Mayor Grant Connect to GreatnessG �148�
R15-055
EXHIBIT "A"
COMMUNITY SUPPORT FUNDS
REQ UES T FORM
Part I - Summary of Request (to be completed by City Clerk)
Date of Request: 02/04/2020
Requested by Mayor/Commissioner: Mayor Grant
Amount Requested $200.00
Recipient/Payee: Connect to Greatness
Description of project, program, or activity to be funded: Enable African American Boys
to re -imagine their reality and become change makers in the World. The Leadership
Academy is a 15 -week program, which helps build character.
Part II - Availability of funds
The annual appropriation of funds available to the requesting Member of the
Commission listed above is $2000.
The balance of funds available for the requesting Member of the Commission is
$200.00.
Accordingly:
X There are funds available as requested
There are insufficient funds available as requested
Dated: By: `
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
V/ The public purpose is beneficial to the entire 9,9.mmunity s rved by such donation
Dated: S- By:
Requesting Member of the City Commission
S:\CC\WP\COMMUNITY INVESTMENT FUNDS\Mayor Grant- Connect to Greatness 2020.docx
❑ MAIL CHECK TO VENDOR ❑ RETURN CHECK TO DEPTH INCLUDE BACK-UP W/ CHECK
CITY OF BOYNTON BEACH
DIRECT PAYMENT REQUISITION
Please issue a check in the amount of $200.00
TO: Connect to Greatness
4034 Arthurium Avenue
Lake Worth, FL 33462
FOR: Community Investment Funds
Mavor Grant Communitv Investment Funds
Requested By: Queenester Nieves
Approvals:
Div Head _
Finance Dept.
City Manager
VENDOR #: 16486
Date: February 12, 2020
FUND
DEPT BASIC
ELE
OBJ
AMOUNT
001
1110 511
95
47
200.00
200.00