The recipient entity's physical address:
           311 Martin Luther King Street
Napoleonville, LA 70390

The recipient entity's mailing address (if different):
           P. O. Box 515
Napoleonville, LA 70390

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

If the entity is a corporation, list the names of the incorporators:
          Shederick Weatherspoon, Sr.
Nehemiah Williams
Daniel Pown
Albert Landry, Jr.
Daniel Pown

The last four digits of the entity's taxpayer ID number:  8208

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:
           Shederick Weatherspoon, Sr. (Worshipful Master)
140 Daggs Street
Belle Rose, LA 70341

Nehemiah Williams (Senior Warden)
P. O. Box 88
Paincourtville, LA 70391

Daniel Pown (Junior Warden)
23935 Harmason Street
Plaquemine, LA 70764

Albert L. Landry, Jr. (Secretary)
4784 Sugar Hollow Lane
Addis, LA 70710

Terrance Williams (Treasurer)
121 Daggs Street
Belle Rose, LA 70341

Provide a summary of the project or program:
           The funds requested are help restore and update the building for community use.
1. Replace roofing
2. Update Electrical to code
3. Update the restroom plumbing and add handicap assess.
4. Replace restroom flooring and fixtures
5. Add tankless hotwater heater
6. Update the lighting to be more energy efficient
7. Update the landscaping for proper drainage
8. Remove dead trees
9. Update handicap ramp.
10. Add Exit signs on all doors
11. Update Front and Bank doors for security purposes.
12. Add Paneling and replace installation to more energy efficient.
13. General items to bring the building up to code.
14. Get the building recertified to be a Polling location for the community to reduce travel for the Community

What is the budget relative to the project for which funding is requested?:
          Salaries. . . . . . . . . . . . . $0
          Professional Services. . . $15,000
          Contracts . . . . . . . . . . . $10,000
          Acquisitions . . . . . . . . . $10,000
          Major Repairs . . . . . . . $50,000
          Operating Services. . . . $10,000
          Other Charges. . . . . . . $5,000

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?
          Mount Moriah Lodge No. 17 is located in a rural area of Assumption Parish. The Lodge has been and is a pillar to the community since 1886. Our Mission is to render service to the people of our communities through unity and brotherly love and to assist in improving their cultural, social, and economic conditions.

What are the goals and objectives for achieving such purpose?
          Goal 1: Our goal is to update our building and satisfy building code requirements for our town and Parish.
Goal 2: By accomplishing Goal #1; we will be able to continue to deliver quality programs as well as new programs to our Community. Our current programs are Back to School, Christmas Giveaway, and a Scholarship drive.
Goal 3: Our future objective will be to add WiFi and offer the building as an after-school location. This after-school location will allow us to provide these services to:
• Meal in the evening where the home may not be able to offer one
• After-school tutoring;
• After-school location to perform homework with Internet access
• Future college and vocational training searches
• Monthly programs of health and welfare.
• Partner with the Food Bank to offer free groceries on a schedule

What is the proposed length of time estimated by the entity to accomplish the purpose?
           2 years

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:  Albert L Landry Jr. 
                                       address:  4784 Sugar Hollow Ln
Addis, LA 70710
                                       phone:  2257763206
                                       fax: 
                                       e-mail:  alandryjr@cox.net
                                       relationship to entity:  Secretary