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719108 <br /> COUNTY OF HAwAi1i <br /> CONTINGENCY LIE S REQUEST <br /> TO: Research and Development ATE: 0812712021 <br /> Department <br /> FROM: Herbert M. "Tim"Richards, Iff PHONE/FAX: 961-8564 <br /> Council Member <br /> A. REQUEST(ATTACK BACKUP INFORMATION,IF AVAILABLE) <br /> 1. MOUNT: $2,500.00 2. To ACCOUNT#(i.e., 010.500.5503.02): 010.161.5163.20.115 <br /> . To ACCOUNT NAME (i.e.,P&R Admin. OCE): Business Development R&D—Misc. Contract Svs. <br /> . PURPOSE(S)ofTRANSFER: A grant for reimbursement of expenses relating to the Kohala Ohana <br /> Support and Wellness Initiative that provides school supplies for Kohala diddle School students <br /> 5. IF THE MONEY IS DESIGNATED FOR A NONPROFIT ORGANIZATION,NAME OF ORGANIZATION: <br /> 6. IS IT A 501(0)(3)? ®YES ❑ No <br /> *If YES,the IRS determination letter and the Nonprofit Conflict <br /> .North Hawai`i Community Resource Center Disclosure Form must be attached to this request form. <br /> 7. COUNTY-RELATED PROGRAM(S)OR ACTIVITY(IES)TO BE FUNDED: Economic Development <br /> 8. DEPARTMENTAL GOALS AND OBJECTIVES To BE ADDRESSED: Support the development of a local <br /> economy that is diverse, stable, and in balance with Hawaii's ecology, community character, and cultural heritage. <br /> 9. FUNDING TO BENEFIT THE PUBLIC-AT-LARGE(AS OPPOSED TO PRIVATE BENEFIT)? ®YES ❑ NO <br /> 10. IS THE PROGRAM OR ACTIVITY FUNDED ESTABLISHED BY CHARTER,ORDINANCE,OR DIRECTION <br /> OF THE MAYOR? ❑YES ®No <br /> B. DEPARTMENT'S RECOMMENDATION: <br /> ®APPROVE ❑DENY ❑DEFER: <br /> RATIONALE: This project fits within the department's mission to collaborate with community-based <br /> orgaAizationh balanc eco mic, social communi , health, and environmental priorities. <br /> DATE: 8130121 <br /> Department Head <br /> C. MAYOR'S ACTION <br /> APPROVED ❑DENIED ❑DEFERRED: <br /> COMMENTS: <br /> DATE: --3 1 <br /> t0A- Mayor <br />