Commissioner Romelus Growing Strong Ministry R15-055
EXHIBIT "A"
COMMUNITY SUPPORT FUNDS
REQUEST FORM
Part I - Summary of Request(to be completed by City Clerk)
Date of Request: / //13// g
Requested by Mayor/Commissioner: \J -'M - \ .o_\c_&.S
Amount Requested:
Recipient/Payee: & � � SYN1ri
Description of project, program, or activity to be funded:-T�r,� •}
Y �S(NO,`(
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Part II -Availability of funds
The annual appropriation of funds available to the requesting Member of the
Commission listed above is $ �jracx�
The balance of funds available for the requesting Member of the Commission is
$ }carr-,
Accordingly:
There are funds available as requested
r There are insufficient funds available as requested
Dated: By: AeAli, r!( T- -
ty 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 s.;.-10,d by such donation
Dated:, ) r! t3 b U By: a,
Requesting Memyer of the City Commission
❑ MAIL CHECK TO VENDOR ❑ 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 # : 16276
TO: Growing Strong Ministries, Inc.
122 SW 4th Avenue
Boynton Beach, FL 33426
FOR: Community Support Funds distribution
Commissioner Romelus
City of Boynton Beach
Requested By: Judith A. Pyle Date: November 27, 2018
FUND DEPT BASIC ELE OBJ AMOUNT
Approvals: 001 1110 511 95 47 500.00
Div Head
Finance Dept.
City Manager
500.00