NGO Funding Request


The recipient entity's full legal name:  Hebert Water System, Inc

The recipient entity's physical address:
           6350 Hwy 561
Columbia, LA 71418


The recipient entity's mailing address (if different):
           6350 Hwy 561
Columbia, LA 71418


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

If the entity is a corporation, list the names of the incorporators:
          A.B. Grigg SR
Palmer Howard
H.M. Cook Jr
Earl Murphy
A.C. Mott


The last four digits of the entity's taxpayer ID number:  6352

What is the dollar amount of the request?  $2,598,650

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:
           Wiley R. Kelly-244 Kelly Road, Columbia, La-President
Donald Wilson-124 Lakeview Dr, Columbia, La-Vice President
Bobby J. Sellers-363 Coop Road, Columbia, LA -Recording Secretary
Raymond Roy-212 Bradberry Lane, Rayville, LA -Board Member
Matt Mills-557 Hwy 561, Rayville, LA -Board Member


Provide a summary of the project or program:
           Construct 10", 8", 6", 4" dia. water mains with appurtenances; 40'x 80' office/shop building; elevated storage tank; and rehabilitate the pumping plant because the existing water mains are undersized and cannot transmit proper volume or water or pressure. These improvements will benefit the 1,1109 customers and allow the water system to comply with LA Sanitary Codes.

What is the budget relative to the project for which funding is requested?:
          Salaries. . . . . . . . . . . . . $0
          Professional Services. . . $316,580
          Contracts . . . . . . . . . . . $2,146,790
          Acquisitions . . . . . . . . . $0
          Major Repairs . . . . . . . $0
          Operating Services. . . . $0
          Other Charges. . . . . . . $135,280

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?
          Construct 10",8",6",4" dia. water mains with appurtenances; 40'x80'building/shop; elevated storage tank; and rehabilitate the pumping plant because the existing water mains are undersized and cannot transmit proper volume of water or pressure. These improvements will benefit the 1,109 customers in the Hebert, LA area, and allow the water system to comply with LA Sanitary Codes.
Thus, being able to provide quality, safe drinking water.


What are the goals and objectives for achieving such purpose?
          Goal: Provide quality, safe potable water by constructing new facilities and rehabilitating the plant.
Obj: Obtain Capital Outlay funding totaling $2,598,650 to pay for project.
Tasks: Apply for funding by Nov. 1, 2015
Obj: Engineer produce plans & specifications, and obtain DHH OPH permit; Advertise bid & award construction contract; construct new facilities.


What is the proposed length of time estimated by the entity to accomplish the purpose?
           20 months from date funding obtained

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:
                
    
     (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: 
               

(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:
                

(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:  Randall L. Mills 
                                       address:  126 Sweet Potato Road
Rayville, LA 71269

                                       phone:  (318) 758-0368
                                       fax:  (318) 649-7006
                                       e-mail:  HebertH2o@aol.com
                                       relationship to entity:  Plant/System Manager