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GRANT NAME: Indian River Lagoon National Estuary Program Small Grants Program GRANT # AMOUNT OF GRANT: $3,816.49 DEPARTMENT RECEIVING GRANT: Parks & Recreation - Conservation Lands CONTACT PERSON: Beth Powell TELEPHONE: 77 772-226-1873 1. How long is the grant for? 12 months Starting Date: July 6, 2021 2. Does the grant require you to fund this function after the grant is over? Yes X No 3. Does the grant require a match? X Yes No Insurance — Life & Health If yes, does the grant allow the match to be In -Kind services? Yes x No 012.17 43 $ 4. Percentage of match to grant % $ 5. Grant match amount required 2938.15 (IRSC committed to $200) $ 6. 'Where are the matching funds coming from (i.e. In -Kind Services; Reserve for Contingency)? Fifth Year IRSC $200; $2,238.15 pre purchased equipment; $500 31521072-068510-18010 $ 7. Does the grant cover capital costs or start-up costs? X Yes No Ifno, how much do you think will be needed in capital costs or start-up costs: $ (Attach a detail listing of costs) 8. Are you adding any additional positions utilizing the grant funds? Yes X 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 0 12. 13 Insurance — Life & Health 012.1 1 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? $ N/A Signature of Preparer: Date: Grant Amount Other Match Costs Not Covered Match Total First Year $ $ $ $ Second Year $ $ $ $ Third Year $ $ $ $ Fourth Year $ $ $ $ Fifth Year $ $ $ $ Signature of Preparer: Date: