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0/t-teik a.kr . l , s, ! • v 0 r� , <br />EXHIBIT A <br />COMMI88ION FOR THE TRANSPORTATION DISADVANTAGED <br />95/96 GRANT APPLICATION INFORMATION FORM <br />CONCERNING PLANNING RELATED ACTIVITIES <br />FOR THE NON -SPONSORED <br />1. DATE SUBMITTED: April 20, 1995 <br />2. LEGAL NAME OF ORGANIZATION: I.R.C. Community Development Dept. <br />3. ADDRESS: 1840 25th Street <br />4. EITY AND STATE: Vero Beach, FL ZIP CODE: 32960 <br />5. CONTACT PERSON FOR THIS GRANT: <br />Sasan Rohani, AICP <br />6. PHONE NUMBER: (007) 567-8000 ext. 250 <br />7. COUNTY FOR WHICH THIS GRANT APPLIES: Indian River County <br />8. PROPOSED PROJECT START DATE: Jan. 1, 1996 ENDING DATE: Dec. 31, 1996 <br />9a. ESTIMATED PROJECT FUNDING: b. PLANNING FUND ALLOCATION <br />TRANSFERRED TO TRIP GRANT <br />State $ 13,697.00 <br />TOTAL $ 13,697.00 <br />State $ 4,000.00 <br />10. I hereby certify that this document has been duly authorized by <br />the governing body of the applicant and the applicant will <br />perform tasks identified in the application manual and comply <br />with any attached assurances if the financial assistance is <br />awarded. <br />a. Robert M. Keating, AICP Community Development Director <br />TYPED NAME OF AUTHORIZED REPRESENTATIVE AND TITLE <br />b. PH• NUMBER OF PERSON ABOVE: (407) 567-8000, ext. 254 <br />C. <br />IGNATURE OF AUTHO <br />ESENTATIVE DA'E <br />11. I hereby certify that this grant, including the budget detail, <br />baA beAD reviewed and approved in its entirety by the <br />Indian an ver County Coordinating Bqa d. <br />�� <br />Form Rev. 12/27/94 <br />Corrmissfoner CarK. Eggert <br />COORDINATING BOARD CHAIRPERSON SIGNATURE <br />PL Grant Appl. Page 1 <br />