The recipient entity's physical address:
           79029 Hwy 437
Covington, LA 70435

The recipient entity's mailing address (if different):
           79029 Hwy 437
Covington, LA 70435

Type of Entity (for instance, a nonprofit corporation):  Other

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

The last four digits of the entity's taxpayer ID number:  9501

What is the dollar amount of the request?  $4,440,000

What type of request is this?  Both

Is this entity in good standing with the Secretary of State?  Not Applicable

Provide the name of each member of the recipient entity's governing board and officers:
           Clayton Foreman (Chairman)
PO Box 2452
Covington, LA 70434

Gregory Byers
79537 Hwy 1129
Covington, LA 70435

William Dawsey
78481 Hwy 437
Covington. LA 70435

Jeffery Barker
18096 Old Barker Rd.
Covington, LA 70435

Daniel Flynn
246 Simalusa Drive
Covington, LA 70435

John P. Taylor (Fire Chief)
78424 Hwy 437
Covington, LA 70435

James Cook (Training Chief)
13008 Hwy 1077
Folsom, LA 70437

Provide a summary of the project or program:
           The project will consist of a multi-purpse facility, that will include a fire department with administrative and living spaces on one side, 3 drive-thry apparatus bays in the middle and on the other side of the bays a open multi-purpose room, that can be utilized as a community center, emergency shelter or voting area.

What is the budget relative to the project for which funding is requested?:
          Salaries. . . . . . . . . . . . . $501,000
          Professional Services. . . $17,000
          Contracts . . . . . . . . . . . $0
          Acquisitions . . . . . . . . . $17,400
          Major Repairs . . . . . . . $62,000
          Operating Services. . . . $113,600
          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?
          Build a new centralized fire station / multi-purpose facility within our fire response district. The facility will function as a central fire station and community center / emergency sheter, etc..

What are the goals and objectives for achieving such purpose?
          Goal is to have a central fire station constructed in order to house personnel and apparatus in a centralized location within the fire district. In addition, the facility will function as a community center, emergency shelter or other needs of the community.

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:
                 0

     (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:  James C. Cook 
                                       address:  13008 Hwy 1077 Folsom, LA 70437
                                       phone:  229-561-9992
                                       fax: 
                                       e-mail:  leeroadtraining@outlook.com
                                       relationship to entity:  Training Chief