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GRANT NAME: EMS County Awards Grant GRANT # N/A <br />AMOUNT OF GRANT: $ 25.048.00 <br />DEPARTMENT RECEIVING GRANT: Fire Rescue <br />,,.,. CONTACT PERSON: Brian Burkeen PHONE NUMBER: 772-226-3864 <br />1. How long is the grant for? 1 year Starting Date: FY 2014/15 <br />2. Does the grant require you to fund this function after the grant is over? Yes X No <br />3. Does the grant require a match? Yes X No <br />If yes, does the grant allow the match to be In Kind Services? (N/A) Yes No <br />4. Percentage of match N/A 0% <br />5. Grant match amount required $ N/A <br />6. Where are the matching funds coming from (i.e. In Kind Services; Reserve for Contingency)? N?A <br />7. Does the grant cover capital costs or start-up costs? Yes X No <br />If no, how much do you think will be needed in capital costs or start up costs <br />(Attach a detail listing of costs) $ <br />8. Are you adding anadditional positions utilizing the grant funds? Yes X No <br />If yes, please list. Radditional space is needed, please attach a schedule.) <br />Acct. <br />Description <br />Position <br />Position <br />Position <br />Position <br />Position <br />011.12 <br />Regular Salaries <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />011.13 <br />Other Salaries & Wages (PT) <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />012.11 <br />Social Security <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />012.12 <br />Retirement -Contributions <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />012.13 <br />Insurance -Life & Health <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />012.14 <br />Worker=s Compensation <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />012.17 <br />S/Sec. Medicare Matching <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />TOTAL <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />9. What is the total cost of each position including benefits, capital, start-up, auto expense, travel and operating? <br />Salary and Benefits <br />Operating Costs <br />Capital <br />Total Costs <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />10. What is the estimated cost of the grant to the county over five years? <br />Signature of Preparer: Z ! _ Date: November 4, 2014 <br />324 <br />Grant <br />mount <br />Other Match Costs <br />Not Covered <br />Match <br />Total <br />First Year <br />$ N/A <br />$ N/A <br />$ N/A <br />$ N/A <br />Second Year <br />$ N/A <br />$ N/A <br />$ N/A <br />$ N/A <br />Third Year <br />$ N/A <br />$ N/A <br />$ N/A <br />$ N/A <br />Fourth Year <br />$ N/A <br />$ N/A <br />$ N/A <br />$ N/A <br />Fifth Year <br />$ N/A <br />$ N/A <br />$ N/A <br />$ N/A <br />Signature of Preparer: Z ! _ Date: November 4, 2014 <br />324 <br />