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Commissioner Penserga Citrus Cove Elementary • • R15-055 EXHIBIT "A" COMMUNITY SUPPORT FUNDS REQUEST FORM Part I - Summary of Request (to be completed by City Clerk) Date of Request: OC-{.o y+201 61 Requested by Mayor/Commissioner: CofAm;ss,a��•Tq tSe.1a Amount Requested: $ WOO. 0)0 Recipient/Payee: C` S Cole Ele. en-4-u Description of project, program, or activity to be funded: C.;.}-,ruts (eve via As Pones Cor k retAttn/pkon,`c5 rorrArk Catted W l&Dn FiAnda+Itocks, Part II - Availability of funds The annual appropriation of funds available to the requesting Member of the Commission listed above is $ po, --0----. The balance of funds available for the requesting Member of the Commission is $c).1 OQ0. g-f-)7 Accordingly: There are funds available as requested There are insufficient funds available as requested Dated: /O/`ll aoi'q By: .i.Ji it.t •� 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 served by such donation Dated: /0//0/4 By: ,r Re. - :.:.:rffi't' ity Commission S:\CC\WP\COMMUNITY INVESTMENT FUNDS\Community_Support_Funs_Policy.2015.doc