HomeMy WebLinkAboutapplicationOMB Approval No. 0348-0043
Vernon 7)03
APPLICATION
FEDERAL ASSISTANCE
1. TYPE OF SUBMISSION:
Application
❑ Construction
FOR
Preapplicallon
❑ Construction
❑ Non -Construction
2. DATE SUBMITTED
8/20/04
Applicant Identifier
Miami Dade Fire Rescue
3. DATE RECEIVED BY STATE
State Application Identifier
4. DATE RECEIVED BY FEDERAL AGENCY
Federal Identifier
► ll Non -Construction
5, APPLICANT INFORMATION
Legal Name:
Miami -Dade Fire Rescue
Organizational Unit:
Department:
Rescue Department
Organizational DUNS:Fire
004148292
Division:
Fire Prevention Division -Community Affairs Bureau
Address:
Street;
9300 NW 4151 Street
Name and telephone number of the person to be contacted on matters Involving
this application (give area code)
City:
Miami
Prefix:
Mrs.
First Name:
Allie
County:
Miami -Dade
Middle Name:
State:
Florida
ZIP;
33178
Last Name:
Grande
Country:
US
Suffix:
6. EMPLOYER IDENTIFICATION NUMBER (FIN):
Phone Number (give area code),
786-331-4653
FAX Number (give area code):
786-331-5259
5
9- 6 0
0
0 5
7 3
8. TYPE OF APPLICATION:
If Revision, enter appropriate
(See back of form for description
Other (specify):
❑ Continuation
7. TYPE OF APPLICANT:
B. County
Other (Specify):
(See back of form for Application Types):
►�1 New
NI Revision
letters) in boxles):
of letters)
9, NAME OF FEDERAL AGENCY:
U. S Health and Human Services Department
10. CATALOG OF FEDERAL
ASSISTANCE NUMBER:
TITLE: (Name of Program):
DOMESTIC
PADDP
-
11. DESCRIPTIVE TITLE OF APPLICANT'S PROJECT:
County/City Partners for PADDP
9 3
2 5 9
12. AREAS AFFECTED BY PROJECT (cities, counties, stares, etc.):
Miami -Dade County
13. PROPOSED PROJECT:
14. CONGRESSIONAL DISTRICTS OF:
Start Dale
10/1/04
Ending Date
9/30/04
a. Applicant
17th and 18th , Nth and 21st
b. Project
15, ESTIMATED FUNDING:
16. IS APPLICATION
PROCESS?
a. ❑ YES.
b. L NO
THIS
AVAILABLE
PROCESS
DATE
PROGRAM
HAS
SUBJECT TO REVIEW BY STATE EXECUTIVE ORDER 112372
PREAPPLICATION)APPLICATION WAS MADE
TO THE STATE EXECUTIVE ORDER 12372
FOR REVIEW ON:
a. Federal
$ 299,643.10
b. Applicant
$ 0.00
c. Slate
$
d Local
$
IS NOT COVERED BY E.O. 12372 OR PROGRAM
NOT BEEN SELECTED STATE FOR REVIEW
e. Other
$
f. Program income
$
17. I5 APPLICATION DELINQUENT ON ANY FEDERAL DEBT?
❑ YES if "Yes," attach an explanation. ® No
g. TOTAL
$ 299,643,1
18. TO THE BEST OF MY KNOWLEDGE AND BELIEF, ALL DATA IN THIS APPLICATIONIPREAPPLtCATION ARE TRUE AND CORRECT, THE DOCUMENT HAS BEEN DULY
AUTHORIZED BY THE GOVERNING BODY OF THE APPLICANT AND THE APPLICANT WILL COMPLY WITH THE ATTACHED ASSURANCES IF THE ASSISTANCE IS AWARDED
a. Authorized Representative
Prefix
Chief
First Name
Herrninio
Middle Name
Last Name
Lorenzo
Suffix
b. Title
Fire Chief
c. Telephone Number (give area code)
786-331-5000
d. Signatur f h ( d Represonta
Al V
e. Date Signed
8/20/04
Previous Editions Not Usable
A ufhnrionrl fnr 1 nrar Rnnrndurfinn
Standard Form 424 (Reis. 9-2003)
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