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CC 2015-03-10_09a CDBG and Community Service Grant ProgramMEMORANDUM TO: CITY COUNCIL FROM: TERESA MCCLISH, COMMUNITY DEVELOPMENT DIRECTOR BY: ~~KELLY HEFFERNON, ASSOCIATE PLANNER SUBJECT: CONSIDERATION OF: 1) COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) PROJECTS FOR YEAR 2015; AND 2) ARROYO GRANDE COMMUNITY SERVICE GRANT PROGRAM ALLOCATIONS DATE: MARCH 10, 2015 RECOMMENDATION: It is recommended the City Council: 1) adopt a Resolution approving projects to be funded with the City's allocation of CDBG funds for the Year 2015 as shown in the table below; and 2) adopt a Resolution approving projects to be funded with the City's . Community Service Grant Program funds. Recommended 2015 CDBG Allocation . ·1' . jedt andqategory> ·.· : ' .. ·• ~. ~ . -. -.-. . ·• ' . . · .... ·-· .. ,. ' ~ :. : CAPSLO -Adult Prevention 201'4 2015 . ·AIIocatibri · ·Requested· . ·.""' . ~ .; . ~~ . $8 657 $0 Item 9.a. - Page 1 CITY COUNCIL CONSIDERATION OF: '1) COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) PROJECTS FOR YEAR 2015; AND 2) CONSIDERATION OF ARROYO GRANDE COMMUNITY SERVICE GRANT PROGRAM ALLOCATIONS MARCH 10, 2015 PAGE 2 . Projectan·d catego~y ' : . '~ ' · ... ,_ .. "'.· . . 0 . 014' · · 201'5 · Propos~d Allocation ·Requested 2015 Allocation IMPACT ON FINANCIAL AND PERSONNEL RESOURCES: CDBG 2015 The County has confirmed that $73,993 in CDBG funds will be available to the City in the fall of 2015. This is $10,098 more than projected when Council considered the preliminary allocation on January 13, 2015. The table above reflects the adjusted allocations given these additional funds. This increase is good news given that the City has received a continuous decrease in CDBG funding over the last several years. Similar to last year, the County will help administer the CDBG program for the City which will reduce City staff time involved. County staff will be paid through the CDBG program funds allocated to the City. Per the Cooperation Agreement between the County and the City entered into on July 15, 20,J4, 13%, or $9,619 of the City's allocation for CDBG funds will be deducted by the County to meet its obligations under the terms of the agreement for administrative costs. The City will receive $5,180 for its administrative costs (see Attachment 1 for the Cooperative Agreement). Community Service Grant Program On September 23, 2014 the City Council approved the Community Service Grant Program process and allocated $20,000 in the FY 2014-15 Annual Budget to implement · the program. BACKGROUND: CDBG 2015 As mentioned above, the City Council approved a Cooperative Agreement with the County last July for the joint participation in the CDBG Program for fiscal years 2015 through 2017. The City, as a participant in the Housing and Urban Development (HUD) designated Urban County program, receives an annual formula-based allocation of CDBG funds. These funds are available for a variety of Community Development Item 9.a. - Page 2 CITY COUNCIL CONSIDERATION OF: 1) COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) PROJECTS FOR YEAR 2015; AND 2) CONSIDERATION OF ARROYO GRANDE COMMUNITY SERVICE GRANT PROGRAM ALLOCATIONS MARCH 10, 2015 PAGE 3 activities as long as the activities meet at least one of three national objectives. The objectives are: 1. Benefit low-and moderate-income persons; 2. Aid in the prevention or elimination of slums or blight; or 3. Address urgent community development needs that pose a serious or immediate threat to public health or welfare. On January 13, 2015, the City Council considered preliminary recommendations and received public input. Council approved staff's preliminary recommendation of proposed projects to be funded with the City's allocation of CDBG funds for the year 2015, and directed staff to send a letter to the County Board of Supervisors in support of CDBG funding for the Family Care Network. A letter was sent to the County for this purpose on January 27, 2015. Community Service Grant Program During consideration of the 2014 CDBG funding recommendations, the City Council directed staff to make changes to the program in the future. The City has historically funded social service agencies through CDBG funds. In addition, the City has funded ADA access barrier removal projects from both CDBG funds and Local Sales Tax funds. However, overall funding for CDBG has decreased over the last several years, with the exception of 2015, which is a nominal increase. The small amount of CDBG funding has made the process cumbersome for small social service agency grants. As a result, it was decided to utilize the full amount of CDBG funds to pay for ADA access barrier removal projects in the future. City funds previously used to pay for ADA access barrier removal projects were then shifted to pay for social service requests. This makes it easier to fund smaller grants through the new Community Service Grant Program, as well as to expand the eligibility for other community service related type of agencies and programs. ANALYSIS OF ISSUES: CDBG 2015 Staff uses the following criteria set forth by the County in the RFP to make funding recommendations: 1. Consistency with Federal regulations and laws; 2. Community support (for example, approval of project by a city council); 3. Seriousness of community development need proposed to be addressed by project; 4. Degree to which project benefits low-income and very low-income families or persons; Item 9.a. - Page 3 CITY COUNCIL CONSIDERATION OF: 1) COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) PROJECTS FOR YEAR 2015; AND 2) CONSIDERATION OF ARROYO GRANDE COMMUNITY SERVICE GRANT PROGRAM ALLOCATIONS MARCH 10, 2015 PAGE4 5. Feasibility of the project to be completed as budgeted and by December 31, 2015; 6. Cost effectiveness of funds requested and leveraging of other funds; and 7. Organization's experience or knowledge regarding CDBG or HOME requirements. The Cooperative Agreement between the County and the City gives discretion to the City regarding allocation of funds. Unless the City's recommendation to the County for funding is clearly in conflict with CDBG regulations, the County will approve the recommendation. The County Board of Supervisors will make its final decision for funding priority in April 2015. CDBG Public Services The competitiveness for public services funds, which is capped at 15 percent, is historically strong and requests far exceed available funds ($41 ,600 is requested and $11,099 is available). Due to the competition for these limited funds, the additional funding criteria below are used as a guideline to establish staff's recommendation: As discussed last year when Council considered the 2014 CDBG allocations, HUD has significantly increased its monitoring efforts of jurisdictions participating in the CDBG program, which means that local jurisdictions must increase their monitoring efforts of recipients as well. According to County staff, the cost to properly monitor a given CDBG activity is approximately $8,000. As indicated, however, the total amount available is only $9,584, which makes funding public services ineffective. The City received a total of four (4) applications from two (2) non-profit organizations: Three (3) from Community Action Partnership of San Luis Obispo County, Inc. (CAPSLO) (Maxine Lewis Memorial Shelter, Forty Wonderful, and Prado Day Center), and one (1) from the Senior Nutrition Program of San Luis Obispo County. Because of the limited amount of CDBG funding, the necessary increase in monitoring efforts described above, and the City's recently established Community Service Grant Program (Council approved an allocation of $20,000 for this Program on September 23, 2014), staff is not recommending any CDBG funding this year be allocated for public services. Note that both of these non-profits have also submitted applications to the City for the Community Service Grant Program. Below is a brief description of the four (4) CDBG public service applications received. Recommended funding $0 ($8,600 requested); Maxine Lewis Memorial Shelter (CAPSLO). This facility provides shelter, food, showers and social services to the homeless. The City has funded this program in the past. CAPSLO also submitted an application for the City's Community Service Grant Program for emergency intervention services and shelter for the homeless in the amount of $8,600. Item 9.a. - Page 4 CITY COUNCIL CONSIDERATION OF: 1) COMMUNITY· DEVELOPMENT BLOCK GRANT (CDBG) PROJECTS FOR YEAR 2015; AND 2) CONSIDERATION OF ARROYO GRANDE COMMUNITY SERVICE GRANT PROGRAM ALLOCATIONS MARCH 10, 2015 PAGE 5 Recommended funding $0 ($1 0,000 requested); Forty Wonderful (CAPSLO). The purpose of this program is to provide no-cost preventative health screening programs for low income women over the age of 40. The City has funded this program in the past. Recommended funding $0 ($8,000 requested); Prado Day Center (CAPSLO). This facility provides daytime food and shelter for the homeless and working poor families and individuals. The City has not funded this program in the past. As mentioned above, CAPSLO also submitted an application for the City's Community Service Grant Program for emergency intervention services and shelter for the homeless in the amount of $8,600. Recommended funding $0 ($15,000 requested); Senior Nutrition Program of San Luis Obispo County -This program provides hot nutritionally balanced meals for seniors. The City has funded this program in the past. This non-profit also submitted an application for the City's Community Service Grant Program for food and food containers for seniors in Arroyo Grande in the amount of $5,000. Public Facilities Staff recommends allocating $59,194 to assist in Americans with Disabilities Act (ADA) improvements by removing architectural barriers within the public right-of-way. The Curb Ramp Installation Project will involve the installation of accessibility curb ramps. The new curb ramps will be located throughout the City's commercial areas as well as areas around schools, parks and public facilities. Priority will be given to locations where mid-block crosswalks exist that do not currently have curb ramps. This funding is important to assist the City in achieving compliance with ADA requirements. It is estimated that there are currently 225 locations within the City that do not have an existing curb ramp. The estimated cost of construction, excluding design costs, is $1,144,000 to install all 225 curb ramps. Given the City's annual allocation of CDBG funds and local sales tax funds appropriated to ADA improvements (total for both is about $75,000), and not adjusting for inflation, it will take the City roughly 20 years to complete these curb ramps. The City also has an estimated 600 locations where there are existing but non-ADA compliant curb ramps. The approximate cost to fix these curb ramps is $4,200,000. There are also other ADA improvements needed at various City- owned facilities and parks. Family Care Network, Inc. submitted an application for $30,000 to rehabilitate the existing South Elm Street complex. This non-profit provides housing, life skills training and guidance, counseling, job skill development and other services to Transitional Age Youth (TAY). The facility has four (4) units to serve former foster youth and one (1) volunteer resident advisor. These units serve 7-10 individuals. CDBG funds would be used to: remodel the building's fac;ade and second floor stairway landing to correct construction defects which have caused significant water damage to the structure; Item 9.a. - Page 5 CITY COUNCIL CONSIDERATION OF: 1) COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) PROJECTS FOR YEAR 2015; AND 2) CONSIDERATION OF ARROYO GRANDE COMMUNITY SERVICE GRANT PROGRAM ALLOCATIONS MARCH 10, 2015 PAGE 6 replace aged and inefficient windows and front doors; paint the exterior; repurpose a storage room to include a secure laundry facility; and build a secure trash enclosure. In addition, the funds would be used to add an irrigation system and low-water landscaping to the front of the property and add a non-water use base to the backyard areas. Because the City has not received an application for CDBG funding from this non-profit in the past and is therefore uncertain of its capacity to perform the necessary monitoring, and given the numerous ADA projects that the City is responsible for implementing and limited CDBG funds available, staff does not recommend funding of this project. In addition, this facility serves a limited clientele, whereas the installation of ADA compliant curb ramps serves the greater Arroyo Grande Community. It is hopeful the Family Care Network will receive County CDBG funding as mentioned above. This non-profit also applied for the City's Community Service Grant Program to purchase a new 12-door mail box in the amount of $1,350. Economic Development The City did not receive any requests for economic development projects. Elimination of Slums and Blight Efforts related to the elimination of slums and blight is limited to a 30 percent area benefit cap ($22, 198). HUD has determined that the City's Fac;ade Improvement Program is invalid based on the lack of blight, and therefore this program has been discontinued. Administration and Planning Funds requested for the administration of the CDBG program have decreased over the last several years in direct proportion to the overall decrease in the City's CDBG funding, even though HUD administrative requirements are increasing. Staff recommends allocating $14,799 for program administration, which is 20% of total funds. As stated above, $9,619 of the City's allocation for CDBG funds will be deducted by the County for its administrative costs as per the Cooperative Agreement, and the City will receive $5,180 for administration . . Arroyo Grande Community Service Grant Program The City received a total of twelve (12) applications totaling $60,948.48, and $20,000 has been budgeted for this program (see Attachment 3 for applications). A Community Service Grant Review Panel was established consisting of one member from each of the City's boards, commissions and committees.· This panel convened on February 11, 2015 to review the applications and recommended the following funding allocations: Item 9.a. - Page 6 CITY COUNCIL CONSIDERATION OF: 1) COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) PROJECTS FOR YEAR 2015; AND 2) CONSIDERATION OF ARROYO GRANDE COMMUNITY SERVICE GRANT PROGRAM ALLOCATIONS MARCH 10, 2015 PAGE 7 :NAME~QF .PROJECT. · ·AREA ,:>· · .. .GRANT AMOUNT: : t'JON 7 PROFIT . . :SUMMARY ... : ' RE~OMMENDED . ·sERVED· .. ·. AMOUNT. .. ' ·-· .. I • •. ~ 0 • ; , . :. .. ' ;. .. . -;_ ~ .. .· ~ . ' •.·. / ...... ·. ' ... •· · .. ·' ·-REQUESTED .. BY THE. ' ... .. . . · · .. ; . . ' . . . . . . · .. . ' CQMMITTEE' .. . , .. .. . .. . ' 5Cities Housing and Five Cities $1,500 $1,500 Homeless other transitional Coalition (5CHC) assistance for the homeless. South County Upgrade and City of AG $2,000 $1,000 Historical maintenance of Society the museum gardens. Arroyo Grande Monument to City of AG $16,000 $0 Public Art (AG in the fire fighters Bloom) of the 9/11 World Trade Center. Senior Nutrition Food and food City of AG $5,000 $3,000 Program of SLO containers for County seniors in AG. CAPSLO Emergency SLO County $8,600 $2,500 intervention services and shelter for the homeless. Central Coast Sage City of AG $3,998 $1,500 Salmon Waterways Enhancement Workshop- school children education. Peoples' Self Educators salary City of AG $10,000 $4,000 Help Housing at Courtland Street Apartments - after school education program. Transitional Provide food City of AG $2,500 $1,500 Food and and shelter for Shelter, Inc. homeless persons who are too ill, injured or disabled to be in an overnight or day shelter. Item 9.a. - Page 7 CITY COUNCIL CONSIDERATION OF: 1) COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) PROJECTS FOR YEAR 2015; AND 2) CONSIDERATION OF ARROYO GRANDE COMMUNITY SERVICE GRANT PROGRAM ALLOCATIONS . MARCH 10, 2015 PAGE 8 Camp Fire Camp Fire Out-Five Cities $2,500 $1,500 Central Coast of of-School-Time California program. SCORE San Entrepreneur SLO County $2,500 $450 Luis Obispo education. Big Brothers Big Staff time for SLO County-$5,000 $1,700 Sisters of SLO training, emphasis on County screening, City of AG enrolling and matching families and volunteers within the City of AG. Family Care Purchase of new City of AG $1,350.48 $1,350 Network, Inc. 12-door CBY Mail Box. :TOTAL:·· ' . ~. ' . .. . '$60,948.48 .. $20,000 . . . ,. ,. .. . . ' ' .. ,. . . .. · . The amounts recommended above were based on the following ranking sheet (information based on the following criteria. Individual scores are not available): . NAME OF GRANT APPLICANT: ., . Scoring_:Categorj_ . .. , ,._ :.]" Meets minimum criteria? 0 Is a non-profit (proof of 501 (c)(3) status with copy of letter from IRS). 0 Serves AG community. 0 Use funds directly to provide a social service, educational, cultural, beautification or recreation program/project in AG. 0 Doesn't restrict participants based upon race, religion, gender, etc. 0 Doesn't use funds for religious activities. Possible Points· · (100 total) n/a :, Points Awarded· · Comments f.. • l n/a If the application does not meet the minimum criteria, the application is ineligible for grant funding. Item 9.a. - Page 8 CITY COUNCIL CONSIDERATION OF: 1) COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) PROJECTS FOR YEAR 2015; AND 2) CONSIDERATION OF ARROYO GRANDE COMM:UNITY SERVICE GRANT PROGRAM ALLOCATIONS MARCH 10, 2015 PAGE 9 ". NAME.OF GRANT APPLICANt::-:. ' "• . -... '" f· 1 . .. ~ Scoring Category : Possible " I • ~· t•• ;: . ' 1 .:;·,-.~:' I •• • , •' • ' • "" . . _ ,_ Points. . .<(1 00 total) : _,- Complete application? 0 Description of community services provided. 0 Relationship of non-profit to the community. 0 Membership information -approx. # of AG residents served. 0 Amount of funds requested, 0 Complete project description and budget plan. 0 Past 2 years financial statements (profit/loss statements, % revenue used for administration, salaries and program costs). 0 Information on annual sources of revenue received. 20 Responsiveness in clearly stating the 20 benefits to be derived by the residents of AG. # of AG residents by age group served 10 by the non-profit (including geographic area(s) and total #of clients served by the non-profit). Non-profit's history of providing 20 community services to the residents of AG. Non-profit's financial need for grant 20 funds to service AG residents. ,_. \ ~ . ~ Poin_ts Awcuded ·_ Comments Item 9.a. - Page 9 CITY COUNCIL CONSIDERATION OF: 1) COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) PROJECTS FOR YEAR 2015; AND 2) CONSIDERATION OF ARROYO GRANDE COMMUNITY SERVICE GRANT PROGRAM ALLOCATIONS MARCH 10, 2015 PAGE10 NAME-Of GRANT APPLICANT: ----.. ,. ~:· .. .. r ; Scoring Catego-ry· . · '· •· -Po~sible Points Awarded· Commen_ts :_ . .. '. ., .. .. .. • . • Points = '· ' 0 . ' .. . . . ' .. .. (100 total) . ' " .. Ability to complete project in a timely 10 manner (preferably within 1 year of grant award). Total Points: 100 Amount of Funding Requested: Amount of Funding Recommended: (a total of $20,000 is available with this grant program) ADVANTAGES: The recommended allocations fund important City priorities. The Community Service Grant Program will assist with funding local public service programs. DISADVANTAGES: The recommendations result in unfunded requests for public services from two non- profit organizations (four requests) and for one public facility project. ALTERNATIVES: The following alternatives are provided for the Council's consideration: -Adopt Resolutions approving staff's recommended funding for CDBG programs and for the City's Community Services Program for the year 2015; Modify staff's recommended funding for both programs and adopt the Resolutions; or Provide direction to staff. ENVIRONMENTAL REVIEW: The allocation of CDBG funds and the City's Community Services Program is not considered a project under the California Environmental Quality Act (CEQA) and National Environmental Policy Act (NEPA). Specific projects that may have environmental impacts will be reviewed under CEQA and NEPA prior to implementation. PUBLIC NOTIFICATION AND COMMENTS: A public hearing notice was published in The Tribune on Friday, February 27, 2015 and mailed to all CDBG project applicants. The Agenda was posted in front of City Hall on Item 9.a. - Page 10 CITY COUNCIL CONSIDERATION OF: 1) COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) PROJECTS FOR YEAR 2015; AND 2) CONSIDERATION OF ARROYO GRANDE COMMUNITY SERVICE GRANT PROGRAM ALLOCATIONS MARCH 10, 2015 PAGE11 Thursday, March 5th and the agenda and staff report were posted on the City's website on Friday, March 6th. No public comments have been received. Attachments: 1. CDBG Applications (available for review at City Hall) 2. Cooperative Agreement between the County of San Luis Obispo and the City of Arroyo Grande for Joint Participation in the CDBG Program, the Home Investment Partnerships Program, the Emergency Solutions Grant Program, and the Housing Opportunities for Persons with AIDS Program for Fiscal Years 2015 through 2017 3. Community Service Grant Applications (12) Item 9.a. - Page 11 RESOLUTION NO. A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF ARROYO GRANDE . APPROVING COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) · PROJECTS FOR YEAR 2015 WHEREAS, via a Cooperative Agreement with the County of San Luis Obispo (hereafter referred to as "County") executed by the City of Arroyo Grande ("City") on July 15, 2014, th_e City agreed to become a participant for a period of three years with the County and other cities therein as an "Urban County" under the Federal Department of Housing and Urban Development (hereafter referred to as "HUD") CDBG program; and WHEREAS, under the Cooperative Agreement, the City retains the authority to determine which projects are to be funded with its allotment of CDBG funds; and WHEREAS, the City expects to receive $73,993 in CDBG funds in 2015; and WHEREAS, in 2014, the County published a "Request for Proposals" for projects to be funded under the 2015 CDBG Programs, which provided that proposals were to be submitted by October 15, 2015; and WHEREAS, on September 17, 2014, the County conducted a public workshop with the City of Arroyo Grande to ascertain the housing and community development needs to be addressed in the document entitled the "One-Year Action Plan" for Program Year 2015; and WHEREAS, at its meeting of January 13, 2015 the City Council gave preliminary approval to a proposed listing of 2015 CDBG projects; and WHEREAS, on February 26, 2015, the County conducted a second public workshop for the City of Arroyo Grande to receive comments on the proposed 2015 CDBG projects; and WHEREAS, on March 10, 2015 the City Council held a duly noticed public hearing to further consider the City's Program Year 2015 CDBG projects. NOW, THEREFORE, BE IT RESOLVED by the City Council of the City of Arroyo Grande, California, to recommend that the Board of Supervisors for the County of San Luis Obispo adopt the 2015 One-Year Action Plan, which shall include the programs listed in Exhibit "A" attached hereto and incorporated herein by this reference, to be funded with the City's allocation of CDBG funds. Item 9.a. - Page 12 RESOLUTION NO. PAGE 2 On motion of Council Member following roll call vote, to wit: AYES: NOES: ABSENT: , seconded by Council Member , and on the the foregoing Resolution was passed and adopted this 1 01h day of March, 2015. Item 9.a. - Page 13 RESOLUTION NO. PAGE 3 JIM HILL, MAYOR ATTEST: KELLY WETMORE, CITY CLERK APPROVED AS TO CONTENT: ROBERT McFALL, INTERIM CITY MANAGER APPROVED AS TO FORM: TIMOTHY J. CARMEL, CITY ATTORNEY ,/ Item 9.a. - Page 14 RESOLUTION NO. PAGE4 EXHIBIT "A" 2015 ONE YEAR ACTION PLAN ALLOCATION OF PROGRAM YEAR 2015 COMMUNITY DEVELOPMENT BLOCK GRANT(CDBG)FUNDS • ' • • . • ~~·. . ... $' · .• -:.: '.-2014. · · ·· 2015. · Propos.ed', Allocation Requested· .2015 . .· )' :. . . -.~ ·.. , · · Allocation ' ·. Public Services 1 CAPSLO CAPSLO-Adult Wellness and Prevention Screen in Pro ram $8 657 $0 $0 Senior Nutrition Program of San Luis Obispo Coun $0 $15 000 $0 Subtotal $8,657 $41,600 $0 . I -----~ Item 9.a. - Page 15 RESOLUTION NO. A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF ARROYO GRANDE APPROVING COMMUNITY SERVICE GRANT PROGRAM PROJECTS FOR YEAR 2015 WHEREAS, on September 23, 2014 the City Council approved the Community Service Grant Program process and allocated $20,000 in the FY 2014-15 Annual Budget to implement the program; and WHEREAS, the City received a total of twelve (12) applications for the Community Service Grant Program; and WHEREAS, the City Council established a Community Service Grant Review Panel consisting of one member from each of the City's boards, commissions and committees; and WHEREAS, this panel convened on February 11, 2015 to review the applications and recommended funding allocations, as indicated in Exhibit A; and WHEREAS, on March 10, 2015 the City Council held a duly noticed public hearing to consider the City's Community Service Grant Program projects. NOW, THEREFORE, BE IT RESOLVED that the City Council of the City of Arroyo Grande, California, hereby approves the 2015 Community Service Grant Program projects as set forth in Exhibit "A" attached hereto and incorporated herein by this reference. On motion of Council Member following roll call vote, to wit: AYES: NOES: ABSENT: , seconded by Council Member , and on the the foregoing Resolution was passed and adopted this 1oth day of March, 2015. Item 9.a. - Page 16 RESOLUTION NO. PAGE 2 JIM HILL, MAYOR ATTEST: KELLY WETMORE, CITY CLERK APPROVED AS TO CONTENT: ROBERT McFALL, INTERIM CITY MANAGER APPROVED AS TO FORM: TIMOTHY J. CARMEL, CITY ATTORNEY Item 9.a. - Page 17 RESOLUTION NO. PAGE 3 EXHIBIT "A" Arroyo Grande 2015 Community Service Grant Program Summary of Applications (12 Total) (Not listed in any particular order) . . .. . . .. '\ ~ GRANT AMOUNT·. IINAME OF'' ·• NON-PROFIT : II PROJECT SUMMARY -~AREA . · · .. SERVED·. : •i AMOUNT RECOMMENDED ~~ .. -·-· .. . .. . .. .. REQUESTED· 1;3YTHE . . . . . .. . . > .':-· ' COMMITTEE .. .. ' --·• 5Cities Housing and I Five Cities ll$1,500 ll$1,500 Homeless other Coalition transitional i(5CHC) assistance for the homeless. South County Upgrade and I Cit~ of AG ll$2,000 ll$1,000 Historical maintenance of Society the museum I gardens. Arroyo Grande Monument to I City of AG ll$16,000 I ISO Public Art (AG the fire fighters in Bloom) of the 9/11 World Trade Center. Senior Nutrition Food and food I City of AG ll$5,000 ll$3,000 Program of SLO containers for County seniors in AG. ICAPSLO I Emergency ISLO Count~ ll$8,600 ll$2,500 intervention services and shelter for the homeless. Central Coast Sage I Cit~ of AG ll$3,998 ll$1,500 Salmon Waterways Enhancement Workshop- school children education. II Peoples' Self I Educators I City of AG ll$10,000 ll$4,000 Help Housing salary at Courtland Street I I I I I I I Item 9.a. - Page 18 RESOLUTION NO. PAGE4 '··: NAMEOF-~~-~~~EACJv l:I~~~~E~-:~:·: -I GRANT·\·., AMOUNT ... NQN~P-ROF.IT AMOUNT--' RECOMMENDED . . ... RE-QUESTED._-~Y.THE ·•· -• -1 ~ I:· <' _-... ·--'. .. "'_,·,· .. COMMITTEE . . . . , . ~ --.. --. ~ --. · .. .. ~ ... '"·' .. . -. Apartments - after school education I program. Transitional Provide food I Cit~ of AG ll$2,500 ll$1,500 I Food and and shelter for Shelter, Inc. homeless persons who are too ill, injured or disabled to be in an overnight or day shelter. Camp Fire Camp Fire Out-I Five Cities ll$2,500 ll$1,500 I Central Coast of-School-Time of California program. SCORE San Ill Entrepreneur IISLO Count~ ll$2,500 ll$450 I Luis Obispo education. Big Brothers Staff time for SLO County-l$5,000 ll$1 ,700 I Big Sisters of training, emphasis on SLO County screening, City of AG enrolling and matching families and volunteers within the City ofAG. ~~Family Care I Purchase of I Cit~ of AG ll$1 ,350.48 ll$1,350 I Network, Inc. new 12-door CBY Mail Box. I Item 9.a. - Page 19 ATTACHMENT 1 CDBG Applications are on file at City Hall for public review and are also archived on the City’s website in the Agenda Center, City Council meeting of January 13, 2015, at http://www.arroyogrande.org/AgendaCenter Item 9.a. - Page 20 •. 1} . l ' '. \ \, \, '· ) - ATTACHMENT 2 AMENDMENTNUMBER1TO A COOPERATION AGREEMENT BETWEEN THE COUNTY OF SAN LUIS OBISPO AND THE CITY OF ARROYO GRANDE FOR JOINT PARTICIPATION IN THE COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM,THE HOME INVESTMENT PARTNERSHIPS PROGRAM, THE EMERGENCY SOLUTIONS GRANT PROGRAM, AND THE HOUSING OPPORTUNITIES FOR PERSONS WITH AIDS PROGRAM FOR FISCAL YEARS 2015 THROUGH 2018 THIS AGRE.EMENT is ~ade ~nd e~tered i~to thi~y of~. , 2014, by and between the County of San Luis Obispo, a political subdivision of the State of California, hereinafter called "County"; and the City of Arroyo Grande, a municipal corporation of the State of California, located in the County of San Luis Obispo, hereinafter called "City"; jointly referred to as "Parties." WITNESSETH WHEREAS, in 1974, the U.S. Congress enacted and the President signed a law entitled, The Housing and Community Development Act of 197 4, herein called the "Act". Said Act is omnibus legislation relating to federal involvement in a wide range of housing and community development activities and contains eight separate titles; and WHEREAS, Title I of the Act is entitled "Community Developmenf' and governs programs for housing and community development within metropolitan cities and urban counties or communities by providing financial assistance annually for area-wide plans and for housing, public services and public works programs; and WHEREAS, the Community Development Block Grant (CDBG) Program, the HOME Investment Partnerships (HOME) Program, the Emergency Solutions Grant (ESG) Program, and the Housing Opportunities for Persons with AIDS (HOPWA) Program are consolidated under Title I of the Act; and . WHEREAS,. the County of San 'Luis Obispo has requested of the federal Department of Housing and Urban Development, hereinafter referred to as "HUD", that the County be designated as an "urban county"; and WHEREAS, the County needs to requalify as an urban county and will be eligible to receive CDBG funds provided that the County's entitled cities defer their entitlement to the County to enable both the County and the entitlement cities to jointly participate in the program; and WHEREAS, the City desires to participate jointly with the County in said program; and Item 9.a. - Page 21 WHEREAS, on July 15, 2014, the County and City entered into a Cooperation Agreement (the Original Cooperation Agreement) in order for the County to requalify as an urban county and submitted said cooperation agreement to the U.S. Department of Housing and Urban D~velopment (HUD); and WHEREAS, HUD reviewed said Original Cooperation Agreement and determined that it must be amended to provide for a three year term and to include additional language required by the Transportatiqn, Housing and Urban Development, and Related agencies Appropriations Act, 2014, Public Law 113- 76. NOW THEREFORE, in consideration of the mutual promises, recitals and other provisions hereof, the Parties agree as follows: · 1. The first sentence of Paragraph C, entitled "C. Term of Agreement - Automatic Renewal Provision," of Section I, entitled "SECTION I. General.," of the Original Cooperation Agreement is hereby amended and replaced to read as follows: The term of this Agreement shall be for a period of three (3) years commencing July 1, 2015 through June 30, 2018. 2. The section entitled "SECTION IV. Use of Program Funds" of the Original Cooperation Agreement is hereby amended to add a new section "I" that reads as follows: I. The City may not sell, trade, or otherwise transfer all or any portion of CDBG funds to another metropolitan city, urban county, unit of general local government, or Indian tribe, or insular area that directly or-indirectly receives CDBG funds in exchange for any other funds, credits or non-Federal considerations, but must use such funds for activities eligible under Title I of the Act. . 3. All other provisions of the Original Cooperation Agreement not specifically amended herein remain in full force and effect. NOW, THEREFORE, the Parties hereto have caused this Amendment Number 1 to the Cooperation Agreement to be executed and attested by their proper officer thereunder duly authorized, and their official seals to be hereunto affixed, all as of the day first above written. 2 Item 9.a. - Page 22 COUNTY OF SAN LUIS OBISPO By:~ · DeputyC~ Date: _q~(,"-1...-:~=-+-L-/r4:-+-----r' By:_____.._.._~-~~/k_· _· Chairperson of the Board of Supervisors Date: q,Sep-ft::m beY"" 23 1 2014- ATTEST: JULIE L. RODEWALD Julie Rodewald, County Clerk ··~''9ttumFeiJ Date: ~bet"" :2~ • 2014 3 ,'J .. _. ''. ,., Item 9.a. - Page 23 . \ ---.... --· -..; \ Date: q -W:Z -/ '( APPROVED AS TO CONTENT: APPROVED AS TO FORM: 4 Item 9.a. - Page 24 A COOPERATION AGREEMENT BETWEEN THE COUNTY OF SAN ·LUIS OBISPO AND THE CITY OF ARROYO GRANDE FOR JOINT PARTICIPATION IN THE COMMUNITY DEVELOPMENT BLOCK· GRA~T · PROGRAM, THE HOME INVESTMENT PARTNERSHIPS PROGRAM, THE EMERGENCY SOLUTIONS GRANT PROGRAM, AND THE . HOUSING OPPORTUNITIES FOR PERSONS WITH AIDS PROGRAM FOR FISCAL YEARS 2015 THROUGH 2017 THIS AGREEMENT is made and entered into this L5+h day of J:,ly , 2014, by and between the County of San Luis Obispo, a political subdivision of the State of California, hereinafter called "County"; and the ·City of Arroyo Grande, a municipal corporation of the State of California, located in the Gpunty of San Luis Obispo, hereinafter called "City''; jointly referred to as "Partiesn. · WITNESSETH WHEREAS, in 1974, the U.S. Congress enacted and the President signed a law entitled, The Housing and Community Development Act of 1974, herein called the "Acf. Said Act _is omnibus legislation relating to federal involvement in a wide range of housing and community development activities and contains eight separate titles; and WHEREAS, Title I of the Act is entitled "Community Developmenf and ·governs programs for housing and community development within metropolitan cities and urban counties· or communities by providing financial assistance annually. for area-wide .plans and for housing, public services and public works programs; and WHEREAS, the Community Development Block Grant (CDBG) Program, the HOME Investment Partnerships (HOME) Program,· the Emergency Solutions Grant (ESG) Program, and the Housing Opportunities for Persons with AIDS (HOPWA) Program are consolidated under Title I of the Act; and · . . WHEREAS, the County of San Luis Obispo has requested of the federal Department of Housing and Urban Development, hereinafter referred to as "HUOn, that the County be designated as an "urban county"; and · WHEREAS, the County needs to requalify as an urban county and will be eligible to receive CDBG funds provided that the County's entitled cities defer their entitlement to the County to enable both the County and the entitlement cities to jointly participate in the program; and · ' WHEREAS, the City desires to participate jointly with the County in said program; and WHEREAS, if HUD redesignates the County as an urban county, the County may also be .eligible to receive funds from the Home Investment Partnership Program (hereinafter referred to as "HOMEn), the Emergency Solutions Program (hereinafter referred to as Item 9.a. - Page 25 "ESG"), and the· Housing Opportunities for Persons with .Aids Program (hereinafter referred to as "HOPWA''); and WHEREAS, the Community Development Block Grant Regulations issued pursuant to the Act provide that qualified urban counties must submit an application to the Department of Housing and Urban Development for funds, and that cities and smaller communities within the met(opolitan area not qualifying as metropolitan cities may join the County in said applicatiol"! and thereby become a part of a more comprehensive County effort; and WHEREAS, as the urban ·county applicant, the Co.unty must take responsibility and assume all obligations of an .applicant under federal statues, including: the analysis of needs, the ·setting of objectives, the development of community development and housing assistance plans, the consolidated plan, and the assurances of certifications; and WHEREAS, by executing this Agreement, the Parties hereby give notice of their intention to participate in the urban county CDBG, HOME, ESG, and HOPWA programs. NOW THEREFORE, in consideration of the· mutual promises, recitals and other provisions hereof, the Parties agree as follows: SECTION I. General. A. Responsible Officers. The Director of the County of San Luis Obispo Department of Planning and Building (hereinafter referred to as "Director") is hereby authorized·to act as applicant for the CDBG, HOME, ESG, and HOPWA programs and to administer funding and activities under the programs. The City Manager is hereby authorized to act as the responsible officer of the City under the programs. · · B. Full Cooperation. Parties agree to fully cooperate and to assist each other in undertaking eligible grant programs or projects, including ·but not limited to community renewal and lower income housing assistance activities, specifically urban renewal and publicly-assisted housing; public services; and economic development. C. Term of Agreement -Automatic Renewal Provision. The term of this Agreement shall be for a period of three (3) years commencing July 1, 2015 through June 30, 2017. In addition, this Agreeme_nt provides for -automatic renewal for participation in successive three-year qualification periods, unless the City provid~s written notice at least-60 days prior to the end of the term that it elects not to participate in a ·new qualification period. Before the end of the first three-year term, the County will notify the City in writing of its right not to participate in the urban county for a succe~sive three-year term. 2 Item 9.a. - Page 26 The Parties agree to adopt amendments to this Agreement incorporating changes necessary to meet the requirements for cooperation agreements ·set forth in an Urban County Qualification Notice by HUD for a subsequent three- year urban County qualification period, prior to the subsequent three-year extension of the term. Any amendmem to this Agreement shall be submitted to HUD as required by the regulations and any failure to adopt required amendments will void the automatic renewal of the Agreem.ent for the relevant qualification period. . The Agreement remains in effect until the CDBG, f-10ME, ESG, and HOPWA program funds and income received wi~h respect to the three-year qualification period, and the subsequent three-year renewals are expended and the funded activities are completed. The Parties may not terminate or withdraw from the Agreement while the Agreement remains in effect. D. Scope of Agreement. This. Agreement covers the following formula funding programs administered by HUD where the County is ·awarded and accepts funding directly from HUD: the CDBG Entitlement Program, the HOME Program, the Emergency Solutions Grant (ESG) Program, and the Housing Opportunities for Persons with AIDS (HOPWA) Program. SECTION II. Preparation and Submittal of CDBG Funding Applications. A Inclusion of City as Applicant Parties agree that City shall be included in the application the County shall submit to the Department of Housing and Urban Development for Title I Housing and Community Development Block funds under the above recited Act. B. Consolidated Plan. City shall assist the County by preparing a community development plan, for . the period of this Agreement, which identifies community development and housing needs, projects and programs for the City; and specifies both short and long-term City objectives, consistent with requirements of the Act. County agrees to: (1) include the City plan in the program application, and (2) include City's desired housing and community development objectives, policies, programs, projects and plans as submitted by City in the County's consolidated pl~n. . C. Application Submittal. County agrees to commit sufficient resources to completing and submitting the Consolidated Plan and supporting documents to HUD in time for the Parties to be eligible to receive funding beg.inning July 1, 2015, and to hold public hearings as required to meet HUD requirements. D. County Responsibility. Parties agree that the County shall, as applicant, be responsible for holding puqlic hearings and preparing and submitting the CDBG funding application and supporting materials in a timely and thorough manner, as required by the Act and the federal regulations established by HUD to secure entitlement grant funding beginning July 1, 2015. 3 Item 9.a. - Page 27 E. Grant Eligibility. In executing this Agreement, the Parties understand that they shall not be eligible to apply for grants under the Small Cities or State CDBG Programs for appropriations for fiscal years during the period in which the Parties are participating in the urban county CDBG entitlement program; and further, the City shall not be eligible to participate in the HOME, ESG or HOPWA programs except through the urban county. SECTION Ill. Program Administration. . A. Program Authorization. The County Administrator is hereby authorized to carry out ~ctivities that will be funded from the annual CDBG, HOME, ESG, and HOPWA programs from fiscal years 2015, 2014, and 2017 appropriations and from any program income.generated from the expenditure of such funds. B. Responsibilities of Parties. Parties agree that the County shall be the governmental entity required to execute any grant agreement received pursuant to the CDBG, HOME, ESG, and HOPWA applications, and subject to the limitations set out in this Agreement, the County shall thereby become liable and responsible thereunder for the proper performance of the plan and CDBG, HOME, ESG, ~nd HOPWA under County programs. City agrees to act in good faith and with due diligence in performance of City obligations and responsibilities under this Agreement and under· all subrecipient ·agreements. City further agrees that it shall fully cooperate with the County in all things required and appropriate to comply with the provisions of an"y Grant Agreement received by the County pursuant to the Act and its Regulations. C. City Assistance. City agrees to undertake, conduct, perform or assist the County in performing the essential community development arid housing assistance activities identified in the City's community development plan. Pursuant to the Act and pursuant to 24 CFR 570.501 (b), the City is subject to the same requirements ~pplicable to subrecipients, including the requirement of a written agreement with the County as set forth in 24 CFR 570.503. SECTION IV. Use of Program Funds. A. Allocation of CDBG funds. All funds received by County pursuant to this Agreement shall be identified and allocated, as described below, to the specific projects or activiti~s set out in the application, and· such allocated amounts shall be expended exclusively for such projects or activities; provided, however, that a different distribution may be made when required by HUD to comply with Title I of the Housing and Community Development Act of 197 4, as amended. 1) Metropolitan Cities' Allocation. The Parties agree that County shall make available to City a total amount of CDBG funds equal to that which City would have been entitled had it applied separately as a "metropolitan city", using HUD allocation formulas as applied by County, except_ that an amount equal to thirteen (13) percent of the Metropolitan Cities' 4 Item 9.a. - Page 28 allocations of CDBG funds will be deducted by the County to meet its obligations under the terms of this Agreement and/or HUD requirements for administrative costs. Further, with respect to the availability of the funds, County agrees to fully cooperate and assist City in expending such funds. 2) Non-Metropolitan Cities' Allocation. ~ounty agrees to allocate a portion of CDBG program funds to the non-Metropolitan, incorporated cities participating in the program. The amount of allocation per city shall be equal to that which the urban county formula award from HUD increases as a result of the HUD allocation formulas as applied by County, except that an amount equal to thirteen (13) percent of the Non- Metropolitan Cities' allocations of CDBG funds will be deducted by the County to meet' its· obligations under the terms of this Agreement and/or HUD requirements for administrative costs. 3) City agrees that it shall not recommend an individual CDBG award of less than $8,000 for public service activities due to the staff cost of processing such awards in compliance with· federal requirements. County may question inclusion of such a project. Notwithstanding, City and County each may make an award of $8,000 which is aggregated to a greater amount. B. Availability of Funds. County agrees to make CDBG funds available to all participating incorporated cities as set out here when HUD makes the CDBG funds available to it. The County shall immediately notify the participating incorporated cities of the availability of the funds. It is understood by the Parties hereto that the CDBG funds being used for the purposes of this Agreement are funds furnished to the County, through HUD, pursuant to the provisions of the Act. Notwithstanding any other provision of this Agreement, the liability of the County shall be limited to CDBG funds available for the Project. The City understands that the County must wait for release of CDBG funds from HUD before CDBG funds may be advanced or reimbursed. The County shall incur no liability to the City, its officers, agents, employees, suppliers, or contractors for any delay in making any such payments. C. Administrative and Public Services Costs. County hereby acknowledges that City, as subrecipient, incurs certain administrative costs in preparing housing and economic development plans, program planning, management and accounting, professional support services, and other reasonable and necessary expenses .to carry out City's plan; and further, County agrees that after the availability of CDBG program funds to City, County shall not use its remaining balance of funds in any way that would limit City's ability to use its 5 Item 9.a. - Page 29 CDBG funds to the maximum extent allowed by HUD for administrative, public service, or program purposes. D. Income Generated. City shall notify the County of any income generated by the expenditure of CDBG funds received by the City. Such program income may be retained by City subject to the provisions of this Agreement, the Act and its Regulations. Any program income retained must only be used for eligible activities in accordance with all CDBG requirements as they apply. E. Use of Program Income. County shall monitor the use of any program income, requiring appropriate record-keeping and reporting by the City as may be needed for this purpose, and shall report the use of such program income to HUD. In the event of close-out or change of status of the City, all program income on hand or received by the City subsequent to the close-out or change of status shall be paid to the County. In the event that the City withdraws from the urban county to become an entitlement grantee, as provided under 24 CFR 570.504, all p·rogram income on hand or received by the City from urban county activities shall be retained by the City to be used as additional CDBG funds subject to all applicable requirements governing the use of CDBG funds. · F. Change·in Use of Property. City shall notify the County of any modification or change in the use of real property acquired or improved in whole or in part using CDBG funds that is within the control of the City, from that use planned at the time of acquisition or improvement including disposition. Such · notification shall be made within thirty (30) calendar days of such change of use and comply with the provisions of 24 CFR 570.505. G. Fair Housing Implementation. Parties agree that no urban county funding shall be allocated or expended for activities in or in support of any cooperating unit. of general local government that does not affirmatively further fair housing within its own jurisdiction or that impedes the County~s actions to comply with its fair housing certification. H. Conflict Resolution. In the event of disagreement between the County and the City as to the allocations, disbursement, use, or reimbursement of CDBG funds, the Parties agree to accept HUD's written determination as to the appropriate resolution or disposition of funds to the extent HUD is willing to resolve such disagreement. SECTION V. Amendment or Extension of Agreement. A. Subrecipient Agreement. For each fiscal year during the term of this Agreement, County and City shall enter into a Subrecipient Agreement, prepared jointly by County and City, which will list the project(s) City will undertake with its CDBG entitlement funds during that program year. Said Subrecipient Agreement will set forth the project changes, time schedule for 6 Item 9.a. - Page 30 completion of the project(s), and . additional funding sources, if any. If substantial compliance with the completion schedule cannot ·be met by the City due to unforeseen or uncontrollable circumstances, the County may extend the ·schedule for project completion, as allowed by federal regulations. B. Amendments. Any amendments to the Agreement shall be in writing. Parties agree that any such fully executed amendment or amendments to this Agreement may be entered into at any time if required or necessary to implement the plans contemplated hereunder, or to comply with any grant agreement or the regulations issued pursuant to the Act. SECTION VI. Compliance with Federal Regulations. A. General. The Parties agree to take all actions necessary to assure compliance with the urban county's certifications required by section 104(b) of Title I of the Housing and Community Development Act of 1974, as amended, regarding Title VI of the Civil Rights Act of 1964, the Fair Housing Act, affirmatively furthering fair housing, Section 109 of Title I of the Housing and Community Development Act of 1974; the National Environmental Policy Act of 1969; the Uniform Relocation Assistance and Real Property Acquisition Act of 1970; and other applicable laws. B. Citizen Participation. The Parties agree to comply with federal citizen ·participation requirements of 24 CFR Part 91, and provide citizens with: 1) An estimate of the amount of CDBG funds proposed to be used for activities that will benefit persons of low and moderate income; and 2) A plan for minimizing displacement of persons as a result of CDBG- assisted activities and programs, and to provide assistance to such persons. C. Citizen Participation Plan. The Parties agree to follow a citizen participation plan which: 1) Provide for and encourages citizen participation, particularly those of low or moderate income who reside in slum or blighted areas where CDBG funds are proposed to be used; 2) Provide citizens with reasonable and timely access ~o local meetings, staff reports, and other information relating to grantee's proposed use of funds, as required by HUD regulations related to the actual use of funds under the Act; 3) Provides for public hearings to obtain citizen views and to respond to proposals and questions at all stages of the community development program, including at least: 1) formulation of needs; 2) review of proposed 7 Item 9.a. - Page 31 grant activities; and 3) review of program performance; for which public hearings· shall be held after adequate notice, at times and locations · convenient to potential or actual beneficiaries, and with accommodation of handicapped persons; 4) Provides for a timely written answer to written complaints and grievances, within 15 working days where practicable; 5) Identifies how the needs of non-English speaking residents will be met in the -case of public hearings where a significant number of non-English speaking residents can be reasonably expected to participate. 6) Identifies the use of non-traditional methods of community outreach, including the provision of CDBG documents in a user-friendly format, including but not limited to Braille, large print, oral format, and delivering copies to homebound individuals. D. The Parties hereby certify, to the best of their knowledge and belief, that: 1) Conflict of Interest No federal grant monies have been paid or will be paid, by or on behalf of the Parties, to any officer or employee or any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federa! grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment or modification of any federal contract, grant, loan, or cooperative agreement. 2) Influence. If any funds other than federally appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit standard form LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. 3) Certifications Disclosure. Parties agree to include this certification in the award documents for all subawards at all tiers (including subcontracts, subgraDts, and contracts under grants, loans,_ and cooperative agr~ements), and that all grant subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was entered into. 8 Item 9.a. - Page 32 E. Certification Regarding Policies Prohibiting Use of Excessive Force and Regarding Enforcement of State and Local Laws Barring Entrances. In accordance with Section 519 Public Law 101-144 (the 1990 HUD . Appropriations Act), the City certifies that it has adopted and is enforcing. 1) A policy prohibiting the use of excessive force by law enforcement agencies within their respective jurisdictions against any individuals engaged in non-violent civil rights demonstrations; and 2) A policy of enforcing applicable State and local laws against physically barring entrance to or exit from a facility or location which is the subject of such nc:m-violent civil rights demonstrations within their jurisdictions. SECTION VII. Execution of Agreement and Recordkeeping . .A. HUD Certification. The Director is hereby authorized to execute and submit to the County the HUD Certification Form with respect to the community development activities carried out within the boundaries of the City·. It is further understood that the County will rely upon the certification executed by the Director for purposes of executing a certification form for submission to HUD. . B. Maintenance of Records. City shall m~intain records of activities for any projects undertaken pursuant to the program, and said records shall be open and available for inspection by auditors assigned by HUD and/or County on reasonable notice during the normal business hours of the City. NOW, THEREFORE, the Parties hereto have caused this Cooperation Agreement to be executed and attested by their proper officer thereunder duly authorized, and their official seals to be hereunto affixed, all as of the day first above written. County Counsel Certification The Office of the County Counsel hereby certifies that the terms and provisions of this Agreement are fully authorized under State and local laws, and that the Agreement provides full legal authority for the County to undertake or assist in undertaking essential community development and housing assistance activities, specifically urban renewal and publicly assisted housing. 9 Item 9.a. - Page 33 Date: 7. I· 2-01 Y COUNTY OF SAN LUIS OBISPO .. By:_~~~---:s~.[9~:...._~-- Chairperson of the Board of Supervisors Date: ----.-;..Jl~ .... :H:'l~l~5....:.'J_n_t4 ______ _ ATTEST: JULIE L. RODEWALD Julie Rodewald, County Clerk ·_ ~y:~L,~R~ Date: .JUL 1 ~5 2014 0~J1V Ct~ 10 Item 9.a. - Page 34 ' . NOW, THEREFORE, the Parties hereto have caused this Cooperation Agreement to be executed and attested.by their proper officer therunder duly authorized, and their official seals to be hereunto affixed, all as of the day first above written . . . CITY OF ARROYO GRANDE Date: fL/zt/t'( ATTEST:.- ·:oate:·· ~<u /2'( It <f__ APPROVED AS TOCONTENT: S~rTY MANAGER Date: IJ / 2'{ /t Y APPROVED AS TO FORM: ~MECCITY ATTORNEY Date: i-h¢<1 I 11 Item 9.a. - Page 35 CITY OF ARROYO GRANDE COMMUNITY SERVICE GRANT PROGRAM APPLICATION FORM 2014-15 ATTACHMENT 3 Please complete the following sections (use additional sheets as necessary): I. NAME AND ADDRESS OF NON-PROFIT ORGANIZATION: (must be the local branch) 5Cities Homeless Coalition (5CHC) Mailing Address: P.O. Box 558, Grover Beach, CA 93483 Location: 1052 East Grand Avenue, Suite A, Arroyo Grande, CA 93420 II. GRANT APPLICANT REPRESENTATIVE'S NAME, ADDRESS AND TELEPHONE NUMBER: (must be the Executive Director or their designated representative) Janna Nichols, 5CHC Executive Director P.O. Box 558, Grover Beach, CA 93483 805-57 4-1638 Ill. DESCRIPTION OF COMMUNITY SERVICES PROVIDED: 5Cities Homeless Coalition works to strengthen the south SLO County community by mobilizing resources, support, and hope for the homeless and those facing poverty. Ending homelessness involves making sure people are healthy, well- nourished, and adequately prepared to find jobs-and that they have adequate housing available. 5CHC works with service-providing organizations, the faith community, service groups and community leaders to assess current services and opportunities for collaboration to provide for immediate needs (not currently being met) that lead toward self- sufficiency. Efforts are targeted at working with homeless families in South County, in partnership with other service providers, to ensure these clients receive guidance to access appropriate benefits, know of and make use of community resources, such as food pantries and other services, and then provide them the additional resources that may be needed to re-house them. Oftentimes 5CHC provides limited short-term financial assistance as a first step in their path to stabilization, but always with the long view of self-sufficiency. 5CHC's referral and client support services are heavily dependent on staff and volunteer time to make the connections needed to help families in crisis find immediate services and transition into stable housing if needed. 5CHC is bringing together strong community partners to collaborate on this project and the programs to address gaps in the current network of services. IV. LIST AREA(S) SERVED BY NON-PROFIT ORGANIZATION: (include brief description of the relationship of your non-profit organization to the residents of the City of Arroyo Grande) 5CHC serves the communities of southern San Luis Obispo County, including Arroyo Grande, Grover Beach, Oceano, Pismo Beach and Nipomo. These services, which are made available to residents of all of these communities, are made possible in part through the financial support of individuals, businesses, service clubs and the faith community in all parts of the South County, including Arroyo Grande. Volunteers from throughout the South County support the work of 5CHC. In Arroyo Grande in September, for example, the third annual Empty Bowls fundraiser benefiting 5CHC was held at St. Patrick's Catholic Church with the help of hundreds of volunteer servers, artists, restaurants and donors. More than half of the agency's financial revenue comes from county-wide, state-wide and even federal grant sources that 5CHC, as a successful convenor and collaborative partner with other local community providers, is able to secure. A recent example is a grant from the Veteran's Administration that 5CHC, in partnership with Good Samaritan Shelter will · use in 2015 to provide homeless prevention and rapid rehousing services for homeless South County veterans and their families. It is the nature of these grants, however, that the funds are most often earmarked for direct expenses such as ·security deposits, rental assistance, and immediate personal needs. Funds for general operating support, including salaries and wages to provide referral and other client support services, is in short supply but sorely needed to help families in our South County service area. Item 9.a. - Page 36 V. NUMBER OF CITY OF ARROYO GRANDE RESIDENTS SERVED BY NON-PROFIT (- ORGANIZATION: (broken down by age groups if available) Following are examples of services provided by 5CHC in the past year to Arroyo Grande (AG) residents: 5CHC provided the financial assistance (generally security deposit and first month's rent) for 9 of the 23 families who moved into the new low income housing at Courtland Apartments; last winter, more than 60 shelter nights were provided at the warming center that 5CHC established in AG during a period of particularly cold weather; and 5CHC helped more than 100 families from AG in the last year through its referral and client support services providing financial assistance, immediate needs housina assistance and referral to other services. VI. AMOUNT OF FUNDS REQUESTED: $1,500 VII. PROPOSED USE AND BUDGET PLAN FOR GRANT FUNDS: (indicate if any of the grant funds will be used for any other purpose than those designated such as overhead, national office, administrative salaries) Grant money will be used to fund the referral and client support services that the 5CHC staff provides to families in crisis, including those living in Arroyo Grande, by connecting them with immediate services and helping them transition into stable housing. Clients include families with children; veterans; the ''working poor"; homeless men, women and children who may be caught out in inclement weather during the winter and who need the proverbial "shelter from the storm"; and many others. Calls come into the 5CHC office every day seeking help from community partners on behalf of their clients, and from individuals and families who often don't know where to turn or where to begin to look for help. 5CHC staff serve as a source of knowledge and referral, move as many as possible into case management , and arrange for funding to meet immediate personal and/or housing needs, such as deposit and rental assistance or eviction prevention. Grant funds will be used solely for payroll expenses for those staff who provide direct referral and client support services. VIII. ADDITIONAL DOCUMENTATION: (if you have received funds in the past, please indicate the amount of funds received (indicate what year) and how the funds were utilized) N/A IX. SUPPLEMENTAL DOCUMENTATION: ~ Past two year's financial statements, including the current year with the balance sheets and the profit/loss statements. ~ Information indicating the percentage of revenue received that is used for administration, salaries, and program costs. I§ Breakdown and description of non-profit organization's sources of revenue. Iii Proof of 501 (c)(3) status with a copy of the letter from the IRS. ~ Copy of the non-profit organizations Board of Directors, Officers and an organization chart. Item 9.a. - Page 37 X. CERTIFICATION: certify on behalf of _5~~~~~~-!iO~e~~~S Coc:~~i?!: _________ ~---non-profit organization. that I have read. understand and agree that the aforesaid information is accurate. factual and current. I understand that an award of funds. if granted. wm be for t'Je sole use as reflected in this application form. I further certify that as a condition of receiving funds. an agreement with the City of Arroyo Grande. in a form and content provided by the City of Arroyo Grande. will be signed and executed by a duly authorized representative of said non-profit orgar.rzation. I am aware of and certifi' that our non-prom organization v.~ll adhere to all City regulations regarding the 2014-·15 Community Ser\'ice Fund Program including. !:>ut not limited to. mair.taining non- discriminator;.-policies. practices and intern. i also. on behalf of our non-profit organization. indemnify. defend, and hold ham1!ess the City of Arroyo Grande relative to anv· and all liability that may arise as a result of tf',e use of the Cit~.-of .t..rrOi'O Grande Community Service Grant Fund monies. Date: 11/20/2014 Item 9.a. - Page 38 3: 5 7 P M 5 Ci t i e s Ho m e l e s s Co a l i t i o n , In c . 10 / 2 0 / 1 4 Ba l a n c e Sh e e t Pr e v Ye a r Co m p a r i s o n Ac c r u a l Ba s i s As o f Se p t e m b e r 30 , 20 1 4 Se p 30 , 14 Se p 30 , 13 $C h a n g e % Ch a .. . AS S E T S Cu r r e n t As s e t s Ch e c k i n g / S a v i n g s 10 0 0 0 · R a b o b a n k - 69 7 8 10 0 0 1 ·O p e r a t i n g Fu n d 23 , 6 0 0 . 1 4 49 , 0 4 9 . 7 4 -2 5 , 4 4 9 . 6 0 -5 1 . 9 % 10 0 0 8 ·T r i l o g y Se r v i c e Cl u b Gr a n t s 9, 8 9 0 . 6 7 0. 0 0 9, 8 9 0 . 6 7 10 0 . 0 % 10 0 1 1 ·T r i l o g y F u n d s · 20 1 4 7, 9 0 2 . 0 0 0. 0 0 7, 9 0 2 . 0 0 10 0 . 0 % 10 0 1 5 · SL O C C F - Or g a n l z Ca p a c i t y 0. 0 0 16 , 4 5 7 . 3 9 -1 6 , 4 5 7 . 3 9 -1 0 0 . 0 % 10 0 1 0 · SL O C C F Si t e Se l e c t i o n Fu n d 0. 0 0 7, 6 9 5 . 7 7 -7 , 6 9 5 . 7 7 -1 0 0 . 0 % 10 0 1 2 · SL O C C F Ge n e r a l Fu n d 1, 6 3 5 . 2 7 0. 0 0 1, 6 3 5 . 2 7 10 0 . 0 % 10 0 2 5 · Do n o r Re s t r i c t e d Gi f t s 2, 5 0 0 . 0 0 2, 5 0 0 . 0 0 0. 0 0 0. 0 % 10 0 2 7 · Du n i n Op p o r t u n i t y Gr a n t 2, 3 1 3 . 4 6 0. 0 0 2, 3 1 3 . 4 6 10 0 . 0 % 10 0 2 8 · Di g n i t y He a l t h Gr a n t 5, 0 7 8 . 9 4 0. 0 0 5, 0 7 8 . 9 4 10 0 . 0 % 10 0 3 1 ·U n i t e d Wa y Co m m Im p a c t Gr a n t 1, 2 5 2 . 0 0 0. 0 0 1, 2 5 2 . 0 0 10 0 . 0 % To t a l 1 0 0 0 0 · Ra b o b a n k - 69 7 8 54 , 1 7 2 . 4 8 75 , 7 0 2 . 9 0 -2 1 , 5 3 0 . 4 2 -2 8 . 4 % To t a l Ch e c k i n g / S a v i n g s 54 , 1 7 2 . 4 8 75 , 7 0 2 . 9 0 -2 1 , 5 3 0 . 4 2 -2 8 . 4 % Ot h e r Cu r r e n t As s e t s 13 1 0 8 · Pr e p a i d Ex p e n s e s - Ho f H 1, 3 3 7 . 5 3 0. 0 0 1, 3 3 7 . 5 3 10 0 . 0 % 13 1 0 5 · Pr e p a i d D& O In s u r a n c e 1, 0 9 0 . 0 0 16 0 . 0 0 93 0 . 0 0 58 1 . 3 % 13 1 0 6 · Pr e p a i d Li a b i l i t y In s u r a n c e 67 6 . 7 8 17 0 . 7 4 50 6 . 0 4 29 6 . 4 % 13 1 1 0 · W o r k Co m p In s De p o s i t 10 1 . 7 6 32 4 . 0 0 -2 2 2 . 2 4 -6 8 . 6 % To t a l Ot h e r Cu r r e n t As s e t s 3, 2 0 6 . 0 7 65 4 . 7 4 2, 5 5 1 . 3 3 38 9 . 7 % - - - To t a l Cu r r e n t As s e t s 57 , 3 7 8 . 5 5 76 , 3 5 7 . 6 4 -1 8 , 9 7 9 . 0 9 -2 4 . 9 % Fi x e d As s e t s 12 0 1 0 ·F u r n i t u r e & Of f i c e Eq u i p m e n t 12 0 2 0 · Co m p u t e r s 1, 2 0 4 . 2 7 1, 2 0 4 . 2 7 0. 0 0 0. 0 % 12 1 2 0 · L e s s Ac c u m De p r e c i a t i o n -6 2 6 . 0 0 -6 2 6 . 0 0 0. 0 0 0. 0 % To t a l 1 2 0 1 0 ·F u r n i t u r e & Of f i c e Eq u i p m e n t 57 8 . 2 7 57 8 . 2 7 0. 0 0 0. 0 % To t a l Fi x e d As s e t s 57 8 . 2 7 57 8 . 2 7 0. 0 0 0. 0 % TO T A L AS S E T S 57 , 9 5 6 . 8 2 76 , 9 3 5 . 9 1 -1 8 , 9 7 9 . 0 9 -2 4 . 7 % LI A B I L I T I E S & EQ U I T Y Li a b i l i t i e s Cu r r e n t ·L i a b i l i t i e s Ac c o u n t s Pa y a b l e 20 0 0 0 · Ac c o u n t s Pa y a b l e 68 1 . 3 6 1, 5 3 4 . 0 8 -8 5 2 . 7 2 -5 5 . 6 % To t a l Ac c o u n t s Pa y a b l e 68 1 . 3 6 1, 5 3 4 . 0 8 -8 5 2 . 7 2 -5 5 . 6 % I oage 1 I ·~ · Item 9.a. - Page 39 3: 5 7 P M I 5 Ci t i e s Ho m e l e L "- - - " . : : o a l i t i o n , In c . __/ - 10 / 2 0 / 1 4 Ba l a n c e Sh e e t Pr e v Ye a r C o m p a r i s o n Ac c r u a l Ba s i s As o f Se p t e m b e r 30 , 20 1 4 Se p 30 , 14 Se p 30 , 13 $C h a n g e % Ch a ... Ot h e r Cu r r e n t Li a b i l i t i e s 21 0 3 2 · De f e r r e d Tr i l o g y Ev e n t In c o m e 7, 9 0 2 . 0 0 0. 0 0 7, 9 0 2 . 0 0 10 0 . 0 % 21 0 3 1 · Un e a r n e d UW Co m m Im p a c t Gr a n t 1, 2 5 2 . 0 0 0. 0 0 1, 2 5 2 . 0 0 10 0 . 0 % 21 0 2 9 · Un e a r n e d SL O C C F Ge n e r a l Gr a n t 1, 6 3 5 . 2 7 0. 0 0 1, 6 3 5 . 2 7 10 0 . 0 % 21 0 2 8 · Un e a r n e d Di g n i t y He a l t h Gr a n t 5, 0 7 8 . 9 4 0. 0 0 5, 0 7 8 . 9 4 10 0 . 0 % 21 0 1 5 ·U n e a r n e d Or g a n i z Ca p a c i t y Gr a n t 0. 0 0 16 , 4 5 7 . 3 9 -1 6 , 4 5 7 . 3 9 -1 0 0 . 0 % 21 0 2 0 · Un e a r n e d Si t e Se l e c t i o n Gr a n t 0. 0 0 7, 6 9 5 . 7 7 -7 , 6 9 5 . 7 7 -1 0 0 . 0 % 21 0 2 1 ·U n e a r n e d UW De n t a l Gr a n t 0. 0 0 1, 9 2 5 . 0 0 -1 , 9 2 5 . 0 0 -1 0 0 . 0 % 21 0 2 2 · Un e a r n e d SL O Cn t y De n t a l Gr a n t 0. 0 0 5, 0 0 0 . 0 0 -5 , 0 0 0 . 0 0 -1 0 0 . 0 % 21 0 2 3 · Un e a r n e d Tr i l o g y Gr a n t s 21 0 2 3 . 9 · Un e a r n e d Tr i l o g y Ad m i n 49 9 . 0 0 0. 0 0 49 9 . 0 0 10 0 . 0 % 21 0 2 3 . 2 ·U n e a r n e d Tr i l o g y lm m e d Ne e d s 1, 5 0 1 . 7 4 0. 0 0 1, 5 0 1 . 7 4 10 0 . 0 % 21 0 2 3 . 1 ·U n e a r n e d Tr i l o g y Ho u s i n g 7, 8 8 9 . 9 3 1, 2 5 0 . 0 0 6, 6 3 9 . 9 3 53 1 . 2 % To t a l 21 0 2 3 · Un e a r n e d Tr i l o g y Gr a n t s 9, 8 9 0 . 6 7 1, 2 5 0 . 0 0 8, 6 4 0 . 6 7 69 1 . 3 % 21 0 2 5 ·D o n o r Re s t r i c t e d Gi f t 2, 5 0 0 . 0 0 2, 5 0 0 . 0 0 0. 0 0 0. 0 % 21 0 2 7 ·U n e a r n e d Du n i n Op p o r t Gr a n t 2, 3 1 3 . 4 6 0. 0 0 2, 3 1 3 . 4 6 10 0 . 0 % 24 0 0 0 · Pa y r o l l Li a b i l i t i e s 24 0 1 0 · CA • ET T Pa y a b l e 0. 0 0 -3 . 2 3 3. 2 3 10 0 . 0 % 24 0 2 0 · C A - Un e m p l o y m e n t Pa y a b l e 0. 0 0 -1 0 9 . 8 1 10 9 . 8 1 10 0 . 0 % 24 0 3 0 · C A - Di s a b l i t y Pa y a b l e 0. 0 0 57 . 5 7 -5 7 . 5 7 -1 0 0 . 0 % 24 0 4 0 · CA -W i t h h o l d i n g Pa y a b l e 0. 0 0 29 1 . 4 4 -2 9 1 . 4 4 -1 0 0 . 0 % 24 0 6 0 · F e d - So c i a l Se c u r i t y Pa y a b l e 0. 0 0 71 3 . 9 4 -7 1 3 . 9 4 -1 0 0 . 0 % 24 0 7 0 · Fe d - Me d i c a r e Pa y a b l e 0. 0 0 16 6 . 9 6 -1 6 6 . 9 6 -1 0 0 . 0 % 24 0 8 0 · Fe d -W i t h h o l d i n g Pa y a b l e 0. 0 0 77 6 . 0 0 -7 7 6 . 0 0 -1 0 0 . 0 % To t a l 24 0 0 0 · Pa y r o l l Li a b i l i t i e s 0. 0 0 1, 8 9 2 . 8 7 -1 , 8 9 2 . 8 7 -1 0 0 . 0 % 25 0 0 0 · Cl e a r i n g -1 . 0 0 -8 4 1 . 8 8 84 0 . 8 8 99 . 9 % To t a l Ot h e r Cu r r e n t Li a b i l i t i e s 30 , 5 7 1 . 3 4 35 , 8 7 9 . 1 5 -5 , 3 0 7 . 8 1 -1 4 . 8 % To t a l Cu r r e n t Li a b i l i t i e s 31 , 2 5 2 . 7 0 37 , 4 1 3 . 2 3 -6 , 1 6 0 . 5 3 -1 6 . 5 % To t a l Li a b i l i t i e s 31 , 2 5 2 . 7 0 37 , 4 1 3 . 2 3 -6 , 1 6 0 . 5 3 -1 6 . 5 % Eq u i t y 32 0 0 0 · Un r e s t r i c t e d Ne t As s e t s 35 , 1 1 4 . 3 0 34 , 6 1 4 . 3 0 50 0 . 0 0 1. 4 % 31 8 0 0 · Pr i o r Ye a r Ad j u s t m e n t -1 , 9 1 6 . 1 2 0. 0 0 -1 , 9 1 6 . 1 2 -1 0 0 . 0 % Ne t In c o m e -6 , 4 9 4 . 0 6 4, 9 0 8 . 3 8 -1 1 , 4 0 2 . 4 4 -2 3 2 . 3 % To t a l Eq u i t y 26 , 7 0 4 . 1 2 39 , 5 2 2 . 6 8 -1 2 , 8 1 8 . 5 6 -3 2 . 4 % TO T A L LI A B I L I T I E S & EQ U I T Y 57 , 9 5 6 . 8 2 76 , 9 3 5 . 9 1 -1 8 , 9 7 9 . 0 9 -2 4 . 7 % Page 2 Item 9.a. - Page 40 3: 5 8 P M 5 C i t i e s Ho m e l e s s Co a l i t i o n , In c . 10 / 2 0 / 1 4 Pr o f i t & L o s s Bu d g e t Pe r f o l l " m a n c e Ac c r u a l Ba s i s Se p t e m b e r 20 1 4 S e p 1 4 Bu d g e t $ O v e r B .. . J a n - Se p .. . YT D Bu d .. . $ O v e r B ... Annual B ... Or d i n a r y In c o m e / E x p e n s e In c o m e 41 0 0 0 · G r a n t s In c o m e 41 0 2 8 · SL O C C F Ge n e r a l Fu n d Gr a n t 0. 0 0 0. 0 0 0. 0 0 3, 1 8 9 . 7 3 2, 2 0 0 . 0 0 989.73 4,385.00 41 0 2 0 · SL O C C F Or g a n i z a t i o n a l Ca p a c i t y 0. 0 0 0. 0 0 0. 0 0 6, 0 0 0 . 0 0 6, 0 0 0 . 0 0 0.00 6,000.00 41 0 1 5 · SL O C C F Si t e Se l e c t i o n Gr a n t 0. 0 0 0. 0 0 0. 0 0 8, 4 4 5 . 7 7 8, 4 4 5 . 0 0 0.77 8,445.00 41 0 2 6 . 1 ·T r i l o g y Ho u s i n g Gr a n t 1, 1 7 8 . 5 0 90 2 . 5 0 27 6 . 0 0 12 , 4 3 8 . 9 4 8, 1 2 2 . 5 0 4, 3 1 6 . 4 4 10,830.00 41 0 2 6 . 2 ·T r i l o g y Im m e d i a t e Ne e d s Gr a n t 36 9 . 4 6 90 2 . 5 0 -5 3 3 . 0 4 2, 0 4 8 . 2 6 8, 1 2 2 . 5 0 -6 , 0 7 4 . 2 4 10,830.00 41 0 2 6 . 9 ·T r i l o g y Ad m i n OH Gr a n t 95 . 0 0 95 . 0 0 0. 0 0 84 0 . 0 0 85 5 . 0 0 -15.00 1 '140.00 41 0 2 7 · Du n l n Op p o r t u n i t y Gr a n t -1 9 7 . 0 0 72 5 . 0 0 -9 2 2 . 0 0 5, 1 9 8 . 9 9 6, 5 2 5 . 0 0 -1 ,326.01 8,000.00 41 0 5 5 ·U n i t e d Wa y De n t a l Gr a n t 0. 0 0 0. 0 0 0. 0 0 3, 1 6 8 . 0 6 2, 6 5 2 . 0 0 516.06 2,652.00 41 0 5 6 · SL O Co u n t y De n t a l Gr a n t 0. 0 0 58 3 . 3 3 -5 8 3 . 3 3 1, 7 0 3 . 2 7 3, 4 5 0 . 9 9 -1 , 7 4 7 . 7 2 5,201.00 41 0 3 1 ·D i g n i t y He a l t h Gr a n t 61 0 . 4 9 1, 0 0 0 . 0 0 -3 8 9 . 5 1 6, 9 2 1 . 0 6 9, 0 0 0 . 0 0 -2 , 0 7 8 . 9 4 12,000.00 41 0 3 2 · Un i o n Pa c i f i c Gr a n t 0. 0 0 0. 0 0 0. 0 0 8, 3 5 0 . 0 0 8, 5 2 5 . 0 0 -175.00 8,525.00 41 0 3 3 ·U n i t e d Wa y Co m m u n i t y Im p a c t 41 6 . 0 0 1, 2 4 8 . 0 0 41 0 2 5 ·P r o g r a m Gr a n t s 0. 0 0 91 6 . 6 7 -9 1 6 . 6 7 0. 0 0 11 , 9 5 1 . 0 1 -1 1 , 9 5 1 . 0 1 21,367.00 To t a l 41 0 0 0 · Gr a n t s In c o m e 2, 4 7 2 . 4 5 5, 1 2 5 . 0 0 -2 , 6 5 2 . 5 5 59 , 5 5 2 . 0 8 75 , 8 4 9 . 0 0 -1 6 , 2 9 6 . 9 2 99,375.00 42 0 0 0 · Co n t r i b u t i o n s 42 0 0 5 · In d i v i d u a l s 53 5 . 0 0 1, 0 0 0 . 0 0 -4 6 5 . 0 0 6, 9 8 7 . 0 0 19 , 8 9 0 . 0 0 -1 2 , 9 0 3 . 0 0 30,890.00 42 0 1 0 · B u s i n e s s e s 0. 0 0 10 0 . 0 0 -1 0 0 . 0 0 16 . 0 0 70 0 . 0 0 -684.00 2,300.00 42 0 1 5 · Fa i t h & No n - P r o f i t Gr o u p s 10 0 . 0 0 20 0 . 0 0 -1 0 0 . 0 0 5, 0 6 8 . 0 0 2, 6 0 7 . 0 0 2, 4 6 1 . 0 0 3,507.00 To t a l 42 0 0 0 · Co n t r i b u t i o n s 63 5 . 0 0 1, 3 0 0 . 0 0 -6 6 5 . 0 0 12 , 0 7 1 . 0 0 23 , 1 9 7 . 0 0 -1 1 , 1 2 6 . 0 0 36,697.00 43 0 0 0 · Fu n d r a i s i n g Ev e n t s 42 0 2 6 · Co n c e r t in th e Pa r k 0. 0 0 0. 0 0 50 0 . 0 0 -500.00 500.00 43 0 1 1 · Fi n ' s Fu n d r a i s e r 0. 0 0 10 , 3 9 8 . 3 7 10 , 0 0 0 . 0 0 398.37 10,000.00 43 0 1 3 ·S u m m e r Fu n d r a i s e r / C o n c e r t 0. 0 0 0. 0 0 5, 0 0 0 . 0 0 -5 , 0 0 0 . 0 0 5,000.00 43 0 2 7 · Em p t y Bo w l s Em p t y Bo w l s -T i c k e t s 14 , 2 0 5 . 0 0 15 , 0 0 0 . 0 0 -7 9 5 . 0 0 14 , 7 5 5 . 0 0 15 , 5 0 0 . 0 0 -745.00 15,500.00 Em p t y Bo w l s -R a f f l e 2, 2 6 7 . 1 5 3, 5 0 0 . 0 0 -1 , 2 3 2 . 8 5 2, 2 9 2 . 1 5 3, 5 0 0 . 0 0 -1 , 2 0 7 . 8 5 3,500.00 Em p t y Bo w l s -C o n t r i b u t i o n s 0. 0 0 1, 0 0 0 . 0 0 -1 , 0 0 0 . 0 0 0. 0 0 1, 0 0 0 . 0 0 -1 , 0 0 0 . 0 0 1,000.00 Em p t y Bo w l s -S p o n s o r s 2, 3 0 0 . 0 0 6, 0 0 0 . 0 0 -3 , 7 0 0 . 0 0 9, 1 0 0 . 0 0 22 , 0 0 0 . 0 0 -1 2 , 9 0 0 . 0 0 22,000.00 To t a l 43 0 2 7 · Em p t y Bo w l s 18 , 7 7 2 . 1 5 25 , 5 0 0 . 0 0 -6 , 7 2 7 . 8 5 26 , 1 4 7 . 1 5 42 , 0 0 0 . 0 0 -1 5 , 8 5 2 . 8 5 42,000.00 43 0 2 9 · Tr i l o g y Ev e n t HH - A r t i s t Bo o t h s 0. 0 0 0. 0 0 HH - S p o n s o r s h i p s 0. 0 0 0. 0 0 To t a l 43 0 2 9 · Tr i l o g y Ev e n t 0. 0 0 0. 0 0 To t a l 43 0 0 0 · Fu n d r a i s i n g Ev e n t s 18 , 7 7 2 . 1 5 25 , 5 0 0 . 0 0 -6 , 7 2 7 . 8 5 36 , 5 4 5 . 5 2 57 , 5 0 0 . 0 0 -2 0 , 9 5 4 . 4 8 57,500.00 44 0 0 0 · Sp e c i a l Co l l e c t i o n s 44 0 0 5 · Go o d Fr i d a y 0. 0 0 1, 3 7 1 . 0 0 To t a l 44 0 0 0 · Sp e c i a l Co l l e c t i o n s 0. 0 0 1, 3 7 1 . 0 0 ·'· '· cage 1 ·- Item 9.a. - Page 41 3: 5 8 P M · ~ 5 C i t i e s Ho m e l e L ___ _ ~;; o a i i t i o n , In c . __/ 10 / 2 0 / 1 4 P r o f i t & l o s s B u d g e t P e r f o r m a n c e Ac c r u a l Ba s i s Se p t e m b e r 20 1 4 Se p 14 Bu d g e t $O v e r B .. . J a n - Se p .. . YT D Bu d .. . $O v e r B ... Annual B ... 45 0 0 0 · In - K i n d Co n t r i b u t i o n s 45 0 3 0 · Of f i c e Sp a c e 80 0 . 0 0 80 0 . 0 0 0. 0 0 7, 2 0 0 . 0 0 7, 2 0 0 . 0 0 0.00 9,600.00 45 0 4 0 · Ot h e r In - K i n d Co n t r i b u t i o n s 0. 0 0 0. 0 0 18 0 . 0 0 -180.00 180.00 To t a l 4 5 0 0 0 · In - K i n d Co n t r i b u t i o n s 80 0 . 0 0 80 0 . 0 0 0. 0 0 7, 2 0 0 . 0 0 7, 3 8 0 . 0 0 -180.00 9,780.00 - - To t a l In c o m e 22 , 6 7 9 . 6 0 32 , 7 2 5 . 0 0 -1 0 , 0 4 5 . 4 0 11 6 , 7 3 9 . 6 0 16 3 , 9 2 6 . 0 0 -4 7 , 1 8 6 . 4 0 203,352.00 - - Gr o s s Pr o f i t 22 , 6 7 9 . 6 0 32 , 7 2 5 . 0 0 -1 0 , 0 4 5 . 4 0 11 6 , 7 3 9 . 6 0 16 3 , 9 2 6 . 0 0 -4 7 , 1 8 6 . 4 0 203,352.00 Ex p e n s e 52 0 0 0 · Fu n d ra i s i n g & De v e l o p m e n t Ex p 52 0 0 8 · Ha r v e s t o f Ho p e Ex p e n s e s 0. 0 0 68 . 3 1 52 0 0 5 · Fu n d r a i s i n g Ex p e n s e (N o n - G r a n t ) 98 6 . 6 2 1, 1 5 4 . 3 0 -1 6 7 . 6 8 2, 0 8 3 . 1 1 2, 3 6 6 . 2 4 -283.13 3,274.52 52 0 0 6 · Pr i n t i n g & Co p y i n g 44 . 6 2 44 . 6 2 776.64 52 0 1 0 · Ho s p i t a l i t y 0. 0 0 21 . 5 8 To t a l 52 0 0 0 • Fu n d r a i s i n g & De v e l o p m e n t Ex p 1, 0 3 1 . 2 4 1, 1 5 4 . 3 0 -1 2 3 . 0 6 2, 2 1 7 . 6 2 2, 3 6 6 . 2 4 -148.62 4,051.16 55 0 0 0 · Pr o g r a m Ex p e n s e 55 0 1 2 · De n t r a l Cl i n i c Ex p e n s e 0. 0 0 44 5 . 0 0 -4 4 5 . 0 0 3, 4 7 0 . 0 0 4, 7 8 5 . 0 0 -1 , 3 1 5 . 0 0 6,121.00 55 5 0 1 · He l p i n g Ha n d s Fu n d 0. 0 0 42 . 0 0 55 0 0 5 · Im m e d i a t e Ne e d s Fu n d 37 2 . 4 6 2, 4 0 0 . 0 0 -2 , 0 2 7 . 5 4 4, 9 4 1 . 8 7 21 , 6 0 0 . 0 0 -1 6 , 6 5 8 . 1 3 28,800.00 55 0 0 3 · Ho u s i n g Su p p o r t 1, 8 7 3 . 5 9 17 , 2 6 6 . 3 3 55 0 0 2 · Wa r m i n g Sh e l t e r 0. 0 0 0. 0 0 0. 0 0 2, 7 1 5 . 4 1 3, 8 1 0 . 0 0 -1 , 0 9 4 . 5 9 9,525.00 55 0 1 0 · Pr o g r a m Su p p l i e s 0. 0 0 50 . 0 0 -5 0 . 0 0 31 7 . 7 6 45 0 . 0 0 -132.24 600.00 55 0 0 7 · Cl o t h i n g Vo u c h e r s 0. 0 0 50 0 . 0 0 -5 0 0 . 0 0 1, 1 5 1 . 3 1 4, 5 0 0 . 0 0 -3 , 3 4 8 . 6 9 6,000.00 55 0 2 5 · Re c r u i t m e n t & Ou t r e a c h 0. 0 0 -3 4 5 . 2 1 55 0 2 6 ·A d m i n Ov e r h e a d 0. 0 0 50 0 . 0 0 55 0 0 0 · Pr o g r a m Ex p e n s e - Ot h e r 0. 0 0 20 0 . 0 0 -2 0 0 . 0 0 0. 0 0 1, 8 0 0 . 0 0 -1 , 8 0 0 . 0 0 2,400.00 To t a l 55 0 0 0 · Pr o g r a m Ex p e n s e 2, 2 4 6 . 0 5 3, 5 9 5 . 0 0 -1 , 3 4 8 . 9 5 30 , 0 5 9 . 4 7 36 , 9 4 5 . 0 0 -6 , 8 8 5 . 5 3 53,446.00 53 0 0 0 · Ma r k e t i n g & Pr o m o t i o n 53 0 0 7 · Co m m u n i t y Ou t r e a c h 0. 0 0 10 0 . 0 0 -1 0 0 . 0 0 75 . 0 0 90 0 . 0 0 -825.00 1,200.00 53 0 0 8 · Ad v e r t i s i n g Ag e n c y Ex p e n s e 0. 0 0 10 0 . 0 0 -1 0 0 . 0 0 0. 0 0 90 0 . 0 0 -900.00 1,200.00 53 0 1 0 · We b s i t e Ex p e n s e 0. 0 0 10 0 . 0 0 -1 0 0 . 0 0 50 . 0 0 90 0 . 0 0 -850.00 1,200.00 To t a l 53 0 0 0 ·M a r k e t i n g & Pr o m o t i o n 0. 0 0 30 0 . 0 0 -3 0 0 . 0 0 12 5 . 0 0 2, 7 0 0 . 0 0 -2 , 5 7 5 . 0 0 3,600.00 54 0 0 0 · Ad m i n i s t r a t i v e Ov e r h e a d 54 0 0 2 · Ba n k Se r v i c e Ch a r g e 0. 0 0 1. 2 5 -1 . 2 5 5. 0 0 10 . 7 0 -5.70 14.45 54 0 0 4 · Bo a r d Ex p e n s e 24 9 . 3 5 70 . 0 0 17 9 . 3 5 32 4 . 3 2 63 0 . 0 0 -305.68 840.00 54 0 0 5 · Co n t r a c t La b o r 90 8 . 0 0 1, 4 2 8 . 0 0 54 0 0 6 · Du e s & Su b s c r i p t i o n s 0. 0 0 15 0 . 0 0 -1 5 0 . 0 0 25 0 . 0 0 40 0 . 0 0 -150.00 400.00 54 0 0 8 · Fi n a n c e Ch a r g e 1. 2 5 23 . 2 2 6.36 54 0 1 0 · In s u r a n c e 54 0 1 4 · Pr o p e r t y In s u r a n c e 0. 0 0 29 . 0 0 -2 9 . 0 0 0. 0 0 26 1 . 0 0 -261.00 348.00 54 0 1 3 ·V o l u n t e e r In s u r a n c e 0. 0 0 16 . 0 0 -1 6 . 0 0 61 . 0 0 14 4 . 0 0 -83.00 192.00 54 0 1 1 · Di r e c t o r s & Of f i c e r s 40 . 0 0 90 . 0 0 -5 0 . 0 0 36 0 . 0 0 81 0 . 0 0 -450.00 1,080.00 54 0 1 2 · Li a b i l i t y In s u r a n c e 53 . 3 3 53 . 3 3 0. 0 0 47 9 . 9 7 48 8 . 8 1 -8.84 648.80 To t a l S4 0 1 0 · In s u r a n c e 93 . 3 3 18 8 . 3 3 -9 5 . 0 0 90 0 . 9 7 1, 7 0 3 . 8 1 -802.84 2,268.80 Page 2 Item 9.a. - Page 42 3: 5 8 P M 5 Ci t i e s H o m e l e s s Co a l i t i o n , In c . 10 / 2 0 / 1 4 P r o f i t & L o s s B u d g e t P e r f o r m a n c e Ac c r u a l Ba s i s Se p t e m b e r 20 1 4 Se p 14 Bu d g e t $ O v e r B .. . J a n - Se p .. . YT D Bu d .. . $ O v e r B ... Annual B ... 54 0 2 3 · Li c e n s e s & Ta x e s 0. 0 0 60 . 0 0 70 . 0 0 -10.00 70.00 54 0 2 4 · Mi l e a g e 0. 0 0 55 . 0 0 -5 5 . 0 0 0. 0 0 49 5 . 0 0 -4 9 5 . 0 0 660.00 54 0 2 5 · Me r c h a n t Fe e s 26 . 1 6 16 5 . 8 2 -1 3 9 . 6 6 75 . 3 7 17 2 . 3 9 -97.02 177.29 54 0 3 5 · Of f i c e Su p p l i e s 0. 0 0 16 5 . 0 0 -1 6 5 . 0 0 94 6 . 5 4 1, 4 8 5 . 0 0 -5 3 8 . 4 6 1,980.00 54 0 4 0 · Pa y r o l l Se r v i c e Fe e s 4. 8 0 10 . 0 0 -5 . 2 0 61 . 1 7 90 . 0 0 -28.83 120.00 54 0 4 5 · Po s t a g e & De l i v e r y 0. 0 0 12 5 . 0 0 -1 2 5 . 0 0 . 24 5 . 0 0 1 '1 2 5 . 0 0 -8 8 0 . 0 0 1,500.00 54 0 4 8 · Re p a i r s & Ma i n t e n a n c e 0. 0 0 25 . 0 0 -2 5 . 0 0 0. 0 0 22 5 . 0 0 -2 2 5 . 0 0 300.00 54 0 5 0 · Te l e p h o n e 17 7 . 2 0 35 0 . 0 0 -1 7 2 . 8 0 1, 6 2 3 . 5 8 3, 1 5 0 . 0 0 -1 , 5 2 6 . 4 2 4,200.00 To t a l 54 0 0 0 · Ad m i n i s t r a t i v e Ov e r h e a d 1, 4 6 0 . 0 9 1, 3 0 5 . 4 0 15 4 . 6 9 5, 9 4 3 . 1 7 9, 5 5 6 . 9 0 -3 , 6 1 3 . 7 3 12,536.90 56 0 0 0 · Eq u i p m e n t 56 0 0 5 · So f t w a r e 39 . 9 9 10 0 . 0 0 -6 0 . 0 1 13 8 . 9 9 90 0 . 0 0 -761.01 1,200.00 56 0 1 0 · Co m p u t e r s 0. 0 0 64 . 8 0 To t a l 56 0 0 0 · Eq u i p m e n t 39 . 9 9 10 0 . 0 0 -6 0 . 0 1 20 3 . 7 9 90 0 . 0 0 -696.21 1,200.00 57 0 0 0 · Pr o f e s s i o n a l Se r v i c e s 57 0 0 5 · Ac c o u n t i n g 32 5 . 0 0 32 5 . 0 0 0. 0 0 3, 3 2 5 . 0 0 3, 2 7 5 . 0 0 50.00 4,250.00 To t a l 57 0 0 0 · Pr o f e s s i o n a l Se r v i c e s 32 5 . 0 0 32 5 . 0 0 0. 0 0 3, 3 2 5 . 0 0 3, 2 7 5 . 0 0 50.00 4,250.00 58 0 0 0 · Oc c u p a n c y Ex p e n s e 58 0 0 5 · R e n t 80 0 . 0 0 80 0 . 0 0 0. 0 0 7, 2 0 0 . 0 0 7, 2 0 0 . 0 0 0.00 9,600.00 58 0 1 0 · Ga s & El e c t r i c 57 . 7 1 10 0 . 0 0 -4 2 . 2 9 46 8 . 3 8 90 0 . 0 0 -431.62 1,200.00 To t a l 58 0 0 0 · Oc c u p a n c y Ex p e n s e 85 7 . 7 1 90 0 . 0 0 -4 2 . 2 9 7, 6 6 8 . 3 8 8, 1 0 0 . 0 0 -431.62 10,800.00 66 0 0 0 · Pa y r o l l Ex p e n s e s 66 0 0 5 · Wa g e s & Sa l a r i e s 6, 5 1 3 . 8 4 8, 6 5 5 . 0 0 -2 , 1 4 1 . 1 6 66 , 9 0 6 . 1 0 77 , 1 3 3 . 0 0 -1 0 , 2 2 6 . 9 0 103,098.00 66 0 6 0 · Fe d -S o c i a l Se c u r i t y Ex p e n s e 40 3 . 8 5 53 6 . 6 1 -1 3 2 . 7 6 4, 1 4 8 . 1 8 4, 7 8 2 . 2 7 -634.09 6,392.08 66 0 7 0 · Fe d - Me d i c a r e Ex p e n s e 94 . 4 5 12 5 . 5 0 -3 1 . 0 5 97 0 . 1 4 1 '1 1 8 . 4 2 -148.28 1,494.92 66 0 1 0 · CA - ET T Ex p e n s e 0. 0 0 0. 0 0 0. 0 0 14 . 0 0 30 . 0 0 -16.00 30.00 66 0 2 0 · CA - Un e m p l o y m e n t Ex p e n s e 0. 0 0 0. 0 0 0. 0 0 60 2 . 0 0 90 0 . 0 0 -298.00 900.00 66 0 7 5 · Wo r k e r s ' Ca m p In s u r a n c e Ex p e n s e 25 1 . 0 0 12 1 . 0 0 13 0 . 0 0 1, 0 8 1 . 8 1 1, 0 8 9 . 0 0 -7.19 1,452.00 To t a l 66 0 0 0 · Pa y r o l l Ex p e n s e s 7, 2 6 3 . 1 4 9, 4 3 8 . 1 1 -2 , 1 7 4 . 9 7 73 , 7 2 2 . 2 3 85 , 0 5 2 . 6 9 -1 1 , 3 3 0 . 4 6 113,367.00 To t a l Ex p e n s e 13 , 2 2 3 . 2 2 17 , 1 1 7 . 8 1 -3 , 8 9 4 . 5 9 12 3 , 2 6 4 . 6 6 14 8 , 8 9 5 . 8 3 -2 5 , 6 3 1 . 1 7 203,251.06 Ne t Or d i n a r y In c o m e 9, 4 5 6 . 3 8 15 , 6 0 7 . 1 9 -6 , 1 5 0 . 8 1 -6 , 5 2 5 . 0 6 15 , 0 3 0 . 1 7 -2 1 , 5 5 5 . 2 3 100.94 Ot h e r In c o m e / E x p e n s e Ot h e r In c o m e Di v i d e n d In c o m e 0. 0 0 31 . 0 0 To t a l Ot h e r In c o m e 0. 0 0 31 . 0 0 Ot h e r Ex p e n s e Op e r a t i n g Re s e r v e 0. 0 0 0. 0 0 To t a l Ot h e r Ex p e n s e 0. 0 0 0. 0 0 Ne t Ot h e r In c o m e 0. 0 0 31 . 0 0 - - Ne t In c o m e 9, 4 5 6 . 3 8 15 , 6 0 7 . 1 9 -6 , 1 5 0 . 8 1 -6 , 4 9 4 . 0 6 15 , 0 3 0 . 1 7 -2 1 , 5 2 4 . 2 3 100.94 .,age 3 " - • ' -· Item 9.a. - Page 43 2:45PM 5 Cities Homeless Coalition, Inc. 02/04114 Balance Sheet Prev Year Comparison Accrual Basis As of December 31, 2013 ( Dec 31,13 Dec 31, 12 $Change %Cha ... ASSETS Current Assets Checking/Savings 10000 · Rabobank • 6978 10001 ·Operating Fund 33,307.57 33.152.64 154.93 0.5% 10006 · UW Dental Grant 728.27 0.00 728.27 100.0% 10007 · SLO County Dental Grant 1,703.27 0.00 1,703.27 100.0% 10008 · Trilogy Service Club Grants 23,808.14 0.00 23,808.14 100.0% 1 0015 · SLOCCF • Organiz Capacity 6,000.00 0.00 6,000.00 100.0% 10010 · SLOCCF Site Selection Fund 8,445.77 7,945.77 500.00 6.3% 10025 · Donor Restricted Gifts 2,500.00 2,500.00 0.00 0.0% 10027 · Dun in Opportunity Grant 12,337.45 0.00 12,337.45 100.0% Total10000 · Rabobank-6978 88,830.47 43,598.41 45,232.06 103.8% 10004 · Pay Pal Account 1,221.30 0.00 1,221.30 100.0% Total Checking/Savings 90,051.77 43,598.41 46,453.36 106.6% Other Current Assets 13105 · Prepaid D&O Insurance 220.00 100.00 12o:oo 120.0% 13106 ·Prepaid Liability Insurance 335.35 66.71 268.64 402.7% 13110 ·Work Comp Ins Deposit 187.07 385.00 -197.93 -51.4% 13112 ·Escrow Fees 0.00 5,000.00 -5,000.00 -100.0% Total Other Current Assets 742.42 5,551.71 -4,809.29 -86.6% Total Current Assets 90,794.19 49,150.12 41,644.07 84.7% Fixed Assets 12010 ·Furniture & Office Equipment 12020 ·Computers 1,204.27 1,204.27 0.00 0.0% 12120 ·Less Accum Depreciation -626.00 -626.00 0.00 0.0% Total 12010 · Furniture & Office Equipment 578.27 578.27 0.00 0.0% Total Fixed Assets 578.27 578.27 0.00 0.0% TOTAL ASSETS 91,372.46 49,728.39 41,644.07 83.7% LIABILITIES & EQUITY Liabilities Current Liabilities Accounts Payable 20000 · Accounts Payable 2,994.66 325.00 2,669.66 821.4% Total Accounts Payable 2,994.66 325.00 2,669.66 821.4% Other Current Liabilities 21015 · Unearned Organiz Capacity Grant 6,000.00 0.00 6,000.00 100.0% 21020 · Unearned Site Selection Grant 8,445.77 7,945.77 500.00 6.3% 21021 · Unearned UW Dental Grant 728.27 0.00 728.27 100.0% 21022 ·Unearned SLO Cnty Dental Grant 1,703.27 0.00 1,703.27 100.0% 21023 · Unearned Trilogy Grants 21023.9 ·Unearned Trilogy Admin 919.40 0.00 919.40 100.0% 21023.2 ·Unearned Trilogy lmmed Needs 11,484.37 0.00 11,484.37 100.0% 21023.1 · Unearned Trilogy Housing 11.404.37 0.00 11,404.37 100.0% Total 21023 ·Unearned Trilogy Grants 23,808.14 0.00 23,808.14 100.0% 21025 ·Donor Restricted Gift 2,500.00 2,500.00 0.00 0.0% 21027 ·Unearned Dunin Opport Grant 12,337.45 0.00 12,337.45 100.0% 2110 · Direct Deposit Liabilities -2,124.93 0.00 -2,124.93 -100.0% Page 1 ~- Item 9.a. - Page 44 2:45PM 5 Cities Homeless Coalition, Inc. 02/04/14 Balance Sheet Prev Year Comparison (-Accrual Basis As of December 31, 2013 Dec 31, 13 Dec 31,12 $Change ·%Cha ... 24000 · Payroll Liabilities 2401 0 · CA • ETT Payable -3.23 0.00 -3.23 -100.0% 24020 · CA • Unemployment Payable -109.81 0.00 -109.81 -100.0% 24030 · CA-Disabllty Payable 42.31 109.64 -67.33 -61.4% 24040 · CA-Withholding Payable 16.42 462.45 -446.03 -96.5% 24060 · Fed -Social Security Payable 637.60 1.140.29 -502.69 -44.1% 24070 · Fed -Medicare Payable 149.12 317.94 -168.82 -53.1% 24080 · Fed -Withholding Payable 475.00 1,353.00 -878.00 -64.9% Total 24000 · Payroll Liabilities 1,207.41 3,383.32 -2,175.91 -64.3% 25000 · Clearing -841.88 960.00 -1,801.88 -187.7% ----- Total Other Current Liabilities 53,763.50 14,789.09 38,974.41 263.5% Total Current Liabilities 56,758.16 15,114.09 41,644.07 275.5% Total Liabilities 56,758.16 15,114.09 41,644.07 275.5% Equity 32000 · Unrestricted Net Assets 34,614.30 23,664.02 10,950.28 46.3% Net Income 0.00 10,950.28 -10,950.28 -100.0% Total Equity 34,614.30 34,614.30 0.00 0.0% TOTAL LIABILITIES & EQUITY 91,372.46 49,728.39 41,644.07 83.7% ( ¢ Page 2 Item 9.a. - Page 45 2:43PM 5 Cities Homeless Coalition, Inc. 02/04/14 Profit & Loss Budget Performance Accrual Basis December 2013 ,- Dec 13 Budget $Over B ... Jan· Dec ... YTD Bud •.. $Over B ... Annual B ... Ordinary lncomeiExpense Income 41000 ·Grants Income 41020 · SLOCCF Organizational Capacity 0.00 4,165.00 -4,165.00 48,000.00 49,980.00 ·1,980.00 49,980.00 41015 · SLOCCF Site Selection Grant 0.00 250.00 8,969.13 -8,719.13 8.969.13 41026.1 ·Trilogy Housing Grant 580.00 580.00 41026.2 ·Trilogy Immediate Needs Grant 500.00 500.00 41026.9 ·Trilogy Admin OH Grant 342.12 342..12 41027 ·Dun in Opportunity Grant 487.55 487.55 41055 ·United Way Dental Grant 201.30 1,196.73 41056 · SLO County Dental Grant 0.00 3,296.73 41025 · Program Grants 0.00 10,000.00 -10.000.00 0.00 58,000.00 -58,000.00 58,000.00 41030 · Pismo Coast Realtors 0.00 5,408.98 41035 ·Service Clubs 0.00 1,000.00 -1,000.00 0.00 4,000.00 -4,000.00 4,000.00 41045 ·Chase Community Giving 0.00 300.00 -300.00 0.00 300.00 -300.00 300.00 Total 41000 · Grants Income 2,110.97 15,465.00 -13,354.03 60,062..11 121,249.13 -81,187.02 121,249.13 42000 ·Contributions 42005 · Individuals 7,700.00 5,000.00 2..700.00 18,700.42 16,200.00 2.500.42 16,200.00 42010 · Businesses 1,160.00 2,189.75 42015 · Faith & Non-Profit Groups 1,165.00 750.00 415.00 3,474.00 9,000.00 -5,526.00 9,000.00 42020 · Memorial Gifts 0.00 50.00 -50.00 0.00 600.00 -800.00 600.00 Total 42000 · Contributions 10,025.00 5,800.00 4,225.00 24,364.17 25,800.00 -1,435.83 25,800.00 43000 · Fundraising Events 42026 · Concert in the Park 0.00 435.00 43020 · Valentine Fundraiser Concert 0.00 8,380.78 9,000.00 -619.22 9,000.00 43027 · Empty Bowls Empty Bowls • Tickets 0.00 15.253.76 Empty Bowls ·Raffle 0.00 3,396.00 Empty Bowls· Contributions 0.00 614.00 Empty Bowls ·Sponsors 3,000.00 18,050.00 43027 · Empty Bowls • Other 0.00 0.00 26,000.00 -26,000.00 26,000.00 Total 43027 · Empty Bowls 3,000.00 37,313.76 26,000.00 11,313.76 26,000.00 43029 · Trilogy Event ( Trilogy Service Club 0.00 0.00 10,000.00 -10,000.00 10,000.00 Total43029 · Trilogy Event 0.00 0.00 10,000.00 -10,000.00 10,000.00 43030 · Salon 132 0.00 0.00 1,000.00 -1,000.00 1.000.00 Total 43000 · Fundraising Events 3,000.00 46,129.54 46,000.00 129.54 46,000.00 44000 · Special Collections 44005 · Good Friday 0.00 0.00 1,000.00 -1,000.00 1,000.00 Total 44000 · Special Collections 0.00 0.00 1,000.00 -1,000.00 1,000.00 45000 · In-Kind Contributions 45030 · Office Space 800.00 800.00 0.00 9,600.00 9,600.00 0.00 9,600.00 45000 · In-Kind Contributions ·Other 0.00 180.00 Total45000 · In-Kind Contributions 800.00 800.00 0.00 9,780.00 9,600.00. 180.00 9,600.00 Total Income 15,935.97 22,065.00 -6,129.03 140,335.82 203,649.13 -63,313.31 203,649.13 Gross Profrt 15.935.97 22.065.00 -6.129.03 140.335.82 203.649.13 -63,313.31 203,649.13 Expense 51000 · Capacity Building Program 51002 · SLOCCF Grants Expenses Site Selection Expenses 0.00 250.00 8,969.13 -8,719.13 8,969.13 Total51002 · SLOCCF Grants Expenses 0.00 250.00 8,969.13 -8,719.13 8,969.13 Total 51000 ·Capacity Building Program 0.00 250.00 8,969.13 -8,719.13 8,969.13 52000 · Fundraising & Development Exp 52004 · Fundraising Supplies (Grant) 0.00 0.00 4,000.00 -4,000.00 4,000.00 52005 · Fundraising Expense (Non-Grant) 0.00 3,274.52 52006 · Printing & Copying 0.00 534.55 52010 · Hospitality 0.00 100.00 -100.00 0.00 1,200.00 -1,200.00 1,200.00 Total 52000 · Fundraising & Development Exp 0.00 100.00 -100.00 3,809.07 5,200.00 -1,390.93 5,200.00 Page 1 Item 9.a. - Page 46 2:43PM 5 Cities Homeless Coalition, Inc. 02104114 Profit & Loss Budget Performance --Accrual Basis December 2013 ( Dec 13 Budget $OverS ... Jan· Dec--YTD Bud ... $Over B ... Annual B ... 55000 · Program Expense 55012 -Dentral Clinic Expense 2,100.00 3,300.00 55005 · Immediate Needs Fund 279.95 1,000.00 -720.05 5,192.16 10,000.00 -4,807.84 10,000.00 55002 · Warming Shelter 0.00 6,800.00 -<l,800.00 472.50 20,400.00 -19,927.50 20,400.00 55010 -Program Supplies 58.80 450.60 55009 · Laundry Vouchers 0.00 500.00 -500.00 0.00 5,000.00 -5,000.00 5,000.00 55007 · Clothing Vouchers 417.00 100.00 317.00 1,788.25 1,100.00 688.25 1,100.00 55025 · Recruitment & Outreach 0.00 0.00 Total 55000 · Program Expense 2,855.75 8,400.00 -5,544.25 11,203.51 36,500.00 -25,296.49 36,500.00 53000 · Marketing & Promotion 53020 · Promotion 0.00 0.00 1,400.00 -1,400.00 1,400.00 53008 · Advertising Agency Expense 0.00 1,248.00 53010 ·Website Expense 0.00 396.00 600.00 -204.00 600.00 53012 · Other Marketing & Promo 0.00 0.00 307.51 -307.51 307.51 Total 53000 · Marketing & Promotion 0.00 1,644.00 2,307.51 -663.51 2,307.51 54000 · Administrative Overhead 54036 · Offiice Furniture (Non.Qeprecia 0.00 300.00 54002 · Bank Service Charge 1.25 14.45 54004 -Board Expense 0.00 200.00 -200.00 759.49 900.00 -140.51 900.00 54006 · Dues & Subscriptions 0.00 400.00 225.00 175.00 225.00 54008 · Finance Charge 0.00 3.18 54010 ·Insurance 54011 · Directors & Officers 40.00 80.00 -40.00 480.00 960.00 -480.00 960.00 54012 · Liability Insurance 53.33 125.00 -71.67 648.80 1,455.00 -606.20 1.455.00 Total 54010 · Insurance 93.33 205.00 -111.67 1,128.80 2,415.00 -1,286.20 2,415.00 54023 · Licenses & Taxes 0.00 70.00 100.00 -30.00 100.00 54024 · Mileage 0.00 100.00 -100.00 20.00 1,200.00 -1,180.00 1,200.00 54025 · Merchant Fees 34.25 211.54 54035 · Office Supplies 0.00 100.00 -100.00 1,410.72 1,200.00 210.72 1,200.00 54037 ·Food 0.00 25.00 -25.00 0.00 300.00 -300.00 300.00 54040 · Payroll Service Fees 9.00 10.00 -1.00 76.10 120.00 -43.90 120.00 54045 · Postage & Delivery 138.00 10.00 128.00 825.94 960.00 -134.06 960.00 -· 54048 · Repairs & Maintenance 0.00 33.19 ( 54049 · Staff Development 0.00 100.00 -100.00 0.00 400.00 -400.00 400.00 ' 54050 · Telephone 206.54 150.00 56.54 2,815.08 1,760.00 1,055.08 1,760.00 Total 54000 · Administrative Overhead 482.37 900.00 -417.63 8,068.49 9,580.00 -1,511.51 9,580.00 56000 · Equipment 56005 · Software 0.00 100.00 -100.00 264.99 1,400.00 -1,135.01 1,400.00 56010 · Computers 0.00 0.00 3,000.00 -3,000.00 3,000.00 Total 56000 · Equipment 0.00 100.00 -.100.00 264.99 4,400.00 -4,135.01 4,400.00 57000 · Professional Services 57005 · Accounting 325.00 375.00 -50.00 4,250.00 5,400.00 -1,150.00 5,400.00 57015 ·IT 0.00 50.00 -50.00 0.00 300.00 -300.00 300.00 Total 57000 · Professional Services 325.00 425.00 -100.00 4,250.00 5,700.00 -1,450.00 5,700.00 58000 · Occupancy Expense 58005 ·Rent 800.00 800.00 0.00 9,600.00 9,600.00 0.00 9,600.00 58010 · Gas & Electric 46.98 150.00 -103.02 880.60 1,800.00 -919.40 1,800.00 58015 · Janitorial 0.00 50.00 -50.00 0.00 600.00 -600.00 600.00 Total 58000 · Occupancy Expense 846.98 1,000.00 -153.02 10,480.60 12,000.00 -1,519.40 12,000.00 66000 · Payroll Expenses 66005 · Wages & Salaries 5,142.04 8,500.00 -3,357.96 87,892.80 101,100.00 -13,207.20 101,100.00 66060 · Fed • Social Security Expense 318.60 552.50 -233.70 5,449.35 6,571.50 -1,122.15 6,571.50 66070 · Fed • Medicare Expense 74.56 127.50 -52.94 1,274.44 1,516.50 -242.06 1,516.50 66010 · CA • ETT Expense 0.00 8.50 -6.50 14.00 101.10 -67.10 101.10 66020 · CA ·Unemployment Expense 0.00 297.50 -297.50 756.00 3,538.50 -2,782.50 3,538.50 66075 ·Workers' Comp Insurance Expense 0.00 1,226.21 66001 · Americorp Stipend 0.00 1,200.00 -1,200.00 3,776.40 6,000.00 -2,223.60 6,000.00 Total 66000 · Payroll Expenses 5,535.40 10,686.00 -5,150.60 100,389.20 118,827.60 -18,438.40 118,827.60 Total Expense 10,045.50 21,611.00 -11,565.50 140,359.86 203,484.24 -63,124.38 203,484.24 Net Ordinary Income 5,890.47 454.00 5,436.47 -24.04 164.89 -188.93 164.89 Page 2 Item 9.a. - Page 47 2:43PM 5 Cities Homeless Coalition, Inc. 02/04114 Profit & Loss Budget Performance Accrual Basis December 2013 \- Dec 13 Budget $Over B.-Jan-Dec .•. YTDBud .•. $Over B.-Annual B ... Other Income/Expense Other Income Interest Income 0.00 11.04 Dividend Income 0.00 13.00 Total Other Income 0.00 24.04 Net Other Income 0.00 24.04 Net Income 5,890.47 454.00 5,436.47 0.00 164.89 -164.89 164.89 ( Page3 Item 9.a. - Page 48 ( _ _.. -$ in 1 ,OOO's 25 ( Income and Expense by Month January through September 2014 Expense Summary January through September 2014 Gtill66000 ·Payroll Expenses [2]55000 · Program Expense 111!58000 · Occupancy Expense 054000 · Administrative Overhead [0J57000 ·Professional Services @liD52000 · Fundraising & Development Exp [2]56000 · Equipment 59.81% 24.39 6.22 4.82 2.70 1.80 0.17 0.10 [Z]53000 · Marketina & Promotion Total $123,264.66 By Account Item 9.a. - Page 49 5Cities Homeless Coalition Sources of Revenue ... ,::~,:~~ .~ .. ~;' Fiscal Year 2014 (Budgeted and Received by 9/30/2014) PERCENTAGE OF SOURCE BUDGETED BUDGET A. Grants $ 99,375 B. Contributions 36,697 C. Fundraising Events 57,500 Totals $ 193,572 A. Grants received from the following sources: Community Foundation San Luis Obispo County Trilogy Service Club United Way of San Luis Obispo County County of San Luis Obispo Dignity Health 51o/o 19o/o 30o/o 100% B. Contributions received from the following sources: Individuals Businesses Faith & Nonprofit Groups C. Fundraising Events include: Fin's Seafood Restaurant Dinner for a Cause Empty Bowls Harvesting Hope Festival RECEIVED BY 9/30/14 $ 59,552 12,071 36,545 $ 108,168 (- ( Item 9.a. - Page 50 (- ( INTERNAL REVENUE SERVICE P .. 0. BOX 2508 CINCINNATI, OH 45201 Date: 5CJTIES HOMELESS COALITION C/O PATRICIA DIEFENDERFER 592 S 13TH ST GROVER BEACH, CA 93433-3820 Dear Applicant: DEPARTMENT OF THE TREASURY Employer Identification Number: 27-0413593 DLN: 17053205320009 Contact Person: CHRIS BROWN Contact Telephone Number: (877) 829-5500 Accounting Period Ending: December 31 Public Charity Status: 170 (b) (1) (A) (vi) Form 990 Required: Yes Effective Date of Exemption: February 17, 2009 Contribution Deductibility: Yes Addendum Applies:. No ID# 31503 We are pleased to inform you that upon review of your application for tax exempt status we have determined that you are exempt from Federal income tax under section 50l(c) (3) of the Internal Revenue Code. Contributions to you are deductible under section 170 of the Code. You are also qualified to receive tax deductible bequests, devises, transfers or gifts under section 2055, 2106 or 2522 of the Code. Because this letter could help resolve any questions regarding your exempt status, you should keep it in your permanent records. Organizations exempt under section SOl(c) (3) of the Code are further classified as either public charities or private foundations. We determined that you are a public charity under the Code section(s) listed in the heading of this letter. Please .see enclosed Publication 4221-PC, Compliance Guide for 50l(c) (3) Public Charities, for some helpful information about your responsibilities as an exempt organization. Letter 947 (DO/CG) Item 9.a. - Page 51 -2- SC~TIES HOMELESS COALITION Enclosures: Publication 4221-PC Sincerely, Robert Choi Director, Exempt Organizations Rulings and Agreements Letter 947 (DO/CG) l- ( Item 9.a. - Page 52 / ( i \ ' 5cit.!es hom~less c·Jalition Steve Adams, Vice President: City Manager, City of Arroyo Grande Dena Beilman, Treasurer : Planning Specialist, California State Parks Tom Clough: Attorney, Intellectual Property Rick Gulino, Secretary: LCSW People's Self-Help Housing Supportive Housing Manager She!iy Higginbotham, President Mayor, City of Pismo Beach Jeff Lee Civil Engineer, Grover Beach City Councilman Laurie Morgan Director of S.A.F.E., So. County Family Resource Centers Chris Soto: Branch Manager, CoastHills Federal Credit Union larry Vernon: Police Officer, Retired Fred Wolf: Educator, Retired Item 9.a. - Page 53 ( '- \ .. 5Cities Homeless Coalition Organizational Chart 2014 .-. "· ,-.~::-•,:. !.:.;: I Board of Directors r--Staff: Executive Director Executive Executive Office Administrator Committee I I I I Fund Development Finance & Board Development & Marketing Administration & Nomination Committee Committee Committee I Program Committee Item 9.a. - Page 54 --, President Gary Hoving Vice-President Ways & ~leans Paul Provence Treasurer Nonnan A. Baxter Secretary Polly Nelson Curator of Collections Jan Scott Membership Ross Kongable Public Information Officer VivianKrug Docent Leader Linda Kime Property Management Joe Swigert Information Systems JeffKime Parliamentarian Eric Nelson South Countg :J-{istorica[ Societg · P.O. 'Bo;c633 Jlrrogo (jranae C9l. 93421-0633 805.489.8282 "Serving the Public Trust by Preserving Local Hist01y" November 21, 2014 City of Arroyo Grande Gentlemen: The South County Historical Society is pleased to submit its grant request under the new Community Service Grant Program of the City of Arroyo Grande. Please find included eleven copies of our submission, as requested. We look forward to working with the City of Arroyo Grande under its new program. Norman A. Baxter Treasurer A non-profit 50l(c)3 Orgn-Federal Tax ID number is 95-3539454 For more information on the South County Historical Society. visit o.ur website at: www.southcountyhistory.org email: info@southcountyhistory.org Item 9.a. - Page 55 -, CITY OF ARROYO GRANDE COMMUNITY SERVICE GRANT PROGRAM APPLICATION FORM 2014-15 Please complete the following sections (use additional sheets as necessary): I. NAME AND ADDRESS OF NON-PROFIT ORGANIZATION: (rnust be the local branch) SOUTH COUNTY HISTORICAL SOCIETY P.O. BOX 633 ARROYO GRANDE, CA 93421 II. GRANT APPLICANT REPRESENTATIVE'S NAME, ADDRESS AND TELEPHONE NUMBER: (must be the Executive Director or their designated representative) NORMAN BAXTER, TREASURER 139 LE POINT ST. ARROYO GRANDE, CA 93420 4 73-4606 Ill. DESCRIPTION OF COMMUNITY SERVICES PROVIDED: THE SOUTH COUNTY HISTORICAL SOCIETY (SCHS) IS AN ACTIVE PARTICIPANT IN THE LIFE OF THE CITY OF ARROYO GRANDE. SCHS SUPPORTS THE PRESERVATION OF THE HISTORY AND CULTURE OF THE CITY BY ivlAINTAINING BOTH CITY-OWNED AND SCHS-OWNED ivlUSEUivl BUILDINGS AND GROUNDS, AND BY PUBLISHING Ai'!D/OR SELLING BOOKS DEDICATED TO THE HISTORY AND CULTURE OF THE CITY AND SOUTH COUNTY. SCHS SUPPORTS THE SUMMER CONCERTS AT HERITAGE PARI< BY PROVIDING CONCESSIONS. SCHS MAINTAINS A DATABASE OF ARTIFACTS, ARCHIVES AND PHOTOGP-APHS THEREBY PRESERVING THE HISTORY AND CULTURE OF THE CITY AND SOUTH COUNTY. SCHS ALSO HOSTS NEARLY 3,000 LOCAL SCHOOL CHILDREN ANNUALLY ON SPECIAL EDUCATIONAL MUSEUM TOURS. SCHS PRESENTS FREE HISTORICAL SUMMER THEATER PROGRAMS HIGHLIGHTING THE HISTORY AND CULTURE OF THE CITY AND SOUTH COUNTY. SCHS PARTICIPATES IN LOCAL PARADES EXHIBITING ITS ANTIQUE VEHICLES. SCHS ATTRACTS VISITORS TO THE CITY AS THE SPONSOR OF THE ANNUAL ANTIQUE SHOW AND ANNUAL YARD/RUMMAGE SALE, AND BY HOSTING IJVEDDING EVENTS ON THE GROUNDS OF THE HERITAGE HOUSE MUSEUM. IV. LIST AREA{S) SERVED BY NON-PROFIT ORGANIZATION: (include brief description of the relationship of your non-profit organization to the residents of the City of Arroyo Grande) SCHS HELPS TO EDUCATE ALL AGES, INCLUDING SCHOOL CHILDREN, ABOUT THE HISTORY AND CULTURE OF THE CITY AND SOUTH COUNTY. MANY RESIDENTS OF THE CITY OF ARROYO GRANDE ARE MEMBERS OF SCHS. SCHS PLAYS AN IMPORTANT AND VISIBLE ROLE IN THE LIFE OF THE CITY AS IT STRIVES TO PRESERVE THE HISTORY AND CULTURE OF THE CITY THROUGH THE ACTIVITIES LISTED ABOVE IN PART Ill. MOREOVER, SCHS CONTRIBUTES TO THE BEAUTY OF THE CITY THROUGH ITS MAINTENANCE OF THE MUSEUMS AND MUSEUfVl GARDENS ON SOUTH MASON STREET, SHORT STREET AND ON CROWN HILL. SCHS HAS 475 MEMBERS. __ I Item 9.a. - Page 56 v. NUMBER OF CITY OF ARROYO GRANDE RESIDENTS SERVED BY NON-PROFIT ORGANIZATION: (broken down by age groups if available) CITIZENS OF ALL AGES OF THE CITY OF ARROYO GRANDE BENEFIT FROtv1 THE ACTIVITIES OF SCHS. FROM THE NEARLY 3,000 SCHOOL CHILDREN WHO VISIT THE MUSEUMS ON SPECIAL TOURS TO THE 100+ SENIOR CITIZENS WHO VOLUNTEER THEIR TIME ON THE BOARD OF DIRECTORS, AS DOCENTS AND AT THE VARIOUS SCI-IS-SPONSORED EVENTS, SCHS REACHES ALL AGE GROUPS. VI. AMOUNT OF FUNDS REQUESTED: $2,000 VII. PROPOSED USE AND BUDGET PLAN FOR GRANT FUNDS: (indicate if any of the grant funds will be used for any other purpose than those designated such as overhead, national office, administrative salaries) SCHS INTENDS TO USE THE GRANT FUNDS FOR THE UPGRADE AND MAINTENANCE OF THE MUSEUM GARDENS ON SOUTH MASON STREET AND SHORT STREET TO BEAUTIFY THE CITY FURTHER. SCHS HAS RECENTLY RECRUITED A VOLUNTEER WITH PROFESSIONAL CREDENTIALS TO OVERSEE THE PLANNING AND EXECUTION OF THE MUSEUM GARDEi'l UPGRADES. VIII. ADDITIONAL DOCUMENTATION: (if you have received funds in the past, please indicate the amount of funds received (indicate vvhat year) and how the funds were utilized) N/A IX. SUPPLEMENTAL DOCUMENTATION: §!! Past two year's financial statements, inclu9ing the current year with the balance sheets and the profit/loss statements. ~ Information indicating the percentage of revenue received that is used for administration, salaries, and program costs. l:ii Breakdown and description of non-profit organization's sources of revenue. l§jj Proof of 501 (c)(3) status 1Nith a copy of the letter from the IRS. ~ Copy of the non-profit organizations Board of Directors, Officers and an organization chart. Item 9.a. - Page 57 - I X. CERTIFICATION: certify on behalf of (;(:·.__.., 'h/ 'i 1 ov 'c·~f ~~e__/t?fv non-profit organization, that I have read, understand and agree that the aforesaid information is accurate, factual and current. I understand that an award of funds, if granted, will be for the sole use as reflected in this application form. I further certify that as a condition of receiving funds, an agreement with the City of Arroyo Grande, in a form and content provided by the City of Arroyo Grande, \Viii be signed and executed by a duly authorized representative of said 1ion-profit organization. I am aware of and certify that our non-profit organization will adhere to all City regulations regarding the 2014-15 Community Service Fund Program including, but not limited to, maintaining non- discriminatOiy policies, practices and intent. I also, on behalf of our non-profit organization, indemnify, defend, and hold harmless the City of Arroyo Grande relative to any and all liability that may arise as a result of the use of the City of Arroyo Grande Community Service Grant Fund monies. Date: Signature: ! J Executive Director or Designee . <:._/ ,_....- / _/'\Jl_,d---f.-·C•.;1)0 ·1 __ Board of Director or Officer Item 9.a. - Page 58 SOUTH COUNTY HISTORICAL SOCIETY SOURCES OF REVENUE The Society's primary, consistent sources of revenue are: 1. Annual membership dues 2. Book sales 3. Antique show: vendor fees, admission fees, cafe sales 4. Annual yard/rummage sale 5. Heritage Park summer concert concessions 6. Wedding events hosted on Heritage House Museum grounds Signed: Date: \ I If ')_ I l \ C--' . i ; 'i 1'1 j Item 9.a. - Page 59 SOUTH COUNTY HISTORICAL SOCIETY ADMINISTRATIVE COSTS The Society has one part-time employee and pays for ongoing professional services, such as a bookkeeper and garden maintenance. Other than that, there are no personnel costs. The Society relies primarily on volunteers to serve on the Board of Directors and support the various Society activities and events. Administrative costs as a percentage of annual revenue from the Society's primary revenue sources are roughly 14%. Part-time employee expense as a percentage of annual revenue from the Society's primarJ revenue sources is roughly 10%. Signed: Date: (~ \-....__/ __ .. c\ 1 n I -! ___...---//] .. , , :/ I . / v / ( ·" :,-IY):J ·'. /fl A t)'"::, _ 1_&_· L.,.:::..i_.i i_·· 1'-/'--./-_; ..... _·!-;._-=--.· _· '_"-_c. __ ·~-· _lc::'_'t-f··~'-· ·-=' ~-->----;-----'~·!l'"""~'--· _ .. ~(.-LVI.~·-,_ ( \ -/ Item 9.a. - Page 60 -, Di.strict Director Oat~: J Ufi. 2 1 ~ ~ South County Historical Society P.O. Box 633 Arroyo Grande, CA 93420 1: D. No. ue!-Jdr trrlenr or tne 1 reasury Pe~on to Contact: T. Ciolek Contact Telephone Number: (213) 688-4152 Based on the information you recently submitted, we have classified your organization as one that is not a private foundation within the meaning of section 509 (a) of the Internal Revenue Code because you are at> organization described in section 509(a)(2). Your exempt status under section 50l(c) (3) of the Code is still in effect. This classification is based on the assumption that your operations will continue as you have stated~ If your sources of support, or your purposes, th~racter, ~r method of operation change, please let us know so we can consider the effect of the ch&1ge on your exempt status a.TJ.d fou..r1dation status. This supersedes our letter dated March 3, 1981. Because this letter could help resolve any questions about your foundation status, you should keep it in your permanent records. It you have any questions I please contact the person 'o'JhOSB name and telephone numbsr are shown above. Sincerely yours, District Director P.O. Box 2350, Lo~ AngelO$, CA 90053 Letter 1078(00) (Rev. 8-82) Item 9.a. - Page 61 2014 ORGAl'UZATIONAL STRUCTURE Directors and Committees · (Standing committees) President Gary Hoving Audit Committee: Antique Show & Sale Nominating Committee Collections Committee Mike Drees (chair), Larry Turner, Eric Nelson, Mike Drees, Larry Turner, Ross Kongable Jan Scott, Nanna Bmion, Edie Juck, Susan Edington, Joe Swigert, Doug & Barbara LeSage, Barbara Main (select committees) Ways & Means-VP Programs Paul Provence Janet Baxter Jan Scott Books & Publishing Annual Rummage Sale Events Coordinator Summer Concelis Diane Maiorano, Diane Krajsa Rich & Kersti Lasiewski Membership Heritage Press Newsletter Secretary Treasurer Corresponding Secretary Historian & Sunshine Public Information Community Relations Webmaster Curator of Collections Librarian Santa Manuela Schoolhouse Ross Kongable Ross Kongable Polly Nelson Bemeda CochTan Bemeda Cochran Nor man Baxter Vivian Krug Vivian Krug Vivian Krug Jan Scott Joe Swigert LindaKime Paulding History House Curator Joe Swigert Property Management Joe Swigert Vehicles Chet & Jackie Thomas Gardening-Ruby's House Gardening-Heritage House Gardening-Santa Manuela Schoolhouse Gardening Paulding History House Docent Leader Linda Kime Heritage House Paulding House Santa Manuela School Student Tours Information Systems Computer Systems and Software Parliamentarian Linda Kime Linda Kirne Linda Kime Norma Harloe JeffKirne JeffKirne Eric Nelson Society Email: info@southcountyhistory.org Website-www.SouthCountyHistory.Org Heritage House 481-4126 The Barn 489-8745 Paulding History House 473-3231 IOOF Hall 489-8114 Santa Manuela School 489-8745 Ruby's House 489-8282 Item 9.a. - Page 62 '• ' ' I ' --! Cash Basis South County Historical Society Balance Sheet As of September 30, 2014 ASSETS Current Assets Checking/Savings 110.00 · Heritage Oaks (Generali 7866 111.08 ·Coast Hills 211923-00-Mankins 112.00 · Coast Hills 211923-01 -HH 113.00 ·Heritage Oaks MM 8766_Mankins 120.00 · Certificates of Deposit 123.08 ·Heritage Oaks MM 4478304 123.11 ·Coast National Bank MM 3560 123.12 · Coast National Cert-2011625 Total 120.00 · Certificates of Deposit 127.00 ·ENDOWMENT 126.01 ·HOB CD 7301171-ENDOWMENT 126.04 · Mankins Capital (11923-20) CH Total127.00 ·ENDOWMENT 106.00 · Pay pal Checking Total Checking/Savings Total Current Assets Fixed Assets 180.00 · Properties & Facilities 184.00 · Facilities -PAULDING HOUSE 187.00 · Facilities -THE BARN Total180.00 · Properties & Facilities 181.0 · Capital Improvements 181.1 · Paulding House (2005-201 0) 181.10 · PHH Materials 181.11 · PHH Contract Labor 181.12 · PHH Subcontractors 181.13 · PHH Historical Designation 181.14 · PHH Equipment Rental 181.15 · PHH Professional Services 181.1 · Paulding House (2005-201 0)-Other Total181.1 ·Paulding House (2005-2010) 181.2 · Meat Locker 181.3 · IOOF Hall 181.4 · Ruby's House (2005-2007) 181.41 ·Harris Labor 181.42 · Harris Materials 181.43 · Volunteer Supplies/Labor 181.44 ·Professional Fees 181.45 · Outside Labor Services 181.4 · Ruby's House (2005-2007)-Other Total 181.4 · Ruby's House (2005-2007) 181.5 · School House 181.6 · Heritage House 181.7 ·Library 181.8 ·Carriage House Total 181.0 · Capital Improvements Total Fixed Assets Other Assets 160.00 ·Artifacts & Displays 160.01 · Tractor, Farmall, 1937 160.00 ·Artifacts & Displays-Other Total160.00 ·Artifacts & Displays 170.00 · Equipment Sep 30, 14 27,742.54 566.83 7,329.80 67,254.68 174,798.54 50,618.29 77,134.20 302,551.03 160,693.88 35,346.82 196,040.70 144.64 601,630.22 601,630.22 13,940.00 67,043.89 3,878.88 4,779.50 124,580.23 3,521.16 945.84 9,310.12 32,012.25 80,983.89 179,027.98 1,394.25 53,166.63 127,544.48 37,107.86 6,973.51 891.00 38,630.22 1,430.00 212,577.07 9,000.77 23,655.00 3,354.00 19,298.78 501,474.48 582,458.37 1,791.23 429.00 2,220.23 Page 1 Item 9.a. - Page 63 Cash Basis South County Historical Society Balance Sheet As of September 30, 2014 171.00 · Computer Equipment 172.00 · Public Address System 173.00 ·Museum Furnishings 174.00 · Recording Equipment 175.00 · Office Equipment 176.00 · Office Furniture 178.00 ·Outside Equipment Total 170.00 · Equipment Total Other Assets TOTAL ASSETS LIABILITIES & EQUITY Liabilities Current Liabilities Other Current Liabilities 2100 · Payroll Liabilities 2101 · Federal W/H 2102 ·FICA Company 2103 ·FICA Employee 2104 · MCare Company 2105 · MCare Employee 2106 · FUTA 2108 · SDI 2109·SUI 2110 · ETT Total 2100 · Payroll Liabilities 220.00 · Sales Tax Payable Total Other Current Liabilities Total Current Liabilities Total Liabilities Equity 390.00 · Retained Earnings Net Income Total Equity TOTAL LIABILITIES & EQUITY Sep 30, 14 12,914.74 2,799.34 402.99 965.24 8,753.26 13,010.24 1,671.49 40,517.30 42,737.53 1,226,826.12 126.00 111.60 111.60 26.10 26.10 42.00 18.00 84.60 1.80 547.80 6.90 554.70 554.70 554.70 1 '1 94,066.88 32,204.54 1 ,226,271.42 1,226,826.12 --, Page 2 _I Item 9.a. - Page 64 __ ., ; r.ash Basis \ South County Historical Society Profit & Loss January through September 2014 Ordinary Income/Expense Income 301.00 · MEMBERSHIP DUES-Current Year 301.00d · Prepaid 2015 301.00e · Prepaid 2016 305.00 · INCOME-SALES 305.01 · Book Sales -Taxable 305.003 · Dunites Book 305.005 · AG Books 305.006 · Face of the Clam 305.01 · Book Sales -Taxable -Other Total 305.01 · Book Sales-Taxable 305.02 · Book Sales -Non -Taxable 305:02a · Postage & Handling 305.021 · Dunites Book 305.023 · AG Books 305.026 · Face of the Clam 305.02 · Book Sales -Non -Taxable -Other Total 30S.02 · Book Sales-Non-Taxable 305.07 · AG Postcards 305.08 · Royalties 305.10 · Script Sales 305.101 · Script Sales_ Taxable Total 305.10 · Script Sales Total 305.00 · INCOME-SALES 310.00 ·DONATIONS/GIFTS-General 310.07 · Donations-Membership Book 310.11 · Donations -Memorial 310.20 · Donations -Properties 310.02 · Donations-Heritage House 310.03 · Donations -Paulding House 310.04 · Donations-School House 310.05 · Donations-Barn Total 310.20 · Donations-Properties 310.30 · Donations -Reference Library 310.36 · History Cards Vivian Krug 31,0.50 · Library Development Fund 310.60 · Bonnet Sales 310.00 ·DONATIONS/GIFTS-General-Other Total 310.00 ·DONATIONS/GIFTS-General 320.00 · EVENTS 321.00 · Antique Show 321.01 · Antique Show -Drawing Tickets 321.02 · Antique Show-Admissions 321.03 ·Antique Show-Dealers 321.04 ·Antique Show-Tea Room/Food 321.05 · Basket ·sales 321.07 ·Antique Show-Pie Sales 321.00 · Antique Show-Other Total 321.00 · Antique Show 324.00 · Rental Event Income 329.00 · Special Events 329.06 · Concession Sales (Summer) Total 329.00 · Special Events 365.00 · Reader's Theatre Project Income Total 320.00 · EVENTS 330.00 · Rent Income Jan-Sep 14 20.00 47.51 78:50 513.17 5,925.00 35.00 35.00 659.18 18.15 743.40 595.56 25.00 788.69 2,170.80 15.00 66.60 41.50 41.50 2,953.08 96.00 535.00 138.00 20.00 330.00 850.00 1,338.00 4.00 20.00 500.00 20.00 4,859.00 1,233.00 63.00 3,195.00 940.37 190.00 5.00 8,136.95 7,372.00 13,763.32 30,355.00 8,240.00 8,240.00 4,389.26 56,747.58 450.00 Page 1 Item 9.a. - Page 65 Cash Basis South County Historical Society Profit & Loss January through September 2014 360.00 · Special Projects Income 310.104 · La France Fire Truck 346.00 · Pacific Railroad Kiosk 360.00 · Special Projects Income -Other Total 360.00 · Special Projects Income 375.00 · Bequests . Total Income Expense 500.00 · EXPENSES 501.00 ·EXPENSES-ADMINISTRATION 501.02 · General Supplies 501.021 · Ricoh Supplies & Maintenance 501.03 · Postage I Freight 501.033 · Newsletter 501.037 · General Postage Total 501.03 · Postage I Freight 501.09 · Awards & Recognition Expense 501.10 · Bank Services 501.102 · Bank Service Charges 501.103 · Credit Card Processing Fees Total 501.10 ·Bank Services 501.11 ·Dues & Subscriptions 501.12 · Telephone (admin) 501.13 · PO Box Rental 501.17 · Information Systems 501.18 · Software Expense 501.20 · Rent-Meat Locker Total 501.00 ·EXPENSES-ADMINISTRATION 502.00 · PERMITS & FEES 507.00 ·PROFESSIONAL SERVICES 507.01 · Bookkeeping Services Total 507.00 · PROFESSIONAL SERVICES 508.00 · INSURANCE EXPENSE 510.00 ·BOOK EXPENSE 510.02 · Book Printing I Reprinting 510.04 · Supplies, Expendable Total 510.00 ·BOOK EXPENSE 511.00 ·DOCENT EXPENSE 515.00 ·CURATOR EXPENSE 515.004 · IOOF Hall 515.04 · Artifact Preservation Expense 515.06 · Curator Office Supplies 515.07 · Storage Supplies Total 515.00 ·CURATOR EXPENSE 515.002 · Exhibit Supplies 515.021 ·EXHIBIT EXPENSES 516.00 ·GENERAL PUBLICITY EXPENSE 516.01 · Advertising 516.06 · Brochures Total 516.00 ·GENERAL PUBLICITY EXPENSE 516.05 ·EVENTS ADVERTISING 516.058 · Harvest Festival Banner Total 516.05 · EVENTS ADVERTISING 520.00 · FACILITY & PROPERTY EXPENSE 521.00 · IOOF HALL 521.01 · Utilities -IOOF Hall Jan-Sep 14 70.00 1,200.00 225.00 611.09 1,758.65 489.43 53.41 542.84 261.34 8.00 4.98 12.98 385.00 415.17 80.00 388.76 1,216.00 4,050.00 1,495.00 1,000.00 76,012.66 9,721.83 231.00 1,975.00 1,975.00 6,110.60 4,906.51 134.00 5,040.51 60.80 8.06 85.00 144.21 131.43 36!3.70 84.75 13.01 444.30 15.11 459.41 100.00 100.00 ) --, Page 2 Item 9.a. - Page 66 Cash Basis South County Historical Society Profit & Loss January through September 2014 521.011 · Utility -PG&E -IOOF 521.012 · Utilities-The Gas Co-IOOF 521.013 · Utilities -City of AG -IOOF 521.014 · Utilities-Trash -IOOF Total 521.01 · Utilities-IOOF Hall 521.015 · Utilities -Cable-IOOF 521.03 ·Security-IOOF Hall 521.04 · Repairs & Maint -IOOF 521.07 · Supplies Expense-IOOF Hall Total 521.00 · IOOF HALL 522.00 · HERITAGE HOUSE EXPENSE 522.01 · Utilities Expense -H H 522.011 · Utilities -PG&E -HH 522.012 · Utilities -The Gas Co-HH 522.013 · Utilities -City of AG -HH Total 522.01 · Utilities Expense-H H 522.02 · Telephon Exp 4126-H H 522.03 · Security Expense -H H 522.04 · Repair & Maint -HH 522.06 · Grounds Expense -H H 522.07 · Supplies Expense -H H Total 522.00 ·HERITAGE HOUSE EXPENSE 523.00 · PAULDING HOUSE EXPENSE 523.01 · Utilities Expense-P H 523.011 · Utilities -PG&E -PH 523.012 · Utilities -The Gas Co -PH 523.013 · Utilities -City of AG -PH Total 523.01 · Utilities Expense-P H 523.02 ·Telephone Exp 3231-PH 523.03 · Security Expense-P H 523.04 · Repair & Maint-PH 523.06 · Grounds Expense-P H 523.07 ·Supplies Expense-P H Total 523.00 · PAULDING HOUSE EXPENSE 524.00 · SCHOOL HOUSE EXPENSE 524.02 · Telephone Exp 8745-S H 524.03 · Security Expense -S H 524.04 · Repair & Maint-SH 524.06 · Grounds Expense -S H 524.07 · Supplies Expense-S H Total 524.00 ·SCHOOL HOUSE EXPENSE 525.00 · RUBY'S HOUSE EXPENSE 525.01 · Utilities Expense -R H 525.011 · Utilities -PG&E -RH 525.012 · Utilities -The Gas Co -RH 525.013 · Utilities -City of AG -RH 525.014 · Trash/Yard-RH Total 525.01 · Utilities Expense-R H 525.02 · Telephone Expense -R .H 525.03 · Security Expense-R H 525.04 · Repair & Maint-RH 525.06 · Grounds Expense -R H 525.07 ·Supplies Expense-RH Total 525.00 ·RUBY'S HOUSE EXPENSE 526.00 · BARN EXPENSE 526.01 · Utilities Expense-Barn 526.011 · Utilities -PG&E -Barn Jan-Sep 14 526.00 243.04 279.80 214.87 1,263.71 647.12 270.00 499.58 361.82 294.36 295.10 33.00 2,713.41 951.28 299.92 270.00 199.00 1,093.41 40.12 424.49 516.18 351.90 2,853.73 1,292;57 280.59 270.00 556.73 51.35 15.11 2,466.35 293.31 117.00 1,834.88 248.30 17.45 328.67 78.98 351.90 768.46 2,510.94 1,528.01 560.74 270.00 888.61 257.80 176.15 3,681.31 438.20 Page 3 Item 9.a. - Page 67 Cash Basis South County Historical Society Profit & Loss January through September 2014 Total 526.01 · Utilities Expense-Barn 526.03 · Security Expense -Barn 526.07 · Supplies Expense-Barn Total 526.00 · BARN EXPENSE 527.00 ·MEAT LOCKER 527.03 · Repairs & Maint-ML Total 527.00 ·MEAT LOCKER Total 520.00 · FACILITY & PROPERTY EXPENSE 530.00 · EVENTS EXPENSE 531.00 ·Antique Show Expense 531.01 · Antique Show Exp-Drawing 531.04 ·Antique Show Exp -Tea Room/Food 531.05 ·Antique Show Exp-Rent Exp 531.06 ·Antique Show Exp-Security 531.07 ·Antique Show Exp-Printing 516.051 ·Antique Show Advertising 531.00 ·Antique Show Expense-Other Total 531.00 ·Antique Show Expense 534.00 · Rental Event Expenses 538.00 ·Special Events 538.07 · Summer Concerts Expense 538.00 · Special Events-Other Total 538.00 · Special Events 519.50 · Reader's Theatre Project Exp 530.00 · EVENTS EXPENSE-Other Total 530.00 · EVENTS EXPENSE Total 500.00 · EXPENSES 516.50 · General Event Expenses 519.00 · Special Projects 516.80 · Pacific Railroad Kiosk .519.00 · Special Projects-Other Total 519.00 ·Special Projects 6560 · Payroll Expenses 6570 · Gross Wages 6561 · Payroll Taxes 6563 ·FICA 6564 · MCare 6565 ·SUI 6566 · ETI Total 6561 · Payroll Taxes Total 6560 · Payroll Expenses Total Expense Net Ordinary Income Other Income/Expense Other Income 300.00 · Interest Income -General 306.00 · Coast National CD 306.04 · Coast CD 3560 306.05 · Coast Cert 2011625 Total 306.00 · Coast National CD 308.00 · Heritage Oaks CO/Investment 308.03 · Heritage Oaks 1171 Jan -Sep 14 438.20 117.00 9.84 565.04 29.00 29.00 14,819.78 200.21 1,024.97 0.00 504.00 489.71 1,294.70 . 1,308.47 4,822.06 6,385.77 2,954.04 47.99 3,002.03 520.86 29.13 14,759.85 53,745.24 131.66 311.78 200.00 511.78 5,400.00 334.80 78.30 253.80 5.40 672.30 56.77 32.74 693.88 6,072.30 60,460.98 15,551.68 89.51 ) I --, Page 4 Item 9.a. - Page 68 pash Basis South County Historical Society Profit & Loss January through September 2014 Total 308.00 · Heritage Oaks CO/Investment 309.00 · Heritage Oaks MMkt 304 311.07 · Coast Hills Cert 311.08 · Coast Hills HH Account 5130 311.09 · Heritage Oaks Bank 8766 Total 300.00 · Interest Income-General 340.00 · Endowment Donations Total Other Income Net Other Income Net Income Jan-Sep 14 693.88 362.60 401.78 5.96 99.13 1,652.86 15,000.00 16,652.86 16,652.86 32,204.54 Page 5 Item 9.a. - Page 69 Cash Basis \ -! South County Historical Society Balance Sheet As of December 31, 2013 ASSETS Current Assets Checking/Savings 110.00 · Heritage Oaks (General) 7866 111.08 · Coast Hills 211923-00 -Mankins 112.00 · Coast Hills 211923-01 -HH 113.00 ·Heritage Oaks MM 8766_Mankins 120.00 · Certificates of Deposit 123.08 · Heritage Oaks MM 4478304 123.11 · Coast National Bank MM 3560 123.12 · Coast National Cert-2011625 Total 120.00 · Certificates of Deposit 127.00 ·ENDOWMENT 126.01 ·HOB CD 7301171-ENDOWMENT 126.04 · Mankins Capital (11923-20) CH Total 127.00 · ENDOWMENT 106.00 · Paypal Checking Total Checking/Savings Total Current Assets Fixed Assets 180.00 · Properties & Facilities 184.00 · Facilities-PAULDING HOUSE 187.00 · Facilities -THE BARN Total 180.00 ·Properties & Facilities 181.0 ·Capital Improvements 181.1 · Paulding House (2005-201 0) 181.10 · PHH Materials 181.11 · PHH Contract Labor 181.12 · PHH Subcontractors 181.13 · PHH Historical Designation 181.14 · PHH Equipment Rental 181.15 · PHH Professional Services 181.1 · Paulding House (2005-201 0) -Other Total 181.1 ·Paulding House (2005-2010) 181.2 · Meat Locker 181.3 · IOOF Hall 181.4 · Ruby's House (2005-2007) 181.41 · Harris Labor 181.42 · Harris Materials 181.43 ·Volunteer Supplies/Labor 181.44 · Professional Fees 181.45 · Outside Labor Services 181.4 · Ruby's House (2005-2007)-Other Total 181.4 · Ruby's House (2005-2007) 181.5 · Schoof House 181.6 · Heritage House 181.7 · Library 181.8 ·Carriage House Total181.0 · Capital Improvements Total Fixed Assets Other Assets 160.00 ·Artifacts & Displays 160.01 ·Tractor, Farmafl, 1937 160.00 ·Artifacts & Displays -Other Total 160.00 ·Artifacts & Displays 170.00 · Equipment Dec 31, 13 11,930.71 511.44 10,724.27 66,155.55 174,435.94 50,561.52 77,101.46 302,098.92 160,000.00 20,000.00 180,000.00 l 144.64 571,565.53 571,565.53 13,940.00 67,043.89 3,878.88 4,779.50 124,580.23 3,521.16 945.84 9,310.12 32,012.25 80,983.89 179,027.98 1,394.25 53,166.63 127,544.48 37,107.86 6,973.51 891.00 38,630.22 1,430.00 212,577.07 9,000.77 23,655.00 3,354.00 19,298.78 501,474.48 582,458.37 1,791.23 429.00 2,220.23 Page 1 Item 9.a. - Page 70 Cash Basis South County Historical Society Balance Sheet As of December 31, 2013 171.00 · Computer Equipment 172.00 · Public Address System 173.00 · Museum Furnishings 174.00 · Recording Equipment 175.00 · Office Equipment 176.00 · Office Furniture 178.00 · Outside Equipment Total170.00 · Equipment Total Other Assets TOTAL ASSETS LIABILITIES & EQUITY Liabilities Current Liabilities Other Current Liabilities 21 DO · Payroll Liabilities 2101 ·Federal W/H 2102 ·FICA Company 2103 ·FICA Employee 2104 · MCare Company 2105 · MCare Employee 2106 · FUTA 2108 ·SOl 2109 ·SUI 2110 · ETT Total 21 DO · Payroll Liabilities 220.00 · Sales Tax Payable Total Other Current Liabilities Total Current Liabilities Total Liabilities Equity 390.00 · Retained Earnings Net Income Total Equity TOTAL LIABILITIES & EQUITY Dec31,13 10,938.39 2,799.34 402.99 965.24 8,753.26 13,010.24 1,671.49 38,540.95 40,761.18 1 '194, 785.08 126.00 111.60 111.60 26.10 26.10 42.00 18.00 83.20 1.60 546.20 172.00 718.20 718.20 718.20 1 '118,690.27 75,376.61 1,194,066.88 1 '194, 785.08 --, Page 2 Item 9.a. - Page 71 \ --, Cash Basis South County Historical Society Profit & Loss January through December 2013 Ordinary Income/Expense Income 301.00 · MEMBERSHIP DUES-Current Year 301.00c · Prepaid 2014 305.00 · INCOME-SALES 305.01 · Book Sales-Taxable 305.001 · Dana Books Sales -Taxable 305.003 · Dunites Book 305.005 · AG Books 305.006 · Face of the Clam 305.01 · Book Sales -Taxable -Other Total 305.01 · Book Sales -Taxable 305.02 · Book Sales -Non -Taxable 305.021 · Dunites Book 305.022 · Dana Book 305.023 · AG Books 305.02 · Book Sales -Non -Taxable-Other Total 305.02 · Book Sales -Non -Taxable 305.10 · Script Sales 305.101 · Script Sales_ Taxable 305.102 · Script Sales_NonTaxable Total 305.10 ·Script Sales Total 305.00 · INCOME-SALES 310.00 ·DONATIONS/GIFTS-General 310.07 · Donations -Membership Book 310.11 · Donations -fVIemorial 310.13 · Donations -Prof. Services 310.20 · Donations-Properties 310.01 · Donations -Museum {IOOF) 310.02 ·Donations-Heritage House 310.03 · Donations -Paulding House 310.04 · Donations -School House 310.05 · Donations-Barn Total 310.20 ·Donations-Properties 310.50 · Library Development Fund 310.60 · Bonnet Sales 310.00 ·DONATIONS/GIFTS-General-Other Total 310.00 ·DONATIONS/GIFTS-General 320.00 · EVENTS 321.00 ·Antique Show 321.01 ·Antique Show-Drawing Tickets 321.02 : Antique Show-Admissions 321.03 · Antique Show-Dealers 321.04 ·Antique Show-Tea Room/Food 321.05 · Basket Sales 321.07 · Antique Show-Pie Sales 321.00 ·Antique Show-Other Total 321.00 · Antique Show 322.00 · Charter Day BBQ Sales 323.00 · Yard Sales 324.00 · Rental Event Income 325.00 · Christmas Event Income 329.00 ·Special Events 329.10 · Evening with the Scotts 329.06 · Concession Sales {Summer) 329.09 · Radiance from Halcyon 329.00 · Special Events -Other Total 329.00 · Special Events Jan-Dec 13 84.12 90.70 582.20 217.35 1,150.30 8,045.00 1,900.00 2,124.67 640.80 616.80 437.03 1,360.98 3,055.61 31.00 80.00 111.00 5,291.28 62.00 3,755.00 75.00 31.00 183.00 275.00 600.00 993.00 2,082.00 3,053.00 100.00 3,518.64 935.00 5,341.00 4,830.00 2,502.00' 1,284.00 512.00 300.00 12,645.64 15,704.00 916.00 3,219.45 18,950.00 30.00 0.00 10,209.59 275.00 295.00 10,779.59 Page 1 Item 9.a. - Page 72 Cash Basis South County Historical Society P refit & Loss January through December 2013 365.00 · Reader's Theatre Project Income Total 320.00 · EVENTS 330.00 · Rent Income 360.00 · Special Projects Income 310.104 ·La France FireTruck 346.00 · Pacific Railroad Kiosk 347.00 · PHH Tree Recovery/Removal Total 360.00 · Special Projects Income Total Income Expense 500.00 · EXPENSES 501.00 ·EXPENSES-ADMINISTRATION 501.02 · General Supplies 501.021 · Ricoh Supplies & Maintenance 501.03 · Postage I Freight 501.033 · Newsletter 501.037 · General Postage Total 501.03 · Postage I Freight 501.05 · Printing I Copy Service 501.056 · Membership Total 501.05 · Printing I Copy Service 501.09 · Awards & Recognition Expense 501.10 · Bank Services 501.11 · Dues & Subscriptions 501.12 · Telephone (admin) 501.13 · PO Box Rental 501.14 ·Taxes 501.15 · Library Program Development 501.16 · Equipment Maintenance 501.17 · Information Systems 501.18 · Software Expense 501.20 · Rent-Meat Locker 501.21 · Document Maintenance Total 501.00 ·EXPENSES-ADMINISTRATION 502.00 · PERMITS & FEES 507.00 · PROFESSIONAL SERVICES 507.01 · Bookkeeping Services Total 507.00 · PROFESSIONAL SERVICES 508.00 ·INSURANCE EXPENSE 509.00 · MEETINGS EXPENSE 509.01 · Second Saturday Mtg Exp 510.00 · BOOK EXPENSE 510.01 · Book Purchases 510.02 · Book Printing I Reprinting 510.023 · Scripts_Printing 510.02 ·Book Printing I Reprinting-Other Total 510.02 · Book Printing I Reprinting Total 510.00 ·BOOK EXPENSE 511.00 · DOCENT EXPENSE 511.01 · Supplies Expense-Display 511.00 · DOCENT EXPENSE-Other Total 511.00 ·DOCENT EXPENSE 512.00 ·WAYS & MEANS 512.02 · Sunshine Supplies Total512.00 ·WAYS & MEANS Jan-Dec 13 3,339.00 52,938.04 650.00 248.00 2,360.21 725.00 692.43 2,666.42 556.05 404.99 961.04 216.03 216.03 104.49 16.00 840.50 529.44 78.00 10.00 6.75 437.79 56.99 29.97 5,400.00 3.16 3,333.21 84,803.17 12,049.01 387.00 2,420.00 2,420.00 3,985.25 152.75 2.78 324.15 50.98 932.38 983.36 1,307.51 4.23 268.49 272.72 81.00 81.00 j --, Page 2 Item 9.a. - Page 73 Cash Basis -, South County Historical Society Profit & Loss January through December 2013 515.00 ·CURATOR EXPENSE 515.005 ·Barn 515.03 · Curator Tools & Equipment 515.06 ·Curator Office Supplies 515.07 · Storage Supplies Total 515.00 ·CURATOR EXPENSE 515.002 · Exhibit Supplies 515.021 ·EXHIBIT EXPENSES 516.00 ·GENERAL PUBLICITY EXPENSE 516.01 · Advertising 516.06 · Brochures Total 516.00 ·GENERAL PUBLICITY EXPENSE 516.05 ·EVENTS ADVERTISING 516.054 ·Yard Sale 516.055 · Rental Event Advertising 516.058 · Harvest Festival Banner Total 516.05 ·EVENTS ADVERTISING 520.00 · FACILITY & PROPERTY EXPENSE 521.00 · IOOF HALL 521.01 · Utilities-IOOF Hall 521.011 · Utility -PG&E -IOOF 521.012 · Utilities -The Gas Co -IOOF 521.013 · Utilities -City of AG -IOOF 521.014 · Utilities-Trash-IOOF Total 521.01 · Utilities -IOOF Hall 521.015 · Utilities -Cable-IOOF 521.03 · Security-IOOF Hall 521.04 · Repairs & Maint -IOOF 521.07 · Supplies Expense-IOOF Hall Total 521.00 · IOOF HALL 522.00 ·HERITAGE HOUSE EXPENSE 522.08 · Outdoor Lighting -HH 522.01 · Utilities Expense -H H 522.011 · Utilities -PG&E -HH 522.012 · Utilities -The Gas Co-HH 522.013 · Utilities -City of AG -HH Total 522.01 · Utilities Expense-H H 522.02 · Telephon Exp 4126-H H 522.03 · Security Expense -H H 522.04 · Repair & Maint-HH 522.06 · Grounds Expense -H H 522.07 · Supplies Expense-H H Total 522.00 ·HERITAGE HOUSE EXPENSE 523.00 ·PAULDING HOUSE EXPENSE 523.01 · Utilities Expense -P H 523.011 · Utilities-PG&E-PH 523.012 · Utilities-The Gas Co-PH 523.013 · Utilities -City of AG -PH Total 523.01 · Utilities Expense-P H 523.02 · Telephone Exp 3231-P H 523.03 · Security Expense -P H 523.04 · Repair & Maint -PH 523.06 · Grounds Expense-P H 523 .. 07 · Supplies Expense-P H Total 523.00 · PAULDING HOUSE EXPENSE 524.00 · SCHOOL HOUSE EXPENSE 524.02 · Telephone Exp 8745-S H ·Jan-Dec 13 63.68 93.30 72.58 50.36 279.92 47.45 8.63 412.27 71.47 483.74 10.35 900.00 100.00 817.97 282.12 366.16 278.77 1,745.02 966.40 360.00 1,070.05 17.58 1,010.35 4,.159.05 621.36 713.28 .326.57 384.83 1,424.68 562.30 360.00 816.16 3,950.00 116.03 602.35 216.78 454.12 7,850.53 1,273.25 573.00 360.00 "557.65 100.00 361.01 3,224.91 538.00 Page 3 Item 9.a. - Page 74 Cash Basis South County Historical Society Profit & Loss January through December 2013 524.03 · Security Expense • S H 524.04 · Repair & Maint · SH 524.06 · Grounds Expense • S H 524.07 · Supplies Expense • S H Total 524.00 · SCHOOL HOUSE EXPENSE 525.00 · RUBY'S HOUSE EXPENSE 525.01 · Utilities Expense • R H 525.011 · Utilities • PG&E • RH 525.012 · Utilities ·The Gas Co • RH 525.013 ·Utilities· City of AG • RH 525.014 ·Trash/Yard· RH Total 525.01 · Utilities Expense· R H 525.02 · Telephone Expense • R H 525.03 · Security Expense· R H 525.04 · Repair & Maint • RH 525.06 · Grounds Expense • R H 525.07 · Supplies Expense· R H Total 525.00 · RUBY'S HOUSE EXPENSE 526.00 · BARN EXPENSE 526.01 · Utilities Expense • Barn 526.011 · Utilities · PG&E • Barn Total 526.01 · Utilities Expense. Barn 526.03 · Security Expense • Barn 526.04 · Repair & Maint · Barn Total 526.00 · BARN EXPENSE 527.00 · 1\qEAT LOCKER 527.02 · ML -Supplies/Furnishings Total 527.00 ·MEAT LOCKER Total 520.00 · FACILITY & PROPERTY EXPENSE 530.00 · EVENTS EXPENSE 531.00 ·Antique Show Expense 531.01 ·Antique Show Exp ·Drawing 531.03 ·Antique Show Exp ·Dealers 531.04 ·Antique Show Exp -Tea Room/Food 531.05 · Antique Show Exp ·Rent Exp 531.06 ·Antique Show Exp ·Security 531.07 · Antique Show Exp • Printing 516.051 ·Antique Show Advertising 531.00 · Antique Show Expense· Other Total 531.00 ·Antique Show Expense 532.00 · Bar-B-Que Sales Expense 534.00 · Rental Event Expenses 538.00 · Special Events 538.04 · Charter Day BBQ 538.05 · Christmas Event Expenses 538.07 · Summer Concerts Expense 538.00 · Special Events· Other Total 538.00 · Special Events 519.50 · Reader's Theatre Project Exp 530.00 · EVENTS EXPENSE· Other Total 530.00 ·EVENTS EXPENSE Total 500.00 · EXPENSES 519.00 · Special Projects 516.90 · PHH Tree Recovery/Removal 516.80 · Pacific Railroad Kiosk Jan· Dec 13 156.00 158.00 826.00 486.06 102.96 454.12 994.96 6.45 1,684.45 2,038.10 1,370.11 360.00 2,412.60 2,805.00 169.08 9,154.89 720.73 720.73 156.00 102.70 979.43 436.27 436.27 27,489.53 231.38 77.83 943.91 500.00 448.00 481.70 1,252.30 702.60 4,637.72 28.32 5,513.60 979.66 203.23 4,528.11 25.01 5,736.01 557.64 27.57 16,500.86 66,478.50 1,291.00 2,937.28 ) --, Page 4 Item 9.a. - Page 75 Cash Basis } _, South County Historical Society Profit & Loss January through December 2013 Total 519.00 · Special Projects 6560 · Payroll Expenses 6570 · Gross Wages 6561 · Payroll Taxes 6562 · FUTA 6563 ·FICA 6564 · MCare 6565 ·SUI 6566 · ETT Total 6561 · Payroll Taxes Total 6560 · Payroll Expenses Total Expense Net Ordinary Income Other Income/Expense Other Income 300.00 · Interest Income-General 306.00 · Coast National CD 306.03 · CD 2006609 306.04 · Coast co 3560 306.05 · Coast Cert 2011625 Total 306.00 · Coast National CD 308.00 · Heritage Oaks CO/Investment 308.01 · Heritage Oaks CD 2168 308.03 · Heritage Oaks 1171 Total 308.00 · Heritage Oaks CO/Investment 309.00 · Heritage Oaks MMkt 304 311.07 · Coast Hills Cert 311.08 · Coast Hills HH Account 5130 311.09 · Heritage Oaks Bank 8766 Total 300.00 · Interest Income-General 340.00 · Endowment Donations Total Other Income Net Other Income Net Income Jan-Dec 13 4,228.28 7,200.00 -42.00 446.40 104.40 364.00 7.00 879.80 34.68 138.80 351.26 8,079.80 78,786.58 6,016.59 524.74 294.98 1,548.04 1,843.02 245.22 340.03 1.46 149.55 3,104.02 66,256.00 69,360.02 69,360.02 75,376.61 Page 5 Item 9.a. - Page 76 Cash Basis ·, } ' --, South County Historical Socie~y Balance Sheet As of December 31, 2012 ASSETS Current Assets Checking/Savings 110.00 · Heritage Oaks (General) 7866 111.08 · Coast Hills 211923-00 -Mankins 112.00 · Coast Hills 211923-01 -HH 120.00 · Certificates of Deposit 123.06 · Coast National Cert -2006609 123.08 · Heritage Oaks MM 4478304 123.11 · Coast National Bank MM 3560 Total 120.00 · Certificates of Deposit 127.00 · ENDOWMENT 126.01 ·HOB CD 7301171-ENDOWMENT 126.02 ·HOB CD 1012820514-ENDOWMENT 126.04 · Mankins Capital (11923-20) CH Total127.00 ·ENDOWMENT 106.00 · Paypal Checking Total Checking/Savings Total Current Assets Fixed Assets 180.00 · Properties & Facilities 184.00 · Facilities -PAULDING HOUSE 187.00 · Facilities -THE BARN Total 180.00 · Properties & Facilities 181.0 · Capital Improvements 181.1 · Paulding House (2005-201 0) 181.10 · PHH Materials .181.11 · PHH Contract Labor 181.12 · PHH Subcontractors 181.13 · PHH Historical Designation 181.14 · PHH Equipment Rental 181.15 · PHH Professional Services 181.1 · Paulding House (2005-201 0)-Other Total181.1 ·Paulding House (2005-2010) 181.2 · Meat Locker 181.3 · IOOF Hall 181.4 · Ruby's House (2005-2007) 181.41 · Harris Labor 181.42 ·Harris Materials 181.43 ·Volunteer Supplies/Labor 181.44 ·Professional Fees 181.45 · Outside Labor Services 181.4 · Ruby's House (2005-2007)-Other Total181.4 ·Ruby's House (2005-2007) 181.5 ·School House 181.6 · Heritage House 181.7 · Library 181.8 · Carriage House Total 181.0 · Capital Improvements Total Fixed Assets Other Assets 160.00 ·Artifacts & Displays 160.01 · Tractor, Farmall, 1937 160.00 ·Artifacts & Displays-Other Total160.00 · Artifacts & Displays 170.00 ·Equipment Dec 31, 12 9,135.32 171.39 10,722.83 76,715.52 71,917.11 50,422.72 199,055.35 160,000.00 100,430.59 20,000.00 280,430.59 144.64 499,660.12 499,660.12 13,940.00 67,043.89 3,878.88 4,779.50 124,580.23 3,521.16 945.84 9,310.12 32,012.25 80,983.89 179,027.98 1,394.25 53,166.63 127,544.48 37,107.86 6,973.51 891.00 38,630.22 1,430.00 212,577.07 9,000.77 20,230.00 3,354.00 19,298.78 498,049.48 579,033.37 1,791.23 429.00 2,220.23 Page 1 Item 9.a. - Page 77 Cash Basis South County Historical Society Balance Sheet As of December 31, 2012 171.00 ·Computer Equipment 172.00 · Public Address System 173.00 · Museum Furnishings 174.00 · Recording Equipment 175.00 · Office Equipment . 176.00 · Office Furniture 178.00 · Outside Equipment Total 170.00 · Equipment Total Other Assets TOTAL ASSETS LIABILITIES & EQUITY Liabilities Current Liabilities Other Current Liabilities 2100 · Payroll Liabilities 2101 ·Federal W/H 2102 · FICA Company 2103 ·FICA Employee 2104 · MCare Company 2105 · MCare Employee 2106 · FUTA 2108 · SDI 2109 ·SUI 2110·ETT Total 2100 · Payroll Liabilities 220.00 · Sales Tax Payable Total Other Current Liabilities Total Current Liabilities Total Liabilities Equity 390.00 · Retained Earnings Net Income Total Equity TOTAL LIABILITIES & EQUITY Dec31,12 10,938.39 2,799.34 402.99 965.24 8,753.26 13,010.24 1,671.49 38,540.95 40,761.18 1 '119,454.67 126.00 111.60 75.60 26.10 26.10 84.00 18.00 54.40 1.60 523.40 241.00 764.40 764.40 764.40 1 ,080,031.82 38,658.45 1 '118,690.27 1 '119,454.67 --, Page 2 Item 9.a. - Page 78 Cash Basis -1 South County Historical Society Profit & Loss January through December 2012 Ordinary Income/Expense. Income 301.00 ·MEMBERSHIP DUES-Current Year 301.00b ·Prepaid 2013 305.00 · INCOME-SALES 305.01 · Book Sales -Taxable 305.001 · Dana Books Sales -Taxable 305.002 · Strawberry Festival Book Sales 305.003 · Dunites Book 305.005 · AG Books 305.006 · Face of the Clam 305.01 · Book Sales -Taxable -Other Total 305.01 · Book Sales-Taxable 305.02 · Book Sales -Non -Taxable 305.021 · Dunites Book 305.02 · Book Sales -Non -Taxable -Other Total 305.02 · Book Sales-Non -Taxable 305.08 · Royalties Total 305.00 ·INCOME-SALES 310.00 ·DONATIONS/GIFTS-General 310.07 · Donations-Membership Book 310.08 · Donations-Meeting -Hall Rent 310.11 · Donations -Memorial 310.20 ·Donations-Properties 310.01 · Donations -Museum (IOOF) 310.02 · Donations -Heritage House 310.03 · Donations-Paulding House 310.04 · Donations-School House 310.05 · Donations-Barn Total 310.20 ·Donations-Properties 310.40 ·Museum Sponsorship Fund 310.50 · Library Development Fund 310.60 · Bonnet Sales 310.00 ·DONATIONS/GIFTS-General-Other Total 310.00 ·DONATIONS/GIFTS-General 320.00 · EVENTS 321.00 ·Antique Show 321.01 ·Antique Show-Drawing Tickets 321.02 ·Antique Show-Admissions 321.03 · Antique Show-Dealers 321.04 ·Antique Show-Tea Room/Food 321.05 · Basket Sales · 321.00 ·Antique Show-Other Total 321.00 ·Antique Show 322.00 · Charter Day BBQ Sales 323.00 · Yard Sales 324.00 · Rental Event Income 326.00 · Bus Tours/Special Tours 329.00 · Special Events 329.06 · Concession Sales (Summer) 329.00 · Special Events-Other Total 329.00 ·Special Events 365.00 · Reader's Theatre Project Income 329.08 · Parking Total 320.00 · EVENTS 330.00 · Rent Income 360.00 · Special Projects Income 310.104 ·La France FireTruck Jan-Dec 12 41.55 114.00 13.05 426.62 123.02 2,149.30 4,215.00 665.00 2,867.54 579.35 439.39 1,018.74 184.67 4,070.95 34.00 13.00 125.00 20.00 333.25 775.00 733.00 1,215.60 3,076.85 500.00 6,200.00 80.00 9,061.59 1,350.00 6,008.00 4,815.00 3,122.50 1,123.00 0.00 19,090.44 16,418.50 955.00 4,000.60 6,370.00 392.00 10,206.33 320.00 10,526.33 4,408.00 100.00 43,170.43 550.00 161.00 Page 1 Item 9.a. - Page 79 Cash Basis . :-;_:-·· South County Historical Society Profit & Loss January through D~cember 2012 310.107 · Chairs-Artifact Preserve 347.00 · PHH Tree Recovery/Removal Total 360.00 · Special Projects Income 366.00 · Reader's Theatre 2nd Saturday 375.00 · Bequests Total Income Expense 500.00 ·EXPENSES 501.00 ·EXPENSES-ADMINISTRATION 501.02 · General Supplies 501.021 · Ricoh Supplies & Maintenance 501.03 · Postage I Freight 501.031 · Membership 501.033 · Newsletter 501.037 · General Postage Total 501.03 · Postage I Freight 5Qj .05 · Printing I Copy Service 501.056 · Me~bership Total 501.05 · Printing I Copy Service 501.07 ·Website 501.09 · Awards & Recognition Expense 501.10 · Bank Services 501.102 · Bank Service Charges Total 501.10 ·Bank Services 501.11 · Dues & Subscriptions 501.12 · Telephone (admin) 501.13 · PO Box Rental 501.14 ·Taxes 501.16 ·Equipment Maintenance 501.17 · Information Systems 501.18 · Software Expense 501.20 · Rent-Meat Locker 501.21 · Document Maintenance Total501.00 ·EXPENSES-ADMINISTRATION -~~ :. 50i:'oo·· P-ERMITS:'& FEES :; 5071QO · PROFESS'fONAL SERVICES 507.01 · Bookkeeping Services Total 507.00 · PROFESSIONAL SERVICES 508.00 · INSURANCE EXPENSE 509.00 · MEETINGS EXPENSE 509.01 · Second Saturday Mtg Exp 510.00 ·BOOK EXPENSE 510.01 · Book Purchases 510.02 · Book Printing I Reprinting ···--·· 512.04 · Heritage Press Products Expense Total 510.02 ·Book Printing I Reprinting 510.03 · Postage I Freight-Books Total 510.00 ·BOOK EXPENSE 511.00 · DOCENT EXPENSE 512.00 ·WAYS & MEANS 512.02 ·Sunshine Supplies ·, ·····... . .-,,~:rotaf5t2:.oo :~cY"-AYs & iviEANs : '512.05 --M~mbership Drive 515.00 ·CURATOR EXPENSE 515.003 · Heritage House 515.004 · IOOF Hall Jan-Dec 12 500.00 1,420.00 567.46 2,413.71 218.06 2,081.00 308.20 10,722.58 84,873.60 801.52 ' : .. 395.43 1,415.01 29.06 29.06 118.80 25.59 5.00 5.00 672.00 534.82 76.00 58.01 243.50 23.26 1_12.10 5,400.00 '22.12 11,716.44 227.00 2,370.00 2,370.00 4,853.05 141.57 149.25 1,934.01 19.38 19.38 8.50 1,961.89 7.99 28.94 71.69 86.57 28.94 11.32 --, Item 9.a. - Page 80 Cash Basis South County Historical Society Balance Sheet As of December 31, 2012 ASSETS Current Assets Checking/Savings 110.00 · Heritage Oaks (General) 7866 111.08 · Coast Hills 211923-00 -Mankins 112.00 · Coast Hills 211923-01 -HH 120.00 · Certificates of Deposit 123.06 ·Coast National Cert-2006609 123.08 · Heritage Oaks MM 4478304 123.11 · Coast National Bank MM 3560 Total120.00 · Certificates of Deposit 127.00 ·ENDOWMENT 126.01 ·HOB CD 7301171-ENDOWMENT 126.02 ·HOB CD 1012820514-ENDOWMENT 126.04 · Mankins Capital (11923-20) CH Total127.00 · ENDOWI\1ENT 106.00 · Paypal Checking Total Checking/Savings Total Current Assets Fixed Assets 180.00 · Properties & Facilities 184.00 ·Facilities-PAULDING HOUSE 187.00 ·Facilities-THE BARN Total 180.00 · Properties & Facilities 181.0 · Capital Improvements 181.1 · Paulding House (2005-201 0) 181.10 · PHH Materials .181.11 · PHH Contract Labor 181.12 · PHH Subcontractors 181.13 · PHH Historical Designation 181.14 · PHH Equipment Rental 181.15 · PHH Professional Services 181.1 · Paulding House (2005-201 0) -Other Total181.1 ·Paulding House (2005-2010) 181.2 · Meat Locker 181.3 ·IOOF Hall 181.4 · Ruby's House (2005-2007) 181.41 ·Harris Labor 181.42 · Harris Materials 181.43 · Volunteer Supplies/Labor 181.44 · Professional Fees 181.45 · Outside Labor Services 181.4 · Ruby's House (2005-2007) -Other Total 181.4 · Ruby's House (2005-2007) 181.5 · School House 181.6 · Heritage House 181.7 ·Library 181.8 · Carriage House Total 181.0 · Capital Improvements Total Fixed Assets Other Assets 160.00 ·Artifacts & Displays 160.01 · Tractor, Farmall, 1937 160.00 · Artifacts & Displays -Other Total 160.00 ·Artifacts & Displays 170.00 · Equipment Dec 31, 12 9,135.32 171.39 10,722.83 76,715.52 71,917.11 50,422.72 199,055.35 160,000.00 100,430.59 20,000.00 280,430.59 144.64 499,660.12 499,660.12 13,940.00 67,043.89 3,878.88 4,779.50 124,580.23 3,521.16 945.84 9,310.1_2 32,012.25 80,983.89 179,027.98 1,394.25 53,166.63 127,544.48 37,107.86 6,973.51 891.00 38,630.22 1,430.00 212,577.07 9,000.77 20,230.00 3,354.00 19,298.78 498,049.48 579,033.37 1 ,791.23 429.00 2,220.23 Page 1 Item 9.a. - Page 81 Cash Basis South County Historical Society Balance Sheet As of December 31, 2012 171o00 ° ComputerEquipment 172000 ° Public Address System 173000 o Museum Furnishings 174000 ° Recording Equipment 175o00 ° Office Equipment 176000 o Office Furniture 178o00 ° Outside Equipment Total170o00 ° Equipment Total Other Assets TOTAL ASSETS LIABILITIES & EQUITY Liabilities Current Liabilities Other Current Liabilities 2100 ° Payroll Liabilities 2101 o Federal W/H 2102 ° FICA Company 2103 o FICA Employee 2104 o MCare Company 2105 o MCare Employee 2106 o FUTA 2108 ° SDI 2109 o SUI 2110 ° ETI 0 Total 2100 ° Payroll Liabilities 220000 ° Sales Tax Payable Total Other Current Liabilities Total Current Liabilities Total Liabilities Equity 390000 ° Retained Earnings Net Income Total Equity TOTAL LIABILITIES & EQUITY Dec31,.12 10,938.39 2,799034 402.99 965.24 8,753.26 13,010.24 1,671.49 38,540.95 40,761.18 1 '119,454067 126.00 111.60 75060 26.10 26010 84.00 18.00 54.40 1.60 523.40 241.00 764.40 764.40 764.40 1,080,031.82 38,658.45 1 '118,690.27 1 '119,454067 ) Page 2 Item 9.a. - Page 82 Cash Basis _\ South County Historical Society Profit & Loss January through December 2012 515.007 · Paulding House 515.03 · Curator Tools & Equipment 515.06 · Curator Office Supplies 515.07. · Storage Supplies Total515.00 ·CURATOR EXPENSE 515.002 · Exhibit Supplies 515.021 ·EXHIBIT EXPENSES 515.028 ·Mark Hammitt Photos Exhibit 515.021 · EXHIBIT EXPENSES ·Other Total 515.021 ·EXHIBIT EXPENSES 516.00 ·GENERAL PUBLICITY EXPENSE 516.01 ·Advertising 516.06 · Brochures Total 516.00 ·GENERAL PUBLICITY EXPENSE 516.05 ·EVENTS ADVERTISING 516.053 · Parades 516.055 ·Rental Event Advertising 516.058 · Harvest Festival Banner Total 516.05 ·EVENTS ADVERTISING 520.00 · FACILITY & PROPERTY EXPENSE 521.00 · IOOF HALL 521.01 · Utilities • IOOF Hall 521.011 · Utility • PG&E • IOOF 521.012 · Utilities • The Gas Co · IOOF 521.013 ·Utilities-City of AG-IOOF 521.014 ·Utilities· Trash· IOOF Total 521.01 · Utilities -IOOF Hall 521.015 · Utilities • Cable • IOOF 521.03 · Security • IOOF Hall 521.04 · Repairs & Maint • IOOF 521.06 · Grounds/Container -IOOF Hall 521.07 · Supplies Expense· IOOF Hall Total 521.00 · IOOF HALL 522.00 · HERITAGE HOUSE EXPENSE 522.01 · Utilities Expense · H H 522.011 · Utilities • PG&E • HH 522.012 · Utilities -The Gas Co· HH 522.013 · Utilities· City of AG • HH 522.014 ·Yard/Trash Total 522.01 · Utilities Expense· H H 522.02 · Telephon Exp 4126 · H H 522.03 · Security Expense • H H 522.04 · Repair & Maint-HH 522.06 · Grounds Expense • H H 522.07 · Supplies Expense· H H Total 522.00 ·HERITAGE HOUSE EXPENSE 523.00 · PAULDING HOUSE EXPENSE 523.01 · Utilities Expense • P H 523.011 · Utilities • PG&E • PH 523.012 ·Utilities· The Gas Co· PH 523.013 · Utilities ·City of AG ·PH Total 523.01 · Utilities Expense· P H 523.02 ·Telephone Exp 3231-PH 523.03 · Security Expense • P H 523.04 · Repair & Maint ·PH 523.06 · Grounds Expense • P H 523.07 · Supplies Expense · P H Jan-Dec 12 6.78 41.38 50.43 622.09 878.94 76.83 182.99 3.43 186.42 683.82 13.78 697.60 49.49 850.00 250.00 776.57 275.99 398.31 273.80 1,724.67 888.79 360.00 438.56 138.24 223.91 1,149.49 3,774.17 553.74 302.60 416.67 -90.05 1,182.96 491.12 360.00 178.00 780.98 598.90 540.31 484.83 28.61 3,021.67 1,624.04 473.16 360.00 3,365.38 1,817.73 42.50 Page 3 Item 9.a. - Page 83 Cash Basis South County Historical Society Profit & Loss January through December 2012 Total 523.00 · PAULDING HOUSE EXPENSE 524.00 ·SCHOOL HOUSE EXPENSE 524.02 · Telephone Exp 8745-S H 524.03 · Security Expense -S H 524.04 · Repair & Maint-SH 524.07 · Supplies Expense-S H Total 524.00 · SCHOOL HOUSE EXPENSE 525.00 · RUBY'S HOUSE EXPENSE 525.01 · Utilities Expense -R H 525.011 · Utilities -PG&E-RH 525.012 · Utilities -The Gas Co -RH 525.013 · Utilities -City of AG -RH 525.014 ·Trash/Yard-RH Total 525.01 · Utilities Expense-R H 525.02 · Telephone Expense -R H 525.03 · Security Expense-R H 525.04 · Repair & Maint-RH 525.07 · Suppli~s Expense-R H Total 525.00 · RUBY'S HOUSE EXPENSE 526.00 ·BARN EXPENSE 526.01 · Utilities Expense -Barn 526.011 · Utilities -PG&E-Barn Total 526.01 · Utilities Expense-Barn 526.03 · Security Expense-Barn 526.04 · Repair & Maint -Barn 526.07 · Supplies Expense-Barn Total 526.00 · BARN EXPENSE 527.00 · MEAT LOCKER 527.01 · Utilities -PG&E (AG Meat Co) Total 527.00 · MEAT LOCKER Total 520.00 · FACILITY & PROPERTY EXPENSE 530.00 ·EVENTS EXPENSE 531.00 ·Antique Show Expense 531.01 · Antique Show Exp -Drawing 531.04 ·Antique Show Exp -Tea Room/Food 531.05 ·Antique Show Exp-Rent Exp 531.06 ·Antique Show Exp-Security 531.07 ·Antique Show Exp-Printing 516.051 · Antique Show Advertising 531.00 ·Antique Show Expense-Other Total531.00 ·Antique Show Expense 533.00 · Yard Sales Expense 534.00 · Rental Event Expenses 538.00 · Special Events 538.04 · Charter Day BBQ 538.05 · Christmas Event Expenses 538.07 · Summer Concerts Expense 538.00 · Special Events -Other Tota1.538.00 · Special Events 519.50 · Reader's Theatre Project Exp Total 530.00 · EVENTS EXPENSE Total 500.00 · EXPENSES 516.50 ·General Event Expenses 517.00 ·VEHICLE EXPENSE Jan-Dec 12 7,682.81 481.67 156.00 418.00 120.33 470.54 96.46 484.83 712.03 1,176.00 1,763.86 1,363.58 360.00 879.00 101.81 4,468.25 571.22 571.22 265.95 331.75 136.19 1,305.11 232.07 232.07 21,660.08 228.31 847.49 1,500.00 432.00 525.55 925.00 926.33 5,384.68 110.74 2,046.31 827.50 434.14 4,339.40 26.68 5,627.72 1,034.08 14,203.53 60,320.34 77.35 Page 4 Item 9.a. - Page 84 Cash Basis South County Historical Society Profit & Loss January through December 2012 517.01 ·Fuel for vehicles 517.03 ·Vehicle Maintenance Total 517.00 · VEHICLE EXPENSE 519.00 · Special Projects 515.048 · IOOF Chairs Total 519.00 · Special Projects 6560 · Payroll Expenses 6570 · Gross Wages 6561 · Payroll Taxes 6562 · FUTA 6563 ·FICA 6564 · MCare 6565 ·SUI 6566 · ETI Total 6561 · Payroll Taxes Total 6560 · Payroll Expenses Total Expense Net Ordinary Income Other Income/Expense Other Income 300.00 · Interest Income -General 306.00 · Coast National CD 306.03 · CD 2006609 306.04 · Coast CD 3560 Total 306.00 · Coast National CD 308.00 · Heritage Oaks CO/Investment 308.01 · Heritage Oaks CD 2168 308.03 ·Heritage Oaks 1171 Total 308.00 · Heritage Oaks CO/Investment 309.00 · Heritage Oaks MMkt 304 311.07 ·Coast Hills Cert 311.08 ·Coast Hills HH Account 5130 Total 300.00 · Interest Income-General 452.00 · Federal Tax Refund 340.00 · Endowment Donations Total Other Income Net Other Income Net Income Jan-Dec 12 50.01 79.93 129.94 450.00 450.00 7,200.00 84.00 446.40 104.40 238.00 7.00 879.80 383.58 120.44 8,079.80 69,057.43 15,816.17 504.02 402.84 1,569.96 1,972.80 152.42 166.39 0.25 2,795.88 46.40 20,000.00 22,842.28 22,842.28 38,658.45 Page 5 Item 9.a. - Page 85 CITY OF ARROYO GRANDE . COMMUNITY SERVICE GRANT PROGRAM APPLICATION FORM 2014-15 Please complete the following sections (use additional sheets as necessary): I. NAME AND ADDRESS OF NON-PROFIT ORGANIZATION: (must be the local branch) Arroyo Grande Public Art, part ofArroyo Grande in Bloom, Inc. 214 East Branch St Arroyo Grande, CA 93420 II. GRANT APPLICANT REPRESENTATIVE'S NAME, ADDRESS AND TELEPHONE NUMBER: (must be the Executive Director or their designated representative) Bob Lund, 214 East Branch St., Arroyo Grande, CA 93420 805-710-4049 Ill. DESCRIPTION OF COMMUNITY SERVICES PROVIDED: The term public art refers to works of art in any media that have been planned and executed with the intention of being staged in the public domain, usually outside and accessible to all. The term is significant within the art world, to whom it signifies a particular working practice, with implications of site specificity, community involvement and collaboration. IV. LIST AREA(S) SERVED BY NON-PROFIT ORGANIZATION: (include brief description of the relationship of your non-profit organization to the residents of the City of Arroyo Grande) The whole of the City of Arroyo Grande. Arroyo Grande Public Art (AGPA) is a non-profit volunteer organization dedicated to bringing public art to the City of Arroyo Grande. It is part of Arroyo Grande In Bloom. We hope to enrich Arroyo Grande's visual appeal with art that reflects the unique culture and rich history of the area, while providing local artists an opportunity to showcase their work, and the community and visitors the opportunity to experience outstanding art in a variety of mediums. Item 9.a. - Page 86 V. NUMBER OF CITY OF ARROYO GRANDE RESIDENTS SERVED BY NON-PROFIT ORGANIZATION: (broken down by age groups if available) All city residents. VI. AMOUNT OF FUNDS REQUESTED: Estimated budget for this project is approximately $16,000.00. VII. PROPOSED USE AND BUDGET PLAN FOR GRANT FUNDS: (indicate if any of the grant funds will be used for any other purpose than those designated such as overhead, national office, administrative salaries) The grant funds will be utilized for the building of a monument to the fire fighters of the 9/11 Worid Trade Center using a piece of the trade center now residing in the Arroyo Grande Fire Department Headquarters: A. Provide a drawn plan for location of the art piece · $ 500.00 B. Develop engineering drawings for the structural integrity 2,500.00 C. Construct sub-base foundation 1,000.00 D. Design support base 1 ,000.00 E. Design and fabricate the finished envelop the artifact will be situated in 5,000.00 F. Outside contracted equipment 1,000.00 G. Artist's profit margin 5,000.00 Total $16,000.00 VIII. ADDITIONAL DOCUMENTATION: (if you have received funds in the past, please indicate the amount of funds received (indicate what year) and how the funds were utilized) No funds have been received to date for this project. IX. SUPPLEMENTAL DOCUMENTATION: !i Past two year's financial statements, including the current year with the balance sheets and the profit/loss statements. iii Information indicating the percentage of revenue received that is used for administration, salaries, and program costs. 1!!1 Breakdown and description of non-profit organization's sources of revenue. til Proof of 501 (c)(3) status with a copy of the letter from the IRS. I§ Copy of the non-profit organizations Board of Directors, Officers and an organization· chart. I Item 9.a. - Page 87 ·X. CERTIFICATION: certify on behalf of Arroyo Grande in Bloom, Inc; non-profit organization, that I have read, understand and agree that the aforesaid information is accurate, factual and current. I understand that an award of funds, if granted, will be for the sole use as reflected in this application form. I further certify that as a condition of receiving funds, an agreement with the City of Arroyo Grande, in a form and content provided by the City of Arroyo Grande, will be signed and executed by a duly authorized representative of said non-profit organization. I am aware of and certify that our non-profit organization will adhere to all City regulations regarding the 2014-15 Community Service Fund Program including, but not limited to, maintaining non- discriminatory policies, practices and intent. I also, on behalf of our non-profit organization, . indemnify, defend, and hold harmless the City of Arroyo Grande relative to any and all liability that may arise as a result of the use of the City of Arroyo Grande Community Service Grant Fund monies. Date: ____.O'--'-~.f-0_;;L_/ ~<.......:_/_Y __ _ Signature: Executive Director or Designee Board ofDirector or Officer Item 9.a. - Page 88 Arroyo Grande Public Art P.O. Box 231, Arroyo Grande, CA 93421 None of the revenues of Arroyo Grande Public Art or Arroyo Grande in Bloom are used for administration, salaries or program costs. Breakdown of sources of revenues: Amounts listed under Individual, Business Contributions consist of amounts raised through the sponsorship of roosters that were painted for auction. Membership fees are contributions from individuals and businesses for support of the organization. Local Government Grants are monies received from the County of San Luis Obispo .. Auctioned items are proceeds from the auction of the painted roosters that were sponsored each year. Item 9.a. - Page 89 11:59 AM Public Art Program 11/20/14 Balance Sheet Prev Year Comparison Accrual Basis As of November 20, 2014 Nov 20, 14 Nov 20, 13 ASSETS Current Assets Checking/Savings Rabobank checking 24,835.07 9,161.56 Total Checking/Savings 24,835.07 9,161.56 Total Current Assets 24,835.07 9,161.56 Other Assets Security Deposits Asset 2,000.00 0.00 Total Other Assets 2,000.00 0.00 TOTAL ASSETS 26,835.07 9,161.56 LIABILITIES & EQUITY Liabilities Current Liabilities Other Current Liabilities Chumash Art Fund 6,350.00 0.00 Harriet Quimby Art Fund 1,000.00 1,000.00 Total Other Current Liabilities 7,350.00 1,000.00 Total Current Liabilities 7,350.00 1,000.00 Total Liabilities 7,350.00 1,000.00 Equity Unrestricted Net Assets 8,161.56 0.00 Net Income 11,323.51 8,161.56 Total Equity 19,485.07 8,161.56 TOTAL LIABILITIES & EQUITY 26,835.07 9,161.56 Page 1 Item 9.a. - Page 90 11:59 AM 11/20/14 Accrual Basis Public Art Program Profit & Loss Prev Year Comparison January 1 through November 20, 2014 Jan 1 -Nov 20, 14 Jan 1 -Nov 20, 13 Income Direct Public Su-pport Corporate Contributions lndivid, Business Contributions membership fees Total Direct Public Support Government Grants Local Government Grants Total Government Grants Other Types of Income fund raising events 50/50 fund raiser Auctioned items Wine & beer sales Total fund raising events Miscellaneous Revenue Total Other Types of Income Total Income Expense Business Expenses Bank fees Business Registration Fees Total Business Expenses Operations Books, Subscriptions, Reference Fund raising events Printing and Copying Rooster purchases Supplies Total Operations Total Expense Netlncame 0.00 6,765.00 1,250,00 8,015.00 1,500.00 0.00 3,165.00 0.00 1,500.00 3,165.00 90.00 3,255.00 12,770.00 110,10 0.00 110.10 0.00 1,206.13 130.26 0.00 0.00 1,336.39 1,446.49 11,323.51 2,000.00 4,903.00 0.00 6,903.00 1,500.00 175.00 5,075.00 451.00 1,500.00 5,701.00 0,00 5,701.00 14,104.00 193.55 25.00 218.55 150.00 938.78 783.54 3,849.07 2.50 5,723.89 5,942.44 8,161.56 Page 1 Item 9.a. - Page 91 Bob Lund, President 1202 Linda Drive Arroyo Grande, CA 93420 7 years of service Retired businessman Tony Ferrara, Vice President 1490 Blackberry Arroyo Grande, CA 93420 7 years of service Mayor of Arroyo Grande Mary Hertel, Secretary 1475 Hillcrest Drive Arroyo Grande, CA 93420 6 years of service Arroyo Grande in Bloom Board of Directors 2014 Landscape designer, chair of landscape designs Laurie Waller, Vice President 1098 A Huasna Road Arroyo Grande, CA 93420 6 years of service Massage Therapist, chair of Floral Disp.lays Item 9.a. - Page 92 :.;.~_::· . INTERNAL REVENUE SERVICE -P. 0. BOX ·2508 CINCINNATI. OH 45201 Date: APR 2 ··5 20111 ARROYO GRANDE IN BLOOM INC C/0 MICHAEL ZIMMERMAN . PO BOX 970 ARROYO GRANDE. CA 93420 · Dear Applicant: DEPARTMENT OF THE TREASURY · . Employer Identification Number: 27-3797711 DLN: . 17053327339040 Contact Person: JAMIE N HEITBRINK ID# 31644 Contact Telephone Number: ( 877) 829-550-o Accounting Period Ending: December 31 Public Ch.a ri ty Status : 170(b)(1){A)Cvi) -FOP~9B0-Reqlfi-r-ed-: Yes Effective Date of Exemption: September 13. 2010 Contribution Deductibility: Yes Addendum Applies: No We are pleased to inform you that upon review of your applicati-on for tax ·exempt status we have determined that you are exempt from Federal income tax ----=-"----rumn-A~de::l.Pr-seetAon-5Ql(c).(3}-.Gf-the. Interna.LReven11e Code Contrihu_tj_Q[l~ __ to you are deductible under section 170 of the Code. You are also qualified to receive . · tax deductible bequests. devises. transfers or gifts under seetion 2055. 2106 or 2522 of the Code. _ Because this letter could help resolve any questions regarding your exempt status. you should keep it in your permanent records. Organizations exempt under section 501Cc)(3) of the Code are further classified as either public charities or private foundations. We det~rmined that you are a public charity under the Code section(s) listed in the heading of this· letter, Please see enclosed Publication 4221-PC. Compliance Guide for 501Cc)C3) Public Charities. for some helpful information about your responsibilities as an exempt organization. -2- ARROYO GRANDE IN BLOOM INC We have sent a copy of this letter to your representative as indicated in your power of attorney. Sinc;jely. · ~,.~~-~ I ni c:: r, I PrnP.r Item 9.a. - Page 93 CITY OF ARROYO GRANDE COMMUNITY SERVICE GRANT PROGRAM APPLICATION FORM 2014-15 Please complete the following sections (use additional sheets as necessary): I. NAME AND ADDRESS OF NON-PROFIT ORGANIZATION: (must be the local branch) Senior Nutrition Program of San Luis Obispo County, 2180 Johnson Avenue, San Luis Obispo, CA 93401 II. GRANT APPLICANT REPRESENTATIVE'S NAME, ADDRESS AND TELEPHONE NUMBER: (must be the Executive Director or their designated representative) Elias Nimeh, Executive Director; 2180 Johnson Avenue, San Luis Obispo, CA 93401; 805-541-3312 Ill. DESCRIPTION OF COMMUNITY SERVICES PROVIDED: The Senior Nutrition Program of SLO County provides free, hot, nutritious noon-time meals to seniors who are at least 60 years old. Seniors who are able to attend can eat meals at 10 community sites throughout the county in congregate · dining. We also deliver meals, with frozen meals for Saturday and Sunday, to qualified seniors who are homebound. We -rely on over 250 volunteers to deliver meals. We are the only program serving senior meals throughout San Luis Obispo County and the only program that includes congregate dining and an opportunity for socialization among the seniors. All of our meals are free to those who are eligible, although some clients choose to make voluntary anonymous donations. Our program has three goals: nutrition, socialization, and safety. Both the congregate dining and the home delivery provide socialization and human contact to help break the cycle ofisolation. Finally, the daily home deliveries by volunteers, along with regular assessments by site supervisors, provide both friendly human contact and a safety net from accidents or physical or financial abuse. All staff and volunteers are mandated to report any suspected abuse. IV. LIST AREA(S) SERVED BY NON-PROFIT ORGANIZATION: (include brief description of the relationship of your non-profit organization to the residents of the City of Arroyo Grande) SNP has its administrative offices and central kitchen at the San Luis Obispo address given above. We serve congregate and home-delivered meals at ten dining sites throughout the county: in San Luis Obispo at the Anderson Hotel and the United Church of Christ Congregational; Atascadero; Cambria; Los Osos; Morro Bay; Nipomo; Oceano; Paso Robles; Santa Margarita. We serve residents of Arroyo Grande through our dining site in Oceano. In fiscal year 2013-2014, Senior Nutrition Program served a total of 99 unduplicated clients in Arroyo Grande. Of these, 55 received home-delivered meals and 44 participated in congregate dining. These Arroyo Grande seniors received 10,478 meals in fiscal year 2013/14, at a total cost of $153,585. The average donation from seniors last year was $.91 per meal. This is a reflection of the effects of our economy and the increasing needs of seniors in the South County for your support. Item 9.a. - Page 94 V. NUMBER OF CITY OF ARROYO GRANDE RESIDENTS SERVED BY NON-PROF11 ORGANIZATION: (broken down by age groups if available) - As mentioned in question IV, in fiscal year 2013-2014, Senior Nutrition Program served a total of 99 unduplicated clients in Arroyo Grande. Of these, 55 received home-delivered meals and 44 participated in congregate dining. All of our clients are 60 years of age or older. VI. AMOUNT OF FUNDS REQUESTED: We are requesting grant funding in the amount of $5000. VII. PROPOS~D USE AND BUDGET PLAN FOR GRANT FUNDS: (indicate if any of the grant funds will be used for any other purpose than those designated such as overhead, national office, administrative salaries) SNP will use the $5,000 grant to help purchase food and food containers for seniors in Arroyo Grande. A grant of $5000 will provide daily meals for 5 new seniors in Arroyo Grande. The cost of food and food supplies, including labor cost, usually makes up 60% of our total budget. SNP total annual administrative salaries make up 15% of the total budget. Budget Plan Food & Food supplies $3,500 Labor & Benefits $5,159 All other costs $5,028 Total $13,687 (cost of meals to 5 seniors for full year.) ( The $8,687 difference in costs will be covered by Federal and State (50%), some senior donations, and our grant writing' I and fundraising efforts. , VIII. ADDITIONAL DOCUMENTATION: (if you have received funds in the past, please indicate the amount of funds received (indicate what year) and how the funds were utilized) In 2012, Senior Nutrition Program received $2501 in CDBG funding from the city of Arroyo Grande. The funds were used to purchase food and food containers for program clients in Arroyo Grande. IX. SUPPLEMENTAL DOCUMENTATION: Iii Past two year's financial statements, including the current year with the balance sheets and the profit/loss statements. Iii Information indicating the percentage of revenue received that is used for administration, salaries, and program costs. Iii Breakdown and description of non-profrt organization's sources of revenue. Iii! Proof of 501 (c)(3) status with a copy of the letter from the IRS. !!I Copy of the non-profit organizations Board of Directors, Officers and an organization 1 , chart. __j Item 9.a. - Page 95 X. CERTIFICATION: !' certify on behatf of Senior Nutrition Program non-profit organization, that I have read, understand and agree that the aforesaid information is accurate, factual and current. I understand that an award of funds, if granted, will be for the sole use as reflected in this application form. I further certify that as a condition of receiving funds, an ag~eement with the City of Arroyo Grande, in a form and content provided by the City of Arroyo Grande, will be signed and executed by a duly authorized representative of said non-profit organization. I am aware of and certify that our non-profit organization will adhere to all City regulations regarding the 2014-15 Community Service Fund Program including, but not limited to, maintaining non- discriminatory policies, practices and intent. I also, on behalf of our non-profit organization, indemnify, defend, and hold harmless the City of Arroyo Grande relative to any and all liability that may arise as a result of the use of the City of Arroyo Grande Community Service Grant Fund monies. Date:/~/,~ Signature: ~ Executive Director or Designee ~ BoardODii"eCf"Or Officer Item 9.a. - Page 96 City of Arroyo Grande 2015 CDBG Program Supplemental Information for Public Services CDBG Applications Organization: Senior Nutrition Program of San Luis Obispo County Program Name: Congregate and Home-Delivered Meals for Seniors Our mission is to enhance the health, reduce the isolation, and increase the socialization of SLO County residents who are at least 60 years of age. We do this by serving free, hot, noontime meals at community dining centers to those seniors who are able to attend, and by delivering meals to qualified seniors who are homebound. Our program has three goals: nutrition, socialization, and safety. Our program provides balanced meals which supply at least 1/3 of the Daily Required Intake (DRI) for an average person. Both the congregate dining and the home delivery provide socialization and human contact to help break the cycle of isolation. Finally, the daily home deliveries by volunteers, along with regular assessments by site supervisors, provide a safety net from accidents or physical or financial abuse. All staff and volunteers are mandated to report any suspected abuse. Federal regulations {24 CFR 570.208(a){2)(A)) provide that elderly persons (62 years or older) and the severely disabled are "principally of low and moderate income." All of our clients are at least 60 years of age; most of them are much older. Of the meals we provide, roughly 60% are home-delivered to people who qualify as disabled under guidelines of the Area Agency on Aging. The bulk of our clients are of low or very low income. In fiscal year 2013-2014, Senior Nutrition Program served a total of 99 unduplicated clients in Arroyo Grande. Ofthese, 55 received home-delivered meals and 44 participated in congregate dining. These numbers are down from the previous year, despite an increasing demand for our service, because of a decrease in our federal funding. With CDBG funding support, we can meet the increasing demand and accommodate the seniors of Arroyo Grande. For each $100 of funding, we can serve meals to one senior for a full month. With $10,000 of funding support, SNP can provide meals for 10 seniors for a full year. Item 9.a. - Page 97 Board of Directors President: Justin Vanderlinden Vice President: Diane Maiorano Secretary: Charmaine Petersen Treasurer: Alex Benson Members: Rudy Campos Chris Fasse Anita Shower Natalie Tartaglia Debbie Trout Meals for Seniors Countywide January 21,2015 Senior Nutrition Prognim of SLO County is required to maintain records of all senior clients who receive meals. All congregate clients reserve the meals daily on the reservation sheets and sign their initials on the day they consume the meals. Homebound seniors also request the days of week or month they want a meal delivered to them by volunteer drivers. The volunteer drives sign their names or initials for the delivery route and mark each meal delivered next to their name. SNP is required to submit monthly reports to the Area Agency on Aging all the meals served to each senior in the dining rooms and the homebound. Mark Wilson Also, all the seniors in our program are assessed quarterly to insure their safety and qualifications in the program. SNP is audited annually by independent auditor, AAA auditor and State auditor to insure accuracy of the reports and qualification for Federal funds and State funds. Elias Nimeh, ED Senior Nutrition Program 2180 Johnson Avenue • San Luis Obispo • California • 93401 (805) 541-3312 [phone] • (805) 541-5631 [fax] • www.snpslo.org Item 9.a. - Page 98 SENIOR NUTRITION PROGRAM Budget Narrative 2013-2014 C1 C2 Total Personnel: Salary/wages 164,334 259,082 423,416 based on current year with projected increase 3cook Payroll taxes 17,501 32,177 49,678 is 10.65% of payroll Employee benefits 17,419 31,686 49,105 is 10.6% of payroll In-kind 90,000 155,000 245,000 volunteer hours for food prep & delivery Total Personnel 289,254 477,945 767,199 Travel and training: Staff travel 3,520 9,880 13,400 staff mileage reimbursement est. as above Staff training 110 312 422 staff training and local conference Total travel/training 3,630 10,192 13,822 Equipment: Expendable 0 0 0 Non-expendable 0 0 0 items over $5,000 Total equipment 0 0 0 Food costs 64,960 167,040 232,000 includes food for all meals prepared Consultants 2,280 2,083 4,363 consultation fees Other costs: Rent 17,000 50,128 67,128 rental charges: sites, central kitchen and office Telephone 2,735 7,030 9,765 telephone charges for sites, kitchen and office Utilities 3,060 9,296 12,356 utility charges for central kitchen and office Insurance 3,443 9,708 13,151 insurance for program operations, vehicles, etc. Acct./auditing 5,040 12,960 18,000 bookkeeping charges Office supplies/postage 3,004 7,367 10,371 office supplies and postage charges Vehicle operations 4,000 10,978 14,978 gas for food transport vehicles Vehicle maintenance/repai1 1,103 2,834 3,937 repair and maintenance for food transport vehicles Building maintenance/repa 1,000 1,990 2,990 repair and maintenance needed in occupied sp Equip. maintenance/repair 2,240 5,760 8,000 repair and maintenance for office, kitchen, site eq Volunteer expenses 787 7,090 7,877 volunteer expenses, including recognition Taxes/licenses 124 124 248 taxes and licenses for vehicles Printing 280 720 1,000 outside printing expense, program literature Advertising 840 2,160 3,000 advertising costs for staff recruiting, program serv Membership/Subscriptions 50 50 100 dues, professional subscriptions Outside services 2,000 4,272 6,272 trash, linen, etc. Program supplies 16,240 41,760 58,000 food service supplies for sites and kitchen F/ coni Total other costs 62,946 174,227 237,173 Totals 423,070 831,487 1,254,557 Item 9.a. - Page 99 Senior Nutrition Revenue Sources FlY 20~/201§" Federal & State Funds Senior Donations City/local Grants In Kind SLO County Grant Misc. Donations Fundraising & Holiday mailers. Total Administrative Costs Total Personnel Costs Program Costs $600,415 $120,000 $27,000 $210,000 ( $75,000 $66,520.00 $127,752 $1,251,687 $122,000 or 15% of total labor $810,000 $471,559 Item 9.a. - Page 100 BiasNimeh Executive Director SNPSLO enimehsnp@sbcglobal.net Justin Vanderlinden Vice President Rabobank Justin.vanderlinden@rabobank.com 269-5503 Work Home 748-0270 Cell Fax Senior Nutrition Program of San Luis Obispo County Board of Directors Rosier 2014-15 Address: 2180 Johnson Ave. San Luis Obispo, CA 93401 Address: 2276 Broad St. San Luis Obispo, CA 93401 541-3312 W ark Home Cell Fax Diane Maiorano Program Manager -Retired R.S.V.P. ddmaiorano@aH.net 544-8740 Work 481-2071 Home Cell 544-9146 Fax Member Since Sep-06 Address: 660 Pismo St. San Luis Obispo, CA 93401 BOD President -Member since Sep-07 BOD Vice President Member since Jan-98 Alex Benson Private Businessman alex.benson@baywoodinn.com 786-4444 Work 786-4440 Harne 704-3333 Cell 786-4441 Fax Address: 1130 Garden Street San Luis Obispo, CA 93401 Treasurer -Member since Jan-07 Chris Fasse Contractor Bli T Service Station 929-8944 Work Home 440-3446 Cell Fax Charmaine Petersen Certified Senior Advisor Senior Uving Consultants charmaine@seniorlivingconsultants.com 545-5901 Work Home 704-1532 Cell Fax Natalie T arlaglia Owner/Broker T ortaglia Realty natalie@TarlagliaRealiy.com 544-1244 Work Home Cell 544-5619 Fax Mark Wilson V .P. -Business Develpoment \l"ilshire Health li Community Services mwilson@wilshirehcs.org 547-7025 xl9 Work Home 286-1018 Cell 547-7030 Fax Address: 630 S. f=rontage Rd. Nipomo,CA 93444 Member since Auo-11 Address: 3165 S. Brood St., '114 San Luis Obispo, CA 93401 Member since Jan-11 Address: 968 Monterey Street San Luis Obispo, CA 93401 Member since Mar-10 Address: 285 South Street, Ste. J San Luis Obispo, CA 9340t -Member since May-14 RudyCampas Retired tducator anneHe.campos@sbcglobal.net Work 543-4979 Home Cell Fax Sid-~indley Refired Court COmmissioner sidlindley@gmail.com \l"ork 543-2027 Home Cell Fax Anila Shower anita@misseliqueHe.com Work 489-9696 Home Cell Fax Debbie Trout Pro. Fiduciary -Stale of CA debratroul@gmail.com Work Home 458-2858 Cell Fax Address: 871 Mirada Dr. San Luis Obispo, CA 93405 Member since Jun-08 Address: 1772 Ouail Circle San Luis Obispo, CA 93405 Member since Mar-09 Address: 867 N. 6th Street Grover Beach, CA 93433 Member since Jul-14 Address: 1303 Higuera, Ste A San Luis Obispo, CA 93401 -Member since Mar-09 Item 9.a. - Page 101 SENIOR NUTRITION PROGRAM OF SAN LUIS OBISPO COUNTY Statement of Financial Position As of December 31, 2014 ASSETS Current Assets Checking/Savings CASH IN BANK-CHECKING CASH IN BANK-PAYROLL PETTY CASH RABOBANK BANK C.D. RABOBANK FUNDRAISER BANK ACCT RABOBANK PAYPAL ACCOUNT Total Checking/Savings Accounts Receivable ACCOUNTS RECEIVABLE Total Accounts Receivable Other Current Assets PREPAID INSURANCE Total Other Current Assets Total Current Assets Fixed Assets FEDERAL ASSETS HELD Total Fixed Assets TOTAL ASSETS LIABILITIES & EQUITY Liabilities Current Liabilities Accounts Payable ACCOUNTS PAYABLE Total Accounts Payable Credit Cards AMERICAN EXPRESS Total Credit Cards Other Current Liabilities ACCRUED PAYROLL TAXES & BONUSES ACCRUED VACATION ACCRUED WAGES DEFERRED INCOME NIP -RABOBANK LOG #6701 Total Other Current Liabilities Total Current Liabilities Total Liabilities Equity RESERVE FOR FED ASSETS HELD SNP FUND BALANCE Net Income Total Equity TOTAL LIABILITIES & EQUITY Dec31,14 Dec 31, 13 62,099 38,427 0 75 322 322 50,056 50,036 600 3,362 1 '181 514 114,258 92,736 31,721 47,162 31,721 47,162 4,334 5,943 4,334 5,943 150,313 145,841 318,636 318,182 318,636 318,182 468,949 464,023 26,633 37,597 26,633 37,597 2,014 0 2,014 0 1,854 0 35,572 33,786 20,040 22,105 0 10,755 50,000 40,000 107,466 106,646 136,113 144,243 136,113 144,243 318,636 318,182 29,229 -2,997 -15,028 4,596 332,837 319,781 468,950 464,024 ,, Page 1 of 1 Item 9.a. - Page 102 '--CITY OF ARROYO GRANDE COMMUNITY SERVICE GRANT PROGRAM APPLICATION FORM 2014-15 Please complete the following sections (use additional sheets as necessary): I. NAME AND ADDRESS OF NON-PROFIT ORGANIZATION: (must be the local branch) Community Action Partnership of San Luis Obispo County, Inc. (CAPSLO) 1 030 Southwood Drive San Luis Obispo, CA 93401 II. GRANT APPLICANT REPRESENTATIVE'S NAME, ADDRESS AND TELEPHONE NUMBER: (must be the Executive Director or their designated representative) Elizabeth "Biz" Steinberg, Chief Executive Officer 1 030 Southwood Drive San Luis Obispo, CA 93401 Rnt;_t:;AA ..Jl~t:;t:; Ill. DESCRIPTION OF COMMUNITY SERVICES PROVIDED: Program description: The San Luis Obispo homeless shelter program has two shelter sites: the Maxine Lewis Memorial (MLM) Shelter at Orcutt and South Broad Street, and the Interfaith Coalition for the Homeless (ICH) Shelter. ICH is a coalition of 14 faith-based groups (supported by volunteers) that formed nearly two decades ago to support emergency overnight sheltering in the community. A different church or synagogue hosts the ICH Shelter each month. Both shelter sites are open seven nights a week, year-round. The MLM Shelter opens at 5:00pm for dinner, showers, client screening/intake for shelter beds, and client information/referral assistance. Families are transported from the MLM Shelter to the ICH Shelter where they will sleep. Individuals and persons with special needs stay at the MLM Shelter. Please see attached sheet for continuation of this section. IV. LIST AREA(S) SERVED BY NON-PROFIT ORGANIZATION: (include brief description of the relationship of your non-profit organization to the re?idents of the City of Arroyo Grande) The MLM Shelter program serves homeless men, women, and children as space is available from throughout the county and beyond. The client population includes youth accompanied by a parent or guardian (from newborns to teenagers), and adults including seniors. We serve persons of all ages, genders, races, and ethnicities without discrimination. This includes the mentally ill, developmentally and physically disabled, persons suffering from or in recovery from substance abuse, veterans, migrant farmworkers, and the working poor. We serve the chronically homeless, situational-homeless, unemployed, under-employed, uninsured, and underinsured. The Shelter has served families and individuals from Arroyo Grande since the facility has been in operation. CAPSLO has had, and continues to have, a strong partnership with the City of Arroyo Grande in serving vulnerable populations with a wide array of services. Arroyo Grande has been a valued supporter of CAPSLO and the services it provides. Item 9.a. - Page 103 v. NUMBER OF CITY OF ARROYO GRANDE RESIDENTS SERVED BY· NON-PROFIT ORGANIZATION: (broken down by age groups if available) Since 201 0 to date the shelter has provided overnight shelter, meals, and other services to over 150 individuals from Arroyo Grande. Last year, 2013, the Shelter provided emergency services to a.total of 40 Arroyo Grande residents. VI. AMOUNT OF FUNDS REQUESTED: $8,600.00 VII. PROPOSED USE AND BUDGET PLAN FOR GRANT FUNDS: (indicate if any of the grant funds will be used for any other purpose than those designated such as overhead, national office, administrative salaries) Please see attached. VIII. ADDITIONAL DOCUMENTATION: (if you have received funds in the past, please indicate the amount of funds received (indicate what year) and how the funds were utilized) 2010: MLM -$5,000, Senior Health Screening -$1,500, Forty Wonderful -$1,500, TAPP-$900. 2011: MLM-$5,000, Senior Health Screening-$1,500, Forty Wonderful-$1,500, TAPP-$1,050 2012: MLM-$5,000, 013: MLM-$8,600, 2014: Adult Wellness-$8,657 All funds used for operations. IX. SUPPLEMENTAL DOCUMENTATION: ii Past two year's financial statements, including the current year with the balance sheets and the profit/loss statements. il Information indicating the percentage of revenue received that is used for administration, salaries, and program costs. I!!!!! Breakdown and description of non-profit organization's sources of revenue. j!g Proof of 501 (c)(3) status with a copy of the letter from the IRS. !! Copy of the non-profit organizations Board of Directors, Officers and an organization chart. L_------~----------------------------------------------~-----------------1 Item 9.a. - Page 104 ( __ X. CERTIFICATION: Community Action Partnership of San Luis Obispo County, Inc. certify on behalf of non-profit organization, that I have read, understand and agree that the aforesaid information is accurate, factual and current. I understand that an award of funds, if granted, will be for the soie use as reflected in this application form. I further certify that as a condition of receiving funds, an agreement with the City of Arroyo Grande, in a form and content provided by the City of Arroyo Grande, will be · signed and executed by a duly authorized representative of said non-profit organization. I am aware of and certify that our non-profit organization will adhere to all City regulations regarding the 2014-15 Community Service Fund Program including, but not limited to, maintaining non- discriminatory policies, practices and intent I also, on behalf of our non-profit organization, indemnify, defend, and hold harmless the City of Arroyo Grande relative to any and all liability that may arise as a result of the use of the City of Arroyo Grande Community Service Grant Fund monies. /~ /tu' ;? / , Signature:!/~~ .c::;~ Executive Dir etor-"Gr DesigneeCJ -I Date: / · 6toJr Officer Item 9.a. - Page 105 i_·_ Part III. Description of Community Services Provided: Who/how will benefit: Who: Homeless individuals and/or families will benefit from the services provided as a result of receiving this funding. According to the 2013 Homeless · Enumeration Report, 2,186 county residents were identified as homeless. It is estimated that 3, 497 persons are homeless at some point in time over the course of a year. Of those surveyed in 2013 who were homeless in San Luis Obispo County: --~ • 50% reported this was not their first time being homeless. • 47% reported they had been homeless for a year or more during this current episode. • Their mean age is 42. • 69% are White/Caucasian, with 14% Hispanic/Latina. • 6% identified themselves as bisexual, gay or lesbian. o 67% are males and 33% are females. • 33% had some college education or college degree. • 71% were living in SLO Co. before becoming homeless. • 12% reported being a veteran. How: The San Luis Obispo shelter program will continue to benefit the county's homeless men, women and children who receive emergency intervention services to meet their most basic needs. Clients receive emotional and educational support to think beyond their immediate challenges and develop a plan to stabilize their lives and move toward greater self-sufficiency. Item 9.a. - Page 106 Community Action Partnership of SLO County, Inc. Maxine Lewis Memorial Shelter Proposed Budget FYE June 30, 2016 Source of Funds: CDBG Funds Requested-SLO County CDBG Funds Requested-SLO City CDBG Funds Requested-Cities: MB Total CDBG Funds Requested Non-CDBG Funds Requested: City of Arroyo Grande -General Fund SLO County ESG SLO County General Fund -Shelter SLO County General Fund -Safe Parking SLO City·General Fund-Safe Parking FEMA City of Pismo Beach Donations Total Funds Expenditures: Salaries Fringe Benefits Office Expense · Transportation Utilities Food Laundry Maintenance & Repairs Program Supplies Advertising, Recruiting and Training Miscellaneous Indirect & Administrative Total Expenditures Excess (Shortfall) of Funds over Expenditures Budget $ 127,080 127,081 8,600 262,761 8,600 42,091 95,211 10,000 10,000 15,000 2,200 93,130 $ 538,993 $ 261,474 115,173 2,938 12,157 21,101 13,303 22,495 12,855 19,911 1,525 16,136 39,925 $ 538,993 $ ( Item 9.a. - Page 107 Exhibit B Community Action Partnership of SLO County, Inc. Maxine Lewis Memorial Shelter Budget FYE June 30, 2015 Source of Funds: CDBG Funds-SLO County CDBG Funds-SLO City Total CDBG Funds Non-CDBG Funds: SLO County ESG SLO County General Fund -Shelter SLO County General Fund -Safe Parking SLO City General Fund -Safe Parking SLO City General Fund FEMA United Way or Corp Foundations City of Pismo Beach Agency CSBG support Donations Total Funds Expenditures: Salaries Fringe Benefits Office Expense Transportation Utilities Food Laundry Maintenance & Repairs Program Supplies Advertising, Recruiting and Training Miscellaneous Indirect & Administrative Total Expenditures Excess (Shortfall) of Funds over Expenditures Budget $ 74,898 74,767 149,665 44,307 50,694 10,000 10,000 46,000 21,000 2,500 2,200 56,732 140,844 $ 533,942 $ 257,609 109,689 2,757 11,578 20,486 12,916 21,840 18,854 19,331 1,677 21,856 35,349 $ 533,942 $ Item 9.a. - Page 108 Community Action Partnership of San Luis Obispo County, Inc. Balance Sheet Maxine Lewis Memorial Shelter and Safe Parking Actual Actual 6/30/2014 6/30/2013 Assets Cash & Cash Equivalents $ 254,004 $ 230,214 Grant Receivable 36,752 31,219 Prepaid Expense 850 850 Fixed Assets 140,405 140,405 Accumulated Depreciation (123,548) (114,988) ·Total Assets $ 308,464 $ 287,701 Liability & Fund Balance Liability Accounts Payable $ 13,583 $ 15,318 Accrued Liabilities 337 0 Accrued Payroll 5,486 9,493 Accrued Payroll Taxes 1,448 2,506 Deferred Revenue 131,309 95,522 Deferred Revenue Other 105,883 105,883 Total Liability 258,045 228,722 Fund Balance Fixed Asset Fund Balance 16,858 25,418 Fund Balance 33,561 33,561 Total Fund Balance 50,419 58,979 Total Liability & Fund Balance $ 308,464 $ 287,701 Item 9.a. - Page 109 Community Action Partnership of San Luis Obispo County, Inc. Income Statement Maxine Lewis Memorial Shelter and Safe Parking I Actual Actual 7/1/2013-7/1/2012- 6/30/2014 6/30/2013 REVENUE County SLO CDBG $ 76,749 $ 68,074 County SLO ESG 41,004 34,326 County SLO General Fund 42,211 64,858 County SLO Gen'l Fund-one time 11,080 25,066 County SLO Gen'l Fund -Safe Parking 10,000 8,750 City SLO CDBG 76,613 75,984 City SLO General Fund 46,000 45,000 City SLO Gen'l Fund-one time 4,000 City SLO Gen'l Fund -Safe Parking 10,000 7,136 City of Arroyo Grande -CDBG 8,600 5,000 City of Morro Bay -CDBG 4,315 City of Pismo -General Fund 2,200 2,200 EFSP/FEMA 21,000 22,601 Agency CSBG Support 86,775 71,757 Interest Income 22 Foundation Income 5,000 2,500 ( Private Corporate Revenue 2,500 2,900 Donations 54,495 . 54,309 Fundraising 74,597 54,050 TOTAL REVENUE 572,823 548,848 EXPENSES Personnel Costs 292,110 280,918 Employee Benefits 106,575 106,360 Service Provider Payments 568 Consultants, Legal and Audit 2,881 5,608 Materials and Supplies 34,434 28,112 Travel and Transportation 10,283 9,287 Repairs and Maintenance 21,863 10,033 Training and Seminars 1,008 488 Rent 3,850 3,970 Utilities and Telephone 16,698 19,325 Insurance 2,927 4,106 Postage and Printing 828 444 Capital Purchases Other Expenses 39,772 30,465 Interest Expense 861 3,714 ·Delegate Agency Services 492 Indirect Expense 38,164 44,740 TOTAL EXPENSES 572,823 548,060 NET SURPLUS/(DEFICIT) $ $ 787 Item 9.a. - Page 110 ··~f~/l Ins lk.p.:::;;;~;,; ,·C!be T:.·.:.'·.::~· ··£M;;) .. r~l.... lutt•rn:J.J RL·\·l·nut· St•r,·in· l9993 P.O. Box 2508 Cincinnati OH In· reply refe:- Aug. 18, 2009 95-2410253 to: 0248226129 45201 LTR 4168C EO 000000 00 00012792 BODC: TE COMMUNITY ACTION PARTNERSHIP OF SAN LUIS OBISPO COUNTY INC 1030 SOUTHWOOD DR SN LUIS OBISP CA 93401-5813 Employer Identification Number: 95-2410253 Person to Contact: Ms. K. Hilson Toll Free Telephone Number: l-877-829-5500 Dear Taxpayer: This is in response to your request of Aug. 07, 2009, regarding your tax-exempt status. Our records indicate that a determination letter was issued in , May 1966, that recognized you as exempt from Federal in~ome tax, and discloses that you are currently exempt under section 50l(c)(3) of the Internal Revenue Code. Our records also indicate you are not a private foundation within the meaning of section 509(a) of the Code because you are described in section(s) 509(a)(1) and l70Cb)(1)(A)(vi). · Donors may deduct contributions to you as provided in section 170 of the Code. Bequests, legacies, devises, transfers, or gifts to you or for your use are deductible for Federal estate and gift tax purposes if they meet the applicable provisions of sections 2055, 2106, and 2522 of the Code. If you have any questions, pleas~ call us at the telephone number shown in the heading of this letter. Sincerely yours, Michele M. Sullivan, Oper. ~lgr. Accounts Management Operations I i Item 9.a. - Page 111 .. ~ - - . r-~ . CO M M U N I T Y AC T I O N PA R T N E R S H I P BO A R D OF DI R E C T O R S an d TE R M DA T E S - 2014 Fr a n I. Co u g h l i n - Pr e s i d e n t Lo w In c o m e Rep ~ e s e n t a t i v e - No r t h Co u n t y 94 6 0 Ca r m e l D i s t r i c t V At a s c a d e r o , CA 93 4 2 2 (H ) 46 1 - 3 3 3 4 (P C ) 42 3 - 1 . 9 0 5 fr c o u q h l i n @ a o l . c o m Sa n t o s Ar r o n a -V i c e Pr e s i d e n t Pr i v a t e Re p r e s e n t a t i v e - Di r e c t o r C 41 0 Co r r i d a Dr i v e . Sa n Lu i s Ob i s p o , CA 93 4 0 1 (H ) 54 4 - 6 6 3 4 (C ) 45 9 - 2 6 3 4 sa r r o n a @ c h a i t e r . n e t Ro b Ga r c i a , Se c r e t a r y / T r e a s u r e r Pr i v a t e Re p r e s e n t a t i v e - Di r e c t o r E 61 3 So u t h Ma i n St r e e t Te m p l e t o n , CA 93 4 6 5 (0 ) 43 4 - 2 6 0 8 ro b @ q a r c i a w e a l t h . c o m (1 2 1 2 0 1 6 ) Ga r y Jo r d a n Lo w - I n c o m e Re p r e s e n t a t i v e - No r t h Co u n t y 20 8 Ca r d i n a l Wa y D i s t r i c t t Pa s o Ro b l e s , CA 93 4 4 6 (H ) 23 9 - 3 7 9 8 (0 ) 45 1 - 3 8 4 1 gd a j o r d a n @ y a b o o . c o m (1 2 1 2 0 1 5 ) De e La c e y Pr i v a t e Re p r e s e n t a t i v e - Di r e c t o r A 11 9 5 Be a v e r Cr e e k La n e Pa s o Ro b l e s , CA 93 4 4 6 (H ) 23 8 - 1 4 8 2 (0 ) 44 0 - 4 9 7 7 jd l a c e y 1 9 6 3 @ g m a i l . c o m (1 2 1 2 0 1 6 ) Sa n d e e Me n g e Lo w - I n c o m e Re p r e s e n t a t i v e - So u t h Co u n t y P. O . Bo x 22 2 8 D i s t r i c t tt l Av i l a Be a c h , CA 93 4 2 4 (H ) 59 5 - 7 3 1 5 (C ) (6 6 1 ) 20 3 - 6 0 3 0 sa n d e e m n g @ q m a i l . c o m Ca r l y n Ch r i s t i a n s o n , Pu b l i c Re p r e s e n t a t i v e (N / A ) De b b i e Ar n o l d , Pu b l i c Re p r e s e n t a t i v e Co u n t y Go v e r n m e n t Ce n t e r / B o a r d of Su p e r v i s o r s 10 5 5 Mo n t e r e y St r e e t , Ro o m D4 3 0 Ci t y of Sa n Lu i s Ob i s p o 99 0 Pa i m St r e e t Sa n Lu i s Ob i s p o , CA 93 4 0 1 (0 ) 78 3 - 1 0 2 0 (C ) 55 0 - 9 3 2 0 cc h r i s t i @ s l o c i t y . o r g Mi c a l W. Bo v e e Pr i v a t e Re p r e s e n t a t i v e - Di r e c t o r B 11 5 0 Pa l m St r e e t Sa n Lu i s Ob i s p o , CA 93 4 0 1 (0 ) 54 4 - 1 4 4 1 (F ) 59 3 - 1 2 3 1 mi c a l . b o v e e @ q l e n n b u r d e t t e . c o r n Li n d a Ho g o b o o m Lo w - I n c o m e Re p r e s e n t a t i v e - So u t h Co u n t y 59 0 Di e g o Ri v e r a D i s t r i c t IV Ar r o y o Gr a n d e , CA 93 4 2 0 (H ) 34 3 - 6 7 9 0 li n d a h o g o b o o m @ g m a i l . c o m R. Mi c h a e l Wr i g h t Pu b l i c Re p r e s e n t a t i v e 25 7 9 Qu a i l La r i e Lo s Os o s , CA 93 4 0 2 (H ) 52 8 - 0 7 0 8 mi k e w 7 8 8 3 @ a o l . c o m Sa n Lu i s Ob i s p o , CA 93 4 0 8 (0 ) 78 1 - 5 4 5 0 (F ) 78 1 - 1 3 5 0 da r n o l d @ c o . s l o . c a . u s (1 2 1 2 0 1 5 ) Ma r g i e Pe r e z - S e s s e r Pr i v a t e Re p r e s e n t a t i v e - Di r e c t o r D 54 9 5 Oa k h u r s t Ca m b r i a , CA 93 4 2 8 (H ) 92 7 - 4 9 9 8 (C ) 90 9 - 7 2 9 8 ma r g i e s e s s e r @ s b c g l o b a l . n e t (1 2 1 2 0 1 6 ) Ma r y An n Re i s s , Pu b l i c Re p r e s e n t a t i v e Ci t y of Pi s m o Be a c h 26 6 En c a n t o Av e n u e Pi s m o . Be a c h , CA 93 4 4 9 (C ) 70 9 - 6 2 9 6 mr e i s s @ p i s m o b e a c h . o r g (1 2 1 2 0 1 6 ) Ca r l o s So s a · Lo w In c o m e Re p r e s e n t a t i v e - Co a s t 43 3 Ma n z a n i t a Dr i v e D i s t r i c t II Lo s Os o s , CA 93 4 0 2 (0 ) 52 8 - 5 0 9 8 (C ) 55 0 - 4 7 4 7 cs o s a 1 9 5 0 @ a o l . c o m (1 2 1 2 0 1 5 ) Du a n e Pi c a n c o Pu b l i c Re p r e s e n t a t i v e 12 3 0 La n a St r e e t Pa s o Ro b l e s , CA 93 4 4 6 (0 ) 22 7 - 7 2 1 2 dp i c a n c o @ p r c i t y . c o m (1212016) (1 2 1 2 0 1 5 ) I - Bo a r d Consultants I (1 2 1 2 0 1 6 ) Ab b y La s s e n , At t o r n e y , Legal Consultant 76 5 Mo n a r c h Ln . Ni p o m o , CA 93 4 4 4 (H ) 92 9 - 3 9 6 3 (C ) 72 0 - 3 5 6 6 ah l a s s e n @ a i m . c o m . (N / A ) 1 - E a r l y - H e a d St a r t / H e a d Start Policy Council I Sa b r i n a Bu s s e l l (10/2014) HS / E H S PC Pr e s i d e n t 15 5 2 El Ti g r e Ct . , #2 Sa n Lu i s Ob i s p o , CA 93 4 0 1 (5 5 9 ) 70 4 - 1 1 3 6 (1 2 1 2 0 1 6 ) Sh e r r y ! Br a g g HS / E H S PC Vi c e Pr e s i d e n t 33 0 8 Pi n e St r e e t Pa s o Ro b l e s , CA 93 4 4 6 (H ) 23 9 - 2 6 1 1 (10/2014) (1 2 1 2 0 1 5 ) I Mi g r a n t & Se a s o n a l Head Start Policy Council I Ca r m e n Ro d r i g u e z · · (6/2014) MS H S Pr e s i d e n t 6 Sa n t a Cl a r a Av e n u e Sa l i n a s , CA 93 9 0 6 (8 3 1 ) 99 8 - 1 4 0 7 (1 2 1 2 0 1 5 ) De n i s e Ja i m e MS H S Vi c e Pr e s i d e n t 40 8 Pr i m a v e r a Ct Gr e e n f i e l d , CA 93 9 2 7 (8 3 1 ) 26 1 - 8 0 3 9 (6/2014) llnrl:::tftlorl· "11::lrl"h A '>A1A h ... 0/\ Item 9.a. - Page 112 . , . Ay u d o n d o Ge n i e . Ca m b i a n d o Vi d o s . G P A of SA DE L CP ' N Up d a t e I Ch i l d , Yo u t h an d Fa m i l y Se r v i c e s Di v i s i o n Bi l l Ca s t e l l a n o s I He a d St a r t Ea r l y He a d St a r t St a t e Ch i l d De v e l o p m e n t De b i We l c h Mi g r a n t an d Se a s o n a l He a d St a r t Bi l l Ca s t e l l a n o s El l e n Pe i o Ch i l d Ca r e Re s o u r c e Co n n e c t i o n Sh e r i Wi l s o n e 20 1 4 I Ex e c u t i v e As s i s t a n t / Ex e c u t i v e Of f i c e Ma n a g e r Ma r c i Sp e r l o I Fr o n t Of f i c e r- Ro s a Av i l a Ca r l o t t a He r b s t r e i t r-t - CA P S L O Or g a n i z a t i o n a l Ch a r t r - - { Ex e c u t i v e Co m m i t t e e J CA P S L O r- - f Fi n a n c e Co m m i t t e e J t - Bo a r d of Di r e c t o r s ' - - ( Li a i s o n Co m m i t t e e J i Hu m a n Re s o u r c e s I Co m m i t t e e Ch i e f Ex e c u t i v e Of f i c e r El i z a b e t h "B i z " St e i n b e r g I I Ch i e f Op e r a t i o n s Of f i c e r Deputy Director Ji m Fa m a l e t t e Grace Mcintosh Adult Day t-Center Fa c i l i t i e s Fi n a n c e Fa m i l y Support Mara Whitten Ja s o n La l Jo a n Li m o v Se r v i c e s 1- Me l i n d a Skolowski Energy -Jim McNamara He a l t h & In f o r m a t i o n Hu m a n Pr e v e n t i o n r-- Te c h n o l o g y Ja r r o d Pl e v e l Re s o u r c e s Ra y e Fleming Ca r o n Mc N e a r n e y Homeless 1-Services Dee Torres Planning and Program Development , ... -- ... , ~--Item 9.a. - Page 113 i ,-- CITY OF ARROYO GRANDE COMMUNITY SERVICE GRANT PROGRAM APPLICATION FORM 2014-15 Please complete the following sections (use additional sheets as necessary): I. NAME AND ADDRESS OF NON-PROFIT ORGANIZATION: (must be the local branch) Central Coast Salmon Enhancement 229 Stanley Ave Arroyo Grande, CA 93420 II. GRANT APPLICANT REPRESENTATIVE'S NAME, ADDRESS AND TELEPHONE NUMBER: (must be the Executive Director or their designated representative) Christopher Lim, Executive Director, (805) 678-0679 229 Stanley Ave Arroyo Grande, CA 93420 Ill. DESCRIPTION OF COMMUNITY SERVICES PROVIDED: CENTRAL COAST SALMON ENHANCEMENT (CCSE) is committed in helping our community to strengthen, protect and understand our watersheds and their fisheries. We believe through education and engagement, we can ensure that our natural resources continue to support the ecological, recreational and economic needs of our community. Together we can find viable solutions for maintaining healthy fish, healthy watersheds and healthy communities. CCSE is dedicated to this stakeholder-approach to fishery restoration. We recognize a need to work, recreate and live in our watersheds. We also recognize that fish serve as a bio-indicator species for our local watershed and are proud to know that the work we do to improve fish habitat will have the added side-effect of improving human habitat. The work we do can ultimately improve local flood issues, preserve agriculture land, ensure water sources for years to come and provide recreational opportunities for future generations. We serve the community through a combination of watershed restoration and classroom education. Our restoration projects provide hands-on opportunities for the community to reconnect with their local watershed, whether through citizen science or service. Our school program aims to inspire the future generations of environmental stewards through place-based learning and experiential learning. IV. LIST AREA(S) SERVED BY NON-PROFIT ORGANIZATION: (include brief description of the relationship of your non-profit organization to the residents of the City of Arroyo Grande) CCSE serves California counties from Monterey to Ventura focusing on coastal watersheds. Our office is located within the City of Arroyo Grande. We have enjoyed a productive working relationship with the City and its residents in the following ways: • The City participated in the development of the Arroyo Grande Creek Watershed Management Plan which led to the development of a City Working Group which helped to inform the City's Creek Resource Protection Study. Many city residents participated as stakeholders in the development of the plan. The South County Historical Society used its research for history of the Creek by ultimately publishing Bob Brown's Story of the Arroyo Grande Creek. • The City provided Measure 0 funding to CCSE for the development and distribution of the Arroyo Grande Creek Care Guide which was distributed to City residents and posted on the City's website. • Residents of the City have been involved in annual Creek Clean-up events and occasional volunteer Ivy Removal efforts hosted by CCSE and co-sponsored by the City. (continued under attached "Section IV continued") Item 9.a. - Page 114 v. NUMBER OF CITY OF ARROYO GRANDE RESIDENTS SERVED BY NON-PROFIT ORGANIZATION: (broken down by age groups if available) (see attached "Section V") VI. AMOUNT OF FUNDS REQUESTED: $3,998 VII. PROPOSED USE AND BUDGET PLAN FOR GRANT FUNDS: (indicate if any of the grant funds will be used for any other purpose than those designated such as overhead, national office, administrative salaries) See attached "Sage Waterways Workshop Description" and attached budget. VIII. ADDITIONAL DOCUMENTATION: (if you have received funds in the past, please indicate the amount of funds received (indicate what year) and how the funds were utilized) $6000 for Arroyo Grande Creek Care Guide in 2009 IX. SUPPLEMENTAL DOCUMENTATION: !!! Past two year's financial statements, including the current year with the balance sheets and the profit/loss statements. iJ Information indicating the percentage of revenue received that is used for administration, salaries, and program costs. 1!!1 Breakdown and description of non-profit organization's sources of revenue. ij Proof of 501 (c)(3) status with a copy of the letter from the IRS. ei Copy of the non-profit organizations Board of Directors, Officers and an organization chart. t_ Item 9.a. - Page 115 X. CERTIFICATION: ·behalf Central Coast Salmon Enhancement certify on of non-profit organization, that I have read, understand and agree that the aforesaid· information is accurate, factual and current. I understand that an award of funds, if granted, will be for the sole use as reflected in this application form. I further certify that as a condition of receiving funds, an agreement with the City of Arroyo Grande, in a form and content provided by the City of Arroyo Grande, will be · signed and executed by a duly authorized representative of said non-profit organization. I am aware of and certify that our non-profit organization will adhere to all City regulations regarding the 2014-15 Community Service Fund Program including, but not limited to, maintaining non- discriminatory policies, practices and intent. I also, on behalf of our non-profit organization, indemnify, defend, and hold harmless the City of Arroyo Grande relative to any and all liability that may arise as a result of the use of the City of Arroyo Grande Community Service Grant Fund monies. Date: 11 /21/2014 Signature: or Designee Board of Director or Officer Item 9.a. - Page 116 (SECTION IV continued) In addition, CCSE has served City residents by: o Initiating the Arroyo Grande Creek Memorandum of Understanding (MOU) group to coordinate/cooperate on projects that benefit the City such as the Tally Ho Restoration project and the Clark property sediment basin project. a Providing language and interpretive sign models for use in developing signage for the bioswale behind the previous location of City Hall. o Developing, funding and implementing plans for two creek aligned trails to complement the City's larger creek trail system. o Assisting the developer of Cherry Creek and the City with a planting palette for the Newsome Springs swale '-.- Item 9.a. - Page 117 ( Section V 1. Assisted Arroyo Grande in Bloom and the Tree Guild-CCSE participated in the AG In Bloom's initial efforts by attending meetings and partnering with the Tree Guild {and Master Gardeners) on the Ivy Removal efforts between Mason and Bridge Streets. 2. Provide watershed education programming in local schools and at our center on Stanley Avenue. Approximate number of students within the city served annually is over 500. Approximate number of adults served annually is over 200. 3. CCSE responds to City residents' inquiries regarding their creek adjoining properties and provides information on Best Management Practices for riparian protection and restoration. If warranted we bring in additional resources to assist such as the Coastal San Luis RCD and the Natural Resources Conservation Service, leveraging our working relationships with many additional local, state and federal agencies. Average number of adults assisted annually is 20. 4. CCSE serves as a local resource for the City to protect and enhance Arroyo Grande Creek resources for the benefit of the City's residents. CCSE has 17 members from Arroyo Grande who have donated $4,617 since 2001. We currently have 702 Arroyo Grande residents and business as contacts in our database. Item 9.a. - Page 118 VII. Sage Waterways Workshop Descriptio·n "We forget that the water cycle and the fife cycle are one."-Jacques Yves Cousteau This quotation is especially important at this time in California because all of our lives, whether we are aware of it or not, are affected by the drought. If all life relies on water, then all the interconnected species that share our watersheds are also affected. Central Coast Salmon Enhancement (CCSE) wants to improve the watershed for people and the species connected to people, in particular, Steelhead trout. The first step is building awareness for how each person's everyday choices can affect the watershed in either a positive or negative way. During previous droughts, conservation efforts such as low flow showerheads became mainstream. Yet, today our severe drought calfs for a new awareness and additional changes in human behavior to adapt to our ever-changing climate. Central Coast Salmon Enhancement understands that the health of our watershed and its fish depend on the everyday choices of the community. Our Sage Waterways Workshop provides the community with positive choices to benefit their own water budget at the start of their watershed, in their homes. Our Sage Waterways Workshop consists of two interconnected sessions, the first half demonstrates how anyone can participate in rain water harvesting while the second half is a community service project that describes the benefits of using native plants in one's garden and culminates in planting natives with the help of a local Boy Scouts troop. The whole day is viewed through the lens of Steel head trout and how water is important for the health of all species in the watershed. Our workshop will utilize hands-on activities and demonstrations. We will utilize our educational space here at the CCSE office for the workshop. The first half of the workshop demonstrates how anyone can participate in rainwater harvesting. Prior to our workshop, CCSE, with the help of a licensed professional, will install 2 rainwater barrels at its office. During the workshop, our contracted rainwater harvesting expert, uses these barrels as a demonstration to attendees on how to install their own rainwater barrels at home. Naturally, participants learn the environmental and economic benefits of rainwater harvesting, how to install the rain barrels, how to estimate the proper size of barrel for their roof, and receive additional resources to take home. One of the main reasons to collect rainwater is the ability to use the water to irrigate one's garden. This is the perfect segue into the second half of the day. The second half of the workshop describes the benefits of using native plants in one's garden for both their own water budget and to improve habitat for Steelhead trout. An expert on native plants describes to participants why he/she should be using native plants and mulch in one's garden. The focus is how much less water can be used when I __ Item 9.a. - Page 119 '-,-landscaping with plants adapted to our state's Mediterranean climate. Furthermore, attendees learn when it is best to plant, which plants are suitable to your garden's level of sunlight and type of soil, and what plants can help attract beneficial insects. Participants also gain awareness for the economic benefits of planting natives, including using less water, fertilizers, and zero pesticides. Participants will also go home with additional handouts. The day concludes with a service project where participants get to improve their local watershed by planting native plants. The planting begins with an overview of the benefits of using native plants, but this time, focused on fish and the health of the watershed. We have three beds located on the front of our property and prior to the workshop, we will develop a planting plan with local experts. Attendees receive a tutorial on how to properly remove plants from their container, how deep a hole to dig, as well as how often to water the plants. Each participant is given the opportunity to plant his/her own plant. We will also partner with a local Boy Scouts troop and they will help with the planting and other tasks, such as mulching and weeding. Since our office is on the banks of Arroyo Grande creek, this planting is a significant opportunity to educate the community on everyday choices one can make to increase the health of the creek for fish and future generations of Arroyo Grande residents. On site, we can tangibly explain the flow of water through the watershed and how our choices on land affect our local waterways and beyond. Our day's planting can help decrease the levels of polluted runoff entering the creek, increase insect diversity, and increase soil permeability. A short excursion during the planting takes participants down to the creek to view a current project by CCSE: Arroyo Grande creek stream gage modification which when completes, will allow Steelhead passage further up the watershed. This project showcases what a small group of concerned citizens can accomplish by choosing to make their watershed better for fish and its citizens. The lasting infrastructure of this workshop is a transformation of the office into a model of sustainable rainwater harvesting and native plant landscaping that will be seen by all who visit. We will use the space as a teaching opportunity for everyone who visits through interpretive signage and could continue to provide the Arroyo Grande community with additional workshops, planting workdays, and garden volunteer groups. We can also host students from Arroyo Grande in need of community service hours and/or internship opportunities. Our outreach for the workshop includes both traditional and modern techniques. We will outreach with fliers to local businesses, libraries, and schools. We will also post the event to our website, Facebook, and Twitter pages. Our workshop will be posted on local community websites and calendars. We also have a database with over 700 emails of Arroyo Grande residents that we could target. Item 9.a. - Page 120 We aim to have 20 members of the Arroyo Grande community attend the 5 hour workshop for a total of 100 contact hours. The Boy Scouts will be an additional partner and will volunteer a combined 20 hours. Our workshop is evaluated using a pre and post survey we will develop. The survey is a combination of multiple choice questions to measure the increase in gained knowledge and a 5-point Likert scale to measure the change in the participants' feelings. A Likert scale typically ranks statements based on an evenly distributed scale, using categories such as "strongly agree," "somewhat agree," "neither agree nor disagree," etc. We will then use statistical software to determine whether the observed change is "statistically significant" and not attributable to randomness. In terms of evaluation, having a one day workshop is highly advantageous because any change we see in the evaluations can be assumed as directly due to the program. We will measure the success of our workshop using the results of our pre and post surveys. For the multiple choice section of the survey, we aim to increase knowledge on no less than 80% of the multiple choice questions. For the Likert scale component of the survey, we aim for a positive "statistically significant" change on at least 80% of the statements. The objective of Sage Waterways Workshop is to illustrate to attendees how their choices at home are interconnected with water, fish, the watershed, and their community. We want people to go home inspired by knowing it only takes one person to make a difference. '-.- Item 9.a. - Page 121 -r B u d g e t - Sa g e Wa t e r w a y s Wo r k s h o p 20 1 5 Pe r s o n n e l ra t e ho u r s to t a l I Pr o g r a m Ma n a q e r 49 ou t r e a c h 16 78 4 me e t i n g s 8 39 2 de l i v e r y 8 39 2 lf ) ( e c u t i v e Di r e c 1 Q _ r " _ - 59 18 10 6 2 fr i n g e be n e f i t s @1 0 % 26 3 to t a l pe r s o n n e l 28 9 3 Su b c o n t r a c t o r s Ra i n Wa t e r Ha r v e s t i n g 20 0 20 0 Co n t r a c t o r Pl a n t i n g pl a n co n t r a c t o r 75 75 Ma t e r i a l s Ra i n w a t e r ba r r e l s + 35 0 35 0 ma t e r i a l s pl a n t s 20 0 20 0 mu l c h 75 75 pl a n t i n g to o l s 75 75 in t e r R _ r e t i v e si g n a _ g e 10 0 10 0 pr i _ Q t i n g an d co g y i n g - 30 - · · · - - · - - 30 I Jo t a l 39 9 8 1 Item 9.a. - Page 122 9:39AM 11/20/14 Accrual Basis Central Coast Salmon Enhancement, Inc. ASSETS Current Assets Balance Sheet As of December 31,2013 Checking/Savings 01-01 · Checking -Rabobank 01-03 · Port San Luis Halibut Derby 01-04 ·CD-Rabobank Total Checking/Savings Accounts Receivable 02-01 · Accounts Receivable Total Accounts Receivable Other Current Assets 03-01 · Undeposited Funds Total Other Current Assets Total Current Assets Fixed Assets 04-01 · Accumulated Depreciation 04-03 · Office Equipment 04-04 · Pen Rearing Equipment 04-05 · Watershed Equipment Total Fixed Assets TOTAL ASSETS LIABILITIES & EQUITY Liabilities Current Liabilities Accounts Payable 05-01 · Accounts Payable Total Accounts Payable Other Current Liabilities 07-01 · Business Reserve Loan 07-02 · Payroll Liabilities 07-10 · Tri Counties Fish Team* 07-11 · Joint Cable/Fisheries Liaison 07-12 ·Clean Beaches Initiative• 07-14 · WSB Donations 07-15 · Port San Luis Harbor District Total Other Current Liabilities Total Current Liabilities Long Term Liabilities Connie O'Henley Total Long Term Liabilities Total Liabilities Equity 08-01 · Net Assets 08-02 · Retained Earnings Net Income Total Equity TOTAL LIABILITIES & EQUITY Dec31,13 7,664.15 257.97 3,408.64 11,330.76 51,270.71 51,270.71 -101.13 -101.13 62,500.34 -128,380.00 5,950.49 119,176.49 4,119.00 865.98 63,366.32 45,068.06 45,068.06 14,604.78 4,432.23 13,242.67 1,797.50 41.06 3,400.00 5,823.00 43,341.24 88,409.30 2,630.59 2,630.59 91,039.89 46,191.20 -51' 114.65 -22,750.12 -27,673.57 63,366.32 '-,- Page 1 Item 9.a. - Page 123 ' ,-- 9:39AM 11/20/14 Accrual Basis Central Coast Salmon Enhancement, Inc .. ASSETS Balance Sheet As of November 20, 2014 Current Assets Checking/Savings 01-01 · Checking-Rabobank 01-03 · Port San Luis Halibut Derby Total Checking/Savings Accounts Receivable 02-01 · Accounts Receivable Total Accounts Receivable Total Current Assets Fixed Assets 04-01 · Accumulated Depreciation 04-03 · Office Equipment 04-05 · Watershed Equipment Total Fixed Assets TOTAL ASSETS LIABILITIES & EQUITY Liabilities Current Liabilities Accounts Payable 05-01 · Accounts Payable Total Accounts Payable Other Current Liabilities 07-01 · Business Reserve Loan 07-02 · Payroll Liabilities 07-10 · Tri Counties Fish Team* 07-14 · WSB Donations 07-16 ·Trout in the Classroom Donation Total Other Current Liabilities Total Current Liabilities Total Liabilities Equity 08-01 · Net Assets 08-02 · Retained Earnings Net Income Total Equity TOTAL LIABILITIES & EQUITY Nov 20, 14 690.87 257.97 948.84 45,655.04 45,655.04 46,603.88 -9,203.51 5,950.49 4,119.00 865.98 47,469.86 38,268.60 38,268.60 24,900.03 3,396.19 11,424.68 1,970.00 1,500.00 43,190.90 81,459.50 81,459.50 46,191.20 -73,864.77 -6,316.07 -33,989.64 47,469.86 Page 1 Item 9.a. - Page 124 9:41AM 11/20/14 Accrual Basis Central Coast Salmon Enhancement, Inc. Profit & Loss January through December 2013 Ordinary Income/Expense Income 09-0100 ·Membership Dues 09-0200 · Fundraising 09-0300 · Contributions Income 09-0400 · Grants 09-0500 · Program Fees 09-0600 · Consultation Total Income Cost of Goods Sold 10-0100 · Cost of Goods Sold 10-7000 · Billable Payroll Expenses Total COGS Gross Profit Expense 11-1000 · Supplies 11-1500 · Equipment 11-2000 · Postage and Delivery 11-2100 · Printing and Reproduction 11-2500 · Training 11-2600 · Travel & Ent 11-3000 · Rent 11-3100 · Utilities 11-3900 · Property Taxes -County 11-4500 · Insurance 11-5000 · Licenses and Permits 11-5500 · Dues and Subscriptions 11-7000 · Payroll Expenses 11-7500 · Contract Labor 11-7600 · Professional Fees 11-8000 · Bank Service Charges 11-8500 · Interest Expense Total Expense Net Ordinary Income ( Other Income/Expense Other Income 12-0100 ·Interest Income 12-0200 ·Other Income Total Other Income Net Other Income Net Income Jan-Dec 13 450.00 531.68 7.730.00 105,969.57 6,649.80 29,230.55 150,561.60 0.00 116.31 116.31 150,445.29 1,533.50 300.50 236.31 2,023.43 409.62 4,265.14 8,000.00 6,038.83 13.16 4,603.43 60.00 1,288.32 110,695.44 30,116.47 9,325.74 492.86 878.72 180,281.47 -29,836.18 3.56 7,082.50 7,086.06 7,086.06 -22,750.12 '-,- Page 1 Item 9.a. - Page 125 ( ' ~-- 9:40AM 11/20/14 Accrual Basis Central Coast Salmon Enhancement, Inc. Profit & Loss January 1 through November 20, 2014 Ordinary Income/Expense Income 09-0100 ·Membership Dues 09-0200 · Fundraising 09-0300 · Contributions Income 09-0400 · Grants 09-0500 · Program Fees 09-0600 · Consultation 09-0800 · Misc. Income Total Income Cost of Goods Sold 10-7000 ·Billable Payroll Expenses Total COGS Gross Profit Expense 11-1000 ·Supplies 11-2000 · Postage and Delivery 11-2100 · Printing and Reproduction 11-2500 · Training 11-2600 · Travel & Ent 11-3000 · Rent 11-3100 · Utilities 11-4500 ·Insurance 11-5000 · Licenses and Permits 11-5500 · Dues and Subscriptions 11-7000 · Payroll Expenses 11-7500 · Contract Labor 11-7600 · Professional Fees 11-8000 · Bank Service Charges 11-8500 · Interest Expense Total Expense Net Ordinary Income Other Income/Expense Other Income 12-0100 · fnterest Income 12-0200 · Other Income Total Other Income Other Expense 13-0100 · Other Expenses Total Other Expense Net Other Income Net Income Jan 1 -Nov 20, 14 '-;. 75.00 2.177.58 2,850.00 138,868.94 3,281.13 12,240.55 302.19 159,795.39 32,029.48 32,029.48 127,765.91 1,409.15 110.52 3,010.64 150.00 1,433.38 10,750.00 4,449.50 8,081.26 758.75 1,065.45 59,514.97 49,177.88 101.60 333.71 2,408.79 142,755.60 -14,989.69 0.51 9,535.41 9,535.92 862.30 862.30 8,673.62 -6,316.07 Page 1 Item 9.a. - Page 126 Revenue percentage 2014 salaries program admin The above chart shows our 2014 revenue percentage broken down into salaries (63%), program costs (23%), and administration (14%). Typically, we would include the salaries into the program costs and that results in a program percentage of 86% and an administration percentage of 14%. Sources of revenue 2014 grants donations contracts earned income The above chart shows our 2014 sources of revenue by percentage. Grants account for 89%, contracts are 7%, donations are 3%, and earned income is 1%. We understand the benefits to not relying on a single major source of funding and are actively working to enhance our fund raising of untapped sources. ' -,- Item 9.a. - Page 127 . I \-.- H~1.... REVENUE SERVICE:· Date: MAR 1 0 1986 Central Coast ~al~en Enhancement, Inc. P.O. Boj: 1343 Arroyo Grance, CA 53420 Deo.r A~}?:iicant: OF THE TREASURY EIN: 77-0079J9G Accounting Period Ending: June 30 Form 990 Required: Yes Person to Contact: To.xpayer Service Representative Contact Telephone Number: {300) 424-1040 Zased on the inior».a.tion su~~liec, o.ha assuning ycur operations will ~e as statec in your a~plication fer recognition of exe~ption, we have ceternined you are exe!i:pt f rem Feaeral incor::e ta:.:: under section 5Dl(c)(3) oi the Intern~l Revenue Coce. :;e have further de1:eniiinea tbc;;t you are not a :;:;rivo.te £ound2.tior: ~it~i~ the ~eanins oi section 509{a) ot the Code, because you are an on;an·i::ation cescrii:>ed in section 509 (a) (1) ana 170 (o) (1) (A) (vi.). Ii your sources of s~~port, or your pur~oses, chara~ter, or cethod of c~e~ation c~ange, Flease let us know so we can cofiEiaer the effect of the c~anse on your exew~t status ana founcation statu~. Also, you snoulc inion:-: us oi all ci:a"nges in your name or ac6ress. As of January 1, 198~, you are liabie for ta~es under the Federal Insurance Contributions Act (social security ta~es) on reuuneration of $100 or oore you pay to eacn of your enployees aurins a calencar year. You are no1: liable for t~e tax i~posed un6er the Feteral Unemployment 7a~ Ac~ (FUTA) • ' Since you are not a private foundation, you are e~cise taxes un6er Chapter 42 o£ the Code. However, li.&tj_c:::.lly exer:-._!;t frow. other Fec<::ral ex·cise taxes. questions a6out e~cise, e~ploy~ent, or o~her FeGerai U!J .kllO\:;. not sujject to the you are nc~ auto- If you h&ve any ta~es, please let ~cnors ~ay 6e~uc~ contrijutions to you as Frcv1ced in section 170 of the Code. Bequests, legacies, 6evises, transfers, or gl~l:S tc you or ipr ~cur use are d~6ucticle for 2e~eral est~te an~ Slft tax ~ur;oses if tne7 ~cct t~e a??lic~jle ~rovision3 oi sec~ions 2053, 2106, &nc.252~ oi ti!~ CcGe. ':'::e jo:; cJ:eckeo i!1 ::i1e i1eaC.ins c::": t~1is letter s~lmis ;·;i:1eti:e:::: you ~~ .. u~-: ii.::..c Forw 990, ?!etur~L cf C·rsC;nize.tion S::e; .. tl_:'~~ .::-c: .. ~ Incor~ie 7.=.:=. ..:.~ "le:.; .:.s c:;ec!~ec, you c.re re.-:.~uir<=u 't:O Eile fen-.. 950 onl:,.' i::: your-sroEs recei~ts ec.c~ year are nor~ally ~ore tjan ~25,CGO. Ii a return is re~uire~, it ~ust oe £iiea by the 15t~ day oi t~e fiith conth &iter tne er.c o~ ~lOUr ani1U<ll <::.ccounL::.n.:; 2er io.::;. 'i'iH~ l.a.\1 i:"!.-•os<:s u. · j:. enc.l t~' of !;10 .:, c...:,'j-, iJi:; to a ;:,i:.:·:i:.i.ui'" o:>: ~5,000, \.'i-.en c. recurn :.:::. ::ilec. late, unles!:i ~~ere is reasor:~ble c~use tur che celQy. Item 9.a. - Page 128 INTi REVENUE SERVICE( DEPAp'Pf1ENT I OF THE TREASURY ·---J Y0u arc ~ot r~guire~ to file Fe~eral inco~e tax returns unles~ you are subject to the ta:: on unrelQte~ b~3iness incoQe under section 511 of tae Co6e. I£ you are sujject to t~is tax, you ~ust file an inco~e tax re:turn on Forn 9~0-T, E;.:e:.:pt Orsanization Eu:::ine.ss Income Tax P.eturn. .-.- In this letter, we are not deter~ini~g whether any o£ your pres&nt or pro?o~eci activities are unrelated traGe or business as defined in section 513 of the Code. This ~eter~ination letter is effective February 2E, 1933. You nee~ an e~ployer identification nuf.lber even if you have no e2~loyees. If an em~loyer i6entification nuwber was not entered on you: a~plication, a nu2cer will be assignea to you anc ycu will be aoviseG of it. Please use tnat nuill~er on all returns you file anci in all correspon- dence ~itn the Internal Revenue Service. Bec2use tnis exe~pt status and fer~anenL recor~s. letter coulG help resolve any suestions iouncation status, you snoul~ keep about it in your your ;f:you have any guesL~ons, please contzct the Ferson whose name an6 telepi:one nl.!:i7.0er are shm-;n in the headin<; of this letter. Sincerely yours, District Director ' OA1()., o . .n r nn\ /l 0-8: 1 ' Item 9.a. - Page 129 I -,- Central Coast Salmon Enhancement, Inc. Thorv Hessellund 925 Sylvan Ridge Arroyo Grande CA 93420 (805) 473-2330 (H) (805) 550-8498 (C) thorva@sbcglobal.net Jim McManus-Secretary 1220 Oak Knoll Rd. Orcutt, CA 93455 (805) 489-4040 (H) (805) 938-8513 (W) jmcmanus@orcutt-schools.net (W) jevj@charter.net (H) Mike Eisner 320 Calle Del Sol Nipomo, CA 93444 (805) 929-2599 (H) (626) 705-2715 (C) theotherm@aol.com Enhancing Fisheries While Improving the Environment Board of Directors Doug Daniels-President Central Coast Salmon Enhancement 229 Stanley Avenue Arroyo Grande, CA 93420 (805) 473-8167 (F) (805) 471-2130 (C) doug@centralcoastsalmon.com Lew Lechter-Treasurer (805) 934-2476 lsleichter@hotmail.com cjl ssd:Users:cjl:Documents:CCSE:fundraising:grants:AG Community Service:ccse board roster 02-2014.docx 11/20/14 Item 9.a. - Page 130 Ex e c u t i v e Co m m l t e e x~~)~t r ~ ~ ~ J ~ 5 W i ~ ~ ~ ~ ~ ~ 1 b l ¥ i . i ~ t ~ Ch a i r / P r e s i d e n t : Do u g Vi c e Pr e s i d e n t : Ce n t r a l Co a s t Sa l m o n En h a n c e m e n t Or g a n i z a t i o n a l Ch a r t w/ Na m e s No v e m b e r 20 1 4 Bo a r d Of . Di r e c t o r s Bo a r d Co m m i t t e e s ;·~·;~:J ; · ~ ~ ~ ; : ; ~ ~ ~ $ ~ ! : i W E A t ~ f . ; ~ ; ; ; ~ ~ ] ~ ~ ; : ~ : u _n JL Pe r s o n n e l Co m m i t t e e ·F i n a n c e Co m m l t e e Fu n d De v e l o p m e n t ~&~ij% f ! 1 ~ ~ ~ i J i \ t ; ~ ; ~ ~ i f 1 ~ 1 ~ ~ r ~ i ~:ij?;:1~ ~ ~ ~ ~ ~ ? ; f 1 ~ ~ ~ ; ~ r . ~ ~ j f ~ · ~ ~ l ; ~ ~ : . 1 ~ Ch a i r : F= Ch a i r : Me m b e r s : Ch a i r : Me m b e r s : F- Se c r e t a r y : Ji m Tr e a s u r e r : Le w r- Me m b e r s : II Ev e n t Ad v i s o r y \fl·.:;;· ; \ : i W ~ ~ i § · ~ · t B ~ : f : ~ : ~ ; ; ; : ; ? : ~ : . ~ ; - ~ ~ l. . : j An n u a l Dl n n : r Pl a n n i n g ;~\:/~f~; ~ r , : ; : ~ : / : Y i ~ ~ f . - ~ ~ ~ ; ? { ~ 6 ! . ~ : \ · · . · . Me m b e r s h i p Ad v i s o r y Co m m i t t e e H Ma r k e t i n g Ad v i s o r y Co m m i t t e e ·i: : : .. ;:~·~.~ ~~~~·~ = ; A g ~ ~ ~ ~~:~;~·~;~ ~ ~ ~ ; ; ~ ~ ; ~ :''·~~ Ex e c u t i v e Di r e c t o r , .. ..• Ch r i s t o p h e r , L i m • . :: ~~·-~; 0 ~ ~ } { { ~ ~ \ t · J . : U h ~ ~ j ~ ~ r : ; ; t : ~ r f . \ t l : l ~ l j[ _ _ II -~ Wa t e r s h e d Pr o j e c t s .M a n a g e r Ad m i n / B o o l < k e e p e r Mo n i t o r i n g Pr o g r a m s 1Ev a l u a t o r : •. -.~.:~, I i ; i ~ m : ~ ~ J . i i ; \ } < ' · ~:.>;:l~ ; . 0 ! .. ~:;f-.. ;~~:;#i~ - f i : ; ~ ~ 0 1 Wa t e r s h e d le a d Sc i e n t i s t .. Ai e k s ; W y d z g a !'·,:: · · ; : . : _ ; ; ~ = : : · . : : : f . ~ . ; : .. ;,,.·. ~ ~ · : , : . .' , , ) , . · .. •.- : --- - - - - · . Wa t e r s h e d s St e w a r d s Pr o g r a m . . )' M i c f i e l l e : P e p p i n g ... ·':\ : ~ : '., ~ .. .~:·~ :~ -~-' < · : r : ~ · . ' ·- ' ! ;·.~' :~·.;;~ ··;;~~·~ : ~ . t ~ ~ g ~ ' R i . ~ , \ \ i : ~ · . · > h · ~ K _ Education and Outreach .. :Projects Manager.,. .•.. t/;·~i·t~~;~~~ffi~~~~i~¥~\t~~~:~.~~~ Environmental Educators ~ . .Tosha Punches, . :i·~\:~~~;l?ttf~!~~~~~~li.~f.;l~~~~i . T. Item 9.a. - Page 131 .( CITY OF ARROYO GRANDE COMMUNITY SERVICE GRANT PROGRAM APPLICATION FORM 2014-15 Please complete the following sections (use additional sheets as necessary): I. NAME AND ADDRESS OF NON-PROFIT ORGANIZATION: (must be the local branch) Peoples' Self-Help Housing, 3533 Empleo Street, San Luis Obispo, CA 93401 Service sites: Cawelti Court, 351 So. Elm Street (27 units), Courtland Street Apartments, 150So. Courtland Street (36 units), Oak Forest Apartments; 163 So. Elm Street (20 units)--all in Arroyo Grande. II. GRANT APPLICANT REPRESENTATIVE'S NAME, ADDRESS AND TELEPHONE NUMBER: (must be the Executive Director or their designated representative) John Fowler, President/CEO, 3533 Empleo Street, San Luis Obispo, CA 93401. (805) 540-2462 Ill. DESCRIPTION OF COMMUNITY SERVICES PROVIDED: Peoples' Self-Help Housing provides affordable apartments for low income families, seniors, and special needs persons in Arroyo Grande. We have 83 units in Arroyo Grande with 270 low income residents. Our newest property Courtland Street Apartments opened in summer, 2014. We don't just 'build the box'! Peoples' provides free supportive social services, such as conflict mediation, counseling, job search assistance, budgeting, and juvenile delinquency prevention, which are provided by trained social workers. In addition, Peoples' built a Youth Learning Center at the Courtland Apartments, which is providing free after school education for 30 low income K-8 students at day. IV. LIST AREA(S) SERVED BY NON-PROFIT ORGANIZATION: (include brief description of the relationship of your non-profit organization to the residents of the City of Arroyo Grande) Arroyo Grande affordable housing projects with supportive services in Arroyo Grande: Peoples' built Cawelti Court, a 28 unit senior property, in 1996. We built Oak ForestApartments, 20 unit multi family apartments in 1997. We built Courtland Apartments, 36 unit multi family apartments, in 2014. Our properties are well constructed and beautifully landscaped and maintained. We are good neighbors and a positive partner in the community. We provide housing that is affordable for people working and living in Arroyo Grande. Peoples' provides much needed housing for low income seniors as well. · We provide free financial education and first time home buyer education workshops that are open to all community members. We also provide free supportive social services by trained social workers for any resident who needs it. Issues could be conflict resolution, juvenile delinquency prevention, substance abuse, domestic violence, aging in place, mental and physical disability issues, etc. PSHH is a good neighbor by taking care of its own residents and reducing the need for city and county services. Item 9.a. - Page 132 v. NUMBER OF CITY OF ARROYO GRANDE RESIDENTS SERVED BY NON-PROFIT ORGANIZATION: (broken down by age groups if available) Total 270 residents 0-5 years--37 persons 6-17-91 16-64--118 65+--24 VI. AMOUNT OF FUNDS REQUESTED: $10,000 VII. PROPOSED USE AND BUDGET PLAN FOR GRANT FUNDS: (indicate if any of the grant funds will be used for any other purpose than those designated such as overhead, national office, administrative salaries) Peoples' is requesting grant funds for Educators salary at Courtland Street Apartments after school education program. The Courtland Learning Center is open Monday through Friday 3:00 -6:00 p.m. The lead educator is Alba Quintanilla. No funds would be used for overhead, administration, or national dues. In fiscal year 2013,87% of our budget was spent on programs and 13% on managemenUadministration. VIII. ADDITIONAL DOCUMENTATION: (if you have received funds in the past, please indicate the amount of funds received (indicate what year) and how the funds were utilized) NA IX. SUPPLEMENTAL DOCUMENTATION: ~ Past two year's financial statements, including the current year with the balance sheets and the profit/loss statements. ~ Information indicating the percentage of revenue received that is used for administration, salaries, and program costs. !!I Breakdown and description of non-profit organization's sources of revenue. ~ Proof of 501 (c)(3) status with a copy of the letter from the IRS. !!I Copy of the non-profit organizations Board of Directors, Officers and an organization chart. Item 9.a. - Page 133 X. CERTIFICATION: certify on behalf of p ~ f Las ' ltz_ /.f, /-.l-e( VO ~ i.;..f / n3 non-profit organization, that I have read, understand and agree that the aforesaid information is accurate, factual and current. I understand that an award of funds, if granted, will be for the sole use as reflected in this application form. I further certify that as a condition of receiving funds, an agreement· with the City of Arroyo Grande, in a form and content provided by the City of Arroyo Grande, will be signed and executed by a duly authorized representative of said non-profit organization. I ~m aware of and certify that our non-profit organization will adhere to all City regulations regarding the 2014-15 Community Service Fund Program including, but not limited to, maintaining non- discriminatory policies, practices and intent. I also, on behalf of our non-profit organization, indemnify, defend, and hold harmless the City of Arroyo Grande relative· to any and all liability that may arise as a result of the use of the City of Arroyo Grande Communi ervic Grant Fund monies. Date: L ~· Signature: Board of Director or Officer Item 9.a. - Page 134 ATTACHMENT TO CITY OF ARROYO GRANDE-HUMAN SERVICES FUNDING FROM PEOPLES' SELF-HELP HOUSING-November 2014 Need for the Program: This is the first year of the opening of the Youth Learning Center at one of our Arroyo Grande affordable family apartment complex Courtland Street Apartments. In this center we operate the Youth Education Enhancement Program (YEEP) is free, daily academically-based program focusing on students K-6 during the critical years when they need to master basic math, learn to read, and to master reading comprehension. Started in 2006, Peoples now operates six other Youth Learning Centers at our larger apartment properties and serves 350 youth after school each day. We have had great results in keeping children at grade level and graduating on time. Our goals are to increase student grades in math . and language arts by one grade level during the course of the school year and to see improvement each year on annual State testing. Research has documented that if children learn to read by the third grade, they are four times more likely to graduate from high school. Peoples' also offers low income parents educational workshops on how prepare their children for academic success and what college and college scholarships are all about. We have seen our resident children in our youth after school education program go on to four year colleges, trade schools, and police and military careers. Several of our students who are now graduating from college (Cal Poly SLO and St. Mary's in Los Angeles, as examples) came from families where the parents were monolingual Spanish speakers with elementary school education levels. Our organization is different from others working to meet the same need because: 1) Programs operate on-site where the parents and children live, 2) There are no rent/occupancy costs and no transportation issues or costs, 3) Programs are free and tailored to our population's needs. Some of our parents are Spanish speakers with low education and literacy levels who are unable to help their children with homework. Poor households do not have computers or internet access where students need to do homework. Low income parents often work two or more jobs, hours dictated by planting and harvest schedules, late ·hours in the hospitality industry (hotels and restaurants), and long work hours. They cannot afford day care, special programs, or transportation to other programs. Some schools have reduced or eliminated summer and after school programs and have increased classroom size which often leaves struggling .students falling behind . . Research supports the need for After-School Education In our YEEP program, we are addressing the following problems and issues in our low-income resident children: • Non-readers in the third grade from low-income families are three times more likely to drop out of high school. For black and Latino students, poor third grade reading skills make the rate eight times greater. • Students who don't read at grade level by third grade are four times more likely to leave high Peoples' Self-Help Housing After School Education in Arroyo Grande 11/14 pg. 1 I ( Item 9.a. - Page 135 school without a diploma. Poverty and ethnicity compound this rate. (Annie Casey Foundation). · • There are approx. 20-25 hours per week that children are out of school while most parents are at work, creating an 'after-school gap" Self-care and boredom increase the likelihood of drug and alcohol experimentation, juvenile victimization, vandalism, inappropriate computer use, etc. • Research published by the University of California, Irvine documented that "students who regularly attend high-quality after-school programs, not only demonstrate significant academic gains and work habits, but also have significant reductions in misconduct and substance abuse." This nationwide study focused on economically disadvantaged minority youth, many whom were children of immigrants, a population similar to the youth population we serve in Carpinteria and Westside Santa Barbara. Our YEEP educators help the students complete their homework every day, as well as provide enrichment activities in the arts, science, community service, nutrition, social studies, and physical education. YEEP offers these at-risk children positive, after-school activities that support positive youth development and produce responsible adult citizens-YEEP has an outstanding track record: keeping students performing at grade level, increasing grades in math and language arts over the course of the school year, and graduating from high school on time. YEEP empowers parents to contribute to their child's academic success and are to support their child's work. YEEP provides a safe and secure place to go after school to complete homework and receive assistance and guidance. *This has been highly effective. In 2014, seven students who grew up in our YEEP program received college scholarships of over $5, 000 each. One received a $20,000 Pel! Award. Program Goals and Specific Outcomes The goals of the YEEP program are to: • Offer free, daily after-school homework assistance to K-6 children living in Arroyo Grande 15 hours per week. o Improve academic performance in language arts and mathematics by creating and implementing an academic plan that addresses areas needing improvement. o Increase parent involvement in their child's academic progress by having meetings with the YEEP educator, teachers, and parents. o Educate students and their parents on opportunities in higher education and career opportunities for the child by hosting at educational workshops throughout the year. Our intended outcomes are: o 80% of the children enrolled in YEEP will attend a minimum off our days per week for two hours/day. o 75% of YEEP students will improve their grades in language arts and/or mathematics by at least one grading mark over the course of the 2014-15 school year. Peoples' Self-Help Housing After School Education in Arroyo Grande 11/14 pg. 2 Item 9.a. - Page 136 .0 How we plan to evaluate the effectiveness or impact ofthe grant • We evaluate the effectiveness of the program by assessing individual student progress in math and language arts (reading, writing and reading comprehension) by tracking report card grades and State test results during the course of the school year. Timeline: Jan. 1 to Dec. 31,2015. • We also track State test results which we expect to continually improve. Results are analyzed at the end of school year. • A written parent survey is conducted annually in order to receive feedback on the program and how it affects the children's academic progress at school. Parents and children are surveyed following workshops to determine if they received helpful information about higher education and job opportunities. Peoples' Self-Help Housing After School Education in Arroyo Grande 11/14 pg. 3 r Item 9.a. - Page 137 ( PEOPLES' SELF-HELP HOUSING CORPORATION: YOUTH EDUCATION ENHANCEMENT PROGRAM YOUTH EDUCATION ENHANCEMENT PROGRAM APPROVED BUDGET FOR FYE 15 ALL CENTERS REVENUES Donations Donations Total Barbara Rubin Foundation Crawford ldema Family Foundation Driscoll's Foundation c/o Comm Foundation of Santa Cruz County Hutton Foundation JPMorgan Chase Foundation La Centra Summerlin Foundation Montecito Bank & Trust Neighborworks Outhwaite Foundation Rabobank, N.A . . Ronald McDonald House Santa Barbara Foundation TJX Foundation ·venoco, Inc. Wells Fargo Weingart Williams Corbett Foundation Womens Fund Yardi Systems Foundation Grants Total CDBG-City of Santa Maria CDBG -County of SB /City of Carpinteria Guadalupe Union School District (ASES) Santa Maria Bonita School District (ASES) Santa Barbara Community Action Commission Government Grants Total Social Service Fees from the Properties Property Fees Total TOTAL REVENUES EXPENSES Salaries & Benefits Employment Services/CPR & First Aid Mileage Travel Workshops/Meetings Meals Rents Utilities Supplies Computer Supplies Telephone Insurance Indirect TOTAL EXPENSES NET INCOME (LOSS) Budget FYE 15 14,900 14,900 10,000 10,000 2,500 10,000 25,000 3,000 5,000 15,243 10,000 "10,000 5,000 5,000 5,000 7,500 18,750 31,250 20,000 50,000 20,000 263,243 4,000 9,082 31,500 72,838 4,800 122,220 59,448 59,448 459,811· Budget FYE 15 297,113 . 720 3,336 400 614 235 5,400 559 11,576 6,420 2,245 1,510 129,683 459,811 (OJ Item 9.a. - Page 138 I~ IRS Department of tho Treasury rf Internal Revenue Sen•lce P.O. Box 2508 Cincinnati OH 45201 PEOPLES SELF-HELP HOUSING · CORPORATION 3533 EMPLEO ST SN LUIS OBISP CA 93401-7334330 RECEIVED JUN 1 7 20fi8 In reply refer to: 0248204092 June.13, 2008 LTR 4168C EO 95-2750154 ·oooooo oo ooo 00020667 BODC: TE Em p 1 o y e r I d en t i f i cat i o n Number : 9 5 -2 7 5 0 15 4· Person to Contact: Ms. Lumpkins Toll Free Teiephone Number: 1-877-829-5500 Dear Taxpayer: This is in response to your request of June 04, 2008, regarding your tax-exempt status. · Our records indicate that a determination letter was issued in July 1971, that recognized you as exempt from Federal income tax, and discloses that you are currently exempt under section 501CcJC3l of the Internal Revenue Code. Our records aJso indicate you are no~ a private foundation within the meaning of section 509Ca) of the Code because you are described in sectionCsl 509(a)(l) and 170CbJC1lCA)Cvil. · Donors may dedu~t contributions to you as provided in section 170 of the Code. Bequests, legacies, devises, transfers, or gifts to you or for your use ~r~ deductible for Federal estate and gift tax purposes if they meet the applicable provisions of sections 2055, 2106, and 2522 of the Code. If you.have any questions, please call us at the telephone number shown in the heading of this letter. Sincerely yours, Michele M. Sullivan, Oper. Mgr. Accounts Management Operafions I Item 9.a. - Page 139 Item 9.a. - Page 140 Item 9.a. - Page 141 ( PEOPLE'S SELF-HELP HOUSING CORPORATION BALANCE SHEET June 30, 2014 ASSETS CURRENT ASSETS Cash & Cash Equivalents s 3,573,693 Cash-Rental Properties 3,576,309 Cash-Restricted 349,990 Cash-Certificates of Deposit 570,344 Accounts Receivable S2,851,416 Grants Receivable 282,042 Contracts Receivable 98,336 Construction ln Progress-Current 3,734,425 Prepaid Expenses 159,408 TOTAL CURRENT ASSETS OTHER ASSETS Notes Receivable s 3,214,335 Endowment Fond 173,071 Other Assets $3,889,201 . Construction in Progress-Noncurrcut 10,222,739 TOTAL OTHER ASSETS PROPERTY & EQUIPMENT, Net of Accumulated Depreciation TOTAL ASSETS LIABILITIES AND NET ASSETS CURRENT LIABILITIES Acwunls Payable & Accrued Liabilities $1,380,165 Line of Credit-Wells Fargo 0 Long-Term Debt-Current Portion 1,978,447 Security Deprul!s 301,383 Deferred Restricted Revenue 1,328~05 TOTAL CURRENT LJA BILITIES OTHER LIABILITrES Construction Warranty Reserve s 247,200 Property Development Reserve 1,737,561 TOTAL OTHER LIABILITIES LONG-TERM LIABILITIES Note Payable-Wells Fargo Bank $ 500,000 Note Payable-Colvert Foundation 456,768 Note Payable-Office Building Notes Paynble-Rental Properties, Construction Loans 32,224,695 TOTAL LONG-TERM LIABILITIES TOTAL LIABILITIES NET ASSETS Unrestricted Net Assets Temporarily Restricted Net Assets Permanently Restricted Net Assets-Endowment Fund TOTAL NET ASSETS TOTAL LIABILITIES AND NET ASSETS s 15,195,964 17,499,345 $28,007,299 s 60,702,608 s 4,988,899 1,984,761 33,181,464 s 40,155,124 20,024,423 349,990 173,071 20,547,484 s 60,702,608 Item 9.a. - Page 142 Grant/Contract Revenue Arrardable H ousins: Rental Income Interest & Dividend Income Gain on Sale or Aasels Miscellaneous Income Contributions TOTAL REVENUFS EXPENDITURES Salaries Fringe Benefits Contractor Fees Professional Fees Fdit Employment Services Comulting Servite.s Bank Clu!rg"-' Mileage Truvelffraining/Meab Workshops/Conrerences Dues/Subscriptions Rent Utilities Office Interest Renllll Property Interest Rental Property Operating Expenses Repairs & Maintenance Snpplica Postage Pro(TSm suppliea Equipment Telephone Printing & Copying Insurance . Tuca & License& Adverfuing Site Rc.!carch Miscellanea as Warranty Expemc Leos Capihliud Expenses PEOPLE'S SELF-HELP HOUSING CORPORATION SCHEDULE OF REVENUES AND EXPENDITURES June 30, 2014 TOTAL EXPENDITURES DEFORE DEPRECIATION NET INCOME (LOSS) DEFORE DEPREClA TION Deprccintion-Rcnllll Prortcrties Depreciation-Office Deprecia lion-Other TOTAL DEPREClATION TOTAL EXPENDITURES NET INCOME (LOSS) $ 4,126,350 4,186,662 167,233 142,494 304,568 490,823 9,418 130 Item 9.a. - Page 143 ( PEOPLES' SELF-HELP HOUSING CORPORATION BOARD OF DIRECTORS Date of Current Term Name Election From-To Occupation Jolie Ditmore 07-26-07 Jan 2014-0ct 2016 Medical Consultant, Morro Bay Dieter E. Eckert 01-24-85 Jan 2014-0ct 2016 Physician, Radiology, San LuisObispo Jose Flores 12-09-10 Jan 2014-0ct 2016 General Contractor, Lompoc Charles E. Fruit 07-31-86 Nov 2011-0ct 2014 Executive Vice President, Coast National Bank, San Luis Obispo B. Ray Gateley 10-25-00 Nov 2012-0ct 2015 Retired, Civil Engineer, Santa Barbara Vito Gioiello 01-23-14 Jan 2014-0ct 2016 Managing Director, First Repul:iic Investment Management, SantaBarbara David K. Gustafson . 05-07-09 Jan 2013-0ct 2016 Retired, City Housing & Redevelopment Manager, Santa Barbara Tensie Hernandez 08-28-14 Aug 20 14-0ct 2016 Community Advocate/Member, Catholic Worker, Santa Maria/Guadalupe Carolyn Johnson 02-23-89 Nov 2012-0ct 2015 Planning Manager, City of Pismo Beach Angela McCormick 10-24-13 Jan 2014-0ct 2016 Deputy Clerk Recorder, County of San Luis Obispo Karol Schulkin 06-07-10 Nov 2011-0ct 2014 Homeless Program Coordinator, Human Services Agency, CountyofVentura Charles H. Stacy 10-10-08 Oct 2012-0ct 2015 Retired, Episcopal Rector Emeritus OFFICERS For the period 04/01/14 to 10/31/14 or until 2014 Annual Meeting if after 10/31/14: Carolyn Johnson Dave Gustafson John Fowler Annette Montoya Monica de Malleville Sheryl Flores Kenneth Trigueiro Eric Michielssen Griffin Moore 08/28/14 Chair Vice Chair President Secretary Treasurer Assistant Secretary!VP ofHousingDevelopment Assistant SecretaryCFO and EVP Assistant Treasurer (Asset Manager and Broker of Record) Assistant Treasurer (Assistant Controller) Item 9.a. - Page 144 OR G A N I Z A T I O N A L CH A R T FO R PE O P L E S ' SE L F - H E L P HO U S I N G No v e m b e r 20 1 4 - , ~ ~ It e m 9 . a . - P a g e 1 4 5 CITY OF ARROYO GRANDE COMMUNITY SERVICE GRANT PROGRAM .. APPLICATION FORM 2014-15 Please complete the following sections (use additional sheets as necessary): I. NAME AND ADDRESS OF NON-PROFIT ORGANIZATION: (must be the local branch) Transitional Food and Shelter, Inc. · . · · 3770 N. River Rd. Paso Robles, CA 93446 II. GRANT APPLICANT REPRESENTATIVE'S NAME, ADDRESS AND TELEPHONE NUMBER: P · . lmu~t be the Executive Director or their designated representative) earlMunaK · · · . . , 3770 N. River Rd. Paso Robles, CA 93446 (805) 238-7056 pearltrans@aol.com (email preferred) Ill. DESCRIPTION OF COMMUNITY SERVICES PROVIDED: We provide temporary, emergency shelter for homeless persons who are too ill, injured or disabled tc be in an overnight shelter, even with a day center, and we provide it 24 hours per day. Services are proV'Ided only when a doctor certifie·s they afe needed to help the client recover from his medical condition, or, if he can never recover, to avoid further deterioration~ We provide shelter in rented apartments and by motel vouchers because wedo not own· a facility. Weare now able to provide casework, having recently employed a caseworker on a contract basis (not as a regular employee) .. The casework is to aid ·the client in dealing with his medical condition(s) and to help him attain self- support through increased income and housing. In the past, we have been unable to cope with referrals of persons with persons who had .mental illness or substance·abuse (alcoholics and drug abusers) in addition to their physical illnesses, and this has been a problem for hospitals·, as they have been unable to discharge such patients when they no longer needed hospital care. Because of our new casework services, we are now able to accept such clients along with those who have · only physical illnesses and minor mental conditions. IV. LIST AREA(S) SERVED BY 'NON-PROFIT ORGANIZATION: (include brief description of · the relationship of your non-profit organization to the residents of the City of Arroyo Grande) We serve the entire county of San Luis .Obispo, including the residents of Arroyo Grande~ Our client are the Medically i=n~igile Homeless, meaning those with a permanent or temporary disability referred by a hospital or social service agency as needing shelter 24 hours/day because of a medical condi- tion, with a letter from a doctor. This now includes persons with severe alcoholism, drug abuse and mental illness who also have a physieal medical condition. We were founded in 1998 as an organization serving North County only, but expanded in 2001 to serve the entire county, as we realized that Arroyo Grande Hospital, French (now Dignity Health) and Sierra Vista also had patients they needed to discharge as no longer needing hospital care, but were unable to do so because they could not make an adequate discharge plan if the patient needed bed rest or shelter 24 hours per day and not j~st a·t night, even if a day center was available. This includes persons with broken lower limbs advised to keep off the limb and keep it elevated so it can heal, as weil as cancer, emphysema, ·spinal disorders, degenerative diseases and terminal condition . Some of our clients are recovering from operations or injuries, or have At Risk Pregnancies (in dang of losin the bab if the can't et bed rest . Item 9.a. - Page 146 V. NUMBER OF CITY OF ARROYO . GRANDE RESIDENTS SERVED BY NON-PROFIT ORGANIZATION: (broken down by age groups if available) · The number varies from year to year, but generally includes 2-5 clients and the members of their household (who are.always sheltered with the client), and the clieritis need for shelter may continue for up to a year. Those who will never re~over need permanent housing to become self-supporting, and this almost alvvays includes subsidized housing, as their maximum income is SSI ($887/mo.), and subsidized housing is very hard to obtain. Without housing, their health will deteriorate. VI. AMOUNT OF FUNDS REQUESTED: $2,500.00 VII. PROPOSED USE AND BUDGET PLAN FOR GRANT FUNDS: (indicate if any of the grant funds will be used for any other purpose than those designated such as overhead, national office, administrative salaries) -•. · · · · · · We propose to use the grant funds for Arroyo Grande clients who need: 1. client shelter: apartment rent or motel vouchers · 2. client special needs for medical expenses riot otherwise, covered, transportation if needed to medical care or to live with family elsewhere, ·rental deposits and utility deposits if not otherwise av.ailable, or other needs necessary to complete the casework plan 3. casework by our part-time, contract caseworker We have no national office. We have no administrative salaries. Our staff are all volunteers except for our contract caseworker, contract bookkeeper and contract_CPA. Our volunteers work from their homes, so we need __ no office. _No funds will be used for overhead (e.g. insurance). VIII. ADDITIONAL DOCUMENTATION: (if you have received funds in the past, please indicate the amount of funds received (indicate what year) and how the funds were utilized) We received $2,500 in 2010-11 from Arroyo Grande in CDBG funds. We are one of the relatively small organizations now excluded from CDBG. . 1 . · Futtcls wer--e. used f(,r--tJ-/.6?11 + she-l+ar {_apT. •"WWT' ara nwfrd vovcl~), IX. SUPPLEMENTAL DOCUMENTATION: Dr Past two year's financial statements, including the current year with the balance sheets and the profit/loss statements. · · ot Information indicating the percentage of revenue received that is used for administration, ~alaries, and program costs. · · ar Breakdown and description of non-profit organization's sources of revenue. rx Proof of 501 (c)(3) status with a copy of the letter from the IRS .. I2l Copy of the non-profit organizations Board of Directors, Officers and an organization chart. · · i, Item 9.a. - Page 147 X. CERTIFICATION: ·-I certify on behalf of Transitional Food and Shelter. Inc. non-profit organization, that I have read, understand and agree that the aforesaid information is accurate, factual and current. I understand that an award of funds, if granted, will be for the sole use as reflected in this application form. I further certify that as a condition of receiving funds, an agreement with the City of Arroyo Grande, in a form and content provided by the City of Arroyo Grande, will be signed and executed by a duly authorized representative of said non-profit organization. I am aware of and certify that our non-profit organization will adhere to all City regulations regarding the 2014-15 Community Service Fund Program including, but not limited to, maintaining non- discriminatory policies, practices and intent. I also, on behalf of our non-profit organization, indemnify, defend, and hold harmless the City of Arroyo Grande relative to any and all liability that may arise as a result of the use of the City of Arroyo Grande Community Service Grant Fund monies. Date: November 3. 2014 Signature: ~~ /·., -~ -~-I :A~~4"4-~~ Exe"CUtl\\e Director or Designee Pearl Munak :; ?f-1/)f.M JY. ~· $_.cc,'£_---JJ- Board of Director or Officer / ,--~ -/~ Jj-- Item 9.a. - Page 148 2:00PM Transitional Food & Shelter, Inc. 07/09/13 Balance Stleet Accrual Basis As of June 30, 2013 · ,-- Jun 30, 13 ASSETS Current Assets Checking/Savings 01-Coast Checking-#3091 4,248.41 ·02-Coast Money Market-#0775 69,596.23 05-PK Chase Account-#3548 2,060.29 Total Checking/Savings 75,904.93 Total Current Assets 75,904.93 Other Assets Security Deposits Asset 3,640.00 Total Other Assets 3,640.00 TOTAL ASSETS 79,544.93 LIABILITIES & EQUITY Liabilities Current Liabilities Accounts Payable Accounts Payable 2,726.17 Total Accounts Payable 2,726.17 Credit Cards 03 -TFS Chase Visa 3,495.66 Total Credit Cards 3,495.66 ::;. Total Current Liabilities 6,221.83 Total Liabilities 6,221.83 Equity Opening Balance Equity 42,564.37 Unrestricted Net Assets 29,460.35 Net Income 1,298.38 Total Equity 73,323.10 TOTAL LIABILITIES & EQUITY 79,544.93 Page 1 Item 9.a. - Page 149 1:59PM 07/09/13 Accrual Basis :; Transiti(;mal Food & Shelter, Inc~ · Profit & Loss July 2012 through June 2013 Ordinary Income/Expense Income Donations Families Helping Families PK -Businesses PK -Individuals TFS -Businesses TFS -Client Donations TFS -Individuals Total Donations Fundraising Needs 'N Wishes Total Fundraising Grants Advanced Funds CBO/PHG CIF EFSP SLO Community Foundation Total Advanced Funds Billed in Arrears City of Arroyo Grande -CDBG City of Paso Robles -CDBG SLO County General Fund Total Billed in Arrears Total Grants Total Income Expense Apartment Maintenance Fees Bank Fees Client Assistance Credit Card Processing Fees Fam Helping Families Operations Postage, Mailing Service Printing and Copying Professional Fees Registration Fees Telephone, Telecommunications Total Operations Other Types of Expenses Dishonesty Bond Insurance -Uability, D and 0 Total Other Types of Expenses PK-Milk & Supplies PK -Utilities Transitional Housing Fees Apartment Rental Fees Grants -Expense Advanced Funds Catholic Healthcare West CBOIPHG CIF SLOCCF PHG WLF Total Advanced Funds Jul'12-Jun 13 1,264.00 12,699.00 5,628.00 2,601.00 1,264.00 630.00 310.19 2,407.00 14,168.78 4,400.40 8,471.41 30,387.78 14,603.26 20,000.00 5,000.00 1,023.50 4,000.00 14,603.26 30,023.50 2,501.00 5,166.00 8,010.00 15,677.00 45,700.50 90,691.54 3,342.16 102.28 370.89 14.24 780.00 170.28 27.30 1,510.00 45.00 1,326.01 3,078.59 929.19 2,389.00 3,318.19 3,052.37 192.00 23,456.00 Page 1 I -,- Item 9.a. - Page 150 ~-- 1:59PM 07/09/13 Accrual Basis ;;. Transitional Food & Shelter, Inc. Profit & Loss July 2012 through June 2013 Billed in Arrears City of Paso COBG Total Billed in Arrears Total Grants-Expense Apartment Rental Fees -Other Total Apartment Rental Fees Motel Daily Charges Grants-Exp Advanced Funds catholic Healthcare West CBOIPHG City of Paso CDBG EFSP SLOCCF PHG WLF Total Advanced Funds Billed in Arears City of Arroyo Grande-COBG SLO County-General Fund Total Billed in Arears Total Grants-Exp Motel Daily Charges -Other Total Motel Daily Charges Total Transitional Housing Fees Volunteer Medical Expenses Total Expense Net Ordinary Income Other Income/Expense Other Income Interest Total Other Income Other Expense Mise Expense Total Other Expense Net Other Income Net Income Jul'12-Jun 13 5,668.00 5,668.00 29,124.00 10,291.00 39,415.00 945.62 6,017.03 662.39 2,127.00 2,300.00 873.60 12,925.64 1,065.68 6,805.24 7,870.92 20,796.56 15,253.11 36,049.67 75,464.67 63.74 89,779.13 912.41 385.97 385.97 0.00 0.00 385.97 1,298.38 Page2 Item 9.a. - Page 151 4: 3 4 P M 07 1 0 9 1 1 4 Ac c r u a l Ba s i s Tr a n s i t i o n a l !F o o d & Sh e l t e r , In c . AS S E T S Ba l a n c e Sh e e t As o f Ju n e 30 , 20 1 4 Cu r r e n t As s e t s Ch e c k i n g i S a v i n g s 01 · C o a s t Ch e c k i n g - # 3 0 9 1 02 - C o a s t Mo n e y Ma r k e t - # 0 7 7 5 05 - P K Ch a s e Ac c o u n t - # 3 5 4 8 O& - c o a s t · P a s o Ca r e s - # 2 1 3 3 Pe t t y Ca s h To t a l Ch e c k l n g i S a v l n g s . Ac c o u n t s Re c e i v a b l e Ac c o u n t s Re c e i v a b l e To t a l Ac c o u n t s Re c e i v a b l e To t a l Cu r r e n t As s e t s Ot h e r As s e t s Se c u r i t y De p o s i t s As s e t To t a l Ot h e r As s e t s TO T A L AS S E T S LI A B I L I T I E S & EQ U I T Y Li a b i l i t i e s Cu r r e n t Li a b i l i t i e s Ac c o u n t s Pa y a b l e Ac c o u n t s Pa y a b l e To t a l Ac c o u n t s Pa y a b l e To t a l Cu r r e n t Li a b i l i t i e s To t a l Li a b i l i t i e s Eq u i t y Op e n i n g Ba l a n c e Eq u i t y Un r e s t r i c t e d Ne t As s e t s Ne t in c o m e To t a l Eq u i t y TO T A L LI A B I L I T I E S & EQ U I T Y Ju n 30 , 14 6, 0 0 1 . 2 2 58 , 2 6 6 . 1 1 2, 9 6 8 . 5 4 2, 8 3 8 . 8 0 70 . 0 0 70 , 1 4 4 . 6 7 14 , 1 4 8 . 9 6 14 , 1 4 8 . 9 6 84 , 2 9 3 . 6 3 3, 6 4 0 . 0 0 3, 6 4 0 . 0 0 87 , 9 3 3 . 6 3 76 4 . 9 5 76 4 . 9 5 76 4 . 9 5 76 4 . 9 5 42 , 5 6 4 . 3 7 30 , 7 5 8 . 7 3 13 , 8 4 5 . 5 8 87 , 1 6 8 . 6 8 87 , 9 3 3 . 6 3 Page 1 -r Item 9.a. - Page 152 4: 3 4 P M 07 / 0 9 / 1 4 Ac c r u a l Ba s i s I_ Tr a n s i t i o n a l Fo o d & Sh e l t e r , In c . Pr o f i t & l o s s . Ju l y 20 1 3 th r o u g h J\ J n e 20 1 4 Or d i n a r y In c o m e / E x p e n s e In c o m e Dl~ i d e n d s Do n a t i o n s Fa m i l i e s He l p i n g Fa m i l i e s PC - I n d i v i d u a l s PK • Bu s i n e s s e s ·P K ·I n d i v i d u a l s TF S • Bu s i n e s s e s TF S ·C l i e n t Do n a t i o n s TF S • In d i v i d u a l s To t a l Do n a t i o n s Fu n d r a i s l n g Fa r m to Fo r k Di n n e r Ne e d s 'N Wi s h e s Fu n d r a l s l n g ·O t h e r To t a l Fu n d r a l s i n g Gr a n t s Ad v a n c e d Fu n d s CB O / P H G CI F SL O Co m m u n i t y Fo u n d a t i o n To t a l Ad v a n c e d Fu n d s Bi l l e d In Ar r e a r s SL O Co u n t y Ge n e r a l Fu n d Un i t e d Wa y SL O Co u n t y To t a l Bi l l e d in Ar r e a r s .T o t a l Gr a n t s Ho u s i n g Re i m b u r s e m e n t Ma r k e t i n g • Ne w s l e t t e r Re b a t e Re t u r n e d Ch e c k s To t a l In c o m e Ex p e n s e Ap a r t m e n t Ma i n t e n a n c e Fe e s Ba n k Fe e s Cl i e n t As s i s t a n c e Cr e d i t Ca r d Pr o c e s s i n g Fe e s Fa m He l p i n g Fa m i l i e s Ju l '1 3 • Ju n 14 85 0 . 0 0 3, 2 1 5 . 0 0 32 0 . 0 0 3, 0 4 3 . 0 0 10 , 5 9 9 . 3 4 8, 6 8 5 . 3 0 20 , 0 5 0 . 0 0 19 9 . 4 9 46 , 7 6 2 . 6 4 13 , 5 8 5 . 0 0 8, 4 0 8 . 2 2 39 6 . 7 5 20 , 0 0 0 . 0 0 3, 7 5 0 . 0 0 7, 0 0 0 . 0 0 22 , 3 8 9 . 9 7 30 , 7 5 0 . 0 0 20 , 4 6 0 . 0 0 1, 3 1 7 . 7 3 21 , 7 7 7 . 7 3 52 , 5 2 7 . 7 3 5, 7 7 1 . 9 2 31 5 . 0 0 1. 6 0 -8 5 . 0 0 12 7 , 8 8 3 . 3 5 5, 7 4 9 . 2 7 6. 0 0 85 . 0 0 56 . 0 3 54 . 1 5 Page 1 Item 9.a. - Page 153 CITY OF ARROYO GRANDE COMMUNITY SERVICE GRANT PROGRAM APPLICATION FORM 2014-15 Please complete the following sections (use additional sheets as necessary): I. NAME AND ADDRESS OF NON-PROFIT ORGANIZATION: (must be the local branch) Camp Fire Central Coast of California II. GRANT APPLICANT REPRESENTATIVE'S NAME, ADDRESS AND TELEPHONE NUMBER: (must be the Executive Director or their designated representative) Kenneth D. Miles, Executive Director 340 Pomeroy Ave. Pismo Beach, CA 93449 Ill. DESCRIPTION OF COMMUNITY SERVICES PROVIDED: Camp Fire is where children and teens discover who they are. Camp Fire provides a nurturing, constructive and fun environment for young people to discover their sparks-unique skills, passions, and interests-and adopt a growth mindset. They chart their own course to healthy habits, community leadership, and connection to nature in collaboration with trained, caring adults. And, in turn, Camp Fire youth give back by sharing those skills in their communities. Camp Fire Community Services projects in Arroyo Grande include Harvest Festival, Halloween Carnival, Easter Egg Hunt, Christmas Parade and Hospice "Light Up a Life." Also in the 5-Cities area projects include Pismo Beach Clam Festival, Pumpkin on the Pier, Thanksgiving Dinner, Grover Beach Christmas Parade, beach clean ups, City Council meetings as well as many other community service projects throughout the Central Coast. Consequently, Camp Fire builds caring, confident youth and future leaders. Youth participating in after school, teen. leadership and camping enrichment programs are actively engaged and are given a voice, which helps build self-esteem and self-reliance. All children and youth are welcomed to Camp Fire and all programming promotes quality of life including healthy living and healthy eating. IV. LIST AREA(S) SERVED BY NON-PROFIT ORGANIZATION: (include brief description of the relationship of your non-profit organization to the residents of the City of Arroyo Grande) CampTacanneko, conducted at the Methodist Camp in Old Arroyo Grande for the last 40 years, is a week long day camp traditionally held the first week of summer break. It hosts over 150 participants that help youth light their fire within through a connection to the natural world. Camp Fire Out-of-School-Time programs provide youth with so much more than simply a place to go after school while parents work. Camp Fire's after school club students have the opportunity to work with trained, caring adults who can teach them about health and wellness, keep them active, engage them in community service projects, and provide mentoring regarding challenges youth face today. Our programs are uniquely focused to help youth thrive. Camp Fire has numerous after school clubs throughout the Central Coast including 5 Cities clubs at Ocean View, Nipomo Library, Arroyo Grande High School, Paulding, Nipomo High School, Grover Heights, Shell Beach, Branch, Grover Beach, and Harloe. Item 9.a. - Page 154 x-~--GERTIFIGATION: certify on behalf of Camp Fire Central Coast of California non-profit organization, that I have read, understand and agree that the aforesaid information is accurate, factual and current. I understand that an award of funds, if granted, will be for the sole use as reflected in this application form. I further certify that as a condition of receiving funds, an agreement with the City of Arroyo Grande, in a form and content provided by the City of Arroyo Grande, will be signed and executed by a duly authorized representative of said non-profit organization. I am aware of and certify that our non-profit organization will adhere to all City regulations regarding the 2014-15 Community Service Fund Program including, but not limited to, maintaining non- discriminatory policies, practices and intent. I also, on behalf of our non-profit organization, indemnify, defend, and hold harmless the City of Arroyo Grande relative to any and all liability that may arise as a result of the use of the City of Arroyo Grande Community Service Grant Fund monies . Date: /J~:tPt / / ' .I Signature: J~~ Executive Director or Designee _j Item 9.a. - Page 155 INCOME EXPENSES SUPPORT REVENUES Camp Fire Central Coast Outside School Time-Clubs 2015 Proposal City of Arroyo Grande Briscoe Foundation Dues Registration & Program Fees Fundraising-Candy Sales Misc. TOTAL INCOME SALARY EXPENSES (including Payroll taxes/workers comp) Program Directors Payroll Taxes Worker's Comp OPERATIONS Mileage Rent Utilities Insurance Advertising Camp Fire Charter fees Council/ Administration Postage PROGRAM Office Supplies Program Supplies Awards TOTAL EXPENSES NET INCOME CST Clubs 2,500 1,500 4,000 5,280 9,000 500 22,780 8,687 868 868 800 800 1,200 1,500 800 1,660 3,171 500 200 800 800 22,654 126 Item 9.a. - Page 156 rent Assets Cash Box -Council Checking -Council Checking -Community Clubs Checking -Money Mkt Natoma Projects Savings Savings -Reserve Total Cash Total Accounts Receivable Merchandise -Store Merchandise -Camp Inventory-Program Awards Inventory -Prog A wards, Clubs Inventory-Prog Awards, Camp Total Inventory Deposits Total Prepaid Assets '.a] Current Assets Property and Equipment Land-Camp Natoma Improvements -Camp Natoma Improvements -SM Cabin Furniture & Equip. -Council Furniture & Equip. -Natoma Vehicles Leasehold Imp.-Council Office Depree: Improv. Natoma Depree: Fum & Equip Council Depree: Fum & Equip Natoma Depree: Vehicles Total Property and Equipment Other Assets Investments Total Other Assets Total Assets · ~ ... rrent Liabilities Federal Inc. Tax Payable $ Camp Fire Council Statement of Financial Position September 30, 2014 ASSETS 50 48,042 3,573 100,579 2,795 48,189 3,155 2,641 325 1,135 1,118 737 126,000 161,717 3,322 80,934 62,254 17,360 3,148 (156,814) (80,934) (62,254) (8,567) 0 $ LIABILITIES AND FUND BALANCES $ 370 Unaudited -For Management Purposes Only 203,228 0 8,374 737 212,339 146,166 0 358,505 Item 9.a. - Page 157 FICA Tax Payable Medicare Tax Payable State Inc. Tax Payable SDI Tax Payable State Unempl. Tax Payable Sales Tax Payable Total Accounts Payable Credit Line Payable Accrued Vacation Accrued Workers' Comp. Ins. Deferred Camp Income Suspense Other Current Liabilities Total Current Liabilities Long-Term Liabilities Total Long-Term Liabilities Total Liabilities Fund Balances Unrestricted Funds Net Income Total Fund Balances Total Liabilities & Fund Balances Camp Fire Council Statement of Financial Position September 30,2014 995 233 55 80 472 575 16,811 2,052 1,200 4,650 1,305 26,018 281,227 48,480 $ Unaudited-For Management Purposes Only 2,780 28,798 0 28,798 329,707 358,505 Item 9.a. - Page 158 Page: I Camp Fire Council Statement of Revenue and Expenses Consolidated For the Nine Months Ending September 30, 2014 ( Current Month Year to Date TD% of Annual Bu Annual Budget • ....;,VENUES Support Camperships (4,132) 8,975 105.59 8,500 Candy Sales 0 17,107 71.28 24,000 Candy Sales -TIA 0 0 0.00 6,000 Candy Sales -Clubs 0 16,837 93.54 18,000 <Candy Cost> 0 (7, 753) 64.61 (12,000) <Candy Cost -TIA> 0 0 0.00 (3,000) <Candy Cost -Clubs> 0 (7, 753) 86.14 (9,000) Candy Rebate Inc -Clubs 0 1,288 0.00 0 Donations (100) 16 0.11 15,000 Donations -Camp/Clubs 0 1,685 0.00 0 Grants-Gov't/Camp/Ciubs 0 4,126 63.48 6,500 Grants -Private 0 0 0.00 10,000 Grants-Private/Camp/Clubs 4,232 59,482 121.76 48,850 Sponsorships 0 500 0.00 0 Sponsorships -TIA 0 250 0.00 0 Sponsorships -Clubs 0 2,300 35.38 6,500 Special Events 200 14,123 23.54 60,000 United Way-Central Coast 0 547 182.33 300 United Way-Camp/Clubs 0 0 0.00 0 Total Support 200 111,730 62.19 179,650 Other Revenue ( •estrnent Income 0 50 0.00 0 .• erestinvestrnent/Misc Income 29 222 222.00 100 Membership Dues -Youth 781 8,801 58.67 15,000 Membership Dues -Adult 120 4,265 142.17 3,000 Merchandise Sales -Store 148 4,413 126.09 3,500 <Merch. Cost -Store> (172) (3,622) 144.88 (2,500) Merch. Sales -Camps 7,160 7,613 101.51 7,500 <Merch. Cost -Camps> 0 (7,119) 229.65 (3, 1 00) Natoma Camp Photos 0 1,980 79.20 2,500 <Camp Photos Cost-Natoma> 0 (620) 44.29 (1,400) Miscellaneous Income-Clubs 0 0 0.00 500 Program Registration Fees 0 340 0.00 0 Prog. Reg. Fees -Camp/Clubs 1,670 163,027 84.69 192,505 Youth T -Shirts 0 0 0.00 0 Total Other Revenue 9,736 179,350 82.42 217,605 Administrative OH 1,977 19,885 63.92 31,110 TOTAL REVENUES 11,913 310,965 72.59 428,365 EXPENSES Salaries & Wages 3,299 28,709 62.64 45,830 Sal/Wages-Camp/Clubs 4,728 71,720 67.54 106,183 Payroll Taxes 254 2,503 54.65 4,580 yroll Taxes -Camp/Clubs 403 6,769 72.06 9,393 vrkers' Comp. Ins. 33 (827) (18.06) 4,580 Workers'.Comp Ins. -Camp/Club 108 6,180 114.83 5,382 Hiring Expense 0 0 0.00 300 For Management Purposes Only Item 9.a. - Page 159 Page: 2 Camp Fire Council Statement of Revenue and Expenses Consolidated For the Nine Months Ending September 30, 2014 Current Month Year to Date TD% of Annual Bu Annual Budget I \ Hiring Expense-Camp/Clubs 0 0 0.00 0 Staff Meals 0 135 0.00 0 StaffMeals-Camp/Clubs 0 16 0.00 0 Staff Mileage 86 508 127.00 400 Staff Mileage-Camp/Clubs 390 2,428 142.82 1,700 Camp Consultant Fee 0 0 0.00 3,000 Contract Labor -Council 0 0 0.00 200 Contract Labor-Camp/Clubs 0 0 0.00 0 Bldg. Maint. & Repair 6 6 0.40 1,500 Bldg. Maint. & Repair-SM 0 2,339 0.00 0 Bldg. Maint. & Repair-Natoma 0 3,152 105.07 3,000 Business License & Fees 0 (30) 0.00 0 Equip. Maint. & Repair 298 4,179 104.48 4,000 Equip. Maint & Repair-Natoma 0 2,982 85.20 3,500 Janitorial Supplies 0 77 38.50 200 Janitorial Supplies-Natoma 0 I ,971 98.55 2,000 Occupancy Exp: -TIA 0 0 0.00 200 Rent 88 1,202 50.08 2,400 Rent-Camp 15 10,167 85.98 11,825 Telephone !53 1,349 56.21 2,400 Telephone -Camp/Clubs 276 1,508 251.33 600 Utilities 93 1,182 147.75 800 Utilities -Camp 111 3,827 57.12 6,700 Advertising/Promotion 15 1,129 94.08 1,200 Advertising -Camp/Clubs 36 6,726 67.39 9,980 Bad Checks/Debts 0 1,000 500.00 200 Bank Charges/Merchant Fees (1,477) 2,674 106.96 2,500 / I Bank Chg/Merch Fees-Natoma 1,537 1,537 0.00 0 Board Expense 40 248 0.00 0 Candy Sale A wards-Clubs 0 824 0.00 0 Candy Sale Rebates-Clubs 0 3,021 0.00 0 Candy Sale Expenses 0 578 0.00 0 Charter Fees 32 170 3.09 5,500 Charter Fees-Camp/Clubs 941 9,061 78.04 11,610 Entrance Fees -Camp (957) 3,403 0.00 0 Food-Camp/Clubs 108 15,483 99.89 . 15,500 Fund Raising Expense 699 3,234 16.17 20,000 Insurance -Gen. Liab./D&O (9,279) 6,284 78.55 8,000 Insurance-Members 213 595 297.50 200 Insurance -MembersffiA 0 0 0.00 500 Insurance -Members/Clubs 0 0 0.00 1,500 Insurance -Nat. Liab/Property 6,961 6,961 215.44 3,231 Insurance-Nat. Campers 0 1,374 137.40 1,000 Insurance-Vehicle Natoma 4,240 4,240 314.07 1,350 Interest Expense 91 853 31.59 2,700 Medical Supp. -Camp/Clubs 0 158 50.97 310 Membership Dues & Fees 100 200 100.00 200 Memb. Fees & Dues-Natoma 0 1,039 64.49 1 ,611 Misc. Expenses 0 0 0.00 0 Office Supplies 615 2,515 125.75 2,000 Office Supplies -Camp/Clubs 169 751 52.52 1,430 Postage (76) 914 91.40 1,000 Postage -Camp/Clubs 84 226 18.30 1,235 Printing 0 0 0.00 0 ( Printing -Camp/Clubs 0 51 0.00 0 Professional Fees-TIA 0 1,280 0.00 0 Professional Fees -Accounting 4,492 9,530 173.27 5,500 For Management Purposes Only Item 9.a. - Page 160 . ugram A wards Program Awards-Camp/Clubs Program Equip. -5 Cities Program Equip.-TIA Program Equip. -Natoma Program Supplies -Camp/Clubs Staff Development StaffDev.-Camp/Clubs Transportation-Camp/Clubs Vehicle Expense-Natoma Volunteer Recognition Vol. Recognition-Camp/Clubs Youth T-Shirts-Camp/Clubs Expenses Subtotal Administrative OH TOTAL EXPENSES NET SURPLUS/(DEFICIT) $ .. PITAL CAMPA1GN t. . .. oma Special Projects Donations -Restricted $ Net Capital Campaign $ Camp Fire Council Statement of Revenue and Expenses ----Consolidated-···· --·-··· For the Nine Months Ending September 30, 2014 Current Month Year to Date TD% of Annual Bu 0 688 137.60 49 780 41.94 0 6 20.00 0 1,404 0.00 0 396 99.00 111 4,719 84.27 0 (1,282) 0.00 0 3,516 219.75 459 4,697 117.43 0 103 1.10 0 164 164.00 0 689 162.12 0 3,902 113.10 19,544 257,893 74.48 1,977 19,412 62.40 21,521 277,305 73.48 (9,608) $ 33,660 66.02 0 $ 14,820 0.00 0 $ 14,820 0.00 For Management Purposes Only Page: 3 Annual Budget 500 1,860 30 0 400 5,600 0 1,600 4,000 9,375 100 425 3,450 346,270 31,110 377,380 $ 50,985 $ 0 $ 0 Item 9.a. - Page 161 Current Assets Cash Box -Council Checking -Council ASSETS Checking -Community Clubs Checking -Money Mkt Natoma Projects Savings Savings -Reserve Total Cash Total Accounts Receivable Merchandise -Store Merchandise -Camp Inventory -Program A wards Inventory -Prog A wards, Clubs Inventory -Prog Awards, Camp Total Inventory Deposits Total Prepaid Assets Total Current Assets Property and Equipment Land -Camp Natoma Improvements -Camp Natoma Improvements -SM Cabin Furniture & Equip. -Council Furniture & Equip. -Natoma Vehicles Leasehold Imp.-Council Office Depree:. Improv. Natoma Depree: Fum & Equip Council Depree: Fum & Equip Natoma Depree: Vehicles Total Property and Equipment Other Assets Investments Total Other Assets 11118/2014 at 12:47 PM ... Camp Fire Council. Statement of Financial Position December 31, 2013 $ 50 38,603 1,864 100,368 1,352 19,168 3,467 1,338 400 597 1,366 895 126,000 160,935 3,322 80,934 62,253 8,567 3,148 (146,150) (80,934) (42,017) (8,567) 18 Unaudited -For Management Purposes Only 161,405 0 7,168 ( 895 169,468 167,491 18 Item 9.a. - Page 162 ········-·--· -----. Total Assets $ 336,977 LIABILITIES AND FUND BALANCES Current Liabilities Federal Inc. Tax Payable $ 178 FICA Tax Payable 548 Medicare Tax Payable 128 State Inc. Tax Payable 107 SDI Tax Payable 298 State Unempl. Tax Payable (1,043) Sales Tax Payable 93 Accounts Payable (635) Total Accounts Payable (326) Credit Line Payable 18,743 Accrued Vacation 1,329 Accrued Workers' Comp. Ins. 2,129 Accrued Interest Expense 234 Deferred Camp Income 1,050 Deferred Inc. -Trading Post 5,682 Suspense (1) ( Other Current Liabilities 29,166 Total Current Liabilities 28,840 Long-Term Liabilities Total Long-Term Liabilities 0 Total Liabilities 28,840 Fund Balances Unrestricted Funds 300,307 Net Income 7,830 Total Fund Balances 308,137 Total Liabilities & Fund Balances $ 336,977 11118/2014 at 12:47 PM Unaudited -For Management Purposes Only Item 9.a. - Page 163 REVENUES Support Camperships Candy Sales Candy Sales -Clubs <Candy Cost> <Candy Cost -Clubs> Candy Rebate Inc -Clubs Champions for Children Contrib Donations Donations -Camp/Clubs Grants-Gov't/Camp/Clubs Grants-Private/Camp/Clubs Special Events Special Events -Clubs <Special Event Direct Costs> Donor Campaign United Way-Central Coast United Way-SLO United Way-Camp/Clubs Total Support Other Revenue Investment Income Interestlnvestment/Misc Income Membership Dues -Youth Membership Dues-Adult Merchandise Sales -Store <Merch. Cost -Store> Merch. Sales -Camps <Merch. Cost-Camps> Natoma Camp Photos <Camp Photos Cost-Natoma> Miscellaneous Income Prog. Reg. Fees -Camp/Clubs Youth T -Shirts Total Other Revenue TOTAL REVENUES EXPENSES Salaries & Wages 11/18/2014 at 12:47 PM Camp Fire Council Statement of Revenue and Expenses Consolidated For the Twelve Months Ending December 31, 2013 Current Month Year to Date 2,630 18,784 0 17,598 0 17,598 0 (7,121) 0 (7, 121) 0 1,483 0 50 0 1,642 0 2,855 0 0 3,750 3,750 2,754 61,590 0 1,759 0 (15,405) 0 500 0 353 0 43 0 0 9,134 98,358 0 104 26 306 20 9,615 0 3,715 170 1,496 (105) (2,683) (111) 563 0 (6,280) 0 1,890 0 (1,087) 605 605 20 137,579 0 0 625 145,823 9,759 244,181 2,103 26,322 For Management Purposes Only ( Page: I Item 9.a. - Page 164 . . . .. . . ·-··. _ Current Month __ Year to Date . Sal/Wages-Camp/Clubs 2,357 70,797 Payroll Taxes 176 2,376 Payroll Taxes -Camp/Clubs 189 6,605 Workers' Comp. Ins. 23 628 Workers' Comp Ins.-Camp/Club 49 6,020 Hiring Expense -Camp/Clubs 0 10 Staff Meals 29 301 Staff Meals -Camp/Clubs 0 0 Staff Mileage 138 1,225 Staff Mileage-Camp/Clubs 83 1,920 Contract Labor-Camp/Clubs 0 0 Bldg. Maint. & Repair 0 1,022 Bldg. Maint. & Repair-Natoma 45 3,786 Business License & Fees 35 160 Equip. Maint. & Repair 408 4,733 Equip. Maint & Repair-Natoma 0 1,648 Janitorial Supplies 12 81 Janitorial Supplies-Natoma 0 816 Rent 96 908 Rent-Camp 110 8,716 Telephone 145 1,831 Telephone -Camp/Clubs 220 827 Utilities 180 1,646 Utilities -Camp 55 4,372 Advertising/Promotion 232 410 Advertising -Camp/Clubs 0 5,471 Bad Checks/Debts 0 505 ( Bank Charges/Merchant Fees 288 2,595 Board Expense 0 106 Candy Sale Awards-Clubs 50 2,195 Candy Sale Rebates-Clubs 0 3,334 Candy Sale Expenses 74 74 Charter Fees 823 3,029 Charter Fees -Camp/Clubs 150 7,674 Entrance Fees-Camp (560) 1,227 Food -Camp/Clubs 274 13,078 Fund Raising Expense 503 6,129 Insurance -Gen. Liab./D&O 0 6,871 Insurance -Members 0 151 Insurance -Natoma Liab. 0 2,043 Insurance -Nat. Campers 0 2,313 Insurance-Vehicle Natoma 0 662 Interest Expense 104 1,479 Medical Supp. -Camp/Clubs 0 240 Membership Dues & Fees 0 225 Memb. Fees & Dues-Natoma 0 1,741 Misc. Expenses 0 0 Newsletter Expense 0 99 Office Supplies 237 3,203 Office Supplies -Camp/Clubs 0 193 Postage 96 1,377 Postage -Camp/Clubs 0 343 Printing 0 26 Printing -Camp/Clubs 0 0 Professional Fees -Accounting 657 3,299 11118/2014 at 12:47 PM For Management Purposes Only Page: 2 Item 9.a. - Page 165 .. Current Month . Year.to Date Program Awards 0 424 Program Awards -Camp/Clubs 253 1,047 Program Equip.-Natoma 0 451 Program Supplies -Camp/Clubs 369 3,168 Staff Development 1,227 3,377 StaffDev.-Camp/Clubs 0 1,212 Transportation -Camp/Clubs 0 6,667 Voluriteer Recognition 0 70 Vol. Recognition-Camp/Clubs 40 462 Youth T -Shirts -Camp/Clubs 0 2,631 Expenses Subtotal 11,270 236,351 Administrative OH 0 0 TOTAL EXPENSES 11,270 236,351 NET SURPLUS/(DEFICIT) ($ 1,511) $ 7,830 ( 11118/2014 at 12:47 PM For Management Purposes Only Page: 3 Item 9.a. - Page 166 ( Camp Fire Council Statement of Financial Position December 31, 2012 Current Assets Cash Box-Council Checking-Council Checking-Community Clubs Checking-Money Market Natoma Projects Savings Savings-Reserve Total Cash Total Accounts Recievable Merchandise -Store Merchandise-Camp Inventory-Program Awards Inventory-Program Awards, Clubs Inventory-Program Awards, Camps Total Inventory Deposits Total Prepaid Assets Total Current Assets Property and Equipment Land -Camp Natoma Improvements-Camp Natoma Improvements-Santa Maria Cabin Furniture & Equipment-Council Furniture & Equipment-Natoma Vehicles Leasehold Imp.-Council Office Depree: lmprov. Natoma Depree: Furn & Equip Council ASSETS $ 50 8,816 1,017 100,085 8,092 40,290 3,467 1,338 400 597 1,366 605 126,000 154,292 3,322 80,934 62,253 8,567 3,148 (146,150) (80,934) 158,350 0 7,168 605 166,123 340 Pomeroy, Pismo Beach, CA 93449 Item 9.a. - Page 167 Depree: Furn & Equip Natoma Depree: Vehicles Total Property and Equipment Other Assets Investments Total Other Assets Total Assets LIABILITIES AND FUND BALANCES Current Liablities Federallnc.Tax Payable FICA Tax Payable Medicare Tax Payable State Inc. Tax Payable SDI Tax Payable State Unempl. Tax Payable Sales Tax Payable Accounts Payable Total Accounts Payable Credit Line Payable Accrued Vacation Accrued Workers' Camp. Ins. Accrued Interest Expense Deferred Camp Income Suspense Other Current Liablities Total Current Liabilities Long-Term Liabilities Total Long-Term Liabilities (42,017) (8,567) 18 192 354 99 70 193 (1,096) 39 113 22,387 935 1,833 234 1,050 2 26,441 160,848 18 326,989 (36) 26,405 0 340 Pomeroy, Pismo Beach, CA 93449 ( Item 9.a. - Page 168 ( Total Liabilities Fund Balances Unrestricted Funds Net Income Total Fund Balances Total Liabilities & Fund Balances 110,684 189,900 26,405 300,584 326,989 340 Pomeroy, Pismo Beach, CA 93449 Item 9.a. - Page 169 Camp Fire Council Statement of Revenue and Expenses Consolidated ( For the Twelve Months Ending December 3 I, 20 I 2 Current Month Year to Date REVENUES Support Camperships 0 I4,47I Candy Sales 0 I9,333 Candy Sales -Clubs 0 I9,333 <Candy Cost> 0 (9,654) <Candy Cost -Clubs> 0 (9,654) Candy Rebate Inc -Clubs 0 1,521 Donations 376 11,205 Donations -Camp/Clubs (6,625) 4,444 Grants-Gov't/Camp/Clubs 0 0 Grants-Private/Camp/Clubs 0 0 Special Events 2,280 55,026 <Special Event Direct Costs> (13,885) (13,885) United Way-Central Coast 0 267 United Way -Camp/Clubs 0 0 Total Support (17,854) 92,407 Other Revenue ( Interestlnvestment!Misc Income 57 108 Membership Dues-Youth 120 8,040 Membership Dues -Adult 240 1,880 Merchandise Sales -Store 92 3,741 <Merch. Cost -Store> (1,121) (2,974) Merch. Sales -Camps 0 4,864 <Merch. Cost -Camps> (1,908) (5,137) Natoma Camp Photos 0 1,650 <Camp Photos Cost -Natoma> 0 (340) Miscellaneous Income 0 23 Prog. Reg. Fees -Camp/Clubs 110 126,334 Youth T -Shirts 0 0 Total Other Revenue (2,410) 138,189 TOTAL REVENUES (20,264) 230,596 EXPENSES Salaries & Wages 340 4,074 Sal!W ages-Camp/Clubs 3,060 63,493 Payroll Taxes 32 378 Payroll Taxes -Camp/Clubs 229 5,566 Workers' Comp. Ins. 4 300 Workers' Comp Ins.-Camp/Club 33 5,231 11/18/2014 at 12:54 PM For Management Purposes Only Page: 1 Item 9.a. - Page 170 . -~··· ·-----.. ··-. -Current Month .... --Year to Date Hiring Expense 295 295 Hiring Expense -Camp/Clubs 0 0 ( StaffMeals-Camp/Clubs 0 0 Staff Mileage 32 316 StaffMi1eage-Camp/Clubs 80 879 Vacation Pay 394 394 Contract Labor -Council 0 212 Contract Labor-Camp/Clubs 0 0 Bldg. Maint. & Repair 0 108 Bldg. Maint. & Repair-Natoma 0 5,973 Equip. Maint. & Repair 304 3,962 Equip. Maint & Repair-Natoma 0 193 Janitorial Supplies. 0 45 Janitorial Supplies-Natoma 0 451 Rent 70 1,017 Rent-Camp 48 6,661 Telephone 191 2,104 Telephone -Camp/Clubs 51 685 Utilities 78 702 Utilities -Camp 66 4,878 Advertising/Promotion 0 1,073 Advertising -Camp/Clubs 0 2,212 Bad Checks/Debts 0 200 Bank Charges/Merchant Fees 226 2,451 Candy Sale Awards-Clubs 329 1,439 Candy Sale Rebates-Clubs 0 3,455 Charter Fees 255 (545) ( Charter Fees -Camp/Clubs 244 6,545 Entrance Fees-Camp 565 287 Food -Camp/Clubs 70 11,461 Fund Raising Expense (10,706) 6,811 Insurance -Gen. Liab./D&O 0 6,063 Insurance-Members 0 149 Insurance-Natoma Liab. 0 3,127 Insurance -Nat. Campers 0 25 Interest Expense 4 2,645 Medical Supp. -Camp/Clubs 0 187 Membership Dues & Fees 0 155 Memb. Fees & Dues-Natoma 0 1,564 Misc. Expenst::s 0 0 Office Supplies 290 1,445 Office Supplies -Camp/Clubs 0 304 Postage 0 778 Postage -Camp/Clubs 0 464 Printing 0 0 Printing -Camp/Clubs 0 56 Professional Fees -Accounting 150 2,533 Program A wards 0 378 Program Awards-Camp/Clubs 334 706 Program Equip. -Natoma 0 166 Program Supplies -Camp/Clubs 31 3,428 Staff Dev. -Camp/Clubs 0 920 Transportation -Camp/Clubs 0 3,965 Vehicle Expense-Natoma 0 291 Volunteer Recognition 0 46 11118/2014 at 12:54 PM For Management Purposes Only Page: 2 Item 9.a. - Page 171 Vol. Recognition-Camp/Clubs Youth T -Sltirts -Camp/Clubs Expenses Subtotal Administrative OH TOTAL EXPENSES NET SURPLUS/(DEFICIT) CAPITAL CAMPAIGN Natoma Special Projects Donations -Restricted Net Capital Campaign Gain/Loss on Sale of Assets 11/18/2014 at 12:54 PM .. ---------Current Month __ __ _ _ Year to Date_ 0 411 0 2,481 (2,901) 175,593 0 0 (2,901) 175,593 ($ 17,363) $ 55,003 $ 8,000 $ 8,000 $ 8,000 $ 8,000 $ 0 $ 126,616 ( For Management Purposes Only Page: 3 Item 9.a. - Page 172 Addendums: 2013 Expense Ratios 2013 Expense %to Total Administration Salaries $26,322 11% Program Salaries $70,797 30% Programming $139,232 59% Total Expenses $236,351 ---- 100% 2013 Sources of Revenue Source Amount Camperships $10,660 Candy Sales $19,742 Grants $63,608 Sponsorships $3,050 Special Events $14,123 United Way $547 Membership Dues $13,066 Program Fees $163,027 Item 9.a. - Page 173 Internal Revenue. Service P .· 0. Box 2508 Cincinnati, OH 45201 _) APR 2 8 2008 Date: CAMP FIRE USA 11 00 WALNUT ST STE 1900 KANSAS CITY MO 64106 . Dear Sir or Madam: Department of the Treasury Person to Contact: Gregory Renier ID# 31-07231 ATIACHMENT#l Toll Free Telephone Number: 877-829-5500 Employer Identification Number: 13-1623921 Group Exemption Number: 1409 This is in resp~:)fise to your letter C?f.January 20, 2008, regarding your tax-exempt status. Our_ records indicate that a determination letter was -issued in March 1958 that recognized you as exempt from Federal income tax. Our reeords further indicate that you are currently exempt under section 501(c)(3) of the Internal Revenue Code. · ' Based onthe information supplied, we recognized the subordinates named on the listyou submitte( · as exempt from Federal income tax under section 501 ( c)(3) of the Code. . , . - Contributions or gifts by indMduals, to domestic fraternal societies,· orders, or associations, .operating· under the lodge system, ·used· exclusively for 501 (c)(3) purposes are deductible under section 170{c)(4) of the Code. If solicitations are made for contributions, or gifts qy individuals for non- 501 (c)(3) purposes, the solicitation must include a statement indicating that these payments are not deductible as charitable contributions· for Federal income tax purposes. If you have any question~, please call us at the telephone number shown in the heading of this letter. Sincerely, ~41/~ ·cin(J Westcott Manager, Exempt Organizations Determinations • ·-· •• :. •• -·"7'. • • ... • • • -. ;. -•• :.: . .~. -. . ... . . . .·-.. -· . * Please see re:verse for further group exemption documentation. Item 9.a. - Page 174 ( ' CAMP FIRE USA CENTRAL COAST COUNCIL ..... BOARD OF Dl RECTORS. . Lisa Hensley, President 293 TallyHo Road Arroyo Grande, CA 93420 805-481-0741 (H) 805-441-4776 (C) Email: mlhensley5@aol.com Shari McCarthy, Secretary 222 Garden Street Arroyo Grande, CA 93420 805-481-5618 (H) Email: symccarthy2955@sbcglobal.com Maria Ramsey 690 Meadow Oak Dr. Arroyo Grande, CA 93420 805-709-0476 (C) Email: mamcramsey@sbcglobal. net Jeremy Thompson 622 Clydesdale Circle Paso Robles, CA 93446 805-441-7023 (C) Email: jeremy@warehousesports.com Julie Tizzano 3857 Cherry Hill Santa Maria, CA 93455 805-481-5990 (W) Email: julie@slocodata.com Keri Schwab San Luis Obispo, CA 93405 805-756-5113 (W) Email: keschwab@calpoly.edu 2014 OFFICERS: John Hutchison, Vice President P.O. Box 104 Grover Beach, CA 93483 805-4 71-17 43 John.hutch2012@gm~il.com Dorothy Truesdale, Treasurer 1833 Corralitos Avenue San Luis Obispo, CA 93401 541-6779 (H) Email: calvint5@charter.net DIRECTORS: · Jamie Stockton 1233 Sylvia Court San Luis Obispo, CA 93401 805-545-8251 (H) 805-441-7192 (C) Email: JJSBB60 1 @aol.com Jennifer Fonteneau 2317 Cordoban Ln. Santa Maria, CA 93455 805-714-4870 (C) Email: Jennifer.Fonteneau@.rRabobank.com Sue A. Viola 1741 Corralitos Avenue San Luis Obispo, CA 93401 805-543-5541 (H) 805-440-2656 (C) Email: saqviola@yahoo.com Item 9.a. - Page 175 I fJ S S O C i f J T E DI R E C T O R OF PR OG R f l i J 1 S Cf l i i 1 P DI R E C T O R S l Cf l i i 1 P ST A F F 0 (e a c h ca m p ha s it s ow n st r u c t u r e ch a r t ) o ~ · ~¥ ;1 1 \ Ca m p F i r e ll g h l l h < ! f l r • w l t h l n Ca m p Fi r e Ce n t r a l Co a s t o f Ca l i f o r n i a Or g a n i z a t i o n a l Ch a r t Bo a r d oF Di r e c t o r s l [ €X€~ ~ ~ : € D / R f C T Q R - -J I fl R E f l SE R V I C E TE f l / 1 1 I I CL . U B L. E f l D E R S 0 I I CL . U B SU P P O R T CO I J 1 1 1 1 1 T T E E o (v o l u n t e e r s : pa r e n t s , OF F I C E IJ 1 f l N f l G E R L. E V E L . 1 - - CO N S U L . Tf J N T I I I fl l u m n , ... - - · .. , Ca m p Fa c i l i t i e s NOIYIINflTING COIJ11J11TTEE I i I flD-I-Ioc: COIJ11J111TEES 0 By-laws Revision; ST A N D I N G CO I J 1 1 J 1 1 T T E E S Fi n a n c e (b u d q e t *F u n d ra i s i n g Personnel o Ca n d y , Co r n , Fi r e w o r k s , 1- / o / / y b e r r y , ! ! D. Proqram -,, *" ' " · · ' ~- · - - - - - · ' - ' · _, . - -'·-·-·1·.----·--· ··'·'· Item 9.a. - Page 176 (_ CITY OF ARROYO GRANDE COMMUNITY SERVICE GRANT PROGRAM APPLICATION FORM 2014-15 Pl~ase complete the following sections (use additional sheets as necessary): I. NAME AND ADDRESS OF NON-PROFIT ORGANIZATION: (must be the local branch) SCORE San Luis Obispo Chapter 597 4251 S. Higuera St. San Luis Obispo. CA 93401 II. GRANT APPLICANT REPRESENTATIVE'S NAME, ADDRESS AND TELEPHONE NUMBER: Lorna Whiteaker, Chapter Chair. 650 S. 9th St. #B. Grover Beach. CA 93433 805 901-3375 Ill. DESCRIPTION OF COMMUNITY SERVICES PROVIDED: Every year, SCORE volunteers help thousands of entrepreneurs. The San Luis Obispo County Chapter of SCORE is part of a national nonprofit association dedicated to entrepreneur education and the formation, grovvth and success of the country s small businesses. SCORE San Luis Obispo provides free and confidential business counseling, tools and resources tailored to meet the needs of small businesses. We also offer free workshops for both start-up and existing small business owners. SLO SCORE is committed to fostering a vibrant small business community in Arroyo Grande through mentoring and education and we support small business success. one business at a time. I IV .. LIST AREA(S) SERVED BY NON-PROFIT ORGANIZATION: (include brief description of the relationship of your non-profit organization to the residents of the City of Arroyo Grande) i ! I I I J SCORE San Luis Obispo pro\·idcs sen·icc-s throughout the San Luis Obispo Count\· and Santa !v1aria Valle\· communities. SLO SCORE is committed lO prO\ iding qual it> counseling scn·ices .and to making our · services and workshops easily and \\ideiy a\aibble. \\-h!le L)Ur primar: office and \\Orkshop site is located within the City of San luis Obispo. many of our ciiems come from A.rroyo Grande as do many of our mentors and meetings are routinely held in the .-\rroyo Grande area. Page I Item 9.a. - Page 177 V. . NUMBER OF. CITY OF ARROYO GRANDE RESIDENTS SERVED BY NON-PROFIT( __ ORGANIZATION: (broken down by aqe qroups if available) SLO SCORE has been serYing the coumy· s smal!·business community for 30 years. In the past l 0 years. m: ·! have counseled o\·er 20(1 clients residin!:! in Arro,·o Grande. In the past 2 Years. SLO SCORE has assisted the formation of almost i 00 ne\\ businesse; <:.nd fos;ered gr0\\1h of ()Y~r 100 .more. 20 of these in Arroyo 1 Grande. Our current expansion program increases our total case load almost 40% per year; in the future, we will be counseling and assisting even more .A.rroyo Grande small businesses and those interested in forming new businesses in Arroyo Grande. ______________ _j VI. AMOUNT OF FUNDS REQUESTED: $2500.00 SLO SCORE Sponsor requested donation i VII. PROPOSED USE AND BUDGET PLAN FOR GRANT FUNDS: iin.jicate if any of the grant funds will be used for any other purpose than those designa;ed such as overhead. national office. administrative salaries) Funds will be used to support v.;orkshop offerings. add new curriculum subjects. especially in the areas of financial education. the critical role of Social Media in small business operations today and how to use technology to retool existing businesses to take advantage of the opportunities available o them through ecommerce. To provide clients with copies of our printed booklets, publications. orkshop materials and educational software. To continue to update our ability to make online data and resources. training and information more accessible to clients and to be able to provide virtual ~orkshops and webinars. To acquire and train additional local SCORE members to provide the l mentorin~ and workshop se~ices needed by our clients throughout the County and.to each local commun1ty we serve, mcludmg Arroyo Grande. · VIII. ADDITIONAL DOCUMENTATION: (if you have received funds in the past, please indicate the amount of funds received (indicate what year) and how the funds were utilized) NOT APPLICABLE IX. SUPPLEMENTAL DOCUMENTATION: jgl Past two year's financial statements. including the current year with the balance sheets and the profit/loss statements. ~ Information indicating the percentage of revenue received that is used for administration, salaries, and program costs. 181 Breakdown and description of non-profit organization'§ sources of revenue. ~ Proof of 501 (c)(3) status with a copy of the letter from the IRS. ~ Copy of the non-profit organizations Board of Directors. Officers and an organization chart. Page 2 Item 9.a. - Page 178 X. CERTIFICATION: r_ certify on ·behalf oi SCORE San Luis Obisoo. Chaoter 597 non-profit oraanization. that I have read. understand and agree that the aforesaid information is accurate, .J factual and current. I understand that an award of funds. if granted. will be for the sole use as reflected in this application form. I further certify that as a condition of receiving funds. an agreement with the City of Arroyo Grande. in a form and content provided by the City of Arroyo Grande, will be signed and executed by a duly authorized representative of said non-profit organization. 1 am aware of and certify that our non-profit organization will adhere to all City regulations regarding the 2014c 15 Community Service Fund Program including. but not limited to. maintaining non- discriminatory policies. practices and intent. I also or. behalf of our non-profit organization. indemnify. defend, and hoid harmless the City of Arroyo Grande relative to any and all liability that may arise as a result of the use of the City of .A.rroyo Grande Community Service Grant Fund monies. Date Nov 14. 2014 Signature ();,,!l J/ii)lti / C:-lAPTER CHAIR Board of Director or Officer ' Page 3 Item 9.a. - Page 179 6:03PM 04117/14 Cash Basis SCORE 597 P refit & Loss October 2012 through September 2013 Ordinary Income/Expense Income 4350 Funds rec'd from Fomn 14 4400 Gifts and Grants other Union Sank Total 4400 Gifts and Grants otner 4500 Interest on 3ank Accounts 4600 Other Income Total Income Expense 5100 Workshops & Seminars 5300 Volunteer Training 5400 Office supplies & postage 5500 Ofc Equipment & Software 5600 Telephone & Answering Svc 5600.1 Telephone 5600.2 Answering Service Total 5600 Telephone & Answering Svc 7000 Rent 7000.1 Meeting Rent Total 7000 Rent 7200 Marketing and Promotion 7500 Donations and Grants 8000 Other Expenses Holiday Luncheon Picnic 8000 Other Expenses ·Other Total 8000 Other Expenses Total Expense Net Ordinary Income Net Income Oct '12 • Sep 13 4.537.38 i .000.00 ; .000 00 725.00 3.550.6.! 501.33 79.38 685.59 2~7.55 20&.29 ~ .373 . .30 i .532. i 7 250.00 250.0[' <A91.00 100.00 5'0.3(: 3C3.3i S5.66 ~ .030.27 5.067.5~ s; 3.10 613.10 (_ Page 4 Item 9.a. - Page 180 o:04PM 04/17/14 ' Cash Basis SCORE 597 Balance Sheet As of September 30, 2013 Sep 30, 13 ASSETS Current Assets Checking/Savings Cert oi Deposit 263045151 Certi of Deposit 263045152 Rabobank Checki:1g Rabobank Savings Total Checking/Savings Total Current Assets TOTAL ASSETS LIABILinEoS & EQUITY Equity Opening Balance Equity Unrestricted Net Assets Net Income· Total Equity TOTAL LiABILITIES & EQUITY 5.2~5.66 5.000.00 1 ~02.33 :3.53:3.85 ·, 8.483.8~ , 8,483.84 20.3S7.0i -2.526.27 Si3. iO i 8.483.84 18,483.84 Page 5 Item 9.a. - Page 181 4:45PM 10/14/14 Cash Basis SCORE 597 Profit & Loss October 2013 through September 2014 Income 4350 Federal Funds (Form 1.!) 4400 Gifts and Grants other City of Grover Beach City of Morro Bay City of Pismo Beach City of San Luis Obispo Coast National Founders Madonna Enterprises Martin Resorts ?G&E Foundation Phillips 65 Rabobank SESLOC Union Sank United Staffing Associates Wells Fargo Total 4400 Gifts and Grants other 4500 Interest on Bank Accounts Total Income Expense 5100 Programs 5101 Workshop Sire Ren; 5102 Workshop Materials 5103 Client Outreach Total 5100 Programs 5300 Volunteer Training 5301 Training & ::vents Total 5300 Volunteer Training S400 Office supplies & postage 5500 Office ::quip & Software 5600 Telephone & Answering Svc ;.;02 Ant:~o.Vo,.i.-,g ~o~ie-o 7otal 5600 Telephone & Answering Svc 5800 Publications and Printing 7000 Office ~ent Security Deposit 7000 Office Rent · Ott·,er 7otal 7000 Office Rent 7200 Marketing and Promotion i5DO SCORE Foundation Donation Total Expense Net Income Oct '13 · Sep 14 3 337.81 2.500.00 1.000.00 1.000.00 500.00 500.00 100.00 500.00 2.500.00 2.000.00 2.500.00 ·,_soc.oo 500.00 500.0(• 2.500.00 i.OOO.OC ' 28~.50 23::.52 : .87S.OO 3. 396.02 .30C'2 ~.300.72 209.20 .. 473.25 297.00 1.19C.OO 714.00 ; 90.!.00 455.73 0.00 S.880.32 12,638.89 I __ _ Page 6 Item 9.a. - Page 182 I -,- 11:30 AM 10/13/14 Cash Basis SCORE 597 Balance Sheet As of September 30, 2014 Sep 30, 14 ASSETS Current Assets Checking/Savings Cert of Deposit 263045',51 Certi of Deposit 263045152 . Rabobank Checking Rabobank Savings Total Checking/Savings Total Current Assets TOTAL ASSETS LIABILITIES & EQUITY Equity Opening Balance Equity Unrestricted Net Assets Net Income Total Equity TOTAL LIABILITIES & EQUITY 5.3 i 5.25 5.000.00 i".95S.82 5.847.66 3l.i22.73 31,122.73 20.397.01 -~ .913.17 ·:2.:335.89 31 122.73 31.122.73 Page 7 Item 9.a. - Page 183 sco~ San Lu1s Obisoo I REVE\TE SOLRCES and LSE Federal Funds constitute 11°-'o of our annual rc\·cnucs and arc used to co\·er administrative expenses which include telephone answering sen·ice. oi'ficc supplies. equipment expense. software. web site hosting. and Yolunteer tra\·el expense. Community suppo11 constitutes 78° o of \.1ur annual re\ enues and is used for program expenses. volunteer training and counseling suppon (otTice space las foliO\\S: Office and meeting rooms Program costs (publications. outreach. Workshop site rent) Federal funding is usually about. 10° o of t1.>tal annual r.:,·enues but is subject to reduction. The remaining approximately 80°6 comes fmm the communit:-and is from pri\·are. corporate and public (cities) resources. Federal funding is barely adequate to co,·er our administrative costs. To date. SCORE San Luis Obispo has been able w ke-ep administrati\·e o\·crhead down b~-in- kind community suppon. Our all-,·oiuntecr chapter membership proudly offers all of our counseling. workshops. training and resources to small business O\\ners and aspiring entrepreneurs ar ~0 COST. In c1rdcr to dc~ :>l' it i~ n<::c.::ssar; !'or SCORE San Luis Obispo to secure funding from community resources. I ___ _ Page 8 Item 9.a. - Page 184 ,-- sco~ ORGA:\IZ.-\ TIO:\ CH.-\RT FOR :\0:\-PROFIT Smali Business .-\dministration SCORE :\ational W. Kenneth Yancey. Jr .. CEO SCORE District Peter Fong. District Director SCORE Chapter 597-San Luis Obispo Lorna Whiteaker. Chair Robert Kenvin. \'icc Chair ( .-\ppointment Pending) Carol Kenrin. Secreta!'\ Robert Aze\·edo, Treasurer Standing Committees The Chapter has tout· (-+ l standing C ommittccs: \ !urketing. \\.orkshops. \'kntoring & Client Ser:ices. and.\ fembership De' elopment &. Recruiting Executive Committee The Ewcuti\·e Comminee is comprised ofthe Chair. Vice-Chair. Secretar;;. Treasurer. Past Chair. Emeritus members and Committee Chairs. \I embers Page 9 Item 9.a. - Page 185 g'~ IRS Department 0frhe Tr~asu7y ~tfz:J"IIJ Internal Revenue Sen·ice In reply refer to: 0248421964 027075 CINCINNATI OH 45999-0038 Sep. 11. 2013 LTR 4168C 0 52-1067290 000000 00 SERVICE CORPS OF RETIRED EXECUTIVES ASSOCIATION 1175 HERNDON PKWV STE 900 HERNDON VA 20170-5532 Employer Identification Number: 52-1067290 Person to Contact: Hs. L Mitchell Toll Free Telephone Number: 1-877-829-5500 Dear Taxpayer: 00008988 BODC: TE This is in response to your Sep. 03, 2013, request for information regarding your tax-exempt status. Our records indicate that you were recognized as exempt under section 50l(c)C3J of the Internal Revenue Code in a determination letter issued in February 1990. I ,-- Our records also indicate that you are not a orivate foundation within (. the meaning of section 509Ca) of the Code because you are described in section(s) 509Ca)(l) and l70Cb)(l)(A)Cvi). Donors may deduct contributions to you as provided in section 170 of the Code. Bequests, legacies, devises, transfers, or gifts to you or for your use are deductible fer Federal estate and gift tax purposes if they meet the applicable provisions of sections 2055, 2106, ana 2522 of the Code. Please refer to our website www.irs.gov/eo for information regarding filing requirements. Specifically, section 6033(j) of the Code provides that failure to file an annual information return for three consecutive years results in revocation of .tax-exempt status as of the filing due date of the third return for organizations required to file. We will publish a list of organizations whose tax-exempt status was revoked under section 6033Cj) of the Code on our website beginning in early 2011. Pao-e 10 0 ( Item 9.a. - Page 186 r_·_ ( \ ( 0 2 {' El 4 2 1 96 c, Sep. ll, 2013 LTR 4168C 0 S2-l067290 000000 00 00008989 SERVICE CORPS OF RETIRED EXECUTIVES ASSOCII\TION 1175 HERNDON PKWV Sl'[ 900 HERNDON VA 20170-5532 I f you have any que s ": ions , Please call us at the telephone numb e I' shown in the heading af this Jetter. Sine<: rely your·s, Richard McKee, Department Manager Accounts t1anagement Operations ·Page 11 Item 9.a. - Page 187 ,-- CITY OF ARROYO GRANDE COMMUNITY SERVICE GRANT PROGRAM APPLICATION FORM 2014-15 Please complete the following sections (use additional sheets as necessary): I. NAME AND ADDRESS OF NON-PROFIT ORGANIZATION: (must be the local branch) Big Brothers Big Sisters of San Luis Obispo County P.O. Box 12644 San Luis Obispo, CA 93406 II. GRANT APPLICANT REPRESENTATIVE'S NAME, ADDRESS AND TELEPHONE NUMBER: (must be the Executive Director or their designated representative) Anna Boyd-Bucy, Executive Director P.O. Box 12644, San Luis Obispo, CA 93406 805-781-3226 Ill. DESCRIPTION OF COMMUNITY SERVICES PROVIDED: Big Brothers Big Sisters is a donor and volunteer supported organization proven to help vulnerable children of single, low-income and/or incarcerated parents succeed. We create professionally supported one-to-one relationships between children facing adversity and trained and supeNised volunteer role models. Funding provides for targeted recruiting, screening, training and matching, as well as ongoing support, safety training and supeNision for volunteers, children and families. Donations allow us to ensure child safety and sustain successful, long-term relationships with proven positive outcomes. In our Community Based Program, volunteers and children spend at least 6 hours a month exploring shared interests and developing positive, stable relationships. Volunteers enrich children's lives by modeling healthy choices and providing connection with their community. Our professional staff provides individualized case management to each match relationship and hosts educational and enriching group activities for all program participants. The agency conducts regular baseline and follow-up suNeys to ensure long-term positive results. IV. LIST AREA(S) SERVED BY NON-PROFIT ORGANIZATION: (include brief description of the relationship of your non-profit organization to the residents of the City of Arroyo Grande) Big Brothers Big sisters of San Luis Obsipo County seNes families throughout the County. Since opening for service in 1995, we have created more than 1 ,800 mentor relationships. Approximately 6% of the families we seNe reside within the City of Arroyo Grande and Mike Hill, an Arroyo Grande resident board member, represents the area during our board meetings. Item 9.a. - Page 188 .------------------------------------------------------------------------------.'-:-v. NUMBER OF CITY OF ARROYO GRANDE RESIDENTS SERVED BY NON-PROFIT ORGANIZATION: (broken down by age groups if available) All of our services are provided to youth between the ages of 6 and 18, though the goal is to provide systemic change to the entire family. We served 328 unduplicated children in 2013, 20 of them live in Arroyo Grande, 113 of them reside within the South County/ Nipomo & 5 Cities area. An additional 9 Arroyo Grande resident children are on our wait list. We hope you will help fund services for those youth. I. VI. AMOUNT OF FUNDS REQUESTED: $5,000 VII. PROPOSED USE AND BUDGET PLAN FOR GRANT FUNDS: (indicate if any of the grant funds will be used for any other purpose than those designated such as overhead, national office, administrative salaries) Our request consists exclusively for funds to pay for staff time associated with training, screening, enrolling and matching families and volunteers who reside within the City of Arroyo Grande, and supporting those matches. It does not include any outreach, overhead, national dues or administrative salaries or other costs associated with activities, screening, insurance, supplies, etc. It does not include costs associated with volunteers or families who may initially enroll but do not stay involved long enough to be matched in the program. To meet child safety and program quality standards, our professional staff members have a minimum of a BA and are highly trained. Their time is billed at $20 an hour. VIII. ADDITIONAL DOCUMENTATION: (if you have received funds in the past, please indicate the amount of funds received (indicate what year) and how the funds were utilized) Past City of Arroyo Grande funding has been for requests similar to the one above through the CDBG program. In 2005 we received $1072, 2006-$2061, 2007-$1738, 2008-$2722, 2009-$941, 2010-$956, 2011-$974, 2012-$876, 2013-$1340 IX. SUPPLEMENTAL DOCUMENTATION: !!! Past two year's financial statements, including the current year with the balance sheets and the profit/loss statements. iii Information indicating the percentage of revenue received that is used for administration, salaries, and program costs. iii· Breakdown and description of non-profit organization's sources of revenue. Iii Proof of 501 (c)(3) status with a copy of the letter from the IRS. ijg Copy of the non-profit organizations Board of Directors, Officers and an organization chart. · ( \. '· Item 9.a. - Page 189 X. CERTIFICATION: 1- behalf Of Big Brothers Big Sisters of San Luis Obsipo County certify on non-profit organization, that I have read, understand and agree that the aforesaid information is accurate, factual and current. I understand that an award of funds, if granted, will be for the sole use as reflected in this application form. I further certify that as a condition of receiving funds, an agreement with the City of Arroyo Grande, in a form and content provided by the City of Arroyo Grande, will be signed and executed by a duly authorized representative of said non-profit organization. I am aware of and certify that our non-profit organization will adhere to all City regulations regarding the 2014-15 Community Service Fund Program including, but not limited to, maintaining non- discriminatory policies, practices and intent. I also, on behalf of our non-profit organization, indemnify, defend, and hold harmless the City of Arroyo Grande relative to any and all liability that may arise as a result of the use of the City of Arroyo Grande Community Service Grant Fund monie·s. Date: 11/18/14 Signature: ~'l\1 Executive Director or Designee ~/-/~{}I Yr.#. Bo_jrd of Director or Officer Item 9.a. - Page 190 I ,- 2:58PM 02/24/14 Accrual Basis Big Brothers Big Sisters of SLO County Balance Sheet As of December 31,2013 ASSETS Current Assets Checking/Savings 1210 · Mission Community #0462 O.A. 1261 · Union Bank MM 1263 · First California Bank Total Checking/Savings Total Other Current Assets Total Current Assets Total Fixed Assets TOTAL ASSETS Dec 31, 13 59,319.41 5,052.19 235,702.12 15,743.34 251,445.46 3,556.46 255,001.92 Page 1 of 2 Item 9.a. - Page 191 2:58PM 02/24/14 Accrual Basis Big Brothers Big Sisters of SLO County Balance Sheet LIABILITIES & EQUITY Liabilities Current Liabilities Accounts Payable As of December 31, 2013 2000 · Accounts Payable Total Accounts Payable Other Current Liabilities 2102 · Accrued Vacation 2104 · Payroll Liabilities Total 2110 ·Grants Payable Total Other Current Liabilities Total Current Liabilities Total Liabilities Equity 3900 · Retained Earnings 3927 · Def Inc 2014-Acct #41055 3928 · Def Inc 2014-Acct #41281 Net Income Dec 31, 13 6,415.62 6,415.62 8,194.34 480.50 28,930.00 37,604.84 44,020.46 44,020.46 206,267.40 1,000.00 1 ,494.12 2,219.94 ,_,- Page 2 of 2 Item 9.a. - Page 192 2:51PM 02/24/14 Accrual Basis Big Brothers Big Sisters of SLO County Profit & Loss Budget Performance December 2013 .-•. -Jan -Dec 13 Annual Budget Ordinary Income/Expense Income 40001 · Contributions 40010 · Comm Support Campgn/Major Gifts 40020 · Realtor's Circle 40030 · Business Partners 40090 · Other Donations Total 40150 · Designated Contributions Total 4.0001 · Contributions 41001 · Events Total 41220 · The Big Event Total 41265 · Bowl For Kids Sake Total 41001 · Events Total 42200 · Grants Total 44000 · Other/Misc. Income Total Income Expense 550001 · Fundraising Expenses 95,028.12 17,950.00 19,500.00 19,775.50 4,153.24 156,406.86 84,076.20 25,494.83 109,571.03 83,040.00 389.47 349,407.36 Total 550005 ·Community Support Campaign E 1,597.27 Total 550080 · Realtor's Circle Expenses 625.00 Total 550100 · Annual Stakeholders Reception 1,434.61 __ ...;... __ Total 550001 · Fundraising Expenses 551001 · Event Expenses Total551010 ·The Big Event Total 551500 · Bowl For Kids Sake Exp. Total 551001 · Event Expenses 557001 · Program Expenses 557007 · Grant Writer/Board Development 557010 · Bookkeeping Services 557015 · Audit & Tax Preparation 557020 · Donor Outreach 557025 · Internet Services 557030 · Bank Service Charges 557050 · Credit Card Discount Fees Total 557060 · Activities 3,656.88 7,544.88 2,231.10 9,775.98 7,080.00 5,295.95 5,802.51 1,051.68 600.00 0.00 2,060.13 1,157.45 105,000.00 14,000.00 13,000.00 24,000.00 3,100.00 159,100.00 91,000.00 29,400.00 120,400.00 89,000.00 850.00 369,350.00 2,300.00 1,000.00 2,000.00 5,300.00 12,000.00 3,400.00 15,400.00 9,600.00 5,000.00 5,000.00 1,000.00 600.00 2,000.00 1,200.00 Page 1 of 2 Item 9.a. - Page 193 2:51PM Big Brothers Big Sisters of SLO County 02/24/14 Profit & Loss Budget Performance Accrual Basis December 2013 Jan-Dec 13 Annual Budget ·-:- 557110 · Awards/Recognition 507.76 500.00 557115 · Background Check 1,701.63 1,500.00 557120 · Dues/Subscriptions 1,077.14 900.00 557130 · Copier Lease 2,446.95 2,500.00 557135 · Equipment Repair/Maintenance 5,026.96 5,000.00 557140 · Program Supplies 1,980.09 2,000.00 Total 557150 · Insurance 21,935.48 24,200.00 557200 · Office Supplies 3,484.86 3,500.00 557225 · Marketing & Recruitment 855.52 2,500.00 557230 · Postage 1,485.32 1,500.00 557235 · Printing 2,943.39 3,300.00 557240 · Promotional Merchandise 0.00 400.00 557245 · Occupancy I Rent 18,000.00 18,000.00 557250 · Telephone 3,163.65 3,600.00 557255 · Training/Conf. -Staff/Board 974.77 2,000.00 557260 · Mileage Reimbursement 3,479.85 4,100.00 557265 · Employee Recruitment/Retention 9,200.97 6,200.00 557270 · Travel -Staff/Board 0.00 500.00 557275 · Meetings/Meals 800.92 800.00 I 557280 · BBBS Affiliation Fees 6,206.55 6,300.00 \ Total 557300 · Wages & Taxes 225,667.97 234,867.00 Total 557001 · Program Expenses 333,987.50 348,567.00 Total Expense 347,420.36 369,267.00 Net Ordinary Income 1,987.00 83.00 Other Income/Expense Other Income 47001 · Unrealized Gain/Loss 232.94 Total Other Income 232.94 Net Other Income 232.94 Net Income 2,219.94 83.00 Page 2 of 2 __j Item 9.a. - Page 194 ~-- 6:42PM 11/16/14 Accrual Basis Big Brothers Big Sisters of SLO County Balance Sheet As of October 31, 2014 ASSETS Current Assets Checking/Savings 121 0 · Heritage Oaks Bank 1264 · Rabobank MM Account Total1265 · Pac Western MM Account Total Checking/Savings Total Other Current Assets Total Current Assets Fixed Assets 1400 · Fixed Assets 1410 · Fixed Assets 1420 · Accum. Depreciation Total 1400 · Fixed Assets Total Fixed Assets TOTAL ASSETS Oct 31, 14 86,402.76 50,069.04 106,857.67 243,329.47 12,323.82 255,653.29 16,399.42 -9,798.00 6,601.42 6,601.42 262,254.71 Page 1 of 2 Item 9.a. - Page 195 6:42PM 11/16/14 Accrual Basis Big Brothers Big Sisters of SLO County Balance Sheet LIABILITIES & EQUITY Liabilities Current Liabilities Other Current Liabilities 2102 · Accrued Vacation Total 2110 · Grants Payable Total Other Current Liabilities Total Current Liabilities Total Liabilities Equity 3900 · Retained Earnings Net Income Total Equity TOTAL LIABILITIES & EQUITY As of October 31, 2014 Oct 31, 14 8,194.34 36,916.72 45,111.06 45,111.06 45,111.06 212,273.30 4,870.35 217,143.65 262,254.71 _,._ .. ( Page 2 of 2 Item 9.a. - Page 196 6:40PM Big Brothers Big Sisters of SLO County 11/16/14 Profit & Loss Budget Performance Accrual Basis October 2014 .-.-Oct 14 Jan-Oct 14 Annual Budget Ordinary Income/Expense Income 40001 · Contributions 40010 · Comm Support Campgn/Major Gifts 37,555.86 58,373.06 105,000.00 40020 · Realtor's Circle 1,100.00 14,400.00 20,000.00 40090 · Other Donations 770.00 14,792.70 22,000.00 Total 40150 · Designated Contributions 97.87 2,534.10 3,700.00 Total 40001 · Contributions 39,523.73 90,099.86 150;700.00 41001 · Events Total 41220 · The Big Event 0.00 126,865.00 111 ,500.00 Total 41265 · Bowl For Kids Sake 0.00 30,913.36 29,400.00 Total 41280 · Winter Wonder SLO 0.00 4,231.12 13,000.00 41290 · One Time Special Event Income 0.00 4,928.00 Total 41001 · Events 0.00 166,937.48 153,900.00 42200 · Grants Total 42200 · Grants 6,358.28 70,013.28 98,700.00 . ( 44000 · Other/Misc. Income Total 44000 · Other/Misc. Income 22.27 242.97 350.00 Total Income 45,904.28 327,293.59 403,650.00 Expense 550001 · Fundraising Expenses Total 550005 · Community Support Campaign E: 374.22 1,065.12 1,800.00 Total 550080 · Realtor's Circle Expenses 0.00 900.00 750.00 Total 550100 · Annual Stakeholders Reception 0.00 1,664.61 1,500.00 Total 550001 · Fundraising Expenses 374.22 3,629.73 4,050.00 551001 · Event Expenses Total 551010 · The Big Event 0.00 20,843.11 18,900.00 Total 551500 · Bowl For Kids Sake Exp. 0.00 2,930.61 2,400.00 Total 551700 · Winter Wonder SLO Expenses 0.00 1,077.81 2,000.00 551800 · One Time Special Event Expense 0.00 2,122.62 Total 551001 · Event Expenses 0.00 26,974.15 23,300.00 557001 · Program Expenses 557010 · Bookkeeping Services 400.00 4,000.00 5,500.00 557015 · Audit & Tax Preparation 0.00 4,800.00 6,000.00 557020 · Donor Outreach 0.00 49.42 800.00 Page 1 of 2 Item 9.a. - Page 197 6:40PM Big Brothers Big Sisters of SLO County 11(16/14 Profit & Loss Budget Performance Accrual Basis October 2014 Oct 14 Jan-Oct 14 Annual Budget I_ ' 557025 · Internet Services 50.00 500.00 600.00 557030 · Bank Service Charges 1.23 1.23 557040 · Donor Database Software 90.00 900.00 2,160.00 557050 · Credit Card Discount Fees 164.99 764.35 2,400.00 Total 557060 · Activities 78.96 227.03 1,200.00 5571 OS · AIM Program Database Software 0.00 0.00 3,000.00 557110 · Awards/Recognition 0.00 391.88 500.00 557115 · Background Check 134.15 1,251.90 1,500.00 557120 · Dues/Subscriptions 22.97 474.76 900.00 557130 · Copier Lease 387.41 2,195.08 2,250.00 557135 · Equipment Repair/Maintenance 0.00 4,616.46 5,000.00 557140 · Program Supplies 200.32 1,523.93 2,000.00 Total 557150 · Insurance 1,149.40 11,628.94 14,150.00 557200 · Office Supplies 64.19 2,775.79 3,500.00 557230 · Postage 220.00 1,892.64 1,500.00 557235 · Printing 2,279.94 4,593.92 3,300.00 557245 · Occupancy I Rent 1,300.00 14,800.00 18,000.00 557250 · Telephone 446.14 2,894.78 3,600.00 557255 · Training/Cont. -Staff/Board 0.00 2,705.01 2,400.00 557260 · Mileage Reimbursement 369.10 3,535.80 4,100.00 557265 · Employee Recruitment/Retention 0.00 1,286.72 7,400.00 557270 · Travel -Staff/Board 0.00 1,604.56 1,800.00 557275 · Meetings/Meals 31.23 548.99 800.00 557280 · BBBS Affiliation Fees 489.14 5,075.18 6,500.00 Total 557300 · Wages & Taxes 23,551.02 227,842.83 275,394.56 Total 557001 · Program Expenses 31,430.19 302,881.20 376,254.56 Total Expense 31,804.41 333,485.08 403,604.56 Net Ordinary Income 14,099.87 -6,191.49 45.44 Page 2 of 2 Item 9.a. - Page 198 ~-- Big Brothers/Big Sisters of San Luis Obispo County Statement of Activities and Changes in Net Assets For the Year Ended December 31, 2013 Expenses Program Services Supporting Services Fundraising Management and General Unallocated payments to national organization Total Expenses Net Assets, Beginning (Unadjusted} Prior Period Adjustments (Note 13} Net Assets, Beginning (Adjusted} Change in Net Assets Net Assets, Ending $ Unrestricted 184,590 105,864 68,094 6,207 364,755 206,268 36,296 242,564 (9,267} 233,297 $ Temporarily Restricted $ See independent auditor's report and accompanying notes. Permanently Restricted $ Totals 184,590 105,864 68,094 6,207 364,75S 206,268 36,296 242,564 (9,267} 233,297 5 Item 9.a. - Page 199 Big Brothers/Big Sisters of San Luis Obispo County Statement of Activities and Changes in Net Assets For the Year Ended December 31, 2013 Revenues, Gains, and Support Special events revenue $ Contributed auction items Less cost of contributed auction items Less direct costs of special events Net revenues from special events Contributed professional services Contributed rent Contributed supplies Federal financial assistance State and local governments financial assistance Federated campaign Private contributions Program mentor service fees Investment income Unrealized investment gains Other revenue Net Assets Released from Restrictions Total Revenues, Gains, and Support Unrestricted 109,571 98,618 (98,618) (9,777) 99,794 18,500 10,500 887 2,790 12,000 3,034 186,7SO 20,000 391 233 609 355,488 355,488 $ Temporarily Restricted See independent auditor's report and accompanying notes. $ Permanently Restricted $ Totals 109,S71 98,618 (98,618) (9,777) 99,794 18,500 10,500 887 2,790 12,000 3,034 186,750 20,000 391 233 609 355,488 355,488 4 I .-.- Item 9.a. - Page 200 IN'1'ERNAL REV:.NUE SERVICE DISTRICT DIRECTOR 2 CUPANIA CIRCLE ~---MONTEREY PARK, CA 91755-7406 Date: MAR 2 5 1994 BIG BROTH£RS/BIG SISTERS OF SAN LOIS OBISPO CO~~y C/0 WILLIAM JODRY 628 SPRING STREET PASO ROBLES, CA 93446 Dear Applicant: DEPARTMENT OF THE TREASURY Employer Identification Number: 77-0348487 Case Number: 954063057 Concact Person: TYRONE THOMAS Contact Telephone Number: (213) 894-2289 Accounting Period Ending: December 31 Form 990 Required: Yes AdneDdum Applies: No Based on information supplied, and .assuming your operations will be as stated in your application for recognition of exemption~ we have determined you are exempt from Federal income tax under section 501{a) of the Internal Revenue Code as an organization described in section SOl{c) (3). We have further determined that you are not a private foundation within the mean.ing of section 509 (a) of the Code, because you are an organization described in sections 509 {a) {1) and 170 (b) (1) (A) (vi). If you:::-sources of support, or your p•1rposes, character, or method of operation char,g-e, please let us ·Y-"'10._.! r''"' we can c ::msider the effect of the change on your exempt status and foundation status. In the case of ~• amend- ment to your organizational document or bylaws, please send us a copy of the amended document or bylaws. Also, you should inform us of all changes in your name or address. As of January 1, 1984, you are liable for taxes under the Federal Insurance Contributions Act (social security taxes) on remuneration of $100 or more you pay to each of your employees during a calendar year. You are not liable for· the tax imposed under the Federal Unemployment Tax Act (FUTA) . Since you are not a private foundation, you are not subject to the excise taxes under Chapter 42 of the Code. However, you are not automatically exempt from other Federal excise taxes. If you have any questions about excise, employment, or other Federal taxes, please let us know. Donors may deduct contributions to you as provided in section 170 of the Code. Bequests, legacies, devises, transfers, or gifts to you or for your use are deductible for Federal estate and gift tax purposes if they meet the applicable provisions of Code sections 2055, 2106, and 2522. Contribution deductions are allowable to donors only to the extent that their contributions are gifts, with no consideration-received. Ticket pur- chases and similar payments in conjunction with fundraising events may no: necessarily qualify as deductible contributions, depending on the circum- Letter 94"1 (DO/CG) Item 9.a. - Page 201 -2- BIG BROTHERS/BIG SISTERS OF SAN stances. See Revenue Ruling 67-246, published in Cumulative Bulletin 1967-2, on page 104, which sets forth guidelines regarding the deductibility, as chari- table contributions, of payments made by taxpayers for admission to or other participation in fundraising activities for charity. In the heading of this letter we have indicated whether you must file Form 990, Return of Organization Exempt From Income Tax. If Yes is indicated, you are required to file Form 990 only if your gross receipts each year are normally more than $25,000. However, if you receive a Form 990 package in the mail, please file the return even if you do not exceed the gross receipts test. If you are_not required to file, simply attach the label provided, check the box in the heading to indicate that your annual gross receipts are normally $25,000 or less, and sign the return. If a return is required, it must be filed by the 15th day of the fifth month after the_ end of your annual accounting period. A penalty of ·$10 a day is charged when a return is filed late, ·unless there is reasonable cause for the delay. However, the maximum penalty charged cannot exceed $5,000 or 5 per- cent of your gross receipts for the year, whichever is less. This penalty may also be charged if·a return is not complete, so please be sure your return is complete before you file it. · You are not required to file Federal income tax returns unless you are subject to the tax on unrelated business income under section 511 of the Code. If you are subj~ct:. to this t.ax, ·you m..:st _file an in::ome ta..~ return on Form 990-T, Exempt Organization 3usiness Income Tax Return. In this letter we are not detemining whether· any of your present or proposed activities are unre- lated trade or business as defined in section 513 of the Code. You need an employer identitication number even if you have no employees. If an employer identification number was not entered on your application, a number will be assigned to you and you will be advised of it. Please use that number on all returns you file and in all correspondence with the Internal Revenue Service. This determination is based on evidence that your funds are dedicated to the purposes listed in section 501(c) (3) of the Code. To assure your continued exemption, you should maintain records to show that funds are expended only for those purposes. If you distribute funds to other organizations, your records should show whether they are exempt under section SOl(c) (3). In cases where the recipient organization is not exempt under section SOl(c) (3), there should be evidence that the funds will remain dedicated to the required purposes and that they will be used for those purposes by the recipient. If we have indicated in the heading of this letter that an addendum applies, the enclosed addendum is an integral part of this letter. Because this letter could help resolve any questions about your exempt status and foundation status, you should keep it in your permanent records. Letter 947 (DO/CG) .-.- Item 9.a. - Page 202 -3- BIG BROTHERS/BIG SISTERS OF SAN If you have any questions, please contact the person whose name and telephone number are shown in the heading of this letter. Sincerely yours, ~P.~ Richard R. Orosco District Director Letter 947 (DO/CG} Item 9.a. - Page 203 ~-·.- ( . Big Brothers Big Sisters . of San Luis Obispo County · Board of Directors President, Karen Colombo, Retired Financial Analyst, 7 years Vice President, Christie Tjong, Fidelity National Title, 9 years Secretary, Hal Sweasey, RE/Max Del Oro, 1 0+ years Treasurer, Dave Axberg, Farm Credit West, 7 years Board Members: Marian Anderson, Union Bank, 1 0+ years Monique Carlton, San Luis Obispo Realty, 1 0+ years Bill Filippin, Heritage Oaks Bank, new C.M. Florence, Oasis Associates, 9 years Bryan Gingg, Investor and Community Advocate, 1 0+ years Jim Hamari, Charles Schwab, 7 years Mike Hill, Althouse and Meade, 4 years Holly Holliday, Create Promotions, new Steve Holtzman, Radiology Associates, new Kaitlin King, Etna Interactive, new Jason Linker, Quivers International, new Ryan Miller, Etna Interactive, new Ziyad Naccasha, Cannel & Naccasha LLP, 6 years JED Nicholson, Attorney at Law, 1 0+ years Sunil Patel, Comfort Inn and Suites, 3 years Clint Pearce, Madonna Enterprises, 1 0+ years Phillip Sullivan, Rabobank, new Item 9.a. - Page 204 Big Brothers Big Sisters of San Luis Obispo County Organizational Chart Board of Directors Executive Director Anna Boyd-Bucy Development Director Patty Carpenter Program Director Madge Morningstar Office Manager Roweena Talasen 1-3 Cal Poly interns or volunteers School Based Coordinator, Tibi Escobedo Community Based Coordinator, Tatiana Abundis Program Specialist, Amy Burke (12 time) 4-6 Cal Poly interns ( I ,-_- J Item 9.a. - Page 205 I __ CITY OF ARROYO GRANDE COMMUNITY SERVICE GRANT PROGRAM APPLICATION FORM 2014-15 Please complete the following sections (use additional sheets as necessary): I. NAME AND ADDRESS OF NON-PROFIT ORGANIZATION: (must be the local branch) Family Care Network, Inc. 1255 Kendall Road San Luis Obispo, CA 93401 II. GRANT APPLICANT REPRESENTATIVE'S NAME, ADDRESS AND TELEPHONE NUMBER: (must be the Executive Director or their designated representative) Jim Roberts, CEO Family Care Network, Inc. 1255 Kendall Road, San Luis Obispo, CA 93401 (805) 781-3535 Ill. DESCRIPTION OF COMMUNITY SERVICES PROVIDED: Family Care Network, Inc. (FCNI), founded in 1987, serves San Luis Obispo and Santa Barbara counties, operating under the mission: "To enhance the wellbeing of children and families in partnership with our community." In its history, the agency has served over 14,000 children, youth and families with an average success rate of 89%. Programs are designed to provide a wide range of services to our community's children, youth and families, including: recruiting, training and supporting foster families to provide therapeutic foster care services; transitional age youth (T AY) support programs for current and former foster youth ages 16-24 who are working to become successful, self-sufficient adults; community-linked services which recruits, trains and supports community volunteers in providing mentoring, interning and tutoring services; school-based mental health services which provides trained Rehabilitation Specialists for support in specialized classrooms to help students stabilize their behaviors to retain successful school placements; and family support programs such as Wraparound services and Therapeutic Behavioral Services which provides parent partners, community linkage supports, in-home Rehabilitation Specialists support and other critical assistance in order to keep families together. The agency serves the most at-risk, high-needs children and youth impacted by trauma and all programs offered are needs-driven, solution-focused, family-centered and community-based, and utilize "best practice" elements and Wraparound principles, ensuring that those served are given voice, choice and preference in their journey towards their individual success · · IV. LIST AREA(S) SERVED BY NON-PROFIT ORGANIZATION: (include brief description of the relationship of your non-profit organization to the residents of the City of Arroyo Grande) FCNI serves all of San Luis Obispo County, including the City of Arroyo Grande. At present, the agency owns two apartment complexes in Arroyo Grande, one located on Halcyon Street and the other located on Elm Street. These two complexes are used to provide affordable and safe housing for current and former foster youth ages 16-24 who are receiving support services through our Transitional Age Youth Services (TAYS) as they are work towards becoming successful, self-sufficient adults. These housing complexes have the following capacity: Elm Street--eight (8) TAY clients plus children and one (1) Residential Advisor, including one (1) Emergency Shelter Bed Halcyon Street--seven (7) TAY clients plus children and one (1) Residential Advisor In our last fiscal year (July 1, 2013-June 30, 2014), FCNI served a total of 15 TAY clients through these housing units. This specific grant request is to install a 12-box Mail Box at our property located at 201 Halcyon, which will serve the eight people housed there (including children) as well as the next door complex which has five units that serves both adults and children. Item 9.a. - Page 206 V. NUMBER OF. CITY OF ARROYO GRANDE RESIDENTS SERVED BY NON-PROF-· - ORGANIZATION: (broken down by age groups if available) FCNI serves an average of 15 TAY clients (16-24 years of age) within its Arroyo Grande housing complexes, along with approximately 15 children (3 to 18 years of age) who are served through by our Arroyo Grande foster parents and seven clients who receive support services at Arroyo Grande High School through FCNI for a total of approximately 37 clients per year in the City of Arroyo Grande. VI. AMOUNT OF FUNDS REQUESTED: $1.350.48 including the tax and installation of Mail Box VII. PROPOSED USE AND BUDGET PLAN FOR GRANT FUNDS: (indicate if any of the grant funds will be used for any other purpose than those designated such as overhead, national office, administrative salaries) Grant dollars will be used to purchase new 12-door CBY US Postal approved Mail Box Special order Mail Box from Budget Mail Box will cost $1,150.48 Install of the approved Mail Box will cost $200.00 For a total cost of the project being $1,350.48 VIII. ADDITIONAL DOCUMENTATION: (if you have received funds in the past, please indicate the amount of funds received (indicate what year) and how the funds were utilized) N/A IX. SUPPLEMENTAL DOCUMENTATION: ~ Past two year's financial statements, including the current year with the balance sheets and the profit/loss statements. ~ Information indicating the percentage of revenue received that is used for administration, salaries, and program costs. ll!§ Breakdown and description of non-profit organization's sources of revenue. ~ Proof of 501 ( c)(3) status with a copy of the letter from the IRS. ~ Copy of the non-profit organizations Board of Directors, Officers and an organization chart. Item 9.a. - Page 207 X. CERliFICATION: certify on behalf of Family Care Network, Inc. non-profi organization, that I have read, understand and agree that the aforesaid information is accurate, factual and current. I understand that an award of funds, if granted, will be for the sole use a~ reflected in this application form. I further certify that as a condition of receiving funds, an agreemen1 with the City ofArroyo Grande, in a form and content provided by the City of Arroyo Grande; will be signed and executed by a duly authorized representative of said non-profit organization. I am aware of and certify that our non-profit organization will adhere to all City regulations regarding the 2014-15 Community Service Fund Program including, but not limited to, maintaining non- discriminatory policies, practices and intent. I also, on behalf of our non-profit organization, indemnify, defend, and hold harmless the City of Arroyo Grande relative to any arid all liability that may arise as a result of the use of the City of Arroyo Grande Community Service Grant Fund monies. Date: Nov. 20, 2014 Signature: E~. \.~ 1ve Jrec or or es1gnee Board of Director or Officer Item 9.a. - Page 208 11/20/2014. 6:28:59 PM Page 1 Family Care Network Statement of Financial Position JUNE 2013 JUNE 2014 OCT 2014 ASSETS CURRENT ASSETS CASH AND CASH EQUIVALENTS PETTY CASH $600 $600 $600 TR MAIN OPERATING ACCOUNT $112,500 $25,000 $64,329 OPERATING $817,640 $1,394,738 $1,473,346 AFLAC $7,484 $8,162 $4,788 FLJNDRAJSING $8,790 $4,595 $5,476 SECURED SAVINGS $251,634 $307,918 $657,943 CHARLES SCHWAB $1,346,649 $1,097,297 $1,098,361 TOTAL CASH AND CASH EQUIVALENTS $2,545,298 $2,838,3 I I $3,304,844 ACCOUNTS RECEIVABLE (NET OF ALLOWANCE) ACCOUNTS RECEIVABLE $1,310,458 $682,305 $270,343 TEMP RESTR. ACCOUNTS RECEIVABLE $50,000 $56,000 $0 TOTAL ACCOUNTS RECEIVABLE (NET OF ALLOWANCE) $1,360,458 $738,305 $270,343 PREPAID EXPENSES PREPAID AUDIT FEES $0 $0 $7,972 PREPAID AUTO LEASE $4,988 $0 $0 PREPAID POSTAGE $113 $196 $697 PREPAID INSURANCE $73,8I2 $77,816 $46,568 FFP INSURANCE RECEIVABLE $1,476 $4,289 $3,269 PREPAID WORKERS COMP INSURANCE ($2,172) ($4, 744) $4,969 PREPAID WAGES $10,358 $9,414 $3,728 MISCELLANEOUS PREP AID EXPENSES $20,267 $26,574 $14,359 REIMBURSABLE EXPENSES ($192) $5,634 $1,826 DENTAL PPD INSURANCE ($15) $8,815 $9,072 VISION PPD INSURANCE ($2) $1,669 ($1,596) COBRA PPD INSURANCE ($165) ($2,066) ($4,059) AFLAC PPD INSURANCE ($2,278) $140 $480 HEALTH PPD INSURANCE $2,582 $138 $85,706 ST!L T DISABILITY PPD INSURANCE $0 $930 ($522) TOTAL PREPAID EXPENSES $108,775 $128,806 $172,470 TOTAL CURRENT ASSETS $4,014,530 $3,705,421 $3,747,657 PROPERTY AND EQUIPMENT AUTOMOBILES $102,396 $132,992 $144,512 CONWUTEREQUWMENT $260,787 $307,366 $307,366 TR TRANSITIONAL HOUSING PROPERTIES $3,741,733 $3,774,949 $3,882,328 FCNI OWNED PROPERTIES $660,000 $4,608,252 $4,610,758 FURNITURE $33,696 $200,271 $200,271 I ___ _j Item 9.a. - Page 209 LEASEHOLD IMPROVEMENTS $15,525 $19,895 $19,895 OFFICE EQUJPMENT $232,541 $322,854 $327,954 CARE SHEPHERD DATABASE $526,507 $692,248 $774,499 : --ACCUMULATED DEPR. AUTOMOBILES ($94,947) ($1 02,538) ($92,236) ACCUMULATED DEPR. EQUIP/FURN/BLDG ($556,013) ($654,229) ($702,365) ACCUMULATED DEPR-BUILDfNGS ($252,391) ($388,190) {$446,486) NET PROPERTY AND EQUJPMENT $4,669,834 $8,913,870 $9,026,496 OTHER ASSETS GENERAL SECURlTY DEPOSITS $38,734 $13,924 $13,424 THPP DEP ALLOWANCE ACCT ($7,900) ($3,51 0) ($3,510) CONSTRUCTION fN PROGRESS $2,289,951 $0 $0 TOTAL OTHER ASSETS $2,320,785 $10,414 $9,914 Total Assets $11,005,150 $12,629,705 $12,784,067 LIABILITIES AND NET ASSETS LIABILITIES CURRENT LIABILITIES ACCOUNTS PAYABLE $787,899 $209,249 $185,920 RENTAL DEPOSITS LIAB $1,000 $0 $0 THP-PLUS EMANCIPATION/RENT PAY AB $35,182 $35,193 $31,574 URMIDEPCAREPAYABLE $11,782 $10,648 $4,949 403B CONTRlBUTIONS $0 $0 $40,443 EMPLOYEE CONTRIBUTIONS PAY ABLE $0 $0 ($50) SALES TAX PAYABLE $225 $1,828 $1,828 SALARlES AND WAGES PAY ABLE $282,542 $283,230 $324,326 VACATION PAYABLE $254,859 $241,185 $241,185 RESTRlCTED DONATIONS UNUSED $2,543 $3,328 $6,416 CONTRACT ADVANCES $0 $0 $165,557 OASDI & MEDICARE -EMPLOYER $20,736 $20,841 $22,634 UNEMPLOYMENT fNSURANCE $6,445 $2,956 ($2,224) SDI $1 $1 $1 DSS WRAP RESERVE $1,611,268 $1,850,637 $1,752,237 TOTAL CURRENT LIABILITIES $3,014,484 $2,659,097 $2,774,796 LONG TERM LIABILITIES L T DEBT SLO HOUSfNG TR. FUND $158,934 $158,763 $158,763 LT DEBT CHASE ADMIN BUILDfNG LOAN $1,536,421 $3,425,237 $3,394,037 TOTAL LONG TERM LIABILITIES $1,695,355 $3,584,000 $3,552,799 TOTAL LIABIUTIES $4,709,838 $6,243,097 $6,327,596 NET ASSETS UNRESTRlCTED NET ASSETS $3,640,498 $3,558,998 $3,542,327 TEMPORARILY RESTRICTED NET ASSETS $2,654.814 $2,827,610 $2,914,144 TOTAL NET ASSETS $6,295,312 $6,386,608 $6,456,472 TOTAL LIABILITIES & NET ASSETS $11,005,150 $12,629,705 $12,784,067 I Item 9.a. - Page 210 11/20/2014 06:26:06 PM Family Care Network p, Revenue and Expense i .-.- YE JUNE 2013 . YE JUNE 2014 JULY-OCT 20 I'+ REVENUE AFDC INCOME $3,384,241.52 $3,211,425.70 $955,484.69 AFDC SLO SHELTER PROBATION $246.00 $0.00 $0.00 CONTRACT INCOME $8,641,898.03 $9,038,533.98 $3,039,604.93 GRANT INCOME $32,482.46 $27,897.15 $9,911.90 TEMPORARILY RESTRJCTED GRANT INCOME $0.00 $56,000.00 $0.00 UNRESTR DONATIONS $393,275.61 $194,477.10 $46,209.83 FUNDRAISING EVENT-DONATIONS AND FUNDRAISING $189,060.07 $191,050.21 $56,883.00 RENT OR OTHER INCOME $23,602.49 $25,684.19 $6,145.34 INTEREST INCOME $0.00 $1,364.47 $652.63 UR NET ASSETS RELEASED FROM RESTRlCTION $137,500.00 $137,500.00 $16,670.68 TR NET ASSETS RELEASED FROM RESTRICTION . ($137,500.00) ($137 ,500.00) ($16,670.68) TOTAL REVENUE $12,664,806.18 $12,746,432.80 $4,114,892.32 EXPENSES COST OF SALES COST OF SALES $17,115.95 $23,231.53 $7,452.52 TOTAL COST OF SALES $17,115.95 $23,231.53 $7,452.52 PAYROLL COSTS PAYROLL $7,036,638.64 $7,273,417.01 $2,351,230.30 AFTER HOUR ON $109,137.60 $115,274.90 $35,981.40 HEALTH INS $541,642.87 $588,600.77 $195,983.58 LIFE & DISABILITY $5,168.26 $4,627.14 $152.66 PAYROLL TAXES $556,649.34 $510,900.60 $173,996.08 WORKER'S COMP $89,016.32 $136,809.59 $29,395.49 403B EMPLOYER MATCH $105,104.71 $126,122.34 $44,854.53 TOTAL PAYROLL COSTS $8,443,357.74 $8,755,752.35 $2,831,594.04 ADMINISTRATION 1ND CONTRACTOR $59,177.96 $43,617.00 $7,739.50 AUDITING $20,250.00 $17,749.98 $7,777.77 LEGAL FEES $6,614.99 $800.70 $0.00 TELEPHONES $87,548.08 $97,979.45 $35,502.81 POSTAGE $6,710.47 $7,762.99 $1,776.84 SUPPLIES $17,217.18 $16,515.98 $4,101.80 CONF, MJGS & TRAINTNGS $43,204.69 $56,054.00 $15,015.48 MEMBERSHIP/DUES $22,923.47 $31,222.88 . $14,731.55 PRINTING/PUBLISHING $735.31 $3,252.12 $0.00 LIABILITY INSURANCE $100,573.63 $103,278.88 $34,384.00 ADVERTISING $16,575.85 $16,086.59 $3,181.29 INTEREST $7,007.12 $122,617.71 $69,020.10 BANK CHARGES $329.43 $0.00 $0.00 OTHER ADMIN $73,437.19 $91,228.08 $36,140.82 TOTAL ADMINISTRATION $462,305.37 $608,166.36 $229,371.96 BUILDING & VEHICLE Item 9.a. - Page 211 11/20/2014 6:26:06PM OFFICE RENT UTILITIES MAINTENANCE BUILD & EQUIP SUPPLIES EQUIPMENT LEASES EQUIPMENT DEPR EXPENDABLE EQUIP IT EXPENDABLE EQUIPMENT FACILITIES VEHICLE DEPRECIATION VEHICLE OPERATING EXPENSE BUILDING DEPRECIATION TOTAL BUILDING & VEHICLE CHILD PLACEMENT COSTS MISC CHILD RELATED COST EMANCIPATION FUND APARTMENT RENT CHILD COST FOSTER PARENT PMTS DIFFICULTY OF CARE RATE TOTAL CHILD PLACEMENT COSTS SHARED ADMIN1STRATION ALLOCATED ADMINISTRATION TOTAL SHARED ADMINISTRATION OTHER INCOME (EXPENSE) PAYMENT ADJUSTMENTS INTEREST INCOME ADMIN FEE SALE OF ASSETS (GAIN/LOSS) TOTAL OTHER INCOME (EXPENSE) TOTAL EXPENSES NET SURPLUS/(DEFICIT) Family Care Network Revenue and Expense YE JUNE 2013 $340,380.04 $81,255.14 $131,727.47 $95,650.98 $28,484.92 $119,027.76 $93,607.46 $700.00 $4,381.79 $523,335. I I $70,720.86 $1.489,271.53 $424,609.24 $46,448.84 $176,863.55 $1 '150,636.00 $70,868.00 $1,869,425.63 $0.00 $0.00 ($267.58) $4,251.87 $361.44 $0.00 ($4.345. 73) $12,277,130.49 $387,675.69 Pa I YE JUNE 2014 JULY-OCT 20 $166,598.24 $27,763.18 $94,867.01 $29,435.12 $162,256.3 5 $36,602.50 $93,250.20 $22,631.65 $26,722.63 $8,456.00 $114,671.70 $48,136.00 $60,503.49 $17,223.96 $3,150.01 $2,100.00 $7,591.21 $3,678.00 $521,708.74 $141,683.21 $135,798.99 $58,296.14 $1,387,118.57 $396,005.76 $479,849.76 $178,73 1.53 $30,499.45 $8,121.25 $137,175.05 $38,597.67 $1,144,403.00 $33 5,821.50 $85,183.00 $18,740.00 $1,877,110.26 $580,011.95 $0.02 $0.00 $0.02 $0.00 $0.00 ($992.63) $0.00 $0.00 $7.68 $0.00 ($3, 765.00) $400.00 $3,757.32 $592.63 $12,655,136.41 $4,045,028.86 . $91,296.39 $69,863.46 Item 9.a. - Page 212 '-,- Family Care Network, Inc. Organization Financial Summary Revenue By Source & Shared Administration Expense Percentage 2013-2014 For the year ended June 30, 2014 shared administration was 11.44% of total expense Income by Source Source YE 13-14 San Luis Obispo Dept of Social Services $ 5,945,782 San Luis Obispo Dept of Behavioral Health $ 4,638,813 Santa Barbara Dept of Social Services $ 1,589,927 Santa Barbara Dept of Mental Health $ 12,000 Atascadero Unified School District $ 31,437 Lucia Mar Unified School District $ 5,416 Paso Robles Unified School District $ 19,289 San Luis Coastal Unified School District $ 6,992 San Luis County Office of Education $ 304 Fund Raising $ 372,865 Other Income $ 25,679 Grant Income $ 96,565 Interest Income $ 1,364 Total Income $ 12,746,433 Item 9.a. - Page 213 Date: September 9, 2005 FAMILY CARE NETWORK INC 3765 S HIGUERA STREET SUITE 100 SAN LUIS OBISPO CA 93401 Dear Sir or Madam: 1Depa:rtme1111~ of Uue Treasury P. 0. Box 2508 Ciii1Ciinnati, OH 45201 !Person to Contact: Dee Anna Jarmon 31-03084 Customer Service Specialist Toi~ Free Telephone Numfoerr: 8:30a.m. to 5:30p.m. ET 877-829-5500 Fax Number: 513-263-3756 Federral Identification Numlbe1r: 77 -Oi 59090 This is in response to your request of September 9, 2005, regarding your organization's tax-exempt status. In June 1992 we issued a determination letter that recognized your organization as exempt from federal income tax. Our records indicate that your organization is currently exempt under section 501 (c)(3) of the Internal Revenue Code. Our records indicate that your organization is also classified as a public charity under sections 509(a)(1) and 170(b)(1 )(A)(vi) of the Internal Revenue Code. Our records indicate that contributions to your organization are deductible under section 170 of the Code, and that you are qualified to receive tax deductible bequests, devises, transfers or gifts under section 2055, 2106 or 2522 of the Internal Revenue Code. If you have any questions, please call us at the telephone number shown in the heading of this letter. Sincerely, ~!(.~ Janna K. Skufca, Director, TE/GE Customer Account Services i -,- Item 9.a. - Page 214 I J'o CJ M : f e . o f / '} i l l ~ { ,:&;:2;~ \ \ ' ~ ~ i · · , ; ~ ~ ~ ~ '= · %/~ " ~ ~(} - C A R c ~ G .~J- v V o R " K , ~ . . l< i m Ol d f i e l d Sh a y Pe c k Ev a n W r i d e Da n Ro w e Le a l a h Br o y l e s 10 1 Ca l l i e Co u r t Ar r o y o Gr a n d e , CA 93 4 2 0 {8 0 5 ) 78 6 - 4 7 1 0 ki m o l d f i e l d @ c r o w n l e g a c y . c o m 69 1 Ha n f o r d St r e e t I Pi s m o Be a c h , CA 93 4 4 9 (8 0 5 ) 77 3 - 4 4 4 1 sh a y _ p e c k @ y a h o o . c o m 35 8 Vi a El Ci e l o , Ar r o y o Gr a n d e , Ca 93 4 2 0 ev a n l w r i d e @ g m a i l . c o m 80 5 - 4 7 4 - 1 1 5 9 Ce l l : 21 3 - 2 8 0 - 1 9 0 7 C / 0 Tr i n i t y Lu t h e r a n Ch u r c h 21 0 2 Su m m i t Dr i v e Pa s o Ro b l e s , CA 93 4 4 6 (8 0 5 ) 23 8 - 3 7 0 2 , dr o w e @ t r i n i t y l u t h e r a n p a s o . o r g 23 2 5 Oa k Ri d g e Dr i v e Lo s Os o s , CA 93 4 0 2 (8 0 5 ) 53 4 - 9 5 1 5 le a la h @s o m e t h in gs a c r e d .c o m Fa m i l y Ca r e Ne t w o r k , In c . Bo a r d Ro s t e r as of ] u l y t, 20 1 4 Sa n Lu i s Ob i s p o Ch a i r Co m m u n i t y M e m b e r FC N I Vi c e Ch a i r Vo l u n t e e r /R e t i r e d te a c h e r Re p r e s e n t s SB Co u n t y Re t i r e d Sy s t e m s Tr e a s u r e r Ex e c u t i v e Fo s t e r / A d o p t i v e Pa r e n t Pa s t o r o f Pa s o Ro b l e s Lu t h e r a n Ch u r c h Pa s t Co n s u m e r / Se c r e t a r y Em p l o y e e I. 1- 8/ 2 0 1 1 6/ 3 0 / 2 0 1 5 Incident Reports CRD Subcommittee 8/ 2 0 1 1 6/ 3 0 / 2 0 1 5 Finance/Audit Committee/ Incident Reports CRD Subcommittee 8/ 2 0 1 2 6. / 3 0 / 2 0 1 6 7/ 2 0 0 1 6/ 3 0 / 2 0 1 6 2/ 2 0 0 9 6/ 3 0 / 2 0 1 6 Item 9.a. - Page 215 Br i a n Ti e t j e 29 0 5 Fe r r o c a r r i l Ro a d Cu r r e n t Vi c e 1/ 2 0 1 4 6/ 3 0 / 2 0 1 6 Chair of CRD At a s c a d e r o , CA 93 4 2 2 Pr o v o s t fo r Subcommittee {8 0 5 ) 42 3 - 1 8 4 7 In t e r n a t i o n a l , bt i e t j @c a I po l y . e d u Gr a d u a t e an d Ca m e r o n In g a l l s 73 1 Gr o v e St r e e t Pa s t Em p l o y e e / 1/ 2 0 1 4 6/ 3 0 / 2 0 1 5 CRD Sa n Lu i s Ob i s p o , CA 93 4 0 1 Ph o t o g r a p h e r Subcommittee· {8 0 5 ) 47 1 - 7 0 5 6 - ca m e r o n (@ c a m e r o n in g a l l s . c o m Ri c h a r d Fo s t e r 11 7 8 Lo n g v i e w Av e n u e Re t i r e d . Bu s i n e s s 12 / 2 0 0 6 6/ 3 0 / 2 0 1 6 Finance/Chair of Pi s m o Be a c h , CA 93 4 4 9 Ex e c u t i v e Audit Committee (8 0 5 ) 77 3 - 0 8 5 8 ro f o s t e r @ e a r t h li n k . ne t Ji m Ro b e r t s 31 8 1 Ci e l o Gr a n d e FC N I CE O 7/ 2 0 0 2 6/ 3 0 / 2 0 1 5 CRD .. At a s c a d e r o , CA 93 4 2 2 Ad m i n i s t r a t i o n .Subcommittee {8 0 5 ) 80 1 - 9 7 7 7 , ji m @ f c n i . o r g ,. <. TH R E E VA C A N C I E S Jo n Ni b b i o co o Non-Director Bo b b i e Bo y e r CF O Non-Director I'~ Item 9.a. - Page 216