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GRANTNAME: Florida Blue Foundation - Mental Well-being Teens GRANT <br />AMOUNT OF GRANT: 300,000 <br />DEPARTMENT RECEIVING GRANT: Parks, Recreation & Conservation <br />CONTACT PERSON. Beth Powell <br />1. How long is the grant for? 3 Year <br />2. Does the grant require you to fund this function after the grant is over? <br />TELEPHONE: 772-226-1785 <br />Starting Date: July 1, 2024 <br />Yes X No <br />3. Does the grant require a match? Yes _11--21110 <br />If yes, does the grant allow the match to be In -Kind services? Yes No <br />4. Percentage of match to grant 0 % <br />5. Grant match amount required 10 <br />6. Where are the matching funds coming from (i.e. In -Kind Services; Reserve for Contingency)? <br />7. Does the grant cover capital costs or start-up costs? Yes X No <br />If no, how much do you think will be needed in capital costs or start-up costs: $ <br />(Attach a detail listing of costs) <br />8. Are you adding any additional positions utilizing the grant funds? X Yes No <br />If yes, please list. (If additional space is needed, please attach a schedule.) <br />Acct. <br />Description Position Position Position Position Position <br />011.12 <br />Regular Salaries 52327.96 Yr 1 54944.36 Yr 2 57691.57 Yr 3 <br />011.13 <br />Other Salaries & Wages (PT) <br />012.11 <br />Social Security <br />012.12 <br />Retirement - Contributions <br />012.13 <br />Insurance - Life & Health <br />012.14 <br />Worker's Compensation <br />012.17 <br />S/Sec. Medicare Matching <br />$100,000.00 <br />TOTAL, $79,383.23 Yr 1 $82,651.20 Yr 2 $86,085.32 Yr 3 <br />9. What is the total cost of each position including benefits, capital, start-up, auto expense, travel and operating? <br />Salary and Benefits <br />Operating Costs <br />Capital Total Costs <br />$79,383.23 Yr 1 <br />approx. $22,000 <br />$101,383.23 approx Yr 1 <br />$82,651.20 Yr 2 <br />approx. $15,000 <br />$97,651.20 approx Yr 2 <br />$86,085.32 Yr 3 <br />approx. $15,000 <br />$101,085.32 approx Yr 3 <br />$ 40.00 <br />$ <br />$100,040.00 <br />Third Year <br />$100,000.00 <br />$ 40.00 <br />fess utas $15,000 for contingency allocated n operating Wdgefs <br />10. What is the estimated cost of the grant to the county over five years? <br />Dip yn0"b by Etra P 1 <br />Elizabeth Powell ,yF1W•EkebO GowA1�mW •°po nAQlnUa mw.pwO•WO•NdanRwer <br />Signature of Preparers l-z20N0- s3,:�,- "" Date: <br />Grant Amount <br />Other Match Costs Not Covered <br />Match <br />Total <br />First Year <br />$100,000.00 <br />$ 40.00 <br />$ <br />$100,040.00 <br />Second Year <br />$100,000.00 <br />$ 40.00 <br />$ <br />$100,040.00 <br />Third Year <br />$100,000.00 <br />$ 40.00 <br />S <br />$100,040.00 <br />Fourth Year <br />$ <br />$ <br />$ <br />$ <br />Fifth Year <br />$ <br />$ <br />S <br />$ ill <br />Dip yn0"b by Etra P 1 <br />Elizabeth Powell ,yF1W•EkebO GowA1�mW •°po nAQlnUa mw.pwO•WO•NdanRwer <br />Signature of Preparers l-z20N0- s3,:�,- "" Date: <br />