r <br /> FINANCIAL STATUS REPORT <br /> i <br /> ~ (Long Form) <br /> (Follow instructions on the back) <br /> 1. Federal Agency and Organizational Element 2. Federal Grant or Other Identifying Number Assigned OMB Approval Page of <br /> i to Which Report is Submitted ey Federal Agency No. <br /> USFWS, Division of Bird Habitat Service: NAWCA Grant 98210-2-G396 0348-0039 <br /> pages <br /> 3. Recipient Organization (Name and complete address, including ZIP code) <br /> City of Eugene, 1820 Roosevelt Blvd., Eugene, OR, 97402 <br /> I <br /> 4. Employer Identfication Number 5. Recipient Account Number or Identifying Number 6. Final Report 7. Basis <br /> 93-6002160 1536-0031-8601 p Yes p No ~ Cash 0 Accrual <br /> I 8. Funding/Grant Period (See instructions) 9. Period Covered by this Report <br /> From: (Month, Day, Year) To: (Month, Day, Year) From: (Month, Day, Year) To: (Month, Day, Year) <br /> 7/12/2002 11/19/2003 7/12/2002 11/19/2003 <br /> 10. Transactions: I 1 III <br /> Previousi Re orted This Period Cumulative <br /> a. Total outlays <br /> 0.00 2,292,500.00 2,292,500.00 <br /> b. Refunds, rebates, eta 0.00 0.00 0.00 <br /> ~ c. Program income used in accordance with the deduction alternative 0.00 0.00 0.00 <br /> I <br /> d. Net outlays (line a, less the sum of lines b and c) 0.00 2,292,500.00 2,292,500.00 <br /> <br /> i <br /> <br /> ' Recipient's share of net outlays, consisting of: <br /> 0.00 <br /> e. Third party (in-kind) contributions <br /> <br /> ~ f. Other Federal awards authorized to be used to match this award <br /> 680,000.00 680,000.00 <br /> g. Program income used in accordance with the matching or cost 0.00 <br /> sharing akemative <br /> h. All other recipient outlays not shown on lines e, f org 1,043,225.00 1,043,225.00 <br /> i. Total recipient share of net outlays (Sum of lines e, f, g and h) 0.00 1,723,225.00 1,723,225.00 <br /> j. _ Federal share of netoutlays (line d less line <br /> 0.00 569,275.00 569,275.00 <br /> k. Total uniiquidated oblgations _ ~ <br /> 0.00. <br /> I. Recipient's share of unliquidated obligations <br /> m. Federal share of unliquidated obligations ~ 430,725.00 <br /> n. Total Federal share (sum of lines j and m) 1,000,000.00 <br /> o. Total Federal funds authorized for this funding period i 1,000,000.00 <br /> p. Unobligated balance of Federal funds (Line o minus line n) 0.00 <br /> i <br /> Program income, consisting of: 0.00 <br /> q. Disbursed program income shown on tines candor g above <br /> r. Disbursed program income using the addition alternative 0.00 <br /> ~ <br /> s: Undisbursed program income ! 430,725.00 <br /> - - - <br /> I - <br /> t Total program income realized (Sum oflines q, rand s) II 430,725.00 <br /> a. Type of Rate (Place '7C" in appropriate box) <br /> 11. Indirect ~ Provlslonal Q Predetermined Q Final ~ Fixed <br /> Expense b. Rate a Base d. Total Amount e. Federal Share <br /> 12._ Remadcs: Attach any explanations deemed necessary orinformation requimd by Federal sponsoring agency incompliance with <br /> governing legislation. <br /> 13. Cert~cation: 1 certify to the best of my knowledge and belief that this report is corcect arrd complete and that all outlays and _ <br /> unli uidated obli ations are for the ur oses set forth in the award documents. <br /> Typed or Printed Name and Title Telephone (Area code, number and extension) <br /> ra v ? s I,t.3 ~ ~ „Q:u S~`71 - b tf g S' <br /> Signa re of Authorized Certifyin ial Date Report Submitted <br /> fU November 19, 2003 <br /> Previous Editioh Usable 269-104 Standard Fonn 269 (Rev. 7-97) <br /> NSN 7540-01-012-4285 Prescribed by OMB Circulars A-102 and A-110 <br /> 200-498 P.0.139 (Face) <br /> <br />