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Girl Scouts ❑ 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 #: 17500 TO: Girl Scouts of Southeast Florida 6944 Lake Worth Road Lake Worth, FL 33467 FOR: Community Support Funds distribution Mayor Ty Penserga City of Boynton Beach Requested By: Catherine Cherry Date: September 9, 2024 FUND DEPT BASIC ELE OBJ AMOUNT Approvals: 001 1110 511 83 05 500.00 Div Head — • Maylee D: esus Finance Dept. City Manager Daniel 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 Penserga Amount Requested: $500 Recipient/Payee: Girls Scouts of Southeast Florida 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 $6,000. Accordingly: ✓ There are funds available as requested There are insufficient funds available as reque -. Dated: q Sal B lM- Maylee I : esus, Ci • 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 served by such donation Dated: C1, 1 larov4 By: Reque • --:e •f the City Commission S:\CC\WP\COMMUNITY SUPPORT FUNDS\FY 2023-2024\Penserga\Girl Scouts of Southeast Florida.doc