85-09
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RES 0 L UTI 0 N
No. B!) - 9
A RESOLUTION OF THE CITY OF CLEARWATER, FLORIDA,
AUTHORIZING THE EXECUTION AND FILING OF A GRANT
APPLICATION UNDER THE COMMUNITY SERVICES BLOCK
GRANT WITH THE STATE OF FLORIDA DEPARTMENT OF
COMMUNITY AFFAIRS.
WHEREAS, local governments are eligible to submit applications
for funding under the community Services Block Grant Program administered
by the Florida Department of Community Affairs, and
WHEREAS, the City of Clearwater dusires to submit such a grant
application, and
~mEREAS, such grant applications must be filed on or before
February 1, 1985; and
WHEREAS, each County has been allocated a share of this money and
any local governmental unit may apply for the funds availabla within its
county:
NOW, THE.REFORE, BE IT RESOLVED BY THE CITY COMMISSION OF THE
CITY OF CLEARWATER, FLORIDA, IN SESSION OULY AND REGULARLY
ASSEMBLED, AS FOLLOWS:
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1. That the appropriate officials are hereby authorized and
..r
directed to execute and file a grant applit"ation for community Services
Block Grant Assistance with the Florida Department of Community Affairs, as
per copy attached hereto and made a part hereof, and to furnish all inform-
ation and data necessary to completo said grant application.
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2. That all funds necessary to meet the contract obligations of
the City \tIith the Department have been appropriated and said funds are un-
. . . .
expended and unencumbered and are available for payment 85 prescribed in
the application.
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That this ~esolution shall become effective immediately upon
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its adoption.
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PASSED AND ADOPTED this 24 thday of
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Res. 85-9
1/24/.8,5
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APPLICANT SUBMISSION FORM
FLORIDA DEPARTMENT OF COMMUNITY AFFAIRS
COMMUNITY SERVICES BLOCK GRANT APPLICATION
FEDERAL FISCAL YEAR 1985
SUBMIT1'ED BY:
CITY OF CLEARWATER
, (APPLICANT)
Application 'is hereby made for funding through the Community Services Block
Grant under the Community Services Block Grant Act of 1981 (PL 97-35), Bnd the
Community Services Block Grant Program Admi~istration Rule 9B-22, Florida
Administrative Codet effective March 1984.
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THE APPLICANT CERTIFIES THAT THE DATA IN THIS APPLICATION ,AND ITS VARIOUS
SECTIONS, INCLUDING BUDGET DATA. ARE TRUE AND CORRECT TO THE BEST OF HIS OR
HER. KNOWLEDGE AND THAT THE FILING OF THIS APPLICATION HAS BEEN DULY ,
AUTIiORIZED AND UNDERSTANDS WAT IT WILL BECOME PART OF THE AGREEMENT
BETWEEN THE DEPARTMENT AND THE APPLICANT.
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Kathleen F. Kelly
Name (t.yped)
Mayor-Commissioner
Title: Mayor. Chairman of Board of County Commissionerst etc..
ATTESTED BY: Lucille Williams
Name (typed)
Signature
City Clerk
Title
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APPLICATIONS MUST BE POSTMARKED BY THE DUE DATE, FEBRUARY 1, 1985
AND RECEIVED WITHIN FIVE DAYS AFTER THAT D~TE TO BE CONSIDERED
FOR FUNDING.
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Res. 85-9
1/2Jf/85
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DEPARTMENT OF c()t-IMUNI1Y AFFAIRS
cQMM\ffi11Y SERVICES aLOC" GRANT
APPLICATION
PostJl1Or aU:
Date Received.:
ReviSion
Rec'd.:
Revision
Rec'd.:
FEDERAL FISCAL yEAR 1985
coNTRACT NO:
ALLOCATION NMOUNT $
pATE APPROVED:
GRANT pERIOD
-
TO
.::=
------------------------.---.--------.---
INSTRUCTIONS' Pl.... compl.t. .11 parta i. thia APplic.tie. which .r.
.pplic.bl. to your ers..i..tien. If ..y p.rt do.a net .pply,
write "N/A". Dc net u.. whit....,ut (corr.ction fluid) o. .ny
part of the application.
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I. APPLICANT CATEGORY:
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[xl Local Government
[ 1 Eligible Entityl
Migrant/Seasonal
Farunlorker
Organization
II. GENERAL ADMINIST1L\TIVE INFORMATION
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.. N.... of APplic..t: qltV of cloar.ater, Florida
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b. APplic.nt'S Addr.s" 112 south osceela .venue
Zip Code 33516
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County: pinella6
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_ City:
c1earwator
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Telephone:1-813) 462-6881
APplicO.t'S ~.llins Address (if different frem abeve):
Zip Code 33518
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P. Q. BOX 4748
c. Chi.f Offici.l er Ex.cutiv. Dir.ctor's N....: yathleen F. ".llY
Title: HaY,"Ir_commi6Sioner
--
. C1ear\llater, FL
.. N.... ef Official te ~.c.ive Stat. W.rrant: o.ni.l 3. oai9nan, Finance olreetor
AddresS: P. Q. BOX 4748
..p-p Cod. 3)5l.~
'Title: o~,
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~lear.,.,ater, FL
f. Contact Person: ~oseph R. McFate II
Hailing AddresS: !-. Q. BoX 4748
Zi1l Co~:_33518
~learwater r FL
Telephone:~1~ 462-6881
g. Tax Exempt Number:
(Non-Profits Only) -
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Ill. ?-.UBGRANTEE INFORMATIOJl N/A
a. Will th.Se. fo.ds b. transferr.d to a subsr..tee? [1 l.s [1 No
b. Give the number ef subSrant.es included in thiS applieatie.'
List fer e.ch (att.ch .dditio..l paS.s if nec.ss.ry). --
subgrantee Name:
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Addrr.sS:
Contact Person:
'Ie] ~phone L )
1/214/85
R... 85-9
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Pa e 2 of
DEPARmENT OF COMMUNITY AFFAIRS
COMMUNITY SERVICES BLOCK GRANT
APPLICATION
FEDERAL FISCAL YEAR 1985
Postmar ate:
Date Received:
Revision
Rec'd:
Revision
Rec'd:
CONTRACT NO:
ALLOCATION AMOUNT $
DATE APPROVED:
GRANT PERIOD
TO
.taaa..______......_..........._..................__.........._......___...............
INSTRUCTIONS: Please complete all parts in this Application which are
applicable to your orsanization. If any part does not apply,
\frite "N/A". Do not use whiteM>out (correction fluid) on any
part of the application.
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I. APPLICANT CATEGORY: [X] Local Government
[ ] Eligible Entityl
Migrant/Seasonal
Farmworker
Organization
II. GENF.RAL ADMINISTRATIVE INFORMATION
a. Name of Applicant:
~ity of Clearwater, Florida
b. Applicant's Address: 112 South Osceola Avenue
County: pinellas
City: Clearwater
Zip Code 33516
Telephone:(B13) 462-6881
c. Applicant's Mailing Address (if 4ifferent from above);
P. o. Box 4748
clearwater, FL
Zip Code 33518
c. Chief Official or Executive Director's Name: Kathleen F. Kelly
Title: Hayor-Commissioner
e. Name of Official to Receive State Warrant; Daniel J. Deignan. Finance Director
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Address: P. O. BoX 4748
Clearwater. FL
f. Contact Person: Joseph R. McFate II
Hailing Address: P. Q. Box 4748
Clearwater. FL
Telephone: ( 813) 462-6881
g. Tax Exempt Number;
(Non-Profits Only)
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III. SUBGRANTEE INFORMATION N/A
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Zip Code 33518
Title: 0iJ::ecbx, Pl.amin:J & Urban ~
Zip Code: 33518
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a. Will thesElfunds be transferred to a subgrantee? [ ] Yes [] No
b. Give the number of subgrantees included in this application:
List for each (attach additional pages if necessary):
Subgrantee Name:
Address:
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R... 85-9
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GENERAL INSTRUCTIONS:
APPLICANT/SUBGRANTEE:
PROGRAM Mlli!:
STAFF PERSON:
GEOGRAPHIC AREA
TO 1m SERVmr-
AMOUNT BUDGETED FOR
THIS PROGRAM AREA:
MEASURABLE
OBJECrrVES:
, '
IMPACI' OF OBJECTIVE
ON POVERTY
"
MEASURABLE ACTIVITIES:
, :
" STARTING ~:
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NON-DUPLICATION
.Q.E SERVICES: ,-
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Rea. 85-9
-
CSBG WORK PLAN INSTRUCTIONS
---
Make multiple copies of the WORK PLAN for completion
by APPLICANT and all potential SUBGRANTEES. All work
plans must be typed. BE SURE TO COMPLETE AT LEAST
ONE PAGE OF THE WORK PLAN FOR EACH PROGRAM AREA THAT
IS IDENTIFIED.
Enter the name of the agency/local government making
application. or the name of the subgrantee who is to
carry out this work plan. EACH SUBGRANTEE IS
RESPONSIBLE FOR FILLING OUT A SEPARATE WORK PLAN.
Program Areas are: (1) Employment. (2) Education.
(3) Use of Available Income, (4) Housing,
(5) Emergency Assistance. (6) Use of other Programs.
(7) Prevention of Starvation and Malnutrition.
(8) Transportation (9) Applicant Administration, and
(10) Sub-grantee Administration. See General
Instructions for further definition of these eligible
program areas (eligible activities).
Enter the appropriate Program Area that you intend to
fund with CSBG monies. Complete ~ ~ plan 12!.
each ProRram Area, for Applicant Administration. and,
if applicable. for Subgrantee Administration.
Enter the appropriate title of the staff person
responsible for this program areB.
Identify the specific areas (neighborhood, city.
county) to be served and impacted by the proposed
objective.
Indicate amount of CSBG dollars that you plan to
spend on this program, the amount of match (cash
and/or in-kind) and total.
Each objective. except administration must state
a quantifiable or measurable expected result within a
specific time frame. All quantities must be
identified as the number of CSBG eligible households
or individuals. Complete one objective per page of
work plan.
Indicate how your proposed objective will have a
measurable and potentially major impact on the causes
of poverty in the geographic area you propose' to
serve.
List the specific activities you intend to carry out
to accomplish your proposed objective.
For each activity. write the anticipated startinR
~.
For each activity. write the anticipated endinR
date.
Identify the programs either within your organization
or in the geographic area to be served which provide
the. same or similar services as indicated in each
objective. Explain how CSBG funds will not duplicate
these services.
1
1/24/85
..
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, CSBG !1UDGZ':' SUMMARn
HAmIl of "PpUeanta
CITY OF CLEARWATER
r.dara1 ElDp1or-r
I4ent1licatJ.=" 59~6000-2B9
AeftnWII
1. CSIG
2. 'CUb Ka1:Cb
3. 1D-J:1a,4 Naecb
4. '1'ot:a1 Mata:b Q..1..=e. 2+3). 557.00'
5. ~ MftD-. tuAu 1+4)
Hat:c:h
Tot:&1 Amcus1t:
CSBG rmm!:D PRCGRAHS Cll'ILY
cor.maf 1.
CSDG
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cor.mar 2
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7. ~t and 0t:1JJ.t.:L.. ...........
8. ~v.l.......................
9. Other........................
10.
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-0-
-0-
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u. saJ,ari.. iaclu41.nq !:1ncz-....
12. ltaa.t. and. C'tiUt1.............
13. ~va1.......................
14. Otbe:........................
],S.
~ (linaa U-14) ..........
-0-
-0-
16.
'l'C'rAL ~ EXPDSE
(linas 10 ~ 15\ ............
-0-
-0-
c:crmm 3
m-!aRD
HUCB
c:ormm ."
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-0-
-0-
-0-
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17.
'1"O'tAIo CSBG ~
EDENS!: PERa:N'1.'AGE (not to
lIXCIM4 15" of u.a. 1)........
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,.:':'..J~11l ~fl,~...-;'.I'(L;.l'&;'....~\;'~,l.~,~~.~"'/~......f)I' ,"')' ,.",1:1 :,:'L~ ;,'A~ J'
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,. '.~~~ ,J ~~, ,.f . , . ~ , :,.. > ~'4'~?: ~~~, :~~ ....i..: .;r~hr' tl\ >?t.~j~" \..~ '-J~'~.tt. {"y.\~ . "
-0-
,
GRAln!!Z PRCC:RAH EXPmSE
18. S&1ar.I... iDclwUnq t:incz-....
19. llent aDd C't:iUt:i.............
20. ~v.l..................~....
21. ~........................
2,643.00
551.00
22. 1'O'DIo (lin.. 18-21)..........
strn~{sl P1\ClGa1\1'l e.......i.:ISE
2,643.00
557.00
2.3. SIlar1Q:I iDc:l.ud.inq ~qe.....
24. Rent aDd OtiLit:i..............
25. ~.~1........................
26. ~~...~.....................
27.
~ CliA.. 23-26).~.........
28.
:onr. p~ EJC!'CtSZ
(lin.. 22 and 27).............
557.00
2,643.00
29. SECOlDAAY ADMnf. !:G'ENSZ
30.
TotZll Expen:s"s
(Lines -16+:!9"~)9.'........'
Res. Oti--
557.00
.'~t,I.;'\:",~~~~t~." ,. I'
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3 200.00
-o~
3,200.00
.
3,200.00
3,200.00
1/24/85
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ADMINISTRATIVE & PROGRAM BUDGET DETAIL
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Line Item
Number
Exponditure Detail
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$3,200.00 to purchase 1,291 home delivered
nutritious meals for low income
elderly residents at a cost of
$2.48 per meal.
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CASH MATCH DOCUMENTATION
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Line Item
Number
Source
Amount
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21
City of Clearwater General Fund
$557.00
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. Re... . 85-9
1/24/85.
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~~~ UUgQ~I ~Ynn6BX IH~I~UQI12H~
The ~~U~ DY~iI ~YDn6BX i_ to b. coapletad by the opplicant onlv.
Subgrant... are to co.plet. only the aubgrant.. budget. The Budget Su.aor, 1.
. co.po.ite of the applicant'. budget and any .ubgrant..'. budgetCa).
Enter the no.. of the applicant and F.deral E.ployer Identification
Mu.bar.
~DI 11 The total a.ount of CSBG dollar. reque.ted aoy not excead the a.ount
allocated.
LiDI 21 Ca.h .atch auat be at lQoat two parc.nt of Line 1.
LiDI a1 In~kind .atch au.t be erghte~n perc.nt of the aaount of line 1. If
1... thon eight.an percent, the difference auat be balanced by
additional caa& aaten.
LiDI ~1 Total aatch auat be at l.cat twenty percent of lin. 1. Do not ahow
over.atch unle.. your agency ia prepared to audit th~ full a.ount.
kin! ~ Total revenue ia the au. of line. 1 and 4.
LiD!. i:lQ gn~ li:&~l Mu.t reflect the applicant'. expenditures.
&4n~ 1l:1~ !D~ i~Zl Kuat reflect the total of all aubgrante.'. oxpendituraa
in each budget cat8Qory. If there are no aubgranteea.
do not co.plete linea 11~16 and 23-27.
Lin~ l~i Total of ^dainiatrativ. Expense.. All expenses r~lQted to the
ad~iniatration.of the grant.
LinI.1Zl Refl.~ta the Adainiatrative Expense percentage not to exceed 15~ of
Line 1.
kin! il1 Total of Prog~ca Expenaec.
LAn. 221 ~g&Q!P.ABI 6~n!B!~Bd!IYg gXf~H~g~ - Mot applicablo.
bin! 30: The total of all Progra. and Adainiatrutive Exponaes.
.
Res. '85..9
1/24/85
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