ It12b3b I~~/~'{~ a~a~fiaix~ ~~~~titxK ~- C~~ '~ tae ~ •~ I~>~X~~~ ash 'i~2 :Sa~a~~~ ~t~x~l A~~ r`E~~~$O 5/~'/?#~ Cla~r~rece ~!. ~,Srrx~. ~, A ~~a. - 1~ t~c~11 SOYit ~~tecrr~d .~l,~i'ncr~ ~~ -~~~ 517t~6 ~ ~ ~~~ ~. ~6~ A7re~+~ ~t~. #c9 w Ii~ia~a aF ~~~ ~~~~ .. * aA~Q g~[ {{~~ j )+y g ~_ €° ' U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT FED ERA I. DISASTER ASSISTANCE ADMINISTRATION SUMMARY OF DOCUMENTATION IN SUPPORT OF AMOUNT CLAIMED `' FROM THE FEDERAL DISASTER ASSISTANCE ADMINISTRATION FOR ELIGIBLE DISASTER WORK APPLICANT Pro~eet Applteotion No. Page No. ` FDAA Stote ~~'~~"' DOCUMENTION AMOUNT Applicant'"s Delivery date List documentation (Applicant's payroll, material out of ' ne item in Approved p licant's PP Reference No. of articles or s stock, applicant owned equipment, and name applicant Project Eligible (Warrant, performance of vendor or contractor) by category and line item in the A li ti Coat Vouc#ier, Claim of asrvica• approved protect application and give • brief description pp ca on orScltetktieNo.) vicea of the articles or aer Doilara Dollars ants y l ~L "YI~I lbw "` x3 - t93~L"D'1'k t,'r .s~ J. yy p~ rr y .A.d.~ ~~~ 4~~1~~ A{r iv."~.s" ~..'t~.nVF~s~ ~..~ 1.t~)R .t1 ~S :1Et3tS~ ~.~~~ t~~l~ ~-`i~J"*~~'11.4~ fly.!°a5"?'/`ni ~y(3~~ F.41,: w «~ ««..u....,.,,,. .~,,..,.~.....k~. ,., M .. w. #~~~L~y4.A j, ~3::j~ 4¢ y ~ ~ ,# l r f F1i. ~-Wk t.&g.(t i:FK •x• ~.i ': ~k«. ~:L.'/f+L ~w ~..ai i'~ !k.YSE iaT ~:.~r .C"ix !';~"cj. ~ w`•~a'1'i't ~~ ~~s'~ftR'l~tt ~ f . s~,~~ s:~~~t.1L3 " .?'1L'k C''~ S^~C~~"~.~ ji ~"'as`k ;+~ « ~a. ~ W '~KT~,.~.~: ~ ,~y gy ~ • !4'~ e'.^Yttl~ ~~ i.`A~~#~~1S.a1,1~~'y t~~~.A'~~. ~'ti.~~~ ~~~ ~.r~ ~. ~!~r~~~~ ~tl~~.~s~z ~.:lF~~l~E~DiI ~' ~' ~1.017~ ~'~~~~.~3~1~ ~~ ~~ar~.~~~4~ ~ , ^{:~ ~~~~. 3./7175 ~~i~.~~~ ,~ ~~~~1: ~,,~ ~? b. ~~~.'~ ~ 7 1`~ / ~a~. ~ 2ipt 3 ~ t ~ ~.~ ~a C 'a ~~ ~! } i `.°l ~~f ~. 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A ~./ ~ M N • d ~ ^f W'R/Gk ~ ~ir~~ ~ ~M~ 1 . ~' j ~ y ~ { y y .. gyp; y ~ y~ y~ i {?3~'~i: ~ Mi~i~J~ ~ F~{~t i l P \'~ ~},~ v/ ~ b r yy4 y ~ 1~ (~', J!'~ j, [ lj{ ~ '} [[''~~ s~]j~A .i.E/~''"'~w'~L.R J`iiy~ ~j ~fy'y f+ + . d ~ ~~®+~' { 6 i M~~` ~y ~y y~~~yt ~j $($ '{. ~r . t. .`~. b~ i { • ~v7. ~n~ ~ ~ 1 ~ i. /~d~{M • ~ {. r ~ fy/~y ~~,~ t ~/RS ~( ~~! :d y'~~ TaFLP ~ ~i.~J'°~i~~ICM r I } Q }y f ~s.lY1M~~~~7 ~ + ~ ' ~ p j'~ p /y + ~ y ~ ~y y 8Y~ F 4J M~~k "1P ~ ' P µVJ.M ~~ ~d.M~~ ~~+~ '~v~~• ~~ •p~q +I~k { ~ ~ q ~ 43 b# ~ ~ ~• ~i ~ #~ i ~ M / ~..~~ ~~ ~ {'y ~~R b ..yy q~ ~A~_~1r~yy .~.+.1,}"'J.f1"~+7i~ jry r,~_~~p~ / g j .PrJ"'Ql ~~7 ~ p~~,, ~ ~ y { ~ , w ry Jy~ 4fiiL e~'~ '"• ~V ~l~~e. t I ~ f i+i.r ~ y g { ~ ~~+G~ t. t J i p ny Y R ~+ ~ ~ AA t~ r ~ gg } y +~ .~..n fl y DIS' I s WHITE -FDAA Audit 8eotion Flle Copy PINK -State Copy GREEN -FDAA Audit Copy GOLD -Applicant Copy YELLOW -FDAA Re~lonal Copy HtJD-+~Bl (6 74) Replaces OEP Form 74 which is obsolete ' U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT FEDERAL DISASTER ASSISTANCE ADMINISTRATION SUMMARY OF DOCUMENTATION IN SUPPORT OF AMOUNT CLAIMED FROM TM6 FEQEI:AI. DISASTER AS~STANCE ADMINISTRATION FOR E~i~adlE DiSASTIIR WORK APPLICANT (%~~' cif C'"~tZ'~~a Z~I.~~~~~- Project Application No. :~, *~; J.. F`, "i t ~: t"* Page No. '~~ 47t' ~i FDAA State ~~ i DOCUMENTION AMOUNT Applicant's Delivery date List documentation (Applicant's payroll, material out of ne item in Reference No. of articles or applicant's stock, applicant owned equipment and name Approved Applicant's (Warrant, performance , of vendor or contactor) by category and line item in the Protect Eligible Voucher, Claim of services approved protect application and Qive • brief description Application Cost arS;cheduleNo.) of the artielei or services Dollars Dollars eats I.Y.I3~ ):C2 )')t}•. ,~ .., ~t~C?it~ t~f'3'Ir 'I'~z7 ')~I'tJ 6~]KC~ ~C~titRP ~.~.,.~~~.,..~»,.,........, .............~,,.. o ~ ~~~».1~,.~17 ~°~ttr.y7~.~. *'s(~ itiC't?i, sx ~t•~~~~~3~' ~~.~~ ~(~.`~ `~A~:j ~' ~ _ i '7 ~ i -; ~ v$ ate. 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DIS 1 t WHITE -FDAA Aadlt 8oatlon F!!e Copy PINK -elate Copy GREEN -FDAA Aodie Capy GOLD - App!lcant Cepy YELLOW-FDAA R. lonel C HUD-481 (6- 4) .piaaa• OEP orT ~ wMeh is o solpts DOCUMENTION AMOUNT A li t' D ' pp can a elivery date List documeatstion (Applicant s payroll, material oat of ne item in Reference No. of articles or applicant's stock, applicant owned equipment gad name Approved Applicant's (Warrant. pertoemance , of Vendor or contractor) by category and line item in the Project Eligible Voudter, Claim S h l d of services approved project application and give a brie! description Application Cost or c e u eNo.) of the articles or services Dollars Dollars eats ~+~TtID ~~ifi"M ~t!• !~ - ~2~DV~~. t!~ ~~Tt{ ~~~R ~1<'il~l8 ~t?4i~)1 ~`i~.~S~ Cif ...t~i~,»+(t~~ ~+~'~'"'~~+~I~}~" ~A ~~~~ ~,tl~ ~,Qtlc`~6T' ~ ~"", ~ ~ ~~IgW~~ y+~y~y. /n y~~ g~ e pw ~w / .. 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DISASTER ASSISTANCE ADMINISTRATION FOR ELIGIBLE DISASTER WORK APPLICANT ~~'.~' t!'~'' ~~~# Z~.L~~$ Proleet Applieotioa No. L ~~ ~, .~'~ ; Page No.,~ FDAA ~~ State *r~r,,_ DOCUMENTION AMOUNT Applicant's Delivery date List documentation (Applicant's payroll, muttorial out o[ ne item in A Applicant's Reference No. of articles or applicant's steak, applicant ovvaed equipment, and name pproved P Eli ible (Warrant. performance of vendor or contractor) by category aad line item in the roject g Voudter, C1sim of services approved project application and give a brief description AppBcation Coat orScheduleNo.) of the articles o< seevicea Dollars Doilara ants la'~~E: ~LBI~ si+t~., ~ ~w ~8'~J3r'~!i ~~~'sdA3."di'J;t~~ '~!'Qlll p'~'~,y1S~lA EDP ~~C ~'"i> +EY.`tr ~ (~l"+iMC$#'>" ~~ ~~ '~; ~'L~'~~ i 't~'Ii'~x ~.d;~~A.,~l #, .,i`~{ 43~a+(3A /.i y+ ,y D~~ ~~44 JKir~~..8.~~ eat eg ~Giis ~Z. ~yg~ w'q;.t ~. ay ~di.. 4.sSFIR I dS.. .ZR M 1i~ it#,4.+ 4 . . . {+y y p ~a9Jl {~ J+~ ~a y Cpl ~Lfi~t~ ,g ~~t '~~1 6. iJ~~~.~,,~:' ~ • • •~• J y~ '{ ® q . µ ~. YR~F9 • ~ i 1.~ Lr ~~ A, a day ~t ~..W w~ ~ iP q`p aye T W. ~t ~Y ^ '"~yt> t31~I73 -~~-+rv~.~~ws+wr ~.~i~aaz' ~zEd ~:~ri~si~.i~,t l,l~t ~a~~r °x~,~, ~CT,~.C~. '~, I2U~7.S ~~si'~hx ,I~d .~~. ~~ 1 r7 W,J,~SLi :wS°Ld.t rA f ~~ r 1}aW * \.l $ .3 Wi/ a 1 g .lyy a { ~~i~+~L tt4$I LTd~ ktit~ C,+0..~E"4l".tR~~ i , » .. . . . ..».. .....« .,.. .. ~ p ~ } LM1A~~~ ~ Twi"~~,~~~~~ r ~ J ~y p~/~ ,#„~ti3'~'l~sd'a634A ,/y e'° W t WHITE A! s t !t C PINK S i E A 9 D t -FDAA ud t •ot oa F • opy - tats Copy GREEN -FDAA Audit copr GOLD -Applicant Copy 'i YELLOW- FDAA Re lose! C x ~'G HUD-481 i6- 4) •plou~ OEP orm 4 whfafi h e •olst• '~ ~._.._ ') ~. i g~~: ~).i ): ).~ ,$~a _~~ ~'. ~~ U.S. DEPARTMENT OF MOUSING AND URBAN DEVELOPMENT FEDERAL DISASTER ASSISTANCE ADMINISTRATION SUMMARY OF DOCUMENTATION IN SUPPORT OF AMOUNT CLAIMED FROM THE FEDERAL DISASTER ASSISTANCE ADMINISTRATION FOR ELIGIBLE DISASTER WORK Page No. ~~' APPLICANT ~ t~~ 1~-,~`,'j_ Pro~eet Application No. FDAA ~~ ~~' Srofe ~~'~t° DOCUMENTTON AMOUNT ' Applicant s Delivery date List documentation (Applicant's payroll, material out of ins item in Reference No. of articles or appllcant'a stock, applioant owned equipment and name Approved Applicant's (Warrant, performance . of vendor or contractor) t-y cat,gory and line item in the Project Eligible Voudter, Claim of services approved project applioation and give a brief dtiscriptio» APPDcation Cost or9cheduleNo.) of the articles or services Dollars Dollars eats ~.~11~t 'k I~+G~. ~ N- "pl°1~. t"s~ 'tDItN +~u "~.~'fB~ ~~`~ ~~ ~~~~~~~ Sdaxtt~r~ '~1;'~$ 6+R'R"~M"~.+~EI '~ • ~~~ D() ;:"~~ "~~t#~b ~OSYC?Mltl~'d Tyr@f7t ~.ex~c~ 2~r~~'~ ~~~ off ~il~~1 ~flrtitkg`t~ °~'X'g'<! 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U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT FEDERAL DISASTER ASSISTANCE ADMINISTRATION SUMMARY OF DOCUMENTATION IN SUPPORT OF AMOUNT CLAIMED FROM THE FEDERAL DISASTER ASSISTANCE ADMINISTRATION FOR ELIGIBLE DISASTER WORK APPLICANT ~'~ ~ ~`* ~~"~*~'~' Proieet ApplleaNon No. ~1~ 7 r~i3 DIS I t WHITE -FDAA Audit Section File Copy PINK -State Copy GREEN +FDAA Audit Copy GOLD -Applicant Copy YELLOW- FDAA Rasiottel Coyy ' Page No. ~ FDAA '~~'~ '~ State ~~'• DOCUMENTION AMOUNT Applicant's Delive d t Li t d ' Reference No. ry a e of articles or s ocumentation (Applicant s payroll, material out of applicant's stock, applicant owned equipment and name ine item in Approved Applicant's (Warrant, performance , of vendor or contractor) by category and Line item in the Protect Eligible Vout~ter, Claim of services approved protect application and give a brief description APPlicatlon Coet ar3che~tleNo ) f th i . o e art cles or services Dollars Dollars ents ,!i~,~~3.1.~s~cs;ue ?*q~ai tit '~~~~~.~ end ~~~t d~ ~ ..~ ~,_..,~.....~.~,~..,w ,,......,.~.,........ ~~O~.T~~~ -- C~~3, +~ 9~1Q/75 ~iiac~a (ax:l~:i13,y~ 5.~7~.5 ~~~is< 3,7'3 ~d,~vl5txal~ 13./3/9' ~I~~~~d gill) 223 '{~~~ I01 ~ 7 i) ] f ~~r~ tfi l+~vi~3. a ~ .~ Cis. X 3 3 w ay ) '1 ' p ~ { p ~ -q 6 xq . ~.i5 ~ 5 1CI~t~ 1 ~ i~ .. 1. t~ ~~ ~r r~~lap 1,3b Ya it~~ • y e y a~`ri~j ~M. y j y w. ~ p ~•if.F.~ k'1F! ~VV B ~~ 911(I~'7~ S~xiek~rr. Etsnc3~kllwd service , ~~~ ~13~1~3 ~ erg ~~~. ~ ax~~ ~ ~ 3~~r717.~ ~are~s+ salt ~~ ~~ ."+~~ '~M/ W41+ ~~ ~ Pic~.el l ~V14 {/~ ~SR bi Ad •J' .. ~~ ~~ t ~ ~ ~~ .)y ~~I spy }q~. y/ ~MV~I~ . M~eG (p }y ~ p ilF6h~~~N~ N. i~BM• ~ ~+M til t,,"~.A '~t~"1'14X, 9,13 «t7Q ~ ~ ?a4 71 HUD-481 (6-74) Replaces OEP orm 4 which is obsolete ~{ t y Y U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT FEDERAL DISASTER ASSISTANCE ADMINISTRATION SUMMARY OF DOCUMENTATION IN SUPPORT OF AMOUNT CLAIMED FROM THE FEDERAL DISASTER ASSISTANCE ADMINISTRATION FOR ELIGIBLE DISASTER WORK APPLICANT ~~~ s?~ ~~'"~Ct2~. '~~,I'~T~_ Pre~eet ApplleaNon No. ~4 `~~ r ps Page No. FDAA ~ ~°'~ ~'~. Stole ~~:.`(,g, DOCUMENTION AMOUNT Applicant's Delivery date Liat documentation (Applicant's payroll, material out of ins item in Reference No. of articles or applicant's stock, applicant Darned equipment and name Approved Applicant's (Warrant, performance , of vendor or contractor) by category and line item in the Protect Eligible Voudser, Clakn of services approved project application and give • brief description APPlication Cost ar9dteduleNo.) of the articles or servicea Dollars Dollars ants ~r~,'~t ~.t.`~~A Cl. .~ *~- ~t+t1?'iE{?'~+b` `. ~;~.~i'!'~.D CJ~' t, ..+.1 ~. • g, .'L FY~:E.~ 6.! 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YELLOW-FDAA Regional CoQy ~~ ''~ HUD-481 (6-74) Replaces OE ~am 74 which fa ebeolet• t ; U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT page No. ~~ FEDERAL DISASTER ASSISTANCE ADMINISTRATION SUMMARY OF DOCUMENTATION IN SUPPORT OF AMOUNT CLAIMED FROM THE FEDERAL DISASTER ASSISTANCE ADMINISTRATION FOR ELIGIBLE DISASTER WORK FDAA ~'~~ ~`~ CIS +~ `' I4~8 APPLICANT Preleet Application No. State ~~~^* t? ~~.; ~"°e ~gg k l.1 DOCUMENTION AMOUNT Applicant's Delivery data Llst documentation (Applicant's payroll, material out of ine Item in Reference No. of articles or applicant's stock, applicant owned equipment and name Approved Applicant's (Warrant, performance . of vendor or contractor) by catagory and line item !n the Project Eligible Vouc~ror, Claim of services appeovad project application and Rive a brief description APP1lcatlon Cost or3clteduleNo.) of the aeticlea or services Dollars Dollars eats ~#~ ~~~ Q« ~ ^w "C`'C'lR~I~~G 4:OZ1~1"Ci~.r Lotltizl ~~~iv~tt~. I~ulrf~~- sxf>~c n 71~3,~75 P~iyrc~l.7. ~ ~~r. ~.2I~~/~r. ~ ~~ . ^~ A. 1.: i a ,k id r !.'4d' ~ ~ V~'S+ di d p~1r ~{y~q +~r~~ 4 '~~~ 7'123w7/~It ~ ~~I~ra1~, ~- SS~~x ~xr~. 3.~~/~i:. 2,~IS~.Sk~ ~A~~ t~ Lti~. M f ~IiY.f.~J.t ~lA\JiV.~.v ~~6~~i~ ~Cir~-P~'~1+1a1r.~~ *.~~ :, .r. at Vm.J['tnS7 f. ~~ ~ ~ ~11~ i g¢yy,~, i i~J iU.~t ~ µ~~si7~E!/Idx• a:~4~~ V ~7 WRY ~LA3iPi ~. ¢.i~~ (f#yi ~ ~+V~ DIS' 1 WHITE A dl B P u i - FD A A t cation Flie Copy INK ~- Btate Copy GREEN -FDAA Audit Copy GOOD - Appilcent Copy YELLOW-FDAA R• tonal Co HUD 181 (6 4) ep aces OEP am 1 which is a selete 1~„ E' ~)` { . i U.S. DEPARTMENT OF HOt1SING'AND URBAN DEVELOPMENT ~~ FEDERAL DISASTER ASSISTANCE ADMINISTRATION Page No. SUMMARY OF DOCUMENTATION IN SUPPORT OF AMOUNT CLAIMED FROM THE FEDERAL DISASTER ASSISTANCE ADMINISTRATION FOR ELIGIRtE biSASTER WORK ~~ ~,R FDAA APPLICANT ~~ tf~' (° ~~,~~'}~'(~_ Prelsat Applieotton No. Sfote ~~"~" DOCUMENTION AMOUNT Applicant's Delive d t Lt t d ' Reference No. ry e a of articles or s ocumentation (Applicant s payroll, material out of appltcant's stock, applicant owned equipment and name ins ikem in Approved APP cant's (Warrant, performance . of vendor or contractor) by category ~utd line item in the Protect Eligible Voucher, Claim of services approved Protect applteation and give a brut description APP cation Cost or3cheduleNo ) I th i . o e art cles or services Dollars Dollars ants ..,~ ' 7~/25/7~ ' P~.~ra~~ ~ 5 hrs. (' ~a),~3~~)11ti'• :~ 5 ~2 ~~ 7123~7l3E~! 3 ~~ylrc~ll ~- 57 1I~.{~ ~c~, ~' 7a5~1/hr. : ~51 "~ ~- 7/25-7'/SDt 5 ~`~,~rrs3.1 ,~ ~~. 7.~~7'I~z. X21 5 1~~x ~ ~~ ._ I 7/25~1lSCI~ . P~.T:~€a<1.~. w SEA ksl~l3. 7.'1'~5/'I~a. A5~ D / 7I~~--x/39/ ' 'F~yra~,, -~ ,SD ~r,~. r 7~R33!'br. 1 ~~ 2 - 5 7 ~ 7 / / d ~a~;a1 ~. ~- t ~ ? ~h~ra. '.~ ~ S lic. 5 .« ~$ « y je g+ ~ • y j ~{ if P j,Ai.7'° l at ~ + ~ y g y p + ` , ~ ~i~' ~ d. ~ J . ~' / ~ d ~}~i'y C: ! . a ~ '+ 1.€ ~ .' M ~ { ~ P G j ~'^ W r (f ^y { / ~l ~I d ~! ~ l }y (~ y~ gy~ gq y y q ~'.~y y }p ~{ ;~y ~ j y, yA~ /j ~~ M' ~~~3+V~.W. ?w. Y'4! 4d~~• W 11./..a, Z,HI p~• µ{1(~py~ .Y'&~4J .py. gg `~ ~"~~~"~tf~9J 7 ~dt')+'T'A~.~, ~" )~Z )AIC'!4. #~.:'t,4~'j#.'il~"w ~y).~~ dN ~! . ...... . .~ ».~« lvfp Mgw~ jM{' ~yq~ `~. 4'~J 1~•iYR15i ~ gy yq{ pryer ~ t KY i w~V ,......¢~~;,.. ~ ~ ~~.~` l~aa~~f~y4x ma~yy,, ~+q~~ °~s~~'414~"33{ ~37.Rt (~ ~+~}iq p~~~~ryy S! & J R'.V r S7CJ ~! qq^4Wr. ~ ~ +#~'«f fi+g~'! J f 11 t u,u,~e -•~ • ••.~~ ..~.. ~..~~. rn . e - rvwea nawaa avassoaa a+aa~ copy r11VR ~ atatt Copy 'GREEN -FDAA Audit Copy GOLD ~ App!lc~nt Copy YELLOW-FDAA Ra ionai C HUD-481 (6-74) Roplous OEP am 4 whteh is obrolot• U:S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT FEDERAL DISASTER ASSISTANCE ADMINISTRATION SUMMARY OF DOCUMENTATION IN SUPPORT OF AMOUNT CLAIMED FROM THE FEDERAL DISASTER ASSISTANCE ADMINISTRATION FOR ELIGIBLE DISASTER WORK APPLICANT ' ~~ `~`$`4".~~ ~+ ~ Preieet A-pplieetton No. ~} k~ ~' .,.. `I i DI t WHITE -FDAA Audit Boation Filo Copy PINK - Btats Copy GREEN ~ FDAA Audtt Copy GOLD - Appllt:ant Copy YELLOW- FDAA R~slonai Co 1 HUD-481 (6- 4) •ploeos OEP ant 4 whieh is obsolNO i Page No. ~ FDAA '~ ' State DOCUMENTION AMOUNT Applicant's Reference No. (Warrant, Vouc#ter, Claim Delivery date of artlclsa or per[ormance of services List documentation (Applicant's payroll, material out of applicant's stock, applicant owned equipment, and name of Vendor or contractor) by category and line item in the approved protect application and save • brief description ine item in Approved Protect APPUcation Applicant's Eligible Cost or3ehedttleNo.) of the articles or services Dollars Dollars ants " ' i +"fM~c , J~~? id~r . ~R~ .G • "1 . ~ i ~ ~~' ~1". ~ T.~ „ , ~,,y.y~ / j w + yq ~ y y y r ~ y , S.eN ~M'Cl L. S~~ ~~+6 ~'iV ~~i.Y. 4.. d~~•f2}i'~b;.~(. ~a ~.~~ p . ~ A:~,r ~ ~.Z~d:u~.~:S..F~•. ~^y '~~~y~p .6 wf' W~ (+ t~ y} f 4~.6«! A ~ ~ ~c+/ g y r ~ y .~y,M F'~p ul +~ ~ ~i~ 'N4A k~ ~ ~ ~y" y~ i.r eylY ~ ~ .~F~~ T~/~ } ~ ~ j ~ 1'( ~1:~3~ 4 T~ . ~$Y+t.- eW~. ~1 p{ ~./Wa~l ,~ ~-qyp }~j jy pp $' Gt ~IF. iIJ 1..7 g w ~q~yR~y ~MAV~ 1F~P(R. ~~~aR~(R~R3 wy Ty /~ I ~4~ti7Sc7 ~ f~/~ {c75} sc ~ ~ A / ~ ~+ M I ~~ Ri~J '~ C `SF ~IR i F~~ . a + Y /y.~,yy •§ ) }y ~] ~{p / , yy y{ y~y p yNyl, syy~ amply p . y/ ry ~[4[T. ~'~.,. 4+'N4 A. ~. ~Y~.~ ~ ~ Yr. hl An ~ d V'IY fit' ' U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT FEDERAL DISASTER ASSISTANCE ADMINISTRATION SUMMARY OF DOCUMENTATION IN SUPPORT OF AMOUNT CLAIMED FROM THE FEDERAL DISASTER ASSISTANCE ADMINISTRATION FOR ELIGIBLE DISASTER WORK APPLICANT ~~ C3$ ~ ~r ~~`~'~`~ Preieet Application No. i~ ~~ Page No. +~~ FDAA A7~1 'ftTt Stets ~'~" DOCUMENTION AMOUNT Applicant's Delivery date List documentation (Applicant's payroll, material out of ' ne item in A d Applicant's Reference No. of articles of applicant s stock, applicant owned equipment and name pprove (Warrant, performance , of Vendor or contractor) by category and line item in the Project Eligible Vouc#ter, Claim of servica• approved project application and give • briar description Application Cost or9chsduleNo.) o[ the articles or services Dollars Dollars ants } ,~p3 s.r~f`~; ? x s'.'.~C'~:~ ~+,. " t?.~ C ~ ° `~~"s ' ~'Y* • y ~'q y~ry ~ ply y y p ~ y y ~w f aS4: ~ ~ ~ .4+wi .9.'fVi i ~ ~TA`~~A. i,. f$ L.A ~J.gkW ~GiR'&e+l\~ g'M yy yy~yy ~~~~ 4/~ r~Yn I: YS~~~ ~.~.~~Ww~w~+.w~+awv,~sww.u...~v~.~WS~N.YY.s a~ +• .v' 6FJ ~.A1r~-1 .~'~1- i '&. f~l' ~ ;7 ib ( Rr ~ ~ Y V 9+FMP ' i ~N+ i 4NiV+. ~n ~i+ ~4e L»V # s~• wF 3~ k~. ~4. A.Fw ~R/~~'}~ ~` yXp /y ~MT V~~ yp~ ~pyEgp~{~, q~~,~y~ YY f~JWVir ki Si y'/y { Y~1~!~Y p,~yypy~~ 'fFW DI t WHITE -FDAA Audit section File Copy PINK -Stars Copy GREEN - PDAA Audit Copy GOLD -Applicant Copy YELLOW- FDAA Red/oaei Copy HUD-481 (6-74) ep aces OEP orn, 4 which ie obeelete f ~,._,. __..~~... ._.... .. _ _.. .~ ~ ~....._.. .. v_. APPLICANT _ ~,3 Page No. FDAA ~~~ ~~' State "~"' DOCUMENTION AMOUNT Applicant's Delivery date List documentation (Applicant's payroll, material out of ' ne item in Approved A 11canNs Pp Reference No. of aetlclee or s stock, applicant ownetd equipment. and name applicant Project Eligible (Warrant, performance of Vendor or contractor) by cateEory and line item !n the A it ati CosC Voudter, Claim of sarvicea approved psoJect application and atve a brief description pp c on ae'9dteduleNo.) of the aeticlos or services Dollars Dollars eats . .. ~.._....w ......,...~......~ ~.1Cti+p ~G4EDA I'IiEi^ :~ '- R~tp~~.1CSi C+[? q~.~C+rlw slE ESE' s3S~.~~T" "~,-..,.4 , ,~~ ~l~x/~~ J~rfrap ~x~1~ii~ . - ~ai~l~.~r.~>~xa~~ ~~ ~s~.a~.l~~; ~~.~ 1, ~~ 3b .x!67 ~1:~17 ~.~a~ ~,~~ t~tartc~ ~>;ty ~~ ~s~ i i i va..~.vv ..v.. vv~p. r,.. ~ - .. .-..~ ~r+ .. .. ..ra GREEN -FDAA Audit Copy GOLD ~ Applicant Copy YELLOW- lDAA R• local Co HUD-481 (6- ) •ploeos OEP orm 4 which is obsolat~ U.S. pEPARTMENT OF HOUSING AND URBAN DEVELOPMENT FEDERAL DISASTER ASSISTANCE ADMINISTRATION SUMMARY OF pOCUMENTATION IN SUPPORT OF AMOUNT CLAIMED FROM THE FEDERAL DISASTER ASSISTANCE ADMINISTRATION FOR ELIGIBLE DISASTER WORK (" L>~ ~' ~'~~~ Project Applieotien Ne. °. I r, _ :..:..:.::. .. .- W ;~sa~x_'F a«~~- ~... ^~,.-n~ ...a-w~,..- ~ , c ,f.:;lu ,,; c^ur. ,.~.in, r t ~:r~* .7` ,- .. :+$~~?'~ ,: N i U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT page No. '~ FEDERAL DISASTER ASSISTANCE ADMINISTRATION SUMMARY OF DOCUMENTATION IN SUPPORT OF AMOUNT CLAIMED FROM THE FEDERAL DISASTER ASSISTANCE ADMINISTRATION FOR ELIGIBLE DISASTER WORK FDAA ~~ ~ APPLICANT _~ t3~ C;~l~(~N. T~iGT02S Pro~act Appilcatien No. State .~ DOCUMENTION AMOUNT Applicant's Delivery date List documentation (Applicant's payroll, material out of ne rem in A A licant's PP Reference No. of articles or applicant's stock, applicant owned equipment. and name pproved P Eligible (Waerant, pertotmance of vendor or contractor) by category and line item in the roject Cost Voudter, Claim of services approved project applicatipn and give a brief description APP cation ar3cheduleNo.) of the articles or services Dollars Dollars ante ~.~.9A~ ~C ~Pb. ~ ." !+s2'~'t~.>~1~. ~'Y'Ct~b317t k~:~ ~&I/1~/TS ~'~°~: ~-tca 'I~~r~~ ~- cxhrtra~ xt~lratc~ar ~~~~ ~y ~y~~p ~#t ~lsiTY `i P~~`r ~1 • 'i 1„c~.{aiv MA.YY Tae6~i4"f ' 4.T~6Ri,il•~ # F3 ~ i F ~'RF~ 4 + i @ M y y~ ~ p, ~ g y ~ p ~ y ,F l1I~iFi~~a4'A ;~yy ~i~a V' f~+~ {vpV ~zl~r~l~ec~lr {p~rt~l~ 2~ ~~ .~.., ~.~ QI : WHITE -FDAA Aadlt 8eotton Ftte Copy PINK -State Copy ;~ GREEN -FDAA Atdlt Copy GOLD - Applicant Copy YELLOW -FDAA R• tonal C HUD-681 (b- 4) apiaea~ OEP am 4 which is obaol•ta a i' r' U.S. DEPARTMENT OF`;HQUSING AND URBAN DEVELOPMENT ~ FEDERAL DISASTEIt''A$SISTANCE ADMINISTRATION APPLICANT Page No.a~__ FDAA ~~~ ~` State ~~`~'" DOCUMENTION AMOUNT Applicant's Delivery date Llt documentation (Applicant•a payroll, awterial out of ' ne item in A A licanNs Referet~e No. of article or s stock, applicant owned equipment. and name applicant Project Eligible (Warrant, pedonnanae of vendor or cant»ctor) by category and line item in the A li ti Coat Claim Vot>~r of seevicoe approved project application and Qive a brief description pp ca on , ar9eheduleNo.) of the articles or services Dollars Dollars ante r~:ti~ ~~+F'.Trz ~`T43. 1~3 ~ 'lieE21°~i8tt~ ~+Mtgl„`!!E'CtAI~ ~Y .. ....._....w._.._.~..,,........._....,,.....,._.~......_.».r,......,.....~.» ~ ~ _.r , _ _..~.,~..~.,. ..,.~.. . . .. ~ ~' ~.r ~ 'y ~qr~ ~*w ~y{ `a!~."' lr ~ ~~Qe: t , k y/y~pys {jK yp yq y r~ q ~ ~Y µ l ~ N~~~ i a ~ 3n ~C1• i ~/ $ 1Y ;J ~~ 'w A~ #l '.; . ~~ k i~ ~ ~'y rC. ~ a.c y'r, ; 1~ y J / ~° 1 ~ ~~1' - ~ g + $ ~ ^ $~ ,. ,} p ~ j ~ ~s ps ~ y y y ~ ~~ "~"- Y ~ 7 { I~~ 53 M ~ 5 [ ~ y l $ 4 ~F ~k •~'( w R '. W ~ : . y~ .~.} 4 .'" ~ yA ji I ~ {, +.'.~ iG ~ ~~' ti l ~ • + ~, @/ + } a . p y y n `~ y y ~ 'r 'T 4 FT~ ~ ,da~~J~ . Y ~ • ~ 4 8iJ ! i ~ / ~ 1'-gT~'p~ ng .f`+.',+'"~/ ~` r~ :, 7 a.a S ~P }.i p~ a; <p y{( p } ~Li 'U~~4 i i~ P ~ ~ ~ /J~ .yy +~5e 1p '~ l~ ~g{. .y VS ~ p.p ~ u !.'6tr ~W ~di A r ~ ~+ A S ~ ~ ~ +W A . W ~ ~. R , 4 ~ ' ~ ~ ~ ~ / 4 ~~. ~ ,( ,. b~j ... ~ . . e {1 t ~i~i ~.~-A~~~ yy // ~~ W~ . + gw t as^ ~e~a~ /) p~ +p~r y' ' ( ~ y gr~ y q ° ~ j, ' / (+. £~~Y'4wi Abr~r ~ Wm" 'T ~~ Rk6 ~Lii \° ~a ~F~~~~i ~ pi ~~/ f ~~`~~ AI WYI C i sw~ • •..JI~ f~~l~ 4i ~ f^..~o DI~1If S~~/~ Pw.... GREEN FDAA Audit Copy GOLD - Appllasnt Copy YELLOW- FDAI- R. local Co l HUD-48T (6- uploee~ OE orm 4 which is obselutu ~ y .,SUMMARY OF DOCUMENTATION IM=SUPPORT OF'AMOUNT CLAIMED FROM THE FEDERAL DISASTER ASSISTANCE ADMINISTRATION FOR EL161BLE DISASTER WORK '~ ~ " " ~~• ~~~ Pro~eet Applieotton No.