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GRANT NAME: Community Development Block Grant GRANT # AMOUNT OF GRANT: $750,000 ($615,500 towards project, $112,500 towards grant administration) DEPARTMENT RECEIVING GRANT: Community Development Department CONTACT PERSON: Bill Schutt TELEPHONE: 226 - 1243 1. How long is the grant for? 2 years Starting Date: October 2018 (estimated) 2. Does the grant require you to fund this function after the grant is over? Yes X No 3. Does the grant require a match? __X_Yes No If yes, does the grant allow the match to be In -Kind services? Yes X No 4. Percentage of match to grant 0% required (6.66% for max. points in competitive jzrant) 5. Grant match amount required $50,000 (max. required for max. points in competitive grant) 6. Where are the matching funds coming from (i.e. In -Kind Services; Reserve for Contingency)? State Housing Initiatives Partnership program 7. Does the grant cover capital costs or start-up costs? X Yes No 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? Yes X No If yes, please list. (If additional space is needed, please attach a schedule.) 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 the estimated cost of the grant to the county over five years? $N/A Signature of Preparer: Date: Attachment 5 Grant Amount Other Match Costs Not Covered Match Total First Year $ $ $ $ Second Year $ $ $ $ Third Year $ $ $ $ Fourth Year $ $ I $ $ Fifth Year $ $ I $ $ Signature of Preparer: Date: Attachment 5