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7/9/08 <br /> COUNTY OF HAWAII <br /> CONTINGENCY RELIEF FUNDS REQUEST <br /> TO: Research and Develpment DATE: December 14, 2017 <br /> Department <br /> FROM: Eileen O'Hara PHONE/FAX: 965-2713 <br /> Council Member <br /> A. REQUEST(ATTACH BACKUP INFORMATION,IF AVAILABLE) <br /> 1. AMOUNT: $1,500 2. To ACCOUNT#(i.e., 010.500.5503.02): 010.161.5162.98.115' <br /> 3. To ACCOUNT NAME (i.e.,P&R Admin. OCE): Resource Center, Misc, Contract <br /> 4. PURPOSE(S)OF TRANSFER: To assist with additional expenses of holding animal spay-neuter clinics <br /> c. .s <br /> in E. Hawai`i <br /> 5. IF THE MONEY IS DESIGNATED FOR A NONPROFIT ORGANIZATION,NAME OF ORGANIZATION: <br /> 6. IS ITA 501(C)(3)? ®YES ❑ No <br /> *If YES,the IRS determination letter and the Nonprofit Conflict <br /> Hui Pono Holoholona Disclosure Form must be attached to this request form. <br /> 7. COUNTY-RELATED PROGRAMS)OR ACTIVITY(IES)TO BE FUNDED: Community Building <br /> 8. DEPARTMENTAL GOALS AND OBJECTIVES To BE ADDRESSED: Facilitating the sustainability of <br /> Hawai`i Island communities through community-based collaboration and capacity building services. <br /> 9. FUNDING TO BENEFIT THE PUBLIC-AT-LARGE(AS OPPOSED TO PRIVATE BENEFIT)? EYES ❑ No <br /> 10. IS THE PROGRAM OR ACTIVITY FUNDED ESTABLISHED BY CHARTER,ORDINANCE,OR DIRECTION <br /> OF THE MAYOR? ❑YES ®No <br /> B. DEPARTMENT'S RECOMMENDATION: <br /> ®APPROVE El DENY ❑DEFER: This project fits within the Departments focus to <br /> RATIONALE: Collaborate with Community-based organizations to balance economic, social and <br /> Community, health and environmental priorities. <br /> DATE: I //s/g0(7 <br /> De$art ent Hea <br /> C. MAYOR'S ACTION <br /> MAPPROVED ❑DENIED ❑DEFERRED: <br /> COMMENTS: <br /> z‘z. <br /> LDATE: DEC 1 8 2017 <br /> ayor <br />