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DAHP Grant Completion Report
General Information
Grant Completion Reports must be submitted at the conclusion of the project or project phase prior to receiving the grant award as a reimbursement.
Historic Resource Type
*
Heritage Barn
Historic Cemetery
Historic Theater
County Courthouse
Other
Grant Contract #
Found on your grant contract
Full Grant Award Amount
*
Found on your grant contract
Reimbursement Request
*
Typically, the full grant award amount - but you can request up to 3 partial reimbursements.
Are you returning unused award funds?
*
Yes, I am forfeiting the remaining amount to the program fund.
No, I used and requested reimbursement of the full grant amount.
Reimbursement Number
*
First Partial Reimbursement
Second Partial Reimbursement
Final Reimbursement (Project Closeout)
Project & Grantee Information
Name of the historic building or site of the project
*
County
*
Adams
Asotin
Benton
Chelan
Clallam
Clark
Columbia
Cowlitz
Douglas
Ferry
Franklin
Garfield
Grant
Grays Harbor
Island
Jefferson
King
Kitsap
Kittitas
Klickitat
Lewis
Lincoln
Mason
Okanogan
Pacific
Pend Oreille
Pierce
San Juan
Skagit
Skamania
Snohomish
Spokane
Stevens
Thurston
Wahkiakum
Walla Walla
Whatcom
Whitman
Yakima
Grantee Name
*
First
Last
Grantee Organization (if on contract)
Email
*
Phone
*
Mailing Address
*
Street Address
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Project Information
Project beginning date
*
Approximation of first working day
MM slash DD slash YYYY
Project completion date
*
Approximation of last working day
MM slash DD slash YYYY
Project Results
*
Describe the project as complete and any notable impacts it had and how the funding was useful for the project and community.
Changes Scope of Work (if any)
*
Describe any changes from the originally approved scope of work, including but not limited to time, cost, materials, or methods.
Historic Preservation Workforce
*
Provide the number of PAID jobs created from this project. In other words, how many different people worked on the project. If possible, please include a breakdown of jobs created according to work elements or roles (eg. 1 lead contractor, 4 on foundation, and 4 others on the roof).
Volunteer Labor
*
Please also indicate the number of people or hours of VOLUNTEER or DONATED labor used, if any (eg. 2 board members and 2 volunteers spent 3 hours each clearing the building of debris and unused equipment prior to construction work).
Project Expenditures and Reimbursement Summary
Typically, reimbursements are issued after the entire project is completed and paid for. For large projects with multiple phases or grantees that need assistance with cash flow from one phase to the next, they may request up to a total of 3 partial reimbursements after some work has been completed and paid for. Partial reimbursements must be coordinated and approved in advance, so please contact grants@
null
preservewa.org if you have any questions.
Total project cost to date
*
Please list each project phase / work element, its cost, and what project element it was related to. Most grantees will only have one project phase. Use the "+" to the right of the boxes to add as many rows as you need. This step is SUMMARIZE only; you may attach a more detailed itemized expense spreadsheet later.
Please list each project phase / work element, its cost, and what project element it was related to. Most grantees will only have one project phase. Use the "+" to the right of the boxes to add as many rows as you need. This step is SUMMARIZE only; you may attach a more detailed itemized expense spreadsheet later.
Project Phase / Work Element
Cash Expended
Value of Donated Labor & Materials
Owner Cash & In-kind Match
Grant Funds Reimbursed (if any already)
Grant Funds Expected (through this reimbursement)
Total reimbursement request at this time
*
This amount should be total of "Grant Funds Expected" if you have multiple Project Phases or Work Elements from the input above. This amount should also not exceed the Grant Award as stated on your grant contract. Partial reimbursements must be coordinated and approved in advance, so please contact grants@
null
preservewa.org if you have any questions.
Supporting Documentation
In this section, upload digital copies of financial documents that relate to each item listed above in the "List of Project Expenses." This should include receipts/invoices and proof of payment for each expense.
For items paid with a credit card, please make sure the receipt(s) included contain both the itemized items purchased and the payment information. For items paid via check, please upload copies of each check. You may also include a report from accounting software such as QuickBooks or a detailed Excel spreadsheet that indicates work items, payee, payment type/check numbers, dates, and amounts.
Drop files here or
Select files
Max. file size: 50 MB.
Program Requirements
Program Requirements
Check all that you have completed. If any are missing or you have questions about, please contact grants@
null
preservewa.org
Select All
The Grant Award Acknowledgement banner sign has been posted during the project
The Preservation Easement has been filed with the associated county
The property was already or has been listed on by project completion
Photo of the posted Grant Award Acknowledgment Sign
If you have already submitted it to staff, you may re-upload or skip.
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Max. file size: 50 MB.
Proof of filing the Preservation Easement with the county clerk
If you have already submitted it to staff, you may re-upload or skip. Proof includes the final draft of the easement and is notarized by the clerk.
Drop files here or
Select files
Max. file size: 50 MB.
Site Visits
Please note any virtual or in-person site visits conducted or planned with program staff.
Project Images
"BEFORE" PHOTOS
Please upload 4-6 high-resolution images of the building and project areas prior to work starting. You may re-upload or refer to your application photos.
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Max. file size: 50 MB.
IN-PROGRESS
Please upload 4-6 high-resolution images of the project in progress.
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Max. file size: 50 MB.
OVERALL IMAGES
Please upload 4-6 high-resolution images of the entire building / resource after project completion.
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Select files
Max. file size: 50 MB.
DETAIL IMAGES
Please upload 4-6 high-resolution images of the specific project area that the grant funds went toward, after project completion.
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Select files
Max. file size: 50 MB.
IMAGE CAPTIONS AND CREDITS
Please upload a text document with image captions and image credits that correspond with the file names of the images you are uploading.
Drop files here or
Select files
Accepted file types: txt, doc, docx, xls, xlsx, pages, Max. file size: 50 MB.
Submission
Thank you for completing the grant project. Staff will review your completion report and reach out if we have any questions or if anything is missing. Reimbursement may take 2-4 weeks to process. Please contact grants@
null
preservewa.org if you have any questions.
Name
Email
Date
MM slash DD slash YYYY
Additional Comments
Please use this prompt to provide any additional comments you may have regarding the grant program (staff, application, process, requirements, outreach, etc.) or contextualize any previous answers or file attachments.