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Page 2 of a <br />Florida Department of Community Affairs <br />CONMIINITY SERVICES BLOCK GRANT APPLICATION <br />FEDERAL FISCAL YEAR 1994 CONTRACT PERIOD: 4-1-94 to 9/30/94 <br />aaaassa¢asssxasaasaaassaasamaaaasesssssasssassssssassss..a ssassassosasasassaaa <br />FOR DCA USE ONLY <br />POSTMARK DATE: CONTRACT NO: <br />DATE RECEIVED: GRANT TYPE: 90% [ ] 5% [X] D&R ( ] <br />REVISION RECD: DCA CONSULTANT: <br />¢a¢¢aaasaa¢sagaaa¢aaxaaaasa¢saasasaas¢asaasassaa¢x¢aax¢xax=¢¢ <br />aaaaaxaxaaa¢a¢s¢¢ <br />INSTRUCTIONS: Please complete all parts in this Application which are <br />applicable to your organization. If any part does not apply, write "N/A". <br />Do not use white-out (correction fluid) on any part of this application. <br />ssassaaosssssss¢aa¢¢es¢asaaxaaaas¢asssaaasass:¢xxamasaasaaaa¢aasaxaaasaaasass¢ <br />I. APP XCANT CATEGORY: ( ] Eligible Entity pt] Local Government <br />[ J Migrant/Seasonal Farmworker organization <br />II. GENERAL ADMINISTRATIVE INFORMATION <br />a. Name of Applicant: Indian River rnunty <br />b. Applicant's Address% 1840 25th Strppt - <br />City: Vero Beach, Florida Zip Code: 32960-3394 <br />Telephone: ( 407 ) 567-8000 county: Tnrlian Rijwx <br />C. Applicant's Mailing Address (if different from above): <br />Indian River Coun_y Housing Authority <br />]j]iR 91)th Plain C»ito (' t/crn Rcnnh Flnr;d _ Zip Code "i9960 <br />d. Chief official or Executive Director: ft L Decker Jr. <br />Title: Executive Director <br />e. Name of Official to Receive State Warrant: <br />Title: Indian River County Finance Department <br />Address: 1840 25th Street <br />Vero Beach. Florida Zip Code 39960-3394 <br />f. Name of Contact Person: Richard Watkins <br />Title: Finance Director <br />Address: 1840 25th Street - <br />Vero Beach, Florida Zip Code: 37960-3394 <br />Telephone: ( 407) 562-8000 Fax: ( ) <br />g. Federal ID #: 59-6000674 _ <br />****************************************************************************** <br />III. SUBGRANTEE INFORMATION <br />a. These funds will be transferred to: [x] I subgrantee(s) [ ] None <br />b. Give the names of subgrantees included in this application: <br />Name and address of subaranteels) contact person & Telephone <br />Indian River County Housing Authority Guy L. Decker, Jr. <br />1028 20th Place, Suite C Executive Director <br />Vero Beach, Florida 32960 (407) 770-5014 <br />