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Line Item <br />your Information directly onto this form (2 pages) and upload onto <br />PERSONNEL <br />MOSAIC ART TILE RELIEF <br />Total Compensation <br />Grant .�. <br />Funds <br />Requested <br />Mosaic Tile Artist Fee <br />4,940 <br />4,940 <br />EQUIPMENT, MATERIALS, AND SUPPLIES <br />Item <br />(equipment, materials, supplies) <br />T <br />Total <br />Cost <br />»» Grant <br />Funds <br />Requested <br />Materials and Supplies <br />1,200 <br />1,200 <br />ADDITIONAL EXPENSES <br />Description �» _ <br />(permits, fees, facility rental for project) <br />Natal Cost <br />Grant Funds <br />Requested <br />Digital work <br />The Installers <br />—'—Masate <br />350 <br />950 <br />350 <br />950 <br />Artist Assistant — <br />� 1,000� <br />1,000 <br />Llahllity Insurance <br />560 <br />560 <br />