DCA Grantee Final Invoice and Report

GRANTEE FINAL INVOICE & REPORT FORM

Grants Administration Division
To navigate through the pages of the Final Invoice & Report Form, please use the "Next" and "Back" buttons at the bottom of each page. Avoid using your web browser's back arrow, as this might reset the form.

Important: We recommend you complete this invoice and reporting form in one sitting. Therefore, we suggest that you prepare your answers in advance prior to starting your report. To view the questions you will encounter in this report, please refer to this PDF file, which should be used for reference purposes.
Grantee Name*
Email
A copy of your report will be sent to this email address after submitting.
Step #1: Download, fill out, sign, and save a copy of the DCA Invoice Form accessed through the following link:

https://culture.lacity.gov/sites/culture.lacity.gov/files/2025-06/INVOICE-FORM-Grants-rev-06-10-2019-1.pdf

Copy the exact “Services to be Provided” language from your grant contract into the blank space in the center of the form.

Once your Invoice Form is completed and saved, click on the "Browse Files" button below to locate and upload your completed Invoice Form.
Upload DCA Invoice Cover Form*

Browse Files

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Community Re-Introduction Event Reporting

If you are submitting a late 2021-22 report, note most organizational contracts included a one-time, non-matching federal grant supplement to support a community re-introduction activity or event. Review the "Services to be Provided" language in your organization's grant contract and indicate whether the report you are preparing is for a contract that included a community re-introduction event for 2021-22. Please mark "no" below if this does not apply.
Do your grant contracted services include a Community Re-Introduction activity, supported by a one-time, non-matching Federal grant supplement?

Yes, the Services to be Provided in my grant contract includes a Community Re-Introduction Event.No, the Services to be Provided in my grant contract does not include a Community Re-Introduction Event.
GRANT CONTRACT INFORMATION
Contract #:
Fiscal Year of Grant
2017-18 or 2018-19
Total Grant Amount:
Requesting Grant Payment of:
Federal Tax ID # (Orgs only)
City Business License # (BTRC)
Proof of General Liability Ins:
Track4LA Certificate Approval Number
Proof or Waiver of Workers' Comp:
Track4LA Certificate Approval Number
Contact Name
Title
Phone Number
Address

Address (line 1)

Address (line 2)

CityState

Zip Code
Copy exact description of "Services to be Provided by the Contractor" from Appendix B of your service contract.
By providing my electronic signature below, I certify under penalty of perjury that the service/s for which payment is hereby requested has/have been performed by me or the above organization I represent in full compliance with the requirements of the provisions of the cultural grant with the Department of Cultural Affairs.
Signature

	Percentage (%) of people engaged
Female
Male

	Percentages (%) of people engaged
African American
Asian American
Caucasian/ European
Latino/ Hispanic
Middle Eastern
Native American
Native Hawaiian/ Pacific Islander
Mixed Heritage
Other

	Number (#) in each relevant category
Artists
At-risk youth (who live or go to school in one of the City’s Gang Reduction Zones)
Correctional residents (adults and/or juveniles)
Differently-abled persons (with physical or mental challenges)
Homeless persons
Immigrants/New arrivals in the USA
Lesbian/ Gay/ Bisexual/ Transgendered persons
Low income persons
Parents/Guardians with children
People in addiction or rehabilitation groups
People with chronic/terminal illnesses (HIV, cancer, etc.)
Tourists (regional, national, or international)
Women (with women specific programs)
Other

4. Outreach Metrics

Provide the estimated number of people solicited/informed of program activities for any of the methods you used listed below (we understand duplicate persons/contacts will be reported in this section).

A.) Community partners and/or co-sponsors:

	Number (#) of People Reached, Estimated
programming partners/sponsors
media partners/sponsors
venue partners/hosts
other

If "other" selected above, please specify partnership:

B.) Internet/ communication media:

	Number (#) of People Reached, Estimated
e-blasts/e-vites
podcasts/broadcast
print advertising
sms texting
websites
other

If "other" selected above, please specify media:

C.) Social media:

	Number (#) of People Reached, Estimated
Facebook
Instagram
Twitter
Youtube
other:

If "other" selected above, please specify social media:

D.) Printed Material(s) Distribution:

	Number (#) of People Reached, Estimated
Flyers
Season Brochures
Invitation Cards
other:

If "other" selected above, please specify printed material(s):

5. Workforce Metrics

A.) Estimated number of paying jobs and volunteer opportunities created/maintained by DCA funds or matching funds:

	# of Full-time	# of Part-time	# of Occasional/ Seasonal	# of Volunteers
Administrative Staff
Artists/ Performers
Consultants/ Other(s)
Technical workers
TOTAL

B.) Estimated number of administrative planning hours associated with all persons enumerated above (in part A):
C.) Estimated number of artistic production (e.g. rehearsal, installation, etc) hours associated with all persons enumerated above (in part A):
D.) Estimated number of public engagement/performance hours associated with all persons enumerated above (in part A):

6. Events and Activities

Detail each public activity that has been supported by DCA-funding and/or matching support.
Please provide basic information (i.e. event name, type, date, start and end times, venue/location, and Council District) for the separate Activities/Events specific to your grant-funded project.

To access the Event and Activities form, please click on the following link:

https://culture.lacity.gov/sites/culture.lacity.gov/files/2025-07/List-of-Activities.xlsx
Click here to Find a City Council District by address
Upload Events and Activities Form here:*

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7. Narrative Report
a.) Describe the key project-engagers (staff, artists, volunteers, participants and audience) and their relationship to intended success.*

0/500
a2.) Community Re-Introduction Narrative: Briefly describe the activities supported by your one-time, non-matching Federal grant supplement. In your response, please indicate which two or more allowable expense categories the funding was used to cover.*

0/500
b.) Describe noteworthy or significant participant/audience feedback messages or survey results. How might qualitative reflections inform future practices?*

0/500
c.) Considering the ratio of people solicited to those ultimately engaged, were your marketing/inclusion strategies effective? How might you change outreach and/or enrollment strategies for improved or ongoing success?*

0/500
d.) Describe how you credited DCA with your project. Be sure to attach copies of marketing, advertising, and/or materials related to project-service activities which showcase either the DCA logo or includes language giving credit to DCA.*

0/500
e.) Please list the names/sources and the amounts of the revenues or values of cash and/or in-kind contributions received or committed to match DCA support. When appropriate designate percentages or sub-amount of that apply to DCA so that we can understand the relationship between your answer here and the numbers registered in your final financial report.*

0/500

8. Final Financial Report
Use the Final Financial Report form to provide us with a breakdown of your DCA project expenses and income.

Important: The purpose of this form is to show the total expenses for your project (and the associated income sources to make the project happen). Please do not use the form just to show how your organizaton demonstrated your grant's minimum matching requirement.

To access the Final Financial Report form, please click on the following link:

https://culture.lacity.gov/sites/culture.lacity.gov/files/2025-07/DCA%20Final-Project-Financial-Report.xlsx
Note: Please ensure your one-time, non-matching Federal grant supplement is accounted for under the "DCA Share" column (both expenses and income) along with your regular DCA grant allocation. Grantees are only expected to show total matching contributions that are greater than or equal to the 2021-22 regular DCA grant allocation.
Attach Final Financial Report here: *

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9. Testimonial Request
Submit a testimonial/story and images of a person (a participating resident or audience member) who was deeply affected (professionally or personally) by its grant-supported activities. DCA will feature some of these stories on our website and social media platforms to highlight the importance and impact of the work of DCA grantees.
Below, please provide a 200-word explanation of how the participant's life was transformed by the artistic/cultural experience you provided.
Image #1

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Images that are not png, jpg, or gif will not be uploaded. Images may not exceed 50 MB in size. Cancelof
Image #2

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Images that are not png, jpg, or gif will not be uploaded. Images may not exceed 50 MB in size. Cancelof
10. Marketing Material
Please attach copies of marketing, advertising, and/or program materials related to project-service activities which showcase either the DCA logo or includes language giving credit to DCA. A minimum of one sample should be attached.
Sample #1*

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What is the sample and where can we find credit to DCA (if not immediately noticeable)?
Sample #2

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What is the sample and where can we find credit to DCA (if not immediately noticeable)?
Sample #3

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What is the sample and where can we find credit to DCA (if not immediately noticeable)?
DCA Grant Amount
Cash Match
In-Kind
Total Project Budget
#1 Biggest DCA Supported Expense
Budget Item
#2 Biggest DCA Supported Expense
Budget Item

Final Report Submission

Before submitting your final report, please remember to review all entries for accuracy. Responses cannot be changed once you click "Submit." It is highly recommended that you click on "Print Form" to save a copy of this invoice for your records.
Should be Empty:

	Number (#) of Individuals engaged IN PERSON	Number (#) of individuals engaged ONLINE
Age Group: 0 to 4
Age Group: 5 to 12
Age Group: 13 to 17
Age Group: 18 to 24
Age Group: 25 to 34
Age Group: 34 to 65
Age Group: 65 and over

GRANTEE FINAL INVOICE & REPORT FORM

Community Re-Introduction Event Reporting

1. Geographic locations of grant-supported public activities:

2. Service Metrics:

3. Engagement Metrics

4. Outreach Metrics

5. Workforce Metrics

6. Events and Activities

7. Narrative Report

8. Final Financial Report

9. Testimonial Request

10. Marketing Material

Final Report Submission