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FLORIDA SMALL CITIES AND DISASTER RECOVERY CDBG CLOSEOUT ( Revised 6 . 08) 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 : 06DB-3C- 10-40-01 -W14 Indian River County 08/20/ 2005 11/ 19/2008 County in which recipient is Local Contact: Phone Number: located : Indian River William Schutt, Senior Economic Planner (772) 226- 1243 1 . Indicate how the project was carried out (administration Grantee Contractors Both and construction ) : Employees X 2 . Indicate how beneficiary data was collected : Census Survey X X 3 . If location of activities changedr changedis a map included? N/A Yes No 4 . Is a Property Management Register included ? N/A Yes No 5 . If an infrastructure project, is an engineering certification included? Yes X No 6 . Is the project located in a Historic District? Yes No X 7 . Is the project located in a Presidentially Declared Disaster Area ? Yes X No 8 . Is the project a Special Assessment activi ? I Yes I No X 1 9 . Is the project a Brownfield Activity? Yes No X 10 . Did the local government provide the assistance (to Grant Deferred, forgiveable loan the beneficiaries in the form of a loan ora rant? X N/A 11 . List all other funds alongwith the source used to support the activities funded with this rant : Source Amount Locai Funds ( i .e . , General Revenue) Indian River County 1 943 596 .47 Grants Florida Housing Finance Corporation — Hurricane ( ) Housing Recovery Program 44 200 . 00 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 must be returned to DCA. Make check payable to the Department of Community Affairs — X CDBG Program and include it with the Closeout. If program income has alread resulted indicate amount : 13 . Has a final Request for Funds been submitted? Yes X No 14 . Does the local government have CDBG Funds on hand? cannot exceed 5 000 If es : No X I