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EXHIB r A� <br />AGENCY REQUEST FOR FUNDING FROM Indian River COUN TY <br />A. Program Cover Page FISCAL YEAR 2020/2021 <br />Agency: Veterans Council of Indian River <br />County, Inc. Telephone: 772.410.5820 <br />Contact Person: Pat Geyer Dir. Line 772-205-1995 <br />Title: Chair—Finance Committee <br />Address: PO Box 1354 <br />Vero Beach, FL 32961 <br />Website Address: www.veteranscouncilirc.org <br />E -Mail: patriciajgeyer@gmail.com <br />Program Title: I I dI1DNunauvn or veterans to VA <br />medical facilities locally and WPB <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 sour4 <br />Ken Dale Treasurer <br />Si atu a Print name and tile . <br />Brie description of the Program for which funding is requested <br />The Program provides transportation for veterans and caregivers from Indian River County to and from <br />medical appointments locally and to the Veterans Administration Medical Center in West Palm Beach, FL <br />at no charge to the veteran. <br />aummary Keport <br />Amount requested from Indian River County for 202012021: $90,000 <br />Total Proposed Program budget for 2020/2021: $90,000 <br />Percent of total Program budget: 100% <br />Current Funding (2019/2020) $90,000 <br />Dollar increase / (decrease) in request: 0 <br />Percent increase / decrease in requests 0% <br />�`t �+"�+. •• u v!u v1 IIIVI C UI IClly eX�iain <br />VA <br />The Organization's Board of Directors has approved this application on (date): April 29, 2020 <br />Martin i k .rtolon I AF (ret) <br />Name of President/Chair of the Board <br />Jim Romanek <br />Name of Exec. Director <br />i <br />EXHIBIT A <br />I <br />