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C116.1.B. - Page 8 ;�ty Attachment 1 <br /> GRANT PROGRAM SUMMARY <br /> GENERAL INFORMATION <br /> Grant Title Grant No. <br /> General Description of Grant Workscope <br /> Granting Agency Agency Contact Phone No. <br /> Pass-Through Grantor Pass-Through Grantors No. <br /> Federal Grantor Federal CFDA No. <br /> Responsible Department Department Contact Extension No. <br /> Council Approval Date Application Date Award Date Est'd Completion Date <br /> GRANT COST AND REVENUE SUMMARY <br /> Program Cost Summary Total Grant Portion City Portion-1 <br /> Employee Costs <br /> Contract Services <br /> Supplies&Services <br /> Capital Outlay <br /> Indirect Costs @_ %of Direct Costs <br /> TOTAL GRANT COSTS AND REVENUES $ - $ - $ - <br /> Method of Funding(Reimbursement,Advance,etc): <br /> Is a Budget Amendment Request Required? Yes ( ) No ( ) ifyes,itshould be attached <br /> Have affected Departments been notified? Yes ( ) No ( ) All affected departments must be notified <br /> OTHER COMMENTS (note any significant or unusual compliance requirements) <br /> Use reverse side if necessary to provide additional information <br /> Grant Program Summary Form Prepared By: P�ease print Date <br /> The section below to be prepared by Finance Department Upon Receipt of completed Form and Grant Award Letter <br /> Recevied By: Date: <br /> General Ledger Number Assigned: eudget Amendment: <br /> Other Comments: <br /> 1-Applicable only if a "city"match is required <br />