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Num <br /> Li <br /> 2019 CDBG-CV Subrecipient Agreement EVERETT <br /> Exhibit E WASHINGTON <br /> City of Everett <br /> Community Development Block Grant — COVID-19 <br /> 2019 Program Year Reporting <br /> Instructions: Complete all sections of this report quarterly, at minimum.All sections are required, unless <br /> otherwise marked. Incomplete reports will be returned to the subrecipient and may delay <br /> reimbursement. For questions, please email Kembra Landry at klandry@everettwa.gov. <br /> Agency: <br /> DUNS# EIN\TIN# <br /> Program: <br /> Date of Report: Time Period Covered: <br /> Person Completing Report: Title: <br /> Phone Number: <br /> Authorization: I certify that to the best of my knowledge and belief this report is correct and complete <br /> and accurately reflects the current status of this approved CDBG project. <br /> Name : Title: <br /> Program Information Summary Report <br /> Financial Reporting <br /> Total Amount of CDBG Funds awarded for this fiscal year <br /> Total Amount of CDBG Funds expended this period <br /> Total Amount of CDBG Funds expended in previous reporting period(s) <br /> Remaining CDBG Funds <br /> Other Funds: (other funds leveraged by this in CDBG funded project) <br /> Other Federal Funds Leveraged this period Year to Date <br /> State Funds Leveraged this period Year to Date <br /> Local Funds Leveraged this period Year to Date <br /> Private Funds Leveraged this period Year to Date <br /> Total Amount of Other Funds this period Year to Date <br /> 1 <br />