2020 NSGP Expense Claim Form

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1	WYOMING OFFICE OF HOMELAND SECURITY
2	2020 NSGP Grant Reimbursement Expense Claim Form
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4	Jurisdiction:					Grant Award ID:
5	Prepared by:
6	Phone:
7	Email:
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9	Vendor		Description of Expense	Purpose of Expense	IJ ID (Found on GAA Attachment A)	Equipment AEL Code*		Core Capability	# of Items	NIMS Typed	Solution Area	Invoice Date	TOTAL
10	Vendor		Description of Expense	Purpose of Expense	IJ ID (Found on GAA Attachment A)	Equipment AEL Code*		Core Capability	# of Items	NIMS Typed	Solution Area	Invoice Date	TOTAL
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26													$ -
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28	I hereby certify that all expenses claimed hereon have been paid in full
29	and supporting documentation is attached.						Signature and Title of Official
30		(Required Documentation includes copies of invoices, receipts, proof of payment, timesheets with names/wages/hours (TURK), cost allocation, warrants, etc.)
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32							Date
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34	Expense Claim Form must be completed in its entirety before reimbursement can be processed.
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36	* This number can be found at http://fema.gov/authorized-equipment-list All equipment purchases must have the corresponding AEL item number.
37	(If the purchase is not equipment, please put whether expense is related to planning, organization, training or exercise in the Solution Area field)
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