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Ll <br />I <br />GRANT APPLICATION Page 1 of _7 r._:. �• <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 <br />2571 EXECUTIVE CENTER CIRCLE, EAST <br />TALLAHASSEE, FLORIDA 32301 <br />SUBMIT FOUR (4) COPIES <br />OF TH19 APPLICATION <br />Due Date: MARCH 15, 197A <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: Tarrenep D. Marr Telephone: ( 305) 562-9037 <br />Address: _3705 16th Vero Bach, Fla. 32960 _ <br />Signature: <br />4. Pue 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 contact 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: <br />(305) 683-6603 <br />Date: March 2, <br />1978 <br />Contacted <br />by: Terrence D. Marr <br />Telephone: <br />( 305) 562-9037 <br />5. Following the completion of the grant application, formal approval of <br />the program proposal must he given by the HRS District Administrator. <br />Anolications will not be accepted unless the following statement is <br />completed by the HRS istrict Administrator: <br />I• nr. Richard Grimm , the,D3.strict HRS Administrator <br />for District _ TX hereby certify one of the following statements of <br />fact: <br />, <br />it,zj� <br />The particular services to be offered in the <br />signature) listed -programs are not duplicative of HRS programs. <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 />�L,,, ►3-; tends for this program are available from HRS and <br />IPA lie applicant will be eligible for funding during <br />he current grant period. The applicant should con- <br />MAM'141978 tact Mr./Ms. for further <br />information. <br />Comnntnity Services <br />• . amniamly Action Gxudmatian <br />r <br />Page 1-C <br />[BOOK 34 FAcF 345 <br />