NGO Funding Request


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

The recipient entity's physical address:
           405 Carter Street
Vidalia, La 71373


The recipient entity's mailing address (if different):
           405 Carter Street
Vidalia, La 71373


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

If the entity is a corporation, list the names of the incorporators:
          Larry Chauvin -4/10/1974; Revised 7/9/1974 by Board of Directors - Edgar Jones, Corinne Randazzo, Elizabeth Davis, Louis Burley, Guylyn Boles, Bobbie Calhoun, William C. Guice, Robert Lee4, Jr., Beverly Knapp, Effie Moreland, John R. Sewell, and C. J. White.

The last four digits of the entity's taxpayer ID number:  5001

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

What type of request is this?  General 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:
           James E. Lee, President, P. O. Box 501, Clayton, La 713326
Guylyn Boles, Vice President 803 Myrtle Street, Vidalia, La 71373
Sue Jernigan, Secretary/Treasurer, 1217 Loop Rd, Jonesville, La 71343
Patricia J. Anderson,2056 Viking St., Vidalia, La. 71373
Pat G. Bivings,415 Concordia Ave., Vidalia, La 71373
Brady Fields, 164 Sunflower Lane, Ferriday, La 71373
Ellest E. Green, P. O. Box 563, Ferriday, La. 71334
Betty Johnson, 325 Iowa St., Ferriday, La 71334
George olla, Jr., 325 Bayou Rd., Ferriday, La 71334
Brittany V Scott - 612 Tennessee Ave., Ferriday, La 71334
Linda P. Wiley, P. O. Box 539, Ferriday, La. 71334
Dorothy H. McDonald, Executive Director,258 Crestview Dr., Ferriday, La ,71334


Provide a summary of the project or program:
           To provide services to the elderly citizens of Concordia Parish, ages 60 yr. and older (Congregate meals, Home Delivered Meals, Recreation, Transportation, Homemaker, Nutrition Education, Wellness, Telephoning, Public Education, Emergency Response systems, Eyeglass Assistance, Outreach, Information and Assistance, etc.)

What is the budget relative to the project for which funding is requested?:
          Salaries. . . . . . . . . . . . . $0
          Professional Services. . . $0
          Contracts . . . . . . . . . . . $0
          Acquisitions . . . . . . . . . $0
          Major Repairs . . . . . . . $0
          Operating Services. . . . $100,000
          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?
          Provide needed services to the elderly

What are the goals and objectives for achieving such purpose?
          To allow elderly citizens to maintain an independent lifestyle in their own homes as long as possible.

What is the proposed length of time estimated by the entity to accomplish the purpose?
           To assist our efforts for the upcoming 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:
                 Jimmy Jernigan, Police Jury, 1217 Loop Rd., Jonesville, La 71343 (Husband of Sue Jernigan - Board Member)

     (c) The percentage of the official's or immediate family member's ownership interest in the recipient entity, if any:
                 0

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

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?  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:
                

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


Contact Information
name:  Dorothy H. McDonald 
                                       address:  Concordia Council on Aging, Inc.
405 Carter St.
Vidalia, La 71373

                                       phone:  318-336-7887
                                       fax:  318-336-7881
                                       e-mail:  conccoa@bellsouth.net
                                       relationship to entity:  Executive Director