ࡱ> CB \pmsagiao Ba==-X/!8X@"1Arial1Arial1Arial1Arial1.Times New Roman1.Times New Roman1.Times New Roman1@Arial1.Times New Roman1.@Times New Roman1.Times New Roman1@Arial1.Times New Roman1.Times New Roman1.Times New Roman1.Times New Roman1 Garamond1.@Times New Roman1.Times New Roman1.Times New Roman1.Times New Roman1Arial1.Times New Roman1.Times New Roman1.Times New Roman1.Times New Roman1Arial1Arial1Arial"$"#,##0_);\("$"#,##0\)!"$"#,##0_);[Red]\("$"#,##0\)""$"#,##0.00_);\("$"#,##0.00\)'""$"#,##0.00_);[Red]\("$"#,##0.00\)7*2_("$"* #,##0_);_("$"* \(#,##0\);_("$"* "-"_);_(@_).))_(* #,##0_);_(* \(#,##0\);_(* "-"_);_(@_)?,:_("$"* #,##0.00_);_("$"* \(#,##0.00\);_("$"* "-"??_);_(@_)6+1_(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_) mm/dd/yy                + ) , *  &     &X   H  &     (   (    &X    & # !       #   "  (     ! "  ! ! &x &p  `   " &    (  (        !8    !   ( #8 #  f@  "8f@  (f@ &8f@ #8 # "8  "  , "< "<  , #< #< "<f@ "  " 83ffff̙3f3fff3f3f33333f33333\` Cover $,AttI AAttIISAttIII  ;-  ;'  ;+   ;*"rj0 3  @@  hUFCity of Hampton#Grant Proposal Overview Cover Sheet Grant TitleGrant AdministratorDepartment/OrganizationGrant Prepared byDate*Attachment I - Grant Proposal Summary Form1. Grant Title2. Name of Awarding Agency3. Grant Administrator(4. Name of Subrecipient (if applicable)YesNob. If not, why? 5. Special Requirements:Amount:CashIn-Kind Attachment II*6. Sources of Grant & Matching Funds Form-6a. Source of Grant Funds - Please check one Federal Federal Catalog Number Pass ThroughStateFoundation/Private;6b. Source of Matching Funds - Please check all that apply Department(s)*Matching Funds PoolOther U*Please identify the following if the match will be drawn from the department budget:Budget Line Item:$Attachment III - Budget Summary Form!7. Grant Award Letter Attached? Yes:No: If not, why? Grant PeriodFr:To:8. Proposed Budget:GrantCity/Department Match Other MatchesIn Kind a. Personnelb. Operating Expenses c. Capital Outlayd. Column TotalsGrand Budget Total:V9. Remarks: Please clearly identify any attached sheets or forms in the space below. 10. Documentation of Review:Budget & Mgt. Analysis:Finance:Clerk of Council:: a. If applicable, is a Subrecipient agreement attached? %Required Matching Funds/Contributions)Non-Required Matching Funds/ContributionsDirect_(Feel free to attach an additional sheet if more than three line item accounts are being used.)4Early Intervention Services For Infants and Toddlers$with Disabilities and their FamiliesWalter B. Credle%Hampton Department of Social Services Cindy Burgess<Department of Mental Health, Retardation and Substance AbuseServicesX@attached draft allocation amount- awaiting state budget approvalJ z=0;.L?C6cc  -"f%  dMbP?_*+%MHP DeskJet 855Cse@nXX@MSUD&HP DeskJet 855Cse5W"dXX??U-    @   J  ; J  ; J  ; J  ; J  ; J  ; ; ; ; ; ; ; ; ; ; ;      SSSSSSSSS SSSSSSSSS   =  >)))))A   ?     @  ?   A   ~ L@Dl((>2>>>> ! " # $ % & ' ( ) * + ,  !"#$%&'()*+,p(    >d.c @Text 1I)]d.c() 8<By request of City Council, a proposal overview is required for presentation to the City Council on all grant proposals for which the City of Hampton serves as the applicant. The purpose of this overview is to provide the City Council with sufficient information from which to make a decision concerning the grant application. Attached you will find the format for this report which addresses specific Council concerns. Grant applications will only be considered during the first Council meeting of each month. Therefore, it is necessary that you complete this report and forward it to the Office of Budget and Management Analysis for review no later than 4:30 P.M. on the third Monday of each month. After the grant application has been reviewed and any changes or revisions made, the applicant will receive a confirmation memo or e-mail that the grant has been forwarded to the Clerk of Council. An Agenda Review Form (010-7 Rev. 2), a Resolution submitted with at least 1" left margins to allow notebook binding and any other supporting documentation must be included with your grant submission. If you have any questions about the grant proposal overview process, please contact Leslie Beauregard in the Office of Budget and Management Analysis at 727-6377. <8 S SU oman>@7  0/R67  dMbP?_*+%M\\FINSER01\BUDHP4P0C odXXLetterDINU"0:)> "dXX??U} $ }  } $ 0   - J  ; J  ; J  ; J  ; J  ; ;@  @ J  @  @ ;  x@ ;@ @ J  @ ; @ ;@ TTTTTTTTT   =   >    B >  C   ?         ,8 !!! "  J "  J### !!      $ %9 & & N' & N'- K %:'('-K - & & N' &N:(:$0$::$.$N 0$. F $ ;@(@)x@*;+;,x@-;.;/; &)'&)* +*- . / 8 h(    DAc  @Text 2]Ac ) % <&a. Financial Obligations: This proposal ( ) will ( X ) will not require matching funds/contributions. Indicate in the space below the amount and whether the match is cash or in-kind. If the grant has both required and non-required matching funds/contributions, please check both spaces.< wE 0L%?  D,Bc  @Text 3 'i],Bc0 ) h(<ib. Future Financial Obligations: This proposal ( ) will (X ) will not incur commitments or financial obligations for the City beyond the grant period. If it will, an authority memorandum from the Budget Office estimating future matching requirements and time period must be attached to this proposal. Please identify this memo under Section 9 - Remarks.<(S5[\Whoman  D|Bc  @Text 4(-U]|Bcl ) 0< c. Resource Obligations: This proposal ( ) will ( X ) will not require special facilities, equipment and/or services provided by the City. If it will, summarize arrangements in a separate memorandum attached to this proposal. Please identify this memo under Section 9 - Remarks. <0 1[I  DBc/@?Text 5 00]@Bc)  <Please identify the source of your grant funds and any required or non-required matches. For Federal grants, a Federal Catalog Number (CFDA) must be supplied (Check with the grant awarding agency if you do not know this number). All grant matches, unless they have historically received a contribution/match from the City Matching Funds Pool or a special arrangement has been made with the Budget Office, must be supplied by the participating department's) or another source. < 5 1>$@... 7  +ELO  dMbP?_*+%M\\FINSER01\BUDHP4P0C odXXLetterDINU"0:)> "dXX??U+   @          w  J  ; J  J  ; J  ; J  ; ; w ; J   J  ; J    SSSSSSSSS @   +       ) J$ U@    )) ,;J -) JD)- .J)- .)J) + #JK #&J&K #&J/KDl(((L(.:$&(000 ;! ;" ;# J $ ;% J & ;' J ( ) *  <  !'<!" # # # #O$ % % % %O& ' ' ' 'O()*((>>>0 (     JLRc /@?Text 5  ]@LRc )  <Please identify the source of your grant funds and any required or non-required matches. For Federal grants, a Federal Catalog Number (CFDA) must be supplied (Check with the grant awarding agency if you do not know this number). All grant matches, unless they have historically received a contribution/match from the City Matching Funds Pool or a special arrangement has been made with the Budget Office, must be supplied by the participating department(s) or another source. < 5 1>'@   7  )V1`a  dMbP?_*+%M\\FINSER01\BUDHP4P0C odXXLetterDINU"0:)> "dXX??U} m}  } }  } }  } } } } )   -2 , w x@ ;@  @  @ ,@  @ @  @ w @ ; ; <@ J@  ; J  ; J  ; J  ;  Y0 @ w Y@  @  ; S!SSSSSSSSSSS 00000111'''''''' +"''''3'''''''' &# J; &$ JD ;;; &% E  )) ;;  ))   ))  );;;;; )) ,& &'~ M`@ ; &(~ M+@  ))  ,&));&)))) +) '' '''''''' ''' 4*  4+  5,  55 ''' - --  -   --''''''''  ''' 6. ~ P`ABPBPCPBP BBBBBCBBB 6/ ~ PHABPBPCPBP BBBBBCBBB 60PBPBPCPBP 6BBBBBCBBB 61~ Q^)H#Q\d %H#Q %I# Q %  H# Q % 7D E2 FD~ R^)G8999 =3  ))))))))BX."JJ***l"``*D"D"." >""! @" @# h@$ w% i@& J ( J !''''''"''''''#'''''' $:4 &,5 & &6 & (-7(,x8@(    Dec/@?Text 30! #K]@ecX) <FOR OFFICE USE ONLY<>@   7 Oh+'0HPp Leslie M. BeauregardmsagiaoMicrosoft Excel@#ZK$@LM!@Xb=՜.+,0\ PXp x City of HamptonG CoverAttIAttIIAttIIIAttI!Print_AreaAttII!Print_AreaAttIII!Print_AreaCover!Print_Area  Worksheets Named Ranges  !"#$%&'()*+,-./013456789;<=>?@ARoot Entry FWorkbookDcSummaryInformation(2DocumentSummaryInformation8: