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HomeMy WebLinkAboutExhibit ACity of Miami Anti -Poverty Initiative Program Funding Request Form CONTACT INFORMATION: Contact Person: Sherria Ellitt Title: VP Phone number: 786-277-2693 Email Address: arkofthecity@gmail.com gmail.com Name of Person completing this form: Sherria Elliott Legal Name of Organization: Ark of the City, Inc. Address (Street, City, State, Zip Code): 6100 NW 2nd Ave. Miami, Fl 33127 Executive Director of Organization: Terry Elliott, Sr. Executive Director email: arkofthecity@gmail.com Executive Director Contact Phone Number: 786-277-2687 The organization is a registered and active State of Florida Corporation (select one): For-profit organization Not -for profit organization {501(3)(c)) Local governmental unit State governmental unit 1-1 Educational and academic institution F]City of Miami department, agency and board Page 1 of 5 Return this form to: mtrevino@miamigov.com Last revised: September 16, 2019 City of Miami Anti -Poverty Initiative Program Funding Request Form ORGANIZATION AND PROGRAM/PROJECT INFORMATION Organization History and Background Information: Christmas on 15th was established in 2007 by Sherria & Terry Elliott, Sr. and whose vision is to give back to underprivileged inner-city youth who would not have an opportunity to enjoy a joyful Christmas. Is your program/project providing direct services to residents of the City of Miami? Yes❑✓ No❑ Number of residents your entity will serve: 500 children and families Frequency of Service: once a year Age Group Served: 1-17 years old Is your program/project impacting one of Miami's disadvantaged communities? Yes[Z]No Geographic Area Served (specific to this project/program) District Served (1, 2, 3, 4, 5, Citywide) 2 Neighborhood/Community being served: Liberty City Program/Project Priority area (Select one): ❑ Educational Programs for children, youth and adults ❑ Crime Prevention F—] Elderly meals, transportation, recreational and health/wellness related activities ZAt -risk youth or youth summerjob programs FITransportation services and programs ❑ Job development, retention and training programs ❑ Homeless Services Page 2 of 5 Return this form to: mtrevino@miamigov.com Last revised: September 16, 2019 City of Miami Anti -Poverty Initiative Program - Funding Request Form Program/Project Title: Christmas on 15th Avenue Project/Program Description: To create an area in Liberty City that encompasses hope, inspiration, and greatness during the Christmas holiday. Toys and food will be given to 500 children and families in an economically disadvantaged area, Liberty City. Other services will be provided such as: dental care check up, high blood pressure check, farm share, and cancer awareness information from Univ. of Miami. Program Start Date: 12/21/19 Program End Date: 12/21/19 Please describe how this program/project and funding will alleviate poverty within the City of Miami? The toys, food, and medical services will aid families living in an economically disadvantaged area. These under-priviledged children and families will have the core purpose of Christmas restored and be provided with health awareness information as well as the holiday spirit despite social and economic challenges that plague their community. IMPACT AND PERFORMANCE: Describe overall expected outcomes and performance measures for this project/program: To bring the children of this community consistent joy and holiday spirit with the added benefit of toys and food. This will be measured by address lists showing the City of Miami residents and pictures. Please attach additional pages to the back of this packet, if the space above is not sufficient~ Return this form to: mtrevino@miamigov.com Last revised: September 16, 2019 City of Miami Anti -Poverty Initiative Program - Funding Request Form FUNDING REQUEST INFORMATION. Amount Requested: $ 10,000 Explain how the City of Miami Anti -Poverty funding will be utilized: The fund will be utilized for a kidzone to include attendees to keep them safe. Meal preparation and distribution to all attendees, advertisements, and our stapple stuffed animal Itemize API funding related to expenditures below: Personnel Salaries & Wages: $ Personnel Benefits $ Space Rental: $ Utilities (Electricity, Phone, Internet): $ Supplies: $ Marketing: $400 Transportation (Participants): $ Meals (Participants): $2,100 Professional Services (List each): Other (please describe): Toys/stapple bears $1,500 Other (please describe): KIDZONE $6,000 Other (please describe): Page 4 of 5 Return this form to: mtrevino@miamigov.com Last revised: September 16, 2019 City of Miami Anti -Poverty Initiative Program Funding Request Form To be completed by the Entity/Recipient By signing below you agree to the guidelines and stipulate that the information provided on this form is accurate and complete. Completed by (Print & Sign): Sherria Elliott Date: 11/06/19 Additional Comments: To be completed by District Commissioner/Mayor's Office Recommended for funding: Yeso No❑ Funding Recommendation: 16 1 ©(9a Commission Meeting Date: Additional Comments: Completed y (P int & Sign): `e i �- �p C'SU_R_�� Date: k� +Q l To be completed by the Department i Received by (Print & Sign): �x ; s. 5x Date: Additional Comments: Page 5 of 5 Return this form to: mtrevino@miamigov.com Last revised: September 16, 2019