Form FEMA Form 112-0-2 FEMA Form 112-0-2 Budget Information - Construction Programs

See reverse for instructions
and Paperwork Burden
Disclosure Notice

U. S. DEPARTMENT OF HOMELAND SECURITY
FEDERAL EMERGENCY MANAGEMENT AGENCY

BUDGET INFORMATION-CONSTRUCTION PROGRAMS
1. NAME OF APPLICANT

3. CFDA NUMBER

O.M.B. No. 1660-0025
Expires November 30 2013

2. FEDERAL IDENTIFICATION NUMBER

4. BUDGET (Check one)

New

Budget Period (Month, Day, Year)

Revised

Beginning Date:

a. Total Cost

COST CLASSIFICATION

5. Grant Program, Functions, Activity

Ending Date:

c. Total Allowable Cost
(Column a-b)

b. Cost Not Allowable

6. Administrative expense

$

$

$

7. Preliminary expense

$

$

$

8. Land, structures, right-of-way

$

$

$

9. Architectural engineering basic fees

$

$

$

10. Other architectural engineering fees

$

$

$

11. Project inspection fees

$

$

$

12. Land development

$

$

$

13. Relocation expense

$

$

$

14. Relocation payments to individuals and businesses

$

$

$

15. Demolition and removal

$

$

$

16. Construction and project improvement

$

$

$

17. Equipment

$

$

$

18. Miscellaneous

$

$

$

19. SUBTOTAL (Sum of lines 6-18)

$

$

$

20. Contingencies

$

$

$

21. SUBTOTAL (Line 19 minus line 20)

$

$

$

22. Project (program ) income

$

$

$

23. TOTAL PROJECT (Subtract #22 from #21)

$

$

$

24. Federal assistance requested, calculations as follows: Multiply allowable costs from line 23c, by the (Federal Participation Percentage Approved by FEMA).
Enter resulting Federal share in block 25.
Enter eligible costs from line 23c x
%

25. Federal share

26. SIGNATURE

DATE

FEMA Form 112-0-2 (11/2010)

PREVIOUS EDITION OBSOLETE

$

PAPERWORK BURDEN DISCLOSURE NOTICE

PAPERWORK BURDEN DISCLOSURE NOTICE
PAPERWORK BURDEN DISCLOSURE NOTICE
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it displays a valid OMB control number. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to: Information Collections Management, Department of
Homeland Security, Federal Emergency Management Agency, 500 C Street SW, Washington, DC 20472-3100, and Paperwork Reduction Project (1660-0025). NOTE: Do not send your completed form to
this address.