NGO Funding Request


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

The recipient entity's physical address:
           965 Hwy 384
Grand Lake
Lake Charles, La. 70607


The recipient entity's mailing address (if different):
           965 Hwy 384
Grand Lake
Lake Charles, La. 70607


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

If the entity is a corporation, list the names of the incorporators:
          Chairperson Lee Allen Benoit
Vice Chairperson Priscilla Collins
Secretary Wilson LeJeune


The last four digits of the entity's taxpayer ID number:  8002

What is the dollar amount of the request?  $25,000

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 Dinah Landry - 337-905-6000 965 Hwy 384, Lake Charles
Chairperson Lee Allen Benoit - 337-802-5126
Vice Chairperson Priscilla Collins - 337-513-6901
Secretary Wilson LeJeune - 337-912-4339


Provide a summary of the project or program:
           Minor repairs to the senior center located at 965 Hwy 384 in Grand Lake:
roof replacement - $8,000.00 metal roof - metal building
replace a window - $800.00
new ramp - $1800.00 (handicapped ramp)
cement for under overhang - $8,000.00 (handicap usage)
repairs to building including restrooms and kitchen - $6,400
total $25,000.00


What is the budget relative to the project for which funding is requested?:
          Salaries. . . . . . . . . . . . . $0
          Professional Services. . . $0
          Contracts . . . . . . . . . . . $0
          Acquisitions . . . . . . . . . $0
          Major Repairs . . . . . . . $25,000
          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?
          Yes

What is the entity's public purpose, sought to be achieved through the use of state monies?
          State monies will be utilized to provide needed repairs to the current senior center located in Grand Lake, in Cameron Parish. The facility was acquire in 2005 (second hand) following the destruction of Cameron Parish by Hurricane Rita. The repairs are necessary to continue to utilize the facility to provide meals and recreation as well as health care services for the elderly of Cameron Parish.

What are the goals and objectives for achieving such purpose?
          The goal of the program is to provide services for those persons over the age of sixty and residents of Cameron Parish. The Cameron Council on Aging provides a wide variety of services. This facility is utilized daily to provide meals, recreation, health care, exercise programs, information and referrals, and other special programs such as flu shots and legal services.

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:
                 na

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


Contact Information
name:  Dinah Landry 
                                       address:  965 Hwy 384
Grand Lake
Lake Charles, La. 70607

                                       phone:  3375323030
                                       fax:  337-905-6500
                                       e-mail:  dinahlandry@yahoo.com
                                       relationship to entity:  Executive Director