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GRANT NAME: FDOT LAP 871 Street from 101" Avenue to CR 51(1 <br />AMOUNT OF GRANT: $1.21L453-00 <br />DEPARTMENT RECEIVING GRANT: Public Works <br />GRANT # 431728-1-58/68-01 <br />CONTACT PERSON: Christopher J. Kafer, Jr.. P.E. Count Engineer TELEPHONE: (772) 226-1221 <br />1. How long is the grant for? Until June 30, 2017 Starting Date: Letting Date prior to 8/7/2015 <br />2. Does the grant require you to fund this function after the grant is over? Yes X No <br />3. Does the grant require a match? Yes _X —No <br />If yes, does the grant allow the match to be In -Kind services? Yes No <br />4. Percentage of match to grant N/A <br />5. Grant match amount required <br />6. Where are the matching funds coming from (i.e. In -Kind Services; Reserve for Contingency)? <br />7. Does the grant cover capital costs or start-up costs? <br />If no, how much do you think will be needed in capital costs or start-up costs: <br />(Attach a detail listing of costs) <br />8. Are you adding any additional positions utilizing the grant funds? <br />If yes, please list. (If additional space is needed, please attach a schedule.) <br />Yes X No <br />$ N/A <br />Yes X No <br />Acct. <br />Description Position Position Position Position Position <br />011.12 <br />Regular Salaries <br />011.13 <br />Other Salaries & Wages (PT) <br />012.11 <br />Social Security <br />012.12 <br />1 Retirement – Contributions <br />012.13 <br />Insurance – Life & Health <br />012.14 <br />Worker's Compensation <br />012.17 <br />S/Sec. Medicare Matching <br />$ <br />TOTAL <br />9. What is the total cost of each position including benefits, capital, start-up, auto expense, travel and operating? <br />Salary and Benefits Operating Costs Capital Total Costs <br />10. What is the estimated cost of the grant to the county over five years? $ 0 <br />i <br />Signature of Prepare( -00 <br />Date: aG sZ ,? - /s <br />124 <br />Grant Amount <br />Other Match Costs Not Covered <br />Match <br />Total <br />First Year <br />$ 1,211,453.00 <br />$ <br />$ <br />$ 1,211,453.00 <br />Second Year <br />$ <br />$ <br />$ <br />$ <br />Third Year <br />$ <br />$ <br />$ <br />$ <br />Fourth Year <br />$ do <br />$ <br />$ <br />$ <br />Fifth Year <br />$ <br />$ <br />i <br />Signature of Prepare( -00 <br />Date: aG sZ ,? - /s <br />124 <br />