Laserfiche WebLink
7/9/08 <br /> COUNTY OF HAWAI`I <br /> CONTINGENCY RELIEF FUNDS REQUEST <br /> TO: Research and Development DATE: September 21, 2017 <br /> Department <br /> FROM: Jen Ruggles PHONE/FAX: 961-8263 <br /> Council Member <br /> A. REQUEST(ATTACH BACKUP INFORMATION,IF AVAILABLE) <br /> 1. AMOUNT: $10,000 2. To ACCOUNT#(Le., 010.500.5503.02): 010.161.5162.98.115 <br /> 3. To ACCOUNT NAME (Le.,P&R Admin. OCE): HI Cly Resource Center Misc. Contract Svs. <br /> 4. PURPOSE(S)OF TRANSFER: Financial Assistance to Puna Community Medical Center_for <br /> Urgent Care medical supplies <br /> 5. IF THE MONEY IS DESIGNATED FOR A NONPROFIT ORGANIZATION,NAME OF ORGANIZATION: <br /> 6. Is ITA 501(c)(3)? E YES ❑ No <br /> *If YES,the IRS determination letter and the Nonprofit Conflict <br /> Puna Community Medical Center Disclosure Form must be attached to this request form. <br /> 7. COUNTY-RELATED PROGRAM(S)OR ACTIVITY(IES)TO BE FUNDED: Resource Center <br /> 8. DEPARTMENTAL GOALS AND OBJECTIVES To BE ADDRESSED: To identify social economic <br /> community-based needs to promote social economic grown <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 E No <br /> B. DEPARTMENT'S RECOMMENDATION: <br /> E APPROVE ❑DENY ❑DEFER: <br /> RATIONALE: This project aligns with the mission of this department wherein community needs are <br /> identified and collaborations made for social economic growth for the community. <br /> 7i(,C(, N' ' DATE: ` I geJ O P <br /> Dep tmentd <br /> C. M <br /> A OR'S ACTION <br /> iAPPROVED ❑DENIED 0 DEFERRED: <br /> COMMENTS: <br /> �/ / <br /> z �. DATE: // <br /> ?s�/ B <br /> • <br /> Mfuy vi <br /> Managing Director <br />