MEA CHP Program - Attachment B

OUTDATED FORM - DO NOT USE
This MEA CHP Quarterly Status Report form is outdated. Please use the updated quarterly status report, which can also be found on the MEA CHP webpage under the "Reporting Resources for Existing Grantees" section.

PART I: Grantee Information
Organization (Grantee) Name*
Federal Tax ID Number*
MEA Grant Number*
Your MEA Grant number can be found on your Grant Agreement
County Where Grant Work is Occuring*
Organization Information
Organization Address*

Street Address

Street Address Line 2

CityState

Zip Code
Congressional District **
**Find your Congressional and MD Legislative Districts at www.mdelect.net
MD Legislative District **
**Find your Congressional and MD Legislative Districts at www.mdelect.net
Grantee Point of Contact Information:
Name*

First NameLast Name
Title
E-mail*
Phone Number*

Area CodePhone Number

PART II: Reporting Period
Reporting Quarter*
Year*
Number of Hours Worked During Reporting Period*
In an effort to document job creation statistics all grantees must provide the total number of hours worked on the project during the reporting period. This should include total hours worked on engineering, design, financing, installation, and commissioning, as applicable, each reporting quarter.

PART III: Project Status Update
Project Development Status*
Project Groundbreaking Status*
Project Construction Status*
Project Commissioning Status*
Additional Project Status Details and Highlights*
Please use the space above to elaborate on any of the project milestones listed above and/or to provide additional information on the overall status of the project. Please detail any roadblocks or challenges encountered, and please provide anticipated, scheduled, and/or finalized dates (as applicable) for Development, Groundbreaking, Construction, and Commissioning. Additionally, please provide a brief description of the equipment being installed and/or work being performed during this reporting quarter.
Work Flow Diagram

Upload a File
Please provide a chart detailing project milestone dates – both initially projected, and actually completed (e.g. Development, Design, Groundbreaking, Construction, etc.). The preferred format is a Gantt Chart, but alternative formats are acceptable as long as they logically and clearly detail the timelines. Cancelof
Job Hours Worked

Please provide the number of hours worked by the respective parties toward the completion of the CHP project. Job hours should be inclusive of all hours pertaining to CHP system completion and the administrative time required to further the Project.
Hours Worked by Grantee Organization
Hours Worked by Contractor(s)
Hours Worked by Subcontractor(s)
Photos & Attachments

Upload a File
If applicable, please provide photos of the Project’s current stage. Please name the photo files appropriately and provide a brief description in the section below regarding what is depicted in each photo. Optional: Please attach any additional documentation relevant to this Quarterly Status Update, and provide a description of the relevance of this documentation in the box below. Cancelof
Descriptions of Photos & Other Documents
Should be Empty:

OUTDATED FORM - DO NOT USE

PART I: Grantee Information

Organization Information

Grantee Point of Contact Information:

PART II: Reporting Period

PART III: Project Status Update