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, � <br /> KEEP ILLINOIS BEAUTIFUL <br /> APPLICATION COVER SHEET I' <br /> Narne and Address of Local Govemment Local Govcrnmeat FEIN: ' <br /> ON� �w� K• ►�o �Sav f��Y�z�4 <br /> D " �t,� -. <br /> �L� I�O�� �as�3 -���.c� t,,O1211�: Ma r�nn <br /> (four digit zip code extension is mandaiory) , <br /> Project Duration: Beginaing; Jan 2001 Ending:Jan 200 Duration: 12 Months <br /> Program Contact: Chief Elected Official: � <br /> Name:Linda_Kehart, Exec. Director Name; Terry M. Howley <br /> Title: Decatur Community Partnership Title: Mayor <br /> Street: 2170 N. Edward St Street: One Gary K. Anderson Plaza <br /> City:_Qecatur City: Decatur <br /> State/Zip: T 1 1 ino;s ��s�� State/Zip: IL / 62523 <br /> Phone: Phone: 217-424-2804 <br /> E-mail:�.TDA��m' -�� * .+o E-maif: <br /> Keep America Beautiful Certification: Legislative Location: <br /> Csrtified: IIlinois House District: <br /> Pre-Certified: 7 02nd <br /> Other: IIlinois Senate District: <br /> Exglain: 51 st <br /> Congressional District: <br /> 18th <br /> Status of Proposed Funding: <br /> SOURCE OF FUNDS qMp�- <br /> KIB Program Funds $ 7 0 4 9 <br /> Other: $__ 6000 <br /> Other:__ Turning Poirtt � <br /> Other� �"�'9 <br /> $ <br /> Total Program Funding$ 14 0 9 8 <br /> To the best of my knowledge and betief,data in this application are true and correct,the <br /> document has be duly autho ' by the governing body of the applicant and the applicant witl <br /> comply with the e as ces if the application is approved. <br /> ` Z � <br /> s I �� <br /> Signature ofAutho zed Official T' e Date Signed <br /> 9 <br />