Enter information in all required fields. Amount totals will fill automatically as you fill in Planning, Training, Exercise and Equipment tabs. Self- checks for HSGP and LETPP funding targets are listed in the budget section. When the entire budget worksheet is complete, save and upload to Blackboard. Print your name at the bottorn of this page. Jurisdiction Name: Mailing Address: . state Email Address: ETeIe hone: FY2014 Funding Summa HSGP Planning HSGP Training HSGP Exercises SHSGP Equipment 127,341 48 SHSGF Total: #REF! LETPP Planning LETPP Training LETPP Exercises LETPA Equipment 33,819.30 LETPA Total: #REF! Emergency Management Special Teams Application Total Certification The requesting jurisdiction understands that this grant will be administered on a reimbursement basis. Upon approval of this grant request, and acceptance of the grant terms and conditions specified in the Grant Award Letter and Memorandum of Understanding, the jurisdiction may incur costs against the grant award and submit invoices to SDEM for reimbursement. Payment will be made on actual costs, except that costs above the amount of the grant award will not be reimbursed. The jurisdiction further understands that all approved grant activities and purchases must be made no later than August 31, 2019. Signature: Printed Name: 0T County/Town Administrator or Chief Elected Official LETPA(Law Enforcement Terrorism Prevention Activities) Equipment Jurisdiction Discipline Allocation Purpose Item AEL Number Quantity Rate per Item Total Cost Justification Web link Total $ *All purchases and reimbursements must meet Federal and State guidelines ** Emergency Medical Services (EMS), Emergency Management (EMA) Fire Service (FS), HazMat (HZ), Public Works (PW), Public Health (PH), Governmental Administrativ (GA), Public Safety Communications (PSC), Health Care (HC), IMAT (IM), CERT (CE), CART (CA), ARES/RACES (AR), Search and Rescue (SA), Decon Strike Team (DST) Regional Response Team (RRT)SHSGP ( State Homeland Security Grant Program) EXPENSES Discipline Jurisdiction Allocation** Purpose Item AEL Number Quantityte per It Total Cost Justification Link - $ Total *All purchases and reimbursements must meet Federal and State guidelines * Emergency Medical Services (EMS), Emergency Management (EMA) Fire Service (FS), HazMat (HZ), Public Works (PW), Public Health (PH), Governmental Administrative (GA), Public Safety Communications (PSC), Health Care (HC), IMAT (IM), CERT (CE), CART (CA), ARES/RACES (AR), Search and Rescue (SA), Decon Strike Team (DST), Regional Response Team (RRT).SHSGP ( State Homeland Security Grant Program) EXPENSES Discipline Jurisdiction Allocation** Purpose Item AEL Number Quantityte per It Total Cost Justification Link - $ Total *All purchases and reimbursements must meet Federal and State guidelines * Emergency Medical Services (EMS), Emergency Management (EMA) Fire Service (FS), HazMat (HZ), Public Works (PW), Public Health (PH), Governmental Administrative (GA), Public Safety Communications (PSC), Health Care (HC), IMAT (IM), CERT (CE), CART (CA), ARES/RACES (AR), Search and Rescue (SA), Decon Strike Team (DST), Regional Response Team (RRT)