Attachment 11.pdf

This is a Subgrantee Payment Request Form submitted to the South Carolina Department of Alcohol & Other Drug Abuse Services dated July 9, 2020, for grant funding during the June 2020 payment period in fiscal year 2020. The form documents expenditures and payment requests across multiple budget categories for the specified grant period.

The payment request totals $5,096.08 against a FY20 budget of $48,829. Requested reimbursement is itemized as follows: Salary ($4,278.45 of $37,080 budgeted), Fringe ($354.35 of $4,002 budgeted), Supplies ($0 of $75 budgeted), Travel & Training ($0 of $2,160 budgeted), Printed Materials ($0 of $923 budgeted), and Miscellaneous expenses including dues, shipping, postage, and indirect costs ($463.28 of $4,589 budgeted). The certifying official attests that all reported expenditures and payments requested are for appropriate purposes and comply with agreed-upon prices in the grant document. The form requires completion by the program director or authorized representative and indicates that incomplete or inaccurate submissions will be returned for correction rather than processed.