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r EXHIBIT A <br />AGENCY REQUEST FOR FUNDING FROM Indian River COUNTY <br />FISCAL YEAR 202012021 <br />A. Program Cover Page <br />Agency: <br />Senior Resource Association <br />Contact Person: <br />Jennifer Johnson <br />Title: <br />Vice President, Chief Financial Officer <br />Address: <br />694 14th Street <br />Vero Beach, FL 92960 <br />Website Address: <br />www.SeniorResouceAssociation.org <br />Program Title: <br />Senior Services <br />i � r <br />Telephone: 772.469.3141 <br />Fax: 772.778.7272 - <br />E -Mail: jjohnson@sramail.org <br />I certify that information contained in this application accurately reflects the activities of this agency and <br />that the expenditures or portions thereof for which County funds are being requested are not reimbursed <br />by any other source. <br />ohnson <br />Jennifer Johnson Date 2" 0.05.0igned bY'12L56- 4'00' <br />Date 2020.05.01 10:1256-0400• Jennifer Johnson, Vice President, Chief Financial Officer <br />Signature <br />Print name and title <br />i <br />tenet description of the Program Tor which Tunoing Is requested: <br />Senior Resource Association (SRA) is requesting match dollars for the Community Care for the Elderly, Alzheimer's Disease <br />Initiative, Home Care for the Elderly and the Older American Act grants. Services are provided to encourage and enhance the <br />natural support system of an older adult, with special emphasis on caregivers and families. <br />ziummary Kepori <br />Amount requested from Indian River County for 202012021: $ 132,200 <br />Total Proposed Program budget for 2020/2021: $ 2,563,500 <br />Percent of total Program budget: 5 % <br />Current Funding (2019/2020) $ 125927 <br />Dollar increase / (decrease) in request: _$6,273 <br />Percent increase / decrease in request. 5 % <br />If request increased 5% or more, briefly explain why: <br />SRA is not requesting funding over 5%. <br />April 23, 2020 <br />The Organization's Board of Directors has approved this application on (date) <br />Don Wright `��—�--- <br />Name of President/Chair of the Board Signature t <br />Karen B. Rose Deigl <br />Name of Exec. Director/CEO Signature <br />i <br />EXHIBIT A I <br />