CCCDC (CULLMAN COUNTY COMMUNITY DEVELOPMENT COMMISSION)                                                                                                                                                                                                     
GRANT CLOSE OUT FORM
GRANT NUMBER_________

 

Issue date of CCCDC grant funds:____________________________

To:_______________________________________________________________________

For:______________________________________________________________________

Amount of grant $________________________________

Date CCCDC grant was received:______________ Date completed: _____________

Visual inspection was made - Yes ____ No _____
Receipts were obtained - Yes _____   No ______

Last date of entity audit ____________________________________________

Name of contact person for CCCDC grant_____________________________________

Phone number:__________________________

This grant was completed by all guidelines of the CCCDC.

_________________________________
Mayor Kenneth Nail

_________________________________
Mike Graves

__________________________________
Staci Bryan

___________________________________
Bill Strandlund

____________________________________
Kelly Duke

 

If CCCDC grant close out form is completed by grantee, please sign and date.

___________________________________              _____________________
Signature                                                                      Date

 

Form 1-4-10B Revised 12-22-11