NGO Funding Request


The recipient entity's full legal name:  Evangeline Council on Aging, Inc.

The recipient entity's physical address:
           1012 N. Reed St.
Ville Platte, LA 70586


The recipient entity's mailing address (if different):
           P.O. Box 312
Ville Platte, LA 70586


Type of Entity (for instance, a nonprofit corporation):  Non-Profit Corporation

If the entity is a corporation, list the names of the incorporators:
          

The last four digits of the entity's taxpayer ID number:  8836

What is the dollar amount of the request?  $200,000

What type of request is this?  Capital Outlay Appropriation

Is this entity in good standing with the Secretary of State?  Yes

Provide the name of each member of the recipient entity's governing board and officers:
           Executive Director - Lisa DeRouen; 1468 Mandy Lane, Ville Platte
President - Jerry Veillon; 1120 Emily Street, Ville Platte
Vice President - Shirley Perron; 807 Main Street, Mamou
Secretary/Treasurer - Melba Young; 584 St. Julian Rd., Ville Platte
Board Member - Earline Boyce; 146 Duffy Lane, Ville Platte
Board Member - Norma Calaway; 1010 Hummingbird Lane, Ville Platte
Board Member - Gloria Soileau; 2819 Monier Street, Reddell
Board Member - Dale Fontenot; 3059 Vidrine Road, Ville Platte
Board Member - Theresa Riley; 1130 Regile Lane, Ville Platte
Board Member - Mary Jenkins; 558 Scenic Drive, Ville Platte
Board Member - Jerrylene Fontenot; 1857 S. Chataignier Rd., Ville Platte
Board Member - Rose May; 3681 Whiteville Rd., Ville Platte
Board Member - James Deshotel; 4434 Vidrine Rd., Ville Platte
Board Member - Mary Soileau; 110 First St., Chataignier
Board Member - Emma Jane Fontenot; 2126 Chataignier Rd., Ville Platte
Board Member - Eugene LeBouef;778 Natchitoches Rd., Ville Platte


Provide a summary of the project or program:
           Purchase a new site for Evangeline Council on Aging Senior Center. The current center is located within an elderly apartment complex, with limited space and times for activities. A larger site with less restrictions could provide more opportunities for all the aging population of the parish to participate.

What is the budget relative to the project for which funding is requested?:
          Salaries. . . . . . . . . . . . . $0
          Professional Services. . . $0
          Contracts . . . . . . . . . . . $0
          Acquisitions . . . . . . . . . $100,000
          Major Repairs . . . . . . . $50,000
          Operating Services. . . . $0
          Other Charges. . . . . . . $0

Does your organization have any outstanding audit issues or findings?  No

If 'Yes' is your organization working with the appropriate governmental agencies to resolve those issues or findings?
          

What is the entity's public purpose, sought to be achieved through the use of state monies?
          At the present time, our Senior Center is located in an elderly apartment complex. Many the seniors who live in our parish do not feel comfortable participating in the activities because they do not live in the apartment complex. A new site, independent of the the apartment complex, would be easily accessible to all seniors in Evangeline Parish, including those living in the many elderly complexes throughout the parish.

What are the goals and objectives for achieving such purpose?
          Our goal would be to reach more seniors in Evangeline Parish, thereby providing information, activities, and instruction that could help the seniors remain independent in their own homes. Keeping seniors in their own homes helps keep the cost of institutional care down. With the expected increase in the aging population, we need to do everything possible to keep costs of eldercare down in our state, without jeopardizing quality of care.

What is the proposed length of time estimated by the entity to accomplish the purpose?
           1 year

If any elected or appointed state official or an immediate family member of such an official is an officer, director, trustee, or employee of the recipient entity who receives compensation or holds any ownership interest therein:
     (a) If an elected or appointed state official, the name and address of the official and the office held by such person:
                 None
    
     (b) If an immediate family member of an elected or appointed state official, the name and address of such person; the name, address, and office of the official to whom the person is related; and the nature of the relationship:
                 None

     (c) The percentage of the official's or immediate family member's ownership interest in the recipient entity, if any:
                 None

     (d) The position, if any, held by the official or immediate family member in the recipient entity:
                  None

If the recipient entity has a contract with any elected or appointed state official or an immediate family member of such an official or with the state or any political subdivision of the state:
(a) If the contract is with an elected or appointed state official, provide the name and address of the official and the office held by such person: 
               None

(b) If the contract is with an immediate family member of an elected or appointed state official:
          Provide the name and address of such person:
               None

          Provide the name, address, and office of the official to whom the person is related:
                None

          What is the nature of the relationship?  None

(c) If the contract is with the state or a political subdivision of the state, provide the name and address of the state entity or political subdivision of the state:
                 LADOTD - Section 5311(Rural Transportation)
1201 Capital Access Rd.
Baton Rouge, LA 70802

DHH - Medicaid Waiver & L.T.P.C.S.
N.E.M.T.


(d) The nature of the contract, including a description of the goods or services provided or to be provided pursuant to the contract:
               Standard Contract fee for services provided. Rural Public Transportation; Non-Emergency Medical Transportation; Sitter services for Community Choice Waiver Program and Long Term Personal Care Service.


Contact Information
name:  Lisa DeRouen 
                                       address:  1468 Mandy Lane
Ville Platte, LA 70586

                                       phone:  3373635161
                                       fax:  3373633834
                                       e-mail:  lisaecoa@centurytel.net
                                       relationship to entity:  Executive Director