The recipient entity's physical address:
           Lafourche Council on Aging, Inc.
4314 Hwy. 1
Raceland, LA 70394

The recipient entity's mailing address (if different):
           Lafourche Council on Aging, Inc.
P O Box 500
Raceland, LA 70394

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

If the entity is a corporation, list the names of the incorporators:
          Kirk J. DeFelice - Chairman
Andrew Robertson - Vice Chairman
Patricia Adams - Secretary/Treasurer

The last four digits of the entity's taxpayer ID number:  6130

What is the dollar amount of the request?  $20,000

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:
           Charelne Rodriguez, Executive Director 103 Myrtle Delaune Street, Lockport, LA 70374
Kirk DeFelice, Chairman, 137 Adam Blvd., Larose, LA 70373
Andrew Robertson Vice Chairman, 202 Winder Road Thibodaux, La 70301
Patricia Adams, Secretary/Treasurer 318 Church Street, Lockport, LA 70374
Rebecca Crochet 314 East 74th Street, Cut Off, LA 70345
Annette Adams 534 Hospital Drive Raceland, LA 70394
Melissa Simmmons P O Box 5608 Thibodaux, LA 70371
Stephen Baudoin 209 Justin Street Lockport, LA 70374
Phillip Gouaux III 1421 Hyland Drive Lockport, LA 70374
Carol Leblanc 292 St. Peter Street Raceland, LA 70394
Tana Dempster 373 Hwy. 307 Thibodaux, LA 70301
Daniel Pellegrin 162 East 123rd Street Galliano, LA 70354
Evelyn Thibodaux 312 Brandywine Road Thibodaux, LA 70301
Sarah Legnion 118 Eddie Lane Golden Meadow, LA 70357

Provide a summary of the project or program:
           This is to provide meals for clients 60 years of age or older who are on a waiting list for homebound meals. This will assist the clients to stay independent in their own homes. This will provide hot meals at lunch time 250 days a year, for one year for 8 clients

What is the budget relative to the project for which funding is requested?:
          Salaries. . . . . . . . . . . . . $0
          Professional Services. . . $0
          Contracts . . . . . . . . . . . $0
          Acquisitions . . . . . . . . . $0
          Major Repairs . . . . . . . $0
          Operating Services. . . . $0
          Other Charges. . . . . . . $233,750

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?
          The public purpose is to assist clients who are home bound to stay in their own home and be as independent as possible. Also, to try and get clients off the waiting list for meals.

What are the goals and objectives for achieving such purpose?
          Goal & Objective: Increase services provided to senior citizens of Lafourche Parish. Assist clients with maintaining a healthy lifestyle and longevity.

What is the proposed length of time estimated by the entity to accomplish the purpose?
           July 1, 2026 - June 30, 2027

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: 
               N/A

(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:
               N/A

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

          What is the nature of the relationship?  N/A

(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:
                 N/A

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


Contact Information
name:  Charlene Rodriguez 
                                       address:  103 Myrtle Delaune Street
Lockport, LA 70374
                                       phone:  9855320457
                                       fax:  9855830800
                                       e-mail:  lafcoadirecto@viscom.net
                                       relationship to entity:  Executive Director