TDC ACH Grant Interim Reimbursement Request

Interim Reimbursement Request
Grant Number*
Organization Name*
Grant Contact Name*
Grant Contact Email Address*
example@example.com
Grant Contact Phone Number*
Please enter a valid phone number.
This interim reimbursement request is for*

Year-Round ProgramEvent Series
Reimbursement Period (date range) for this request*

Event Location*
Event Date*

MonthDayYear
Date
Event Name*
Did the event date change from what was submitted with the grant application*

YesNo
Original Date of Event:*

MonthDayYear
Date
Date SJCC was notified of the change*

MonthDayYear
Date
Reason for change*

0/500

Please describe your programming during the reimbursement period. Include open hours and days, special event dates, overall attendance/visitation numbers, and out-of-county attendance. *

0/1000
Date Event(s) and/or Program(s) were added to historiccoastculture.com*

MonthDayYear
Date
Did your organization sell advertising space or include provided advertising space to sponsors in any of the materials you have presented to the TDC office for payment using TDC funds*

YesNo
Please provide sponsorship amounts and describe benefits received by the sponsors. *
***Remember that the TDC and Cultural Council should receive the same benefits as other sponsors who contributed amounts equal to the grant amount.
Were tickets/free admittance to all grant funded events provided to the St. Johns Cultural Council?*

YesNo

Upload a year-to-date financial statement for your organization. *

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Please read and follow the instructions below.

1. Download the reimbursement expenditure log here and input all transactions for which you are requesting reimbursement.
- A single expense/payee over $5,000 requires an invoice and proof of payment be uploaded for reimbursement.
- The out-of-county reimbursement must:
  - equal 25% or more of the total reimbursement request.
  - match uploaded advertising documentation (see below).
2. For each advertising transaction for which reimbursement is requested, upload in this order and preferably in a single document:
1. Invoice/ad purchase request
2. Proof of payment (cleared check, paid receipt, bank statement, etc. that shows the bill was paid)
3. Ad copy showing the TDC and SJCC logos/recognition as follows:
Print Ads: publication must be distributed outside of St. Johns County
- Tear sheet or photo of ad in publication with easy-to-read logos
- Distribution list provided by the publication to demonstrate out-of-county reach
VISIT FLORIDA: Eligible expenses include membership fee, cost of printing rack cards, and rental fee for welcome center display
- Rack card with logo
- Proof of payment
Digital Ads: must target out of county tourists and click to webpage with logos and/or recognition statement
- Send digital ad link as soon as it goes live to grants@historiccoastculture.com
- Take screenshot of ad and the webpage it links to
- Distribution data from publisher
Radio Ads / Sponsorships: must run outside of St. Johns County and include recognition language.
- Provide script and recording of ad
- Provide invoice including broadcast area from station
Social Media Posts
- Screenshot of the Ad Center set up page showing the targeted location in the audience details
- Screenshot of boosted ad that shows:
  - Link to webpage with logos/recognition statement
  - Tag @HistoricCoastCulture
Television/Video Ads
- Video file or link to video w/logos or recognition language in at least one frame
- Broadcast area from provider / station
“Sponsored in part by the St. Johns County Tourism Development Council and St. Johns Cultural Council.”

Google Ad Campaigns
- Must clearly be an out-of-market campaign*
- Report showing target locations, URL to campaign page, screenshot of page showing logos or recognition statement and results of campaign
- Reimbursement for Ad Clicks or $150/month of Google Ad management fee
*Our market area includes St. Johns, Clay, Duval, Flagler and Putnam Counties. Those counties can be included in the Out-of-Market Google Ad campaign, but they cannot be the only counties. You must have at least three locations outside those counties.

Do not include any advertising expenses for reimbursement that do not have the required logos or recognition.
3. Upload your completed reimbursement request expense form. *

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4. Upload advertising expense documentation per the instructions in #2. *

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5. Upload invoice and proof of payment for any single expense/payee of $5,000 or greater, if applicable.

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Certification
The undersigned individual, First and Last Name* certifies, on behalf of Organization Name that information contained in this final report is true and correct.
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Interim Reimbursement Request

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