Form FEMA Form 080-0-0- FEMA Form 080-0-0- Final Performance Report

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Overview

Narrative
Request Details
Return Funds
Review and Submit

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Sheet 1: Narrative

AFG Closeout Report - Narrative section
Question	Instructional Text	Original question	Form	Section / page	Notes
Narrative overview In this section, if applicable, update your NFIRS reporting information. Then, write a performance report to explain what your organization achieved with this grant money, and the impact it had on your community.
NFIRS Reporting Questions Your organization may be required to provide information to the National Fire Incident Reporting System (NFIRS) during the period of your grant. We pre-populated your responses in this section based on the information you provided in your grant application. Review each question and edit any information that is incorrect.
Did you start reporting to NFIRS before your first AFG award?
Do you currently report to NFIRS?		080-0-2 Do you currently report to the National Fire Incident Reporting System (NFIRS)?	AFG Application - 1660-0054	080-0-2 Fire department characteristics Part I (pg. 6)
When did you begin reporting to NFIRS?
What is your FDID / FDIN number?	Your FDID number is 5 digits	080-0-2 If you answered "Yes" above, please enter your FDID/FDIN.	AFG Application - 1660-0054	080-0-2 Fire department characteristics Part I (pg. 6)
Performance Report Narrative In your narrative please explain: • The qualitative accomplishments your department achieved with this grant funding • The impact of any special initiatives accomplished with this grant • What exists now in the communities you serve that did not exist prior to this grant
Narrative	For example, if your grant was in the personal protective equipment category, in addition to indicating the number of pieces of equipment purchased (e.g. SCBAs), you should describe the results of the purchase, referencing your department's response capacity, the safety of firefighters, or other improvements.		Closeout Module

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Sheet 2: Request Details

AFG Closeout Report - Request details
Question	Instructional text	Original question	Form	Section / page	Notes
Request details overview In your grant application and amendments, you requested the following activities: [Activity list] Navigate to each activity to report the purchases you made under them.
Grant writer awarded amount [pre-populated]	Pre-populated from your grant application	Enter grant-writing fee associated with the preparation of the request. Enter "0" if there is no fee.	AFG Application - 1660-0054	080-0-2 Request information (page 11)
Total cost for all requests [auto-calculated]	Auto-calculated based on the information you report in this section
Do you want to add another activity to your grant? [user enters] yes/no		Select a program for which you are applying. If you are interested in applying under both vehicle acquisition and operations and safety, and/or regional application, you will need to submit separate applications	AFG Application - 1660-0054	080-0-2 Request information (page 11)
(If yes is selected) Select the activities you would like to add. [user enters] checkboxes for each activity that recipient doesn't have	Select all that apply
Request details - Equipment Use the table below to describe the equipment items purchased under the grant. If you requested an item but did not purchase it, enter "0" as the quantity and the item will not be counted towards your total cost.					Questions are the same for each type of request (Training, Personal Protective Equipment, Wellness and Fitness, and Modify Facilities)
Item [pre-populated]		What equipment will your organization purchase with this grant?	AFG Application - 1660-0054	080-0-2b Add operations and fire safety - equipment (page 2)
Description [user enters]		Please provide a detailed description of the item selected above	AFG Application - 1660-0054	080-0-2b Add operations and fire safety - equipment (page 2)
Budget class [user enters]	[If other is selected - modal comment box appears] Add a comment When you select a budget object class of other, you must explain why. text field label - Budget object class explanation Will add blue info box with BoC descriptions	Select object class	AFG Application - 1660-0054	080-0-2b Add Budget item (page 9)
Quantity awarded [pre-populated]		Number of units	AFG Application - 1660-0054	080-0-2b Add operations and fire safety - equipment (page 2)
Price per item [pre-populated]		Cost per unit	AFG Application - 1660-0054	080-0-2b Add operations and fire safety - equipment (page 2)
Quantity purchased [user enters]			Closeout module
Price per item [user enters]			Closeout module
Total [auto-calculated]			Closeout module
Additional funding Use this space to add purchases that are necessary for this project to succeed, even though they may not fall under this activity. For example, let’s say you requested treadmills within the equipment category, and needed training before you could use them. You would add the instructor you hired to conduct the training to your additional funding section
Budget class [user enters]					where do the additional funding questions come from?
Description [user enters]
Total cost [user enters]
Total [auto-calculated]
Total cost for activity and additional funding [auto-calculated]
[Table, same as equipment]
[Table, same as equipment]
[List, same as equipment]
Did you use this grant to make additional purchases for any other trainings?

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Sheet 3: Return Funds

AFG Closeout Report - Return funds

AFG Closeout Report - Return funds

Form

Section / page

Original question

Question

Instructional Text

Original question

Form

Section / page

Notes

Return Funds Based on the information your organization has provided in the request details section of this closeout report, you owe FEMA money.

Total to return to FEMA If you owe more than $100, you must repay FEMA via check. Enter your check details below, and follow the instructions for mailing the check. If you owe less than $100, you do not need to reimburse FEMA.

Closeout module

Unused funds [auto-calculated]

Your unused funds will be added to your SF-425 as "total cash on hand"

Closeout module

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FEMA share of unused supplies [auto-calculated]

This is the share of unused supplies determined by your equipment and supplies inventory

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Total to return to FEMA [auto-calculated]

This is the amount you must pay FEMA. If this amount is negative, or under $100, you do not need to return funds to FEMA.

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Check number [user enters]

The check number is located on the upper right corner of your check.

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Check amount [user enters]

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Check date [user enters]

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Comments [user enters]

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Interest earned If you have had these unused funds for over 30 days, you may owe interest. Please contact the FEMA grants call center at (866) 927-5646 or [email protected] to determine whether or not you owe interest. If you did not hold federal funds for over 30 days, you do not need to complete this section.

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Check number [user enters]

The check number is located on the upper right corner of your check.

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Check amount [user enters]

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Check date [user enters]

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Comments [user enters]

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Send your check to FEMA Print your check details and mail both the check and the check details to FEMA's address below.

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Sheet 4: Review and Submit

AFG Closeout Report - Review and Submit
Question	Instructional Text	Original question	Form	Section / page	Notes
Organization and Contact Information Please review the information below and correct any inaccuracies.
Recipient [pre-populated]		Organization name	AFG Application - 1660-0054	080-0-2 Applicant Information (page 3)
Grant number [pre-populated]			Closeout module
Program [pre-populated]
Address [pre-populated]		What is the legal business address of your Entity as it appears in SAM.gov? Mailing Address 1 Mailing Address 2 City State Zip	AFG Application - 1660-0054	080-0-2 Applicant Information (page 3)
Who is your primary point of contact? [user enters] First name Middle name Last name		First Name Middle Initial Last Name	AFG Application - 1660-0054	080-0-2 Alternate contact information (page 2)
How can we contact this person? [user enters] Phone type Phone number Extension Email		Primary Phone Secondary Phone Optional Phone Fax Email	AFG Application - 1660-0054	080-0-2 Alternate contact information (page 2)
Federal Financial Report (SF-425) The information below is auto-calculated and prepopulated based on your responses in the request details section of this closeout report. If any information is inaccurate, please correct it in the request details section, and your updates will be reflected below.
[See next sheet]
Submit your Closeout Report Once all of the information in your closeout report is complete, submit it to FEMA. FEMA program specialists will review the information to certify it is accurate. Then, a FEMA financial specialist will ensure your organization’s grant funds are reconciled.
Closeout report certification By signing this closeout report, I certify the following— I have the authority to submit this closeout report on behalf of my organization. I have read and understand the questions, instructions, and my answers. To the best of my knowledge and belief the closeout report, including the SF-425 form, is true, complete, and accurate, and the expenditures, disbursements and cash receipts are for the purposes and intent set forth in the award documents. I am aware that any false, fictitious, or fraudulent information may subject me to criminal, civil, or administrative penalties. (U.S. Code, Title 18, Section 1001). I understand that inputting my password below signifies that I am the identified signatory on behalf of the organization. Further, I understand that this electronic signature shall bind the organization as if the closeout report and SF-425 were physically signed and filed.			AFG application - 1660-0054	080-0-2 Applicant's Acknowledgements (page 1)	GPD lawyers came up with this certification - we are combing certifications from the SF-425, SF-428 and AFG application
Password [user enters]		Password [user enters]	AFG application - 1660-0054	080-0-2 Applicant's Acknowledgements (page 1)