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COUNTY OF HAWAII <br /> CONTINGENCY RELIEF FUNDS REQUEST <br /> TO: Parks and Recreation DATE: March 10, 2017 <br /> Department <br /> FROM: Karen Eo ff, Council District 8 PHONE/FAX: 808/32.3-4279_ <br /> Council Member <br /> A. REQUEST(ATTACH BACKUP INFORMATION,IF AVAILABLE) <br /> 1. AMOUNT: $3,051 2. To ACCOUNT#(i.e., 010.500.5503.02): 010.481.5481.32.449 <br /> 3. To ACCOUNT NAME (i.e.,P&R Admin. OCE): Coordinated Services County OCE, Motor Vehicles <br /> 4. PURPOSE(S)OF TRANSFER: To provide a portion of the 20%matching fund requirement to acquire <br /> a passenger van from DOT for the Elderly Activities Division, to benefit the North&South Kona area. <br /> 5. IF THE MONEY IS DESIGNATED FOR A NONPROFIT ORGANIZATION,NAME OF ORGANIZATION: <br /> 6. Is ITA 501(C)(3)? ❑YES ® No <br /> *If YES,the IRS determination letter and the Nonprofit Conflict <br /> Disclosure Form must be attached to this request form. <br /> 7. COUNTY-RELATED PROGRAM(S)OR ACTIVITY(IES)TO BE FUNDED: <br /> Elderly Activities, Coordinated Services <br /> 8. DEPARTMENTAL GOALS AND OBJECTIVES To BE ADDRESSED: To provide transportation for the <br /> elderly and those with disabilities to a wide array of essential services and recreational opportunities. <br /> 9. FUNDING TO BENEFIT THE PUBLIC-AT-LARGE(AS OPPOSED TO PRIVATE BENEFIT)? EYES ❑ 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: <br /> ,-—, • <br /> oycecc it`e-ite4-Y DATE: <br /> Department Head <br /> C. MAYOR'S ACTION <br /> NAPPROVED ❑DENIED ❑DEFERRED: <br /> COMMENTS: <br /> fj DATE: MAR 13 2017 <br /> Mayor <br />