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AGR FORM 304-5543 (R/8/15) Page 1 of 2 <br /> <br /> <br /> <br /> <br />APPLICATION FOR CAPITAL IMPROVEMENT GRANT FUNDS <br />Application deadline: November 18, 2015 <br />(See reverse for eligibility requirements & application process) <br />NAME OF FAIR <br />Kittitas County Fair <br />APPLICATION DATE <br />4/17/17 <br />STREET ADDRESS <br />901 East 7th Suite 1 <br />MAILING ADDRESS <br />901 East 7th, Suite 1 <br />CITY <br />Ellensburg <br />STATE <br />WA <br />ZIP <br />98926 <br />MAILING CITY <br />Ellensburg <br />STATE <br />WA <br />ZIP <br />98926 <br />NAME OF REQUESTING OFFICER (PLEASE PRINT) <br />Jill Scheffer, Director KVEC <br />TELEPHONE NUMBER (INCLUDE AREA CODE) <br />509-962-7639 <br />E-MAIL ADDRESS <br />jill.scheffer@co.kittitas.wa.us <br />IF YOU SUBMIT MORE THAN ONE APPLICATION FOR SPECIAL ASSISTANCE GRANT FUNDS, WHAT PRIORITY IS THIS APPLICATION (1 BEING THE HIGHEST PRIORITY)? <br />This application is priority number 2 of the 2 grant applications we intend to submit for this fair. <br /> <br />CAPITAL IMPROVEMENT DETAIL <br />DESCRIPTION OF CAPITAL IMPROVEMENT (USE ADDITIONAL PAGES IF NECESSARY) <br />This request is for some matching funds to complete various improvements, replacements and patches for concrete/asphalt <br />throughout the fairgrounds. These areas are potential human health and safety hazards and we have in fact had a few <br />incidents due to these problem areas already this year. We are anxious to replace/fix and repair these areas prior to the <br />2017 fair. Photos attached to this application clearly show the problem areas throughout the fairgrounds - they impede <br />safe movement of people, animals and vehicles. <br />AMOUNT BEING REQUESTED FROM WSDA <br />$2500.00 <br /> TOTAL PROJECT AMOUNT <br />$4544.40 <br />TYPE OF MATCH <br /> Monetary In-kind Both monetary & in-kind No match <br />DESCRIPTION OF MATCH <br />The Kittitas Valley Event Center has $2,500.00 budgeted for concrete/asphalt paving and repair. We will use that source <br />of funding to match grant funds from WSDA. <br />HEALTH / SAFETY / LEGAL REQUIREMENT OF CAPITAL IMPROVEMENT <br />This is a public safety improvement project. <br />WHAT IS THE IMPACT IF YOU WERE TO RECEIVE A GRANT AWARD LESS THAN REQUESTED? <br />We will work to complete as many projects as we can with funds provided. <br />CAN THE PROJECT BE COMPLETED <br />BY JUNE 30, 2017? <br /> Yes No <br /> <br />APPLICANT CERTIFICATION <br />I hereby certify under penalty of perjury that the foregoing information is true an d correct to the best of my knowledge. <br />SIGNATURE OF OFFICER COMPLETING APPLICATION <br /> <br />DATE SIGNED <br /> <br />Fairs Program <br />PO Box 42560 <br />Olympia WA 98504-2560 <br />(360) 902-1802