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Application for Funding Assistance r � <br /> Florida Department of Law Enforcement <br /> Edward Byrne Memorial State and Local Law Enforcement Assistance Formula grant P aM >" <br /> Please read instructions before completing this applicati01 . JUN " 4 2004 <br /> • The term "Department" , unless otherwise stated , refers to the Department of Law Enforcen ignt, . �1 ' ,C:( � ��. TS <br /> • The term "OCJG " refers to the Office of Criminal Justice Grants . ( ' <br /> • The term "subgrant recipient" or "subgrantee" refers to the governing body of a city, county, state agency, or an <br /> Indian Tribe that performs criminal justice functions as determined by the U .S. Secretary of the Interior. <br /> • The term "implementing agency" is a subordinate agency of a city, county, state agency, or Indian Tribe, or an <br /> agency under the direction of an elected official (for example , Sheriff or Clerk of the Court) . It may also be an entity <br /> eligible to be a subgrantee (ex. City of Live Oak) <br /> • Instructions are incorporated in this document by reference. <br /> A. Subgrant Data <br /> 1 . This section to be completed by Subgrantee 2. This section to be completed !?X OCJG <br /> Continuation of Previous Subgrant? otYes ❑ No Project ID # Program Area #: CFDA M 16. 579 <br /> If Yes , enter CJ Contract # of Previous Subgrant — p 4, <br /> SFY 2004 CJ Contract # SFY 2005 CJ Contract # <br /> 2004- CJ — J3 - 10- 40 - 01 - 060 2005 - CJ - - LO -0410 <br /> B. Applicant Information <br /> 1 . Subgrant Recipient (Subgrantee) <br /> Name of Subgrant Recipient (Unit of Government): Indian River Board of County County <br /> Commissioners Indian River <br /> Name of Chief Elected Official / State Agency Head : Caroline D . Ginn <br /> Title: Chairman , Board of County Commissioners <br /> Address: 1840 25th Street Area Code / Phone # <br /> 772-567-8000 <br /> City, County, State , Zip Code: Vero Beach , Florida 32960-3365 SUNCOM # <br /> 224- 1490 <br /> E-mail Address :cginn ircgov. com Area Code / Fax # <br /> 772-770-5334 <br /> 2, Chief Financial Officer of Subgrant Recipient (Subgrantee) <br /> Name of Chief Financial Officer: Edwin Fry County <br /> Indian River <br /> Address : 1840 25th Street Area Code / Phone # <br /> 772-5674000 x 1205 <br /> City, County, State , Zip Code: Vero Beach , Florida 32960-3365 SUNCOM # <br /> 224- 1205 <br /> E-mail Address: efry@.co . indian-river. fl . us Area Code / Fax # <br /> 772-770-5331 <br /> 3. Implementing Agency <br /> Name of Implementing Agency: Indian River County Sheriffs Office County <br /> Name of Chief Executive Official / State Agency Head / Subgrantee representative Indian River <br /> (if a subordinate agency of the subgrant recipient) : Roy Raymond <br /> Title: Sheriff, Indian River County <br /> Address: 4055 41St Avenue Area Code / Phone # <br /> 772-569-6700 <br /> City, County, State , Zip Code: Vero Beach , Florida 32960 SUNCOM # <br /> 234-9404 <br /> E-mail Address : rraymondOiresheriff. orq Area Code / Fax # <br /> 772-569-8144 <br /> FDLE Byrne Formula Grant Application Package Grant Application <br /> Section Il - Page 1 <br /> Rule 11 D-9.006 OCJG - 005 (rev. April 2004) <br />