Organization's objective and history (briefly stated including major activities and length of time in business)

Transcription

1 1 Miami County Foundation 317 N. Wayne Street, P.O. Box 1526, Piqua, OH (937) Grant Application Form Submission deadline: last day of February and August See additional information on page 1 before completing the application Name of organization Mainstreet USA, Inc. Street address 100 N. Main Street City/State/Zip Piqua, OH Contact person Jane Smith Daytime Phone (937) mainstreetusa@help.net Internal Revenue Service status 501(c)(3) or equivalent? X Yes No Federal ID# Organization's objective and history (briefly stated including major activities and length of time in business) Mainstreet USA organizes community efforts to create an attractive, viable downtown environment, and promotes the downtown's unique historical assets using the National Main Street Center's Four Point Approach: Organization, Design, Promotion and Economic Development. Major activities include special events, business retention and recruitment and beautification. The organization was incorporated in 1993 and serves the greater Piqua community. Purpose for grant (for additional space attach a separate page) Grant funds will be used to purchase a new primary computer for the Mainstreet USA office. The organization's present computer is six years old and is struggling to efficiently run our basic office software and accounting software and has reached its capacity for upgrades. An updated computer, purchased with the guidance of the City of Piqua Information Technology Department, will continue to expand our in-house design capabilities, assist our ongoing web presence and run all our organizational software. We will also purchase the latest version of the Microsoft Office Software and new flat screen computer monitor. Area(s) of Miami County served by project: The greater Piqua community Number of Miami County residents affected by project 21,000+ Amount requested $800 (rounded to nearest dollar) Total project budget $1,070 Other sources contacted for support of this project and amounts Mainstreet USA will use the organization's general operating funds to cover additional expenses relating to the computer purchase. Organization's history with the Miami County Foundation: First Grant Request? Yes X No Date of Last Request: Fall 2008 Date Last Grant Awarded: Spring 2008 THE FOLLOWING SIGNATURES ARE REQUIRED: I certify the information is accurate to the best of my knowledge and 5 sets of this application along with the documents listed below have been included. Director Jane Smith Signature Jane Smith Date Board President: William Service Signature William Service Date Submit 5 sets. Each set must include: grant application form (prefer application be typed) basic budget statement for the proposed project or purchase most recent financial statement organization's annual report or equivalent List of Governing Board members Submit 1 copy of the organization's letter of determination from the Internal Revenue Service certifying 501 (c)(3) status or equivalent

2 Mainstreet USA Purchase Budget Miami County Foundation Grant Request ~ Spring 2011 Computer Hardrive & Accessories Computer Monitor Software $ * $ " Flat Screen $ Microsoft Office Professional $ 1, (Not including Shipping etc.) * (500GB hard Drive, keyboard, mouse, speakers, 4GM memory, DVD/CD RW, etc.)

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4 Southern Computer Warehouse Doc # Description ACER 22" LCD SalesRep Ship To Customer Mainstreet USA Piqua, Ohio ' Acer V223W Bbd 1 LCD display - TFT - 22" - widescreen x 1050/60 Hz cd/m : 1 (dynamic) - ET.EV3WP.BOl 1 No $ $ ms mm DVI-D, VGA - black Subtotal: Tax (0.000%): Shipping: Total All returns must be authorized and clearly marked with a valid RMA number. Memory prices are subject to change without notice. Quote valid for 30 days unless formal bid provides different term. Sales tax will be collected where applicable. (CA, FL, GA, MA, NC, & TN) These prices do NOT include applicable taxes, insurance, shipping, delivery, setup fees, or any cables or cabling services or material unless specifically listed above. All prices are subject to change without notice. Supply subject to availability. $ $150.51

5 Southern Computer Warehouse Date Doc # Description Microsoft Office Professional 2007 SalesRep Customer Contact Ship To Customer Mainstreet USA Piqua, Ohio Quote valid for 30 days unless formal bid provides different term. Sales tax will be collected where applicable. (CA, FL, GA, MA, NC, & TN) N o All returns must be authorized and clearly marked with a valid RMA number. Memory prices are subject to change without notice. Tax (0.000%): Shipping: Total: These prices do NOT include applicable taxes, insurance, shipping, delivery, setup fees, or any cables or cabling services or material unless specifically listed above. All prices are subject to change without notice. Supply subject to availability.