Laserfiche WebLink
GRANT APPLICATION Page 6 of. 7 <br />Local novernmental Unit Applying: Indian River County Commission <br />Lawn, county, or city <br />13.CONTRACTTTAL TNFORMATTnN - Complete one for each Delegate Aqency <br />General <br />Name of. Delegate Aaencv: Vero Beach YMCA <br />Address: 3705 16th st. Vero Beach, Fla. 32960 <br />contact Person: Terrence D. Marr <br />Telephone: (305) 562-9037 <br />Tax Exempt Numher: * 05-00162-00-41 <br />*If none, attach a copy of the certificate of incorporation <br />DF,LFr.ATF, ArFNCY BUDGET FOR TFIS PROGRAM <br />ADMINTSTRATTVE FXPFNSFS <br />1. salaries 1100 in kind 16 hrs. at 3 1139.00 <br />?_ Rental -Space__ - - - - -- ____ _ __ - - - --- �_ <br />3.. Trave 1— — — — — — — — — — •- --- — — — — — — — — —-RF <br />4. Tupi)T1PC- _ .-- - - - - - - - - - - - - - - - - - <br />'w <br />5. other Tspecify—nn attachment) — — �- — — — — -- — — — — 0 <br />6.*------Tli-nes_1—throTi--—_—__--`_ ------ 1205.00 <br />PRnr-PAM FXPFNSFS <br />7. salaries 2000 in kind 5600.00 <br />8. Dental Sp — _ _ ace — _ — — �' — — — — — -' 1500,00 <br />9. Travel ----————————————————— <br />10. Fa—iEment —- ——————— — — — — —— 365.00 <br />11. Other Tspeci-fv—on attachmentj_- — — — — — — — — — — — — 425.00 <br />12. TOTAL Tlines_ 7—t)-irouah 1T) — -'— — — --- — — — — — 200.00 <br />--------__�---------------- 8090.00 <br />13. TOTAL EXPFNSFS —(line 6 and line 12) <br />——-————— — — — — —— 95.00 <br />*Mav not exceed 158 of line 13. <br />THE DrLvrPTr VZZY-NCY HERP13Y APPROVES THIS APPLTCATION AND 14ILL COMPLY <br />`4ITH ALL PULPS, PF,C:TILATTONS AND CONTRACTS RELATING THERETO: <br />n►'npnvrD nv; Exec. Director YMCA ��. <br />('?'itle Signature) <br />AT'"ESTI-D >3v: _ Administrative Secret__ <br />TTitleF <br />Page 6-C <br />Signature <br />