Healthy Homes Grant Final Report
Owner/Applicant Information
Property Owner(s)
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Property Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Completed Exterior Improvements
Describe the physical improvements you completed as part of the grant program.
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Please attach photos of completed work
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Project Expenses
Please provide a breakdown by vendor/contractor.
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Rows
Vendor/Contractor
Date of Invoice/Receipt
Amount
Expense 1
Expense 2
Expense 3
Expense 4
Expense 5
Expense 6
Expense 7
Expense 8
Expense 9
Expense 10
Copies of each vendor invoice/receipt and proof of payment for each component of the project must be attached to the final report.
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Vendor estimates are REQUIRED
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Signature
Applicant/Owner Signature
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