EMTS Funding Program - Accounts Payable Form
Grantees who can't submit a final reimbursement request before June 30, 2023, must fill out this form. We will use the information on this form to enter an accounts payable amount for your project. An accounts payable amount is the amount EMTS will roll over for project costs that can't be requested until after the end of the state fiscal year. This form does not request or grant a project extension.

Once you're ready to request final or partial reimbursement, please review the grant manage guide and then submit the CDPHE reimbursement request form. 

To give us the best estimate of the amount of your final reimbursement request, answer the questions on this form. Email Andre Smith at andrek.smith@state.co.us with questions. 
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Adresse e-mail *
Organization Name *
Your Name *
Phone Number
PO\Contract Number *
Number taken from the purchase order or contract issued by CDPHE and starts with either "PO" or "CT". This form must be submitted again if you have more than one EMTS purchase order or contract.
Funded Grant Category *
Select the outstanding grant categories that will be included in your final reimbursement request. Only select funded categories that have a remaining award amount and will be included in your final reimbursement request.
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