R-2 Claim Checklist (1) (1).xlsx

	A	B	C	D	E	F	G
1	Florida Division of Emergency Management
2	R-2 Claim Checklist
3	Use this form to develop your Resoure Provider's claim package. If you have answered "Yes" or "N/A" to all questions, the claim is ready for submission to the Requesting Party.
4	Item #	Question	Note	Yes	No	N/A	Comment
5	Mission and Supporting Documents
6	A.1	Does the R-2 include all elgible expenses?	This checklist is designed to identify as many expenses eligible for reimbursement as possible. Please read each question thoroughly to ensure your provider is made financially whole.
7	A.2	Is the R-2 signed by an authorized representative of my provider?
8	A.3	Is a copy of the Resource Support Agreement (RSA) included with the claim package?	If you do not have a copy of the RSA, please reach out to the State EMAC Coordinator.
9	A.4	Is a copy of my provider's IRS Form W-9 included with the claim package?	Please refer to box G.1 for the proper order of claim documentation.
10	Personnel
11	B.1	Is personnel and/or backfill labor being claimed? If not, all items in this section are N/A.	Regular time and overtime hours worked outside of the home jurisdiction are eligible for reimbursement.
12	B.2	Are all applicable payroll policies and/or Collective Bargaining Agreements included with the claim package?	Please include the effective dates of each policy/agreement. The policy must have been in effect during the claimed period.
13	B.3	Does all claimed labor adhere to the provided payroll policies and/or Collective Bargaining Agreements (CBA)?	Agreements often pertain to position classification (Sergeant, Lieutenant, etc.) and must be individually reviewed to ensure eligibility for reimbursement.
14	B.4	Are timesheets included for all claimed personnel hours (including backfill)?	Permanent employees with reassigned duties on a normally scheduled working day are not eligible for backfill unless they were backfilled themselves.
15	B.5	Are all daily activity logs (ICS-214 or equivalent) for all claimed personnel included in the claim package?	Daily activity logs for claimed personnel must support the labor hours claimed, align to the mission start/end dates, and reflect the purpose of the mission.
16	B.6	Are detailed payroll records (pay stubs, payroll register or equivalent) for all claimed personnel for the entire pay period included with the claim package?
17	B.7	Do the payroll records support all labor being claimed?	Regular time, overtime hours, and associated amounts paid for each should be clearly delineated in the records. All claimed rounded amounts must be supported by proof of payment to the employee.
18	B.8	Are all completed fringe benefit calculation sheets for each class of employee included in the claim package?	Multiple calculation sheets are required if benefits vary between positions.
19	B.9	Does the backfill labor being claimed show a direct correlation between the backfill position and the responding personnel?	Supporting documentation should include a roster and clearly demonstrate who the backfill employee was covering.
20	B.10	Is all backfill labor supported by payroll records and are the costs eligible under the respective pay policy/CBA? Station/shift rosters or other documentation showing the backfill employee's assignment must be provided.	This is a reimbursable expense only if the backfill employee is contracted, temporary staff, or a permanent employee working on a scheduled day off.
21	Equipment
22	C.1	Is equipment being claimed? If not, all items in this section are N/A.	All equipment performing work in direct support of the Mission is eligible for reimbursement.
23	C.2	Are all claimed Equipment Cost Codes and associated mileage/hourly rates correct and in adherence to the FEMA Equipment Rates in effect at the time of use?	FEMA equipment rates changed in 2017, 2019, and 2021. Be sure the effective dates of the equipment rates being claimed align with the equipment dates of use. Any equipment claimed without a rate (e.g. drones) should be supported by a reasonable rate calculation.
24	C.3	For equipment requiring an operator, has the operator's name been identified and included with the claimed personnel?
25	C.4	Are all equipment hourly rates and mileage rates being claimed separately? Reimbursement cannot be provided for both mileage and hourly rates during the same period of use.	If the primary purpose of a vehicle is transportation to and from the incident site, mileage must be claimed with the start/end odometer readings documented. Hourly rates should only be used for working/running time (e.g., police car running with lights on) at the incident location.
26	C.5	Is proof of operation (ICS 218 or equivalent) for all claimed equipment hours included in the claim package?	Equipment must have been in use performing work in support of the mission during the time claimed.
27	Materials and Other
28	D.1	Are materials, supplies, supporting contracts, or other expenses being claimed? If not, all items in this section are N/A.
29	D.2	Are all claimed receipts/invoices included with the claim package and do the purchase dates align with the Mission's start/end dates?	If an employee was reimbursed for a cash purchase, copies of the receipt, as well as proof of reimbursement to the employee must be provided.
30	D.3	Has sufficient proof of payment (check register, credit card statement, etc.) for all receipts/invoices been provided?
31	D.4	Were any fuel expenses claimed? If so, are they an eligible expense (i.e., associated with rental equipment or equipment use not already covered by hourly/mileage rates)?	FEMA equipment rates are calculated to include fuel, oil, depreciation, overhead, and maintenance. Therefore, fuel cannot be claimed if the equipment is being reimbursed using hourly rates or mileage. Fuel receipts should be notated with the vehicle in which it was used (i.e., rental agreement number or other indicator). ** Federally funded equipment shall be reimbursed for the actual cost of fuel and repairs only, not hourly rates.
32	D.5	Were any equipment repair expenses (tires, brakes, etc.) claimed? If so, is it properly documented through a memorandum or other explanation?	The explanation should detail how the repair was attributed to the Mission's emergency response; routine wear and tear is not eligible. Federally funded equipment must be reimbursed for the actual cost of fuel and repairs only, not hourly rates.
33	D.6	Is justification provided for all claimed miscellaneous expenses?	All claimed expenses in this category must align with the purpose of the mission.
34	D.7	If contract costs are claimed, is a copy of the applicable procurement policy, contract, vendor invoice package, and proof of payment to the contractor provided?
35	Travel
36	E.1	Are travel expenses being claimed? If not, all items in this section are N/A.
37	E.2	Are all applicable travel policies included in the claim package?
38	E.3	Do all claimed travel costs align with the Mission's start and end dates?
39	E.4	Have all invoices/receipts associated with claimed travel costs been provided? If so, do the purchase dates align with the mission start/end dates?	If an employee was reimbursed for a cash purchase, copies of receipts, as well as proof of reimbursement to the employee must be provided.
40	E.5	If meals or grocery items were claimed, has an explanation been provided that explains why the items were necessary and not covered under meal allowances?	Tips may be reimbursed if supported by the your provider's travel policy.
41	E.6	Is sufficient proof of payment (check register, credit card statement, etc.) for all receipts/invoices included in the claim package?
42	E.7	Are all travel costs compliant with the applicable travel policy?	This includes rules related to per diem, daily meal allowances, etc.
43	E.8	Are all claimed travel expenses paid to employees supported by proof of payment to each employee?
44	E.9	If hotel expenses are being claimed, do the hotel invoices identify the individual room occupants and individual room numbers?	Claimed hotel expenses must adhere to the applicable travel policy.
45	Rental
46	F.1	Is rental equipment being claimed? If not, all items in this section are N/A.
47	F.2	Are complete rental agreements included in the claim package?
48	F.3	Do all rental agreements identify the item(s), period of use, cost, and align with the mission start/end dates?
49	F.3	Is a memorandum or other explanation provided to justify renting the item(s)?
50	F.4	If vehicles were rented from a common carrier (Avis, Budget, etc.), are fuel costs included in the claim package?
51	Final Review
52	G.1	Has the claim package been arranged as a single PDF for final submission? ‎The order of claim documentation should follow the order of this checklist, as applicable. Please see the notes column.‎ Please provide an Excel copy of the R-2 alongside the final PDF package.	A.1: EMAC R-2 A.3: Resource Support Agreement (RSA) A.4: W9 B.2: Payroll Policy/CBA B.4: Time Sheets B.5: Daily Activity Logs B.6: Payroll Records B.4: Backfill Timesheets B.10: Backfill Roster B.10: Backfill Payroll Records C.5: Equipment Proof of Operation D.2: Purchase Receipts/Invoices D.3: Credit Card Statements D.3: Check Registers D.5: Fuel Receipts D.6: Maintenance Receipts D.7: Contract Support Documents E.2: Travel Policy E.4: Travel Invoices E.5: Travel Receipts E.5: Travel Purchase Justification E.6: Travel Expenses Proof of Payment E.8: Travel Reimbursement to Employee F.2: Rental Agreements F.2: Rental Invoices‎‎ F.3: Rental Justification F.4: Rental Fuel Receipts
53	If you have answered "Yes" or "N/A" to all questions, the claim is ready for submission to the Requesting Party.
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