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� ch � fi i� C FLORIDA SMALL CITIES AND DISASTER RECOVERY CDBG CLOSEOUT ( Revised 6 .08) f� tJr Closeout forms must be submitted to the Department of Community Affairs, Florida Small Cities CDBG or Disaster Recovery Program, within 45 days after the contract termination or expiration date . A Final Request for Funds should be submitted prior to, or with, the closeout since funds not requested will be deobligated at closeout. Closeout requirements can be found in Rule 9B-43 . 0051 ( 11 ), F .A . C. Instructions All grant recipients must complete Section I . Section II applies to Commercial Revitalization or Neighborhood Revitalization activities . Section III relates only to Commercial Revitalization or Economic Development activities . And, Section IV relates to Housing activities . All grant recipients must complete the Beneficiary Data form and the Status of Accomplishments and Expenditures form . The Closeout Approval form must be signed by the Chief Elected Official . Enter the information requested or circle the response . Section I . Contract Information Contract Number: Recipient: Beginning Date : Ending Date: 06D6-3C- 10-40-01 -W14 Indian River County 08/20/2005 11/ 19/2008 Phone Number: County in which recipient is Local Contact: (772) 226- 1243 located : Indian River William Schutt, Senior Economic Planner 1 . Indicate how the project was carried out (administration Grantee Contractors Both Employees i X and construction ) : TC:ensus Survey 2 . Indicate how beneficiary data was collected : X X 3 . If location of activities chap ed is a ma included? N A Yes No 4 . Is a Property Management Register included? N/A Yes No Yes X No 5 . If an infrastructure project, is an en ineering certification included ? Yes No X 6 . Is the roject located in a Historic District? 7 Is the project located in a Presidentially Declared Disaster Area? Yes X a No 8 Is the project a Special Assessment activity? I Yes No _ X 9 . Is the project a Brownfield Activity? Yes_ No X 1 nce (to Grant Deferred , forgiveable loan 10 . Did the local government provide the assista the beneficiaries in the form of a loan or a rant . X N/A 11 . List all other funds alongwith the source used to support the activities funded with this rant : Amount Source Local Funds (Le . , General Revenue) Indian River Coun 1943596 .47 Grant( s) Florida Housing Finance Corporation - Hurricane Housing Recovery Program 441200s00 Private Funds ( i . e . , Participating Party, etc . Loan (s) Other ( Specify) 12 . Will the project result in program income? Program income not expended before closeout Yes No X must be returned to DCA. Make check payable to the Department of Community Affairs - CDBG Program and include it with the Closeout. • If ro ram income has already resulted indicate amount: Yes X No 13 . Has a final Regi iest for Funds been submitted? No X 14 . Does the local overnment have CDBG Funds on hand? cannot exceed 5 000 If es : 1