OGLECOUNTYCLEAN-UPDAY GRANTAPPLICATION

INSTRUCTIONS: Pleasecompletethisapplicationpriortoyour collectionevent.IfapprovedbytheOgle County SolidWasteCommitteeoftheCountyBoard,youwillbenotified.Then,aftertheevent,youmustsubmittheClean-Up Day GrantVoucherFormwithcopiesofreceipts,andthen,paymentuptotheapprovedgrantamountwillbemadefor actualcostsincurred. Itmaybetoyour advantagetoestimatehigh,thewastevolumes,haulinganddisposalcosts.

1.Nameof

Municipality/Township:

2.Nameandtitleof Official

CompletingApplication:

3.Address: Phone:

PROJECTDESCRIPTION

4.Pleaseprovidea generaldescriptionofplannedactivity:

5.Date forClean-upDay project: ______

6.Hoursof operation: ______

7.LocationofClean-upDay Event:streetaddressordescription: ______

8.Namephone#ofperson(s)monitoringdisposal site: ______
______

9.Describehowthemunicipality/townshipplanstopublicizeandpromotethecleanupdayproject:

10.Recyclingofanywasteisstronglyencouraged. Ifavailable,pleasespecifyhowyouplanto separate recyclablematerialsandwhat facilitytherecyclablematerialswillbesent to:

______

PROJECTBUDGET

PERSONNELLaborcostscanbe appliedtowardsthematchingfundamount.Pleasespecifywitha ‘V’by thehourlyrateif laborwillbe providedby volunteers(Scouts,Jaycees,etc.)as "in-kindhours."Mark'P' for paid labor.

11. / Name / Affiliation / Hourlyrate / Estimated / Estimated
Hours / Cost

TOTALPERSONNELCOST(ifany)$

SOLIDWASTEHAULER

12.Nameof CompanyEstimated# ofCostperEstimatedTotalfor

ContainersContainerContainers

Needed.

______

13.Sizeofroll-offcontainer(s)(20cu.yds.30cu.yds.etc.)

LANDFILL/TransferStationtobeused:

Estimated#EstimatedLandfill

14.Name ofLandfill/TSTippingfee/Tonof TonsCost

TOTAL DISPOSALCOSTS(Hauling & landfill costs)
$______

OTHERCOSTS(ex.recycling, printing,advertising,etc.)

______$______

______$______

TOTALOTHERCOSTS $______

15. / TOTALEstimatedCOST / $
LOCALSHARE(50%Matching Amount) / $
TotalFundsAppliedfor: (Nottoexceed$2000.00) / $

Signatureof VillagePresident/Mayoror TownshipOfficialDate

ReturnCompletedApplicationto: StephenJ. Rypkema,Director

Ogle CountySolidWasteManagementDept.

909PinesRoad

Oregon,IL. 61061

Grant application with voucher

9/27/2018

Clean-UpDayGrant

VoucherForm

Pleasecompletethefollowingformandreturnitwithreceiptsfordisposal/recyclingofwastecollectedat yourcleanupday. Returnitafteryourevent,butnolaterthanNovember1st. Paymentofthegrantwillbe madeafterthisformandreceiptsaresubmittedandapproved.
Municipality/Township:
ContactName:
Phone#:
Datesof Collection:
TypeofWaste / Tons
Landfilled / Tons
Recycled / HaulingCost / Disposal/ RecyclingCost / Totals
Appliances/metal
Bulkywaste(junk,sofas,etc.)
Tires
Landscapewaste
Otherwaste(listtype)
OtherCosts / Rate/Hour / #Hours / Totals
Labor:(mark"P"forpaidor
"V"forvolunteer
Printing/Promotion
OtherExpenses(list)
GrandTotalofExpenditures
LocalShare(50%)
Grantamountdue(50%upto$2000)
Signature: / Date:

GrantVoucherForm

2/8/2017

OgleCountySolidWasteManagementDepartment

909PinesRoad

Oregon,IL61061

815-732-4020

Fax:815-732-3709

Email: