10-18 Last five years funding history and Resolutions

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RECEIVED REQUEST FOR PUBLIC FUNDING T7777- Non-profit agencies requesting funding from the City of Paris for projects that benefit the citizeTGffY the following information to be eligible for consideration (you may use additional pages, if necessar"eTH 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 presentationn on their project at a city council meeting. Agency Name: \R~s._~iZ Date: 1'2~ - ~r2P) Agency Mailing Address:_ C) \ \ _-T'~_ ,7 C1 Agency Phone Number: Agency Fax Number: _ Contact Person: Cq,~-~ a ` Title: C i Contact's Mailing Address: A(~ C/ Contact's Phone Number: <_-(99 q 6, Contact's Fax Number: Contact's Email Address• p~ C u,~ti~c ~ (jZ ~ ~ C cam` Name of Project, Location/Service Area of Project: \ Total Project Budget: $'2-~~~®0Ct Total Amount Requested from City: 1 L t N ber of Beneficiariest:Summary of Project: J hti Describe how your project will benefit the City of Paris and its citizens: 6 l~ List other sources of funding for this project and the amounts: Is a de filed project budget, in hiding column and descriptions for allocations of c ty funding and the agency's matching funds, attached? Yes L2'1~lo Is the agency's most recent financial statement or audit attached? Yes [~o Have you received funding from the City of Paris in the last five years for this or any other project? R!P~es EU-N;ff` 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: City of Paris 0055 Revised 7/07/09 EXHIBIT A