Agenda - 10-06-1997 - 9b - Laserfiche WebLink

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s U.S. Department of Justice CFDA No.:16.710 . Office of Community Oriented Policing Services SAI No.(ter tt.t,sPOC.x an)y): Date submitted to SPOC: Universal Hiring Program-Applicafion Form 3 This form is to be completed by jurisdictions wishing to apply-for grants to pay for salaries and benefits of new or rehired police officers under the Universal Hiring Program. Complete the information below. By signing this form you also acknowledge your understanding that Universal Hiring grants provide a maxi- mum federal contribution-of T% of the approved salary and benefits of each officer over three years unless a waiver is authorized, up to a cap of 575,000 per officer, with the federal share decreasing and local share increasing from year to}tear. All budget-calculat ons must be based on the salary of an entry level officer in , your department. All requested information must be typed. Applicant Organization's Legal Name: _Orange County Sheriff Department Applicant Agency EIN Number(Assigned by the IRS): (If your department has been assigned an EIN number by the Office of Justice Programs,please use that assigned number. Otherwise,your Internal Revenue Service EIN number should be used.) Applicant Agency ORI Number(Assigned by FBI for UCR Reporting): NCOBSJ000 Congressional District:nth Are you contracting for law enforcement services? O No ;3 Yes If"yes,"enter the name and agency informa- tion of the contract late enforcement department in the Law Enforcement Executive Information section below. Exert tive lift idoll: Law Enforcement Executive's Name: Albert C. Pendergrass Title: Sheriff Agency Name: Orange County Sheriff Office Address: 144 F- MarearAfi 1 an,* City,__ Ha i i chorat'gh State: N.C_ Zip Code: 7727A Telephone: (919) 644-3050 FAX (919) 732-6403 Name of contact person in your department who is familiar with this grant Min T.-:we t rive Telephone: (919) 644-Ingn FAX: �gZg� 732-6403 (OV.