Laserfiche WebLink
M <br />GmNT A)'PLICATION Paye 6 of 7 <br />lfinq• Indian River County Commission <br />_ r— <br />�al C;overnmental unit 'App )--�t��;in county or city <br />ONTRACTttAL ION - Cornplet:e one for each Delegate Agency 4 <br />eneral + <br />:ame of. Delegate Acrency: Economic 0 ortunities Council <br />...,ddress: 1316 20th St. , <br />P. 0. Box 2766, Vero Beach9_ Fla. 32960 <br />t <br />Derson: Arlene S. Elmore <br />Contact _ <br />Telephone: %5)'562-417 I <br />Tax Exempt Number:* <br />06_h a copy <br />of the certificate of incorporation' <br />" If none, - <br />DELEGATEAGENCY BUDCF.T FOR THIS PROGRAM <br />ADMIN CSTRATIVE FXPFNSk:S <br />1. -------- <br />Salaries___----- <br />2. Rental_Space_- <br />3.. Travel___ -=--- <br />9. <br />5 _ 0liC7 _(sRecif.Y7np_ <br />6_ * JTAL (lines_ 1_throuoh <br />PROGRAM 3 XPFNGFS _ <br />7. Salaries- - - - - - --- - - - - - -.- - _ -P-0 0-1. - - _ _ $1,175.00 <br />B. pental Space_ _ _ _ _ _ - - - - - r _ - _ - _ - 1' 500.00 <br />9. Travel_ .- _ - <br />1p _ Fqui},ment - - - - _ geat 1�T80_ 00 <br />1.1. Other TspecifY on attachment) _ _ - - - _ _ 4,i55.Q0__ <br />12. TOTAL 71_nes-7_throuah_1T)_ <br />- - - <br />13. TOTAL EXPENS- <br />ES -(line _6_and_line 12) <br />*Mav not exceed 15% of line 13. <br />A ND <br />F. r:GA.TF: AM' -- }j :,Rx'.BY. APPROVE <br />THE S THIS AR.F•LATINGOTI3F}21;TOILL COMPLY . <br />THE 11 L <br />• '•?IT}} ALL nt1LFS, p} Gt1LAT70NS 7011D CONTRACT. <br />npPnnvFD Bv: Admin strati��e S3 cmaturc) ? <br />� • . (:rule) .. • <br />mmx;cTPA ?3Y: q ��ture <br />.) tom. • 1 <br />• 1 �. . ✓ . •i moi' .i:� .. �_. _ �: .. <br />rt _ �ti•'.,i/ .. ;tib. �: <br />� • ' '.tea., <br />ear <br />FEB 91977 8 : �. 438 <br />