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GRANT NAME: GRANT # LPA0018 AMOUNT OF GRANT: $650,000 DEPARTMENT RECEIVING GRANT: Public Works CONTACT PERSON: Keith McCullyv. P.E. TELEPHONE: (772) 226-1562 1. How long is the grant for? 30 months Starting Date: 2. Does the grant require you to fund this function after the grant is over? Yes No 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 N/A 5. Grant match amount required -n- 6. Where are the matching funds coming from (i.e. In -Kind Services; Reserve for Contingency)? N/A — NO MATCH REOUIRED Yes X_ No Yes No 7. Does the grant cover capital costs or start-up costs? _� Yes 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? If yes, please list. (If additional space is needed, please attach a schedule.) Yes No Acct. Description Position Position Position Position Position 011.12 Regular Salaries $ 0 Second Year $ $ $ 011.13 Other Salaries & Wages (PT) $ $ $ $ Fourth Year 012.11 Social Security $ $ Fifth Year $ $ 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? N/A Salary and Benefits Operating Costs Capital Total Costs 10. What is the estimated cost of the grant to the county over five years? $n Signature of Preparer: Zeit! 1/2,ea€4 Date: 1/14/2020 73 Grant Amount Other Match Costs Not Covered Match Total First Year $ 650,000 $0 $0 $ 0 Second Year $ $ $ $ Third Year $ $ $ $ Fourth Year $ $ $ $ Fifth Year $ $ $ $ Signature of Preparer: Zeit! 1/2,ea€4 Date: 1/14/2020 73