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1. <br />BOARD OF GOVERINNIENT INNOVATION <br />AND COOPERATION <br />APPLICATION 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. If necessary, use attachments to respond <br />to spec{fc questions. The Board shall return or reject applications that it determines do not <br />provide an adequate response to the specific questions. <br />Name of participating local government units. <br />Fridley <br />Mounds View <br />New Brighton <br />Spring Lake Park <br />2. Name, address and telephone number of an individual who is able to respond to questions regarding the <br />grant application. <br />Name: William W. Eurus Position: City Manager <br />Address: City of Fridley 6431 University Avenue N.E. <br />QVaaae of a p u%=pwmg hoed cov+t_ or repmetatine thereon <br />Fridley, MN 55432 <br />(Cky, stale and 71p Code! <br />(Street Added <br />Telephone Number: 572-3506 <br />3. What is the specific service(s) or program(s) which are to be provided under a shared service: <br />agreement between the participating local units of government? How will this shared service: <br />agreement be different from existing shared services arrangements? Explain how other, non- <br />participating local governments may benefit from this project. <br />(Please Attach Response; limit response to a maximum of one typed page) <br />4. Total amount of state grant requested: $_ 120,000 <br />5. Please identify all necessary one-time only start-up casts for the proposed shared services. Provide a <br />detailed description of all start-up costs. Indicate which start-up costs are to be funded by the gram <br />from the Board of Government Innovation and Cooperation and which start-up casts are to be fundec <br />from other sources of revenue. Identify all other sources of revenue that will be used to fund a portior <br />of the start-up costs. <br />(Please Attach Response; limit response to a maximum of one typed page) <br />1 <br />