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Attachment K <br /> Department of Community Affairs <br /> Florida Small Cities Community Development Block Grant (CDBG) Program <br /> SIGNATURE AUTHORITY FORM <br /> Submit an onginal Signature Authority form with each contract <br /> Recipient Contract # <br /> Indian River County _ _ _ _ 08DB-D3-10-40-01 -Al2 <br /> Mailing Address (Street or Post Office Box) <br /> 1801 27th Street <br /> . . . . <br /> City, State and Zip Code <br /> Vero Beach , Florida 32960-3365 <br /> Project Contact Person Telephone # <br /> (772) 226 - 1254 <br /> Robert M . Keating , AICP E-mail Address <br /> bkeating@ircgov. com <br /> Financial Contact Person Telephone # (772) 226 - 1257 <br /> Jason Brown E-mail Address <br /> _,__., Ibrownalocgoy com _ . . _ <br /> Requests for Funds ( RFFs) from the Florida Small Cities CDBG Program require (check one): [ X ] one signature [ ] two <br /> signatures of individuals authorized below. No more than two individuals can be authorized to use FloridaPAPERS. CDBG <br /> contracts require that at least one ( 1) RFFs must be submitted each quarter and should reflect all expenditures incurred during <br /> that reporting period . <br /> Typed Name Date ) f Sign/a raaT �yyJ <br /> Robert M . Keating ��/ S ! � � _Ln�,Z �/<•- <br /> [ X ] Check here if the above person will be the E-m d Address <br /> designated FlorldaPAPERS user. bkeating(alircgov.com <br /> Typed Name Date Signature <br /> -_. ..... .... .. ..__ __.. -_. _... _.... .__. ........... . .... . ... ... __. <br /> [ ] Check here if the above person will be the E-mail Address <br /> designated FlorldaPAPERS user. <br /> Typed Name Date Signature <br /> [ ] Check here if the above person will be the E-mail Address <br /> designated FlorldaPAPERS user. <br /> I certify, as the recipient's Chief Elected Official, that the above signatures are of the individuals authorized to sign Reques; 54or <br /> Funds and to submit RFFs electronically to the Small Cities Community Development Block Grant Program using Florida PAPERS. <br /> Typed L. B Date S ure <br /> Sandraa L Bowden April 29 2008 <br /> [ X ] Check here if your local government utilizes Electronic Funds Transfer( rom the State z4florida . <br /> [ X ] Check here if your local government will be working on a reimbursement sis. <br /> CDBG payments to /oca/ governments using EFTare automatically deposited in the local government's general acco11 unt. If the <br /> account is interest bearing, the CDBG funds must be transferred to a non-interest bearing account. Please call the CDBG <br /> Program at 850/922- 1878 or 487-3644 if you have questions. You can check the status of your deposit at the Comptroller's <br /> website : htto : //flair.dbf.state.fl . us/. <br /> Local governments not receiving EFT, and not working on a reimbursement basis, must establish a non-interest bearing account. <br /> Provide account information for the financial institution (insured by FDIC) below. All signatures on the account must be bonded . <br /> Name of Financial Institution Account Number <br /> RCB BANK 7680027195 <br /> Street Address or Post Office Box Telephone Number <br /> 1417 CENTURA HIGHWAY (252) 454 3557 or (800) 226-5985 <br /> City, State and Zip Code <br /> ROCKY MOUNT, INC 27802 <br /> F:\Community Deve1opment\Users\CD13G\2007 Neighborhood Rev\Contracts\DCA Contract\forms - Attachments\1 Signature Authorization.doc <br />