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Greater Boynton Foundation - Com. Fitpatrick ❑ FORWARD CHECK. CITY OF BOYNTON BEACH DIRECT PAYMENT REQUISITION Please issue a check in the amount of $ 1,500.00 . TO: GREATER BOYNTON BEACH FOUNDATION 1375 GATEWAY BLVD BOYNTON BEACH FL 33426 FOR: To assist with costs associated with a community clean-up event at the Old High School Expenses such as supplies, mold study to ensure air quality, etc. (Commissioner Fitzpatrick's Community Support Funds) Requested By: Janet M. Prainito Date: September 22, 2015 Approvals: FUND DEPT BASIC ELE OBJ AMOUNT 001 1110 511 95 47 1,500.00 Div Head S • /Y)- / - et M. Prainito Finance Dept. Tim Howard City Manager Lori LaVerriere 1,500.00 R15-055 EXHIBIT "A" COMMUNITY SUPPORT FUNDS REQUEST FORM Part I - Summary of Request (to be completed by City Clerk) Date of Request: /1 5 E/° a,0/6— Requested by Mayor/Commissioner: F (1-2. to A ;ale lc. Amount Requested: $ /,-cone' Recipient/Payee: - rr u,+ ae,-,0y,4,,6. CLC!f eg4ow Description of project, program, or activity to be funaet1"e, uc aysss e_%a to a __yit u Ad/ %.ee-.;i- eiz/ 14. fie,.d tel Ac. ®6 A•12•01s _ . ` .< ;/-0 / s& i • Part II -Availability of funds The annual appropriation of funds available to the requesting Member of the Commission listed above is $,,e-trZi . The balance of funds available for the requesting Member of the Commission is $ •—o Accordingly: E There are funds available as requested ❑ There are insufficient funds available as requested Dated: q/rf,&0/5' By: ),./tei.Ofba City Clerk ontry Part III-Eligibility Evaluation R- 4ublic 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 /he public purpose is beneficial to the entire commu 'ty served by such do ation Dated: /t I'd '/1c By: ' A' 4 Requesting Member of t - City Comm sion S:\CC\WP\COMMUNITY INVESTMENT FUNDS\Community_Support_Funs_Policy.2015.doc