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State Accounting Information PO Number: ________________ <br />CONSERVATION PARTNERS LEGACY GRANT PROGRAM <br /> ENCUMBRANCE WORKSHEET <br />«Organization_Name»/ «Project_Name» <br />State Accounting information: <br />SWIFT Contract Doc. Type: SWIFT Contract #: <br />SWIFT Contract Line # (Annual Plans): SWIFT Purchase Order #: <br />Agency: Submitted By: Origin: Vendor #: Category <br />Code: <br />«Vendor_Number» <br />R2901 David SteinA24 <br />84101501 <br />Total Amount of For FY: <br />$«Total_Grant_Amount_Reque <br />Total Amount of Contract:$ <br />Contract for ALL <br />25 <br />years: <br />sted» <br />«Total_Grant_Amount_Requested» <br />Total Amount of For FY: For FY: <br />Total Amount of Contract: $ <br />Contract: <br />Contract Start Date:Upon Execution Speedchart Name: <br />Contract Expiration Date:June 30, 2028 Speedchart Number: <br />Grantee Name and Address: «Organization_Name» <br />«Fiscal_Street_Address_1» <br /> <br />«Fiscal_City», «Fiscal_State» <br />«Fiscal_Zip_Code» <br />Did you remember to: <br />Check for debarred vendor? Yes No <br />Check for annual plan limit? Yes No <br />Work on state lands? Yes No <br />PO Reference: DS-FY25 CPL «Project_Name» <br />Description:FY2025 CPL Round 1; «Organization_Name», «Project_Name». «Recital» <br /> <br />Statewide/ Agency Reporting Funding String <br />LineBudget/AmountFundFinDeptIDAppropIDAccountStatewide Agency Agency <br />Bond Year Cost Cost 1Cost 2 <br />$«Total_Gra <br />nt_Amount«Account <br />1 25 2300 R2936725 «Appr_ID» 2W205 <br />_Requested_Code» <br />» <br /> <br />Project/ Grant Reporting Funding String <br />Line PC Business Project Activity Source TypeCategory Sub-Category <br />Unit <br /> <br /> <br />Rev. 8/21 1 <br />Qbhf!236!pg!286 <br /> <br />