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r (at AXI A�JeLl(�ATIUN - aCe b Or. <br />-��UL.21 1982 six 50 Pr,�;5 <br />. �i_ <br />Local Coveta2. U. -4i` App Ivy ag : INDIAN RIVER COUNTY <br />�1 <br />*'This pace applicable only to p=-; vat_delegata acanc:es <br />Complete a separate page 6 for each delegata ager.c: prcvider <br />o ros` ail name: DEVELOPMENTAL TRAINING <br />Name of Oelecate Agency: Vocational Training and Sheltered Workshop in Indian <br />Addz. ess : 1385 16th Ave, Vero Beach, ffatyIA98- <br />Contact Person: Richard Szott <br />Telephone: (305 ) 562-6854 <br />Tax Exempt Number: <br />59-164-7746 <br />l= none, attach a copy of. the certificate of <br />incorporation) <br />ADMINISTHATIV^c {?ENSES <br />1. Salaries <br />2. 'Rental <br />CASH <br />s <br />3. <br />Travel. <br />• 4. <br />Supplie$,_ <br />S. <br />Other (specify on attachment) <br />6 . <br />TOTAL, ( lines I through S) <br />PROGRAM EXPrNSLs <br />7. <br />Salaries <br />8. <br />Rental Space <br />1529.75 <br />9. <br />Travel <br />---------- <br />3.0. <br />Equipment <br />2789.25 ' .. <br />11. <br />Other (specify on attachment) <br />•1.800.00 <br />_ 12. <br />TOTAL ( lines 7 through 11) <br />.4589.25 <br />.1529.75 . <br />13. <br />TOTAL EXPENSES (line 6 and line <br />12) 4589.25 <br />TOTAL BUDGET <br />6119.00 <br />THE. <br />WITH <br />DELEGATE AGENCY HEREBY APPROVES THIS ���ATION <br />ALL RULES, 'REGULATIONS <br />AND WILL COMPLY <br />AND CONTRAC <br />L.AT1�VG F.E. <br />=0: <br />APPROVED BY:* FKanklin H. Cox <br />President of Board-.. <br />(Signature) <br />' <br />Typed Name <br />ATTESTED BY: Richard Szott <br />qL, �, It <br />I <br />Typed Name <br />(Signature) <br />Executive Director�Acting <br />Title <br />BY ATTACH.Z.T Tvti <br />. NY L__ � I__.l <br />OVER. $500. <br />