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n <br />s <br />GRA14T APPLICATION Page 4 of 7 <br />Name of Applicant: Indian River County Commission <br />Fiscal Officer Responsible for Grant: <br />!lame: Mr. 4�illiam Jackson Finance Officer <br />Address: Count Courthouse 2145 <br />Telephones 305 562-7927 <br />3^. Tn"'AL <br />11. TOTAL BIWET <br />and line_29)_ _ _ <br />8,090.00 <br />(Include figures from all programs operated) <br />F}:T'I^IT))TIM , (Lino 17 .anti <br />1. <br />REVF.NIIF. _ .. •_ - - <br />a4 -Ar: <br />1. <br />State Grant__ _____________ <br />-Match <br />4128.00 <br />2. <br />Cash (no federal ftmds, ee�t„seye�ne_shat3i,��w�dL <br />2064.00 <br />3. <br />In=K1nd Vatch <br />3100.00 <br />----------__ ------ <br />9292.00 <br />rMANTRF. AnMTNTSTFATT.VF EXPFNSF <br />5. <br />Salaries _ _ <br />0 <br />6. <br />vental Space--------------_.------ <br />7. <br />Travel ---------- -'------ <br />8. <br />Sunn1 iPs- - - - - - - - - - - - - - - - - - - .. - - - <br />9. <br />Other (snscifv on atta-chment) - - - - - - - - - - <br />10. <br />Total (lines_5_throuah-9 _ _ _ _ _ _ _ _ _ _ _ _ _ ` <br />DELEGATE ADMTI-IISTRATIVF. EXPENSE <br />11. <br />Salaries 1100 in kind <br />1,136.00 <br />12. <br />ReRtalSUace-------------i-- - - -_-- <br />0 <br />13. <br />Travcel------------------- - - - - -- <br />40.00 <br />14. <br />Supplies----------------------- <br />26.00 <br />15. <br />- - - - - - <br />Other (snecifyon attachRent'T <br />0 <br />16. <br />_ _ _ _ _ - <br />ns 11 through 16) - - - --- - <br />Total (lie <br />1.202.00 <br />17. <br />_- <br />T7_AL AP2KIVZSTPATIVF._CCSTS* (Line 10 -and Line 167 _ <br />1.202.00 <br />GRANT::F PR,)GPAM F.XPFNSE <br />18. <br />Salaries-__-__ <br />0 <br />19. <br />____ <br />ental Soace '- - - - - - - - - - <br />-__--------.---------- <br />0 <br />26. <br />TravPl <br />0 <br />21. <br />I:t?uinment-- - - - -- <br />------------ <br />0 <br />22. <br />-- �' <br />C`ther (snecif�� on attachmentt -_ -_ <br />0 <br />23. <br />_ _ _ _ _ _ _- _- <br />i'otal 71ir.es_1R through 22) <br />0 <br />D1'IV!rATr Pry fZn% 1"4 rXPENSF <br />24. <br />Salaries -2000 in-kind <br />5,600.00 <br />25. <br />pental Sna-e--------------- --- <br />1,500.00 <br />25. <br />Tr_-��►n•.1------------------------ <br />365.00 <br />27. <br />1•:nuit�rtint---------------- - - - - -- <br />25.00 <br />2R. <br />Ot�7or. (sr'.ec.ifv on atter-chmCrit) - - <br />0.0 <br />29. <br />_2i throgh f _ _ _ _ _ _ sT - _ _ - - - - <br />Total (linesu <br />81090.00 <br />3^. Tn"'AL <br />rrnnPk.+ rXT'V'TISFS (TAnc._23 <br />and line_29)_ _ _ <br />8,090.00 <br />31. T0,11M. <br />F}:T'I^IT))TIM , (Lino 17 .anti <br />line 30) _ _ _ _ _ <br />9,292.00 <br />a4 -Ar: <br />:iOT.J. TIM"411F MUST rOUAL <br />TOTAI. EXPENDITURES <br />*"ay not oxceed 15's of 2 tunes the state ctrant <br />I:F11P•II1I T- : St ztr•• Grant: 10,000 <br />Cash .�'Mxh 5,0no <br />?n -}:inn Klatch in,nn0 <br />TMAL T:I E. I I Ic•; 2 57W6 <br />-tlxi^`I1tT !•tlr+lal.::trrlt'i.v�r Crints - 154 of 2 x $1n,onn (Stage Grant) <br />151 of 201000 <br />$3,Ono <br />Page 4-C <br />i <br />Booz 34 PACE. .1 8 <br />It' <br />a� <br />