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Last modified
12/9/2019 3:43:20 PM
Creation date
12/9/2019 3:43:18 PM
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Template:
Resolutions
Resolution Number
2019-01ESD
Approved Date
12/03/2019
Agenda Item Number
15.A.2.
Resolution Type
ESD Grant
Entity Name
Emergency Services District (ESD)
Subject
Medical Services (EMS) Grant Award Application
to the State of Florida Department of Health, Bureau of Emergency Medical Services
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Instructions: County Government Application Form 2019-2020 <br /> The amount of your new grant is in the "Total" column of the county amount table at the state EMS website link. <br /> The first application form page has five numbered items. The first three are self-explanatory. <br /> However, note that Item 2 on the first application page is where the county's authorized person must provide his/her <br /> signature and date. <br /> Item 4 describes the content of the "resolution." Please provide this in your county's customary format and approval <br /> process. The resolution must be current; or if a previous resolution has continuing authority, include a message <br /> from a lead county official stating that the resolution is still in-effect, with a copy of it. <br /> Item 5 of the first page of the application form asks for the name of the organization(s) to which you decide to <br /> allocate funds from your new county grant. The second page of the application form is the budget page, and one of <br /> these budget pages is needed for each organization listed in item 5, <br /> The budget page for each organization must have on it specific and quantifiable items or services, with the cost for <br /> each unit or type of item or service. <br /> All costs combined must total to the exact amount of new funds for your grant. You can request budget changes <br /> after the new grant begins. <br /> Your budget totals in the application should be added for you if you place your cursor over a subtotal or total field, <br /> right click your mouse, then left click "Update Field." <br /> You should copy this form on your computer to use it. If you place the application in restricted editing mode, you can <br /> use your keyboard Tab key to go from field to field. <br /> Request for Grant Fund Distribution Form <br /> Request for Grant Fund Distribution Form: this is the last page herein and you must complete the top part of the <br /> form. State EMS will complete the bottom part, as indicated on the form. The address on this form must be an <br /> address in the state MyFloridaMarketplace (MFMP) system. A mailing address you place on this form is not usable <br /> by state finance if it is not in the MFMP system. <br /> Ask a staff member of your organization who does cash transactions with the state for the organization name to use <br /> on the Distribution Form, the address, and its corresponding 9-digit federal tax ID plus its 3-digit sequence code. <br /> Otherwise, no funds can be sent to you until this situation is resolved. <br /> If needed, you can contact MFMP customer service at 1-866-352-3776 Monday to Friday, 8 a.m. to 6 p.m., or by <br /> email at: MyFloridaMarketPlace(a�dms.myflorida.com. <br />
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