BUSHFIRE MITIGATION GRANTS PROGRAMME 2016-17

PROJECT COMPLETION REPORT

PROJECT TITLE:______

AGENCY:______

DATE OF REPORT:______

  1. Expected key outcomes of project

Section 6 of your original Application (which was also incorporated into the Scheduleto the Agreement) states what you planned to achieve. You can use this section and amend the application as necessary due to project variations and other factors not mentioned in the Application, Schedule or the Inception Report.

  1. Description of methodology

Brief description of major elements on the project including linkages between them.

  1. Evaluation of project and its outcomes and outputs (in accordance with methodology proposed)

Compare final outcomes and outputs of project with that given in the Schedule to the Agreement. If there are differences, explain why more or less work was undertaken.

  1. Community consultation and/or project advertising undertaken

List activities undertaken, eg. information on notice boards or in Council offices, ads or articles in newspapers or on web-site, public meetings, surveys, presentations. If relevant or of interest, describe public response (or lack of). You may wish to provide photos or examples of any evidence of compliance as set in the Schedule to the Agreement.

  1. Future actions to be taken based on project outputs

Describe major alternative structural and non-structural options considered during project, including any conditions that must be met before they can be implemented.

PROJECT OFFICER:______

SIGNATURE: ______

BUSHFIRE MITIGATION GRANTS PROGRAMME 2016-17

CERTIFIED STATEMENT OF REVENUE EXPENDITURE AT COMPLETION OF PROJECT

PROJECT TITLE:______

AGENCY:______

Total Revenue (Commonwealth/State & third party) for the project

Date / Source / Invoice Ref. / Amount
$(excl. GST)
Commonwealth
State
Other (not your agency)

Total

Total Expenditure for the project

Item / Commonwealth $ / State
$ / Agency
$ / Other
$ / Amount
$(excl. GST)

Total

Total unspent fundsplus any accrued interest / $

I …………………………(name) certify that the above details are correct and that the funds received have been expended solely for the purposes of the Project.

Signed for and on behalf of:

Name:______

Agency:______

Signature:______

Position (Qualified Auditor):______

Dated:………/………./……….

BUSHFIRE MITIGATION GRANTS PROGRAMME 2016-17

STATEMENT OF COMPLIANCE

To be completed by the Chief Executive Officer or his or her authorised representative.

I hereby certify that Australian Government funds under the Bushfire MitigationGrants Program, as per clause 4.4 of the Agreement between the <insert name of your organisation> and the State of Victoria:

  1. have been expended solely for the purposes of the scheme; and
  2. the terms and conditions included in the Agreement have been complied with, or, where the terms and conditions have not been complied with, the reasons for non-compliance are attached.

Name:______

Position:______

Signature:______

Dated:………/………./……….

COMPLETION REPORT-BUSHFIRE MITIGATION GRANTS PROGRAMME (CD/16/60444)Page 1 of 5