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A TRUE COPY CERTIFICATION ON LAST PAGE Instructions: County Government Application Form 2020-2021 J.R. SMITH, CLERK The amount of your new grant is in the "Total" column of the county amount table accessible at the state EMS website link. The first application form page has five numbered items. The first three are self-explanatory. However, note that item 2 on the first application page is where the county's authorized person must provide his/her signature and date. Item 4 describes the content of the "resolution." Please provide this in your county's customary format and approval process. The resolution must be current; or if a previous resolution has continuing authority, include a message from a lead county official stating that the resolution is still in -effect, with a copy of it. Item 5 of the first page of the application form asks for the name of the organization(s) to which you decide to allocate funds from your new county grant. The second page of the application form is the budget page. One of these budget pages is needed for each organization listed in item 5. The budget page for each organization must have on it specific and quantifiable items or services, with the cost for each unit or type of item or service. However, all costs in your budget combined must total to the exact amount of total new funds for your grant. You can request budget changes and add unexpended previous funds after the new grant begins. Your budget totals in the application should be added for you if you place your cursor over a subtotal or total field, right click your mouse, then left click "Update Field" on the resulting menu. You should copy this form on your computer to use it. If you place the application in restricted editing mode, you can use your keyboard Tab key to go from field to field. Request for Grant Fund Distribution Form Request for Grant Fund Distribution Form: this is the last page herein and you must complete the top part of the form. State EMS will complete the bottom part, as indicated on the form. Your address on this form must be an address in the state MyFlorida Marketplace (MFMP) system. A mailing address you place on this form is not usable by state finance if it is not in the MFMP system. Ask a staff member of your organization who does cash transactions with the state for the organization name to use on the top half of the Distribution Form, the corresponding address and its 9 -digit federal tax ID plus its 3 -digit sequence code. Otherwise, no funds can be sent to you until this situation is resolved. If needed, you can contact MFMP customer service at 1-866-352-3776, Monday to Friday, 8 a.m. to 6 p.m., or at the website: MyFloridaMarketPlace(a)dms.myflorida com