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EXHIBIT A <br />INDIAN RIVER COUNTY NONPROFIT / QUASI AGENCY REQUEST FOR FUNDING <br />A. Program Cover Page <br />Agency: Treasure Coast Homeless Services Telephone: 772-567-7790 <br />Council, Inc <br />Contact Person: Louise Hubbard Fax: 772-567-5991 <br />Title: Executive Director E -Mail: irhsclh(a--)aol.com <br />Address: 2525 St. Lucie Ave <br />Website Address: www.tchelpspot.org <br />Program Title: Homeless Resource Center <br />I Agree - By checking the "I Agree" box and entering your name below, you certify that information <br />contained <br />in this application accurately reflects the activities of this agency and that the expenditures or portions <br />thereof for <br />which County funds are being requested are not reimbursed by any other source. <br />Name: Louise Hubbard Title: Executive Director <br />:jrleT description OT the Nroaram Tor wnicn tunaina is reauestea: <br />The primary function of the Resource Center is to provide housing assistance to prevent and end <br />homelessness. The programs provide assistance to individuals and families to prevent homelessness by <br />avoiding evictions for low income persons, and to rehouse eligible homeless individuals and families in fair <br />market rental housing in the community. Target populations also include homeless disabled persons and <br />Veterans who are homeless or about to become homeless. <br />Summary Keport <br />Amount requested from Indian River County for 2021/2022: 15,270.00 <br />Total Proposed Program budget for 2021/2022: 884,256.00 <br />Percent of total Program budget: 1.73% <br />Current Funding (2020/2021) 15,270.00 <br />Dollar increase / (decrease) in request: $0.00 <br />Percent increase / decrease in request: 0% <br />request increased 5% or more, briefly explain why: <br />This is not an increase <br />The Organization's Board of Directors has approved this application on (date): 03/19/2021 <br />Name of President/Chair of the Board: Todd Heckman <br />Name of Exec. Director/CEO: Louise Hubbard <br />EXHIBIT A <br />