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TREASURE COAST HOMELESS SERVICES COUNCIL INC. CONTINUUM OF CARE <br />Section I: Project Summary Information <br />Part A: General Project Information (All Projects) <br />1. Project Priority Number <br />2. ❑ New Project <br />3. If renewal, list previous Previous Grant Number: <br />Project Priority <br />®Renewal Project <br />171,29B309003(From <br />grant number & project <br />in <br />Chart Exhibitl): _4_ <br />identifier number (PIN) PIN Number: FL 1311 <br />4. HUD -Defined CoC Name: <br />5. CoC Number: <br />Ft. Pierce/St. Lucie. hidian Ricer, Martin Counties CoC <br />FL509 <br />6. Applicant's Organization Name (Legal Name from SF424) <br />8. Applicant's DUNS Number <br />Indian Ricer Counts Board of Count Commissioners <br />(From SF424): <br />079-208-989 <br />7. El Check box if Applicant is a Faith -Based Organization <br />® Check box if Applicant his ever received a federal grant. either directly from <br />a federal agency or through a state/local a enc% <br />9. Project Applicant's Address (From SF424) <br />10. Applicant's Employer <br />Street: 1840 21t" Street <br />Identification Number (EIN) (From <br />Cit%: Vero Beach State: FL Zi :329(,0 <br />SF -424): 59-6000074 <br />11. Contact person of Project Applicant: (From SF -424) <br />❑Check box if <br />Name: JasonBroxvn Phone number: 772-567-8000 <br />A <br />Applicant is die same as Project <br />Title: Budget Director Fax number: 772-567-5991 <br />Sponsor <br />Email Address: w <br />jbron m 7flrcgoc.co <br />13. Project Name: <br />14. Project's location 6 -digit <br />FMS <br />Geographic Code: <br />15, Project Address (S+C SRAs. if multiple sites list all addresses including): <br />18. ❑ Check box if Energ} Star is <br />Street: 2525 St. Lucie Avenue <br />used in this project <br />City: Vero Beach State: FL Zip: 32960 <br />19. Project Congressional District <br />16. ❑ Check box if project is located in a Rural Area <br />15-16 <br />17. If project contains housing units. are these units: ❑ Leased? ❑ Owned? <br />20. Project Sponsor's Organization Name (If different from Applicant) <br />22. Sponsor's DUNS Number: <br />Treasure Coast Homeless Sen ices Council, hic. <br />21. Check box if Project Sponsor is a Faith -Based Organization <br />® Check box if Project Sponsor has ever received a federal gruit. either <br />directly from a federal agency or through a state/local agency <br />23. Project Sponsor's Address (if different from Applicant) <br />24. Sponsor's Emplo}er <br />Street: 2525 St. Lucie Avenue <br />Identification Nuiniber (EIN): <br />City: Vero Beach State: FL Zip: 32960 <br />25. Contact person of Project Sponsor (if different from Applicant) <br />Name: Louise Hubbard Phone number: 772-567-7790 <br />Title: Executive Director Fax number: 772-567-5991 <br />Email Address: irhsclhtiaofcom <br />