HomeMy WebLinkAbout2008-420 � ch � fi i� C
FLORIDA SMALL CITIES AND DISASTER RECOVERY CDBG CLOSEOUT ( Revised 6 .08) f� tJr
Closeout forms must be submitted to the Department of Community Affairs, Florida Small Cities CDBG or Disaster Recovery
Program, within 45 days after the contract termination or expiration date . A Final Request for Funds should be submitted
prior to, or with, the closeout since funds not requested will be deobligated at closeout. Closeout requirements can be
found in Rule 9B-43 . 0051 ( 11 ), F .A . C.
Instructions
All grant recipients must complete Section I . Section II applies to Commercial Revitalization or Neighborhood
Revitalization activities . Section III relates only to Commercial Revitalization or Economic Development activities . And,
Section IV relates to Housing activities . All grant recipients must complete the Beneficiary Data form and the Status of
Accomplishments and Expenditures form . The Closeout Approval form must be signed by the Chief Elected Official . Enter
the information requested or circle the response .
Section I . Contract Information
Contract Number: Recipient: Beginning Date : Ending Date:
06D6-3C- 10-40-01 -W14 Indian River County
08/20/2005 11/ 19/2008
Phone Number:
County in which recipient is Local Contact: (772) 226- 1243
located : Indian River William Schutt, Senior Economic Planner
1 . Indicate how the project was carried out (administration Grantee Contractors Both
Employees i X
and construction ) : TC:ensus Survey
2 . Indicate how beneficiary data was collected : X X
3 . If location of activities chap ed is a ma included? N A Yes No
4 . Is a Property Management Register included? N/A Yes No
Yes X No
5 . If an infrastructure project, is an en ineering certification included ? Yes No X
6 . Is the roject located in a Historic District?
7 Is the project located in a Presidentially Declared Disaster Area? Yes X a No
8 Is the project a Special Assessment activity? I Yes No _ X
9 . Is the project a Brownfield Activity? Yes_ No X
1
nce (to Grant Deferred , forgiveable loan
10 . Did the local government provide the assista
the beneficiaries in the form of a loan or a rant . X N/A
11 . List all other funds alongwith the source used to support the activities funded with this rant : Amount
Source
Local Funds (Le . , General Revenue)
Indian River Coun 1943596 .47
Grant( s) Florida Housing Finance Corporation - Hurricane
Housing Recovery Program 441200s00
Private Funds ( i . e . , Participating
Party, etc .
Loan (s)
Other ( Specify)
12 . Will the project result in program income? Program income not expended before closeout Yes No X
must be returned to DCA. Make check payable to the Department of Community Affairs -
CDBG Program and include it with the Closeout.
• If ro ram income has already resulted indicate amount: Yes X No
13 . Has a final Regi iest for Funds been submitted? No X
14 . Does the local overnment have CDBG Funds on hand? cannot exceed 5 000 If es :
1
Section II. Service, Benefit, Public Facility and Infrastructure
To be completed by Commercial Revitalization, Neighborhood Revitalization or Disaster Recovery grant recipients If public
services are offered or new or improved public facilities or infrastructure is provided.
Service or Benefit ( i . e., Water and Sewer Hookups)
2.
a . Number of persons with new access to this service or benefit
b . Number of persons with improved access to this service or benefit 210
c. Number of persons now receiving a service or benefit that is no longer substandard 0
3 . Public Facility or Infrastructure Improvement (Water Tank, Treatment Plant, Street Paving) 0
E4.
a . Number of persons with new access to this type of public facility or infrastructure improvement
b . Number of persons with improved access to this type if public facility or infrastructure 0
improvement 27336
c. Number of persons served by public facility or infrastructure that is no longer substandard
0
Section III. Commercial Revitalization or Economic Development - N /A
*Recipients of Commercial Revitalization grants should only respond to items with an asterisk (*), These items may also
pertain to Disaster grants.
*Number of businesses assisted with commercial facade improvements
i
j * Number of businesses assisted that provide goods or services to meet the needs of a particular service
area, neighborhood or community
* Number of businesses assisted
Number of unemployed prior to taking jobs created by this activity
i
Number of jobs with employer-sponsored health care benefits
Number of new businesses assisted j Number of existing businesses assisted
Number of existing businesses expanding j Number of existing businesses relocating
Number of full-time positions created j
P Number of full -time positions retained I
I
Number of full -time low/mod positions created Number of full-time low/mod positions retained 1
Number of part-time positions created Number of hours per week
i
Number of art-time positions retained
Number of hours per week
P
Number of art-time low/mod positions created Number of hours per week
i !
Number of part-time low/mod positions retained j Number of hours per week
L I
i
2
T
Section III . Commercial Revitalization or Economic Development (Continued)
Indicate below the number of jobs created by type :
....._...................................._......................................_........_...._.................................,..........................................,..._........_....
._.__......_._..........._._............_........__....__._..........._............_..._.._;......---......_......................
Officials and...Managers._............................ .......................................... ....Craft .Workers _(mskilled ).__..._._.._................i.._.__.........................
_....;
Professional _..._E..........................................t..._......
Operatives Semi-skilled.)._..._.._.......
.....t......._._..._......._......_...�
_...._........_.._..__..._................................._..........................._.
Technicians . . . . . . .
Laborers-...__....(._.....__.........__...unskilled
_
.. ..... ... ........_._................_ ............................._........ .......... .. ..... .................... --
r. ----..... �............................._...__.._ _......_..........._.... .........
Salesi Service Workers I
..._...................................................._.....;..................................._. .
._..........._..._..._._.._......_....... ._................................................................._...,......_.......4..._.__. _. _.
Office and Clerical ... .................._.......__.............._..............._ ....._.......__..............
.....
* For each business assisted, enter the business name and DUNS # :
.............._............_............_._......................_...._..........................................._._.......,. ._._......_........_...............
.........._......................................................._............................
... ... _ ..... ... . DUNS #
Business ;
_. __.............................................. ............................................................................................._. DUNS
#
Business
............................................................._............................................__.;........_ _..............._.... .
...... ........ . ....__._.....__.._..._ ...... ......._.............._....................._............._......_.._.
............_.. ._. . . __.. . . _ .
.... ............_....................._.........._ . DUNS #
Business
....._......._.............._......................._......
...
_._..._._. . . .. ........................................................................._....._.............._._............_.._......._..
J........._......__......_....._._................................_._............
... ... .............................................................__........._.._................................................._........_.._.
Business DUNS #
.............._............,_........._...................... . __.............._........__............_........................_............_..,
Section IV, Housing — N / A
To be completed for Housing Rehabilitation/ Replacement activities . Accomplishments are measured by housing units
completed ; beneficiaries are measured by households assisted ( rather than the number of persons in a household ) . Race
and ethnicity data reported on the Beneficiary Data form ( Section VI) should be reflected for the head of household .
Total number of units occupied prior to the project j
11 Total number of units occupied by a household of low and moderate income prior to the project
Total number of units occupied upon completion of the project
Total number of units occupied by a household of low and moderate income upon completion
Number of multi-family units rehabilitated
Number of permanent displacements/ relocations
Number of units made handicapped accessible
Number of pre- 1978 units brought into compliance with lead safety requirements
Number of units qualified as "energy star"
Number of single-family houses rehabilitated
V Number owner-occupied at completion
V Number renter-occupied at completion
V Number of one-for-one replacements
If applicable, number of beds created in overnight shelter of emergency housing
3
Section IV. Housing (Continued )
If new affordable housing units were created :
0 Enter the number of years that affordability is guaranteed
V Enter the number of units made handicapped accessible
V Enter the number of units qualified as "energy star"
0 Enter the number of households previously living in subsidized housing
All grant recipients providing housing activities must complete the Housing Benefit form .
4
Housing Benefit Form
(Make copies of this page if necessary to report on units addressed .)
unit # Owner (0) Name of Owner Name of Occupant Street Address Total Cost Total CDBG Date Rehab Replace- #
of`
or (street, city and zip) of Rehab or Funds Invested Completed (Yes or ment Bed-
Renter (R) (If replacement, new address) Replacement No) (Yes or rooms
No)
Occupied
N/A -- -- --
2 $ $
3 $ $
4 - $ $
6 $ $
8 $ $
9 $ $
10
12
13 $ $
15 --- -- $ $ --
5
Section V. STATUS OF ACCOMPLISHMENTS AND EXPENDITURES
- -- ---
r (B) (C) (D) (E ' ; (F) (G) (H) (I) - (�
Servic Impacted Census Activit Activity IDIS , CDBG Current CDBG Funds Final RFF At Other
e Area Tracts and Block y Name # Accomplishments Approved CDBG Received To Date Closeout Leverage
# Groups* # DCA Use _ Budget (If Applicable) Funds Expended
Proposed Actual
(Contracted (Completed)
for
1 N/A 21A Administration N/A N/A $ 415, 047 . 89 $ 254 $ 160, 500 . 00
- - - - --- 547 . 89 $ 0 . 00
1 N/A 216 Engineering It N/A N/A $ 89,451 . 00 $ 89,451 . 00 $ 0 .00 $ 0 . 00
50601 . 11 50603 .01 - ----- - -- -
50603 . 21 50603.31
50604. 11 50604. 21
50605 . 21 50605.31
50606, 1, 50606,21
50606.41 50703 . 1f
50703 . 21 50703 .31 Fire Station
1 50903 . 21 50606.3 030 Replacement ,, 1 BLDG 1 BLDG $ 21130,096 . 03 $ 2 130 096 . 03 $ 0 .00 $ 56,
068 . 00
50400 . 6 033 Sanita Sewer 21500 LF1 23384 LF $ 4 2O4 477 . 08 $ 4 177, 024o97 27 452 . 11 $ 11887f528
, 47
Potable Water Lines
50803 . 3 033 Phase I 7050 LF 7050 LF $ 555, 083 . 50 555 083 . 50 $ 0 . 00
$ 29,900 . 00
$
Potable Water Lines - ---
50803 . 3 033 Phase II 1650 LF i 1650 LF $ 105, 844 . 50
$ 105 844 . 50 $ 0 . 00 $ 14,300 . 00
TOTALS - - --- ---
, ' $ 7,500,000.00 ,
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - '
_ $ 7,312 047.89 $ 187,952. 11 $ 11987, 796 .47
- - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
(K) Total CDBG Approved Budget: Total of Column (G) - - - - - -
- - - - - - - - - - - - - - - - - - - - -
$ 7, 500f000000
(L) Total CDBG Funds Received To Date: Total of Column (H) 7 312,047 . 89
(M) Total Amount of Final RFF: Total of Column (I) $ 187, 952 . 11
(N) Total Amount of CDBG Funds Requested : Total of Column (H) + (1) $ 7, 5001000 . 00
(0) Refund Due to DCA: If Line (N) is greater than Line (K) enter the difference _ $ 0 . 00
(P) Amount to be Deobligated : If Line (N) is less than Line (K) enter the difference $ 0 . 00
* You must indicate which census tracks in which work was conducted regardless of whether census tract information was used to determine LMI
benefit or not.
6
Section We BENEFICIARY DATA Do not enter Administration or Engineering activities _ _.
' Activity # 03J Activity # 03J _d Activity # 03J — Activity # 030 Activity # Activity #
Potable Water Lines Phs Fire Station
r
Sanit Sewer Potable Water Lines Phs 1�_ II _ _ Replacement
Total Beneficiaries Proposed = 25669
1667 161 _ 59 —
Total Beneficiaries Actually Served ' 25669
1667 164 � 46 —
s Proposed 10190
1049 141 G 48 _
Beneficiaries Actually Served 43 10190
1049 144 _- - ! _
i
Proposed N/A N/A
N/A N/A — --- — --
Beneficiaries Actually Served �II N/A N/A
N/A N/A --- -- -----
LICATED BENEFICARIES 46 25669
1667 164 —__—Maier 809 79 —_- 22 _-- 12418
Female 85 24 13251
858 —_ — _ � ---
Disabled 10 5560
362 36
Female Head of Household N/A
Elderly N/A
N/A N/A ----
Elderly
488 48 13 7495
RACE Total # of Hispanic Total # of Hispanic 1 Total # of Hispanic Total # of Hispanic Total # of Hispanic Total # of Hispanic
Ethnicity Ethnicity Ethnicity Ethnicity Ethnicity Ethnicity
White ( 11 )
1462 51 510___ 0 0 _ 22447 859
African American ( 12) 46 2103
137 148
Asian (13) 12 1 - -- - 0 — 190
American Indian or Alaskan Native (14) 0 63
Native Hawaiian Pacific Islander ( 15) 0 0 7
American Indian or Alaskan Native and White 0 0
16) 0 0 --- --
Asian and White ( 17) 0 0 0
0 --- _—.
African American and White (18) 0 0
American Indian/Alaskan Native and African 0 0
American 19 0 0f46
Other Multi-racial (20) 0 0
Totals1616 51 154 10 0 24810 859
07
Section VII . PROPERTY MANAGEMENT REGISTER
FecipiEent N/A Contract End Date
umber Local Contact
1 2 3 --- 4 --
Description of Property ---- -- -or Type of Equipment
Identification Number - -- - --� --
Date of Purchase or - - -- - -
Acquisition
Total Cost of Property - -- -- - --
CDBG Cost - - - -- -
CDBG % of Total Cost - - -- - --
Physical Location -- - -- - -- -- --
Condition ( New or Used) -- ---- -- - - -
Residual Value - - - -- --- -
Disposition Date - - -- - -
Disposition Amount - - - - - --- -- -
Method of Disposition -- - - -
8
UNMET NEED — FOR DISASTER GRANTS ONLY
.................._........................_....,.................................._..........._.............................................................,
..............._................................................................._I........................
,
Activity Activity Name ! Units Needed Funds Needed Funds Available
i I
# i ..... .. . .
..._...........
...................._..........._. ....................................................................................................................................................._.
41.....0......._......I...._......I ....................._............_.
.._....._
i.............................................................................................................
I '
( .i...._....__._................................................._.._...._...... . i......N A .........................._
....r_..................._.............................................................. .._............. _
.........
_........
i _.._...............__....................._.....4.0........_.4..._....... _..................too....................
_................._...._....._......_....._......
i
' .... do
.......................................... ..._-........
................._..................................I.............._......._.._._ ......_.........._.................._................_....._
..............................._.....i r_..
j i I
i
...... ._._... - . ......_............. ....._. . ._ .
... . . . . ........ ._....s.._... _ ........
. .. . . .. _ ... .. .......... ..__................_..........._...
......._._...._._.._._.........._......._...._...__........_....__.._..........__........_..._.
:
... ....._ . . . . .W ........................................_._............._......._....._..................__..t.._._...._.._............ . --
9
Section VIII . CLOSEOUT APPROVAL
I certify that, to the best of my knowledge, all activities undertaken by the Recipient with funds under this grant
agreement have been carried out in accordance with the grant agreement, that proper provision has been made for the
payment of all paid costs identified; that the State of Florida is under no obligation to make further payment to the
Recipient under the grant agreement in excess of the amount identified on Line K of the STATUS OF ACCOMPLISH-
MENTS AND EXPENDITURES form submitted with this closeout package; that every statement and amount set forth in
this instrument is true and correct as of this date; that all required audits as of this date have been submitted and
approved ; and I acknowledge that the DCA reserves the right to recover any disallowed costs identified in an audit
completed after this closeout.
Chief Elected Official
Signature
Wesley S . Davis, Board of County Commissioners Chairman
l9cemler 16 2008
Date
For DCA use only :
I
j Approval of this Closeout Package authorizes the deobligation of unexpended CDBG contract funds in the
I
amount of $
I
Division of Housing and Community Development DCA Finance and Accounting Section
Name and Title Name and Title
Date Date
FACommunity Development\Users\CDBG\cdbg 2005\CloseOut\Final Versions\Closeout\CloseoutDocuments.doc
10
FLORIDA SMALL CITIES AND DISASTER RECOVERY CDBG CLOSEOUT ( Revised 6 . 08)
Closeout forms must be submitted to the Department of Community Affairs, Florida Small Cities CDBG or Disaster Recovery
Program , within 45 days after the contract termination or expiration date . A Final Request for Funds should be submitted
prior to, or with , the closeout since funds not requested will be deobligated at closeout . Closeout requirements can be
found in Rule 9B-43 . 0051 ( 11 ), F .A . C.
Instructions
All grant recipients must complete Section I . Section II applies to Commercial Revitalization or Neighborhood
Revitalization activities . Section III relates only to Commercial Revitalization or Economic Development activities . And,
Section IV relates to Housing activities . All grant recipients must complete the Beneficiary Data form and the Status of
Accomplishments and Expenditures form . The Closeout Approval form must be signed by the Chief Elected Official . Enter
the information requested or circle the response .
Section I . Contract Information
Contract Number: Recipient: Beginning Date : Ending Date :
06DB-3C- 10-40-01 -W14 Indian River County 08/20/ 2005 11/ 19/2008
County in which recipient is Local Contact: Phone Number:
located : Indian River William Schutt, Senior Economic Planner (772) 226- 1243
1 . Indicate how the project was carried out (administration Grantee Contractors Both
and construction ) : Employees X
2 . Indicate how beneficiary data was collected : Census Survey
X X
3 . If location of activities changedr changedis a map included? N/A Yes No
4 . Is a Property Management Register included ? N/A Yes No
5 . If an infrastructure project, is an engineering certification included? Yes X No
6 . Is the project located in a Historic District? Yes No X
7 . Is the project located in a Presidentially Declared Disaster Area ? Yes X No
8 . Is the project a Special Assessment activi ? I Yes I No X
1 9 . Is the project a Brownfield Activity? Yes No X
10 . Did the local government provide the assistance (to Grant Deferred, forgiveable loan
the beneficiaries in the form of a loan ora rant? X N/A
11 . List all other funds alongwith the source used to support the activities funded with this rant :
Source Amount
Locai Funds ( i .e . , General Revenue)
Indian River County 1 943 596 .47
Grants Florida Housing Finance Corporation — Hurricane
( )
Housing Recovery Program 44 200 . 00
Private Funds ( i . e . , Participating
Party, etc.
Loan(s)
Other (Specify)
12 . Will the project result in program income? Program income not expended before closeout Yes No
must be returned to DCA. Make check payable to the Department of Community Affairs — X
CDBG Program and include it with the Closeout.
If program income has alread resulted indicate amount :
13 . Has a final Request for Funds been submitted? Yes X No
14 . Does the local government have CDBG Funds on hand? cannot exceed 5 000 If es : No X
I
Section II. Service, Benefit, Public Facility and Infrastructure
To be completed by Commercial Revitalization, Neighborhood Revitalization or Disaster Recovery grant recipients If public
services are offered or new or improved public facilities or infrastructure is provided.
1 . Service or Benefit (i . e., Water and Sewer Hookups)
2.
a . Number of persons with new access to this service or benefit
b. Number of persons with improved access to this service or benefit 210
c. Number of persons now receiving a service or benefit that is no longer substandard 0
3 . Public Facility or Infrastructure Improvement (Water Tank, Treatment Plant, Street Paving) 0
4.
a . Number of persons with new access to this type of public facility or infrastructure improvement
b . Number of persons with improved access to this type if public facility or infrastructure 0
improvement 27336
c . Number of persons served by public facility or infrastructure that is no longer substandard
0
Section III . Commercial Revitalization or Economic Development - N / A
*Recipients of Commercial Revitalization grants should only respond to items with an asterisk (*), These items may also
pertain to Disaster grants.
* Number of businesses assisted with commercial facade improvements
i
I * Number of businesses assisted that provide goods or services to meet the needs of a particular service
area
__neighborhood or community _
* Number of businesses assisted
Number of unemployed prior to taking jobs created by this activity
Number of jobs with employer-sponsored health care benefits
Number of new businesses assisted Number of existing businesses assisted
Number of existing businesses expanding Number of existing businesses relocating
I
Number of full -time positions created Number of full-time positions retained
Number of full -time low/ mod positions created Number of full-time low/mod positions retained
I
Number of part-time positions created Number of hours per week
Number of part-time positions retained Number of hours per week
i
F
Number of part-time low/ mod positions created Number of hours per week
Number of part-time low/mod positions retained Number of hours per week
i
2
Section III . Commercial Revitalization or Economic Development (Continued )
Indicate below the number of jobs created by type :
._......................_.......................--........I._....._.......-..... .. -_..........................................;...............................................................
-..........�._....._...._...._................................................................................,...............-...-............
. ......
Officials- and Mana ers Craft Workers skilled }
... ... .. .. _ ..... .... . .. .g ........... ......... ... ...._ ... ..' ....................._..- . . (._._- _..._-....... )
. ... ........... ... ......
.Professional.......... . .._... .....- ........- . .. .. . .. ................ ...... . . . . . . .. ....._ . ._Operatives semi -skilled
. ..-_............._.-........-.._. .._Z-. - . _.. ._....{. .. . .. .......
Technicians Laborers unskilled , ,_,,,,__,,,___,,,,_.,.. .j
.. .. . . . . ... ._... ... .... . ......................................_........................................ ................................._..-... .....-.__.......-.._
.-...__.......A......- --_...............)..............._................_...._...; . - 1
Sales............................_...................... ......................._............................... ... ....................................;_._Service Workers.....-.....-_.
.....-_.._......-......._............. ........._...............-..-........
Office and Clerical ......'
* For each business assisted, enter the business name and DUNS # :
.............-_......................................................-.............-...................._..................._...........-........-......................................
.....................-...._........................-....__.......__ ....._ ........-....._........-......-...... .... . .. ... - ... .... .... ... . . -........ ...........
............._.-. . .-...........................
. . ._. .. ... ... . . .. . .... ......... . . . ....... . .
_............................................ .... .. . DUNS #
Business
...............................-................................................................................_.............._.........................__............................
........................................-............._..._._.................................. _......-.-..........._.....-...._......................................................................
..................................__......................................................
Business ; DUNS #
................................................-........ .. .....
..............................................................................................._......_...__....................-................................................
......................._..._...._._...... ..................-._..........-..-........................................-........_............................._.-....-................-.................
...-.,............-.........
Business ; DUNS #
......-
....._........_........... ...... ...................................._.......... ..................-...................._............._......................_...................
._............... ....__........_......-......-.._.........._......_._...................._.... ._...............-.........._..........................................................._........
............._.-...................................................................-..........,
Business DUNS #
........_-............................................................._....................................-_........ ...............................-...........
........................_.................._...................................._......................._.............._........._..... ........
Section IV. Housing — N / A
To be completed for Housing Rehabilitation/ Replacement activities . Accomplishments are measured by housing units
completed ; beneficiaries are measured by households assisted ( rather than the number of persons in a household ) . Race
and ethnicity data reported on the Beneficiary Data form ( Section VI) should be reflected for the head of household .
Total number of units occupied prior to the project j
Total number of units occupied by a household of low and moderate income prior to the project
Total number of units occupied upon completion of the project
Total number of units occupied by a household of low and moderate income upon completion
Number of multi-family units rehabilitated
Number of permanent displacements/ relocations
Number of units made handicapped accessible
Number of pre- 1978 units brought into compliance with lead safety requirements
Number of units qualified as "energy star"
Number of single-family houses rehabilitated
V Number owner-occupied at completion
V Number renter-occupied at completion
V Number of one-for-one replacements
If applicable, number of beds created in overnight shelter of emergency housing
3
Section IV. Housing (Continued)
If new affordable housing units were created :
V Enter the number of years that affordability is guaranteed
V Enter the number of units made handicapped accessible
V Enter the number of units qualified as "energy star"
V Enter the number of households previously living in subsidized housing
All grant recipients providing housing activities must complete the Housing Benefit form .
4
Housing Benefit Form
( Make copies of this page if necessary to report on units addressed .)
Unit # Owner (0) Name of Owner Name of Occupant Street Address Total Cost Total CDBG Date Rehab Replace-
# of
or (street, city and zip) of Rehab or Funds Invested Completed (Yes or ment Bed-
Renter (R) (if replacement, new address) Replacement No) (Yes or rooms
No)
Occupied
N/A _— -- -- -- — $
2
7 $ $
10
11 $ $
12
i
13 $ $
14 I $ $
I
15 5
i
Section V. STATUS OF ACCOMPLISHMENTS AND EXPENDITURES
(A) (B) (C) (D) (E) (F) - -- — (G) (H) (I) (J) —
Servic Impacted Census Activit Activity IDIS-% CDBG Current CDBG Funds Final RFF At Other
e Area Tracts and Block y Name # Accomplishments Approved CDBG Received To Date Closeout Leverage
# Groups* # rDCA .f�se - Budget (If Applicable) Funds Expended
Unly Proposed Actual
(Contracted (Completed)
1 N/A 21A Administration N/A N/A $ 415, 047 . 89 254 547 . 89 $ 160, 500 . 00 $ 0 . 00
1 N/A 21B Engineering N/A N/A $ 89,451 . 00 $ 89,451 . 00 $ 0 . 00 $ 0 . 00
50601 , 11 50603 .0, — --- ---- - --- _--- —__
50603 , 21 50603 .31
50604. 11 50604. 21
50605 . 2f 50605 .3f
50606, 11 50606. 21
50606.41 50703. 11
50703 . 21 50703 .31 Fire Station
1 50903 . 21 50606.3 030 Replacement :: 1 BLDG 1 BLDG $ 2, 130096 . 03 $ 2, 130 096 . 03
--- $ 0 . 00 $ 56,068 . 00
50400 . 6 033 Sanitary Sewer 21500 LF_ 23384 LF $ 4, 204,477 . 08 $ 41177, 024a97 $ 27 452 . 11 11887,
528o47
Potable Water Lines
50803 . 3 033 Phase IL 7050 LF 7050 LF $ 555r081500600$ 0 . 00 $ 29, 900 . 00
Potable Water Lines �
- - -
50803 . 3 03J Phase II 1650 LF 1650 LF $ 105, 844 . 50 $ 105, 844. 50 $ 0 .00 $ 141300 . 00
TOTALS -- - - - - — ---
$ 7,500rOOMOO $ 7,312,047.89 187,952. 11 $ 1, 987, 79
6x47
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - -
Total CDBG Approved Budget: Total of Column (G) $ 7 500 000 . 00
(L) Total CDBG Funds Received To Date: Total of Column (IT) 7j3121047889
(M) Total Amount of Final RFF: Total of Column (1) _ $ 187 952 . 11
(N) Total Amount of CDBG Funds Requested : Total of Column (IT) + (I) _ $ 7 500 000 . 00
(0) Refund Due to DCA : If Line (N) is greater than Line (K) enter the difference ____ _ _ _ _ $ 0 . 00
(P) Amount to be Deobligated : If Line (N) is less than Line (K) enter the difference --_ _ — $ 0 . 00
* You must indicate which census tracks in which work was conducted regardless of whether census tract information was used to determine LMI
benefit or not.
6
Section VI . BENEFICIARY DATA Do not enter Administration or Engineering activities)
Activity03
# 03J Activity # J _ Activity # 03J Activity # 030 Activi # Activity #
Potable Water Lines Phs Fire Station
Sanitary Sewer Potable Water Lines Phs 1 II _ Replacement _
Total Beneficiaries Proposed
1667 161 59 25669
Total Beneficiaries Actually Served
1667 164 46 — 25669
LMI Beneficiaries Proposed
1049 141 48 10190 _
LMI Beneficiaries Actually Served
1049 144 43 _ ._ 10190
VL1 Beneficiaries Proposed
N/A N/A N/A N/A —_
VLl Beneficiaries Actually Served
N/A N/A N/A _ N/A
TOTAL UNDUPLICATED BENEFICARIES
1667 164 46 25669
Male
809 79 22 12418
Female
858 85 _ 24 13251
Disabled
362 36 10 5560
Female Head of Household
N/A N/A N/A N/A
Elderly
Ogg 48 _ 13 _ 7495
RACE Total # of Hispanic Total # of Hispanic Total # of Hispanic Total # of Hispanic Total # of Hispanic Total # of Hispanic
Ethnicity Ethnicity Ethnicity Ethnicity Ethnicity Ethnicity
White ( 11 )
1462 51 5 10 0 _ 0 22447 859
African American ( 12)
137 148 46 2103
Asian (13)
12 1 0 _ 190
American Indian or Alaskan Native ( 14)
4 0 0 63
Native Hawaiian Pacific Islander ( 15)
7
American Indian or Alaskan Native and White
16) 0 0 _---- 0 -- 0
Asian and White ( 17)
African American and White ( 18)
American Indian/Alaskan Native and African
American 19 0 0 _ _ 0 0 _
Other Multi-racial (20)
Totals
1616 =11 '54 10 — 46 1 0 24810 859
7
Section VII . PROPERTY MANAGEMENT REGISTER
Recipient N/A Contract End Date
Contract Number Local Contact
1 2 3 4 5
Description of Property —_— — ----
or Type of Equipment
Identification Number —
Date of Purchase or ---
Acquisition
Total Cost of Property
CDBG Cost
CDBG % of Total Cost - - -
Physical Location — --
Condition ( New or Used)
Residual Value
Disposition Date — -- - -
Disposition Amount
Method of Disposition
8
UNMET NEED — FOR DISASTER GRANTS ONLY
.............................................._........._..............................................................,........_........_........................_..
_...._..._...............................................;................._....................._............................._._........................_...._..,
Activity Activity Name Units Needed Funds Needed Funds Available
#
_. _.................. .........................._............................................................_....__...........!.._...................._.._._......
.................................................. ...._... ...... _..................................._....._..._........_.................
...............................................:.............
_........... __. i
I i
N /A ' ... ............ 'i
i
I
;
i
i ....................__..............._.._.................._... ............................_..................._....................................._................
... . .._............_............................_.._...._.... ..
._.._......_..........._...........................................................
...............................................j......................................_.....................................................,........................._.
. ..................._........_.. ............
i !
.... ......
i
;
.............._..................._......_.._.............._...._........................_.............._..i..........._...................................................._..
.... ...................._
9
Section VIII. CLOSEOUT APPROVAL
I certify that, to the best of my knowledge, all activities undertaken by the Recipient with funds under this grant
agreement have been carried out in accordance with the grant agreement, that proper provision has been made for the
payment of all paid costs identified ; that the State of Florida is under no obligation to make further payment to the
Recipient under the grant agreement in excess of the amount identified on Line K of the STATUS OF ACCOMPLISH-
MENTS AND EXPENDITURES form submitted with this closeout package; that every statement and amount set forth in
this instrument is true and correct as of this date; that all required audits as of this date have been submitted and
approved; and I acknowledge that the DCA reserves the right to recover any disallowed costs identified in an audit
completed after this closeout.
Chief Elected Official
Signature
Wesley S . Davis, Board of County Commissioners Chairman
December 16 , 2008
Date
For DCA use only,
Approval of this Closeout Package authorizes the deobligation of unexpended CDBG contract funds in the
amount of $
Division of Housing and Community Development DCA Finance and Accounting Section
Name and Title Name and Title
Date Date
FACommunity Development\Users\CDBG\cdbg 2005\CloseOut\Final Versions\Closeout\CloseoutDocuments. doc
10
FLORIDA SMALL CITIES AND DISASTER RECOVERY CDBG CLOSEOUT ( Revised 6. 08)
Closeout forms must be submitted to the Department of Community Affairs, Florida Small Cities CDBG or Disaster Recovery
Program, within 45 days after the contract termination or expiration date . A Final Request for Funds should be submitted
prior to, or with , the closeout since funds not requested will be deobligated at closeout. Closeout requirements can be
found in Rule 9B-43 . 0051 ( 11 ), F . A. C .
Instructions
All grant recipients must complete Section I . Section II applies to Commercial Revitalization or Neighborhood
Revitalization activities . Section III relates only to Commercial Revitalization or Economic Development activities . And,
Section IV relates to Housing activities . All grant recipients must complete the Beneficiary Data form and the Status of
Accomplishments and Expenditures form . The Closeout Approval form must be signed by the Chief Elected Official . Enter
the information requested or circle the response .
Section I . Contract Information
Contract Number: Recipient: Beginning Date : Ending Date :
06DB-3C- 1040-01 -W14 Indian River County 08/20/ 2005 11/ 19/2008
County in which recipient is Local Contact: Phone Number:
located : Indian River William Schutt, Senior Economic Planner (772) 226- 1243
1 . Indicate how the project was carried out (administration Grantee Contractors Both
and construction ) : I Employees X
2 . Indicate how beneficiary data was collected : Census Survey
X X
3 . If location of activities changed , is a map included? N/A Yes No
4 . Is a Property Management Register included ? N/A Yes No
5 . If an infrastructure project, is an engineering certification included? Yes X Yes No X
6 . Is the project located in a Historic District?
7 . Is the proiect located in a Presidentially Declared Disaster Area? Yes X No
8a Is the project a Special Assessment activity? ; Yes No X
9 . Is the project a Brownfield Activity? ___. ___ ___ __ _J_ Yes _ ; No X
10 . Did the local government provide the assistance (to Grant Deferred, forgiveable loan
the beneficiaries in the form of a loan ora rant? X I. I N A
11 . List all other funds alon with the source used to support the activities funded with this rant : Amount
Source
Local Funds ( i . e . , General Revenue) 1 943 596 .47
Indian River County
Grant(s) Florida Housing Finance Corporation - Hurricane
HousingRecoveryProgram
44 200 . 00
Private Funds ( i .e . , Participating
Pa etc .
Loan (s)
Other (Specify)
12 . Will the project result in program income? Program income not expended before closeout Yes No X
must be returned to DCA . Make check payable to the Department of Community Affairs -
CDBG Pro ram and include it with the Closeout.
If program income has alreadyresulted indicate amount :
13 . Has a final Request for Funds been submitted? Yes X No
14 . Does the local government have CDBG Funds on hand? cannot exceed S 000 If es : No X
1
Section II. Service, Benefit, Public Facility and Infrastructure
To be completed by Commercial Revitalization, Neighborhood Revitalization or Disaster Recovery grant recipients ifpub/ic
services are offered or new or improved public facilities or infrastructure is provided.
1 . Service or Benefit (i . e., Water and Sewer Hookups)
2 .
a . Number of persons with new access to this service or benefit
210
b . Number of persons with improved access to this service or benefit
c . Number of persons now receiving a service or benefit that is no longer substandard 0
0
3 . Public Facility or Infrastructure Improvement (Water Tank, Treatment Plant, Street Paving)
4.
a . Number of persons with new access to this type of public facility or infrastructure improvement
b . Number of persons with improved access to this type if public facility or infrastructure 0
im rovement 27336
c. Number of persons served by public facility or infrastructure that is no longer substandard
0
Section III. Commercial Revitalization or Economic Development - N / A
*Recipients of Commercial Revitalization grants should only respond to items with an asterisk (*). These items may also
pertain to Disaster grants.
* Number of businesses assisted with commercial facade improvements
j * Number of businesses assisted that provide goods or services to meet the needs of a particular service
area, neighborhood or community _
* Number of businesses assisted
Number of unemployed prior to taking jobs created by this activity
Number of jobs with employer-sponsored health care benefits
i
Number of new businesses assisted j Number of existing businesses assisted
i
Number of existing businesses expanding Number of existing businesses relocating
Number of full -timeositions created i
P ! Number of full -time positions retained
Number of full-time low/mod positions created Number of full-time low/mod positions retained
Number of part-time positions created i Number of hours per week
i
Number of part-time positions retained Number of hours per week
p low/
mod of art-time low mod p ositions created Number of hours per week j
Number of part-time low/ mod positions retained Number of hours per week
2
Section III . Commercial Revitalization or Economic Development (Continued)
Indicate below. the number of jobs created by type:
...4.............. _..._..._.. __ ._......_.............................................................................._............__...........
.
;...Officials andManaers .. CrafWrkers _s_
k...._i.l._l
._d.....�
........... . ._............_ ................._.. . ............._ ..._ ._ .... .._._..._........................
..._ g
ProfessionalOperatives semi-skilled)
........... .... . .........._...... _ ...............°_..__....._._.._..........._....................
..._..... ......._ __.................. . ......._.............._.................. ......_..........._. ,.
TechniciansLaborers .( unskilled)
......................................... _ .. ........... _..... .._...................... _.....__.._........._........!;;'
Sales
..._.............._....... Service Workers__........_................_.........._.... .._..
....._..;....__....................... + ..........._.............._.......
_..._........._..._..........................................._.._._.............. _. __..__....._....._.........._._,
Office and Clerical
__....._._.........
...................._........_..............._....... ............._...........
...._;
* For each business assisted, enter the business name and DUNS # :
............................:.
_........................_. . DUNS #
Business
Business
...................... ............................ ........._..................._ . _. DUNS #
.........................
_._. _...._............_............_....................._.............__...................._...................._...._.......t._.._..__.._..__................._._._..
......_................... ........._.._...._........._........................................_..._........_.__..........._:
................................._.........__...__......................................................__.............. _. _. _....
DUNS #
Business
.... .............._....._................................_.............__............................_...... ........._......_...._.._._.._..._..
.._..............._............_............_._...._._..................__.................__..........._............._......._.
._. ..._...__........................�...........................�......_.._..........._...._........................�...................._.._.....__....___..............____._.
.. _............... ; DUNS #
Business
.. . ......................._....................._....................................................................................................................................
....
........._._................................__.............................._....................._
.......... ............... ...
.............................................................__.............................................
Section IV. Housing — N / A
To be completed for Housing Rehabilitation/ Replacement activities . Accomplishments are measured by housing units
completed ; beneficiaries are measured by households assisted ( rather than the number of persons in a household ) . Race
and ethnicity data reported on the Beneficiary Data form (Section VI) should be reflected for the head of household .
Total number of units occupied prior to the project I
Total number of units occupied by a household of low and moderate income prior to the project
Total number of units occupied upon completion of the project
Total number of units occupied by a household of low and moderate income upon completion
Number of multi -family units rehabilitated
Number of permanent displacements/ relocations
Number of units made handicapped accessible
Number of pre- 1978 units brought into compliance with lead safety requirements
Number of units qualified as "energy star"
Number of single-family houses rehabilitated
V Number owner-occupied at completion
V Number renter-occupied at completion
V Number of one-for-one replacements
If applicable, number of beds created in overnight shelter of emergency housing
3
Section IV. Housing (Continued)
If new affordable housing units were created :
V Enter the number of years that affordability is guaranteed
V Enter the number of units made handicapped accessible
V Enter the number of units qualified as "energy star"
V Enter the number of households previously living in subsidized housing
All grant recipients providing housing activities must complete the Housing Benefit form .
4
Housing Benefit Form
( Make copies of this page if necessary to report on units addressed . )
Unit # Owner (0) Name of Owner Name of Occupant Street Address Total Cost Total CDBG Date Rehab Replace- # of
or (street, city and zip) of Rehab or Funds Invested Completed (Yes or ment Bed-
Renter (R) (If replacement, new address.) Replacement No) (Yes or rooms
Occupied No)
i
1
i
N/A ---- � $
2
I
i
5 � $ $
P
_
9 i $ $
i
to $ $
i
i
12 - - - 7 $
i
14 $ --- $
5
Section V. STATUS OF ACCOMPLISHMENTS AND EXPENDITURES
(A) (B) (C) (D) f (F) (G ) (H) (I) V)
Servic Impacted Census Activit Activity IDIS f CDBG Current CDBG Funds Final RFF At Other
e Area Tracts and Block y Name # " Accomplishments Approved CDBG Received To Date Closeout Leverage
# Groups* # DCA Use= Budget (If Applicable) Funds Expended
Only.; proposed Actual
(Contracted (Completed)
for
1 N/A 21A Administration N/A N/A $ 415,047 . 89
$ 254 547 . 89 $ 160, 500 . 00 $ 0 . 00
1 N/A 21B Engineering N/A N/A $ 89,451 . 00 $ 89 451 . 00 $ 0 . 00 $ 0 . 00
50601 . 11 50603 .01 -- - - -
50603 . 21 50603 .31
50604. 1 , 50604. 2,
50605. 21 50605 .31
50606. 11 50606.2,
50606.41 50703 . 11
50703 . 21 50703 .31 Fire Station
1 50903 . 21 50606.3 030 Re lacement 1 BLDG 1 BLDG $ 2, 130,096 . 03 $ 2 130, 096 . 03
t___ $ 0 . 00 $ 56, 068 . 00
50400 . 6 033 Sanitary Sewer 21500 LF 23384 LF 4204 dV7 . 08 $ 41177, 024o97 27 452 . 11 1 887
528 . 47
Potable Water Lines
50803 . 3 033 Phase I 7050 LF 7050 LF $ 555,083 . 50
$ 555 083 . 50 $ 0 . 00 $ 291900 . 00
Potable Water Lines
50803 . 3 033 Phase II 1650 LF 1650 LF $ 105,844 . 50 105 844 . 50 $ 0 . 00 $ 14, 300 . 00
TOTALS -
$ 71500,000.00 $ 7,312,047.89 $ 187,952. 11 $ 1 , 987, 796 .47
- - - - - - - - - - - - - - - - - - ==" - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - "" - - - - - - - - - - - - - - - - - - - - - - - - - - _187 - - 52. 1 - - -
(K) Total CDBG Approved Budget: Total of Column (G) _ 71500,000 , 00
(L) Total CDBG Funds Received To Date: Total of Column (H) _ _ 71312, 047e89
(M) Total Amount of Final RFF: Total of Column (I) 187t952 , 11
(N) Total Amount of CDBG Funds Requested : Total of Column (H) + (I) _ $ 71500,000 , 00
(0) Refund Due to DCA : If Line (N) is greater than Line (K) enter the difference $ 0 . 00
(P) Amount to be Deobligated : If Line (N) is less than Line (K) enter the difference $ 0 . 00
*You must indicate which census tracks in which work was conducted regardless of whether census tract information was used to determine LMI
benefit or not.
6
Section VI . BENEFICIARY DATA Do not enter Administration or Engineerin activities)
Activity # 03J Activity # 03J _ Activity # 03J Activity # 030 Activity # _ Activity #
Potable Water Lines Phs Fire Station
Sanitary Sewer Potable Water Lines Phs I II _ _ Replacement
Total Beneficiaries Proposed
1667 161 _ 59 _ _ 25669
Total Beneficiaries Actually Served
1667 164 46 __-- 25669 — --
LMI Beneficiaries Proposed
1049 141 _ 48 10190
LMI Beneficiaries Actually Served
1049 144 —_-- -- 43 ___-- 10190 _
VLI Beneficiaries Proposed
N/A N/A -- N/A --- - N/A
VLI Beneficiaries Actually Served
N/A N/A N/A N/A _
TOTAL UNDUPLICATED BENEFICARIES
1667 164 46 25669
Male
809 79 ------ 22 -- - 12418 __ ----
Female
848 gg — 24 — 13251
Disabled
362 36 _ 10 — 5560
Female Head of Household
N/A N/A N/A _ N/A
Elderly
qgg 48 13 7495
RACE Total # of Hispanic Total # of Hispanic Total # of Hispanic Total # of Hispanic Total # of Hispanic Total # of Hispanic
Ethnicity Ethnicity Ethniciry Ethnicity Ethnicity Ethnicity
White ( 11 )
1462 51 5 10 0 0 22447 859
African American ( 12)
137 148 46 2103
Asian ( 13)
12 1 - - - 0 --- 190
American Indian or Alaskan Native (14)
4 0 0 -- 63 -
Native Hawaiian Pacific Islander ( 15)
1 0 0 --- 7 - --
American Indian or Alaskan Native and White
( 16) 0 0 0 0
Asian and White ( 17)
African American and White ( 18)
American Indian/Alaskan Native and African
American 19 0 0 0 0 _--
Other Multi-racial (20)
0 =154
_ 0 0
- - —
Totals
1616 5110 _— 46 0 _ 24810 859 _
7
Section VII. PROPERTY MANAGEMENT REGISTER
Recipient N/A Contract End Date
Contract Number Local Contact
1 2 3 4 5
Description of Property -----
or Type of Equipment
Identification Number ---
Date of Purchase or --
Acquisition
Total Cost of Property
CDBG Cost - —
CDBG % of Total Cost -- -
Physical Location - -- --
Condition ( New or Used ) --
Residual Value - -- - -
Disposition Date - - - -
Disposition Amount -- - - -
Method of Disposition - - --
8
UNMET NEED — FOR DISASTER GRANTS ONLY
......................._...._......_.................................................._._......_................................................................................................
......................._............... ....................._.............._............._.........................._............_._._ W...................._......_.................._..............
................................................................................................................... ................................
.... ...:
Activity Activity Name Units Needed Funds Needed Funds Available
..._.....___.......__....... . ..........._..._............................_........... .._..._........_._............_... ......_...._................_..
..................._............ ................................................�---.......... . . ..................._.....
................................._...........;_...................._.........._._..................._...................._._..........................................................._......
�........................................... ._
N /A ...............>.................... .......... ....................... .._ .......................
......................................._..;...._...__..................-...........-......................................_...............................
........................................................
._ ..._...._._......_..........................._...._...................._......................_.. ._.......__............_......._.........._......._.._..
..........._................_. .. .._.... ..._........... . ;
1
i
I i
..._....__._...... .................4........_..........._....: _................._......._.._.........._......................._._.._._._...............
...._......_......._................._......._....................................._................. ........................................_........................ .._...._.......
.... _._.................
i_......................................................._....._............._...._...... r T
;
_............................................_............._....._ .................._..._................_.............._._.._......_._._.....................
.... . ..
.... t....................... ................_........... ..._._........................._...._........_...
................................................,......................_......................................................__._......
�
j
I
..................._........................_..._...................._. ..._ .._ ._. 4......._.... -...._...... ._..........................._._......
......_......_..........__._........._........................................................................._........................................................... .. .
.. ..............._..........................__._............:.......... ....... ............. ................
9
Section VIII . CLOSEOUT APPROVAL
I certify that, to the best of my knowledge, all activities undertaken by the Recipient with funds under this grant
agreement have been carried out in accordance with the grant agreement, that proper provision has been made for the
payment of all paid costs identified ; that the State of Florida is under no obligation to make further payment to the
Recipient under the grant agreement in excess of the amount identified on Line K of the STATUS OF ACCOMPLISH -
MENTS AND EXPENDITURES form submitted with this closeout package; that every statement and amount set forth in
this instrument is true and correct as of this date; that all required audits as of this date have been submitted and
approved ; and I acknowledge that the DCA reserves the right to recover any disallowed costs identified in an audit
completed after this closeout.
Chief Elected Official
Signature
Wesley S . Davis, Board of County Commissioners Chairman
December 16 , 2008
Date
For DCA use only :
1 Approval of this Closeout Package authorizes the deobligation of unexpended CDBG contract funds in the
amount of $
I
Division of Housing and Community Development DCA Finance and Accounting Section
I
i
Name and Title Name and Title
Date Date
R\Community Development\Users\CDBG\cdbg 2005\CloseOuffinal Versions\Closeout\CloseoutDocuments . doc
10
CIVIL RIGHTS PROFILE (07 .02)
RECIPIENT NAME Indian River County -
CONTRACT NUMBER 06DB-3C- 10-40-01 -W 14 DATE : December 2 , 2008
DEMOGRAPHIC DATA
1 . Total Number of Local Government Employees : 828 ( Do NOT include constitutional officers)
2 . Number of Employees who work on CDBG funded activities : 6
3 . Total Number of Local Government Minority Employees : 119 ( Do NOT include constitutional officers)
4 . Number of Minority Employees who work on CDBG funded activities : 0
5 . Local Government Population # 71 , 660 (Counties do NOT include populations of incorporated cities)
6 . Local Government Minority Population : 18 , 697 (Counties do NOT include populations of incorporated
cities)
7 . Local Government Minority Population Percentage : 16 . 6 % ( Counties do NOT include populations of
incorporated cities )
8 . Percentage of Persons of Low and Moderate Income in the Local Government: 39 . 3 °10 ( Counties do NOT
include populations of incorporated cities)
For Neighborhood Revitalization and Commercial Revitalization Only
9 . Service Area Population : NA
10 . Percentage of Persons of Low and Moderate Income in the Service Area : NA
To document civil rights compliance , this profile should be completed and returned to :
CDBG Program
Department of Community Affairs
2555 Shumard Oak Boulevard
Tallahassee , Florida 32399-2100
Retain a file copy in the event that a CDBG grants monitor wishes to review it during a monitoring visit.
CIVIL RIGHTS PROFILE (07 . 02 )
Use application survey data or census data , as appropriate , to determine beneficiary information . Complete a form
for each activity , except Administration and Engineering . Submit civil rights information with executed contract and
update upon completion of grant .
1 . Total Beneficiaries in Service Area :
Using project data on eligible individuals , enter number of individual beneficiaries in each population group
to be assisted .
2 . LMI Beneficiaries in Service Area :
Using project data regarding individuals , enter number of individual LMI beneficiaries in each population
group to be assisted .
FOR ECONOMIC DEVELOPMENT GRANTS ONLY (should be provided at the time of grant completion )
3 . Job Applicants :
Use job applicant information provided by the employer and enter number of individual job applicants in
each population group to complete .
4 . Job Hires :
Use job applicant and hiring information provided by the employer and enter number of job hires
(employees) holding jobs when final job creation requirements have been met.
5 . FOR HOUSING GRANTS ONLY:
( Complete column 2 below at closeout using data provided by assisted households . )
ACTIVITY NAME : Rockrid4e Sanitary Sewer Facilities
Population 1 . 2 . 3 . 4 . 5 .
Group Total LMI Job Employees Housing
Beneficiaries Beneficiaries Applicants Hired Beneficiaries
1667 1049
White/non 1 ,462 920 N/A N/A N/A
Hispanic
Black/non 137 86 N/A N/A N/A
Hispanic
Hispanic 51 32 N/A N/A NIA
Asian/Pacific 13 8 N/A N/A N/A
Islander
American Indian 4 3 N/A N/A N/A
/Alaskan Native
Hasidic Jews 0 0 N/A N/A N/A
Female Head of N/A N/A N/A NIA N/A
Household
Elderly Head 488 307 NIA N/A N/A
of Household
Handicapped 362 228 N/A N/A NIA
CIVIL RIGHTS PROFILE ( 07 .02)
Use application survey data or census data , as appropriate , to determine beneficiary information . Complete a form
for each activity , except Administration and Engineering . Submit civil rights information with executed contract and
update upon completion of grant.
1 . Total Beneficiaries in Service Area :
Using project data on eligible individuals , enter number of individual beneficiaries in each population group
to be assisted .
2 . LMI Beneficiaries in Service Area :
Using project data regarding individuals, enter number of individual LMI beneficiaries in each population
group to be assisted .
FOR ECONOMIC DEVELOPMENT GRANTS ONLY ( should be provided at the time of grant completion )
6 . Job Applicants :
Use job applicant information provided by the employer and enter number of individual job applicants in
each population group to complete .
7 . Job Hires :
Use job applicant and hiring information provided by the employer and enter number of job hires
(employees) holding jobs when final job creation requirements have been met.
8 . FOR HOUSING GRANTS ONLY :
(Complete column 2 below at closeout using data provided by assisted households . )
ACTIVITY NAME : West Wabasso Potable Water Lines
Population 1 • 2 • 3 . 4 . 5 .
Group Total LMI Job Employees Housing
Beneficiaries Beneficiaries Applicants Hired Beneficiaries
210 187
White/non 5 4 NIA N/A N/A
Hispanic
Black/non 194 174 N/A N/A N/A
Hispanic
Hispanic 10 9 N/A N/A N/A
Asian/Pacific 1 0 N/A N/A N/A
Islander
American Indian 0 0 N/A N/A N/A
/Alaskan Native
Hasidic Jews 0 0 NIA N/A N/A
Female Head of N/A N/A N/A NIA N/A
Household
Elderly Head 61 54 N/A N/A N/A
of Household
Handicapped 46 41 N/A NIA NIA
CIVIL RIGHTS PROFILE ( 07 .02)
Use application survey data or census data , as appropriate , to determine beneficiary information . Complete a form
for each activity , except Administration and Engineering . Submit civil rights information with executed contract and
update upon completion of grant.
1 . Total Beneficiaries in Service Area :
Using project data on eligible individuals , enter number of individual beneficiaries in each population group
to be assisted .
2 . LMI Beneficiaries in Service Area :
Using project data regarding individuals , enter number of individual LMI beneficiaries in each population
group to be assisted .
FOR ECONOMIC DEVELOPMENT GRANTS ONLY (should be provided at the time of grant completion )
9 . Job Applicants :
Use job applicant information provided by the employer and enter number of individual job applicants in
each population group to complete .
10 . Job Hires :
Use job applicant and hiring information provided by the employer and enter number of job hires
(employees ) holding jobs when final job creation requirements have been met.
11 . FOR HOUSING GRANTS ONLY:
( Complete column 2 below at closeout using data provided by assisted households )
ACTIVITY NAME : Fire Station #4 Replacement
Population 1 . 2 . 3 . 4 . 5 .
Group I Total LMI Job Employees Housing
Beneficiaries Beneficiaries Applicants , Hired Beneficiaries
25 ,669 10 , 190
White/non 22 ,447 80911 NIA N/A N/A
Hispanic
Black/non 2 , 103 835 N/A N/A N/A
Hispanic
Hispanic 859 341 N/A N/A N/A
Asian/Pacific 197 78 N/A N/A N/A
Islander
American Indian 63 25 N/A N/A N/A
/Alaskan Native
Hasidic Jews 0 0 N/A N/A N/A
Female Head of N/A N/A N/A N/A N/A
Household
Elderly Head 71495 2 , 976 N/A N/A N/A
of Household
Handicapped 51560 29207 N/A N/A N/A
October 15 , 2008
211 -001 . 03
Mr. Larry Brown , P . E .
Indian River County Utility Services
1801 27th Street
Vero Beach , FL 32960
Dear Mr. Brown :
Reference : Certification of Completion
Rockridge Mitigated Sewer System
The construction of the Rockridge Mitigated Sewer System has been completed by Giannetti
Contracting Corporation . The vacuum mains have been installed , the vacuum chambers have
been completed , the houses have been hooked up to the system , the pump station has been
completed , and the entire system has been tested to approximately 125% of the design capacity .
The system has been completed in accordance with the contract documents .
Eckler Engineering certifies the completion and operation of this mitigated sewer system for Indian
River County.
if you have any questions or require additional information pertaining to this certification or the
project in general , please do not hesitate to contact our office .
Sincerely , `/l ,
Donald A. Eckler, P . E .
Encl .
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INDIAN RIVER COUNTY
DEPARTMENT OF UTILITY SERVICES
1840 25th Street, Vero Beach, Flora 32960
October 24, 2008 �oRto�
Ms . Gail Stafford , Interim CDBG Program Administrator
Community Development Block Grant Program
Florida Department of Community Affairs
2555 Shumard Oak Boulevard
Tallahassee, FI 32399-2100
Re . ENGINEER'S CERTIFICATION LETTER FOR INDIAN RIVER COUNTY DISASTER RECOVERY
INITIATIVE GRANT #06DB-3C4040-01 -W14
WEST WABASSO WATER PROJECT — PHASE I
This letter is to certify that the Indian River County Community Development Block Grant
(CDBG ) project referenced above was completed in accordance with the approved specification
and plans on November 20, 2007 . All components are fully operational .
Please fee free to contact me at 772- 770-5089 if you have any questions .
Sincerely,
is Y ANl
Himanshu H . Mehta, P . E . ( FL)
Environmental Engineer, Dept. of Utility Services
i
INDIAN RIVER COUNTY
DEPARTMENT OF UTILITY SERVICES
1840 25th Street, Vern Beach, Florida 32960
StIV�R
r
October 24, 2008
Ms . Gail Stafford, Interim CDBG Program Administrator
Community Development Block Grant Program
Florida Department of Community Affairs
2555 Shumard Oak Boulevard
Tallahassee, FI 32399 -2100
Re : ENGINEER'S CERTIFICATION LETTER FOR INDIAN RIVER COUNTY DISASTER RECOVERY
INITIATIVE GRANT #06DB-3C-10-40-01-W14
WEST WABASSO WATER PROJECT — PHASE 11
This letter is to certify that the Indian River County Community Development Block Grant
( CDBG ) project referenced above was completed in accordance with the approved specification
and plans on August 12, 2008 . All components are fully operational .
Please fee free to contact me at 772470-5089 if you have any questions .
Sincerely,
Himanshu H . Mehta , P . E . ( FL)
Environmental Engineer, Dept . of Utility Services
EDLUND • DRITENBAS • BINKLEY
ARCHITECTS AND ASSOCIATES, P.A .
Members of the American Institute of Architects
AR# AAGOOO9®6
October 9, 2008
Indian River County
1840 25"' Street
Vero Beach, FL' 32960
Ree Indian- RiverCounty' EMS Station #4
To Whom It May Concern :
This ' letter is certifying that the Indian River County EMS Station #4 was completed in accordance
with the approved specifications and pians on June 28, 200.7 . All components: are fully operational
Please . feel free to contact me if you have any questions .
Respectfull 'tted,
aul U . Dritenbas, A. I .A.
Architect
65 Royal Palm Pointe, Suite D , Vero Beach , FL 32960:
Vero 6iaoh 711 , r7>�f.I . ., .3 �0 DeerN td N� oh sH64�4g9-0984
F" 77>�/6Z09` l4e 8hi4/4>Q1 -®8f39
REQUEST FOR FUNDS & REPORT ON ACCOMPLISHMENTS TO DATE
Small Cities Community Development Block Grant (CDBG ) Program
Department of Community Affairs
( 1 ) Initial Contract Period August 20 2005 through to August 19 , 2007
(2 ) Local Government Indian River County ( 3 ) Contract # 06DB-3C- 1040-01 -W14 (4) Request for Funds #
13 ,
(5) Contract Expiration Date August 19 2008 (6) Request Period From October 1 , 2008 To December 31 , 2008
(7 ) Form Prepared By: Name Fred Fox Enterprises Inc. Telephone _(904) 810-5183
Email fred fox(c4fredfoxenterprises . com Fax ( 904) 810-5302
8 g 10 11 ( 12) 13 14 15
ICumulative
DIS
Current Budget i Amount Remaining Project Non-CDBG Funds Activity
Activity Activit Name Number From Contract or
Y � Requested Balance Disbursed to Date Accomplishments
Number (DCDnIy)se Last Amendment To Date
21A Program Administration $ 415 , 047 . 89 ; $ 160 , 500 . 00 $ 0 . 00 $ 0 . 00 N/A
21 B Engineering $ 89 , 451 . 00 $ 0 . 00 $ 0 . 00 $ 0 . 00 N/A
031 Flood & Drainage $ 0 . 00 ` $ 0 . 00 $ 0 . 00 $ 0 . 00 N/A
03J Sewer Facilities $ 41204 , 477 . 08 $ 271452 . 11 $ 0 . 00 $ 11887 , 528 . 47 23 , 384 LF
03J Potable Water Lines $ 660 , 928 . 00 $ 0 . 00 $ 0 . 00 $ 44 , 200 . 00 8170OLF
030 Fire Station Rehab $ 0 . 00 $ 0 . 00 $ 0 . 00 $ 0 . 00 N/A
030 Fire Station Replacement $ 21130 , 096 . 03 $ 0 . 00 $ 0 . 00 $ 56 , 068 . 00 1 Bldg
030 Fire Station Rehab $ 0 . 00 $ 0 . 00 $ 0 . 00 $ 0 . 00 N/A
COLUMN TOTALS $ 71500 , 000 . 00 $ 187 , 952 . 11 $ 0 . 00 $ 11987 , 796 . 47
i
✓ � Date December 16 , 2008
( 16) Submitted By Wesley S Davis BCC Chairman Signatu eZ - `
w
l,. BOARD OF COUNTY COMMISSIONERS
1801 27th Street, Vero Beach FL 32960
772-226- 1490 / 772-770- 5334 fax
* *
www. ircgov. com
�ORIU �'
December 16 , 2008
Mr. Jim Austin, Financial Specialist
Florida Department of Community Affairs
2555 Shumard Oak Boulevard
Tallahassee, Florida 32399-2100
RE : Closeout Documents
Indian River County Disaster Recovery Initiative Grant #061)13-3C - 10-40- 01 -W14
Dear Mr. Austin :
Please find enclosed documents prepared to initiate the close out of the above referenced
Community Development Block Grant (CDBG) . The documents that the county is submitting
are :
1 . Florida Small Cities and Disaster Recovery CDBG Closeout forms (3 originals) ;
2 . Civil Rights Profile ;
3 . Four (4) Engineer' s Certification of Completions, one for each of the projects that
were completed utilizing funding from this grant; and
4 . Final Request for Funds .
If you have any questions regarding these documents, please contact Mr. Fred Fox, the County ' s
Grant Administrator, at (904) 810-5183 .
Sincerely,
Wesley S . Davis
Board of County Commissioners Chairman
Enclosures as referenced
cc : Joseph A. Baird, County Administrator
Michael C . Zito, Assistant County Administrator
Robert M. Keating, AICP, Community Development Director
Fred Fox, Fred Fox Enterprises, Inc .
Jason E. Brown, Management and Budget Director
Sasan Rohani, AICP, Chief Long Range Planning
Bill Schutt, AICP, Senior Economic Development Planner
FACommunity Development\Users\CDBG\cdbg 2005\CloseOut\Final Versions\Cover letter to DCA Closeout. doc