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TREASURE COAST HOMELESS SERVICES COUNCIL INC. CONTINUUM OF CARE Part A* General Prqiect Information Projects) 1. Project PriorityNumber 2. El New Project 3. If renewal, lis[ previous Precious Gram Number: (From Project Priority ®Renewal BOJ grant number & project FL29B509002 Chart in Exhibitl): 2_ identifier number (PIN) PIN Number: FL13199 4. HUD -Defined CoC Name: 5. CoC Number: Ft. Pierce/St. Lucie, Indian Ricer. D9artin Counties CoC FL -509 6. Applicant's Organization Name (Legal Name from SF -424) 8. Applicant's DUNS Number Indian Ricer Coumh Board of County commissioners (From SF -424): 079-208-989 7. rl Check box if Applicant is a Faith -Based Organization ® Check box if Applicant has ever received a federal grant. either directly from a federal agency or through a state/local agency 9. Project Applicaut's Address (From SF -424) 10. Applicant's Employer Street: 1&10 25m Street Identification Nmnber (EIN) (From City: Vero Beach State: Fl Zi :32960 SF -424): 59-6000674 11. Contact person of Project Applicant: (From SF -424) li Check boy Name: Jason Brown Phone number:772-567-8000 mProject A Applicant is the same as Project Title: Budget Director Fax number: 772-567-5991 Sponsor Email Address: jbrmyriiircu o.cont 13. Project Name: 14. Project's location 6 -digit Family Options Transitional Housing Geographic Code: 129061 15. Project Address (S+C SRAs, if multiple sites list all addresses including): 18. ® Check box if Energy Star is Street: 720 4`s Street used in this project City: Vero Beach State: Fl Zip: 32962 19. Project Congressional Districts 16. ❑ Check box if project is located in a Rural Area 15-16- 5-16:17. 17.If project contains housing units, are these units: ❑ Leased? ® Owned? 20. Project Sponsor's Organization Name (If different from Applicant) 22. Sponsor's DUNS Number: 21. 0 Check box if Project Sponsor is a Faith -Based Organization ❑ Check box if Project Sponsor has ever received a federal grant, either directly from a federal agency or through a state/local a eiucc 23. Project Sponsor's Address (if different from Applicant) 24. Sponsors Employer Street: Identification Number (EIN): City: State: Zip: 25. Contact person of Project Sponsor (if different from Applicant) N/A Name: Phone number: Title: Fax number: Email Address: