The recipient entity's physical address:
           101 Bocage Drive
Donaldsonville, LA 70346

The recipient entity's mailing address (if different):
           P.O. Box 412
Donaldsonville, LA 70346

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

If the entity is a corporation, list the names of the incorporators:
          Donald Capello
Jessica Geason
Elisa Foret

The last four digits of the entity's taxpayer ID number:  6386

What is the dollar amount of the request?  $300,000

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:
           Chairman Donald Capello, 39080 Driftwood Crossing Ct., Prairieville, LA 70769
Vice-Chairman Jessica Geason, 2320 S. Edwards Avenue, Gonzales, LA 70737
Sec/Treasurer Elisa Foret, 914 Mulberry Street, Donaldsonville, LA 70346

Executive Director Darlene C. Schexnayder, 10121 Lake Ridge Avenue, Gonzales, LA 70737

Provide a summary of the project or program:
           To purchase furniture and equipment for the Prairieville Senior Wellness Center including but not limited to: desks, computers, file cabinets, phone system, dining room tables and chairs, game room equipment and furniture, living room furniture, craft room furniture and equipment, cardio room exercise equipment, group exercise room equipment.

What is the budget relative to the project for which funding is requested?:
          Salaries. . . . . . . . . . . . . $0
          Professional Services. . . $0
          Contracts . . . . . . . . . . . $300,000
          Acquisitions . . . . . . . . . $0
          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 reduce overcrowding at our Gonzales Senior Center and Gonzales Wellness Centers, we are building a center in Prairieville that will combine the functions of both centers in Gonzales. The new center will serve the areas of Prairieville and Geismar. This funding will replace local funds that had to be used in the construction of the center. This funding will be used for purchasing furniture and equipment.

What are the goals and objectives for achieving such purpose?
          The goals are to serve the Prairieville and Geismar communities and to reduce overcrowding at our Gonzales Senior Center and Gonzales Wellness Center.

What is the proposed length of time estimated by the entity to accomplish the purpose?
           12-18 months

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:
                

     (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: 
               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:
              

          Provide the name, address, and office of the official to whom the person is related:
               

          What is the nature of the relationship? 

(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:
                 Governor's Office of Elderly Affairs, 602 North 5th Street, Baton Rouge, LA 70802

LADOTD - 1201 Capitol Access Rd., Baton Rouge, LA 70802

(d) The nature of the contract, including a description of the goods or services provided or to be provided pursuant to the contract:
               Title III Services funding to provide services to seniors 60 and above

LADOTD - FTA contract for Capital Grant for vehicles for 5310 Elderly and Disabled Transportation


Contact Information
name:  Darlene Schexnayder 
                                       address:  P.O. Box 412
Donaldsonville
                                       phone:  2254733789
                                       fax:  2254731387
                                       e-mail:  darlenes@ascensioncoa.org
                                       relationship to entity:  Executive Director