ICYG ❑ MAIL CHECK TO VENDOR E 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 #: 19617
TO: ICYG
1032 Center Stone Lane
Riviera Beah, FL 33404
FOR: Community Support/Funds Distribution
Mayor Ty Penserga
City of Boynton Beach
Requested By: Tammy Stanzione Date:
FUND DEPT BASIC ELE OBJ AMOUNT
Approvals: 001 1110 511 83 05 500.00
Div Head _
Mayle: D= Jesus
Finance Dept.
Peter Kajokas
City Manager
Dan Dugger
500.00
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 Penserqa
Amount Requested: $500
Recipient/Payee: Inner City Youth Golfer's
Association
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
$500.
Accordingly:
✓ There are funds available as requested
There are insufficient funds available as re•uested
Dated: Or B . .'t .t'
May ee�‘a Jes" :, 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
✓ The public purpose is beneficial to the entire community se, ed by such donation
II �
Dated: (1lS gOvL) By: �i
Reque •• ' , •er of the City Commission
S:\CC\WP\COMMUNITY SUPPORT FUNDS\FY 2023-2024\Penserga\Inner City Y. Golfer's Association.doc