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GRANT NAME: Homeland Security GRANT# 13-DS-97-08-39-01-XXX <br /> AMOUNT OF GRANT:$ 15,778.00 <br /> DEPARTMENT RECEIVING GRANT: Emergency Services <br /> 'ONTACT PERSON:_ John King PHONE NUMBER: 226-3859 <br /> 1. How long is the grant for? 18 months Starting Date: October 1,2012 <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 /> Ifyes,does the grant allow the match to be In Kind Services? Yes No <br /> 4. Percentage of match N/A p�/a <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)?_ <br /> 7. Does the grant cover capital costs or start-up costs? Yes 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 anase dditional positions utilizing the grant funds? Yes ---X—No <br /> If yes,please list. Nadditional space is needed,pleaattach a schedule.) <br /> Acct. Description Position Position Position Position Position <br /> 011.12 Regular Salaries NIA <br /> 011.13 Other Salaries&Wages(PT) NIA <br /> 012.11 Social Security N/A <br /> 012.12 Retirement-Contributions N/A <br /> 012.13 Insurance-Life&Health N/A <br /> 012.14 Worker=s Compensation N/A <br /> +12.17 S/Sec.Medicare Matching NIA <br /> TOTAL 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 Operating Costs Capital Total Costs <br /> NIA N/A N/A N/A <br /> 10. What is the estimated cost of the grant to the county over five years?$ <br /> Grant Other Match Costs <br /> Amount Not Covered Match Total <br /> First Year $ 15,778.00 $ N/A $ N/A $ 15,778.00 <br /> Second Year $ N/A $ $ $ N/A <br /> Third Year $ $ $ $ <br /> Fourth Year $ $ $ $ <br /> Fifth Year $ IF $ IF $ $ <br /> ,gnature of Preparer: Date: ) �'•13 <br /> 98 <br />