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5"- 7 -,?6 <br />EXHIBIT A <br />COMMISSION FOR THE TRANSPORTATION DISADVANTAGED <br />96/97 GRANT APPLICATION INFORMATION FORM <br />CONCERNING PLANNING RELATED ACTIVITIES <br />1. DATE SUBMITTED: Apri 1 18, 1996 <br />2. LEGAL NAME OF ORGANIZATION: Indian River County Cmmunity Development Department I <br />3.ADDRESS: 1840 25th Street <br />4. CITY AND STATE: Vero Beach, Florida ZIP CODE: 32960 <br />S. CONTACT PERSON FOR THIS GRANT: Sasan P,ohani AICP <br />6. PHONE NUMBER: (407) 567-8000, ext, 250 <br />7. COUNTY FOR WHICH THIS GRANT APPLIES: Indi an River County <br />8. PROPOSED PROJECT START DATE: 1/1/97 ENDING DATE: 12/31/97 <br />9a. ESTIMATED PROJECT FUNDING: <br />State S 13, 694.00 <br />TOTAL $ 17.694.00 <br />9b. PLANNING FUND ALLOCATION <br />TRANSFERRED TO TRIP GRANT <br />State $ 4,000.00 <br />10. I hereby certify that this document has been duly authorized by the governing body of the <br />applicant and the applicant will perform tasks identified in the application manual and comply with <br />any attached assurances if the financial assistance is awarded. <br />a. Robert M Keating, AICP Communitv Development Director <br />TYPED NAME OF AUTHORIZED REPRESENTATIVE AND TITLE <br />b. PQR OF PERSON ABOVE: (407) 562-8000, ext. 254 <br />C. 4/5/96 <br />SAUTHO ED SENTATIVE DATE <br />11. I hereby certify that this grant including the budget detail, has been reviewed and approved in its <br />entirety the Indian iver <br />County Coordinating Board. <br />CZ <br />er Carol : 1 rt 4/18/96 <br />COORDINA G BO HAIRP .2 nm S SIGNATURE DATE <br />Fong Rrv. 1IIN% <br />Plan mg (Iran App] Flag, I <br />