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7/9/08 <br /> COUNTY OF HAWAII <br /> CONTINGENCY RELIEF FUNDS REQUEST <br /> TO: Liquor Control DATE: 05/01/2019 <br /> Department <br /> FROM: Herbert M. "Tim"Richards, III PHONE/FAX: 961-8564 <br /> Council Member <br /> A. REQUEST(ATTACH BACKUP INFORMATION,IF AVAILABLE) <br /> 1. AMOUNT: $2,100 2. To ACCOUNT#(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 Program, Misc Contract Svcs <br /> 4. PURPOSE(S)OF TRANSFER: A grant to Hamakua Health Center, Inc. dba Hamakua-Kohala Health <br /> towards their community outreach programs involving health and welfare needs of the community. <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 /> P <br /> Hamakua Health Center, Inc., dba Hamakua-Kohala Health Disclosure Form must be attached to this request form. <br /> 7. COUNTY-RELATED PROGRAM(S)OR ACTIVITY(IES)TO BE FUNDED: Supports alcohol free and <br /> and drug-free programs which focuses on safety and welfare needs of the community. <br /> 8. DEPARTMENTAL GOALS AND OBJECTIVES To BE ADDRESSED: Drug-free and alcohol free <br /> Programs that promote the health, safety, and welfare of the community. <br /> 9. FUNDING TO BENEFIT THE PUBLIC-AT-LARGE(AS OPPOSED TO PRIVATE BENEFIT)? DYES ❑ 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 /> [e"APPROVE ❑DENY ❑DEFER: <br /> RATIONALE: The Department of Liquor Control supports alcohol free and drug-free programs which <br /> promote the health, safety and welfare for our community members. <br /> DATE: MAY 01 2019 <br /> Department Head <br /> C. MAYOR'S ACTION <br /> XAPPROVED El DENIED ❑DEFERRED: <br /> COMMENTS: <br /> ,#/t• -• 4-7 Al <br /> DATE: <br /> Managing Director Mayor <br />