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79 09 <br />COUNTY OF HAWAI`f <br />CONTINGENCY RELIEF FUNDS REQUEST <br />TO: Department o/ZCY <br />Control DATE <br />Deportment <br />11/0112023 <br />FROM: Ashley Kier&ieuicr PHONE/FAX: (808) 961-8265 <br />Cow"'I'tentber <br />A. REQUEST (ATTACH BACKUP INFORMATION, IF AVAILABLE) <br />1. AMOUNT: $3,500 2. ToACCOUNT#(i.e., 010.500.5503.02): 010.251.5251.39.115 <br />3. To ACCOUNT NAME (i.e., P&R Admin. OCE). Liquor Control -Public Prog_,ams, Mise Contract Sres <br />4. PURPOSE(S) OF TRANSFER: Commtntity-driren beautification efforts (or the Pahoa Roundabout <br />Earmrttmrtti-literdcw Gn+-rNw.w+� Coo-.-oh...-'r CJ <br />5. IF THE MONEY IS DESIGNATED FOR A NONPROFIT ORGANIZATION, NAME OF ORGANIZATION: <br />6. IS IF A 501(c)(3)? ® YES ❑ No <br />*If YES, the IRS determination letter and the Nonprofit Conflict <br />Malama O Puna Disclosure Form must he attached to this request form_ <br />7. COUNTY -RELATED PROGRAM(S) OR AC OT II'H ES) TO BE FUNDED: Community-driren <br />beautification efforts for the Pahoa Roundabout Community Garden <br />8. DEPARTMENTAL GOALS AND OBJECTIVES TO BE ADDRESSED: Supporting eommtln A -based <br />programs that promote education, health, and hell -being in dnug_[ree, and alcohol -free venues <br />9. FUNDING 'Io BENEFIT THE PUBLIC -AT -LARGE (AS OPPOSED TO PRIVATE BENEFIT)? ®YES ❑ NO <br />10. IS THE PROGRAM OR ACTIVITY FENDED ESTABLISHED BY CHARTER, ORDINANCE, OR DIRECTION <br />OF THE MAYOR? ❑ YF.S ®NO <br />B. DEPARTMENT'S RECOMMENDATION: <br />® APPROVE ❑ DENY ❑ DEFER: <br />RATIONALE: the Department of Liquor Control supports organi�ation.c that focus on the well-being and <br />health of communitl members throuKh alcohol -free and drug-Ime projects <br />NOV - 1 2023 <br />C. DATE: <br />Depnrtm ntH td <br />C. MAYOR'S ACTION <br />KIAPPROVED ❑ DENIED ❑ DEFERRED: <br />COMMENTS: <br />QDATE: �� 2 <br />