Member Community Infrastructure Program
Progress Report
Rev 1/2017
Member Community Infrastructure Program
PROGRESS REPORT
Instructions:
Provide a summary of the accomplishments with respect to objectives, degree of completion based on
the Project application, and any problems encountered. Progress Reports must be submitted within 30
days of written request from the District Representative, as an attachment to all Reimbursement
Requests, or at quarterly reporting dates prescribed in the MCIP Agreement.
Project Information
M
ember Community: _______________________________________________________________
Project Title: ___________________________________________________
________
P
.O. #: _______________________
Authorized Signature
I certify that the information in this Progress Report is accurate and reflects current status of the Project.
Furthermore, I affirm that the information contained herein is, to the best of my knowledge and belief,
accurate and complete.
N
ame (print or type): ___________________________________________________________
Ti
tle: ________________________________________________________________________
Tel
ephone Number: _________________________________
E
mail Address: ______________________________________
S
ignature: __________________________________________
D
ate: ______________________________________________
Nathan Hale Stormwater Basin Project
click to sign
signature
click to edit