Laserfiche WebLink
COMPANY DETAILS <br />1. NAME OF AGENCY: Senior Resource Association, Inc. <br />MAILING ADDRESS: 694 14th Street <br />CITYVero Beach COUNTY Indian River <br />ZIP CODE: 32960 BUSINESS PHONE: 772-569-0903 <br />2. TYPE OF OWNERSHIP(i.e. Private, Government, Volunteer, Partnership, <br />etc.): <br />Private Non Profit <br />3. MANAGER'S NAME: Karen Delgl <br />ADDRESS: 694 14th Street, Vero Beach, FL 32960 <br />PHONE #: 772-473-2935 <br />4. <br />PROVIDE NAME OF OWNER(s) OR LIST ALL OFFICERS, PARTNERS, <br />DIRECTORS, AND SHAREHOLDERS, IF A CORPORATION (attach a <br />separate sheet if necessary): <br />NAME <br />ADDRESS POSITION <br />Jennifer Johnson <br />694 14th Street C.F.O. <br />Lizbeth Bruner <br />694 14th Street V.P. of Philanthropy <br />5. <br />PROVIDE NAMES AND ADDRESSES OF AT LEAST THREE (3) LOCAL <br />REFERENCES <br />NAME <br />ADDRESS PHONE11 <br />Brian Freeman <br />1301 27th Street 772-226-1990 <br />Ginger Atwood <br />12.1 19th Pi. B-401 772-231-5999 <br />Tad Stone <br />4225 43rd. Ave 772-226-3900 <br />UABelMelh Casano EOCICOPCNIRENEWAL PACKETS%COPCN Application.doc 2 <br />36 <br />