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A TRUE COPY <br />CERTIFICATION ON LAST PAGE <br />RYAN L. BUTLER, CLERK <br />EMS COUNTY GRANT APPLICATION <br />FLORIDA DEPARTMENT OF HEALTH <br />Emergency Medical Services Program <br />HEALTH <br />Complete all items <br />ID. Code The State EMS Program will assign the ID Code — leave this blank <br />1. Count Name: Indian River Count <br />Business Address: 1801 27"' St <br />Vero Beach, FL 32960 <br />Telephone: 772-226-3900 <br />Federal Tax ID Number Nine Digit Number): VF 59-60006764 <br />2. Certification: (The applicant signatory who has autho.' *... Fg pts, grants, and other legal <br />documents for the county.) I certify that all information atd to icounty grant application and <br />its attachments are true and correct. My signature acktiail s as rets that the county shall <br />comply fully with the co 'tions outlined in th FI S ant r�pj�lication. <br />Si nature: o Date: June 4 2024 <br />Printed Nam : S an Adams ; o, <br />Position Title: hairman, Board of County C is i' ' . d <br />'•v,'vRIV.RC� . <br />3. Contact Person: (The individual with direct knowledge of the project on a day-to-day basis and has <br />responsibility for the implementation of the grant activities. This person is authorized to sign project <br />reports and may request project changes. The signer and the contact person may be the same.) <br />Name: Stephen R. Greer <br />Position Title: Assistant Fire Chief of EMS <br />Address: 4225 431 Ave <br />Vero Beach, FL 32967 <br />Telephone: 772-226-3900 Fax Number: 772-978-1820 <br />E-mail Address: s reer indianriver. ov <br />4. Resolution: Attach a resolution from the Board of County Commissioners certifying the grant funds <br />will improve and expand the county pre -hospital EMS system and will not be used to supplant current <br />levels of county expenditures. We cannot process for funds without this resolution. <br />5. Organization List: Complete a budget page(s) for each organization, which at your option you will <br />provide funds. List the organization(s) below. (Use additional pages if necessary) <br />Lim ioo4, uecemer zuuzs (rtev. uuiy zuits) 64J-1.015, F.A.C. <br />