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7/9/08 <br /> COUNTY OF HAWAII <br /> CONTINGENCY RELIEF FUNDS REQUEST <br /> TO: DATE: <br /> Department <br /> FROM: PHONE/FAX: <br /> Council Member <br /> A. REQUEST(ATTACH BACKUP INFORMATION,IF AVAILABLE) <br /> 1. AMOUNT: $ 2. To ACCOUNT#(i.a, 010.500.5503.02): <br /> 3. To ACCOUNT NAME (L e., P&R Admin. OCE): <br /> 4. PURPOSE(S)OF TRANSFER: <br /> 5. IF THE MONEY IS DESIGNATED FOR A NONPROFIT ORGANIZATION,NAME OF ORGANIZATION: <br /> 6. IS IT A 501(C)(3)? ❑YES ❑ No <br /> *If YES,IRS determination letter must be <br /> attached to this form <br /> 7. COUNTY-RELATED PROGRAM(S)OR ACTIVITY(IES)TO BE FUNDED: <br /> 8. DEPARTMENTAL GOALS AND OBJECTIVES TO BE ADDRESSED: <br /> 9. FUNDING TO BENEFIT THE PUBLIC-AT-LARGE(AS OPPOSED TO PRIVATE BENEFIT)? ❑YES ❑ 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 /> DATE: <br /> Department Head <br /> C. MAYOR'S ACTION <br /> ❑APPROVED ❑ DENIED ❑ DEFERRED: <br /> COMMENTS: <br /> DATE: <br /> Mayor <br />