2023-09-22 Closeout Certification-CovidNEBRASKA Nebraska Emergency Management Agency
EMEROFNCY "ANAGEMEW a6ENCY Subrecipient Closeout Certification Form
Date:
09/22/2023
Subrecipient:
Blair, City Of
Contact Person:
Brenda Wheeler
Phone:
(402) 426-6694
Email:
cityofblair@blairnebraska.org
Grant:
FEMA Public Assistance, DR 4521 - Nebraska COVID-19
Catalog of Federal Domestic
Assistance (CFDA) Number:
97.036
FIPS ID Number:
177-05350-00
I HEREBY CERTIFY THAT FOR THE PROJECT WORKSHEET(S) INDICATED ABOVE THAT:
1. All work and costs claimed are eligible in accordance with the grant conditions.
2. All work claimed has been completed.
3. All expenses for work claimed and deemed eligible have been paid in full.
4. We make no further claim for damages the referenced Grant.
Signed By: Date: 9122-123
C,J
Subrecipient Authorized Representative
Printed Name: Title:
� �6; WIyr-/if C CI �,
Subrecipient Closeout
Certification Form Rev: July 2023