Grant Amount: ___
Grant Match Amount: ___
(Total from cash & in-kind services, below. Must be at least 30% of the Total Project Amount)
Total Project Amount:
___
(Cost of the entire project: Grant Amount + Grant Match Amount)
List cash and in-kind services in the boxes below (must be a minimum of 30% of the Total Project Amount). Cash Contribution:
Cash Source (list each name and amount individually for multiple cash sources) Amount
Amount
Total Cash Contributions:
In-Kind Services:
Labor type Description Hourly wage Total Hours Amount
Equipment Type Description Rental Rate Total Time Amount
Total In-Kind Services: Grant Match Amount: (Total Cash Contributions + Total In-Kind Services) $
Project Location: (Enter legal description(s) of property on which project will take place. Attach maps as needed)
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