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Broomfield Health and Human Services Private Non-Profit Grant Report Form 2019 (Semiannual)
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* Indicates required question
Email
*
Your email
Agency
*
Your answer
Representative completing form
*
Name, Title, Phone Number
Your answer
Type of Report
*
Mid-Year Report (1/1/19-6/30/19) DUE 7/31/19
Year-End Report (7/1/19-12/31/19) DUE 1/31/20
Amount of Broomfield funds expended
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Year-To-Date
Your answer
Unduplicated number of Broomfield residents served using City and County grant funds
*
If Mid-Year Report, from 1/1/19-6/30/19; if Year-End Report, from 1/1/19-12/31/19.
Your answer
Unduplicated number of Broomfield residents served in total using all funds
*
If Mid-Year Report, from 1/1/19-6/30/19; if Year-End Report, from 1/1/19-12/31/19.
Your answer
Nature and/or type of services provided and outcomes
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Please refer to your agency's grant application ROMA model. If outreach was part of your agency’s proposal, provide information regarding where and to whom you outreached.
Your answer
Other client demographics collected that accurately reflect the services provided under these funds
*
Your answer
Have there been any changes to your organization’s federal tax exempt status since you were awarded this grant?
*
Yes
No
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