Form FEMA Form 112-0-2 FEMA Form 112-0-2 Budget Information - Construction Programs

FEMA Emergency Preparedness and Response Directorate Grants Administration Forms

FEMA Form 112-0-2

Budget Information-Construction Progams

OMB: 1660-0025

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and Paperwork Burden
Disclosure Notice

U. S. DEPARTMENT OF HOMELAND SECURITY
FEDERAL EMERGENCY MANAGEMENT AGENCY

BUDGET INFORMATION-CONSTRUCTION PROGRAMS
1. NAME OF APPLICANT

3. CFDA NUMBER

O.M.B. No. 1660-0025
Expires November 30 2013

2. FEDERAL IDENTIFICATION NUMBER

4. BUDGET (Check one)

New

Budget Period (Month, Day, Year)

Revised

Beginning Date:

a. Total Cost

COST CLASSIFICATION

5. Grant Program, Functions, Activity

Ending Date:

c. Total Allowable Cost
(Column a-b)

b. Cost Not Allowable

6. Administrative expense

$

$

$

7. Preliminary expense

$

$

$

8. Land, structures, right-of-way

$

$

$

9. Architectural engineering basic fees

$

$

$

10. Other architectural engineering fees

$

$

$

11. Project inspection fees

$

$

$

12. Land development

$

$

$

13. Relocation expense

$

$

$

14. Relocation payments to individuals and businesses

$

$

$

15. Demolition and removal

$

$

$

16. Construction and project improvement

$

$

$

17. Equipment

$

$

$

18. Miscellaneous

$

$

$

19. SUBTOTAL (Sum of lines 6-18)

$

$

$

20. Contingencies

$

$

$

21. SUBTOTAL (Line 19 minus line 20)

$

$

$

22. Project (program ) income

$

$

$

23. TOTAL PROJECT (Subtract #22 from #21)

$

$

$

24. Federal assistance requested, calculations as follows: Multiply allowable costs from line 23c, by the (Federal Participation Percentage Approved by FEMA).
Enter resulting Federal share in block 25.
Enter eligible costs from line 23c x
%

25. Federal share

26. SIGNATURE

DATE

FEMA Form 112-0-2 (11/2010)

PREVIOUS EDITION OBSOLETE

$

PAPERWORK BURDEN DISCLOSURE NOTICE

PAPERWORK BURDEN DISCLOSURE NOTICE
PAPERWORK BURDEN DISCLOSURE NOTICE
Public reporting burden for this form is estimated to average 17.2 hours per response. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and
maintaining the data needed, and completing, and submitting the form. This collection of information is required to obtain or retain benefits. You are not required to submit to this collection of information unless
it displays a valid OMB control number. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to: Information Collections Management, Department of
Homeland Security, Federal Emergency Management Agency, 500 C Street SW, Washington, DC 20472-3100, and Paperwork Reduction Project (1660-0025). NOTE: Do not send your completed form to
this address.


File Typeapplication/pdf
File TitleBudget Information - Construction Programs
SubjectThe Budget Information-Construction Program is for a proposed application budget for an EOC. It will be submitted with an appli
Authorssmith1
File Modified2014-05-29
File Created2014-05-29

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