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GRANT NAME: State Aid to Libraries GRANT # AMOUNT OF GRANT: $100,798 Estimated DEPARTMENT RECEIVING GRANT: General Services / Library Services CONTACT PERSON: Anne Shepherd TELEPHONE: 772-770-5060 1. How long is the grant for? One Year 2. Does the grant require you to fund this function after the grant is over? 3. Does the grant require a match? If yes, does the grant allow the match to be In -Kind services? 4. Percentage of match to grant % 5. Grant match amount required Starting Date: October 1, 2018 Yes X No - Yes ___X__No Yes No 6. Where are the matching funds coming from (i.e. In -Kind Services; Reserve for Contingency)? 7. Does the grant cover capital costs or start-up costs? Yes ___.K__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: Cj 1 Date: - .9 Grant Amount Other Match Costs Not Covered Match Total First Year $ $ $ $ Second Year $ $ $ $ Third Year $ $ $ $ Fourth Year $ $ $ $ Fifth Year $ $ $ $ Signature of Preparer: Cj 1 Date: - .9