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Connect to Greatness R15-055 R22-140 EXHIBIT "A" COMMUNITY SUPPORT FUNDS REQUEST FORM Part I - Summary of Request (to be completed by City Clerk) Date of Request: August 15, 2024 Requested by Mayor/Commissioner: Mayor Penserga Amount Requested: $500 Recipient/Payee: Connect 2 Greatness Description of project, program, or activity to be funded: Part II - Availability of funds The annual appropriation of funds available to the requesting Member of the Commission listed above is $6,000. The balance of funds available for the requesting Member of the Commission is $3,000. Accordingly: ✓ There are funds available as requested There are insufficient funds available as requested AP- Dated: 9Icl f B - fo Maylee lie -sus, City Clerk Part III-Eligibility Evaluation ✓ Public funds will not be used to improve private property unless there is a clear public need, purpose and benefit ✓ The recipient/payee provides services within the City ,4Th pu lic purpose is beneficial to the entire community served by such donation Dated: C1 C By: 77 4411IP Requesti r,.4 ;•-.: - . t e City Commission S:\CC\WP\COMMUNITY SUPPORT FUNDS\FV 2023-2024\Penserga\Connect 2 Greatness.doc ❑ MAIL CHECK TO VENDOR 2 RETURN CHECK TO DEPT. ❑ INCLUDE BACK-UP W/ CHECK CITY OF BOYNTON BEACH DIRECT PAYMENT REQUISITION Please issue a check in the amount of $ 500.00 VENDOR #: 16486 TO: Connect to Greatness 1530 W. Boynton Beach Blvd. #3525 Boynton Beach Florida 33424 FOR: Community Support Funds distribution Mayor Penserga City of Boynton Beach Requested By: Tammy Stanzione Date: September 9, 2024 FUND DEPT BASIC ELE OBJ AMOUNT Approvals: 001 1110 511 83 05 500.00 Div Head AI It O Maylee D: esus Finance Dept. City Manager Daniel Dugger 500.00