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GRANT NAME: FDOT Small County Outreach Program (SCOP) CONSTRUCTION (MILLING AND RESURFACING) AND CONSTRUCTION ENGINEERING INSPECTION (CEI) SERVICES FOR 6TH AVENUE FROM SR-5/US-1 TO 21ST STREET. GRANT # 438074-1-54-01 AMOUNT OF GRANT: $1,061,672.00 DEPARTMENT RECEIVING GRANT: Public Works i CONTACT PERSON: James W. Ennis. P.E. PMP, County Engineer TELEPHONE: (772) 226-1221 1. How long is the grant for? Until December31.2023 2. Does the grant require you to fund this function after the' grant is over? 3. Does the grant require a match? i If yes, does the grant allow the match to be In -Kind services? 4. Percentage of match to grant 47.935 I 5. Grant match amount required $ 977.480 1 Starting Date: Once FDOT issues NTP Yes X No X Yes No Yes X No 6. Where are the matching funds coming from (i.e. In -Kind Services; Reserve for Contingency)? 7. Does the grant cover capital costs or start-up costs? Yes X No If no, how much do you think will be needed in capital costs or start-up costs: $ N/A (Attach a detail listing of costs) 8. Are you adding any additional positions utilizing the grant funds? Yes _2�_No If yes, please list. (If additional space is needed, please attach a schedule.) Acct. Description Position Position Position Position Position 011.12 Regular Salaries 011.13 Other Salaries & Wages (PT) 012.11 Social Security 012.12 Retirement — Contributions 012.13 Insurance — Life & Health 012.14 Worker's Compensation 012.17 S/Sec. Medicare Matching $ TOTAL 9. What is the total cost of each position including benefits, capital, start-up, auto expense, travel and operating? Salary and Benefits Operating Costs Capital Total Costs 10. What is the estimated cost of the grant to the county over five years? 977,480 Signature of Preparer: Date: Grant Amount Other Match Costs Not Covered Match Total First Year $ 1,061,672 $ $977,480 $ 2,039,152 Second Year $ $ $ $ Third Year $ $ $ $ Fourth Year $ $ ' $ $ Fifth Year $ $ $ $ Signature of Preparer: Date: