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r; <br /> „ City of Decatur Neighborhood Improvements Commission <br /> Funding Application <br /> Name of Applicant/Group: 1' � C �4-�v �S C��'� <br /> Project Contact (Resp nsible for signing completed application): <br /> Name: �.����Q..�1 �� �a�� <br /> Address: ( 3 u S �• �0.�i � ! � <br /> �- � <br /> Zip: �2��-�- Daytime Phone: �I7-�{��`���,C�g� 9( � � <br /> Neighborhood Organization: N ��,,�.�, Endorsement (Y/N) , <br /> (OPT) Description of neighborhood area impacted: i, <br /> Description of Project (attaeh additional pages if necessary): <br /> ��� 1 A�C' ��� <br /> Project Value To Area: <br /> Res onsibilit for Pro'ect Maintenance If A licable : I <br /> P Y 1 � Pp ) <br /> Funding Request: $ � �� �� <br /> Describe Applicant Contribution �z5%of grant amount required in matching funds or volunteer hours): <br /> * Signature: , Date: � y �0 <br /> Print Name: �or��,�� �na �'ar� � <br /> Grantee shall be responsible for providing a.full accounting of expenditures to the City of Decatur <br /> in the form of receipts or other proof of purchase for all grant dollars spent. The City shall be <br /> entitled to repayment of dollars spent that cannot be accounted for or for full repayment of the , <br /> -- grant-ifiit-is-determined-by-a-majority-of-the-Neighborhood-Improvements-Commission-ancl- <br /> Decatur City Council that funds were used for expenses outside the scope of the project for which I <br /> this application is made. <br /> Please Retum Completed Application To: City of Decatur, City Manager's Office I <br /> 3rd Floor, Decatur Civic Center <br /> 1 Gary K. Anderson Plaza <br /> Decatur, IL 62523 i <br /> "` Signature acknowledges acceptance of terms of grant process as outlined in brochure. � <br /> � <br />