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` GRANT APPLICATION Page 6 of 7 <br />e Local Govern. ^e.^.t3� 0.^.i = iC^?�1�1�y : INDIAN RIVER COUNTY <br />* <br />This cage applicable on-',, ,.o priva;_'non-Oro- t dejagag-anc:es <br />Complete a separate ;age o for eachdelegata agenc-, ?rovider <br />Program Name: DEVELOPMENTAL TRAINING <br />Name of Delegate Agency- Vocational Training and Sheltered [Jorkshop in Indian <br />Address: 1385 16th Ave, Vero Ueach�oFTaY'N2998I' <br />Contact Person: Richard Szott <br />Telephone: (305 ) 562-6854 <br />0 • Tax Exempt ;Dumber: 59-164-7746 <br />11: none, attach a cony of the certificate of <br />incorporation) <br />ADM1NISTR.AT':'VE E:t3E,ISES CASH I:D-:ZI,DD <br />1. Salaries <br />Z. `~Rental <br />3. Travel <br />4: Supplies <br />S. Other (specify on attachment) <br />6. TOTAL (lines 1 through 5) <br />PRCG?-%,% EXPE`NSES <br />7. Salaries <br />8. Rental Space 1529.75 <br />9. Travel . <br />10. Equipment 2789.25 9 <br />11. Other (specify on attachment) .1800.00 <br />12. TOTAL ( lines 7 through 11) 4589.25 1529.75 <br />13. TOTAL EXPENSES (line 6 and line 12) 4589.25 <br />TOTAL BUDGET 6119.00 <br />THE DELEGATE AGENCY HEREBY APPROVES THIS ="�A ON AND WILL COMPLY <br />WITH ALL RULES, -REGULATIONS AND CONTRAC S LaTI��]G KEON <br />APPROVED BY: Franklin Il. Cox <br />President of Board (Sig ature) <br />Typed Name <br />ATTESTED BY: Richard Szott L� <br />r Typed Name (Signature) <br />Executive Director,Acting <br />Title <br />EXPLAIN BY ATTACHMENT ANY LT_`IE ITEM OVER $500. <br />dwwv- <br />