HomeMy WebLinkAboutBEULAH GROVE COMMUNITY RESOURCE CENTER DBA LAMAR MEDICAL CENTER
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'-- APR 2 8 2008
BY: --------------------
uest from Outside A
Agency: Beulah Grove Comm':lnity Resource Center
Dba Lamar Medical Center
Budget Time Fra/i,e: 1/1/08 to 12/31/08
Submitted by: ... Lill~~);l'- k.
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1. The agency shall provide the county with a narrative description of the program and a
detailed program budget. The budget should include all funding sources that the
agency anticipates receiving.
2. The Agency shall provide the following information as part of the narrative:
This AGREEMENT made and entered this 8th day of April, 2008, between Augusta, Georgia,
acting by and through the Augusta-Richmond County Commission, a political subdivision of
the State of Georgia (hereinafter referred to as "Augusta" or "County"), and the Beulah Grove
Resource Center dba Lamar Medical Center., (hereinafter referred to as the "Organization" or
"AGENCY"); WITNESSETH:
WHEREAS, the Augusta-Richmond County Commission desires to contract
with the above named Organization to PROVIDE FUNDS FOR THE OPERA nONS OF
THE AGENCY
Whereas the amount of $50,000 are now available for use by AGENCY., according to
the GENERAL FUND BUDGET ADOPTED ON DECEMBER 6, 2007;
NOW, THEREFORE, for and in consideration of the mutual covenants and
agreements between the parties, it is agreed as follows:
The County agrees to appropriate the following sums to the Organization for the
purpose of: Indigent Care Services $50,000
The Organization agrees to use such funds that it may receive, pursuant to this
Agreement, solely and exclusively for the above described Project; said Project, including the
Project Budget, is more specifically described at "Exhibits" attached hereto and incorporated
herein.
In consideration of the disbursement of said funds, AGENCY shall observe all
conditions that the law imposes on the use of said funds, which shall include, but not be
limited to, the following
a. Mission Statement
b. Performance Budget Overview
c. Budget Request
d. Summary
3. The Agency shall complete the following forms as part ofthe budgeting process:
a. Budget Preparation Checklist
b. Agency / Joint Funding Budget Request (Form AJ)
c. Agency / Joint Funding Budget Request Payroll Costs (Form AJ-l)
d. Copy of Agencies most recent financial statements.
4. The agency shall have an annual audit performed by an independent CPA Firm. The
Agency should specify the County as a funding source. The agency shall provide the
County a copy of the audited financial statements within 30 days of delivery of the
audit by the contractor. Said reports shall be delivered to Augusta Finance
Department, Municipal Building Augusta, GA 30911 to the attention of Ms. Donna
Williams, Finance Director or her Designee.
5. The agency shall also submit a completed form W-9 to Augusta Finance Department.
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AUGUSTA-RICHMOND COUNTY COMMISSION
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Mayor
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ORGANIZA nON: