Form FEMA Form 089-0-11 FEMA Form 089-0-11 Urban Search and Rescue Response System Semi-Annual Perf

Department of Homeland Security
Federal Emergency Management Agency

URBAN SEARCH AND RESCUE RESPONSE SYSTEM
SEMI-ANNUAL PERFORMANCE REPORT

OMB 1660-007
Expires July 31, 2012

Paperwork Burden Disclosure Notice
Public reporting burdern for this form is estimated to be 2 hours per response. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering
and maintaining the data needed, and completing and submitting the form. You are not required to respond to this collection of information unless is displays a valid OMB Number. Send
comments regarding the accuracy of this burden estimate and any suggestions for reducing the burden to: Collections and Research Branch, Department of Homeland Security, Federal
Emergency Management Agency, 1800 South Bell Street, Arlington, VA 20590-3305, Paperwork Reduction Project (1660-0073). Note: Do not send your completed form to this
address.

INSTRUCTIONS
This report is due on the date outlined in the current US&R Grant Guidance/Statement of Work
Fill in all highlighted sections in all pages of the workbook
File a copy of this report within all open Task Force cooperative agreements files
Type in the name and title of person submitting report. After printing document, sign and date to submit
Submit completed report in accordance with current procedure
Performance Report - Narrative Section
This report is used to provide information to the US&R Branch, FEMA Leadership and the
Grant Programs Directorate on Task Force activities within the 4 budget categories
Report activities from the last 6 months of all open cooperative agreements
Performance Report - Funds Supplement
Fill in the highlighted boxes with your task force information
This document is used to report all open US&R cooperative agreements during this time period
The "Grant Fiscal Year" represents the year the funds were allocated
The "Grant ID Number" represents the grant award number
The "Beginning Balance" is the amount of funds available at the beginning of this reporting time period
The "Funds Spent" represent the actual amount of funds fully paid during this reporting time period
The 'Remaining Balance" will be calculated automatically
The actual "Period of Performance" dates are required to be filled in for each open grant
For each cooperative agreement worksheet, provide any minor changes made in space allotted, by category

FEMA FORM 089-0-11

Page 1 of 9

Semi-Annual Performance Report - Narrative

Task Force:
Reporting Date:
A.

TF-

For Time Period:

to

Management

1. Describe the adequacy of staffing for the Task Force Program Management Team (Full Time/
Significant Part Time members) including actual or anticipated vacancies and expected fill dates.

2. Provide status of all open Cooperative Agreements as to whether there are any anticipated
budget changes, extensions or delays in closeout package submission.

3. Identify Local and National meetings attended and National work groups supported.

4. Provide at least 3 overall Task Force management goals or objectives for the next 6 months.

5. Discuss any anticipated problems/issues you foresee within the next 6 months that may impact the
management objectives defined in the Task Force's budget plan(s).

FEMA FORM 089-11

Page 2 of 9

Training and Exercises

B.

1. Summarize local general and/or specialized training conducted and National (sponsored)
courses attended during the previous 6-month period. Identify number of participants attending
training and associated costs.

Cost

Number of TF
attendees

Course Title

2. Indicate number of Task Force Members:
Rostered Members:
Deployable Members:
Fully Trained Members:
New Recruits:

Course Date

Prior Period

Course Location

Current

3. Provide at least 3 overall Task Force training and/or exercise goals or objectives for the next 6
months and briefly describe any performance benefits from the cooperative agreement funding.

4. Discuss any anticipated problems/issues you Task Force foresees within the next 6 months that
may impact the training and/or exercise objectives defined in the Task Force's budget plan(s):

FEMA FORM 089-11

Page 3 of 9

C.

Equipment

1. US&R Task Force Tools and Equipment cache – identify the adequacy, shortfalls, and
procurement actions in progress and/or associated problems. Identify the number of inventories
conducted. Discuss any equipment replacement issues or delays.

2. Provide any overall Task Force equipment procurement/accountability goals or objectives for
the next 6 months.

3. Discuss any anticipated problems/issues your Task Force foresees within the next 6 months that
may impact the equipment procurement/accountability objectives defined in the Task Force's
budget plan(s):

D.

Storage and Maintenance

1. Provide information on the adequacy of your warehouse facility, management of this facility
and any lease, owernship, or security issues. Discuss any issues or planned actions to improve your
facilities.

2. Provide an explanation of availability of all needed vehicles to deploy your Task Force.
Identify any Task Force shortfalls and plan to resolve these issues, including completion dates.

FEMA FORM 089-11

Page 4 of 9

E.

Overall Performance

Feel free to provide any information you feel should be relayed to either the US&R Program
Office or Grant Programs Directorate on the performance of your Task Force or any issues you
are facing in the administration your US&R cooperative agreement(s).

Submitted by:

Name Printed

Signature

Title

Date

FEMA FORM 089-11

Page 5 of 9

National Urban Search and Rescue Response System
Semi-Annual Performance Report Supplement - continuation A
Cooperative Agreement Summary
Information Page
Task Force:

xx-TFx

Reporting Period:

7/31/20XX

For Time Period

Linked to Page 1

to

1/1/20XX

Linked to Page 2

Grant Fiscal Year

FY 20xx

Linked to Page 3

Grant Fiscal Year

Federal Grant ID Number:

6/30/20XX

FY 20xx

Grant Fiscal Year

Federal Grant ID Number:

FY 20xx

Federal Grant ID Number:

Grant Award Amount:

$

-

Grant Award Amount:

$

-

Grant Award Amount:

$

-

Beginning Period Balance:

$

-

Beginning Balance:

$

-

Beginning Balance:

$

-

Funds Spent this Period:
Administration/Management
Training
Equipment Purchases
Storage and Maintenance
Total Funds Spent:

Current Expenditures
$
$
$
$
$
-

Remaining Grant Balance:

$

Funds Spent this Period:
Current Expenditures
Administration/Management $
Training
$
Equipment Purchases
$
Storage and Maintenance
$
Total Funds Spent:
$
-

Funds Spent this Period:
Administration/Management
Training
Equipment Purchases
Storage and Maintenance
Total Funds Spent:

Remaining Grant Balance:

Remaining Grant Balance:

$

-

Current Expenditures
$
$
$
$
$
$

-

-

Additional General Grant Information entered below this line
Catalog of Federal Domestic Assistance

Period of Performance

Total funds remaining

$

Name of Person Submitting Report

Old CFDA #
New CFDA #

FY 20xx

0

00/00/200x

to

00/00/200X

FY 20xx

0

00/00/200x

to

00/00/200X

FY 20xx

0

00/00/200x

to

00/00/200X

(Typed Name)
Program Manager
Title

Signature

Date

FEMA FORM 089-11
Page 6 of 9

National Urban Search and Rescue Response System
Semi-Annual Performance Report Supplement - continuation B
Task Force:

xx-TFx

Reporting Period:

Linked to Funds Report Page

Grant Fiscal Year
Federal Grant ID Number:
Local Grant ID Number
Award Amount:
Beginning Period Balance:

7/31/20XX
Original or Modified
Budgeted
Amount
FY 20xx

1/1/20XX

Remaining
Actual
Amount

Amount
(+ or -) of
BUDGET

$

6/30/20XX

$
Budgeted

$
$
$
$

-

Previous
Expenditures
$
$
$
$
$
-

Current
Expenditures

$
$
$
$
$

+ or - Budget
-

Remaining Grant Balance:
Period of Performance

to

0

Funds Expended:
Administration/Management
Training
Equipment Purchases
Storage and Maintenance
Total Funds Expended:

Previously
Expended Total
Amount

For Time Period

FY 20xx

0

$
$
$
$
$

-

$

00/00/200x

% Not Spent
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!

`
#DIV/0!
to

00/00/200X

Explanation on Spending Plan: Describe your progress to meet your spending plan goals
Administration/Management

Training

Equipment

Storage and Maintenance

Name of Person Submitting Report
(Typed Name)
Program Manager
Title
FEMA FORM 089-11

FEMA FORM 089-11

Signature

Date
Page 7 of 9

Page 7 of 9

National Urban Search and Rescue Response System
Semi-Annual Performance Report Supplement - continuation C
Task Force:

xx-TFx

Reporting Period:

Linked to Funds Report Page

Grant Fiscal Year
Federal Grant ID Number:
Local Grant ID Number:
Award Amount:
Beginning Period Balance:

7/31/20XX
Original or Modified
Budgeted
Amount
FY 20xx

1/1/20XX

Remaining
Actual
Amount

Amount
(+ or -) of
BUDGET

$

6/30/20XX

$
Budgeted

$
$
$
$

-

Previous
Expenditures
$
$
$
$
$
-

Current
Expenditures

$
$
$
$
$

+ or - Budget
-

Remaining Grant Balance:
Period of Performance

to

0

Funds Expended:
Administration/Management
Training
Equipment Purchases
Storage and Maintenance
Total Funds Expended:

Previously
Expended Total
Amount

For Time Period

FY 20xx

0

% Not Spent

$
$
$
$
$

-

#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!

$

-

#DIV/0!

00/00/200x

to

00/00/200X

Explanation on Spending Plan: Describe your progress to meet your spending plan goals
Administration/Management

(Example: We are on target to meet our spending plan goals.)

Training

Equipment

Storage and Maintenance

Name of Person Submitting Report
(Typed Name)
Program Manager
Title

FEMA FORM 089-11

Signature

Date

Page 8 of 9

National Urban Search and Rescue Response System
Semi-Annual Performance Report Supplement - continuation D
Task Force:

xx-TFx

Reporting Period:

Linked to Funds Report Page

Grant Fiscal Year
Federal Grant ID Number:
Local Grant ID Number:
Award Amount:
Beginning Period Balance:

7/31/20XX
Original or Modified
Budgeted
Amount
FY 20xx

1/1/20XX

Remaining
Actual
Amount

Amount
(+ or -) of
BUDGET

$

6/30/20XX

$
Budgeted

$
$
$
$

-

Previous
Expenditures
$
$
$
$
$
-

Current
Expenditures

$
$
$
$
$

+ or - Budget
-

Remaining Grant Balance:
Period of Performance

to

0

Funds Expended:
Administration/Management
Training
Equipment Purchases
Storage and Maintenance
Total Funds Expended:

Previously
Expended Total
Amount

For Time Period

FY 20xx

0

% Not Spent

$
$
$
$
$

-

#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!

$

-

#DIV/0!

00/00/200x

to

00/00/200X

Explanation on Spending Plan: Describe your progress to meet your spending plan goals
Administration/Management

(Example: We are on target to meet our spending plan goals.)

Training

Equipment

Storage and Maintenance

Name of Person Submitting Report
(Typed Name)
Program Manager
Title

FEMA FORM 089-11

Signature

Date

Page 9 of 9