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City and County of Honolulu Grants in Aid
Fiscal Year 2012 Grants
Fiscal Year 2012 Appropriation
Fiscal Year 2011 Grants
Payment Request Form
Grant Status Report Form
Instructions:
1. Please enter all applicable information. Failure to do so could delay processing.
2. Section II measure, shown in yellow, should contain measures that are specific to the grantee's project. Edit as needed.
3. Please attach documentation as evidence of your grant activities and spending.
4. Your report must include a narrative description summarizing your activities and the status of your program, relative to the grant.
5. For final reports:
a. Complete the attached (GIA final report cover sheet).
b. Attach your final payment request worksheet (link shown above)
c. In addition, the following must be updated:
(1) Non-Gratuity Affidavit AND
(2) Tax Clearance & Certificate of Compliance for Final Payment OR
(3) Certificate of Vendor Compliance
Final Report Cover Sheet
Non-Gratuity Affidavit
Certificate of Vendor Compliance
Contact
Lori Okami
(808) 768-7762
lokami@honolulu.gov
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