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! ' <br /> AGENCY REQUEST FOR FUNDING FROM INDIAN RIVER COUNTY <br /> FISCAL YEAR%U1512O1G <br /> A. Program Cover Page <br /> • <br /> - ^ • <br /> \. _ • . Agency: Florida Forest Service 8B <br /> Telephone: 63)462-5372 <br /> Contact •""^` • <br /> Person: ` ' <br /> Lisa Ridley Fax 8B�3\4O2-5162 <br /> _ • <br /> Title: AdministrativeAom�toht| E-Mail: L�a.RW|ay��FreohFromFkor�onom <br /> Address: 5200 Highway 441 North <br /> Okeechobee, FL 34972 <br /> Website http://www.freshfromflorida.com/Divisions- <br /> Address: Offices/Florida-Forest-Service <br /> Program <br /> Fire Control Assessment <br /> Title: <br /> contained in this application accurately reflects the activities of this agency and that the <br /> expenItifirr s thereof for which County funds are being requested are not reimbursed by any other soirce, <br /> Tim Eider/ Forestry District Manager <br /> Signature Print name and title <br /> Brief description of the Proqram for which fundinit requested: <br /> Each county shall be assessed each fiscal year, its share of the cost of providing fire protection, a sum in <br /> dollars equal to the total forest and wild land acreage of the county,as determined by the Florida Forest <br /> Service, multiplied by 7 cents. <br /> '-- <br /> Summary Report <br /> Amount requested from Indian River Counb��2U15/2O16: $13.821.36 <br /> Toba Program budget for 2015/2016: . $13.821.36 <br /> Percent of total Program budget: <br /> Current Fundin (2014/2015) � <br /> Dollar increase/(decrease) in request: � <br /> Percent increase/decrease in request: Y6 <br /> If request increased 5% or more, briefly explain why: <br /> • <br /> • ! <br /> The Organization's Board of Directors has approved this aon (date): <br /> Name of President/Cair of the Board Signature <br /> . ` <br /> Name of ExecDirector/CEO Signature <br /> 131 <br /> ---- <br />