HomeMy WebLinkAboutAttachment RATTACHMENT R
FOR GOVERNMENT ENTITIES ONLY - Semi -Annual Emplovee
Certification for Supportive Housing, Programs
"This form is to be submitted to the
Miami -Dade County Homeless Trust every six months.
Agency:
Project Number:
Project Name:
Period Covered:
FL14B
The following employee/s worked solely on SBP project
Employee Name/Names:
Signature Date
Name Signature Date
Name Signature Date
Name Signature Date
By signing, I hereby certify that I have worked 100% of the time on the above
referenced SEP project during the period specified above.
Supervisor Certification
Title
Signature Date
I hereby certify as the supervisor of the above named individuals that they have
worked solely on the above referenced grant during the above referenced time
period