CHURCH AND MANSE RENOVATION AND REPAIRS

Please complete and return by May 1st, 2009

to

Extension and Survey Committee

Finance and Extension Board

301 Lansdowne Avenue

Westmount, QC H3Z 2L5

Church Name                                                                                                               

            Address ______________________________________  _______________

            Contact Person ___________________ Telephone  ___________________

                        FAX ____________________ E-mail  _________________________

Briefly describe the scope of work and technical description of your project.

                                                                                                                                      

                                                                                                                                      

                                                                                                                                      

Estimated cost                                                Requested Grant                                   

Proposed method of supervision of project

                                                                                                                                          

                                                                                                                                          

Briefly describe future projects

                                                                                                                                            

                                                                                                                                            

                                                                                                                                             

                                                                                                                                              

Approval of Trustees              Yes                    No                    Date                           

Approval of Congregation       Yes                    No                    Date                           

Other Comments

                                                                                                                                                   

                                                                                                                                                     

___________________________________________________________________________

List of contractors bidding on invitation to tender. Please append common bid documents (To be completed after scope of work and technical description are approved.)

1.                                                                                                                                            

2.                                                                                                                                            

3.                                                                                                                                            

                                                                                                                                               
Signature                                                                     Address

                                                                                                                                               
Title                                                                            

                                                                                                                                               
Date                                                                            Telephone

...................................................................................................................................................

Committee use only

Approval in principle of scope of work   Yes _____ No _____ Date ______

Approval in principle of technical description  Yes _____  No _____ Date ______

Project Specifications included  Yes _____  No _____  Date ______

Bids received            Yes _____ No _____ Date ______

Grant approved         Yes _____ No _____ Date ______