The recipient entity's physical address:
           254 Highway 3048
Rayville, La 71269

The recipient entity's mailing address (if different):
           254 Highway 3048
Rayville, La 71269

Type of Entity (for instance, a nonprofit corporation):  Other

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

The last four digits of the entity's taxpayer ID number:  9028

What is the dollar amount of the request?  $100,000

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:
           Bill Worsley, Board Chair Oliver Holland, Board Vice Chair
254 Hwy 3048 254 Hwy 3048
Rayville, La 71269 Rayville, La 71269

Beth Green Addison Thompson
254 Hwy 3048 254 Hwy 3048
Rayville, La 71269 Rayville, La 71269

Regina Craig Jason Bruyninckx
254 Hwy 3048 254 Hwy 3048
Rayville, La 71269 Rayville, La 71269

James W. Barrett, CEO
254 Hwy 3048
Rayville, La 71269

Provide a summary of the project or program:
           Our goal is to have a building that will have a dual role use. One is for the storing of Emergency Preparedness Supplies. During the COVID emergency we had problems keeping the needed supplies on hand to take care of our patients. We have limited space inside the hospital to store supplies and at times, we had the critical supplies available to us but we had no place to put them. Our plan is to have a building on campus that will have both conditioned and no conditioned space for storage. That will give us the ability to store an adequate amount of emergency supplies that will be readily accessible to the hospital and community when needed. The other half of the space will be used as a maintenance facility with equipment and supplies needed to keep the hospital operational. We currently use several portable buildings placed in various spots on campus that are not adequate to meet our needs.

What is the budget relative to the project for which funding is requested?:
          Salaries. . . . . . . . . . . . . $0
          Professional Services. . . $45,000
          Contracts . . . . . . . . . . . $0
          Acquisitions . . . . . . . . . $58,862
          Major Repairs . . . . . . . $0
          Operating Services. . . . $0
          Other Charges. . . . . . . $15,000

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?
          Richardson Medical Center's public purpose is to provide healthcare to the people of Richland Parish and the surrounding communities. This money will provide the Hospital with needed space for both storage of emergency supplies and a space to be used for the maintenance of the facility

What are the goals and objectives for achieving such purpose?
          The goal is to have both conditioned and unconditioned space to store enough emergency supplies for 7 days of operation incase of and actual emergency. The second goal is to have adequate space to be used in the daily maintenance and operations of the hospital.

What is the proposed length of time estimated by the entity to accomplish the purpose?
           6 months

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:
                 N/A
    
     (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:
                 N/A

     (c) The percentage of the official's or immediate family member's ownership interest in the recipient entity, if any:
                 0%

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

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:  Butch Tolbert 
                                       address:  Butch Tolbert
254 Hwy 3048
Rayville, La 71269
                                       phone:  318 728-4181
                                       fax:  318 728-8107
                                       e-mail:  butcht@richardsonmed.org
                                       relationship to entity:  Employed by entity