NGO Funding Request


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

The recipient entity's physical address:
           405 Carter Street
Vidalia, La 71373


The recipient entity's mailing address (if different):
           conccoa@bellsouth.net

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

If the entity is a corporation, list the names of the incorporators:
          Board of Directors
Larry Chauvin
Jaunita Polk
Joe Milby
Fred Faulkenheiner
Jim Brown
Clyde Ray Webber
Bingham Green


The last four digits of the entity's taxpayer ID number:  0054

What is the dollar amount of the request?  $150,000

What type of request is this?  General 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:
           Linda Cantu - President - 156 Ray Blount Rd., Ferriday, La 71334
Hyram Copeland - Vice President -603 Elm St., Vidalia, La 71373
Catherine Cartwright - Secretary Treasurer - 124 Concordia Park, Vidalia, La 71373
Dorothy H. McDonald - Executive Director - 258 Crestview Drive, Ferriday, La 71334


Provide a summary of the project or program:
           Operating expenses for Concordia Council on Aging, Inc. needed to provide services to elderly of Concprdia Parish, La.

What is the budget relative to the project for which funding is requested?:
          Salaries. . . . . . . . . . . . . $399,085
          Professional Services. . . $0
          Contracts . . . . . . . . . . . $0
          Acquisitions . . . . . . . . . $0
          Major Repairs . . . . . . . $0
          Operating Services. . . . $68,721
          Other Charges. . . . . . . $254,906

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?
          To provide services to the elderly of Concordia Parish aged 60 and over to allow them to maintain an indepenent lifestyle while remaining in their own homes.

What are the goals and objectives for achieving such purpose?
          Collect facts and statistics and make studies of needs of elderly; promote the welfare of aging; Provide two Senior Centers for client participation and meals; provide Home Delivered meals to Homebound with greatest need; provide
Transportation for clients as much as possible with funding available.


What is the proposed length of time estimated by the entity to accomplish the purpose?
           one 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:
                

     (c) The percentage of the official's or immediate family member's ownership interest in the recipient entity, if any:
                

     (d) The position, if any, held by the official or immediate family member in the recipient entity:
                 

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:
              

          Provide the name, address, and office of the official to whom the person is related:
               

          What is the nature of the relationship? 

(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:
                 None

(d) The nature of the contract, including a description of the goods or services provided or to be provided pursuant to the contract:
               


Contact Information
name:  Dorothy H. McDonald 
                                       address:  Concordia Council on Aging, Inc.
405 Carter St.
Vidalia, La 71373

                                       phone:  318-336-7887
                                       fax:  318-336-7881
                                       e-mail:  conccoa@bellsouith.net
                                       relationship to entity:  Executive Director