NGO Funding Request


The recipient entity's full legal name:  St. Mary Parish Council on Aging, Inc.

The recipient entity's physical address:
           600 Main Street, Suite 110
Franklin, Louisiana 70538


The recipient entity's mailing address (if different):
           600 Mai Street, Suite 110
Franklin, Louisiana 70538


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

If the entity is a corporation, list the names of the incorporators:
          Mrs. Jane Powers, Mrs. Cora Lunny, Mrs. Anthony Ibert,
Mrs. Laura Belle Porche, Rev. C. R. McCammon, Mrs. Ann Ford, Mrs. Albert Loustalat, Miss Eunice Oliver, Mrs. Mary
Miller, Mrs. Nanc Jolivet, Mrs. Marguerite Bell, Miss Lydia Phillips, Mr. B. Defils, Mrs. Mazei Ball, Mr. Wilbur
Larence


The last four digits of the entity's taxpayer ID number:  8665

What is the dollar amount of the request?  $50,000

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:
           John Benge, P. O. Box 1584, Patterson, Louisiana 70392
Cathy Broussard, 412 Jacobs Street, Berwick, Louisiana 70342
Emma Dell Broussard, 2116 Hebert Street, Franklin, Louisiana 70538
Della Carson Bellard, 1502 Pine Street, Franklin, Louisiana 70538
Verline Kenze, P. O. Box 226, Franklin, Louisiana 70538 - Chairman
Troy LeRive 106 Callahan Patterson, Louisiana
John Renthrop, P. O. Box 950, Patterson, Louisiana 70392
Dense Romero, P. O. Box 2328, Patterson, Louisiana 70392 Sec/Treas.
Beverly Domengeaux, 800 Second Street, Franklin La. 70538 Ex. Dir


Provide a summary of the project or program:
           Purchase of 2 delivery vehicles in order to accommodate the growing
request for homedelivered meals. Drivers are difficult to find and
retain because of delivery in their own vehicles...these 2 vans
would elimate payment of mileage which adds to the cost of doing
service to the deserving seniors


What is the budget relative to the project for which funding is requested?:
          Salaries. . . . . . . . . . . . . $0
          Professional Services. . . $0
          Contracts . . . . . . . . . . . $0
          Acquisitions . . . . . . . . . $50,000
          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 allow us to meet the needs of the homebound seniors and to
allow the seniors to remain in their own homes longer, This is
less costly to the State than having them in a Nursing Home.


What are the goals and objectives for achieving such purpose?
          Feed more homebound seniors by having delivery vans which would
cut the cost of distribution.


What is the proposed length of time estimated by the entity to accomplish the purpose?
           immediately and ongoing

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:  Beverly Domengeaux 
                                       address:  St. Mary Council ON Aging
600 Main Street - Suite 110
Franklin, Louisiana

                                       phone:  337-828-4100-183
                                       fax:  337-828-7557
                                       e-mail:  stmarycoa@teche.net
                                       relationship to entity:  Executive Director