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TEST AGENCY <br />< Organizational Capacity > <br />1. Provide the mission statement and vision of your organization. <br /># of Full Time Employees <br /># of Part Time Employees <br /># of Volunteers <br />Agency Fiscal Year: <br />2. Please briefly explain your policies and procedures on performing background checks on all <br />staff and volunteers interacting with children? <br />3. Does the Agency have a Board -approved written, active strategic plan? If yes, when was it <br />last updated? <br />4. Board of Directors composition and policies: <br />a. Please explain board Attendance policies including the # of times the Board <br />meets annually, # of Board members, and # of vacancies. <br />b. How many board members representing Indian River County? Please attach a Board <br />Listing including each director's home city, state, and zip code. <br />c. Please describe the Board's Conflict of Interest policy and how it is implemented. <br />5. Agency By -Laws: <br />a. What is the date of most recent bylaws? Please attach current bylaws. <br />6. Has your Agency EVER had any county, state or federal investigations into its operations? If <br />yes, please explain. <br />7. Does the agency hold at least 3 months of operating cash on hand? <br />a. Total unrestricted cash on hand at most recent Fiscal Year End: <br />b. Average estimated monthly cash expenditures [(annual expenditures less depreciation <br />and other non-cash items)/12] <br />8. As of the most recent fiscal year end, what is the agency's working capital? <br />a. current assets: <br />b. current liabilities: <br />c. Working capital (a) -(b)= <br />9. Describe briefly the Agency's current fundraising activities. <br />a. Provide net fundraising revenue from most recent fiscal year. <br />10. Is the Agency audited or reviewed by a CPA? <br />a. If Yes: <br />i. Please attach most recent fiscal year financial statements with attestation <br />report. <br />ii. Please attach any internal control letters of weakness or deficiencies that were <br />provided to the Agency with its most recent attestation engagement. <br />b. If No: <br />i. Please attach most recent 2 full fiscal years internal financial statements <br />including Balance Sheet and Profit & Loss Statement for each year. <br />53 <br />