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GRANT NAME: Surfing `s Evolution & Preservation Foundation <br />AMOUNT OF GRANT: 3 Beach Wheelchairs $8,487, one ATV cost TBD <br />DEPARTMENT RECEIVING GRANT: Parks Recreation & Conservation <br />CONTACT PERSON: Gustavo Vergara <br />1. How long is the grant for? N/A <br />2. Does the grant require you to fund this function after the grant is over? <br />3. Does the grant require a match? <br />If yes, does the grant allow the match to be In -Kind services? <br />4. Percentage of match to grant <br />5. Grant match amount required <br />GRANT # N/A <br />TELEPHONE: 226-1777 <br />Starting Date: 3/11/2025 (chairs) <br />Yes 2L—No <br />6. Where are the matching funds coming from (i.e. In -Kind Services; Reserve for Contingency)? <br />7. Does the grant cover capital costs or start-up costs? <br />If no, how much do you think will be needed in capital costs or start-up costs: <br />(Attach a detail listing of costs) <br />8. Are you adding any additional positions utilizing the grant funds? <br />If yes, please list. (If additional space is needed, please attach a schedule.) <br />Yes x No <br />Yes No <br />X Yes No <br />Yes X No <br />Acct. <br />Description Position position Position position position <br />011.12 <br />Regular Salaries <br />011.13 <br />Other Salaries & Wages (PT) <br />012.11 <br />Social Security <br />012.12 <br />1 Retirement — Contributions <br />012.13 <br />Insurance — Life & Health <br />012.14 <br />Worker's Compensation <br />012.17 <br />S/Sec. Medicare Matching <br />$ <br />TOTAL <br />9. What is the total cost of each position including benefits, capital, start-up, auto expense, travel and operating? <br />Salary and Benefits Operating Costs Capital Total Costs <br />10. What is the estimated cost of the grant to the county over five years? <br />0i"iy,gn by: Gee vas, <br />Signature of Preparer: Gustavo Ver(�ara ^^N^ wa,CIM a �o�=PaMa`Rm�.l�e°�,; .�° Date: 2/11/2025 <br />g 1� J C(Me: 2025,02.11 12:N:2845100' <br />Grant Amount <br />Other Match Costs Not Covered <br />Match <br />Total <br />First Year <br />$8487 Value <br />$ <br />S <br />$8487 <br />Second Year <br />$TBD <br />S <br />$ <br />$TBD <br />Third Year <br />$ <br />S <br />$ <br />$ <br />Fourth Year <br />$, <br />$ <br />S <br />Fifth Year <br />$ <br />$ <br />$ <br />$ <br />0i"iy,gn by: Gee vas, <br />Signature of Preparer: Gustavo Ver(�ara ^^N^ wa,CIM a �o�=PaMa`Rm�.l�e°�,; .�° Date: 2/11/2025 <br />g 1� J C(Me: 2025,02.11 12:N:2845100' <br />