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GRANT NAME : EMS County Awards Grant GRANT # N/A <br /> AMOUNT OF GRANT: $ 17 439 . 00 <br /> DEPARTMENT RECEIVING GRANT: Fire Rescue <br /> CONTACT PERSON : Brian Burkeen PHONE NUMBER : 772-226-3864 <br /> 1 . How long is the grant for? 1 year Starting Date : FY 2013/ 14 <br /> 2 . Does the grant require you to fund this function after the grant is over? Yes X No <br /> 3 . Does the grant require a match ? Yes X No <br /> If yes, does the grant allow the match to be In Kind Services? (N/A ) Yes No <br /> 4 . Percentage of match N/A 0% <br /> 5 . Grant match amount required $ N/A <br /> 6 . Where are the matching funds coming from ( i .e. In Kind Services ; Reserve for Contingency)? N ?A <br /> 7 . Does the grant cover capital costs or start-up costs ? Yes X No <br /> If no, how much do you think will be needed in capital costs or start up costs $ <br /> (Attach a detail listing of costs ) <br /> 8 . Are you adding any additional positions utilizingthe grant funds? Yes No <br /> If yes, please list. ( If additional space is neededXplease attach a schedule . ) <br /> Acct. Description Position Position Position Position Position <br /> 011 . 12 Regular Salaries N/A N/A N/A N/A N/A <br /> 011 . 13 Other Salaries & Wages (PT) N/A N/A N/A N/A N/A <br /> 012 . 11 Social Security N/A N/A N/A N/A N/A <br /> 012 . 12 Retirement-Contributions N/A N/A N/A N/A N/A <br /> 012 . 13 Insurance-Life & Health N/A N/A N/A N/A N/A <br /> 012 . 14 Worker= s Compensation N/A N/A N/A N/A N/A <br /> 012 . 17 S/Sec . Medicare Matching N/A N/A N/A N/A N/A <br /> TOTAL N/A N/A N/A N/A N/A <br /> 9 . What is the total cost of each position including benefits , capital , start-up , auto expense, travel and operating? <br /> Salary and Benefits Operating Costs Capital Total Costs <br /> N/A N/A N/A N/A <br /> N/A N/A N/A N/A <br /> N/A N/A N/A N/A <br /> N/A N/A N/A N/A <br /> N/A N/A N/A N/A <br /> 10 . What is the estimated cost of the grant to the county over five years? $ <br /> Grant Other Match Costs Total <br /> Amount Not overed Match <br /> First Year $ N/A $ N /A $ N/A Second Year $ N/A $ N/A $ N/A <br /> Third Year $ N/A $ N/A $ N/A $ N/A <br /> Fourth Year $ N/A $ N/A $ N/A $ N/A <br /> Fifth Year $ N/A $ N/A $ N/A $ N/A <br /> Signature of Preparers Date : October 29 . 2012 <br />