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Application <br />A TRUE COPY <br />CERTIFICATION ON LAST PAGE <br />i.R. Snni T H, Cl- ERV, <br />County, group INDIAN RIVER COUNTY <br />of counties or <br />region <br />Total Amount Requested: $207,472.16 <br />Project Title: REGION GRANT -GIS RESPOSITORY <br />1. Board of County, group of counties or _Chairman Joseph Earman <br />region Commissioners Chair: <br />Mailing Address: Indian River County BOCC <br />City: <br />State: <br />Phone: <br />Email Address: <br />1 t5U1 27"' street <br />Vero Beach <br />Florida <br />( 772 ) 226-3900 <br />Jearman@ircgov.com <br />2. County, group of counties Karen Rackard <br />or region 911 Coordinator: <br />Mailing Address: 422543 Id AvAvenue <br />City: <br />State: <br />Phone: <br />Email Address <br />Vero beach <br />riorlaa <br />( 772 ) 226-3943 <br />Krackard@ircgov.com <br />3. Federal Tax ID Number: 59-6000674 <br />Zip: 32960 - <br />Fax: <br />Zip: 32967 - <br />Fax: <br />Application and instructions for 911 Grant Programs, revised July 2021 <br />W Form 3A, incorporated by reference in Fla. Admin. Code R. 60FF1-5.003 911 Grant Programs <br />15 <br />