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SEP 51979 <br />GRANT APPLICATION Page 6 of 7 <br />Boor 41 470 <br />Local Governmental Unit Applying: Indian Riverotnty <br />(Town, County, or City) <br />Delegate Agency Budget - Complete one for each Delegate Agency <br />11rogram Name: <br />Name of Dele;ate Agency: Vocational Training -&Sheltered Workshop In Indinn Ri-el <br />Address: 1385 16th, Vero Becch. Fla zip:32960 Co. Inc. <br />Contact Person: John M. Rezanka <br />Telephone: 0 05) 652-6854 <br />Tax Exempt Number: <br />if none, attach a copy of the certificate of <br />incorporation) <br />�iD:IINIST 1ATIVE EXPENSES CASII IN -::IND <br />1. <br />Salaries <br />444.22 <br />2. <br />Rental________________ <br />3. <br />Travel <br />4. <br />Suaplies_______________ <br />5. <br />Other (specify_on <br />attachment) _ _ <br />_ _ <br />6. <br />TOTAI. (lines_1_through_5) <br />_ _ _ _ <br />_ _ 444.22 <br />PROGRAM EXPENSES <br />7. <br />Salaries <br />8. <br />Rentral :space_____________ <br />1480.50 <br />9. <br />Travel <br />10. <br />Equipment _ <br />2500.00 <br />11. <br />Other (saecify_on <br />attachment) _ _ <br />_ _ 1497.28 <br />12. <br />TOTAL (lines_7_through_ll)_ <br />_ _ _ <br />_ _ 3997.28 <br />13. TOTAL EXPENSES—(line-6—and—line 12) 5922.00 <br />THE DELEGATE. AGENCY HEREBY APPROVES TRIS APPLICATION AND 'FILL COMPLY <br />WITH ALL RULES, REGULATIONS AND CONTRACTS RELATING TIERETO: <br />? <br />APPROVED BY: Paul A. Barbee �i,+r.1 <br />President of Board <br />ATT ^STED BY. John M. Rezanka <br />N ame <br />Director <br />Title <br />