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GRANT NAME: FDOT Small County Outreach Program (SCOP)CONSTRUCTION AND CEI (RESURFACING) OF <br />69th. STREET FROM 66TH AVENUE TO SR5/US-1, <br />GRANT # 438073 -1 -54 -OI <br />AMOUNT OF GRANT: $1,128,607.00 <br />DEPARTMENT RECEIVING GRANT: Public Works <br />CONTACT PERSON: James W. Ennis. P.E. PMP, Countyengineer TELEPHONE: <br />(772) 226-1221 <br />L How long is the grant for? Until December 31, 2022 Starting Date: Once FDOT issues NTP <br />2. Does the grant require you to fund this function after the grant is over? <br />Yes X No <br />3. Does the grant require a match? X <br />Yes No <br />If yes, does the grant allow the match to be In -Kind services? <br />Yes X No <br />4. Percentage of match to grant 45.876 % <br />012.13 <br />5. Grant match amount required $ 956.620.00 <br />012.14 <br />6. Where are the :matching funds coming from (i.e. In -Kind Services; Reserve for Contingency)? <br />012.17 <br />7. Does the grant cover capital costs or start-up costs? <br />Yes _X No <br />If no, how much do you think will be needed in capital costs or start-up costs: $ N/A <br />$ <br />(Attach a detail listing of costs) <br />Fourth Year <br />8. Are you adding any additional positions utilizing the grant funds? <br />Yes _2L—No <br />If yes, please list. (If additional space is needed, please attach a schedule.) <br />$ <br />Acct. <br />Description Position Position Position Position Position <br />011.12 <br />Regular Salaries <br />011.13 <br />Other Salaries '& Wages (PT) <br />012.11 <br />Social Security <br />012.12 <br />1 Retirement — Contributions <br />012.13 <br />Insurance — Life & Health <br />012.14 <br />Worker's Compensation <br />012.17 <br />_S/Sec. Medicare .Matching <br />$ <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? $ 956.620.00 <br />Signature of Preparer: Date: t 2 Z ZM&O <br />26 <br />Grant Amount. <br />Other Match Costs Not Covered <br />Match <br />Total <br />First Year <br />$ 1,128,607.00 <br />$ <br />$956,620.00 <br />$ 2,085,227.00 <br />Second Year <br />$ <br />$ <br />$ <br />$ <br />Third Year <br />$ <br />$ <br />$ <br />$ <br />Fourth Year <br />$ <br />$ <br />$ <br />$ <br />Fifth Year <br />$ <br />$ <br />$ <br />$ <br />Signature of Preparer: Date: t 2 Z ZM&O <br />26 <br />