My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
2008-022
CBCC
>
Official Documents
>
2000's
>
2008
>
2008-022
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
3/21/2016 11:38:35 AM
Creation date
10/1/2015 1:22:44 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Grant
Approved Date
01/15/2008
Control Number
2008-022
Agenda Item Number
14.A.2
Entity Name
Department of Health EMS Grant Program
Subject
BEMS Grant Program
Supplemental fields
SmeadsoftID
8718
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
4
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
- q <br /> GRANT APPLICATION <br /> FLORIDA DEPARTMENT OF HEALTH <br /> Bureau of Emergency Medical Services <br /> Complete all items <br /> ID. Code (T he State Bureau of EMS will assign the ID Code — leave this blank) C <br /> 1 . County Name : Indian River County <br /> Business Address : 1800 27 Street Vero Beach Florida 32960 <br /> Telephone : 772 ) 226 -3900 <br /> Federal Tax ID Number ( Nine Digit Number) . VF 59 - 60006764 <br /> 2 . Certification : (The applicant signatory who has authority to sign contracts , grants , <br /> and other legal documents for the county) I certify that all information and data in this <br /> EMS county grant application and its attachments are true and correct . My signature <br /> acknowledges and assures that the County shall comply fully with the conditions <br /> outlined in the Florida EMS County Grant Application . <br /> Signature : <br /> Date : <br /> Printed Name : Sandra L . Bowden <br /> Position Title : Chairman , Board of County Commissioners <br /> 3 . Contact Person : (The individual with direct knowledge of the project on a day-to- <br /> day basis and has responsibility for the implementation of the grant activities . This <br /> person is authorized to sign project reports and may request project changes . The <br /> signer and the contact person may be the same . ) <br /> Name : Brian S . Burkeen <br /> Position Title : Assistant Chief <br /> Address : 4225 43r Avenue Vero Beach Florida 32966 <br /> Telephone : (772) 226 -3900 X 3864 Fax Number: (772 ) 226 -3868 <br /> E- mail Address : bburkeen@ircgov . com <br /> 4. Resolution : Attach a current resolution from the Board of County Commissioners <br /> certifying the grant funds will improve and expand the county pre-hospital EMS system <br /> and will not be used to supplant current levels of county expenditures . <br /> 5 . Budget . Complete a budget page (s) for each organization to which you shall provide <br /> funds . <br /> List the organization (s) below. ( Use additional pages if necessary) <br /> Indian River County Fire Rescue <br /> DH Form 1684 , Rev. June 2002 <br />
The URL can be used to link to this page
Your browser does not support the video tag.