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06/19/2002 Match Commitment IV.B. MA ~~H COMMITMENT OF CASH DO~' - TION Agency Name: Monroe County Board of County Commissioners/Monroe County In Home Services Program Donor Identification: Name: Monroe County Board of County Commissioners Street: GATO Building - 1100 Simonton Street City: Key West S~ate: FL ZIp: 33040 Phone: 305-292-4572 Authorized Representative: Charles McCoy Mayor Monroe County Board of County Commissione s Total Amount $ ,9,303.00 ALZHEIMER"S DISEASE INITIATIVE # Payments 1 :;> Amount/Payment $ pro ~?ted Contribution Period 7/1/02 thru 6/30/03 Special Conditions: ("J ;;r J'" :::0 C) ;;r.; 0,2: ,.., A -I: ('j . r- 0,): C:;o::"t-, Z. 0 :J> I hereby certify intent to make the cash donation set forth above for use in ttie~iieci~d program during the program's upcoming funding period. This cash is not in~d~ as'? match for any other State or Federally assisted program...Qt cQntract and is rin b()rn~y the federal government directly under any federal gr9J"! ()J('lntracl. Signature of Oonor or Representative: ~ \ .' MAYOR CHARLES MCCOY Donor Certification: Date: /,., z...., c.'-. . OC./lqJO~ fjf;~~., .~ "."'. , . !~ ,. : .) L... . GUfI'K t 'k"'" J .-... .. " 1(""" ... .-.'.... .. . \\. '{~;_~,i-~;-<..,--~, c~,,___ Jao,,'Y 2002,\" "'i...." ", · .... ".~,;;~;::..';..:<!' ..pU CL f'o.,) <:= c:= ~ L c: Z N c.n IV.B. MA-~H COMMITMENT OF CASH DOt. - TION Agency Name: Monroe County Board of County Commissioners/Monroe County In Home Services Program Donor Identification: Name: Monroe County Board of County Commissioners Street: GATO Building - 1100 Simonton Street City: Key West S~ate: FL Zip: 33040 Phone: 305-292-4572 Authorized Representative: Charles MCCoy Mayor Monroe County Board of County Commissione s Total Amount $ 10fl 00 HOME CARE FOR THE ELDERLY # Payments 1 ? Amount/Payment $ ]?ro-R?te>d Contribution Period 7/1/02 thru 6/30/03 ..-~'" o 0 Special Conditions: ~. ..1--.'~ ::0 ;;!' C) ;::2 ;~: Pl ;:-r. -( g~;" c;::o::r ~. c_: ~C"')r- . -l;:C . )! ~ c:> l> ,." Donor Certification: .&- CT\ I hereby certify intent to make the cash donation set forth above for use in the specified program during the program's upcoming funding period. This cash is not included as match for any other State or Federally assisted program..,Pt ~Qntract and is not borne by the federal government directly under any federal grYlt.cgntract. Signature of Donor or Representative: ~\ Date: O<'-/IYO~ ~...'Z.. MAYOR CHARLES MCCOY January 2002 ,~~/~i::~;.; :': ,/ . {!".;;; '-,':' .7' '''~1 ',;. ~;'1~~ Il \\~. ~ -'~f~~,~(,-:~_, '^~ ~, \\;,,\~.,f~:;.;,,;. C' ... ..... ~ L.- '~~:.~.:;-~:~ ~7'~:~:, 'c: __:"', . "~'. >, ~- ~..o.' LERK '.,',~ '--"_ _vc.,...,,~ ~ = = '" L C ;;z: N Ul ~ :::E: '.D