Laserfiche WebLink
GRANT APPLICATION Page 1 of 7 <br />(Type and Complete All Items) <br />Application for State Assistance Through the <br />'COMMUNITY SERVICES TRUST FUND <br />DEPARTMENT OF COMMUNITY AFFAIRS , <br />DIVISION OF COMMUNITY. SERVICES SUBMIT FOUR (4) COPIES <br />2571 EXECUTIVE CENTER CIRCLE, EAST OF THIS 1PPLICATION <br />TALLAHASSEE, FLORIDA 32301 Due Date: "IARGH 15, 1978 <br />1. Local Governmental Unit Applying for Grant: <br />Name: Indian River County Commission Telephone: (305 ) 562-4186 <br />name of town, city or county) <br />Address: Indian River County Courthouse, Vero Beach, Fla. 32960 <br />County: Indian River <br />2. Date Submitted: March 3, 1978 <br />3. Official with over-all responsibility of grant: (Our Department will <br />contact this person should questions arise in the application process): <br />Name: Terrence D. Marr Tele?hone: ( 305) 562-9037 <br />Address: 3705 16th St. -.Vero Beach, Fla. 32960 <br />Sianature: <br />4. Due to new legislative requirements, all services must be certified by <br />the Department of Health and Rehabilitative Services (HRS) District <br />Administrator as not being duplicative. In -order to accomplish this <br />requirement, all applicants must contacL the District Administrator <br />prior to development of program proposals. Therefore, complete the <br />following: <br />HRS person contacted: Dr. Richard Grimm <br />(District Administrator) <br />Telephone: (305) 683-6603 Date: March 2, 1978 <br />Contacted by: Terrence D. Marr <br />Telephone: ( 305) 562-9037 <br />5. Following the completion of the grant application, formal approval of <br />the program proposal must be given by the HRS District Administrator. <br />Anvlications will not be accepted unless the following statement is <br />completed by the HRS Administrator: <br />11 _nr_ Richard Grimm , the District HRS Administrator <br />for District' .Jg , hereby certify one of the following statements of <br />fact: <br />�C 1. The particular services to be offered in the <br />signature) listed programs are not duplicative of'HRS proarams. <br />Although similar services may he available from HRS, <br />we cannot provide these particular services to these <br />clients without the use of this money. <br />2. HRS has made maximum use of federal funds for the <br />(signature) above listed program areas: <br />3. Funds for this program are available from HRS and <br />signature) the applicant will be eligible for funding during <br />the current grant period. The applicant should con- <br />tact Mr./Ms. for further <br />information. <br />Page 1-C <br />FEB 2219.7 <br />