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Account Name Past Actual 3 Past Actual 2 Past Actual 1 Projected <br />Cruisin' for Hospice $ 7762.70 $ 6138.45 $ 10301.75 $ 9380.00 <br />In-Kind Contributions <br />Account Name Past Actual 3 Past Actual 2 Past Actual 1 Projected <br />$ 0.00 $ 0.00 $ 0.00 $ 0.00 <br />Past Actual 3 Past Actual 2 Past Actual 1 Projected <br />Revenue Totals $ 7762.70 $ 6138.45 $ 10301 .75 $ 9855 .00 <br />Expenses <br />Account Name Past Actual 3 Past Actual 2 Past Actual 1 Projected <br />Cruisin' for Hospice $ 4596.13 $ 3589.73 $ 5875.59 $ 5550.00 <br />Past Actual 3 Past Actual 2 Past Actual 1 Projected <br />Expense Totals $4596.13 $ 3589.73 $ 5875.59 $ 5550 ,00 <br />Profit & Loss <br />Past Actual 3 Past Actual 2 Past Actual 1 Projected <br />$ 3166.57 $ 2548.72 $ 4426.16 $ 4305 .00 <br />Application Certification ~ <br />The applicant here certifies and affirms: 1. That it does not now, nor will it during the performance of any contract arising <br />from this application , unlawfully discriminate against any employee, applicant for employment , client. customer, or other <br />person v.A,o might benefit from said contract, by reason of age , race , color , ethnicity, sex, religion , military status, sexual <br />orientation, creed , place of birth, or disability ; 2. That it will abide by all relevant local , state and federal laws and <br />regulations and; 3 . That it has read the information contained in the Instructions on pages 1 and 2 and understands and <br />will comply with all provisions thereof. <br />Certified by:* <br />Name* Ginny Ann Blackson <br />Applicant's Title* Executive Director