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GRANT NAME: 2016 Small Scale Derelict Vessel Removal Program i AMOUNT OF!GRANT: $4,500 i DEPARTMENT RECEIVING GRANT: Public Works/Coastal Engineering t CONTACT PERSON: James D. Gray, Jr. 1. How long is the grant for? Unspecified 2. Does the grant require you to fund this function after the grant is over? 3. Does the giant require a match? If yes, does the grant allow the match to be In -Kind services? 4. Percentage+of match to grant 25.00% i 5. Grant match amount required $1,125 GRANT No. FIND ICW-IR-16-01 TELEPHONE: ext. 1344 Starting Date: Upon grant execution YES NO X 6. Where are the matching funds coming from (i.e. In -Kind Services; Reserve for Contingency)? 7. Does the giant cover capital costs or start-up costs? If no, how much do you think will be needed in capital costs or start-up costs (Attach a detail listing of costs) 8. Are you adding any additional positions utilizing the grant funds? If yes, please list. (If additional space is needed, please attach a schedule.) X M No No Acct. Description Position Position Position Position Position 011.12 Regular Salaries 011 13 Other Salaries & Wages (PT) 012.11 Social Security 012.12 Retirement — Contributions 012.13 Insurance — Life & Health 012.14 Worker's Compensation 012.17 S/Sec. Medicare Matching $ TOTAL 9. What is the total cost of each position including benefits, capital, start-up, auto expense, travel and operating? Salary and Benefits Operating Costs Capital Total Costs 10. What is th i estimated cost of the grant to the county over five years? $ $=� Grant Amount Other Match Costs Not Covered Match Total First Year $ $ $ $ Second Year $ $ $ $ Third Year $ $ $ $ Fourth Year $ $ $ $ Fifth Year $ $ $ 1 $ Signature of PreparersM k Date: 41511h 90