Recovery Report - Blank.doc

ARRA-Performance Progress Report

SF-PPR-Recovery (cover page)

Page of

Pages

1.Federal Agency and Organization Element to Which Report is Submitted

USDA FS, Mark Twain National Forest

2. Federal Grant or Other Identifying Number Assigned by Federal Agency

AG-4419-

3a. DUNS Number

3.c. CFDA

3b. EIN

4. Recipient Organization (Name and complete address including zip code)

Wood Product Signs 4890 County Road 76

Parlin, CO 81239-9601

5. Recipient Identifying Number or Account Number

(optional)

Yes

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No

Start Date: (Month, Day, Year)

End Date: (Month, Day, Year)

(Month, Day, Year)

9. Report Frequency

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annual FORMCHECKBOX semi-annual

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quarterly FORMCHECKBOX other

(If other, describe: __________ __________________________)

10. Performance Narrative

(Describe the Project or Activities for which recovery of funds were expended or obligated.)

LEAVE BLANK – DO NOT COMPLETE

11. Other Attachments (attach other documents as needed or as instructed by the awarding Federal Agency)

12. Certification: I certify to the best of my knowledge and belief that this report is correct and complete for performance of activities for the purposes set forth in the award documents.

12a. Typed or Printed Name and Title of Authorized Certifying Official

12c. Telephone (area code, number and extension)

12d. Email Address

12b. Signature of Authorized Certifying Official

12e. Date Report Submitted (Month, Day, Year)

13. Agency use only

OMB Approval No. TBD SF-PPR-Recovery-B

“Program Indicators”

1.Federal Agency and Organization Element to Which Report is Submitted

USDA FS – Mark Twain National Forest

2. Federal Grant or Other Identifying Number Assigned by Federal Agency

3a. DUNS

4. Reporting Period End Date

(Month, Day, Year)

3b. EIN

Section 1 Award Recipient Information:

Please provide requested information.

(1)

Label (2)

Question (3)

Response (4)

1.Federal Agency and Organization Element to Which Report is Submitted

USDA FS – Mark Twain National Forest

2. Federal Grant or Other Identifying Number Assigned by Federal Agency

3a. DUNS

4. Reporting Period End Date

(Month, Day, Year)

3b. EIN

Section 2 Project / Activity Information Please provide requested information for each project of activity for which recovery funds were expended or obligated.

(1)

Label (2)

Requested Information (3)

(4)

(Please choose one.)

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Not started

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Less than 50% completed

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Completed 50% or more

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Fully Completed

Completed

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In progress: NEPA is not triggered

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In progress: Categorical Exclusion

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In progress: Environmental Assessment

In progress: Environmental Impact Statement

Note: This page can be duplicated for one or more projects or activities.

1.Federal Agency and Organization Element to Which Report is Submitted

2. Federal Grant or Other Identifying Number Assigned by Federal Agency

3b. EIN Leave blank

4. Reporting Period End Date

(Month, Day, Year)

Section 3 Subawardee or Subcontract Award Information Please provide requested information for each sub-awardee or sub-contract for which $25,000 or more of recovery funds were obligated or expended.

(1)

Label (2)

Requested Information (3)

(4)

City:____________________________

County:_________________________

State Postal Code:______

Zip Code:_______-_______ Congressional District:_______

(Select primary category. from the list of categories provided in the instructions.)

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(Select one or more that apply from the list of categories provided in the instructions.)

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A

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B

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C

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D

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E

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F

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G

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H

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I

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J

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K

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L

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M

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N

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O

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P

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Q

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R

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S

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T

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U

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V

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W

X

City:____________________________

County:_________________________

State Postal Code:______

Zip Code:____________

Congressional District:_____

(See instructions to determine if this information is required) Name

Total Compensation 1.

3.

4.

5.

Note: This page can be duplicated for one or more Subawardees or Subcontracts,

1.Federal Agency and Organization Element to Which Report is Submitted

2. Federal Grant or Other Identifying Number Assigned by Federal Agency

3b. EIN Leave blank

4. Reporting Period End Date

(Month, Day, Year)

Section 4 SubAwardee or SubContract Award Information--Aggregate Report Please provide requested aggregated information for subawards or subcontracts for which less than $25,000 in recovery funds were obligated or expended.

(1)

Label (2)

Requested Information (3)

(4)

Paperwork Burden Statement

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. The valid OMB control number for this information collection is TBD. The time required to complete this information collection is estimated to average three (3) hours per response, including the time to review the instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have suggestions about the accuracy of the estimate, we would be happy to hear from you. You can email us at.

TBD.