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Contract No. <br /> <br />Funded Portion Completion Report <br /> <br />1. Name of Grantee <br /> <br />2. Name of Local Contact Person <br /> Address <br /> <br />Telephone Number <br /> <br />3. List on the reverse side the activities and estimated costs of each <br /> which were listed in Appendix B and which were funded by Local <br /> Planning Assistance Grant Funds. Also list the actual cost of each <br /> activity and the date completed, if the total actual remaining cost <br /> is less than the grant award, then additional tasks must be listed <br /> and documented to bring the total actual remaining cost to an amount <br /> equal to or greater than the grant award. <br /> <br />4. For each Major Task or Activity, prepare and attach a brief <br /> description of the work which was completed. Also attach one copy <br /> of any work product(s) if at all possible. If no copies of the work <br /> exist at this time, indicate where the originals of the work <br /> product(s) are located and the person the Council may contact in <br /> order to examine the work. <br /> <br />5. Certification and Request for Final Payment <br /> <br />I hereby certify on behalf of the Grantee that the above information <br />is accurate and in compliance with the terms of the Contract <br />Number dated between the <br />Metropolitan Council and the Grantee, and that not' more than 100% <br />of the above Actual Cost was funded by Local Planning Assistance <br />Grants plus grant funds from other sources. <br /> <br />I hereby request on behalf of the G~antee the final payment of <br />Local Planning Assistance Grant Funds in the amount of $ <br /> <br />(signature) <br /> <br />Title: <br /> <br /> Date: <br /> <br /> <br />