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BOARD OF GOVERNMENT INNOVATION <br />AND COOPERATION <br />APPLICA17ION FORM <br />Application For A <br />Service Sharing Grant <br />This application is submitted to the Board of Government Innovation and Cooperation <br />pursuant to Minnesota Statutes, § 465.80. Pursuant to Minnesota Statutes, an eligible applicant <br />for a Service Sharing shall include two or more local government units. For Service Sharing <br />Grants, a local unit of government is defined as a city, county or township. The local <br />government units applying for this grant agree to abide by the requirements of Minnesota <br />Statutes and the approved procedures for the Board. <br />Please respond to the following questions. (%necessary, use attachments to respond <br />to spec#lc questions. The Board si:aa return or reject applications that it determines do not <br />provide an adequate response to the specific questions. <br />- 1. Name of participating local government units. <br />Fridley New Brighton <br />Mounds View <br />Spring Lake Pack <br />2. Name, address and telephone number of an individual who is able to respond to questions regarding i <br />grant application. <br />Name: William W. Durns Position: City Manaaer <br />Address: City of Fridley 6431 University Avenue N.E. <br />Plus Of n WddpYin" cowl, or ftv uaftn <br />IS� Add,.) <br />Fridley, m 55432 Telephone Number: 572-3506 <br />(Cry. sirr m Zip Codd <br />3. What is the specific service(s) or program(s) which are to be provided under a shared servic <br />agreement between the participating local units of government? How will this shared servic <br />agreement be different from existing shared services arrangements? Explain how other, nc <br />participating local governments may benefit from this project. <br />(Please Attach Response; limo response to a maximum of one typed lwge) <br />4. Total amount of state grant requested: $ 120,000 <br />S. Please identify all necessary one -tune only start-up costs for the proposed shared services. Provid( <br />detailed description of all start-up costs. Indicate which start-up costs are to be funded by the gn <br />from the Board of Government innovation and Cooperation and which start-up costs are to be fund <br />from other sources of revenue. Identify all other sources of revenue that will be used to fund a porti <br />of the start-up costs. <br />(Please Attach Response, limit response to a MaXLMM of one typed page) <br />