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FLORIDA SMALL CITIES OR DISASTER RECOVERY CDBG CLOSEOUT ( 12 . 07) <br /> Closeout forms must be submitted to the Department of Community Affairs, Florida Small Cities CDBG or Disaster <br /> Recovery Program , within 45 days after the contract termination or expiration date . A Final Request for Funds should <br /> be submitted prior to, or with , the closeout since funds not requested will be deobligated at closeout . Closeout <br /> requirements can be found in Rule 9B -43 . 0051 ( 11 ), F . A . C . <br /> Instructions <br /> All grant recipients must complete Section I . Commercial Revitalization or Neighborhood Revitalization grant recipients <br /> must complete Section II . Recipients of Commercial Revitalization or Economic Development grants must complete the <br /> relevant portions of Section III, and Housing grant recipients must complete Section IV . All grant recipients must <br /> complete the Beneficiary Data form and the Status of Accomplishments and Expenditures form . The Closeout Approval <br /> form must be signed by the Chief Elected Official . Enter the information requested or circle the response . <br /> Section I . Contract Information <br /> Contract Number : Beginning Date : Ending Date : <br /> 08DB= T3 - 10= 40- 01 - N25 10 / 31 / 2007 4/ 30 / 10 <br /> Recipient : Local Contact : Phone Number : <br /> Indian River County Robert Keating, Community ( 772) 226- 1254 <br /> Development Director <br /> 1 . Indicate how the project was carried out (administration Grantee Employees Contractors Both <br /> and construction ) : x <br /> 2 . Indicate how beneficiary data was collected : Census Survey <br /> 3 . Enter the Census Tract( s ) and/or Block Group( s) for service area ( s) : Census Tract( s ) Block Group( s) x <br /> 503 . 02 1 =4 <br /> 4 . If location of activities changed , is a map included ? nl h Yes No x <br /> 5 . Is a Property Management Register included ? G 1 Yes No x <br /> 6 . If an infrastructure project, is an engineering certification included ? Yes x No <br /> 7 . Is the project located in a Historic District? Yes No x <br /> 8 . Is the project located in a Presidentially Declared Disaster Area ? Yes No x <br /> 9 . Is the project a Special Assessment activity? Yes No x <br /> 10 . Is the project a Brownfield Activity? Yes No x <br /> 11 . Did the local government provide the assistance (to Grant Loan Deferred , forgiveable loan <br /> the beneficiaries ) in the form of a loan or a grant? x <br /> 12 . If a loan , indicate : Interest Rate Monthly Loan Amount Amortization <br /> % $ Period in Months <br /> 13 . List all other funds, along with the source, used to support the activities funded with this grant : <br /> Source Amount <br /> Local Funds ( i . e . , General Revenue ) County General Revenue $ 250, 000 . 00 <br /> County General Revenue $ 1 , 207304 . 62 <br /> Grant( s ) $ 1, 4571304 . 62 <br /> $ 0 <br /> Private Funds ( i . e . , Participating Party, $ 0 <br /> etc . ) <br /> Loan ( s ) $0 <br /> Other ( Specify) $ 0 <br /> 14 . Will the project result in program income ? Program income earned but not expended Yes No <br /> before closeout must be returned to DCA . Make check payable to the Department of x <br /> Community Affairs — CDBG Program and include it with the Closeout. <br /> 1 <br />