HomeMy WebLinkAboutKelley F.Cornish
Augusta Richmond GA
DOCUMENT NAME: "'i-e.U1LLj -y:. (DYY, \ ~ \J
DOCUMENT TYPE:
YEAR: . ~l
BOX NUMBER: 03
F~ENUMBER: \()~l9~
NUMBER OF PAGES:
\9
~~
;.
. --'
'-~,_..........-.--:-
~
STATE OF.GEORGIA
COUNTY OF RICHMOND
THIS INDENTURE, made and entered this 20th day of November,
1997, by and between Kelley F. Cornish, d/b/a Avery & Associates
Consulting Firm whose principal office and place of business
situate at 515 Ridge Cliff Ct, North Augusta, S. C., hereafter
referred to as "AVERY" and Augusta, Georgia hereinafter referred to
as "AUGUSTA".
WIT N E SSE T H; WHEREAS, AUGUSTA receives funds from the
United States Government under Title I of the Housing and Community
Development Act of 1974, Public Law 93-383; and
WHEREAS, AUGUSTA desires to engage AVERY to p~ovide management,
administrative and technical assistance to potential borrowers of
Augusta's Economic Development Loan Fund for the purpose of
implementing and effectuating such project in Richmond County, and
WHEREAS, Avery represents that it has the requisite expertise to
provide such services and to fairly and efficiently implement and
oversee such program;
NOW, THEREFORE, for and in consideration of the premises and the
mutual covenants and agreements herein contained the parties hereto
agree as follows:
1. Avery, acting as an independent contractor, shall implement
and oversee the project in accordance with all applicable
governmental regulations and guidelines issued by the United States
Department of Housing and Urban Development and Augusta - Richmond
County Consolidated Government. Such services include management
and technical assistance to the potential and existing borrowers of
the Loan Program that are referred to Avery & Associates by The
Housing & Neighborhood Development Department as a result of a
review of the application (see Exhibit A). This management,
administrative and technical assistance will include preparing
business plans/loan proposals. These loan packages will include,
but are not limited to the following:
I. Cover Letter
A. Dollar amount requested
B. Suggested terms and timing
C. Purpose of Loan
D. New or Existing Business
II. Executive Summary
A. Business Description
~.
,
~'.
1. Name of business
2. Location and plan description
3. Management expertise
B. Business Goals
C. Summary of financial needs and breakdown of how loan funds
will be used .
D. Earnings projections
E. Number of low/moderate income jobs created or retained
F. Collateral Analysis
III. Market Analysis
A. Description
B. Industry trend
C. Target market
D. Competition
IV. Marketing Strategy
A. Overall strategy
B. pricing policy
C. Method of selling, distribut~ng and se~vicing products
V. Products/Services
A. Description of product/service line
B. Proprietary position: patents, copyrights, and legal and
technical consideration
VI. Manufacturing process ( if applicable)
A. Material
B. Source of supply
C. 'production methods
VII. Management Plan
A. Form of business organization
B. Board of directors composition
C. Officers: organizational chart and responsibilities
D. Resumes of key personnel
E. Staffing plan/number of employees
F. Facilities plan/planned capital improvements
G. Operating plan/schedule of upcoming work for next one to
two years
VIII. Financial Data
A. Current Personal and Business Financial statements
{Previous three years, if this is and existing business}
B. Financial projections
1. 12 - month profit -and- loss (income) statement
2. 12 - month cash flow forecast
3. Balance sheet upon receiving loan
C. Explanation of projections
D. Personal and Corporate Tax Returns for the past three
years for all principals
F. Credit Report
IX. Appendix
",
A. Amortization Schedule on loan repayment
B. ARCMLF loan application
C. Start - up Cost ( if applicable)
D. Copy of vendor quotes showing machinery, equipment,
fixtures or furniture to be purchases
E. Sales contract (if real estate or business 'being
purchased)
F. Appraisal from acceptable appraiser on land and building
being offered as collateral or tax assessor's statement of
value
G. Copy of Lease if premises is leased
H. Construction bid or contract on site improvement
I. Copy of Franchise Agreement (if applicable)
J. Copy of Articles of Incorporation
K. Copy of Current Business License
2. This contract shall become effective upon the execution hereof
by the parties. Avery shall diligently undertake and pursue its
obligation pursuant to this contract in such sequence at to assure
expedition completion of all work required.
3. All work and services required hereunder shall be completed
within thirty (30) days from the date the client is assigned to
Avery.
4. This contract shall terminate one year from the date signed,
November 20, 1998 , unless sooner terminated under terms hereof or
unless extended in writing by parties.
5. All formal communication regarding this contract shall be in
writing between Mrs. Kelley F. Cornish on behalf of Avery and
designated administrator of Augusta, to wit: Keven J. Mack;
however, no change, modification, or amendment to this contract
shall be effiective unless approved by the Mayor and Council
Commission of the Augusta - Richmond County Consolidated Government
and entered upon its minutes and duly executed in writing by Avery
designated agent named above or such successor as may be designated
by Avery.
6. It is understood that Avery is an independent contractor and
time, manner, and method of performance of its work and services
hereunder is left to the discretion of Avery so long as it achieves
the desired result and observes all of the provisions of this
agreement and applicable federal, state, and local laws,
regulations, and guidelines.
7. To insure adequate effectiveness of the Avery's performance
and the effectiveness of the project, as well as proper
coordination.among all those involved, Augusta shall be kept fully
informed of the progress of work and service performed hereunder.
Avery may be required to meet with designated representatives of
Augusta from time to time to review the work and services
performed. Authorized representatives of Augusta may at all
reasonable times review and inspect the work and activities of
Avery in performance of this agreement as well as all data
collected pursuant to this agreement.
Avery shall be bound by the provisions governing retention of
records and custodial requirements of records contained in the
Community Development Block Grant (CDBG) Requlations.
8. The U. S. Department of Housing and Urban Development, and
Augusta shall have access to any pertinent books, documents,
papers, and records of Avery for the purpose of making audit
examinations excerpts, and transcripts. Avery records retention
requirements shall be no less than (5) years for submission of
final expenditure reports. In the event any litigation, claim, or
audit is started before the expiration of such period, the records
shall be retained until all such litigation, claim, or audits
involving the records have been fully resolved.
9. Avery represents that all required business licenses have been
paid for and procured by it. Avery further represents that it
presently has or will secure at its own expense all personnel
required to perform services under this contract. None of the
personnel so employed shall be an employee of Augusta.
10. Avery shall furn.ish to Augusta monthly proj ect performance
reports in such form as specified by Augusta, describing the work
accomplished by it. Such reports shall be furnished to Augusta
within five (5) days after the end of the reporting period. Avery
understands and agreE!S that all reports, studies, records, and
other data prepared by or for- it under the terms of this contract
shall be, become, and remain the sole property of Augusta upon the
completion of the work at the termination of this contract.
Augusta shall have the right to use all such data without
restriction or limitation and without compensation to Avery other
than as provided for in this contract. For purpose of this
contract, such "data" includes all writings, inspections,
photographs, film, video tapes, or other graphic representations
and works of a similar nature. No documents, material, or data
produce in whole or in part under this contract shall be the
subject of an application for copyright by or on behalf of Avery.
Avery acknowledges tha.t all matters regarding rights to inventions
and material generated. by or arising out of this contract may be
subject to regulations issued by the funding agencies.
12. Avery shall certify the
distribution records to support
employee(s) of Avery.
time, attendance, and
all salary and wages
payroll
paid to
13. Avery shall be compensated for her work and services under
this contract at the rates provided in Attachment A attached hereto
and by reference made a part hereof. Unless otherwise approved in
writing by Augusta, payments to Avery shall be made on the
following basis:
(a) Avery shall submit to Augusta, in a form acceptable to
Augusta, a request for payment (Attachment B) for all of the
management and technical assistance projects completed by Avery in
accordance with the pay schedule attached hereto as Exhibit Band
by reference made a part hereof.
(b) Augusta will make payment to Avery provided Avery has
satisfactorily complied with the terms of the agreement and the
payment request is presented in proper form; and further provided
its monthly progress report of the preceding month is satisfactory
and in order. Augusta may withhold any payment in the event that
Avery has failed to comply with the terms of this agreement or to
file its request in the proper form or has failed to file its
required progress reports.
(c) Avery's payment request for the last month of the term of
this contract must be received by Augusta no later that five days
after the termination date of this contract. Adjustments
subsequent to this date must be reported within fifteen (15) days
of the contract termination. Augusta may, at its discretion,
disallow payment of all or part of a final request received after
this deadline.
14. In the event of any overpayment of Avery, it will, upon
request, refund same to Augusta within thirty (30) days of
notification of such overpayment.
~15. .~~~ covenants and agrees that it has no direct or indirect
~ conflict of interest in any manner which would impair its impartial
and unbiased performanc~ of the covenants and provisions of this
agreement.
16. Avery shall indemnify, . save and hold harmless Augusta, its
agents, servants and employees from any and all claims for damage
for personal injury, property damage and damages or losses of any
kind or nature, including reasonable attorney fees and cost of
defense incident to any such claim and as to any causes of action
of any kind arising from performance or failure to perform by
Avery, its agent, servants, or employees.
17. Avery shall not assign or transfer any of its obligations
under the terms of this agreement without prior written approval of
Augusta.
18. Any modifications or.amendment of any kind to this contract
shall be of no force or effect unless duly approved in writing by
both parties and entered upon the minutes of Augusta.
19. Augusta covenants will assure compliance with the following:
(a) Title VI or the Civil Rights Act of 1964 ( P.L. 88-352
and 42 U.S.C. 2000d) and in accordance with Title VI of that Act,
no person in the United States shall, on the ground of age,
handicap, religion, creed, color, or national origin, be excluded
..
from participation in, be denied the benefits of, or be otherwise
subjected to discrimination under any program or activity of which
the applicant receives Federal financial assistance and will
immoderately take any measures necessary to effectuate this
assurance. It will further comply with Title VI provisions
prohibiting employment discrimination where the primary purpose of
a grant is to provide employment. It will not discriminate against
any qualified employee, subcontractor, or client because of age,
handicap, religion, creed, political affiliation, race, color, sex
or national origin. It shall take affirmative action to ensure
that qualified applicants are employed and qualified subcontractors
are selected, and that qualified employees are treated during
employment, without regard to their age, handicap, religion, creed
or belief, political affiliation, race, color, sex, or national
origin. Such action shall include but not be limited to the
following: employment, upgrading, demotions, or transfers;
recruitment, or redruitment advertising layoffs or terminations;
rates or payor other including apprenticeship, and participation
in recreational and educational activities. It agrees to post in
a conspicuous place available to employees and applicant for
employment notices to be provided setting forth the provisions of
this non - discrimination clause.
(b) It shall not discriminate against any qualified client or
recipient of services provided through this contract on the basis
of age, handicap, religion, creed or sex or national origin.
(c) It shall keep such records and submit such reports
concerning the racial and ethnic origin of applicants for
employment and employees as Augusta may require.
(d) It agrees to comply with such rules, regulations or
guidelines as Augusta may issue to implement the requirement of
this paragraph.
(e) It will comply with the applicable provisions of the
Hatch Act which limit~: the political activity of employees.
20. No part of the funds under this contract shall be used to pay
the salary or expense of Augusta, or agent acting on behalf of
Augusta to engage in any activity designed to influence legislation
or appropriation pending before the Congress of the United States.
21. Augusta reserves. the right to immediately suspend and / or
terminate this contra.ct in whole or in part if at any time
Augusta determines Avery is .failing to' substantially provide the
quality of services required by this contract or to substantially
comply with any of its duties and responsibilities hereunder.
22. Avery agrees to meet with potential business owners at her
Augusta location. The address is as follows: 1729 Walton Way.
Auqusta. Georqia
23. The parties may mutually agree at any time to terminate this
'.\
contract in whole or in part.
24. Augusta may, at any time, with or without cause, terminate
this contract on thirty (30) days written notice to Avery.
25. This contract shall in all respects be constructed pursuant to
the laws of the State of "Georgia.
26. This Contract, and any and all exhibits thereto, and/or
documents incorporated by reference into this Contract, shall
constitute the whole agreement between the parties. There are no
promises, terms, condition, or obligations other than those
contained herein, and this Contract shall supersede all previous
communications, representations, or agreements, written or verbal,
between the parties hereto related to the Provision for Services
decribed herein.
"
AVERY ~ ASSOCIATES r
BY:?;~ GQ,~3~ ~
KE~EY F. ~ORNI SH
.AS ITS 1~~~.
signed-_catJ.~ sealed in
t~h ..~"c~ /;, f
~_ .~_ e-"pre~7n.~e 0 I
;:-:iJ:G-X!~ LIt -Wo(C)/U
. -(...._. ........ "J '- 0
. - No~.a:r;iY:..:J?u~,-*,c N Public ~.~ tI ~ Ga
. .....;; _ ...~ ~ ~cnm!'\~_ ,
~ ~ /{2 E;' Ml COmmIllIdon ~ June . lB98
My-,comm~sBxon expires
..,.-~ '~"7'$
...,.........
#If
~
BY AND THROUGH
THE AUGUSTA-
OMMISSION
~~
As its Clerk
This docullltllt Ipprovld as
1!!fc~"lt!y;l1
"
Attachment A
Avery shall receive compensation for services outlined in the Scope
of Work in Section 1 of this agreement as follows:
$20.00 per hour for each applicant referred by Housing &
Neighborhood Development (HND) Department. A maximum of
thirty hours per referral.
Augusta also agrees to reimburse Avery Ten dollars ($10) per credit
report for each referral. Avery agrees to comply with all
applicable laws and/or regulations, including without limitation
the Fair Credit Reporting Act, pertaining to the obtaining and/or
use of consumer credit reports. Additionally, Augusta will
reimburse Avery reasonable mileage at a rate of $.31 per mile
associated with the provisions of the program.
The maximum compensation allowed under the provisions of the
agreement are:
$10.000 for management, administrative and technical
assistance, to include $200 for mileage (See mileage report
Exhibit C) .
CONSULTING FIRM NAME:
ADDRESS:
PHONE NUMBER:
ASSIGNED CLIENT
REQUEST FOR PAYMENT
SERVICES RENDERED
(Please be detailed)
Attachment B
HOURS AND RATE
"
/'
Exhibit A
INITIAL CLIENT DATA
'-
Referred By
Telephone #( )
Name
Address
(City)
(State)
(County)
(Zip Code)
Minority GrouD (Check One)
Black! Afro-American
Mexican-American
Puerto Rican
Cuban American
Other
American Indian
Eskimo & Aleut
Asian-American
Other Minority
Non-Minority
Telephone#{
)
Education .
Gender
Marital Status
Number of Dependents
Spouse's Name
TELL US ABOUT
(Yourself)
(Your Spouse)
Social Security#
Social ~curity#
Age
Date of Birth
Age
Date of Birth
EMPWYMENT
Employer's Name
Employer's Name
Address
Address
Telephone#{
)
Telephone#{ )
How Long Employed?
How Long Employed?
Position
Position
Monthly Income
Monthly Income
Do You: Own Your Home?
Rent
Name of Address of Mortgage, Company
BANKING RELATIONS
(N.ame\ .
(Address)-
(fype' of'Account)
.----:::- -- ---
Briefly describe the venture or business in which you are interested
---.-
Experience for proposed business or venture
BANKING RELA nONS (CONTINUED)
Proposed location of business
Equity Capital: Cash $
Property Value
Type of assistance desired
Amount of loan desired for proposed venture of business
Do you own a business?
Percentage of Ownership
If yes, please fill out Business Infonnation Section. If No, Proposed
YOUR BUSINESS
Employer Identification No.
Telephone#( )
Name of Business
Date . Established
Address
(City)
(State)
(County)
(Zip Code)
Pumose of M&TA
8(a) Certified
Emolovees
Gross Receiots
New Start
Expansion
Maintain
Survival
Year-to-date
Last year 19
2-years ago
3-years ago
Yes_No_
Total
Minority
Paid
Non-Minority
Was business founded by present owner? Yes No
acquired? New Start ; Buyout acquisition
Joint Venture ; SpirK>ff ; Other
If No, bow was ownership of this business
; Merger/combination
Business Type (Check One)
Franchise
Dealership
Distributionship
Licensee
Independent
No If No, LeaselRent Per Month $
% Minority: Yes No
% Minority: Yes No
% Minority: Yes No
Le2al Structure (Check One)
Corporation
Partnership
Sole Proprietorship
Other
Own Location Yes
Ownership:
Ownership:
Ownership:
NOTE: %(8) MUST TOTAL lUO%
Housing & Neighborhood Development Department
A TIN: ED Loan Program
One Tenth Street, Sulte.430
Augusta, Georgia 30901
(706) 821-1797
AUGUSTA. RICHMOND COUNTY. ARCMLF
APPLlCA liON FOR LOAN
I. Request:
Dace:
Amounc IOf Loan Request: $
Tenn Requested:
II. GENERAL INFORHAnON:
Name of Borrower:
Operating Name (If different):
Corporation, PannershJp, or Proprlecorshlp?
How Long? Date Established:
New or Existing Business? Type of Business:
Address of Pr,oJect:
Clcy:
County:
Scace:
Zip:
Phone #:
. Minority Borrower?
III. ECONOMIC IMPACT:
A. Job Impact: # Retained
+ # Creaced
-
-
Total
Loan Amounc $
divided by $5,000 =
Jobs
Meets Job Requirements?
Low moderace Income Jobs Co be Creaced
B. Community Project: If che projecc does noc meet che Job requirements, attach a separaCe
Justlflcatlon for quaJlflcadon.
IV. USE OF PROCEEDS
Land Acqulsldon...
$
$
$
$
$
$
$
$
$
$
$
$
$
Land Improvements...
Construction/Renovation Cosc...
Purchase ExJstlng Land 8[ Building...
Purchase Machinery and Equipment...
Purchase Furniture and Flxcures...
Wor!c-Ing_~pltal.~. __
Invencory. ..
Debt Consolidation...
Professional Fees...
Interim Interest...
Other
TOTAL PROJECT COST...
----------------
------.----------
..:
"./
/ V. SOURCES OF FUNDS
.,
TOTAL SOURCES OF FUNDS...
VI. COLLATERAl
%
s
% S
% S
% S
100.0% S
----------------
----------------
The collateral offered to secure this 10m Is as follows:
(1)
(2)
(])
(4)
TOTAL COLLATERAL OFFERED...
Guarantees/Life Insurance/Other:
VII. INDEBTEDNESS
S
S
S
S
S
----------------
----------------
Furnish the following Information on all Installment debt owed by the business or in relation to
the business:
Original Original Present Payment
To Whom
Amount
Date
Balance Amount
Matures
Security
VIII. MANAGEMENT/OWNERSHIP
/
---
List ~II proprietors, partners, officers, directors, and holders of stock, 1 00% ownership must be
shown: - --
Name
Scx:lal Security #
COinDlete Address
Owned%
IX. BANKING RELATIONSHIP
Name of Current Bank:
Address:
Bankers Name:
Phone #:
X. AGREEMENTS AND CERTIFICATION
The applicant agrees, to the maximum extent possible, to we labor of low-income persoru. The applicant
certifies that neither they nor members of their families hold my leg~ or financUl Interest in the Aupsu -
Richmond County CornmissionlCoundJ, nor does any Commission/Council member own any legal or financial
Interest or Influence with the applicant. The undersigned assures that It does and/or will at all times comply
with Tltfe VI of the Civil Riehu Act of 1964, "Nondiscrimination in Federally Assisted Programs," (42 U.S.C.
2000d - 200Od-4) and that It wiD not discriminate on the basis of race, color, religion, national origin, age,
physical or mental handicap, sex or marital status with respect to lu day to day operations. The applicant
certifies by signing dYt the proposed bwlness Is located within Augusta-Richmond Couney, Georlia. Tbe
applicant certifies that the finandng they are requesting is not available from other federal, state, or private
sector programs. The applicant certifies that those facilities under iu ownership, lease or supervision which will
be utilized In the accomplishment of the project noted above are not listed on the Environmental Protection
Agency's (EPA) List of Violating Facilities. The undersigned will notify Augusta-Richmond County of the
receipt of any communication from EPA of activity indicating that the facility is under consideration for listing
on the Violating Facilities list.
XI. CERTIFICATION
The undersigned hereby certifies that all informacion contained above and in exhibits attached hereto are true
and complete to the best knowtedge and belief of the applicant and are submitted for the purpose of Inducing
Augusca-Richmond County to consider his/her financial request. This also certifies that Augusta-Richmond
County, Howing and Neighborhood Develol)ment Department staff is authorized to check the applican~s credit
and employment history and to ask questions about their experiences with the applicant for the purposes of
coruidering the financial assistance requested in this application. Whether or not the financial assistance herein
applied for is approved, applicant agrees to pay for the cost of any survey, tide or mortgage examinations,
appraisals, etc., performed by non-Augusca-Rkhmond County personnel with consent of the applicant.
APPLICANT SHALL IMMEDIATELY NOTIfY THE AUGUSTA - RICHMOND COUNTY DEPARTMENT OF
HOUSING AND NEIGHBORHOOD DEVELOPMENT OffiCE Of ECONOMIC DEVELOPMENT OF ANY
CHANGE IN OR ADDITION TO THE INFORMATION ABOVE
BY:_
------......"------~ .'
nnE:
ArrEST:
(SEAL)
TInE:
Personal Financial Statement
(Confidential)
As Of , ,19
\Se arate financialstatemenll are re
Penonallnformation:
Name
Social &curl #
Residence Address
Ci . State, Zi
Residence Phone
aired anless aU information will .
Date of Birth
Number Of De ndenls
Business Or nilation
Business Phone
Partner or Officer in an other business
Aaaeta: Lia bilitiea:
Cash on hand and in banks Notes Payable-Secured
Accounts Receivable to Banks- Unsecured
Notes Receiva bIc Notes Pavable to others
Stocb and Bonm-see Schedule A Accounts Pavable
Real Estate-Schedule B Unpaid Taxes
Cash value of life ins.-Schedule C MortPleS on Real Estate-Schedule B
Automobiles Other Debts(itemize)
Other Assets (itemize)
.
Total Liabilities
Net Worth .
Total Assets Total Liabilities aDd Net Worth - --
Total
eots?
-";
--"'.......... ...." ~ .,\"^'~ &au ~.w..
-;
. oC Sbara Dua;ptioa ID Name ex Are llIeae Mar....et
FIICC Value pDelwk matwity OD bonds) Pkdged7 VallIC
(Boada \ . -
\
\
.
Scliledllle B - Ileal Ealale
Addrua a. T)'pe of Property "11e In Name ex %Of Dale CoIl Martel MortPF
, (M,n""hill Acouired ValllC Amount
.
Sct.ed.1c C - Ufe luaruce
Name or Imurance CDmpall)' Owner of Policy BenerlCiaty Face Policy Cuh Surrender
AmOl1llt ~ VaJu..
I
!
Sdiedllle D - Depolll Accoaata ud o-edlt wi... Flaucial lA.lll.dou
fila.... Savi.....d Lan Auoc:iatiou ud Credit V.lou\
Name ud Add.rca AccowII or Credil in Ac:counl Original Secured or OrigiJlal Malurity Currenl Loan
or IDllilulion The Name or Cub Valu Lou Ami. Unsecured Dale Date Ba.Iance
(Use Addition&) Scbedulea If Neoea.ary)
1be iDlormatklo coatalll~ mthil.talement it prcMded for the purpoae or obtainiJIg or aWntaiaiag credil with you for the W1denigned, or penoas.linns
or corpontioos iIl..bote bebalfthe undenigned lIlay either severally or joinlly wilh othcn. elCQlle a guatIJIty in)'OW' Ca'ttlf. I (we) uodcnllJld thai you &I
relyiq 00 this iJlformatioo (UlCludll\g the duigMlion made u to owllenbip of property) in deciding 10 vaal or cooliaue credit. I (we) represent and
wvrut that the informalion prcMded it true and complele. You may consider this al.alement 10 be \nIe and correc:l WItill (we) notify you in writiJIg of a
cIwIF. You are authorized 10 make all inquirea)'Ou consider II<<UIW)' 10 verily tbe accuracy ollhese al.alemenlS and 10 delermine my (our)
credilWorthiueu. You are authorized 10 answer quealions abouI)'OW' credil experillCCl wilh lIlC (III).
(Dale)
Signature (lDduviduaJ)
Signalure (lnduviduaJ)
\.
~.... "'~-CO
'- -NN
as
~~ CD~O'"
c: . -NN
~ (I) ~Ncr)cD
, --N
.... CD~O'"
-NN
/
~ 'IIIl:: LnNenCD
~ --N
'IIIl:: (I) .. - co U")
1IC --N
~
+J
.r-i
..0
'r-i
..c:
><
~
+J
c::
<1l
E
0.
o
~
<1l
>
<1l
Q
"0
0-
o
..c:
~
o ~
.0 ~
..c: "0
C'I c::
.r-i <1l
<1l ~
Z 10
()
GC
c::
C'I 0
c:: .r-i
'r-i en
en en
::1 'r-i
o E
=: ..0
::1
:>, CI)
+J
c:: <1l
::1 U
o 'r-i
() 0
>
"0 c::
c:: H
o
E
..c:
U
.r-i
Q;
I
It!
+J
en
::1
C'I
::1
~
'" CI) ~ - CO U")
en --N
en
_ u..MO""~-
--NM
....NenCDMO
-NM
:>-Q)U")NO")
> -NN
,... CI) MO,.... ~-
en --NM
~u..NenCD~O
-NM
.... - CXHt') N en
-NN
:> ,...~-co
> -NN
'" Cl)CDMO'"
en -NN
en~
- -...- ~N
1-~-Q)Lt)
--N
...>MO"'~
a>> --N
.J:Je .... N 0') CD~O
-N~
!~-CIOU")Nen
Co . -NN
,4) CI) '" ~ _ CIO
CI) -NN
.'!,
..
~.... ~-COU")
= --N
~~ MO"'~
... --N
.J:J
a>(I) NenCDM
u.. -N
'" CI) - Q) U") N
0'). -N
0')'
_ u.. "'~-CO
-NN
I- CDMO'"
-NN
:> U")NO')CD
> --N
,.... CI)"" ~ - CO
en -NN
~u..CDMO'"
-NN
I-U")NenCD
--N
:>~-COLf')
> --N
I-MO,....~
--N
4)~NenCDMO
c -NM
-= CI) - CO Lf')N en
, -NN
....1- "'~-Q)
a> -NN
.J:J
O~ CDMO'"
~ -NN
~ (I) ~NenCD
--N
I-NO')CDMO
-NM
>-COU")Nen
> -NN
'" CI) ~ - CO U")
(1) --N
(1)
-
"
i
..
,.... CI) Lt') N en CD
(1) --N
(1)
_u..~-COLf')
--N
.... I-MO""~-
--NM
:> :>NO'HOMO
::> ::> -NM
.... ~ - CO U") .... - CO Lf') N en
.J:; --N -NN
~ ~ MO"'~- >~ ""~-co
.= --NM _ -NN
c:::: (I) N (1) CD M 0 -= CI) CD M 0 '"
~ -NM" -NN
,.... CI) - Q) Il') N 0')
0') . -NN
0')
_ u.. "'~-cc
-NN
CoO M 0,...
-NN
Lt) N 0") CD
--N
'" CI) - CO U") N en
0') -NN
2? u.. ~~
I- CoOMO'"
-NN
:> Lt)NO")CD
...::> --N
Q,}
.J:J I- ~ - Q) Lf')
e --N
a>~ MO"'~
> --N
ZOCl) NO")CDMO
-NM
I--COU")NO")
-NN
_ c:::: "'~-CO
'c 1IC -NN
:CI) CDMO"""
. -NN
,... CI) Il') N en CD
0') --N
0')
_ u..~-Q)U")
--N
I-MO"'~
--N
:>NO')CDMO
> -NM
,.... Cl)N en CD~O '" Cl)CoOMO'"
en -N~ 0') -NN
~u.._~~ 2?~~
I- ,.....~-CO 1-~-CCLf')
-NN --N
:> CDMO,... :>MO""~-
> -NN ...:> --NM
Q,}
I- Lf')NenCD .J:JI-NO")CDMO
~ --N E -NM
~~. lIl:t -COil') Q,} ~-COU")NO')
en --N V -NN
~ CI) M 0,.... ~ - Qa> CI) ,... ~ -CC
< --NM -NN
~
Z U
o <1l
o..c:
Z U
Z+J
~ ><
=: <1l
E-; c::
Q; <1l
~..c:
E-;+J
~
...:I c::
'r-i
o
Z"O
<1l
~'O
~ ::1
It!~
+J U
en c::
.~
:>,
..0 <1l
..0
'0
<1l 0
>+J
.r-i
<1l <1l
U >
<1l 0
l-l..o
It!
<1l
..oc::
~
+J 0
en..c:
::1 en
E
en
+J <1l
c:: +J .
<1l It! <1l
E'O~
:>.. U
It! '0 :>,
o.<1lU
~
l-lUe.
o ~ 0
~.r-i'r-i
U+J
+J It!
en <1l l-l
<1l..c: It!
::1 +J 0.
0' <1l
<1l~ l-l
Q;00.
.. ~y Ii
Exhibit C
MILEAGE REPORT
FOR CDBG EUGIBLf ACTMTIES
(Use of personal vehicle while conducting ,CDBG eligible activities.)
Beginning Ending Total
Date Odometer Odom eter Mileage Purpose of Trip
Approval/or reimbursement
Staff HOlM
Dale