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TREASURE COAST HOMELESS SERVICES COUNCIL , INC. CONTINUUM OF CARE <br /> Technical Project Number _ FL2913409002 <br /> Submission Project Identifier — FL 13167 <br /> (RENEWALS ONLY) <br /> Recipient ' s Name : HUD Project Number : <br /> Indian River County Board of County Commissioners FL2913409002 <br /> Check the program component/type that classifies your project: <br /> ❑ Transitional Housing (TH) <br /> ❑ Permanent Housing for Homeless Persons with Disabilities (PH) <br /> ❑ Supportive Services Only (SSO) <br /> ❑ Safe Haven/Transitional Housing (SH/TH) — Characteristics of TH/participant not required to execute a lease <br /> ❑ Safe Haven/Permanent Housing (SH/PH) — Characteristics of PH/participant required to execute a lease <br /> ® Homeless Management Information System (IMS) <br /> ❑ Innovative Supportive Housing (ISH) <br /> Table Of Contents <br /> (Enter the page number for each Exhibit in the space provided below . ) <br /> _4_ Exhibit 1 Project Summary <br /> _ 6_ Exhibit 2 Real Property Leasing, Supportive Services, BMS and Operating <br /> Budget <br /> Certification . <br /> Name & Title of the Person who can answer questions about this document: Phone (include area code) : <br /> Louise Hubbard, Executive Director, Treasure Coast Homeless Services Council, 772 -567-7790 <br /> Inc. <br /> Address : <br /> 2525 St. Lucie Avenue <br /> Vero Beach, FL 32960 <br /> I hereby certify that all the information stated herein is true and accurate. <br /> Warning : HUD will prosecute false claims and statements . Conviction may result in criminal and/or civil <br /> penalties . ( 18 U. S . C. 1001 , 1010 , 1012 ; 31 U. S . C. 3729, 3802) <br /> Name & Title of Authorized Official : Signature & Date : <br /> 3 <br />