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Attachment K Department of Community Affairs Neighborhood Stabilization Program Florida Small Cities Community Development Block Grant (CDBG) Program SIGNATURE AUTHORITY FORM 2Q09 AUG 2 � Pry 3� _ Submit an ori Inal Slggnature Authority Form with each contract. _ Recipient Contract # Local Government DUNS Number I Indian River County 10DB-4X- 10-40-01 -F13 079208989 Mailing Address (Street or Post Office Box) ^� 1801 27th Street City, State and Zip Code —� Vero Beach Florida 32960-338.8 Project Contact Person Telephone # _(772 226-1254. Robert M . Keating, Community Development Director E-mail Address bkeatin Ca irc og vcom Financial Contact Person Telephone # 772 226- 1205 Diane Bernardo - Finance Director E-mail Address M- __ , dbernardo_@clerk. indian-river. org Requests for Funds ( RFFs) from the Florida Small Cities CDBG Program require (check one): [ ] one signature [ ] two signatures of individuals authorized below. No more than two individuals can be authorized to use FloridaPAPERS. CDBG contracts require that at least one ( 1) RFFs must be submitted each quarter and should reflect all expenditures incurred during that reporting Derliod . _ Typed Name Date iSi atur Robert M . Keating, Community Dev Director _ ' [ X ] Check here if the above person will be the E-mail Ad ess _ designated FloridaPAPERS user. bkeating@ircgov. com Typed Name Date Signature [ ] Check here if the above person will be the E-mail Address designated FloridaPAPERS user._ Typed Name Date Signature [ ] Check here if the above person will be the E-mail Address designated FloridaPAPERS user. 1 I certify, as the recipient's Chief Elected Official, that the above signatures are of the individuals authorized to sign Requests for l I Funds and to submit RFF's electronically to the Small Cities Community Development Block Grant Program using FlcridaPAPERS . 1 Typed NameDate ^ Wesley S . Davis, BCC Chairman — U .gust-1 $ ,�QO If [X] Check here if your local government utilizes Electronic Funds Transfer ( EFT) from the Stare of Florida . [X] Check here if your local government will be working on a reimbursement basis. [ ] If this signature authority form pertains to a housing grant, check here if your local government will use an escrow account for housing activities. _ .... i CDBG payments to local governments using EFTare automatically deposited in the local government's general account. If the account is interest bearing, the CDBG funds must be transferred to a non-interest bearing account. Please call the CDBG i Program at 850/922- 1878 or 487-3644 if you have questions. You can check the status of your deposit at the Comptroller's website : htto : //fIair.dbf. state .fl . us/ . Local governments not receiving EFT, and not working on a reimbursement basis, must establish a non-interest bearing account. Provide account information for the financial institution (insured by FDIC) below. All signatures on the account must be bonded . Name of Financial Institution � ! Account Number RBC Bank _ 053100850-76800_27195 Street Address or Post Office Box Telephone Number 1417 Centura Hyhw _ - _._ „ (252) 454-3557 or (800) 226-5985 City, State and Zip Code _ Roc Mount1 NC 27802