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Home My WebLink About2004-229O fly - zz..go Indian River County Grant Contract This Grant Contract ("Contract" ) entered into effective this 1st day of October 2004 by and between Indian River County, a political subdivision of the State of Florida , 1840 25th Street, Vero Beach FL , 32960 ("County') and ( Recipient) : P� Box 3068 Vero Beach Florida 32964 Background Recitals A. The County has determined that it is in the public interest to promote healthy children in a healthy community. B . The County adopted Ordinance 99- 1 on January 19 , 1999 ("Ordinance") and established the Children 's Services Advisory Committee to promote healthy children in a healthy community and to provide a unified system of planning and delivery within which children 's needs can be identified , targeted , evaluated and addressed . C . The Children 's Services Advisory Committee has issued a request for proposals from individuals and entities that will assist the Children 's Services Advisory Committee in fulfilling its purpose . D . The proposals submitted to the Children 's Services Advisory Committee and the recommendation of the Children 's Services Advisory Committee have been reviewed by the County. E . The Recipient, by submitting a proposal to the Children 's Services Advisory Committee , has applied for a grant of money ("Grant") for the Grant Period (as such term is hereinafter defined ) on the terms and conditions set forth herein . F . The County has agreed to provide such Grant funds to the Recipient for the Grant Period (as such term is hereinafter defined ) on the terms and conditions set forth herein . NOW THEREFORE , in consideration of the mutual covenants and promises herein contained , and other good and valuable consideration , the receipt and adequacy of which are hereby acknowledged , the parties agree as follows : 1 . Background Recitals The background recitals are true and correct and form a material part of this Contract . 2 . Purpose of Grant The Grant shall be used only for the purposes set forth in the complete proposal submitted by the Recipient attached hereto as Exhibit "A" and incorporated herein by this reference (such purposes hereinafter referenced as "Grant Purposes") . 3 . Term The Recipient acknowledges and agrees that the Grant is limited to the fiscal year 2004/2005 ("Grant Period") . The Grant Period commences on October 1 , 2004 and ends on September 30 , 2005 . - 1 - 4 . Grant Funds and Payment The approved Grant for the Grant Period is Thirty- Five Thousand Dollars ($35 , 000) . The County agrees to reimburse the Recipient from such Grant funds for actual documented costs incurred for Grant Purposes provided in accordance with this Contract . Reimbursement requests may be made no more frequently than monthly. Each reimbursement request shall contain the information , at a minimum , that is set forth in Exhibit "B" attached hereto and incorporated herein by this reference . All reimbursement requests are subject to audit by the County. In addition , the County may require additional documentation of expenditures , as it deems appropriate . 5 . Additional Obligations of Recipient . 5 . 1 Records . The Recipient shall maintain adequate internal controls in order to safeguard the Grant. In addition , the Recipient shall maintain adequate records fully to document the use of the Grant funds for at least three (3 ) years after the expiration of the Grant Period , The County shall have access to all books , records , and documents as required in this Section for the purpose of inspection or audit during normal business hours at the County's expense , upon five (5) days prior written notice . 5 .2 Compliance with Laws . The Recipient shall comply at all times with all applicable federal , state , and local laws , rules , and regulations . 5 . 3 Quarterly Performance Reports . The Recipient shall submit Quarterly Performance Reports to the Human Services Department of the County within fifteen ( 15 ) business days following : December 31 , March 31 , June 30 , and September 30 . 5 .4 Audit Requirements . If Recipient receives $25 , 000 or more in the aggregate from all Indian River County government funding sources , the Recipient is required to have an audit completed by an independent certified public accountant at the end of the Recipient's fiscal year. Within 120 days of the end of the Recipient's fiscal year, the Recipient shall submit the audit to the Indian River County Office of Management and Budget . The fiscal year will be as reported on the application for funding , and the Recipient agrees to notify the County prior to any change in the fiscal period of Recipient . The Recipient acknowledges that the County may deny funding to any Recipient if an audit required by this Contract for a prior fiscal year is past due and has not been submitted by May 1 . 5 .4 . 1 The Recipient further acknowledges that, promptly upon receipt of a qualified opinion from its independent auditor, such qualified opinion shall immediately be provided to the Indian River County Office of Management and Budget. The qualified opinion shall thereupon be reported to the Board of Commissioners and funding . under this Contract will cease immediately. The foregoing termination right is in addition to any other right of the County to terminate this Contract. 5 .4 .2 The Indian River County Office of Management and Budget reserves the right at any time to send a letter to the Recipient requesting clarification if there are any questions regarding a part of the financial statements , audit comments , or notes . 5 . 5 Insurance Requirements . Recipient shall , no later than September 21 , 2004 , provide to the Indian River County Risk Management Division a certificate or certificates issued by an insurer or insurers authorized to conduct business in Florida 2 - that is rated not less than category A- : VII by A. M . Best, subject to approval by Indian River County's risk manager, of the following types and amounts of insurance : (i) Commercial General Liability Insurance in an amount not less than $ 1 , 000 , 000 combined single limit for bodily injury and property damage , including coverage for premises/operations , products/completed operations , contractual liability, and independent contractors ; ( ii ) Business Auto Liability Insurance in an amount not less than $ 1 , 000 , 000 per occurrence combined single limit for bodily injury and property damage , including coverage for owned autos and other vehicles , hired autos and other vehicles , non -owned autos and other vehicles ; and (iii ) Workers ' Compensation and Employer's Liability (current Florida statutory limit) 5 . 6 Insurance Administration . The insurance certificates , evidencing all required insurance coverages shall be fully acceptable to County in both form and content, and shall provide and specify that the related insurance coverage shall not be cancelled without at least thirty (30 ) calendar days prior written notice having been given to the County. In addition , the County may request such other proofs and assurances as it may reasonably require that the insurance is and at all times remains in full force and effect . Recipient agrees that it is the Recipient's sole responsibility to coordinate activities among itself, the County, and the Recipient's insurer(s ) so that the insurance certificates are acceptable to and accepted by County within the time limits set forth in this Contract . The County shall be listed as an additional insured on all insurance coverage required by this Contract, except Workers ' Compensation insurance . The Recipient shall , upon ten ( 10 ) days' prior written request from the County, deliver copies to the County, or make copies available for the County's inspection at Recipient's place of business , of any and all insurance policies that are required in this Contract. If the Recipient fails to deliver or make copies of the policies available to the County; fails to obtain replacement insurance or have previous insurance policies reinstated or renewed upon termination or cancellation of existing required coverages ; or fails in any other regard to obtain coverages sufficient to meet the terms and conditions of this Contract , then the County may, at its sole option , terminate this Contract. 5 . 7 Indemnification . The Recipient shall indemnify and save harmless the County, its agents , officials , and employees from and against any and all claims , liabilities , losses , damage , or causes of action which may arise from any misconduct, negligent act, or omissions of the Recipient, its agents , officers , or employees in connection with the performance of this Contract . 5 . 8 Public Records , The Recipient agrees to comply with the provisions of Chapter 119 , Florida Statutes ( Public Records Law) in connection with this Contract. 6 . Termination . This Contract may be terminated by either party, without cause , upon thirty (30 ) days prior written notice to the other party. In addition , the County may terminate this Contract for convenience upon ten ( 10 ) days prior written notice to the Recipient if the County determines that such termination is in the public interest. 7 . Availability of Funds . The obligations of the County under this Contract are subject to the availability of funds lawfully appropriated for its purpose by the Board of County Commissioners of Indian River County. 3 - 8 . Standard Terms . This Contract is subject to the standard terms attached hereto as Exhibit C and incorporated herein in its entirety by this reference . IN WITNESS WHEREOF , County and Recipient have entered into this Contract on the date first above written . INDIAN RIVER COUNTY BOARD OF COUNTY COMMISSIONERS By. •lam.-L�i' ` f Caroline D . Ginn , Chairm f BCC Approved : �D4 ' r T- Attest -;: .. arton , Clerk r �a ray r � y CA y , tt - � 4 1Y . •r Y•. . • 1r .wr �� VWA ) fFf l By, i . Deputy Clerk " ; PATRICIA M . Approved&Jo A . Baird Administrator 7 Appr ved to form nd legal sufficiency: is ell , iPrssisclfa�nt CKqWAtA166 RECIPIENT: B ' ,I oys & Girls Club of Indian River County, Inc 4 - J 1 EXHIBIT A [Copy of complete proposal/application] - 1 - ' 1 1 • 1 1 • r • • e 1D [,fix s • jtl1 • , , 4 al • • �� C•dd � ! • • alp : ; • kyj m ilk1 i • • • E _ • • • , • • 1 . 1 • g LYI 1 r • • • ' • : ra IN Ece Emm ' • 1 • 1 • • URN mtffl�j F};+ !.`.+hl�n le ' W * ' , . • . . . " .� , ' • ' earfRYr 3rs S 1 aMyuiY�y1 Apk t., �'Lr a � "'�halia '. '• r,319�•'tiF.—��.�. 1 ��1 �1 « fSf � t k� ` � • 1 • i i i Cis � i I / � . i • i - i iii i • P / ii - i i • � i � / / • .,, .y •,5> : .r�Y`c'r r' y ' t" `', r,� ti � '}Y i .v.a , p L ; f 'h>. ✓ .$1: „ ta` -Ilk7 d�' � "�C�L� o-' • d. .S i' t „a 1`: r r t r s n f '. "2 :! p..: k "• r3 ,i Y ` x '� .Y ;.3' a �.e. � x1Lid Y' d ,.. : �`e > 'L. :+F' r+ r r ,#�a^ 4 t } t. ' c,3. r• +S I' .a„ ,I«iw r7'"' Ir. : ..F . :i.v o a .p: ^.te..- 'kG , rr S� d y�::, r. • f fa n: y t) . _r,; ' 3 (. 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's '$' ,�1 k W'4 < ,fie '"s R ,w ;k ,t' , L j,, 4f Y'1 s,ydv;I . ;3r J ': -Y- t' • h r 1 •" Boys & Girls Club of Indian River County, Inc. - Youth Volunteer Corps Program - Grant Application to the United Way of Indian River County, Inc. UNIFORM GRANT APPLICATION BUDGET NARRATIVE WORKSHEET h^; RTANT: The Budget Narrative should provide details to justify the amount requested in each line item of the budget for your program. From this worksheet, your figures will be linked to the Total Agency Budget, Total Program Budget and Funder Specific Budget Forms. AGENCY/PROGRAM : Boys & Girls Clubs of Indian River County, Inc ./YVC Program FUNDER : United Way of Indian River County, Inc . ! CA UTION : Do not enter any figures where a cell is colored in dark blue - Formulas and/or links are in place. Gray areas should j be used for calculations and to write information only. - , In . b }' a` i' vs� t" fi ",y� ,a r _ g � �� xTota! ra r .�rr �� nc�`�rSpectc ;�rit Qys ' �mo :� ' ,gef .. ...x...r .%z illlo '' Butlge[ ` 1 Children 's Services Coun it-St. Lucie 2 Children's Services Council-Martin 3 Advisory Committee-Indian River 40,000.00 40, 000 .00 130 ,000.00 4 United Way-St. Lucie County 5 United Way-Martin County 6 United Way-Indian River County 54 ,000 .00 159 ,000. 00 7 Department of Children & Families ` ' 8 County Funds 9 Contributions -Cash ` 3,000.00 223 ,000.00 10 Program Fees ¢ k� 300.00 11 JFund Raising Events -Net 200.00 131 ,692 .0 1? es to Public - Net 200.00 n 1 ,000.00 100050. 00 1 . mbership Dues z 14 Investment Income 15 Miscellaneous .: yazst 16 Legacies & Bequests :.{ 17 Funds from Other Sources * 18 , 333.34 758000.00 18 Reserve Funds Used for Operating21 > 19 In-Kind Donations (Not included in total) i.1 Mll "I .-A'A� 39 ,270.00 781540.00 20 TOTAL REVENUES (doesn't Include line 19) , a:< $ 116 , 533.34 $409000.00 $729, 242.00 Mi.' . .. .. .: a %'��< zr vaf r'^ h%'�s axzk' Pa r 1YH EXPENDl1 ORES " �ArARsort Propose ofaf Pr z �� , AOENCYuieoNLY iv;.0 �' ° -` � y""A F,iJ,tftler` Spec�iicButlget � TotalAgencyn.= x: tsyovrcAlsuu�norostwg a Bulget � E BUale'� . >= 21 Salaries - (must complete chart on next age) 93 ,330.00 33f500. 00 472 , 174 . 00 _'.. ., . . .. . .:: Sala z ry. ..A t.I�..; � .:. 22 FICA - Total salaries x 0. 0765 ° 1157 41829.00 2 , 562 .75 26 ,872 . 00 Retirement - Annual pension toT qualifiedF 23 staff � ; „ � 5 ,350 .00 0. 00 330403 .00 Life/Health - e Ica enta ort-term r. 24 Disab. a : 4 ,050.00 3 , 937. 25 32 ,574 .00 Workers Compensation - # employees x ' 25 rate r ; 1 , 692 .00 0. 00 9 ,415 .00 Florida aUnemployment- projected ; 26 employees x $7,000 x UCT-6, rate638 .00 0.00 21801 .00 it"11 $JrT01 LC57� N ` Y `Fos on `l'ftfe,1not J 5 a HIMMIM I rite 1 0-� A^ 6* Boys 8 Girls Club of Indian River County, Inc. - Youth Volunteer Corps Program Grant Application to the United Way of Indian River County, Inc, Director of Club Operations/40 hrs 50 000. 00 Program Director/40 hr28 , 500. 00 III 25,000.00 5, 000 . 00 50,00°/ 28, Summer Asst. Program Director/30 hrs 4 , 440. 00 500.00 28 , 500.00 100.00% Summer Pro ram S ecialist/30 hrs4 ,440.00 0. 00 100.00% 2 , 590. 00 2 , 590.00 m 0.00 mer Program Specialist/30 hrs 2, 590. 00 100.000 edcorps Team Leader/32 hrs2,590.00 0 . 00 100.00°/ 61042. 00 6,042.00 Americorps Team Leader/32 hrs 6 , 042. 00 0. 00 100.00°/ 6 , 042 .00 Americorps Team Leader/32 hrs 6, 042.00 0.00 100.00°/ 6 ,042.00 0 .00 Americorps Team Leader/32 hrs 61042. 00 100.00% Americorps Team Leader/32 hrs6,042.00 0. 00 100.00°! 6, 042. 00 6, 042.00 0.00 100. 00°/ #DIV/0l #DIV/01 #DIV/0l #DIV/01 #DIV/01 #DIV/0l #DIV/01 #DIV/0I #DIV/01 Remaining positions throughout the agency 3530844 . 00 #DIV/01 Total Salaries $472, 174 .00 $ 93 ,330. 000 $33, 500.00 19. 77 /0 FRINGE BENEFITS DETAIL g , C � $�n��3` :;�' >2w �� .t s'>" s 'x �'4?� i 4P � :�` ' ia� o t ,x. ...... :: K x A � fix (Funder 5pe` r � Br �igef � , ns� or. � R1e �l �ColumCxrIII — aiiembya U . ��Total Fnnges ��h�w�. PoslfiomTitley o � rs Bd f - m . e` G�ori end _ " al � wk - Specirl , ., oeoo30000 , zaoao Director of Club Operations/40 hrs 50000 .00 � _ tr582 5 382.50 112.49 494.9 ram Director/40 hrs 28 , 500.00 21, 180.25 3 , 824. 76 mer Asst. Program Director/30 hrs 0. 00 0.00 6,005. 01 aSummer Program Specialist/30 hrs 0. 00 0. 00 0. 0 Summer Program Specialist/30 hrs 0.000. 00 0. 00 Americorps Team Leader/32 hrs 0 . 00 0.00 0. 00 Americorps Team Leader/32 hrs0.00 0 . 00 0.00 Americorps Team Leader/32 hrs 0 . 00 0.00 0 . 00 Americorps Team Leader/32 hrs0. 0 0. 00 0.00 0. 00 Americorps Team Leader/32 hrs 0. 00 0 . 00 0 . 0. 000. 0 0 0 . _ 0.00 0. 00 0. 00 0.00 0 0. 000. 00 0.00 0.00 0 0. 00 0. 00 0 0. 000. 00 0 0. 00 0. 00 0.00 0.00 0 0.0 0.00 0.00 0 0.0 0. 00 0 0.00 0.00 0. 00 0.00 0.00 0 0.00 0.00 0.0 Total Funder Request Fringe Benefits $33 ,500. 00 $2,562.75 $ 3, 937.25 $ 0.0011 $ 0. 001 $6,500 .00 •x f �� ' U � f i � � u ,. a iri s .�a ° uY ;x s g. :5 �. � x9r xa � ` ' ,uGks+ ' ' t s ERCP&' �DITURE� DRA ; Re�s roR x P s Fre ota1 Prgrota/ Aenc AOENC173E�ONLY TD '" .§ +?. .,n'� >: x . w � G..-✓t+ tga f/ J SHO'WDETAIL :. rY g�` F �►cier �peeefcr�udg t° Bud eatt , Brrtl �" .,,. _ s.. . .,. �a.:a'? +rs: :a , .{ , .s :i ?t u=, 3$ xs .''," � z 7 Travel-Daily A0.4IIIIt 4 ,046 .00 f 0.00 5,938 .00 taff x average of miles/wk x 50 wks x w, #, 9 timated Dally'.Travel/Mileage Reimb ' 8 Travel/C .- onferent:esiTraining � ��W 15,630.00 C C a Boys 3 Gids Club of Indian River County, Inc. - Youth Volunteer Corps Program 1 Grant Application to the United Way of Indian River County, Inc. • National Conference (cost per staff) ' • Training/Seminar (cost per staff) ° . • Other Trainings (cost of travel, lodging, si registration , food) - e sato fraintrig tce SuS _ PPs:. 961 .00 ffice supplies (monthly average x 12 6 ,455. 0 00 00 z h° months = estimated cost of office supplies 08 trr6CitT1t� r a a 8U, k based on present history. 30 Tele gx ' phone . 3, 880 00 # 0 Phone lines x average cost per month x 00 •, . , a 12,080 00 12 months = local phone cost • Average long distance calls x 12 months df"sang T Estimated cost of long distance n s . u 31 Postage/Shipping - _ . . 0.00 • Quarterly Mailing of Newsletter 0.00 1 , 169.00 x • Special events , etc. Bulk mailings - appealstit M" . k . 32 Utilities • Electricity ($-:i: 12 months) 0.00 ~ 0.00 161500.00 • Water/Sewer ($ x 12 months) • Garbage ($ x 12 months) . b. 33 Occupancy (Building & Grounds) ; 4. x Mortgage/Rent ($ x 12 months ) F ¢� � :, . 6100 00 u k 0 00 9311028 .00 ;17�� , , _ Janitorial ($ x 12 months) $500 Ip Aind r r cw .c` rN tic • Grounds Maint. ( $ x 12 months) Refit + $i0tpi �§ , , � rr �� • annfrai Real Estate Taxes expense k _ x R bs� r ' � w Xl x 34 Printing & Publications # � t • Quarterly Newsletter ($ x 4) YVC produces a 625000 0. 0c I 14 ,700 00 Letterheads , Envelopes , etc. rnonihty � z * ` x = Ars " r Fundraising materials Other c.salendao4fvns sne¢o . ,- �c-r :F x rmnk w �"4.' xa' 3436�, i" '.ac;.u�.: " ssk "� '` '.•-s. '""x ° '.� aaM1 . c. ' - 3 , scription/Dues/Memberships 11600 .00 embership to National Organization0 00 9,835 00 Dues BCCA Dues "" Subscriptions to Newspapers/magazines , Art a Alhance � � fi Dues YVCA� � zp a etc. Dues?, x &Y 36 Insurance 6Al ` 3 kv 3 n ZYn4pR � aaug 3 Lt n 4 , 824 00 Directors/Officers Liab. �, 00 191,016 . 01] y � �x 1 9 Commercial/General Insurance 0 • Bond Ins. • Auto Insurance _ Aut i abbe ms's ..,f'� ,E. °" X1, 17 . 37 Equipment: Renta l & Maintenance 1 , 175 00 • opier ease x Monts 0. 00 71525. 001 r , , • Meter lease ($ x 12 months) Y.5 ;, s • Copier Maintenance Copt r awk 5nezq + 4r a P $ x 12 months) • Computer MaintenanceLeasemal tensa x h - ( $ x 12 months) • Other 97 x months --i� 38 Advertising . .. 800. 00 0. 00 1 300 00 • Newspaper ads • 09 , Fundraising ads/promotions ` Other (vacancies) Remi ins ' . � F >/ xv 'i 39 Equipment Purchases : Capital Expense k 0. 00 .k y000 000 • Computer/monitor (# x $) � � �, Y ? y • Laser Printer }� ^, _ r � x 's„a sartw.x:r..3 .•..u.c..x,3 ._.: z .„ ax*.iN'v,. .m .. . 1. :u3E4`.. -a'k' R. .��" t .t ".$3^` z'� .n : _`i'. s `.$. s8' -z t r �, : 40 Professional Fees ( Legal, Consulting ) 0. 00 • Legal advice ( estimated #hrs x $) 3 0 _ 0 . 00 0 0 • Consultant fees • Other 41 s/Educational Materials - w =�" ea . . : �Y 3,70900 xu � . . . 0.00 � k� . . 4: 12,345.00 . Ks/videos g r. •: Mate rials ($ x staff) . > ' • _ � _ ` 42 Food & Nutri tionb . - ' o.00 o.00 Illt . 200.00 � ,, 11 AI Ip n LIN IrinmEnflmixto 0E_ 4.Tro III a ml Lelia m- Mu= r � 1 11 1 11 111 11 1 11 — 1 11 — I 11 � y jr- liPlelliz a C . e • a • � 11 C . • • • • • ' • 3tY N n r. ' 1] • - e • • 'mall, • • • - - 1 11 _- 1 11 � 1 11 v . • 1 111 11 . 11 / 1 3 w n u x �+ Xf ,,.ry�.. ' T.u✓ ti.'�., I t', >< ; 0 r )JN 'er v' r`Tti Ort •� .. . c - 6 t wb 4 y. a+' x., t i f _ 1• �✓ s ^r4 $" �� .., .r�`,±talc, r.,k �' .$k t +.d" 'it jd'§�Jw,� i�,1�9 _,,? r ''ri �k&-�• Y" �j�r r „x3.. x .'°a+C, •!R � Y7l e 'yY�r At M x > �kg�' ,' s r `# ��:j4st -k• x ^ t . . R �iW."-A"s'j.';.�"rS lmi ' "�^..,:«f...:,.''8.."''�:,ft? '.x,.d, .aS..ia:;v."yFy}.^`.r.:a ,w+ r $!.iy..tAd,;p.».tr.,.'s.?:.'_`;".'r.+.+,""+f; i5t. ��tajs1.�.::.. ..�.ej�.t. xa9>y':�e*p-j§.'.1-H3+ ,"r.+�'.,.de,s'::.,6a;��'Jgq M'r rC nr i4t t ' :kr�. ltd{' T.,H r.J"':sri+ae';""-rj. MLt�.¢Y{:.+ nw.9„.' rvx "y.}.t'<.. .rey}r .'i MF,.;.::.1k i♦' �; q Y . '! . .4. 1 A", i 'Y'i. 'dn'x.„",„ , "'."V ” a5 :.s,.r�•w MIR $ yFri-w a#v { JYd Aye-., Prfn.wW . . . 5 d; r y .eta .,m r r 't 1At 4rrcFdvs+�Xx. i..'. .. « . .:t' r r ,£ :, n _....i.F:rr2'.� .,;.:• ,r " 'F ,'+"{{ AM, yv , t,M 'f* r i+d . rxvf f' ,, .. r, & +Y k•` rZ ) Pb`ua .,. - .q ? r, ` x s a a+ `ytt, "t + : .. rf aP-x A , 4n tTu' .sr, W s . t-", c*✓. .M i ''t r .+f2. �5 „ ., . ;y J wry x -..:r, i ,r :. n•+ C Y. , ?`�. t, Sm,S"7; � .:c r24 �r»:;n + . ;,. ,. r+' ". sk ex" `. .. - ` # • x '." .iaxasr . ...,;,tx i` S:v : a, .s ` c� ., w, RYdrA5, ' , . " t , fisc .. .i, +: . .+ a . ... - .r.s. +r# ; "� x .. :' ` •n u*fx :x .js `Ru . . , p, +.n �'J ." .. x r ', r::,. 9` , . r to rr � . spr '#yr"ta'rt+ fits x rYay�, 'F: if'. �„` Ie; R' wx C@'>: .rr� * z II. 5 rrr }} ... ... -.. ,. . . sy vn+�:4 ts --�'r,:R:*��` . '�'r,�' . S ��,T. ,aYb-. . :rah .,v +p,j:C:<w ,. ti*F,2� . . .. �':, m � •. , y+'�.ri,.a ,. . j 1..{ r.,.5:. ..v ,. -.{;f�:.rj!y Y { , ': :c. "e' „t.lt , , . .^y, `” h� . - t. i". a :,'{t'�.'G,Ip� at .±. ...5 ' h7�j . 9.. �..r• a ; '• ; Y { . , ,'i�-, . 5 .. _ .ykta � "':M •R .,r31 ,,%,,�".a 15: ,°.,K'e. A ' dr. ro ,dc ':t °9 . .pk l P .3 .1::ry Rye ,qer, .4k 'S :r:�...; '" se �;,, -; :' � n +,y. . . - • F4 U^,5-.:.0 ,yq,�+.s. � qt _ n ,: it v t 5 - "i. t e K" �T .s I ,,.F''r' '.dr �> "� , Ur ij Y ... 3 4y e e�3s �s .r n . x F / '+". F' zh° It "t x v r . FY 02103 FY 03/04 FY 04/05 TOTALFYE June 30 FYE June 30 FYE June 30 Ing : 11 . • . REVENUES BUDGETED ' - • 1 11 1 11 1 11 � • 1 Children's • 1 1 1 1 1 1 1 1 1 • 1 • ' • • • ' 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 ■ 1 1 1 . Mrj ' ' � Lucie • 1 11 1 11 / 11 • 1 United County 1 1 1 ■ 1 1 1 1 1 1 • 1 to - • EXUZ Fire • • 1 1 1 1 : Ili 1 1 11 1 1 1 DepartmentofChildren & Families1 1 1 1 1 1 1 ! I • 1 County • " 111 1 IM 1 II • 1 Contributions-Cash 111 it 11111 ® 1117, Program� Fun ■� 1 1 1 1 1 1 1 1 1 1 1 . ' Raising 1 11 11 11 1 Sales toPublic-Net . � 11 tl • 11 11 1 11 ' , 1A . 194 . • • -Investment 1 11 1 1 1 1 1 1 1 1 1 Income 1 11 / 11 • 1 ' " ' _� � 1 11 1 11 • 1 ' • - : - • 1 1 1 1 1 1 1 1 1 • 7 1 Funds • Other Sources 1 / 111 11 - • • • r - • 1 1 1 1 1 1 1 1 1 • • 1 • In -Kin • Donations ' • 11 11 ! Florida Unemployment 1 • 1 . 11 � 11 1 • : : 1 1 • ■ 1 11 11 11 11 1 1 / 1 . 11 11 : Travel-Daily1 / • 111 1 1 11 Travel/Conferences/Traininq • iOffice Supplies11 11 1 Postage/Shipping ' • 1 1 • � . . 11 11 11 • ' . • • . Egoism= 1 11 1 1 1 Printing & Publications Subscription/Dues/Memberships Insurance .�Ifl 11 1 11 • • • 11 II 11 1 . ' EAdvertising • r • r • - - 1 1 1 1 1 1 • 1 , • • • - • . • r � 1 1 1 1 1 1 1 1 � • 1 Books/Educational Materials 11 11 r • r • 1 . 1 1 1 1 / 1 1 1 Administrative Costs1 1 1 1 1 1 1 / 1 • 1 . 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NEXT FY BUDGET 1 TOTALREVENUES • ROPOSED BUDGETED BUDGETED • • 1 1 1 MM 1 11 1 ! 1 • • i l l 11 1 1 1 1 • I . • . • • • � i� / 11111 . 1 111 11 1 11 ' . • • 1 1 1 1 1 1 1 1 1 • 1 - • • 1 1 1 1 1 1 1 1 1 / 1 , ' • r • . 1 1 1 1 : 1 1 1 1 1 1 1 1 1 1 • - • . • • - 1 1 1 1 1 1 1 1 1 • 1 • • 1 11 1 11 1 1 / • 1 • • • • 1 1 1 1 1 1 1 1 1 1 1 11 1 1 1 ' . Program1Sales 1 1 . 1 1 1 . 1 1 1 • 1 . • •Merri . 1 1 1 1 1 1 1 1 1 • 1 • - • • ues Income 1 1 1 1 / 1 1 / 1 • 1 ' Miscellaneous 1 1 1 1 1 1 1 / 1 • 1 • • Bequests 1 1 1 ® 1 1 1 — 1 1 1 • • 1, Funds - • Other Sources1 1 1 1 1 1 . t t • .� • • Donations pp 1 / 1 1 1 1 ■ • 1 1 • 1 ® 11 EXPENDITURES Retirement 11 1 11 • 1 1 11 11 1 • 1 1 1 • 11 . - . . • . 1 1 1 1 1 . . • 1 1 1 , . . . oyment1 / 1 11 11 Travel-Dailyjel . 11 11 11 Travel/ConferencWs/Training WI �017�Jce Supplies 1 - • • ne 11 : 1 11 1 . • • • hipping 1 • 1 1 1 1 1 1 / 1 1 1 • 111 . 1 11 • 1 • • • • • • • �Fl•1R17• 1 1 1 1 / 1 1 1 . 1 1 1 1 1 • . 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Office Supplies In-crease i PIoLe�caused increase in projected offi—ce supplies. ncrease in SL fees and addition�OfYVC cell phones for each Team • • . . . & Grounds) • - • back to ad—minoffice therefore a Awre of the rent is divided over the program. • • • • ues/M embershiPsdues werenot Previously divided over the programsthe • • • - Insurance t - theyare now which accounts for the variance. Insurance was not previously divided over the programs in the • • r - • acc • for the variance. nd maintenance & child tracking software maintenance. 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'' �s1 ' � r t`Fr .}�: r; .: C, rw?`+ . k: ,<�. ,� r.! .1 x } r7 T t, „C; 7'i • ,at'.„ -.- .y't k s.:. ,. , r t” . :i .r~. .,b > tc ,�. .,..+. , . '.�, 5 ,r. -, :. , ...a: . r ; T,.. ;�:, • e :. ..t+,+�.t� x < ;, ,p,:.y1 y , ,: ws • ' .af r .~�pk',. . ... f, t%4 ;� .r , a, "t ,�• .t �.y, 1 ra t ": '.5,., . t` t •'�.5��$nk ;r ;Yl r! i. t l.F. Y �'a r..,W. ,,.� . r:.. t3 n , .:..,: $* : . .... a.? . � :, 5 ^, v . ., p. i a '� x.' dt a : . . . . ,.+, y1dt 51 ,:,x. . - ;. 3}. •nr.,+sF ,a +. ',., . rA:h: .sf�a .iy. i x.5;:.. Yt4 � . TC.N F' "' ^ +: , ,$.: « ,, .';; x . . •�' rV" ,�;,,, `� .gyp ,. .., f .y, , .., .+ A +.,nk,„s u �. y ._ 5 �. �•k - h ."-.gf .tr.ay. h }:.. P � i $ t '*qt i;� � 6 4 . . , ✓a a •4: R3 ! {� x z jit Y a q } .,. t t 4 .: ,{N7i y1•.;4;.4 it : e aNr Y�� >w. a K S .I . ;� s,y }^ •:' 4 {SH EXHIBIT B [From policy adopted by Indian River County Board Of County Commissioners on February 19 , 2002] " D . Nonprofit Agency Responsibilities After Award of Funding Indian River County provides funding to all nonprofit agencies on a reimbursement basis only. All reimbursable expenses must be documented by an invoice and/or a copy of the canceled check . Any expense not documented properly to the satisfaction of the Office of Management & Budget and/or the County Administrator may not be reimbursed . If an agency repeatedly fails to provide adequate documentation , this may be reported to the Board of Commissioners . In the event an agency provides inadequate documentation on a consistent basis , funding may be discontinued immediately. Additionally, this may adversely affect future funding requests . Expenditures may only be reimbursed from the fiscal year for which funding was awarded . For example , no expenditures prior to October 1St may be reimbursed with funds from the following year. Additionally, if any funds are unexpended at the end of a fiscal year, these funds are not carried over to the next year unless expressly authorized by the Board of Commissioners . All requests for reimbursement at fiscal year end (September 30th) must be submitted on a timely basis . Each year, the Office of Management & Budget will send a letter to all nonprofit agencies advising of the deadline for reimbursement requests for the fiscal year. This deadline is typically early to mid October, since the Finance Department does not process checks for the prior fiscal year beyond that point . Each reimbursement request must include a summary of expenses by type . These summaries should be broken down into salaries , benefits , supplies , contractual services , etc. If Indian River County is reimbursing an agency for only a portion of an expense (e . g , salary of an employee) , then the method for this portion should be disclosed on the summary. The Office of Management & Budget has summary forms available . Indian River County will not reimburse certain types of expenditures . These expenditure types are listed below. a . Travel expenses for travel outside the County including but not limited to ; mileage reimbursement , hotel rooms , meals , meal allowances , per Diem , and tolls . Mileage reimbursement for local travel (within Indian River County) is allowable . b . Sick or Vacation payments for employees . Since agencies may have various sick and vacation pay policies , these must be provided from other sources . c . Any expenses not associated with the provision of the program for which the County has awarded funding . d . Any expense not outlined in the agency's funding application . The County reserves the right to decline reimbursement for any expense as deemed necessary." - 1 - a � EXHIBIT C STANDARD TERMS FOR GRANT CONTRACT 1 . Notices : Any notice , request, demand , consent, approval or other communication required or permitted by this Contract shall be given or made in writing , by any of the following methods : facsimile transmission ; hand delivery to the other party; delivery by commercial overnight courier service ; or mailed by registered or certified mail (postage prepaid ) , return receipt requested at the addresses of the parties shown below: County: Joyce Johnston -Carlson , Director Indian River County Human Services 184025 th Street Vero Beach , Florida 32960-3365 Recipient : Boys & Girls Club of Indian River County, Inc . P . O . Box 3068 Vero Beach , Florida 32964 2 . Venue: Choice of Law: The validity, interpretation , construction , and effect of this Contract shall be in accordance with and governed by the laws of the State of Florida , only. The location for settlement of any and all claims , controversies , or disputes , arising out of or relating to any part of this Contract , or any breach hereof, as well as any litigation between the parties , shall be Indian River County, Florida for claims brought in state court , and the Southern District of Florida for those claims justifiable in federal court . 3 . Entirety of Agreement : This Contract incorporates and includes all prior and contemporaneous negotiations , correspondence , conversations , agreements , and understandings applicable to the matters contained herein and the parties agree that there are no commitments , agreements , or understandings concerning the subject matter of this Contract that are not contained herein . Accordingly, it is agreed that no deviation from the terms hereof shall be predicated upon any prior representations or agreements , whether oral or written . It is further agreed that no modification , amendment or alteration in the terms and conditions contained herein shall be effective unless contained in a written document signed by both parties . 4 . Severability: In the event any provision of this Contract is determined to be unenforceable or invalid , such unenforceability or invalidity shall not affect the remaining provisions of this Contract, and every other term and provision of this Contract shall be deemed valid and enforceable to the extent permitted by law. To that extent, this Contract is deemed severable . 5 . Captions and Interpretations : Captions in this Contract are included for convenience only and are not to be considered in any construction or interpretation of this Contract or any of its provisions . Unless the context indicates otherwise , words importing the singular number include the plural number, and vice versa . Words of any gender include the correlative words of the other genders , unless the sense indicates otherwise . 6 . Independent Contractor, The Recipient is and shall be an independent contractor for all purposes under this Contract . The Recipient is not an agent or employee of the County , and any and all persons engaged in any of the services or activities funded in whole or in part performed pursuant to this Contract shall at all times and in all places be subject to the Recipient's sole direction , supervision , and control . 7 . Assignment , This Contract may not be assigned by the Recipient without the prior written consent of the County. - 1 - � N ACORD CERTIFICATE OF LIABILITY INSURANCEDATE (MM/DD/YYYY) 11010812004 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Day Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AMEND , EXTEND OR 11320 SE Federal Hwy. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, Hobe Sound FL 33455 772-546-5767 INSURERS AFFORDING COVERAGE NAIC # INSURED Boys & Girls Club of Indian River County, Inc. INSURER A: Markel Insurance Co PO Box 3068 INSURER B: Vero Beach FL 32964 INSURER C: INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN , THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS , EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. II TR NSRDD' TYPE FINSI ]RAMM: POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE (mm1nprYY) DATE twimiDnim LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1 ,000,000 A X COMMERCIAL GENERAL LIABILITY 8502CY2201284 09/13/04 09113105 DAMAGE TO RENTED $ 100,000 CLAIMS MADE FX ] OCCUR MED EXP (Any oneperson) $ 5, 000 PERSONAL & ADV INJURY $ 11000, 000 GENERAL AGGREGATE $ 3,0001000 GEN' LAGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OPAGG $ 1 , 000, 000 -X1 POLICY PRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT A X ANY AUTO 8502CY2201284 09113104 09113/05 (Ea accident) $ 1 ,000, 000 X ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) X HIREDAUTOS X BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTYDAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR EICLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WC STATU- OTH- EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E. L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYE $ If yes, describe under SPECIAL PROVISIONS below E .L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS certificateholder is additional insured for General Liability & auto 30 Days notice applies except for non-payment of premium CERTIFICATE HOLDER CANCELLATION Indian River County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Board of County Commissioners DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN 1840 25th St NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Vero Beach, FL 329604365 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORED REPRESENTATIVE <AJD> ACORD 25 (2001 /08) 04CORD CORPOR ION 1988 • � N IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed . A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s) . If SUBROGATION IS WAIVED , subject to the terms and conditions of the policy , certain policies may require an endorsement . A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s) . DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s) , authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend , extend or alter the coverage afforded by the policies listed thereon . ACORD 25 (2001 /08) 11 �` s� 212E� �34 05 : 46 5612993b4t1 EDVS GIRLS CLUE IR�.� PAGE u� 2 � �� ' ��-- � �?�- 2 ^ � a. WED n5 � i4 °h! W>�, :� R� , SNC , rAX N� . 77 � 546 5T; � r . u ., . •. „ � �x 3 it � J Hurt} ,tf �lYtr�u'rc : .. tl', " �4 � t! ' ffi�eU1r ,Yr , 1s' . l 'Iinisroon, S,,v �'N}' (•rRl � r �. :'� �'rrfi/N.tferr�'� OI� .°�Aff►Idril4i>fc'F 1y7� C .u.,� � : S ., r.lrkr, 5' , �v < 1 �.r�� rvt, , . lt�ln, t. � � �•,`• �*�`°�•n'� 1' { l iitr4v$�; r1 .,tkC�lldel, i '1. 33�� i) t •11�)K;� � to >ti'a�•,yNtsNl:$ )it�4�/Srlq.c. fr,nl '1 'Iw, ,n�� h_ Yd 'ti�; , l , l..�, rl�, r�J �:. w�;;�y�ti ' �i' Irl'#t��tti` i � 6 ,11 �`n�� <!fi�;lwu' l .�;lip�2 $ 2-7658 + �'� sflklx ) (t14(`wl �l�S`� .....,. � .__,. � "b ,al , lt. W ,�w x� � ,,.:�� It�_ �>r : o �ao- z58ba iSSl ,;Ei7 T0 : Yndit�n River County Board of Gaunty CommissianMr3 1640 5th St Vero rlemth , FN, 32960 - 3365 � , r F . Q ., X "9 L 329 - - , - y ,•.cr: � � y that go.Y.s . �• Girls Cs1,� in .d-!;311 . Rlver_G:Ru,�.y...�n,� � � Orsi.et�r�..F�.� s�...�.._ . . ._ .�a� , <: w � � �� ; ac>. kC� the r0uisions of I:he Florida Workers ' Compensation l,a �v, hes secured the payment a�' any P r � '< - �> " compensation benertts due by insuring their rix : w ! th the ;'lor ? yip Retail Federation 5clf ? rtsurers fund. � tJ �ls.:Y � UM►t'_+ERI .0 � 7�Ct_z Stakutgry Limits- - Static of Fir� 1'idd Employers �iabiiity r = -. "r `.-' S DAT[ : ��, nLlter ,l � , . z00±} '$ 500 , Q00 ( Each pccldent� � 500, OOb � ; pi5ease- - 6acit Errtploycc} � '- : '�{ti;"it7�' DI►T� ; Se�IZGC�t?� ' . 200 . $ 500 , Oe� 4 � ©Is�ase - - Policy Lirnit� rcr'tiflt8tf» f5 nal a polFcy and of itself saes not afford any insurance . nothing contained ! n this µ • � :� , ; ', .r ' ! he con3trued 8s amending , extE� nding , or altering �aderage not afforded by the policy shown - ° ^ �� r, ir• g insurar. ca to any insr.� red not Warned shave . � ! ? c.y of insurance listed abav2 has bccn issued to t11e named EnsWred for the paii`y period ind ?eat^ d . . . :� `� ;, t '� t� ct ^ g any requirement, term or Gondltion df any cvnt+�ett or atitrr dacz.iment to which this ce, rtlflcata - - _^ y f; erta ' n , t?ie tnsuranco rnAdC 8vall8ble l) y the desGrihCd policy Ln this �ertificatC 15 Subject tis arty thr± • t , ,- =, ^ xclus!ons and conditions of SUCIt policy , Fald claims may have rediJc@c1 tfio > hawn limits . 1 ' '�„h :•, �j �iity descrlued i1V�1VC' is can :elled before thu expiratic+n date indlcatee , the issuing company ,r�rili - : • � � : :, � ,- y � ' 30 rr>ays' wrlttcn �? ntlte to the certificate holder named shave , although if tanceiiast� on is far , :c �! ” :nt or• ;premium , then thr issuing company will attempt to mail 1!0 days' written npticC trs tCse rrr`, ' ; cc, t ' itoidcr � 1n any �v� nt, the issuing tams�ny , its agents, and rep ►;esent�Uve� accept no at�EEgrticn ar �' � a � ; i '."y of cony kind far failure to mail such notire , pate 11 / 03 / 2004 _��L=.--�-r - C;•; :". aul. � i ^ ,.i , Crc „ a'� . 'Iti. nl, � txdCCk � ir; ,r R4ldiX 9� �CYeiGi.4n G87 �E Stti>tiUXezt p'uTc 10,/ 2312004 11 : 23 5612993040 BOYS GIRLS CLUB IRC PA u 'L 1 ; 2Crion ftl) IQ : 45 PAX NUJS yt ,� uax .• �! ;� to Ate rA PAGE 02 IN1ER*IAL REVENUE SERVICE WEPARTNErK: Or THE 9 - O , Box 7508 CINCINNATI , ::h 45201 Employer t3eatification NuT.trr ; Date) 59 - 3623298 17a530 �iQOG07c . BOYS 4 GIRLS ctiul Oy rz%MrAN RIVER Contact Perron . COMM INC Yvot%M L f GGETT I oR 31296 9 : 7 ZRACXYJ M BLVlJ Contact Telephone NWT' Ser : WRO HEACHr FL 7963 ( 877 ) 879 - 3500 Accounting period Ending : Dtcomber 31 ; FawhLdatlmn 5tat4 :p claosificaticnt 509 ( atf ( I ) MVante Ruling Period Begins ! r• bnuary 4 , : 2000 Advanco Rulinq Poriod Enda : Decenber 31 , 2004 Adde=d= Appltea : No , D = ar Applicants Based on irxforraacion you suppiied , , and tLvxuairg your eparations will be as statC4 in your applitatio !s LCV zecagT. itien of examptica , V4 hal.va detaxmined yo , are tx&n>, t frons federal income tax under Rection sol ( a ) of the Internal Revcnut 04dc as an a.gahltaLlon described in section 5Q1 ( e ) ( 3 ) . beoaiive you are & bewly == &ted erg&uizatian , wC ; aarc not new making a tinal dctcsanination of your foundoe 'ten status =od = a +ierion 509 ( • 7 or tht Code . Row+cver , we have dcternined that you can renaonebly a Toot to be a puhlj. cly suppgrted arejazizatiort daacr/)fed in asctions 509 ( a ) ( 1 ) and 140 ( k ) ( 1 ) (A ) ( vi ) . Ar.cordinUly , duxirv; 6n advance rul, irg period you will be treated as a publicly supported or'+ganixaation , and mot asi a privuta tonr_d &tion . Thie advance ruling period beginw and tndw on the dates ohovn above . with4n 90 days after the, and of your advance ruling period , you ". t $ t xa-d us the i449ormation needed to Oetermize whetAar you hetwe mot tnc require - Monts of c )ae applicable suvpgrt teeG du :: ng the advance riling pariod . It you establ4vh that you hpye been a publicly 6upported oxVa>Siratiort , we will elassi - f•y you AN a +lection 549 ( n, ) ( 1 ) or 509 (ax ) ( 2 ) orgaylyatior. As long as you eont : nvve ;. a meet the wa v: irempntx of the eppl4c&b1c support cmat . If you do not *a^ et the Fralslic support requirements during the advance ruling period , we will claa ® ify you At s priyats foundation for futuro periods , Alco ; if we claseifv you asp a privet + foundation , we will treat you rC 4 pa:-iva,te foundation : rvm your beaicu nq dace for purpoacp of ee04. . on 5o7 ( d ) and 4940 . Grantors and contribu ara may . eZy on our datermirmtion that you gra not a pr. vate foundation until 90 d = ye atter the end of your advsknce rulir.g rarl' od . If you !send up the rair4jrad intormmtion within this 9c dayot grantors and contributors= may concinx=a : o rely on the advance detezmination usltil We matte Lec _ er 1045 ' �O / :Gi 10 / 23 / 2004 11 : 23 5612993840 $OYS GIRLS CLUE IRC PAGE 03 U7l1b ; . UI,W !• L' i! tlr ; IJ fh.1, KU7J ht:NUkii. ) Q-N ti .tiL Yi 4CF04ioo $ EOyS L' CTgLS CLUFi up llypTA."t. RTVSR a : ina1 der. ezrcinacion at your foundation statue . IE we publish a notice: in the InternAl Revenue Bulletin eca : ing that „G W • ' 1 no longer treat you At, ,4k publioly supported oregmnization , ? r3ntors and concributore may not rely en' this detezm,inaeior, attar t 'ie date we putlich tic nvcice ; Lr. lttiditivn , if y" )u lose your vtatLe ae a publicly supported orcrana - cation , oral a graxxtor or contributor wxe . respanriblc for , 7r was avere of , Cl:e act or fti ?ure cc act , thxt resultnd '_ ri your lose of surf: aitatue , t4at persors ccay rot rely on thlq dcGezninatiaa from the data of tht act or failure to act . p. lsc , i ." a gr =n : az as corscr_ L`utor 19ai-ped that we had given notice that you would be removed from clar. • sificatlon : c a publicly oq* orted czganization , then that pt- sot m4y not rely cm this detewrtunation at of the dace he or she ac:qu ,� red sorts Y-� �+ lfdga , . f You change yoLr saurc4z of support , your purposes , character , or metk:od of apcsration , please let as %nrdv ars we ease Consider the start of the change on your r_krmpc atxtua end f ""%dition status , If you tmard your organiZationa ? document or bylaws , pleat & Rand us a copy of tte dmandcd document or bylaws . Also , LEt us know all chstizgcs in yeas umme or addrern . . Acs o ; Je.nuxry 1•, 110A , you sire liahle for social security taxes under Che fu ederal Trurance ContribytioAs Act arc amounra of $ loo or more you pay to enCK of your etrp �ov n . . aurissg a cal- c es . ypas , You ewe not liable for thm sax Iropolsed unser the Fedezv l VYherrploymant Tax Ret• ( rTTA ) . pi ,Vani : ztioncs that arc not private foundacjons are pot sub ; ecz to t ;s++ ? r . - vate foundhLtion excise t.axcr . under Chapter 42 of the lbtexna,l Revenue Code . Howcvat , you are not; Automa.t :cally exeMpt Ezoam othcr federal excise taxes . . f you have+ any quoetiorr shout excise , employment , or aches federal taxes , please let us: kzQW , Dcucrr may ded•1CG : cont=butious to ysu as provided in sect =on 170 of Uta Internal Rtvezuc Cade , Bequests , lejaciea , devices , transfareY , or gifts to you or for your use arc dee.uctible for pedtral estate and rrift tax pus-Foxes if they msec the appli. Cabl. e pxovi. aio= or eectionc 2455 , 2106 , Wand 25x42 of the Cad6 , Donors may deduct Ccntributianr to you only to the extent tha,G their contributions art gi. ftx , with no Consideration received . T,. cket purchases arca .% Qmilar payrne:=ts in - cvi:ijune_ iap witA fundra,iainq evencn may not necessarily rualify a ;. dedurtlbir «ontributavna , depending on the circumacaneas . novenae Ruling ; 67 - 4' 16 , publiahod in C.urulec : ve Sullet =r. 1167 - 2 , on page 104 , givev guidtkI4 er rtgarding whir, tzxpaycre may deduct payacatm Eor admltaion to , or otlhcr in , fundraising aC . ivitics for charity , YoU are not req irrd to file- Form 990 , Itecus'ri Orf organization zxempr From Zncome TAX . : f your grcNas .�acvipta etch year arc normally X25 , 004 or lm=zl : f YOU reCeivo a Form 990 packx9pa in ta,t mail . sjWly attseh the label provided , chock th4 'sax is the hcddizv_ tc indieato that your ant7uai 477QUF raeeipcs arc normally $ < S , 000 or lacy . and sic- the recurn _ Hecauat yGu will be tccated ae a Publ . :: c:',arity to = return f ; lirg puzvooct during /a•ar enc_ se advance ruling pr : aotl , yo L: ahould fila rant: - 9a0 for each )Aver 4 ;1 your advance rul -ing period Letter : 445 ; Do / r�G1 10423V2004 11 : 23 5612WM40 . LOPS GIRLS CLUE IRC PAGE 04 BOYS c, GIRLS CLOS OF INDIAN RIVER that you emerged the $25 . 000 ening threshold even if yevr sou = rs: of aupror. do nct eatidZY ' ,he public support cert specified in the hendin.-, of tills letter . If- a recLurri in required , it must be fi1Cd by Cha 15th day e ! the £ iKth m. nth after t ' ; 4w end of your annual arcounGing ; nrind . A penalty of 720 a day is charged yhan a return is filed mate . %inlcss there it rnaaonabIc cause foc the delay . Huwtver , the Maximum Danalty charged gannot exceed 7LO . 000 or 5 percent of you.x grovel rreeLpts for the year , wnicbever is lees - For o :'gsn: zaCiaus with groes rec alpte exceeding $ 1 , 000 . 000 in, any year , the penalty is 5100 per day per retuz—z , unless there: is rt46onable cause for the delay The maxittum petla. l_t, y for Kr: organization with grow receipts exceeding $ 1 , 0000004 ehalo pot exated $ 50 , 000 . This penalty may also be charged if i return ie not atampltte . So . please be sure your Zteurt : c complete bnTore you fila You are noc required to file federal inco :te ta.x returns tinlecs you are subJect to the Calc on unrelated 9usinezu incotra under section 51I. of the code , TI you err oubjeruz CD this taut , yuu must file an incvmt tax return on Totm 990 - T , Exempt OXwganittatior. B -abintss Tnc .me Ta.x Aerurn , In this letter we are net dxtrrmining whether any of your present yr peopoped acti%'itieb JLCe uh- ' Q - latec trade or 'business ae defined . in section 513 of the code . You are re -vireed to maks your arurval infozmation return , roFrn 990 or FQrl1 990 • ZZ . available for public nspeetion ;or three years atzcz the later of the due date of the return or the date the return to filed . You are also vequIrtd tO tnakrg Wve. ilAble: twx public invpvCtion your txeMption applieaeian , any support-ung docuisc nes , and your exemption Letter , copies of these docurn;nts Are 6190 required to be provided to any individual upon written cr in person zequevt without charge vthor than reagorable feaa for copying and brstage _ You m,iy f 'sizii.l thin ra4-uitenerrt by placinci theic document & on tht: Internet , PermItielb may be lwpQued for failure to coM� ly with these ree& ire +ae_xts . Additional information i. c available in Publication 557 , TaxoExetthpt Stat * iIz for Your Organization , or you may call our toll free number shown above . You need s<,i employer idontificnt: en number eves if you have no employees . ZP err employe. t' _ dentixScaCion number was not entered or. your application , we will ace ;, gm s n %Amber to you and advice you tl . it . Please ua@ t :®. t MUMbez un all returns yol,: tile: and in all cozreapordenca with the Internal Revan%; a ServiCG . 19 we said, ' c tho heading of this lotter that an addendum applias , the add *ndUM ePc1ozc:d is. an integral part :_. f this letter . Becauoe chis letter ceU: Q help us rCsoly% any questions ab3ut 1ro12r ovlatnp !, etacup and tourdation et4rus , you should kerp it in your permanent rerordr . Le . Ce ; ! 045 10j2ZZ 2Q004 11 : 23 5612993840 BOYS GIRLS CLUB IRC PAGE 05 P , BOYS =tm GP T17VIM Rtvza It you have any questions , ple3oc CDII::aC '_ Lb_ person whose azar.'In arci � � = e� itrna 'wmber sre shcwc in the heading at this letter . £ : rce :r3y your.n , 5teveri. ; , Millvr Dir: c � or , tx® rrpk Orcr:,nSexcitlna Emir iU5l3ZL ( c i - i 4Tit1 8 i f ^ ti TJ4C . or '� na5 : D� .!cGl T4Trl. ? : 05