NGO Funding Request


The recipient entity's full legal name:  Evangeline Council on Aging, Inc.

The recipient entity's physical address:
           1012 North Reed Street
Ville Platte, LA 70586


The recipient entity's mailing address (if different):
           P.O. Box 312
Ville Platte, LA 70586


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

If the entity is a corporation, list the names of the incorporators:
          

The last four digits of the entity's taxpayer ID number:  8836

What is the dollar amount of the request?  $100,000

What type of request is this?  Capital Outlay Appropriation

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:
           Executive Director - Lisa DeRouen; 1468 Mandy Lane, Ville Platte
President - Jerry Veillon; 1120 Emily Street, Ville Platte
Vice President - Shirley Perron; 807 Main Street, Mamou
Secretary/Treasurer - Melba Young; PO Box 117, Chataignier
Board Member - Earline Boyce; 1700 Lincoln Road, Ville Platte
Board Member - Norma Calaway; PO Box 771, Ville Platte
Board Member - Gloria Soileau; PO Box 114, Reddell
Board Member - John Roderick Fontenot; 3059 Vidrine Road, Ville Platte
Board Member - Irene Fontenot; 1001 North Reed Street, Ville Platte
Board Member - Mary Jenkins; 558 Scenic Drive, Ville Platte
Board Member - Jerrylene Fontenot; PO Box 499, Ville Platte
Board Member - Rose May; 3681 Whiteville Road, Ville Platte
Board Member - James Deshotel; 4434 Vidrine Road, Ville Platte
Board Member - Mary Soileau; PO Box 173, Chataignier
Board Member - Emma Jane Fontenot; 2126 Chataignier Road, Ville Platte
Board Member - Eugene LeBoeuf; 778 Natchitoches Road, Ville Platte


Provide a summary of the project or program:
           Purchase a larger site for the Evangeline Council on Aging Senior Center. This new site would require some renovation and the addition of a state approved kitchen. This site would be centrally located and provide better access to all members of the parish.

What is the budget relative to the project for which funding is requested?:
          Salaries. . . . . . . . . . . . . $0
          Professional Services. . . $0
          Contracts . . . . . . . . . . . $0
          Acquisitions . . . . . . . . . $100,000
          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 provide a larger, more accessible Senior Center.

What are the goals and objectives for achieving such purpose?
          We would be able to reach more seniors in Evangeline Parish. Thereby, providing more information, activities and instruction that could help the seniors remain independent in their own homes. Keeping seniors in their own homes helps keep the cost of institutional care down. With expected increase in the elderly population, we need to do everything possible to keep costs of elder care down in our state, without jeopardizing quality of life.

What is the proposed length of time estimated by the entity to accomplish the purpose?
           1 year

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:
                 None
    
     (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:
                 None

     (c) The percentage of the official's or immediate family member's ownership interest in the recipient entity, if any:
                 None

     (d) The position, if any, held by the official or immediate family member in the recipient entity:
                  None

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: 
               None

(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:
               None

          Provide the name, address, and office of the official to whom the person is related:
                None

          What is the nature of the relationship?  None

(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:
                 LADOTD - Section 5311 (Rural Transportation)
1201 Capitol Access Rd.
Headquarters Building
Baton Rouge, LA 70802

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(d) The nature of the contract, including a description of the goods or services provided or to be provided pursuant to the contract:
               Rural Public Transportation
Community Choice Waiver Program
L.T.P.C.S. Program
Non-Emergency Transportation



Contact Information
name:  Lisa S. DeRouen 
                                       address:  1012 N. Reed St.
                                       phone:  337-363-5161
                                       fax:  337-363-3834
                                       e-mail:  lisaecoa@centurytel.net
                                       relationship to entity:  Executive Director