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85-56 . , .,, c ~ i"" -'. 4.' \ >' _.__, . ". ',' " , " . , .' , ~. i , " .' .'>,' , , ' , , (,' I I '~ .. . ..!"."1 t I",'.' ',i , , . 1.' . . . , ",'c. } " .,:" ...... '. , . ". I :: . ~: ! -. . ~ ., I',". ',' :/:,';' ,i ~:,:, f. 'f. ;. +" .:: . ' ~ . 'c \~ C \ "e, '. . I. I \11:: .':. <. .: : . ".'; ; ::>... : '. ',1,.) -:.i'; ',~, V:", I;" tl ",' U i:;<} ,;,:. ,':;(;i:, r . ." ,: i: ~,:', ;:" ':~:' 1.. . , . o o RESOLUTION No. 85 - 56 A RESOLUTION OF THE CITY OF CLEP~RWATER, FLORIDA, AUTHORIZING THE EXECUTION ANp FILING OF A GRANT APPLICATION UNDER THE FLORIDA FINANCIAL ASSISTANCE FOR COMMUNITY SERVICES ACT WITH 'THE STATE OF FLORIDA DEPARTMENT OF COMMUNITY AFFAIRS. WHEREAS, local governments are eligible to submit applications for funding under the 'Florida Financial Assistance for Community Services Act administered by the Florida Department of Community Affairs; and WHEREAS, the City of Clearwater desires to submit such a grant application; and WHEREAS, such grant applications must be filed on or before County; NOW, THEREFORE, BE IT RESOLVED BY THE CITY COMMISSION OF THE CITY OF CLEARWATER, FLORIDA, IN SESSION DULY , , . AND REGULARLY ASSEMBLED, AS FOLLOWS: 1. That the appropriate officials are hereby authorized and directed to execute and file a grant application under the Florida Financial Assistance for Community Services Act with the Florida Department of Community Affairs, as per copy attached hereto and made a part hereof, and to furnish all information and data necessary to complete said grant application. 2. That all funds necessary to meet the contract obligations of the City with the Department have been appropriated and said funds are unexpended and unencumbered and are available for payment as prescribed in the application. 3. That this resolution shall become effective immediately upon its adoption. PASSED AND ADOPTED this 10th day ...- '- .' ~ I ~ I r . . ~.~ .. ~ ( "....., /', .'" r . r, "w. . J, . .f".. , ,. , I'L- :,' " :.~, ...../ . \ "~_;; \,..., ,,~" ~~. r ..".. ./.::.~ .~ At~. '".- t. c c li~-~ '":0"'& II {} , . ~.(....,~. . ...:. . \' ~f.. _ '. ,~~:;;..; - C ' C~f:'","';":--"\'-'-"-- J. ty ~J.crh, ',' RES., .~ ~ +... ~ , " .' 7118/85 , "'::'~'~~@~~~~~Virr~:;"~, ,I c '..~ T ; ~~~. ....~. ..;1 ) , '\ . l; ., ~ \' '< l!' f' .., " ' '. . ,,' " \ , , :.~ , . , ...~. ~~,.' :..~ _. . , -..' . , I . .. '..~ ~) >, . " " ,. ;I~, ,. , " . >. I , r' < <I, ... I ' :,}.~:,::,;",'< ,:' ::;,: '~',' . .' ..:,....'. ,I .. ; , , . ~ . " '~; .::.~:... "':':,'r,: ';:,/:::.'i,~"!~: . l.. '" / . < ::: ~, : I . ~ ~ ': . ,<.' ' ", ~ > , . . ~ . '( ,I I L~' . ~( : ':~":.:' ,l..', " I ,-;t! , \ ~." .... '. t'. .", , . . ~ . " " , . , o '. , . o Page 1 of 7 FOR DCA USE ONLY Postmark 1:iote: Date received: Contract no: Allocation amount: $ Date approved: FLORIDA FINANCIAL ASSISTANCE FOR COMMUNITY SERVICES ACT OF 1974 FLORIDA DEPAR1l1ENT OF COMMUNITY AFFAIRS CO~lMUNlTY SERVICES TRUST FUND GRANT APPLICATION See general instructions for information on how to properly complete this application. THIS APPLICATION MUST BE POSTMARKED ON OR BEFORE AUGUST 1. 1985 TO BE CONSIDERED FOR FUNDING. 1. Local governmental unit applying for grant: Name: City of Clearwater, Florida (name of townt city or county) Telephone: Cs13) 462-6880 Sun com 751-6880 Address: P. O. Box 4749 County: Pinelhl.s 33518 City: Clearwater Zip: 2. Person to he contacted by the Department of Community Affairs should questions arise: Name: Joseph R. McFate II Telephone: (813) 462-6880 Suncom 751-6880 Title: Director, Planning & Urban Development Dept. Address: P. O. Box 4748 C1eanla ter, Florida Zip: 33518 3. Name and address of person authorized to receive funds. If this application is funded. checks viII be mailed to this person. All checks will be made payable to the local government. Name: Daniel Deignan, Finance Director Telephone: (813_ 462-6930 Suncom 751-6930 Address: P.O. Box 4 748 Clearwater, Florida Zip: 33518 4. Are there any delegate agencies covered in this application? Yes--K- No_, List below the name of each delegate agency included in this application. Religious Community Services, Inc. Neighborly Senior services, Inc. .' ,. I: ~ .~..Jt~..~-,t~.~ . .Iot..- ... _ .', , :w:>....."',~~~''Ui>...v..~,~_~~~~k..~..,~- . . " \. ~. . "'" " .. ~.,-.,'~~.~ .;.'~ ...-,- ...'" :~~""""'f~~",:'1;......tl' . ~.~. . 'oJ. .. ,.' ~ '-''':''''r ..._'(';:;,'l:";J~ .",.,1/""';''''' ~~ .....v.:w;... ~:,\r~... ~ ~, . '~.....'c. . ,'. '';:'' . ~f '. .... .... ...,~.';f~~~]~!,;?~<;>;, ..' ,'T~(J'ji*V:"';:::j' ---'~'~.-.. " , , 8 CD "j .1 Page 2 of 7 \' ~) < CSTF GRANT APPLICATION t, . Complete B separate pBge 2 for each individual program/delegate. Use an attachment page(s) if necessary. " . .' ," GRANTEE/DELEGATE: NAME OF PROGRAM: Religious Community Services, Inc. Emergency Housing Program " ,; \" " i '." '. f. ;",: 1. Give a brief overview of the proposed program, identifying the unmet human service need that this program will address and the specific target group to be served (handicapped, elderly, low-income, etc.) Specify the number of unduplicated clients to be served and the number of services to be provided. . ',",:..,. Program provides funding assistance for operational costs, such as utilities, for temporary emergency housing to displaced and homeless low-income persons, particularly those . who are potential recipients or current recipients of public financial assistance. There is an emphasis on 'providing services to families with young childre~. Eight hundred sixty unduplicated residents will be provided shelter, along with supporting food, clothing, and counseling. (~ne basic service with three supporting services.) ,', ( .." . '"1 -, ;.1, ; , " , , . .~.... ~''': -... . " ',' \ . " , ~ 2. Will this program be coordinated with any other program or services? Identify all linkages and how coordination of services viII be accomplished. Explain how duplication will be avoided. , '. ... :1 , " There is an on-going referral relationship from the program to Pinellas County Social services and to tile Florida Department of Health and Rehabilitative Services (Public Assistance, Food Stamps), as well as to various local employers and other local resources. There is an on-qoinq referral to the proqram from Pinellas County Social Services, Florida DHRS, area churches, and other sources. Most contact is by telephone. ,-: <:/;i:, . :.'::::,' :",'" "',:," , " ',{>?:' .,'i' :;/-~ ~ .~ :~ ' ,i:, . J"': . f f :: . . ~ . Duplication not an issue due to the basic nature of the .. ,.proqram".people "can only live at one place at any one time. .. . .., . ' . ..'~'.' ." :;: '~: I' <0 d........ -.< ~. . :'.).' .:' ,~. ~. '. ~: ~,~,!,.:'D;' ,::. i':\ . . :.. " ~' . c{.' ::.,. -:.: .C'..:~' _'. " . ,~: . '. : . '.;:, t . it r ~',: . I.. i~;ti!~', {::\\/ lc.1"1 j' \;t . . \. \'~ : \,~"r.". :..,,'.j ~" N~~);:" .':':~:::"i~~ :(k:f\) ('.. r "<',?:~ ~ ';" ,,~tlI " ~, 3. Will these grant funds be used to match a federal or other grant? Yes No --X..X If yes, identify the type and acount. 'J ~ . '; ~,!;' . I . " ,....~,~ : , '. " , I.----od .. "... <._.'. '~..J, f .. ,'~. " e - " . Page 2 of 7 \\ " CSTF GRANT APPLICATION , . .\, , " Complete B separate page 2 for each individual program/delegate. Use an attachment puge(s) if necessary. , , , '.' , ~ ~ , GRANTEE/DELEGATE : NAME OF PROGRAM: Neighborlv Senior Services, Inc. Nutrition Progr~ 1. Give a brief overview of the propos~d program. identifying the unmet human service need that this program will address and the specific target group to be served (handicapped.. elderly. low-income. ete.) Specify the number of ' un duplicated clients 'to be served and the number of services to be provided. " "', i ~ ," . " , , , ' \ Provide nutritious meals to low-income elderly in the Clearwater area, through the Older Americans Act Nutri~ion Program Five hundred fifty unduplicated participants will be served nutritious meals, along with being provided supporting recreation and counseling. (ODe basic service with two major supporting services.) : ;',' , ., ' .: ~" .~.. ..... ',' k.- , i, , " ~ I' . I . ~ .... . Will this program be coordinated with any other program or services? Identify all linkages and how coordination of services will be accomplished. Explain how duplication will be avoided. 2. . > > , ~ ~ " , " C" . " , " '1 . I .," '..' .~. ...t ~ , ,I: " ' ~ c',' <,,' .' ":,:,""\:i> "~ r . ' ~ I _ I' r , .:', ~r I'~:~' / This program is coordinated by referrals, funding, and monitoring relationships with the Florida Department of Health and Rehabilitative Services and the Area Agency on Aging, as well as through mututal referrals with the Family Counseling Center Homemaker Services, and other local resources including other services of the Delegate Agency through the Florida Community Care for the Elderly Act. , . I > .:.,. .' ~:.: :.c' '. t;i)\:':'Fj.:; . )\;~:': !,' ,;':':':i;,;~'; ~'..:j(',.,> ::.; .<:. :c"' .::.'::.:' . ;" F;,'"" ,. " \I,! )'. '.'~ . \ ~~'~ .{ :.' 'I;'\~~ IrJ.i :,' \l":; ',. / :,:"r.J '\ }~'~'l:~'~'.~,' .'<, ;:.'.:t~:~:\;r.'. ", . "" ',,' I'" '. ~.<'~~'..' :,:' ":I.~~\..',:.' I ,j I . . '. ~. I I :?i'" .. "i:'!( :.: \ ' . ~ ,Duplication is not an issue due to this program being the sole source of,'governmentally supported dining program in 'the area. " 3. ' ,Will these grant funds be used to match a federal or other grant? Yes XX No If yest identify the type and amount. .' Title III of Older Americans Act \' .,t. . . t, ;;....;.~;(."'!hJ.~\.~:..r~~#;-fo-:i\~ :~ '4;".\:~, : ~..:).~ ':. ;\/, .'!l::;.......:,..........~.~\'.;..~:,..J"\::~fot.....:..;.,~..~~., .~.~...~~ ~..'i..~~. - ~ , ) \ . I' \ , , .' ., ','> , . l. ~ . ;..>:.,,:'t':...~ ..... ," if ':' \ " .' ; ., .. . ~ " . ~ I ~ .. I c., ", ,; '. ,~ . ~.. .~. '. I , . ..: . i ~ ~ ( .c "". ,I " 1 t . _. "+' Iq ,. i It . J!',.' . I i 1. , ,:~'. ".4 + '+1 ".~.' ;.:':'>'.~ i: . ", ,!,:"C,,' ':." +':' c' ".', ~ /- \ " : . . ~.: . . ~ ". . ~ ~ : ,r. ,': .~. ~ "'. ~ . :.: ."; ":.; ..... '. I -,::J.' i ,: "/l' '.,:~'.:,',: ';:~, :::",{' . , r ~ . .~ ... J.:- ~:""~' , .. . i . '.'; ~. 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'". b1 C. lJl s:: ON ~ "C o 't:I ~ -Pi QJ '.-I ~ ~ 't:I >t tll IU """,.f ~ "r-i ~ 0 >.,.f >>'lJl~Ol:: OkOo..k::l . kQJ""::Jp,e~ Ol>~Ul eo 'r-i QJ 0 ,:C "r-I r-4 k Ul U .r:QJItSQJO >. 0'ljs::.r:.c:1U.-I ItS 0 ~..qJ 'tJ $.I QJ tJ'l'r-i 0 -,.f QJ kS::+J tll""'tS +J-r-i I'lS 't:lltl 0 r-l ::S'ljQJS:: .-Irq O::S""nj.s::lkl ~o 0 OJ 4.l 0 OJ ..::f QJ .c: ~.~ k tn tll :5 ~ P! ..-~ Ul "" "N rc:I QJ.-I QJ.c: 0 U 0 0 QJ tJ lJl4-l ,,.., O"r-i U1'.-I ::f .J.I44>l::>OOJ k k::fk~k ",~QJOQJ..c:1'lS PfOtllUtll+JO OJ IIJ.-I 't:I QJ 'r-i '.-I <II ~<<l. · Ill> 'tJ Id>>. >. .s:: OJ 0 "r-i IIJ r-4 r-fIllOk k> "" .... klO""Pl <110 OJOJOJ QJ O::f OJ 'tJ.... +J ..-PO 't:I 0 r-4 .c: r-l IJ! Id <<l .-t Or-4.-tU1r-4~O O~QJQJ o OJ ItS QJ 'r-i r-4 +J I-J e o Ok~OC1Jr-4 '" OJ .. Q) 0 .fJ :5'M III QJ tn IS :; :S ~ ~ ij1.c: ~ ~ 8.~ 8 'tj.s::ao~.c:ClJ ~s:: tJlO S::~ C1J+J 00 Ei Q,llUor-i ~.J.IldOtnllJ .,.., .c:SI 'tS to In.c: III e ~i~.J.I ~~' '..I r-4 't:I +J Q)""" ~ 0 s:: o.-t > lIS S::'r-i .J.I It! tn ..,.-I '01 o CD ::s ~ lIS k 0 +J +J llb-' k IS ~ tn QJ k O..-f 0J'r-i IlJ n. lJl OJ 't:I tll ,:C "" +J tll 0 lIl-a......Q,I -iJS::1lI0 a:s .OOJ4-lHlO::f<<l.c:...... 'Pi 01'&4.-1"0 I H ij a PIP! -&J:;:e-: "'OJ SH 00'8 ij.B lI).... ..c:.r: C QJ.Pi 0 .,.f ..-f J.4 lJ1 0 4J r-4 k 0 +J.c: OJ III -iJ . +J lIP .JJ OJ .. ~ +J r-4 to ::J U 1U.4-I (;) -,.., e 0 IU or-i .Q < a-a 0r-4E-l,:C1D o..:l <<l , ' ,. I' -. ~ .'. . ' ~. --: < , . ~ ! 0' I, I I.., , ' I. >'" , , ( .... . . ,,' I ~ . . . ",1\ <.} . . ; '~ ~" ';",' .: .( . _,:>,1 I,'.' . . ' .1 . .. Q CSTF TRUST FlND TOTAL Bl.IlXiET e Holme 0' PJlPL s'CAHr I City Jl!VDiUI of Clearwater, Florida . "tl~ II'.Ud! (Col. t) (C4I. z) OEPARnl!HT usr QtlLV . 1. CSTF Gt"alIC ~as1: %. e.uJI HaC= 3. In Xtnd )-laCe:. ~. Toea I I\I'C= (1ln~ 2.+-3) 100 = J. Tce.al ~Yen~ l1r~u r..i, ,.~ A. Include figures %rom ell delegcte cgency budgets (p. G) B. ' Explain br att~ch~ent all expenditures 2~r 5500~OO E![ !!~~ !~~!~ C. All ,expend,itures ..in. the line ite. "ot.her" ,!~st ~ g!E!~!!!!!s! ';!!9~~~i!~ D. C~sh .etcb !y~~ E~ ct, 1~~2S en!=h9!i of the state grant request. E. The c~sb and in-kind .etch combinpd !y~t ggy~! the statB srant. F. Use 2n!l ~Q!la~! = U2 S~D~!~ Round off all figurea to the nearest whole dollar. G. Ho iedarcl ~und$. except %sderal revenue sharin9 %unds. .ey be used for _etch. CSTF FUNDED PROGRAMS ONLY.. : .1 eo f r.==l 4- c=rt::n 5 CQ r \:::d , Co, r t.::ID" T CS'IT CASH IH ICIND . lUHD!' ,1I,AiO( ,>>.A, toi i01"At. I I I , f f ~ t J I I I I I I I I . I I , I r t I I I I I I I GRANTEE ADMINI STRAT 1 V ~ EXPENSES 6. 7. 8. 9. Salaries includiIlg tringe ?ent and Utilities T=e.ve~ Other 10. Total. (li::1es 6-9) . DE::Lr:GA'I'E ( s) ADMINIS'!RATIVE EXPENSES U. Salaries induding :t'r-!le;e 12. Rent and Utilities 13. ':=a.vel 14. Other 15. '!'otaJ. (Hnes U-14) 16. TOTAL ADMINlSTRAf.rIVE ~SES (lines 10 and'15) 11. ~ CSTF .ADMINISTRATIVE E}G-.:li ::it; ?EaCEN'l'.AG E Note: Co~u::m 7, liDe J.6, !::aVO oat exceed 15% of 2 ti:es :U.ne L '" . J I I I t I I I f , J t I I 1 I 1 I I 2 901 I 0 I 5,802 I J I 5,476 t 5,476 , 0 , 10,952 8,377 I 8,377 t 0 .I 16,754 8,377 I 8,377 0 I 16,754 8,377 I 8,377 0 I 16,754 GRAnTEE PR9GRAM ~SE.:S lB. Sala.ri.es incJ.uding t'::!..nge 19. Rent lUld Utilities 20. T:'a.vel 22. otber 22. Total. (llDes 1S-2J.) DEL..:.UA~(S) aOGRAM u..:-::.!lSES 23. Sela.:.-ies :lIlc.1uding r=i=1ge 24. Rent ~d Uti2ities 25. T:'avel 26. Otber 27. Total (lines 23-26) 28. 'l'O'r.AL PROGRAM EX?:E:'lS:::S (liDes 22 and 21) 29. TOTAL EX?ENDITli'RES (lines 16 + 28) : I " ..... . \ ~ . ~ .. . ~ .. ..' 'I' . \', ~. \ 1 . , ' , e ,. , . CSTF GRANT APPLICATION _ " Local Governmental Unit ~pplyin91 city of Clearwater, Florida i " 1 .. \ : CASH AND IN-KDm MATCH I. Cash Hatch Cno federal. funds allowed except ~ederal revenue sharing) 1. City of Clearwater General Revenue Source Amount 1. 8,377.00 .. 2. ... ~ : 3. 4. . . I. 'l'O'I'AL CASH MA'l'CB , .' 1:1. In-nnd Salaries incl, Benefits-Position Title Hourly Rate ..... ...... . $ $ $ $ S $ $ $ S I:I. '!'OrAL SALARIES "\ ,.--!" . . 1:17. other In-lCind OescriDtion & Source Unit Cost , " .' ".,.,. $ ".';' , " ~ ~ ~ , . ' s . ' '. ~ ~T t ~ . <. .~ :c'. :. :. ':. .1 . ,J ~ :. $ " , : \.. .:..:i $ ~'. ., , . ,,' . . , :.. _ ~'., ' . ::, ' $ , ..~' . ~~ r $ ",5!.i.,'~~ 'Fir:;;::' I...,J,..;' .... \ 1 j '''. ; ~'.:l'>~~ ~..+' :,.I~:rl\i: \' ',' ," \' "( ~' /~:'~':: .:: "<: .:f<~~l~\{.i I . . ~ . '. .;.'.' ;\....~ iI ~ : ';.\:', '!.':~'.i~~//:,~::' ..',..t:j.';I."1 ' -"t':::. ';' $ _$ i $ " . 111. TOTAL arHER " _, ~ ,l . " I ~ " 2. 3. 4. 8,377.00 Bouxly Worked X X X X X. X X X X Total "" - - .' - - - - - - Number Total Units :J: - X - X .. X - X ... X - X - X - X - '. " 1, T 'r ,'. < . " l.< . ...: ... . .1.:--. . :... ',< , I: ' ".. .:f' .....Il... , . '. .!, ~ i': ( : .' L.. 'J.' , ' '. ' . ' ,., . ' ~. : . . , , < .. 'I, ..,. .' ",' ',' l : ~ . , ' , ':: '/': ,::"~ :.:'" '!. :,' ~ , " \)':' ,;'.;'I/J!J .~ . ",:,. :: ' .,,:., \ ; I, , , \ "\ : CD . · L' cat Page 6 of 7 ......' ".l'I-'_..~""__') "-. .............-..,.,,_.',oy ....._.......~..~..-..:..~ 10-40111-......1.. l-t ......b,........._...... ~ ..,-...!',."-.i.....", ~'....._. ~~...-V-~- ...- .---........-..T... ~ ., ...."... "'- ,,_ . .. .. " "-, :;~~~~~~~;. ~~~---~":""'O""::-r7, ~,.~:=. ../. ...~.~....;., "': '~:~.f;?:;~[i~f$~t~::\.<- e,'>. .. ,.'.; ~ , ',"":",:~~':,t;~.:i.\, .;\ CSTF DELEGATE BUrGET Complete a separate pase 6 for each delegate (private non-profit) agency. NAME OF GRANTEE: City of Clearw~ter, Florida Religious 'col1ununity Services, Inc. Emergency Housing Program ',I . NAME OF DELEGATE: PROGRAM NAME: ADDRESS: 1125 Holt Avenue " Clearwater, Florida ZIP CODE: 33515 CONTACT PERSON: . Pat Davis TITLE: Emergency nousing. Manager .TELEPHONE:'. 813/ 446-5964 FEDERAL E.~LOYER ID NUMBER: 59-13091-86 (if none. ac~ach a copy of the ce4cificaee of inco~poration) EXPLAIN BY ATIACHNENT ANY UNE ITFM OVER 5500 AND ALL E..1PENSFS UNDER THE LINE ITEM "OTHER". (Do not include cents. round off co the nearest: ",hole dollar). The following line ;tems correspond to the CSTF Total Budget, page 4 of 7. DELEGATE ADMINISTRATIVE EXPENSE IN-KIND MATCH TOTAL CSTF FUN'DS CASH MATCH 11. Salaries including fringe benefits I I I 12. Rent and Utilities 13. Travel 14. Other 15. Total (lines 11-14) DELEGATE PROGRAM ~~PENSE 23. Salaries including fringe benefits I I I I- I 5 B02 ... 24. Rene and Utilities 2,901 2,901 o 5 802 25. Travel 26. Other ,. . I I. 21901 27. Total (lines 23-26) 2,901 2 901 o 5 B02 TOTAL DELEGATE EXPENSES (lines 15 and 27) 2,901 o THE DELEGATE AGENCY HEREBY CEnIHS IT'WILL CO~,tPLY \nTH ALL RULES. REGULATIONS ANjj CONTRAcr5 RELATING TO TIiE CSTF GRANT: APPROVED BY: Fred Korosy ( Ty ped .~ar.le) \ ( Signaturej President (Title) ArrESTED BY: (Typed Name) (Sisnature) . I' , " .' -~..... , , ;,I,..:,:..{~~ \~..f.\.' '1..~ ~ { ,.' I'.. .~. ::~.i,,' ^. ',,'~:' \';~'. . '.. ' . .'. ~ ~ .,: , . ' . . ~, J D. ," , , . \' ., ; , " ,+ .. " ~ ,'> ~.. " , . , ... .. i" _... '. J ;,~ :~ ,l~ :, ~ ," J " , , I j" ", . '" , .. ~,~ . . I I" . ~ L. . , " ... . ," :. "CD CSTF DELEGATE BUDGET Complete a separate page 6 for each delegate (private non-profit) agency. CD Page 6 of 7 , . NAME OF GRANTEE: NAME OF DELEGATE: PROGRAM RAKE: ADDRESS: City of Clearwater, Florida Neighborly Senior Services, Inc. 'Nutrition Program 13650 Stoneybrook Drive Clearwater, Florida CONTACT,PERSON: TITI.E: TELEPHONE:' ZIP CODE: 33520 FEDERAL EMPLOYER ID NUMBER: 59-1218100 (if none, attach a copy of the cer~ificate of 1nco~poration) I EXPLAIN BY ATIACHNENT ANY LINE ITIli OVER 5500 AND ALL EXPENSES UNDER THE LINE ITEM ftQTHER". (Do not include cents. rOWld off co the nearest whole dollar). The following line ~~ems correspond to the CSTF Total Budget, page 4 of 7. DELEGATE ADMINISTRATIVE EXPENSE CASH MATCH CSTF FUNDS it 11. Salaries including fringe benefies 12. Rene and Utilities 13. Travel 14. Other IS. Total (lines 11-14) DELEGATE PROGRAM EXPENSE 23. Salaries including fringe benefits 24. Rent and Utilities I I I I I. 5,476 25. Travel I 5,476 I I. I 26. Other 5,476 27. Total (lines 23-26) 5',476 5,476 TOTAL DELEGATE EXPE:~SES (lines 15 and 27) 5,476 IN-KIND MATCH TOTAL THE DELEGATE AGENCY HEREBY CERTIFIES, IT" WILL COf1PLY WITH ALL RULFS. REGULATIONS ANii CONTRACI'S RELATING TO TIlE CSTF GRANT: APPROVED BY: (Typed'NaJile) (Title) ATTESTED BY: .. (Typed Name) -~-"r~.~"""""""''''''''~-......-tlW~-tfJ.~;(..:'1I'' o 10 952 " '" >-'- --- - " . -" --~ .~. '/:~~i~r;":'-7~'7""~:',!7t~ 'if;\~ o 10,952 o 10,952 (Signaturej (Signature) " '..'. " ~\~.f ~. : , , 't'. , , , 0, I ~. .' i, , ...." , , . ~ ' I' , \, " , , ~ , c. .' ~~ ,~.: ..\ ;, ," \ , r <(' I ~ . ., ~ ~. :' . , . ',1 <. ,. '. ,,' t...... .... ,'.,' " ~. .f . .' n ..j "".' . ); , l.~ It \ , \. ',~ -tl t . ' '. ~ '. " ;, .' ,~ . ~ . , . :.~: ";:'./ ,~ : , \.~; ... . t ,j I ,'" . . . i.... ~ , , ~: " . .v.~'.::" ':':, ~'. '!:' ~::<,;~?<:',' , : !~,~:-~: :,;::,: ,",: '~,'i.,j }~'(;/ \" :' ' ,',' . ; I" : ,,} ;\ :;\:-.' :,:,i.:'~,~,:, .~;: !,~ I.';; , . . - 1-" \' I ~~\' ;;';:~7.;\%1 ,i /. ";', . " ~ ' T ~. . '.: " '-._ ~. . . " ' . . ""..", .. _. 0 . . ..~.. ... " e , . Pag8 7 of 7 CSTF GRANT AP~LlCATION Local governmental unit applying: City of Clearwater, Florida (name of city or county) The applicant certifies that the data in this application and its vadous sections, including budget data, are true and correct to the best of hisJher knowledge. The .applicant further certifies that: 8. the filing of this application has been duly authorizedr b. should this proposal he funded, this application ,,'ill become part of the contract between the Department of Community' Affairs and, the applicant; c. the Board of county Cottmlissioners or the City Council has passed an appropriate resolution authorizing the expenditure of funds for the specified programsr d. if fees or contributions are to be used rlS matching for this grant, or if a delegate agency is to provide the matching share, and these funds are not forthcoming, this resolution also specifies' that the city or county will provide the necessary match; e. services to be provided "through this contract do not duplicate any other currently existing services, and that the proposed services are no~ being provided nor are they available from any other state agency. f. if similar services are available, that no resource exists to provide these partic~lar services to these clients without the use of this money. Kathleen F. Kelly Name (typed) Signature Mayor-Commissioner Title: Mayor, Chairman of Board of County COllUllissioners, etc. (8l~ 462-6700 Telephone Date ATTESTED BY: Name (typed) Signatura \. ' I ~ '-, ' , .' ".':::, :':~/;~: ~~".'~.,~~f' t. 01 ~ _ ~ . ...-..:.."' , ' , .'.. " ~.., - ..:..- ~'-4I.' "'__~~_