2009-228H - Laserfiche WebLink

Home Browse Search

Attachment K Department of Community Affairs Neighborhood Stabilization Program Florida Small Cities Community Development Block Grant (CDBG ) Program dJ 0 8 G SIGNATURE AUTHORITY FORM P' ... WWWW _. _ ._........._. ___._. ._........._. . ___. _._ _.__._.._._Submitan original Signature AuthorltyF.orm with each contract.. 2009 AUG 24 pM3_. Reci pieContract # Local Government DUNS Number Indian River County 10DB-4X- 10-40-01 - F13 079208989 _ ... ....__.._ . _ ................_...... .,......__......_-.........._�.... -- ......_.,....-..-..._......-._............. --- __...................... ---- -- -_.__..........._............ ........_..-.._.. ._. .__... .._.._..... _....._...._,........_....... Mailing Address (Street or Post Office Box) 1801 27`h Street I City, State and Zip Code Vero Beach, Florida. 32960-3388 __ _ .... .._. __-. ----.--- . . .. _ .. ._.____.__ _.._. ._.. ...__..._ .. .... .............. _ .... .. _ .-.-- ....._. _ .__.. _.__. __._ . _. ._. ._ Project Contact Person . _ ( Telephone # i (772 _. . _ ) 2261254- . . . .. _ .......... . _. . . . _.._...........--- -- - . ._ .. .. .... ._ _I. ...... - - Robert M . Keating, Community Development Director E-mail Address ... ... bkeatin9 ) ircgov. com ------._..__... - _ ...._. ..._................_.. ........... __...__......__..,_._.. . . _........_.. _._..........__...._..................... ... .........._....... ... ...... .... ._...._.__._................._... ............ _.....__.....__ Financial Contact Person ( Telephone # (772) 226- 1205 F_._.. __._.._... ._......_..._..... ........................_.........._...... .... ..................... __. ........_.. ...III._........_...__._. _..__.._...._._._..__..-..........- Diane Bernardo - Finance Director I E-mail Address i dber_nardo@clerk. indian-river. or — .__.._._. mWWWWWW Requests for Funds ( RFFs) from the Florida Small Cities CDBG Program require (check one): [ ] one signature [ ] two i signatures of individuals authorized below. No more than two individuals can be authorized to use Florida PAPERS. CDBG contracts require that at least one ( 1) RFFs must be submitted each quarter and should reflect all expenditures incurred during that reporting period . Typed Name Da 1 Si atur Robert M Keating, Communi_ty_ Dev Director - �[� Q _ ✓` _._.._ . _..__. _ .. - .. i [ X ] Check here if the above person will be the E-mail Ad ess i designated FloridaPAPERSuser. w.. bkeating@ircgov . com _._......_.. ___....._..._......_...._..._.._.._............_.._._.____.. _ . ._ .......... . ........ g .... .. ... .. Typed Name Date � Si nature _ . _ -- __._�_._._.._.._. ..... . .. _.... ..._._ ._................. . _.... .__._ ._..._ a [ ] Check here if the above person will be the E- mail Address i designated _ FloridaPAPERS_ .... ._user._._ _._ --.....- - -- .._.__...__... ._ _.. .. , Typed Name Date Signature _ - . _ _ -_ ._. _ ._ _ __ ___ _ , -._ _ .._ [ J Check here if the above person will be the E-mail Address designatedFloridaPAPERS user, _._..._.__.._.-.._..._._._..._-._-..- __---.-...._...._._......___--.--.._.._._..._...__....-_................_...__.------.-.-.. ......._.._...____..__ _.._._._ WWI] I certify, as the recipient's Chief Elected Official, that the above signatures are of the individuals authorized to sign Requests for Funds and to submit RFFs electronically to the Small Cities Community Development B: o4k Grant Program using FloridaPAPERS . ..... .__-_._.-._.............------_-_........................._...._._.............. . -- -- ..__.... _ _ ...._._..._._._/..............._.. ...... - . .._...._......._... ---._......_.._._.__._._ Typed NameWm Date e Wesley S . Davis, BCC Chairman - - ugust._...�$ PQ.. ___._._ IW d✓ I ._ _._... ._.__.._.... . - --........ ..........._..__.._...._...... I.. ......_....I....__..... - ... [X] Check here if your local government utilizes Electronic Funds Transfer ( EFT) from the St a of Florida . I [X] Check here if your local government will be working on a reimbursement basis. [ ] If this signature authority form pertains to a housing grant, check here if your local government will use an escrow account forhousing activities_-- --- ............ .----....__._. .....-..._._-....._._........ _............._.......__.....WWW.... .... ................... ..--- CDBG payments to local governments using EFTare automatically deposited in the local government's general account. If the j account is interest bearing, the CDBG funds must be transferred to a non- interest bearing account. Please call the CDBG Program at 850/922- 1878 or 487-3644 if you have questions. You can check the status of your deposit at the Comptroller's website : http : /Iflair . dbf. state .fl . us/ . ..... ..... ....... ._. _ ......... _._._._ . . ....._....-- --..__.. .__... __ ....._..._....-......__.._..-........._.__..... ........_I......A............. _I _. . . . ....... - ... __ ........-- ---- - ........._ .. . ...._....._._......... .......-_ _ __..._.._ -- --... ---- -.... ._... Local governments not receiving EFT, and not working on a reimbursement basis, must establish a non- interest bearing account. Provide account information for the financial institution ( insured by FDIC) below. All signatures on the account must be bonded . . . .. .. .. ...... ... .. .... _ ......_. ....I... _. . _ ... ... Name of Financial Institution Account Number RBC Bank _. .. . _.._ _._ . _.__. 053100850-7680027195 .. .. . __ ........... .._ - }- - . . ._ .... . . _. . ._. ..... - . - Street Address or Post Office Box Telephone Number 1417 Centura Highway 1 (252). 454 . 3557I. or (800) 226-5985 . ---._... _ . ......_ .._.. . .. . City, State and Zip Code __.. . . _ Rocky Mount, NC 27802