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GRANT NAME: IRC/SJRWMD Countywide Well-Plugging Cost-Share Agreement GRANT# Contract#35837 <br /> AMOUNT OF GRANT: $20,000 <br /> DEPARTMENT RECEIVING GRANT: Community Development <br /> CONTACT PERSON: Andrew Sobczak TELEPHONE: ext. 1258 <br /> 1. How long is the grant for?Three years(to September 30,2022) Starting Date: October 2020 <br /> 2. Does the grant require you to fund this function after the grant is over? Yes X No <br /> 3. Does the grant require a match? x Yes No <br /> If yes,does the grant allow the match to be In-Kind services? Yes X No <br /> 4: Percentage of match to grant 50% <br /> 5. Grant match amount required $'OPO <br /> 6. Where are the matching funds coming from? <br /> Plannina/Code Enforcement Budget Account#00420724-033190.under"Professional Services"(FY 2020/21.2021/2022, <br /> 2022/2023). <br /> 7. Does the grant cover capital costs or start-up costs? N/A Yes No <br /> If no,how much do you think will be needed in capital costs or start-up costs: N/A <br /> (Attach a detail listing of costs) <br /> 8. Are you adding any additional positions utilizing the grant funds? Yes X No <br /> If yes,please list. (If additional space is needed,please attach a schedule.) <br /> Acct. Description Position Position Position Position Position <br /> 011.12 Regular Salaries <br /> 011.13 Other Salaries&Wages(PT) <br /> 012.11 Social Security <br /> 012.12 Retirement—Contributions <br /> 012.13 Insurance—Life&Health <br /> 012.14 Worker's Compensation <br /> 012.17 S/Sec.Medicare Matching <br /> TOTAL <br /> 9. What is the total cost of each position including benefits,capital,start-up,auto expense,travel and operating? <br /> Salary and Benefits Operating Costs Capital Total Costs <br /> 10. What is the estimated cost of the grant to the county over five years? ,tFnpnn <br /> Grant Amount Other Match Costs Not Covered Match Total <br /> First Year $20,000 $ $20,000 $40,000 <br /> Second Year $20,000 $ $20,000 $40,000 <br /> Third Year $20,000 $ $20,000 $40,000 <br /> Fourth Year $ $ $ $ <br /> Fifth Year $ $ $ $ <br /> Signature of Preparer: Date: <br /> 156 <br />