The recipient entity's physical address:
           1725 St. Bernard Ave.

The recipient entity's mailing address (if different):
           !725 St. Bernard Ave

Type of Entity (for instance, a nonprofit corporation):  Non-Profit Corporation

If the entity is a corporation, list the names of the incorporators:
          Keith Ellsworth President
Daryl Hubbard Vice President
George Robertson Treasure, Director

The last four digits of the entity's taxpayer ID number:  2680

What is the dollar amount of the request?  $65,000

What type of request is this?  Both

Is this entity in good standing with the Secretary of State?  Yes

Provide the name of each member of the recipient entity's governing board and officers:
           Keith Ellsworth 11437 Melvin Place N.O. La. President
Daryl Hubbard 4346 Spain Street N.O. La. Vice President
George Robertson 4425 Plum Orchard Ave. N.O. La. Treasurer, Director
Langston Ford 11227 Fernley Drive N.O. La. 70128 Financial Sec/Project Manager

Provide a summary of the project or program:
           Site Preparation before installing elevator. Minimal electric work, plumbing work, cement slab, carpentry work, remodeling pathway for entering the upstairs area, cameras to monitor elevator on 1st and 2nd floor. Installation of elevator

What is the budget relative to the project for which funding is requested?:
          Salaries. . . . . . . . . . . . . $0
          Professional Services. . . $0
          Contracts . . . . . . . . . . . $65,000
          Acquisitions . . . . . . . . . $0
          Major Repairs . . . . . . . $0
          Operating Services. . . . $0
          Other Charges. . . . . . . $0

Does your organization have any outstanding audit issues or findings?  No

If 'Yes' is your organization working with the appropriate governmental agencies to resolve those issues or findings?
          

What is the entity's public purpose, sought to be achieved through the use of state monies?
          To give the elderly guest easier access to our 2nd floor, including wheelchairs.

What are the goals and objectives for achieving such purpose?
          Our primary goal for this funding is to install an elevator, providing second-floor access for senior members and guests. Many of our senior members have difficulty navigating stairs, and installing an elevator will ensure they can fully participate in events held on the second floor. Since 1924, stairs have been the only way upstairs. The elevator will also facilitate moving supplies and equipment as needed. In addition, the elevator will streamline event setup and reduce the risk of injury when transporting heavy items between floors, improving both efficiency and safety.

What is the proposed length of time estimated by the entity to accomplish the purpose?
           Two or Three months

If any elected or appointed state official or an immediate family member of such an official is an officer, director, trustee, or employee of the recipient entity who receives compensation or holds any ownership interest therein:
     (a) If an elected or appointed state official, the name and address of the official and the office held by such person:
                 N/A
    
     (b) If an immediate family member of an elected or appointed state official, the name and address of such person; the name, address, and office of the official to whom the person is related; and the nature of the relationship:
                 N/A

     (c) The percentage of the official's or immediate family member's ownership interest in the recipient entity, if any:
                 N/A

     (d) The position, if any, held by the official or immediate family member in the recipient entity:
                  N/A

If the recipient entity has a contract with any elected or appointed state official or an immediate family member of such an official or with the state or any political subdivision of the state:
(a) If the contract is with an elected or appointed state official, provide the name and address of the official and the office held by such person: 
               N/A

(b) If the contract is with an immediate family member of an elected or appointed state official:
          Provide the name and address of such person:
               N/A

          Provide the name, address, and office of the official to whom the person is related:
                N/A

          What is the nature of the relationship?  N/A

(c) If the contract is with the state or a political subdivision of the state, provide the name and address of the state entity or political subdivision of the state:
                 N/A

(d) The nature of the contract, including a description of the goods or services provided or to be provided pursuant to the contract:
               N/A


Contact Information
name:  Keith G Ellsworth 
                                       address:  11437 Melvin Place
                                       phone:  5047225424
                                       fax: 
                                       e-mail:  ellsworthii@aol.com
                                       relationship to entity:  President