Offshore Wind Workforce Program Milestone

Maryland Offshore Wind Workforce Program - FY 2019

Milestone 1 Invoice Submission Form
Reporting Information
PLEASE NOTE: Your participation in this grant program requires you, the grantee, to submit this invoice after the completion of each project milestone.

Failure to submit a properly completed milestone invoice may result in a significant delay in your financial reimbursements.
Acknowledgement*

I understand

Part 1 - Milestone Checklist

Milestone Invoice Required Materials Checklist
Please verify that you have the following documents ready to upload on Part 5 of this form. A document will be required, unless otherwise noted, for all items in this checklist. MEA, at its sole discretion, may request additional documentation not specified in this form. This will be carried out on a case by case basis for each Grantee.

If you have any questions regarding the requirements, please contact Samuel Beirne, MEA Wind Program Manager at wind.mea@maryland.gov or 410-537-4090.

NOTE: This form must be submitted with an invoice from the Grantee. The invoice should be on the Grantee’s letterhead or standard invoicing document.
Required Materials - General
Required Materials - Student Graduation
Miscellaneous Materials (Optional)

Part 2 - Grantee Information
Organization (Grantee) Name*
Federal Tax ID Number*
MEA Grant Number*
Your MEA Grant number can be found on your Grant Agreement
Jurisdiction Where Work is Occurring*
Maryland County or Baltimore City
Organization Information
Organization (Grantee) Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Grantee Point of Contact Information
Name of Authorized Representative*

First NameLast Name
Title of Authorized Representative*
Email of Authorized Representative*
example@example.com
Phone Number of Authorized Representative*

Area CodePhone Number

Part 3 - Reporting Period, Milestone, & Grantee Invoice
Reporting Period
Month*
Year*
Invoice
Total Grant Award Amount*
Total Reimbursement Request*
Please refer to your grant agreement for the specified milestone amounts
Grantee Invoice Number*

Part 4 - Supporting Documents
Required Materials - General
Milestone Reimbursement Invoice

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For Grantee reimbursement, an invoice must: be issued to MEA; placed on Grantee’s letterhead or standard invoicing document; contain the Grantee invoice number, MEA Grant number, Grantee federal tax identification number, address where work is being completed, and Grantee contact information. The Grantee’s organization name must match the name listed on the submitted IRS W-9 form. The invoice must be billed to: Maryland Energy Administration, 1800 Washington Blvd, Suite 755, Baltimore, MD 21230. Cancelof
Invoice Overview Spreadsheet

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This document is available on the Program webpage in the section titled "Reporting and Invoicing for Existing Grantees." Cancelof
Invoice(s) Paid by Grantee

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Copy of developer/vendor/manufacture invoice (issued to Grantee) providing proof of costs incurred equal to or greater than twice the total reimbursement request from MEA as provided above. Cancelof
Insurance Policy Certificate

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Insurance policy certificate indicating MEA as an additional insured. Cancelof
Project Team Organization Chart

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Project team organizational chart with contact information. Cancelof
Required Materials - Student Achievement
Student Information Spreadsheet

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The information required is specified in Attachment A of the Grant Agreement and can be included in the Final Report or as a separate document. Cancelof
Proof of Student Graduation

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Proof of Student Certificate Received

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Miscellaneous Documents (Optional)
Photos of Work Completed

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If the file size is too large, pictures may be emailed to the MEA Program Manager. Cancelof
Additional Documents

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Upload as many additional documents as desired. Cancelof

Submit
I certify the information provided in this submission and all of its attachments are complete, accurate, and true. In addition, I am authorized to provide MEA with this submission on behalf of the Grantee.*

I Agree
Please sign your name using your mouse. *

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Print Name*

First NameLast Name
Date*

MonthDayYear
DateHourMinutesAM/PM Option
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Maryland Offshore Wind Workforce Program - FY 2019

Reporting Information

Part 1 - Milestone Checklist

Part 2 - Grantee Information

Organization Information

Grantee Point of Contact Information

Part 3 - Reporting Period, Milestone, & Grantee Invoice

Reporting Period

Invoice

Part 4 - Supporting Documents

Required Materials - General

Required Materials - Student Achievement

Miscellaneous Documents (Optional)

Submit