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GRANT APPLICATION Page 4 of 7 <br />Name of. Applicant: Indian River County Commission <br />Fiscal Officer Responsi'hle for Grant: <br />Name: Mr. William Jackson Finance Officer <br />Address: County Courthouse 2145 <br />Telephone: j305, 562-7927 <br />1. RF. VEN UE <br />11. TOTAL BUDGET <br />(Include figures from all programs operated) <br />6 <br />1. State Grant _ _ _ _ _ <br />2. Cash match (- federal -f i - -- - - - - - 4130.00 <br />- T • _ i nds, ex9eQt „•XeVeauQ sha��� aj1•DWed) 2065.00 <br />3. I`n-Kxnd Match 3100.00 <br />------------------ -- 9295.00 <br />r1'AXTr•F ADMINISTPATTVF F.XPENSF <br />5. Salaries 0 <br />6. Pental -- <br />SLace-------------- - - - - -- 0 <br />7. Travcol---------- -- - - -- - - - <br />R. Suonl i -es - - - - - - - - - - - - - - - - - - --- - - - <br />9. Otho -r. (s -re ifv on attachment) - ` - - - ` - - '-' - �- <br />10. Total-(lints_5'throuah,9) - _ _ ` , _ _ _ _ _ _ _ - <br />DELEGATE ADMTNISTRATIVF. FXPENSF <br />11. Salaries _ - ' '- -' - 1100 in kind 1,139.00 <br />12. Rental Space - <br />13. Travel ----------------------- <br />14. SupnIies-------------- - - - - -. - -- <br />15. Other .(specify --on attachmentT ` - -' - - - " <br />i 16. Total (lines _ _ 11 through 16) _ _- - - _- - _` _- - _- _` _ 1,p05 00 <br />17. - - An!%�INISTP•A- - -C- - (Line 10 -and -Line 16) <br />GRANTEF PP.OGRAM EXPENSE <br />18. Salaries <br />19. Rental_Space- - - - - - - " - 0 <br />20. Travel ---------------------- 0 <br />21. Rq'd cment---------------- - - - - -- 0 <br />0 <br />22. Other (sneci fv on attachments ` ` - ` _ - "' " '" "' - 0 <br />23. Total dines 1R tthrouah 22) - - ` - ` - <br />Drj.PgATr Pnn!'Z*;A*, FXPF.NSF <br />24. Salaries 2000 in kind 5,600.00 <br />•2.5. penial Snacc� "------------ -- �- <br />26. Tr -ANY -01 - - - - - - - - -------- - - - --- OE <br />M- <br />26. <br />1�:c,Livmc- - -_ _ - 365.00 <br />nt ------------- --- <br />2R, ntrhor. (s- -i v -on attachment) 425.00 <br />29. Total (lines 2Q tu <br />hrogh 2Aj - - - ` - - - `" - - - _ 200.00 <br />30. Tn..AL rrnrt:>m r'<pr�1SF.S (Line -23 and line 29) $ 090.00 <br />31. TOTAL 1?XP?^JntTtTRFS (Linc' -17 and l.ine_30)- - - - - - •- 9,295.00 <br />g0LE: TOTAL PrVEN11F MUST rQUAL TOTAI, EXPENDITURES <br />*"ay not exceed 15Y, of 2 times the state Brant <br />RXAMPI, :: State Crant 10,000 <br />Cash Match 5,000 <br />In -Kind Match in, non <br />TOTAL 1tKVY'.91TE, -25,006 <br />"axiT-nm Adrlini.r.trai-ive Cnst.s - 15t of 2 x $10,000 (State Grant-) <br />15% of 20,000 <br />Page 4-C <br />FEB2 21979oo�c :+ <br />