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["CASH  REQUEST"]
["LARCA 2.0 (Gang Injunction Curfew Settlement)"]
["Economic and Workforce Development Department, City of Los Angeles"]
[]
[]
["Service Provider:",{"$f":"ExpenditureRptTracking!A1","v":"Service Provider"},null,null,null,"City Contract No.:"]
["Region:",null,null,null,null,"Contract Period:","6/1/17- 06/30/21"]
["Program Year:","PY 20-21",null,null,null,"Amendment No.:",2]
[null,null,null,null,null,"Contract Amount:","$XX,XXX"]
["For the Month(s) of:",{"$f":"ExpenditureRptTracking!A3","v":"2020-11-01"},null," Request No.:   ",1]
[]
[]
["BILLING  SUMMARY"]
[]
[null,"SERVICE MODULE",null,null,null,null,"REQUESTED"]
[null,null,null,null,null,null,"AMOUNT"]
["A.  OUTREACH, ENROLLMENT, EVALUATION & ASSESSMENT",null,null,null,null,null,{"$f":"ExpenditureRptTracking!F5","v":0}]
["B.  CASE MANAGEMENT SESSIONS  ",null,null,null,null,null,{"$f":"ExpenditureRptTracking!I5","v":0}]
["C.  CAREER SERVICES & EMPLOYMENT READINESS WORKSHOPS",null,null,null,null,null,{"$f":"ExpenditureRptTracking!L5","v":0}]
["D.  EDUCATION & VOCATIONAL TRAINING ",null,null,null,null,null,{"$f":"ExpenditureRptTracking!O5","v":0}]
["E.  EDUCATION & VOCATIONAL TRAINING STIPENDS  ",null,null,null,null,null,{"$f":"ExpenditureRptTracking!R5","v":0}]
["F.  TRANSITIONAL EMPLOYMENT WAGES & FEES* ",null,null,null,null,null,{"$f":"ExpenditureRptTracking!U5","v":0}]
["G.  JOB PLACEMENT & FOLLOW-UP SERVICES ",null,null,null,null,null,{"$f":"ExpenditureRptTracking!X5","v":0}]
["H.  SUPPORT SERVICES** ",null,null,null,null,null,{"$f":"ExpenditureRptTracking!AA5","v":0}]
[null,null,"T O T A L",null,null,null,{"$f":"SUM(G17:G24)","v":0}]
[null,"APPROVED CASH RELEASE BY EWDD"]
["* Total wages & payroll related costs."]
["** Cost of Support Services."]
["CERTIFICATION BY SERVICE PROVIDER"]
[]
["          We hereby certify under penalty of perjury under the laws of the State of California that  (a) the Service Module minimum required service elements have been met "]
["           and all expenditure supporting documentation as outlined in the Contract Expenditure Table are in the participant's files;  (b) supporting documentation have been uploaded"]
["           to the JobsLA system;  (c ) all required service activities have been reported in JobsLA.org;  (d) this Cash Request and its supporting financial records are true in all respects;"]
["          and (e ) all funds have been or will be used solely for the purposes set forth in the Statement of Work contained in the contract entered into by this Service Provider and the"]
["          Economic and Workforce Development Department (EWDD).  We also understand that allowability of cash requested is subject to final acceptance by EWDD and that payroll tax returns"]
["          have been timely filed and applicable payroll taxes have been timely paid."]
[]
[]
[]
["Preparer's Name","Signature",null,"Title","Tel. No.","E-mail Address"]
[]
[]
[]
["Authorized Reviewer's Name","Signature",null,"Title","Tel. No.","E-mail Address"]
[]
["F O R     C I T Y     U S E     O N L Y"]
["FINANCIAL MANAGEMENT DIVISION APPROVAL"]
[]
[null,null,null,null,"               PAID",null,"INSURANCE"]
[]
[null,null,null,null,"               CRTS UPDATED",null,"MAT'L RECEIPT"]
[null,null,null,null,null,null,"VERIFICATION"]
[" FMD Preparer's Name & Signature",null,"Date"]
[null,null,null,null,"              CHECKED LOG",null,"BTRC / VRN"]
[]
[null,null,null,null,"               LWO",null,"EBO"]
[]
[" FMD Supervisor's Name & Signature",null,"Date",null,"               HOLD RELEASE DATE: _________________________________"]
[]
[null,null,null,null,"               HOLD RELEASE REASON: ______________________________"]
[]
[]
["BATCH #:   ______________________________________"]
[]
["GAX  #:  __________________________",null,null,"$","FMD Preparer's Name & Signature                                        Date"]
[]
["GAX  #:  __________________________",null,null,"$"]
[]
[null,null,"TOTAL","$","FMD Supervisor's Name & Signature                                      Date"]
["ADDITIONAL REMARKS FROM SERVICE PROVIDER:"]
["CASH REQUEST for LARCA 2.0 (Gang Injunction Curfew Settlement), Financial "]

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["Service Provider"]
["Month/ Year of Invoices:"]
["2020-11-01"]
[]
[null,null,null,"TOTALS",{"$f":"SUM(E12:E100)","v":0},0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,null,{"$f":"SUM(AD12:AD55)","v":0},{"$f":"SUM(AE12:AE55)","v":0},{"$f":"SUM(AF12:AF55)","v":0}]
[null,null,null,null,"A. Outreach, \nMax. $10,000\nEnrollment, Evaluation, & Assessment  \nMax $300 / Participant",null,null,"B. Case Management Sessions & Supports Activities\nMax $3,600 / Participant",null,null,"C.  Career Services and Employment Readiness Workshop  \nMax $500 / Participant",null,null,"D. Education & Vocational Training       \nMax $5,000 / Participant",null,null,"E. Education & Vocational Training  Stipends\nMax $1,000 / Participant",null,null,"F. Transitional Employment Wages\n& Fees\nMax $6,500 / Participant",null,null,"G. Job Placement and Follow-up Services \nMax $900 / Participant",null,null,"H. Support Services\nMax $1,000 / Participant",null,null,null,"TOTAL"]
[]
[]
[]
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{"sheet":"Instructions","index":2,"n_rows":35,"n_cols":3,"rows_kept":35,"cut":false,"hidden":false,"merged":[]}
[]
[null,"HOW TO ENTER SERVICE AMOUNTS PER PARTICIPANT"]
[null,"A.) To Enter Data at the Beginning of the Month"]
[null,null,"1. Begin by entering correct Month on cell A3"]
[null,null,"                 *You are no longer to report date of expenditure"]
[null,null,"2. Move all current amounts to  previous month by clicking  on the  \"Roll Over Current to Prior\" Button "]
[null,null,"Then continue to instructions B."]
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[null,"B.)To Enter Service Amounts of each Module to its corresponding Claim #","1. Open the Data Entry Form by clicking the button"]
[]
[null,null,"There are two options "]
[]
[null,null,"(1 A.) To enter new claim number, and if needed entering service amounts."]
[null,null,"                 - add the claim # in the claim # field box, and amounts if desired and  click \"Add New Claim #\" "]
[null,null,"                         *Note: The system will not allow you to enter duplicates in the claim # field box"]
[]
[]
[null,null,"(1 B.) To Enter Service amounts to current Claim #"]
[null,null,"           -Click on \"Update Cost to Claim #\" button"]
[null,null,"           - Click on the scroll down menu option and choose the desired claim #"]
[null,null,"           - Enter the amounts in the service module"]
[null,null,"                   *If there are previous amounts already in the field box please calculate the total amount to be reflected on the spreadsheet , "]
[null,null,"                      upon entering the amount"]
[]
[null,null,"*Please Do not rename the sheets "]
[null,null,"*If user adds claim # and clicks on the save buton, and wishes to go back and insert amounts on its service module then user must "]
[null,null,"exit the form and re-open it  to update the data. "]