10-18 Last five years funding history and Resolutions

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REQUEST FOR PUBLIC FUNDING Non-profit agencies requesting funding from the City of Paris for projects that benefit the citizens of Paris must complete the following information to be eligible for consideration (you may use additional pages, if necessary). In addition, please submit with this form a copy of your agency's most recent financial statement or audit and a detailed budget for the project. Agencies must also make a brief presentation on their project at a city council meeting. Agency Name: Date: 1 Agency Mailing Address: C I Agency Phone Number: Agency Fax Number: Contact Person: Contact's Title: [ :Z; ;'6itt rte.:' Contact's Mailing Address: 3 5 j ~,ri au ,,..Ci~c`'~L I~ t 8a ~a~ _ 7~C Contact's Phone Number: t+ tt It Contact's Fax Number: Contact's Email Address: Jl1Dy-ov `D i t5 U (Gi 1At w 1 cx~ Name of Project:. w Location/Service Area of Project: Total Project Budget: $ . G' ✓ Total Amount Requested from City: Number of Beneficiaries: T - v Am ary of Project: _1 116ZCA 1`d ~~.~t%~L 'i>~.$~~,~'✓ ~..$:'.~cL,LCc"l'L ~''.'l/LL_$:h_~r~.1.1i;'Wt.F'M.A, ~ Ci~.1'l.' /}'L1,~1 .3'Y r Y.il. ILI, U/_0 Ce,wzl lUA- Describe how your project will benefit the City of Paris and its citizens:. G4,Q; (l i List other sources of funding for this project and the amounts: 1 Is a detailed project budget, including columns and descriptions for allocations of city funding and the agency's matching funds, attached? Yes ❑ No Is the agency's most recent financial statement or audit attached? Yes ❑ No Have you received funding from the City of Paris in the last five years for this or Jcothe, projec ❑-Y/ es ❑ No If you have received previous funding from the City, list the name of the project, the amount of the City's award, and the year awarded: REV C'. GT?ll~. f City of Paris Revised 7/07/09 EXHIBIT A 0090