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2013-2014 VOCA GRANT APPLICATION P4RT 1. APPLICANT INFORMATION ,%,,.ame of Applicant Agency: The applicant agency is the legal name of the agency that is seeking VOCA funding. Enter the name as it should appear on a contract in the event the agency receives VOCA funding. Indian River County Sheriffs Office Federal Data Universal Numbering System (DUNS) Number: 039894332 Federal Employee Identification Number(FEIN): 59-66000675 Registered with the System of Award Management (formerly CCR)? IYES Agency Director: Prefix(Mr.,Ms.,Dr.,etc.) Mr. Title:I Sheriff —� Name:lDeryl Loar Telephone#: 772-569-6700 x 6404 Fax#: 772-569-8144 Mailing Address:14055 41 st Avenue (Street, P.O.Box,etc.) City: Vero Beach State: FI 9-Digit Zip Code: 32960-1802 E-Mail Address: idloar@ircsheriff.org Performance Report Contact: Prefix(Mr., Ms., Dr.,etc.) Mrs. Title:IVictim Advocates Coordinator Name]Shirley Rosemond �.- Telephone#:1772-978-6255 Fax#: 772-569-8144 1 Mailing Address: 4055 41 st AV (Street, P.O.Box,etc.) City:lVero Beach I State: FI 9-Digit Zip Code: 32960-1802 E-Mail Address: srosemon iresheriff.or Financial Contact: Prefix(Mr., Ms., Dr.,etc.)El Title:I Planner Name:I Kimberly Poole Telephone#: 772-978-6214 Fax#: 772-569-8144 Mailing Address: 4055 41 st AV (Street,P.O. Box, etc.) City:IVero Beach I State: FI 9-Digit Zip Code: 32960-1802 E-Mail Address: k oole iresheriff.or I acknowledge that 1 have read, understand, and agree to the conditions set forth in the Victims of Crime Act Grant Application, Instructions and the Final Program Guidelines for the duration of the grant period. I certify that any VOCA grant funds that this agency might receive will not be used to supplant any state and local funds that would otherwise be available for crime victim services. Further, I certi that the information contained in this application is true, Fplete and correct. Signature of Agency Director: �'V" Date:Al!) V3 87