HomeMy WebLinkAboutII (A2) Request for Funds for Health Alliance Building Fund Agenda 9-19-2000
Item II A
"CENTER OF GOOD LIVING-PRIDE OF WEST ORANGE" MAYOR•COMMISSIONER
coee
S.SCOTT VANDERGRIFT
CITY OF OCOEEDANNV HOWELL
ISO N. LAKISIIORP.DRIVIS SCOST ANDERSON
0OIT, Fl ORIDA 34761-2258 RUSTY JOHNSON
��� (407)905-3100NANCY,I. FARKER
GOO-S� CI MANAGER
EI.LIS SHAPIRO
Staff Report
Date: September 13,2000
To: The Honorable Mayor and City Commission
From: Janet G. Shira, Community Relations/Projects Director
Subject: Request for Funds from the West Orange Health Alliance
Staff was recently approached by the West Orange Health Alliance with a request for support for
the new West Orange healthcare facility which will be built on Plant Street just west of the new
Beltway.
Although there arc currently no funds available in the community promotions account, staff felt
it would be helpful for the organization to complete one of the grant forms to explain a little
about the organization and what they were requesting. Members of the Alliance will also be at
the Commission meeting to give a brief presentation about the new community health Facility.
Commissioner Anderson is a board member on behalf of the City.
In a meeting with the Alliance, it was discussed that the best way to handle the funds if the City
wants to assist in funding the building would be to take the $50,000 out of Contingency with
$25,000 from this year and $25,000 next year.
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CITY OF OCOEE
GRANT APPLICATION
West Orange Health Alliance, Inc . Jill Wojdyla
Name of Organization (PRINT or TYPE) Contact Person (18 years or older)
10000 W. Colonial Drive; Ocoee, Fl34761 407-296-1823
Address of Organization Daytime Phone Number
PURPOSE (TYPE) OF ORGANIZATION:construct & maintain clinic for
uninsured
PLEASE CHECK ( El ) ONE AND COMPLETE TAX ID INFORMATION:
❑ For Profit Tax ID # 59 3566234
'ff Not-For-Profit Status No.
❑ Non Profit
❑ Unit of Government
❑ Other (please explain)
We are requesting a grant in the amount of S 50 , 000 for the purpose of (Please be
specific: entry fee, uniform, etc.) construction costs
We have requested funds from the City of Ocoee: (Check Q appropriate boxes)
❑ Last Year and received funds in the amount of$
❑ Previous Years and received:
$ /year $ /year
$ /year $ /year
We have received support for this project/event from the following organizations and/or
individuals:
Name/Organization (attach additional sheet if needed) Amount Granted
see attached sheet $
$
$
Total #of members in organization: 15 Total # of members/Ocoee residents:
Describe benefit to Ocoee residents from this grant: All residents, regardless of
income or insurance status, will have access to a full complement
of primary care services.
If funding is granted, the organization certifies that the funds will be used as requested. A written
report of the event shall be submitted to the City no later than 30 days after the event. Organization
agrees to immediately return all funds back to the City if not used for the purpose intended.
NOTE: Grant Applications are included in the Agenda for City Commission Meetings, which
are held the first and third Tuesday of every month. To be placed on an Agenda, your grant
application must be received a minimum of one week before the scheduled Commission
Meeting and be determined to be complete. Please submit Grant Application to: City of Ocoee,
150 N. e, re rive, Ocoee, FL 34761, Attn: Janet Shiro.
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Sr ead of Ag nc rganization Date
(Must be 18 years or older) -
West Orange Health Alliance
Fundraising Status as of September 11, 2000
Total Project Cost 4,300,000
Public Support(Gifts and Pledges)
State of Florida DOH Construction Grant 1,500,000
State of Florida DOH Equipment Grant 300,000
Community Development Block Grant 1,000,000
Orange County Government Match Grant 550,000
Total Public Support 3,350,000
Private Support (Gifts and Pledges)
Health Central Land Purchase 220,000
Health Central Foundation 100,000
Jerry Chicone Foundation 100,000
Chatlos Foundation, Inc. 100,000
McCree, Inc. 60,000
Roper Brothers Foundation 45,000
Hunton Brady Pryor Maso 45,000
Jennifer Nichols Kennedy Design Group 45,000
West Orange Junior Service League unknown
R.D. Keene Foundation 2,500
Daphne Seybolt Culpeper Memorial Foundation 1,000
Total Private Support 718,500
Total Public and Private Support 4,068,500
Remaining Fundraising Goal 231,500