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C-1 <br />• <br />•0 <br />GRANT APPLICATION Page 4 of 7 <br />INDIAN <br />Name of Anizlicsnt: RIVER OOUNIY <br />(C-zy or county) <br />TGT. BLDG :.T <br />A. Include figures from all delegate agency budgetslpps• 6) <br />$. Explain by attachment all expenditures over 5500 per line item. <br />C. Cash match must be at least one half of state grant=eeuested. <br />D. The cash and in-kind match combined must equal the state grant. <br />REVE-NUE Use only dollars- No cents <br />l• <br />State arant <br />6,119,00 <br />2- <br />Cash X :h (DQ °2.'x.2_31 !-"ZdZj <br />__:Z2=2 3h3_=--gi � d) a?ir a 3,059.50 <br />3. <br />In -Kind ?latch <br />3,059.50 <br />4. <br />TQT3L 3"j,_"jDE <br />12.238.00 <br />GRANTEE ADMIVISTRATZTE EXPENSE <br />CASH IN -K=0 <br />5. <br />Salaries <br />6. <br />Rental Soace <br />7. <br />Travel <br />S. <br />Supplies <br />9. <br />Other (speci-fy on attachment) <br />10. <br />TOTAL (lines 5 through 9 ) <br />DELEGATE ?DMINISTRATZIT EXPENSE <br />11. <br />Salaries <br />12. <br />Renta? Space <br />13. <br />Travel <br />14. <br />Sucolies <br />15. <br />Other (specify on attachment) <br />16. <br />TOTAL (lines 11 through 16) <br />*17. <br />TOTX.L ADMZ:lISTRATIVE EXPE:1SEs <br />( line 10 and 16 ) <br />*LiL-ie 17 must no: exceed -3% of <br />two times li :e 1. <br />GRA,�TEE PROGRAM E.0ENSE <br />18. Salaries <br />19. Rental Space <br />20. Travel <br />21. Equipment <br />22. Other (specify on attachment) <br />23. TOTAL (lines 18 through 22) <br />DELEGATE PRCGRAM E:0?ENSE <br />24. Salaries <br />25. Rental Soace <br />26. Travel 299.25 <br />27. Equipment 2,789.25 <br />28. Other (specify on attachment) ,803 pp--' <br />29. TOTAL ( lines 24 through 28) g 178 50 <br />30. TOTAL PROGR.M EXPENSES (lines 23 and 9 <br />29) ,178,50 <br />31. TOTAL EXPENDITURES (line 17 and 30) <br />32. TCTAL COMBINED EXPENDITURES (Cash and <br />__ 1.529.75 <br />1.529.75 <br />i 059 Sn <br />3,059.50 <br />3.099 Sn <br />12,238.00 <br />