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GRANT NAME: Ixora Park Sewer Rehabilitation Im, r' Zwy LPA0306 IS I TO CERTIFY TH T OF THE RIGINAL FILE IN I6 OFFICE AMOUNT OF GRANT: $3,000,000 Rv _0Z . - DEPARTMENT DEPARTMENT RECEIVING GRANT: Utility Services DATE e 1 l ' U - d CONTACT PERSON: Howard Richards TELEPHONE: 772-226- 1. How long is the grant for? At the time of execution date until April 30, 2027 Starting Date: Upon execution 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? Yes X No If yes, does the grant allow the match to be In -Kind services? Yes No 4. Percentage of match to grant 0.00 % 5. Grant match amount required $Il 00 6. Where are the matching funds coming from (i.e. In -Kind Services; Reserve for Contingency)? N/a 7. Does the grant cover capital costs or start-up costs? X Yes No If no, 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 012.13 Insurance - Life & Health 012.14 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? Signature of Preparer: Date: Grant Amount Other Match Costs Not Covered Match Total First Year $3.000.000 $ 0 $0.00 $3,000.000.00 Second Year $ $ $ $ Third Year $ $ $ $ Fourth Year $ $ $ $ Fifth Year $ $ $ $ Signature of Preparer: Date: