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2003-253T
Board 03-04 5/27/2003 B . - RrefixE Ftr-st . .. ate. . , , ° � s �latn`` i2LCi nIN°ame dd �ss�.: " ' " a, i .. or , Phone. - 1 Mr_ Lou A rile 1029 Orchid Oak Drive Vero Beach FL 32963- 772 567-6600 2 Capt . Bill Brunner IRCSO 4055 41 st Avenue Vero Beach FL 32960- 772 ) 978-6160 3 Rev . Robert Cosmas2575 58th Avenue Vero Beach FL 32966- (772 ) 778- 1500 4 Chief_ Hugh Cox Indian River Shores 6001 N A1A Vero Beach FL 32963- (772 ) 231 -4699 5 Mr. James Davis Treasure & Space Coast Radio 1235 16th Street Vero Beach FL 32960- (772 ) 567-0937 6 Mr. Travis Eslin er 1735 18th Street Vero Beach FL 32960" 1(772 ) 473-0019 7 Mr. Jack Fitzharris Florida Center for Recovery 3451 West Midway Road Ft. Pierce FL 34981 - (772) 460-2777 8 , Joan Gent en Dept. of Health , TLC Newborn 1900 27th Street Vero Beach IFL 32960- (772 ) 794-7484 9 Mr, William Hanlon Alcohope 5925 37th Street Vero Beach FL 32960- (772 ) 778-7215 1 lCorporal Fred Jones Florida Highway Patrol 1638 Fatima Court Sebastian FL 32958- (772 ) 473-3998 1 Karen McHenry SafeKids of IRC 1603 10th AvenueVero Beach FL 32960- (772 ) 563-9118 1 Mrs . Carol Molloy 2565 Riverview Court Vero Beach FL 32963- 772 ) 589-2283 1 Judge David Morgan IRC Courthouse 2000 16th Avenue Vero Beach FL 32960- (772 ) 770-5070 1 Mariana NighVero Beach FL 772 ) 231 -6233 1 Miss Megan Scott VBHS 2205 Vero Beach Avenue Vero Beach FL 32960- 772 778-8928 1 Beckie Selph SRHS 9001 90th Avenue Sebastian FL 32958- (772 ) 5644319 1 MPO David Shapiro VBPD 1055 20th Street Vero Beach FL 32960- 772 ) 978-4649 1 Charlene Tardi IRC School Board 1900 25th Street Vero Beach FL 32960- (772 ) 564-3057 1jMrs . Virginia Welton 1618 26th Avenue Ivero Beach FL 32960- (772 ) 562-6928 Q � U Page 1 � Q�l Advisory Board 5/27/2003 4l ' .r PrefixWO M Dr. Paul Bakule 1315 River Ridge Dr, Vero Beach FL 32963 567-7111 Mr. Jeffery K. Barton Clerk of the Courts 1840 25th St Vero Beach FL 32960 770-5185 770-5008 Judge Marc Cianca Circuit Chief 218 S . 2nd Street Ft. Pierce FL 32950 772 )462- 1461 770-5133 Mr. Bruce Colton State Attorney's Office 411 S . Second St Ft. Pierce FL 134950 (561 ) 465-3000 462- 1214 Dr. Roger Dearing IRC School 1990 25th StVero Beach FL 132960 564-3040 Chief James Gabbard Vero Beach Police Dept. 1055 20th St Vero Beach FL 32960 9784600 778-7846 Ms , Diamond Litty Public Defender's Office 216 S . Second St. Ft. Pierce FL 34950 561 ) 462-2048 ( 561 ) 462-204 Capt. Bill McMullen IRC Sheriffs Office 4055 41 st Ave Vero Beach FL 32960 Mr. Harry Offutt Offutt & Barton , CPA' s 686 Date Palm Rd Vero Beach FL 32963 231 -2100 234-4333 Sheriff Roy Raymond IRC Sheriffs Office . 4055 41st Ave Vero Beach FL 32960 569-6700 404569-8144 Mrs . Bonnie Swanson Principal , Pelican Island E 5840 24th Street Vero Beach IFL 32966 564-6500 Mr. Tom White City of Vero Beach 1556 30th Ave. Vero Beach IFL 32960 ( 561 ) 778-2745 569-9405 Pagel SUBSTANCE ABUSE COUNCIL OF INDIAN RRTR. COUNTY, INC. Financial Statements witli Independent Auditors' Report September 30, 2002 and 2001 MAS F. i \ ® ,Haire, K! ( I etz, Nuttall, Field MICOHAEL L. OKMETZEC CPA, MEMEME® mom SCOTT A. NUTTALL, CPA, CFP NEENEE SRF )E� & Co . , chartered DANIEL E. FIELD, CPA A® 1 'tf ' V r .ON BRIAN J .K K. GRA , CPA, CVA PATRICK K. GRAHAM, CPA L`sl . ® Tax, Business and Financial Consultants HARVEY L. HERRST, CPA 1 ® TERESA M . LASOTA, CPA Independent Auditors ' Report To the Board of Directors Substance Abuse Council of Indian River County, Inc : We have audited the accompanying statements of financial position of Substance Abuse Council of Indian River County, Inc . (a nonprofit organization) . as of September 30, 2002 and 2001 , and the related statements of activities, functional expenses, and cash flows for the years then ended. These financial statements are the responsibility of the Substance Abuse Council of Indian River County, Inc. 's management. Our responsibility is to express an opinion on these financial statements based on our audits . We conducted our audits in accordance with generally accepted auditing standards . Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatement. An audit includes exammmg, on a test basis, evidence supporting the amounts. and disclosures in the financial statements . An audit also includes assessing the accounting principles used and significant estimates made by management, as well as evaluatingr the overall financial statement presentation. We believe that our audits provide a reasonable basis for our opinion. In our opinion, the financial statements referred to above present fairly, in all material respects, the financial position of Substance Abuse Council of Indian River County, Inc. as of September 30, 2002 and 2001 , and the changes in its net assets and its cash flows for the years then ended in conformity with generally accepted accounting principles . O 'Haire, Kmetz, Nuttall, Field & Co ., chartered Certified Public Accountants December 12 , 2002 3111 CARDINAL DRIVE • VERO BEACH , FLORIDA 32963 • TELEPHONE (772) 231 -6902 • FACSIMILE (772) 231 -4099 email@oknf-cpas. com Substance Abuse Council of Indian River County, Inc. Statements of Financial Position September 30, 2002 2001 Assets Current Assets : Cash $ 19 , 179 $ 4609 Grants receivable 545186 34,389 Deposits 27574 22574 Total current assets 75 ,939 83 ,652 Property and equipment, net 43 ,087 543980 Total assets $ 119 ,026 $ 138 , 632 Liabilities and Net Assets Current Liabilities : Accounts payable $ 102100 $ 43768 Accrued expenses 11 ,284 61338 Accrued compensated absences 102318 93218 Deferred revenue V01 141050 Note payable, current portion - 19659 Total current liabilities 40 ,903 361633 . Net Assets : Unrestricted 695715 71 ,210 Temporarily restricted 8 ,408 31 ,389 Total net assets 78 , 123 1027599 Total liabilities and net assets $ 1195026 $ 1382632 See accompanying notes to financial statements. - -2- Substance Abuse Council of Indian River County, Inc. Statements of Activities For the Year ended September 30 , 2002 , with comparative totals for 2001 Temporarily Total Unrestricted Restricted Total 2001 Revenues Grants from governmental agencies _ $ 418 , 117 $ $ 418 , 117 $ 368 , 556 Program revenue 45 , 754 - 455754 29 ,787 United Way grant 402419 - 40,419 362127 Contributions 47, 594 - 472594 43 ,265 Fundraising 351256 - 351256 44 , 135 Interest income - - 696 Other revenue 8 , 071 - 82071 6 , 102 Net assets released from restriction 22,981 (22 ,981 ) Total revenues 618 , 192 (22 ,981 ) 5955211 528 , 668 Expenses Program services : Drug abuse prevention education 560, 710 - 560, 710 4701816 Grant service coordination 19, 023 19, 023 171931 Total program services 5797733 5792733 4881747 Supporting services : Management and .general 24,539 24, 539 203443 Fundraising 152415 - 15 , 415 8 , 103 Total supporting services 395954 - 392954 28 ,546 Total expenses 6197687 - 6191687 5177293 Increase (decrease) in net assets ( 11495 ) (22 ,981 ) (24 ,476) 117375 Net assets , beginning of year 71 ,210 31 ,389 102 ,599 91 ,224 Net assets , end of year $ 69,715 $ 8 ,408 $ 781123 $ 102 ,599 See accompanying notes to financial statements. -3 - Substance Abuse Council of Indian River County , Inc. Statement of Functional Expenses For the Year ended September 30 , 2002 , with comparative totals for 2001 Program Supporting Total Total Services Services 2002 2001 Drug Abuse Grant Prevention Service Management Education Coordination and General. Fundraising Salaries $ 298 , 197 $ 151200 $ 6 , 276 $ 1 ,255 $ 32.0 , 928 $ 255 ,373 Payroll taxes 252301 12163 783 157 272404 19 , 536 Total payroll 323 , 498 161363 7, 059 1 ,412 3481332 274 , 909 Employee benefits 28 ,331 1 ,554 955 191 31 , 031 . 26 ,445 Professional services 252 8 , 082 - 81334 7 , 101 Program supplies 499809 93 513 103 50 , 518 31 , 153 General education material 5 ,778 - 5 , 778 10 ,245 Postage 1 , 191 - 704 704 2 , 599 2 , 127 Telephone 10 , 543 - 354 71 103968 9 , 728 Rent 211708 11199 240 233147 211538 Insurance 5 ,492 172 34 57698 6 , 137 Utilities 22788 1 , 841 31629 1 , 917 Repairs and maintenance 27191 71 14 25276 11 , 759 Printing 147032 2 ,452 2 ,452 18 ,936 82287 Travel 15 , 807 345 - - 161152 13 , 512 Contract labor 392120 - - 392120 36 , 615 Subscriptions - - 599 - 599 - Professional development 163641 - - 167641 13 ,388 Depreciation 152407 668 765 111 162951 15 ,450 Speck assistance 4 , 108 - - 47108 172639 Miscellaneous 4 , 014 - 773 1003 14 , 870 9 ,343 Total expenses $ 560 , 710 $ 19 , 023 $ 241539 $ 151415 $ 619 , 687 $ 517 , 293 See accompanying notes to financial statements. -4- Substance Abuse Council of Indian River County, Inc. Statements of Cash Flows Year ended September 30 , 2002 2001 Cash flows from operating activities : Increase (decrease) in net assets $ (247476 ) $ 117375 Adjustments to reconcile increase (decrease) in net assets to net cash flows provided by operating activities : Depreciation - 16,95. 1 15 , 450 (Increase) decrease m : Grant receivable ( 19, 797) 35084 Deposits Increase (decrease) in : Accounts payable5 ,332 (457) Accrued expenses 4 ;946 765 Accrued compensated absences 1 , 100 63 Deferred revenue (45849) 14 , 050 Net cash provided by (used for) operating activities (207793 ) 432319 Cash flows from investing activities : Purchase of equipment (52058 ) (23 , 144 ) Cash flows from financing activities : Payments on note ( 1 ,659) (3 ,468 ) Net increase (decrease) in cash (272510) 162707 Cash , beginning of year 46;689 297982 Cash , end of year $ 191179 $ 461689 See accompanying notes to financial statements. Supplemental disclosure of cash flow information : Interest paid $ 142 $ 322 -5 - Substance Abuse Council of Indian River County, Inc. Notes to Financial Statements Note 1 — Summary of Significant Accounting Policies Organization The Substance Abuse Council of Indian River County, Inc. (the Council) is a nonprofit organization incorporated on April 17, 1990, under the laws of Florida. The Council's mission is education and referral to aid in the prevention of alcohol and drug abuse. Method of Accounting The accompanying financial statements have been prepared on the accrual basis of accounting. Net Assets Contributions received are recorded as . unrestricted, temporarily restricted, or permanently restricted support, depending on the existence and/or nature of any donor restrictions . Support that is restricted by the donor is reported as an increase in unrestricted net assets if the restriction expires in the reporting period in which the support is recognized, All other donor-restricted support is reported as an increase in temporarily or permanently restricted net assets, depending on the nature of the restriction. When a restriction expires, that is, when a stipulated time restriction ends or purpose restriction is accomplished, temporarily restricted net assets are reclassified to unrestricted net assets and reported in the statement of activities as net assets released from restrictions . Property and Equipment Property and equipment acquisitions greater than $500 are 6capitalized and are Stated at cost . Donated property and equipment is recorded at the fair market value at the date of the gift. Depreciation is provided on a straight-line basis over the estimated useful life of the asset, which range from 5 -7 years . Income Tax Status The Council is exempt from federal income tax under Section 501 (c)(3 ) of the Internal Revenue Code . In addition the Council has been determined, not to be a private foundation within the meaning of Section 509(a) of the Code. Functional Allocation of Expenses The cost of providing the various programs and other activities has been summarized on a functional basis in the statement of functional expenses . . Accordingly, certain costs have been allocated among the programs and supporting services benefited . Contributed Services The Council receives various amounts of donated services from unpaid volunteers . However, these amounts have not been recognized in the accompanying financial statements because the criteria for recognition of such volunteer efforts under SFAS No . 116 have not been satisfied. Use of Estimates The preparation of financial statements in conformity with generally accepted accounting principles requires management to make estimates and assumptions that affect certain reported amounts and disclosures . Accordingly, actual results could differ from those esti nates . -6- Substance Abuse Council of Indian River County, Inc. Notes to Financial Statements (continued) Note 2 — Property and Equipment, net The following is a summary of property and equipment : Balance Balance September 30, September 30, 2001 Additions Deletions 2002 Furniture and equipment $ 925497 . $ 5 , 058 $ - $ 97,555 Accumulated depreciation (372517) ( 162951 ) (54,468) $ 54,980 $ ( 11 , 893 ) $ - $ 43 ,087 Note 3 — Temporarily Restricted Net Assets Temporarily restricted net assets consist of the following : September 30 , 2002 2001 Character Counts training program $ 8 ,368 $ 23 , 126 Capital purchases - 3 ,600 Dasie Hope Outreach program 40 41663 $ 82408 $ 31 ,389 Note 4 — Accrued Compensated Absences Accrued compensated absences reflect the liability of the Council for accrued annual leave of its employees . Note 5 — Deferred Revenue Deferred revenue consists of entry fees, which were received during the fiscal years ended September 30, 2002 and 2001 , for golf tournament fundraisers held subsequent to the respective years ' end . Note 6 — Concentrations For the year fiscal years ended September 30, 2002 and 2001 , the Council received approximately 70% of its revenue, from governmental agency grants . 8010 02/07/2003 12:12 PM r Form t 990 OMB No. 1545-0047 Return of Organization Exempt From Income Tax 2001 Under section 501 (c), 527, or 4947(a)(1 ) of the Internal Revenue Code (except black lung Department of the Treasury benefit trust or private foundation) - I iMemai Revenue Service The organization m have to use a co of this return to satisfystate reporting requirements. 10 4 .<r. A For the 2001 calendar year, or tax year beginning 10 / 01 / 01 andending 9 / 30 / 02 B Check if applicable: Please C Name of organization D Employer ID number Address change laeIRS bel o SUBSTANCE ABUSE COUNCIL 65 - 0202835 la Name change print or OF INDIAN RIVER COUNTY INC . E Telephone number Initial return type. Number and street (or P.O. box if mail is not delivered to street address) Room/suite 772 - 770 - 4811 Final return see 2501 27TH AVENUE A- 7 F Accounting method: U Cash Amended return SpecifiFVERO City or town state or country, � , and ZIP + 4 ® Accrual � Other (specrTy) Application tions: BEACH FL 32960 ► pending *Section 501 (cx3) organizations and 4947(ax1 ) nonexempt charltatill H and I are not applicable to section 527 organizations. trusts must attach a completed Schedule A. (Form 990 or 990-EZ). H(a) Is this a group return for affiliates? Yes No G Web site: ► H(b) If "Yes," ender no. of affiliates ► NIA J organization type H(c) Are all afil-iates included? ® NIA Yes No check only one ► 501 c 3 s insert no: 4§47(a)(1 ) or n 527 (if "No," att. a fist See instr.) K Check here ► 1j. if the organization's gross receipts are normally riot more than H(d) Is this a separate return filed by an N!A $25,000. The organization need not file a return with the IRS; but if the organization matron covered a groupnun ? Yes No received a Form 990 Package in the mall, it should file a return without financial data. . 1 Enter 4-digit GEN ► Some states require a complete rpolm. M Check ► if the organization is not required L Gross receipts: Add lines 668b 9b and 10b to line 12 . ► 595 211 to .attach Sch. B Form 990, 990-E4 or 990-PF). Revenue Expenses, and Changes in Net Assets or Fund Balances See Specific Instructions on paqe 16: 1 Contributions, gifts, grants, and similar amounts received: - -a Direct public support . . . . .. . . . : . . . . . . . . . . . . . . . : . . . . . . . .. . . . . . . . . . . . . . . . .. la 4 7 5 94 b Indirect public support 1b 75 675 Pu PPo . . : . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . . . . . . .. c Government contributions (grants) . . . . . . 1c d Total (add lines to through 1c) (cash .$ I23 , 269 noncash . $ ) 1d 123f269 2 Program service revenue including government fees and contracts (from Part VII , line 93) 2 455r739 . . . . . . . . . . . . . . . . . . . . 3 Membership dues and assessments 3 6A26 . . . . 4 Interest on savings and temporary cash investments - 4 . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . ., . . . . . . . 5 Dividends and interest from securities : . . . . . . . . . . : . : . . . . . . . . . : : . .. 5 6a Gross rents 6a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Less: rental expenses _ : . . . . . . . . . . . . . . 6b . . . . . . c Net rental income or doss) (subtract line 6b from line 6a) 6c R 7 Other investment income (describe ► . . . . . . . . . . . . . . . . . . . . . . . . . 7 e 8a Gross amount from sales of assets other A securities fa Other v e than inventory 8a n . . . . . . . . . . . . . . 6 . . . . . . . . . . . . . . . . . . . . u b Less: cost or other basis and sales rases 8b . . e . . . . . . . c Gain or (loss) (attach schedule) Sc . . . . . . . . . . . . . . . . . . . d Net gain or poss) (combine line 8c, columns (A) and (B)) 8d . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Special events and activities (attach schedule) a Gross revenue (not including $ of contributions reported online 1 a) 9a b Less: direct expenses other than fundraising expenses . 9b c Net income or (loss) from special events (subtract line 9b from line 9a) . . . . . . . . . . . . . . . . Sc 10a Gross sales of inventory, less returns and allowances _ _ _ 10a 8 132 b Less: cost of goods sold 10b 3 7 4 8 0 c Gross profit or (loss) from sales of inventory (aft. sch.) (subtract line 10b from line 10a) S_ _TMT 1 10c 4 : 384 11 Other revenue from Part VII , line 103 11 1 r 645 12 Total revenue add lines Id, 2, 3, 4, 5 6c 7 8d, 9c, 10c, and 11 . . . . . , . . . . • , . , • - . . : . _ . _ . . . . . . . 12 5 91 4 63 E 13 Program services (from line 44, column (B)) 13 575r985 X . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . p 14 Management and general (from line 44, column (C)) 14 24 r 539 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . n 15 Fundraising (from line 44, column (D)) 15 15 415 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . S 16 Payments to affiliates (attach schedule) 16 e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . S 17 Total expenses add lines 16 and 44, column A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 615 939 A 18 Excess or (deficit) for the year (subtract line 17 from line 12) 18 — 24f476 N s 19 Net assets or fund balances at beginning of year (from line 73, column (A)) 19 102 5 99 t i 20 Other changes in net assets or fund balances (attach explanation) 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . s 21 Net assets or fund balances at end of year (combine lines 18 19, and 20 21 78 r 123 For Paperwork Reduction Act Notice, see the separate instructions. Form 990 (2001 ) DAA 8010 02/07/2003 12:12 PM r Form P90 2001 SUBSTANCE ABUSE COUNCIL (35 - 0202835 Page 2 Statement of Ali organizations must complete column (A). Columns (B), (C), and (D) are required for section 501 (c)(3) and (4) organizations Functional Expenses and section 4947 a 1 nonexempt charitable trusts but optional for others. See SPecific Instructions on page 21 .) Do not include amounts reported on line (B) Program (C) Management 6b, 8b , 913 10b, or 16 of Part I . (A) Total seMcesand general (D) Fundraising 22 Grants and allocations (attach schedule) non- . . . . . . . . . . . . . . . . . . . . . . (cash $ cash $ ) 22 23 Specific assistance to individuals 23 4 10 8 41108 24 Benefits paid to or for members 24 25 Compensation of officers, directors, etc. 25 52570 50 144 2r226 _ 26 other salaries and wages 200 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2s 268 358 263 253 4 050 2 1 055 7 Pension plan contributions 27 28 other employee benefits . . . . . . . 28 31 031 29 885 955 191 29 Payroll taxes 29 27 404 26 464 783 157 30 Professional fundraising fees 30 31 Accounting fees . . . . _ 31 8 0 0 0 80 0 0 32 Legal fees 32 33 supplies . . . . . . . 33 56 296 55 680 513 103 34 Telephone . _ . . 34 10 f 968 10 f 543 354 71 35 Postage and shipping . . _ 0 .35 .2 .599 1191 704 704 2 . . 36 occupancy . _ 36 26 , 776 24 496 040 240 37 Equipment rental and maintenance 37 2 276 2 f.191 71 T4 38 Printing and public tions . . . . . .. . el . . . 38 18 936 14 032 2 , 452 2 4 52 3s . Travel 39 16 152 16r152 40 conferences, conventions, and meetings 40 41 . Interest 41 42 Depreciation, depletion, etc. (att. sch,) . . 42 16r951 16 075 765 111 43 Other expenses not covered above (itemize): a 43a b SEE STATEMENT 2 . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . . 43b 73 514 61 771 1 626 10 117 . c 43c d 43d e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43e 44 Total functional expenses (add lines 22 - 43) Organizations ' completing columns PJARLcarry these totals to lines 13-IS 44 615r939 575F985 24 539 15A15 ' Joint costs. Check ► U if you are following SOP 98-2. Are any joint costs from a 00mtiined educational campaign and fundraising solicitation reported in (B) Program services? a . . . ► Yes ® No . If "Yes," enter I the a . . . . f ) aggregate amount of these joint costs $ ; (11) the amount allocated to Program services $ (iii) the amount allocated to Management and general $ and (ivi the amount allocated to Fundralsfng $ 4�dilk�f[� 1T9TAm r i o w -A— _ -- •^- - Program &irvice raccom itshments See Specific Instructions on page 24, What is the organization's primary exempt purpose? Program Service ► DRUG ABUSE PREVENTION Expenses All organiietions*must describe their exempt . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . (Required for 501 (c)(3) and purpose achievements in a clear and concise manner. State the number• � � � � . . ' - of dents served, publications issued, etc. iscuss achievements that are not measurable. Section 501 (c)(3) and 4 (4) orgs., and 4947(a)(1) organ itions and 4947 a 1 nonexem charitable trusts must also enter the amount of rants and allocates to e(th)ers. trusts, but optional for a SEE STATEMENT 3 off. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Grams and allocations $ 575r985 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . .. . . . . . . . . c Grants and allocations $ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . d Grants and allocations $ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Grants and allocations $ e Other program services attach schedule f Grants and allocations $ Total of Program Service Expenses (should equal line 44 column (B) Program services) DAAv ► 575 , 985 Form 990 (2001 ) 8010 02/07/2003 12: 12 PM Form R90 (2001 ) SUBSTANCE ABUSE COUNCIL 65 - 0202835 Page 3 Paarxll Balance Sheets (See Specific Instructions on page 24 .) Note: Where required, attached schedules and amounts within the description (q) (BI column should be for end-of-year amounts only, Beginning of year End of year 45 Cash-non-interest-bearing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21279 45 1 126 46 Savings and temporary cash investments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 , 410 as 18f053 47a Accounts receivable 47a 54r186 b Less: allowance for doubtful accounts 47b 34f389 47c 54 , 186 48a Pledges receivable 48a b Less: allowance for doubtful accounts 48b 48c 49 Grants receivable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 50 Receivables from officers, directors, trustees, and key employees A (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . . . . . . . . . . . Z 51a Other notes and loans receivable (attach s schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51a e b Less: allowance for doubtful accounts 51b 51c t 52 Inventories for sale or use 52 . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . .. . . . . . . . . . s 53 Prepaid expenses and deferred charges . . . . . 53 54 Investments-securities . .Co � . FMV 55a Investments-land, buildings, and equipment: basis55a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Less: .accumulated depreciation (attach schedule) < . - 55b 5r� 56 Investments-other (attach schedule). . . . . . . . . . . . . r� . . . . . . . . . . . . . . . . . . . . . . 57a Land, buildings, and equipment: basis 57a 97 , 555 b Less: accumulated depreciation (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . 57b 54A68 54 980 57c 43 087 58 other assets (describe ► SEE S TMT .4 ) 2 5 7 4 5s 2 574 . 59 Total assets add fines 45 through 58 must equal line 74 . . . . . _ . . 138r632 59 119 r026 . . . . . . . . . . . . . . . 60 Accounts payable and accrued expenses . 34 , 374 so 4 0 903 . . . . . . . . . . . . . . . 1 61 Grants payable 61 a 62 Deferred revenue 62 b . . . . . . . . . . . . . . . . . . .. . . . . . . . . .. . . . . . . . . . . . . . . : . . . . . . . . . . . . . . . . . . . . I 63 Loans from officers, directors, trustees, and .key employees (attach I schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . 63 I 64a Tax-exempt bond liabilities (attach schedule) . 64a t : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Mortgages and other notes payable (attach schedule) 64b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . e 65 Other liabilities (describe ► SEE STMT 5 ) 1 659 65 s 66 Total liabilities add lines 60.thr h 65 36 033 66 4 0 903 Organizations that follow SFAS 117, check here ► and complete lines 67 through 69 and lines 73 and 74. N F 67 Unrestricted eu 71 210 67 69r715 t n 68 Temporarily restricted 31 , 389, 1 389 68 B408 d 69 Permanently restricted 69 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A Organizations that do not follow SFAS 117, check here ► and s B complete lines 70 through 74. s a 70 Capital stock, trust principal, or current funds e 1 70 t a 71 Paid-in or capital surplus, or land, building , and equipment fund . . 71 s n 72 Retained earnings, endowment, accumulated income, or other funds . . . . . . . . . . . . . . . 72 c 73 Total net assets or fund balances (add lines 67 through 69 OR lines 0e , r s 70 through 72; column (A) must equal line 19; column (B) must equal line 21 ) . . . . . . . . . . . . . . . . . . . . . . 102 599 73 78 123 4 Total liabilities and net assets / fund balances add lines 66 and 73 _ . . . . _ . . _ 138 632 74 119 026 Form 990 is available for public inspection and, for some people, serves as the primary or sole source of information about a particular organization. How the public perceives an organization in such cases may be determined by the information presented on its return. Therefore , please make sure the return is complete and accurate and fully describes, in Part III , the organization's Programs and accomplishments . DAA : 1 1 1 1 11 i gvxg • - • - • i,Tt •!•�n"z .� 6 '1s`` ' 43sr ..as- MON, 4 • X49 � xFu � d� J , �M,�3f.. . • fe5�t H`',vkn^�Ry4R}."�� �._'va�''%eP'���, _ - • • . . . .1 • • • - "sf ice"-`��`s,T`�-3lesi'a� ��\r ��s�si -� . . _ �.4 .�r�� ��s�os<..{ �s�"� . "�'�ss'" tg < g2 • . - • • - . • k.vINS �0t«.�, ,���'..$� �,-��^a 3. -r� • ' • e • • - • • P,.•�5 �r £'' v��`' fie,- �'aga'"" >'�' � 1 • • �'z'4 t�'�� 1'd ,d ^4'�` x5.x.�i �� �� _ ? � f,;i'.`'a�',� r��' u s .�, '� �; 111 . 10 will WO 0 awl a 10 0 ^s' x � �' 's"- P • t . - •2 Yrs"` *�'`''sdf�.� h m^ �. sx...?�^�p'��- ' > °� Y�.,�, � r�:�atz;�z S.`€<.�r _:. `� �akt�i �-*.�`-�> xi�'�y"•t`�• � . ,` z;�q, L..s��., . . . . 1 1 / 1 / / / / 1 • • - • - • - • - • • - - . • • - . . - • • - • • • - IJ 111 IN IF 8010 02/072003 12 : 12 PM Form. 990 2001 SUBSTANCE ABUSE COUNCIL 65 - 0202835 Pae 5 Other Information See Specific Instructions on page 27 . Yes No 76 Did the organization engage in any activity not previously reported to the IRS? If "Yes," attach a detailed description of each activity 77 Were any changes made in the organizing or governing documents but not reported to the IRS? 77 X If "Yes," attach a conformed copy of the changes. 78a Did the organization have unrelated business gross inc. of $1 ,000 or more during the year covered by this return? 78a X . . . . . . . . . . . . . . . . . . . . . b If "Yes," has it filed a tax return on Form 990-T for this year? . . . . . . . . . . . 78b X . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79 Was there a liquidation, dissolution, termination, or substantial contraction during the year? If "Yes," attach a statement 80a_ Is the organization related (other than by association with a statewide or nationwide organization) through common membership, governing bodies, trustees, officers, etc., to any other exempt or nonexempt organization? 80a X . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b If."Yes," enter the name of the organization ► . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . .. . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . .. . . . . . . . . . . . . . , . . . . . . . . . . . and check whether is exempt OR a nonexempt. 81a. Enter director indirect political expenditures. See line 81 instr. 81a . . . . . . . . . . . . . . b Did the organization file Form 1120-POL for this year? . . . . . . . . 81 b X 82a Did the organization receive donated services or the use of materials, equipment, or facilities at no charge or at substantially less than fair rental value? 82a X . . . . . . . . . .... . . . . . . . . . . . . . . . . . . . . : . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . b If "Yes," you may indicate the value of these items here. Do -riot include this amount as revenue in Part I or as an expense in Part II. (See instructions in Part IIL) 82b men 88a Did the organization comply with fife public inspection requirements for returns and exemption applications? 83a X . . . . . . .. . . . . . . . . . . . . . . . . . . . b. Did the organization comply with the disclosure requirements relating to quid pro quo contributions? 83b X 84a Did theorganization solicit any contributions or gifts that were not tax deductible? . . .. . . . . . . . . . . . . . . . .. . . . . . . . .. . . . . . . . .: . . . 84a X b If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . . . : . . . . . . . .. . . . . . . . . . . . . . N/A 84b . 85 501 (c)(4), :(5), or (6) organizations. a Were substantially all dues nondeductible by members? N/A 85a . . . . . . . . . . . . . . , . . . . . . . . . . . , . . . . . . . b Did the organization make only in-house lobbyingexpenditures of $2,000 ,or less? 85b If "Yes" was answered to either 859 or 85b, do not complete 85c through 85h below unless the organization received a waiver for proxy tax owed for the prior year. c Dues, assessments, and similar amounts from members 85C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d . Section 162(e) lobbying and political expenditures85d . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . . . . . . . . : . . . : . . . e Aggregate nondeductible amount of section 6033(e)(1 )(A) dues notices 85e . . . . . . . . . . . . . : . . . . . . . f Taxable amount of lobbying and political expenditures pine 85d less 85e) 85f g Does the organization elect to pay the section 6033(e) tax on the amount in 85f7 % N A 8 h If section 6033(e)(1 )(A) dues notices were sent, does the organization agree to add the amount in 85f to its reasonable estimate of dues allocable to nondeductible lobbying and political expenditures for the following tax year? N/A 85h 86 501 (c)(7) orgs. Enter. a Initiation fees and capital contributions included on line 1286a b Gross receipts, included on line 12, for public use of club facilities86b . . . . . . . . . . . . . . . . . . . . . . . . 0 . . . . . . . . 87 501 (c)(12) orgs. Enter. a Gross income from members or shareholders87a b Gross income from other sources. (Do not net amounts due or paid to other sources against amounts due or received from them.) 87b 88 At any time during the year, did the organization own a 50% or greater. interest in a taxable corporation or partnership, or an entity disregarded as separate from the organization under Regulations sections 301 .7701 -2 and 301 .7701 -3? If "Yes," complete Part V 88 X . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89a 501 (c)(3) organizations. Enter. Amount of tax imposed on the organization during the year under. section 4911 ► 0 ; section 4912 ► 0 ; section 4955 ► 0 a F1 - b 501 (c)(3) and 501 (c)(4) orgs. Did the organization engage in any section 4958 excess benefit transaction during the year or did it become aware of an excess benefit transaction from a prior year? If "Yes," attach a statement explaining each transaction 89b X c Enter: Amount of tax imposed on the organization managers or disqualified persons during the year under sections 4912, 4955, and 4958 ► 0 d Enter. Amount of tax on line 89c, above, reimbursed by the organizationpop 0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90a List the states with which a copy of this return is filed ► , . . , , - • • - _FL , • . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Number of employees employed in the pay period that includes March • 12, 2001 (See instructions.) 190b 91 The books are in care of ► COLETTE HEID EXEC . DIR . Tele hone no. ► 772 - 770 - 4811 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - Locatedat ► 2501 27TH AVE , SUITE A- 7 , VERO BEACH , FL ZIP + 4 ► 32960 92 Section 4947(a)(1 ) non ewexempt charitable trusts filing Form 990 in lieu of Form 1041 - Check here ► . . . . . . . . . . . . . . . . . . . . . . . and enter the amount of tax-exempt interest received or accrued during the tax year ► 92 Form 990 (2001 ) DAA 8010 02/07/2003 12:12 PM Form990 (2001 ) SUBSTANCE ABUSE COUNCIL 65 - 0202835 _ Page s Part11!11 Analysis of Income-Producin Activities See Specific Instructions on page 32. Note: Enter gross amounts unless otherwise Unrelated business income Excluded by sec. 512, 513, or 514 (E) Related or Indicated. Business code Amount xdusio Amount exempt function 93 Program service revenue: code income a OTHER 37 , 622. b GOVERNMENTAL GRANTS 418r117 c d e f Medicare/Medicaid payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . g Fees and contracts from government agencies 94 Membership dues and assessments 6 4 2 6 95 Interest on savings and temporary cash investments 96 Dividends and interest from securities . . . . . . . . . . . . . . . . . . . . . . 97 Net rental income or (loss) from real estate: a debt-financed property . .. . . . . . . . . . . . . . . . . . . . . . . . . .. . . . b not debt-financed property . . . .. . . . . . . . . . . . . . . . . . . . . 98 Net rental income or (loss) from personal property . . . . . : 99 Other investment income ' 100 Gain or (loss) from sales of assef& other than inventory 101 Net income or (loss) from special events 102 Gross profit"or. Doss) from sales of inventory 41 4r384 103 Other revenue: a . b OTHER REVENUE 1r645. d e 104 Subtotal (add columns (B), (D), and (E)) OEM 4 , 384 " 4 63 810 105 Total (add line 104, columns (B), (D), and (E)) . . . . . . . . . . . .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . .. . . . . . . . . . . . . . . . ► 468r194. Note: Une 105 plus line 1 d Part I should equal the amount on fine 12 Part 1. Relationship of Activities to the Accomplishment of Exempt Purposes see .spectric Instructions on page 32 .Line No. Explain how each activity for which income is. reported in column (E) of Part VII contributed importantly to the accomplishment • . . of the organization's exempt other than by providingfunds for such 93A PROVIDE SUBSTANCE ABUSE PREVENTION EDUCATION 94 PROVIDE SUBSTANCE ABUSE PREVENTION EDUCATION 103 PROVIDE SUBSTANCE ABUSE PREVENTION EDUCATION _ - Information Re ardin Taxable Subsidiaries and Disregarded Entitiessees tfic instructions on page 33. (A) (B) (C) (D) (E) . Name, addressi and EIN of corporation, Percentage of Nature of activities Total Income End-of-year partnership, or disregarded entity ownership Interest assets N/A 04 Information kegarding RegardingTransfers Associated with Personal Benefit Contracts See Specific Instructions on pg . 33. (a) Did the organization, during the year, receive any funds, directly or indirectly, to pay premiums on a personal benefit contract? Yes No (b) Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? . . . . . . . . . . . . . . . . . . . . . H Yes No . . . . . . . . . . . . . . . . . . . . . . . . . Note: If "Yes" to (b), file Form 8870 and Form 4720 see instructions). Under penalties of perjury, I declare that 1 have examined this retum, including accompanying schedules and statements, and to the best of my knowledge and belief, it e, correct, and com ete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge. Please Sign Here Sin Cure of Date Type or print name a96 tftl Preparers Rol 9 20U Check if Preparees SSN or "N (See Gen. Instr. W) Paid nature em siI ► P00293972 Preparer's Firm's name (oryours 0 '- HAIP4 KNETZ NUTTALL FIELD & CO . EIN ► 59 - 1718139 Use Only if self-employed), 3111 CARDINAL DR . Phone address, and ZIP + 4 VERO BEACH FL 32963 no. ► 772 - 231 - 6902 DAA Form 990 (2001 ) 8010 02/07/2003 12: 12 PM SCH€DULE A Organization Exempt Under Section 501 (c)(3) (Form 990 or 9904EZ) (Except Private Foundation) and section 501 (e), 5o1 (f), 501 (k), OMB No. 1545-0047 501 (n), or Section 4947(a)(1 ) Nonexempt Charitable Trust DSupplementary InformationgSee separate instructions .) 2001 epartment of the Treasury Internal Revenue Service ► MUST be completed -by the above organizations and attached to their Form 990 or 990-EZ Name of the organization Employer identification number SUBSTANCE ABUSE COUNCIL OF INDIAN RIVER COUNTY INC . 65 - 0202835 Compensation of the Five Highest Paid Employees Other Than Officers , Directors , and Trustees See page 1 of the instructions. List each one. If there are none enter "None . (a) Name and address of each employee paid more (b) Title and average hours (d) Contributions to (e) Expense than $50.000 . per week devoted to position (c) Compensation employee ben. plans & account and other deferred compensation atbwances COLETTE . HEID EXEC . DIR . VERO BEACH FL 45 52 , 570 0 0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . Total. number of other employees paid over $501000 . . . . . . . . . Compensation of the Five Highest Paid Independent Contractors for Professional Services See page 2 of the instr. List each one whether individuals or firms) . If there are none enter "None . (a) Name and address of each independent contractor paid more than $ 50,000 . (b) Type of service (c) Compensation NONE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Total number of others receiving over $50,000 for professional services . . _ . _ . . . _ . For Paperwork Reduction Act Notice, see the Instructions for Form 990 and Form 990-EZ. Schedule A (Form 990 or 990-EZ) 2001 DAA 8010 02/07/2003 1 2' 12 PM Schedule Form 990 or 990-EZ 2001 SUBSTANCE ABUSE COUNCIL 65 - 0202835 Pa e2 f?arlt Statements About Activities (See page 2 of the instructions .) Yes No 1 During the year, has the organization attempted to influence national, state, or local legislation, including any attempt to influence public opinion on a legislative matter or referendum? If "Yes," enter the total expenses paid 1 X or incurred in connection with the lobbying activities ►$ (Must equal amount on line 38, Part VI-A, or line i of Part VI-B .) Organizations that made an election under section 501 (h) by filing Form 5768 must complete Part VI-A. Other organizations checking "Yes," must complete Part VI-B AND attach a statement giving a detailed description of the lobbying activities. 2 During the year, has the organization, either directly or indirectly, engaged in any of the following acts with any substantial contributors, trustees, directors, officers, creators, key employees, or members of their families, of with any taxable organization with which any such person is affiliated as an officer, director, trustee, majority owner, or principal beneficiary? (If the answer to any question is "Yes," attach a detailed statement explaining the transactions.) a Sale, exchange, or leasing of property? X b Lending of money or other extension of credit? 2b X c Furnishing of goods, services, or facilities? 2c X . d Payment of compensation (or payment or reimbursement of exp. if more than $1 ,000)? 2d X e . Transfer of any part of its income orassets? 2e X 3 Does the organization make grants for scholarships, fellowships, student bans, etc.? (See Note below.) 3 X 4 Do you have a section 403(b) annuity plan'for your employees? 4 X Note: Attach a statement to explain how the organization determines that individuals or organizations receiving grants or bans from it in furtherance of its charitable programs "qualifyw to receive Reason for Non-Private 'Foundation Status (See pages 3 through 6 of the instructions.) The o anization is not a _private foundation because it:is: .(Please check only ONE applicable box.) 5 A church, convention of churches, or association of churches. Section 170(b)(1 )(A)CQ. 6 A school. Section 170(b)(1 )(A)Cx). (Also complete Part V.) 7 A hospital or a cooperative hospital service organization. Section 170(b)(1 )(A)(w). 8 A Federal, state, or local government or govemmental unit. Section 170(b)(1 )(A)(v). 9 A medical research organization operated in conjunction with a hospital. Section 170(b)(1 )(A)(ru). Enter the hospitars name, city, and .state 10 0 An organization operated for the bereft' of a col ental . . . . . . . . lege or university owned or operated by a governmental unit. Sedan 170(b)(1 )(A)Crv). (Also complete the Support Schedule in Part IV-A.) . 11a ® An organization that normally receives a substantial part of its support from a governmental unit or from the general public. Section 170(b)(1 )(A)(vi). (Also complete the Support Schedule in Part IV-A.) 11b a A community trust. Section 170(b)(1 )(A)(w). (Also complete the Support Schedule in Part IV-A.) 12 An organization that normally receives: (1 ) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its charitable, etc., functions-subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Also complete the Support Schedule in Part IV-A.) 13 An organization that is not controlled by any disqualified persons (other than foundation managers) and supports organizations described in: (1 ) lines 5 through 12 above; or (2) section 501 (c)(4) , (5), or (6), if they meet the test of section 509(a)(2). (See section 509(a)(3).) Provide the following information about the supported organizations. See page 5 of the instructions. (a) Name(s) of supported organization (b) Line numbers) from above 14 An organization organized and operated to test for public safety. Section 509(a)(4) (See page 6 of the instructions.) DAA Schedule A (Form 990 or 990-EZ) 2001 8010 02/07/2003 12: 12 PM Schedule A (Form 990 or 990-EZ) 2001 SUBSTANCE ABUSE COUNCIL 65 - 0202835 Page 3 !# IVA •,• Support Schedule (Complete only if you checked a box online 10, 11 , or 12.) Use cash method of accounting. Note: You may use the worksheet in the instructions for converting from the accrual to the cash method of accounting. Calendar year (or fiscal year beginning in ► (a) 2000 (b) 1999 (c) 1998 (d) 1997 e) Total 15 Gifts, grants, and contributions received. (Do not include -unusual rants. See line 28.) . . . . . . . . . . . . . . . . . 514f239 402 079 384r564 182P797 1 , 483r679 16 Membership fees received - 5 4 96 1 r 080 6 f235 6 160 18f971 17 Gross receipts from admissions, merchandise sold or services performed, or furnishing of facilities in any activity that is related to the organization's charitable, etc. ; purpose 7 631 11r366 13 703 20r791 53r491 18 Gross inc. from int. , dividends, amounts received from pymt on securities loans (section 512(x)(5)), rents, royattim, & unrelated busn. taxable inc. (less sec. 511 taxes) from businesses acquired by the organization after June 30, 1975 . . - . - 696 1 320 1 151 1 , 226 4 393 19 Net income from unrelated business . activities not included in line 18 . . . . . . . . 20 Tax revn. levied for the organization's ben. & either paid to it or expended on its beftlf • 21 The value of sm. or facl, furnished to the org- by a governmental unit without charge Do not incl. the value of serv. or fac. gen eralty fumished to the DublIc without charge 22 Other income. Attach a schedule. Do not include gain or (loss) . from sale of cap. assets 607 607 23 " Total offines 15through 22 . . - . . - . - - 528 , 669 415f845 405 ,r653 210r974 1 561 141 24 Line 23 minus line 17 . . . . . . . . . . . . . . . . 521f038 404r479 391 . 950 190 , 183 l 507 r 650 25 Enter s % of line 23 5 287 4 r 158 4 O57 2 110 26 Organizations described on lines 10 or 11 : a Enter 2% of amount in column (e), line 24 —No WN ► 26a 30 153 b Prepare a list for your records to show. the name of and amount contributed by each person (other than a . governmental unit or"publicly supported organization) whose total gifts for 1997 through 2000 exceeded the amount shown in line 26a. Do not file this list with your, retum. Enter the total of all these excess amounts. ► 261b " c Total support for section 509(a)(1 ) test: Enter line 24, column (e) ► 26c 1 507 650 . . . . . . . . . . . . . . . . . . : : . . . .. . .. . .. . . . . . . . . . . . . . d Add: Amounts from column '(e) for fines: 18 4 , 3 93 19 22 607 26b ► 26d 5 000 e Public support (line 26c minus fine 26d total) . • . • - • . • • • • - ► 26e 1 502 650 If Public support percentage line 26e numerator divided by line 26c denominator . . . . . ► 26f 9906684 % 27 Organizations described on line 12: a For amounts included in lines 15 16 and 17 that were received from a "disqualified person," prepare a list for your records to show the name of, and total amounts received in each year from, each "disqualified . person." Do not file this list with your return. Enter the sum of such amounts for each year. N /A ( 7) (2000) . . . . . . . . . . . . . . . . . . . . . . (1999) - • - - • - - . . . . . . - . . . . 1998 ( ). . . . . . . . . . . . . . . . . . . . . . . . . . . 199 . . . . - b For any amount included in line 17 that was received from each person (other than "disqualified persons"), prepare a list for your records to. - . . . . . . . . . . . . . show the name of, and amount received for each year, that was more than the larger of ( 1 ) the amount on line 25 for the year or (2) $5,000. (Include in the list organizations described in lines 5 through 11 , as well as individuals.) Do not file this list with your return. After computing the difference between the amount received and the larger amount described in (1 ) or (2), enter the sum of these differences (the excess amounts) for each year: N/A (2000) . . . . . . . . . . . . . . . . . . . . . . . (19%) . - . . . . . . (1998) . . . . . . . . . . . . . . (1997) . . - . . . . . . - - . . . . . . . . . . . . c Add: Amounts from column (e) for lines: 15 16 . . . . . . 17 20 21 ► 27c and line 27b total d Add: Line 27a total • . . • . • . . • - - - ► 27d . . . . . . . - - . . . . . . . . . . e Public support (line 27c total minus line 27d total) ► 27e Total support for section 509(a)(2) test: Enter amount on line 23, column (e) ► 47fuc" g Public support percentage (line 27e (numerator) divided by line 27f (denominator)) ► Y7g % h Investment income percentage (line 18, column (e) (numerator) divided by line 27f (denominator)) ► 27h % 28 Unusual Grants : For an organization described in line 101 11 , or 12 that received any unusual grants during 1997 through 2000, prepare a list for your records to show, for each year, the name of the contributor, the date and amount of the grant, and a brief description of the nature of the grant Do not file this list with your returnDo not include these grants in line 1 S DAA Schedule A (Form 990 or 9904EZ) 2001 8010 02/07/2003 12: 12 PM Schedule A (Form 990 or 990- EZ) 2001 SUBSTANCE ABUSE COUNCIL 65 - 0202835 Page x1 Private School Questionnaire (See page 7 of the instructions .) To be completed ONLY by schools that checked the box on line 6 in Part N 29 Does the organization have a racially nondiscriminatory policy toward students by statement in its charter, bylaws, N/A Yes No other governing instrument, or in a resolution of its governing body? . . . . . 29 30 Does the organization include a statement of its racially nondiscriminatory policy toward students in all its brochures, catalogues, and other written communications with the public dealing with student admissions, programs, and scholarships? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 31 Has the organization publicized its racially nondiscriminatory policy through newspaper or broadcast media during the period of solicitation for students, or during the registration period if it has no solicitation program, in a way that makes the policy known to all parts of the general community it serves? If "Yes," please describe; if "No," please explain. (If you need more space, attach a separate statement:) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 Does the organization maintain the following: . a Records indicating the racial composition of the student body, faculty, and administrative stafr? . . . . . . . . . . . 0 . . . . . . . . . : . . . . . . . . . . . . . . . . 32a b Records documenting that scholarships and other financial assistance are awarded on a racially nondiscriminatory basis? 32b c Copies of all catalogues, brochure!;; announcements, and other written communications to the public dealing with student admissions, programs, and scholarships? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . 32c d Copies of all material used by the organization or on its behalf to solicit contributions? 32d If you answered "No" to any of the above, please explain. (if you need more space, attach a separate statement.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : : . .. . . . . . . . .. . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . 33 Does the organization discriminate by race ' in any way with respect to: a Students' rights or privileges? • • . . . . . .. . . . . . . .. . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . 33a b, . Admissions policies? . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . . . . . .. : . . 33b c Employment of faculty or administrative staff? . . . . . . . . . . .. . . . . . . . . . . . . . . . . . : . . . . d Scholarships or other financial assistance? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . 33d e Educational policies? 33e f Use of facilities? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33f g Athletic programs? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 h Other extracurricular activities? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . . 33h If you answered "Yes" to any of the above, please explain. (If you need more space, attach a separate statement.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34a Does the organization receive any financial aid or assistance from a governmental agency? 34a . . . . . . . . . . . 0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Has the organization's right to such aid ever been revoked or suspended? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34b 4 ' 0 . + If you answered to to either 34a or b , please explain using an attached statement. ;' 41 � 35 Does the organization certify that it has complied with the applicable requirements of sections 4.01 through 4.05 of Rev. Proc . 75-50, 1975-2 C . B . 587, covering racial nondiscrimination? If "No," attach an exolanatjon . . . . . . . . . . . . . 35. Schedule A (Form 990 or 900-EZ) 2001 DAA ' • I dog • • 1 • • • 1 1'1 • UNTol will 1 . • • . . . • • • • . . • - * two ' s • , • TEr . • . . • . • • . • • • - 11 • IJ _ ` � , I �.-,e sof �`�,,�s �-�e-T � .a� -s .,0.. -y.� :'€ �* '�"+" 1 ' • 1 - • • - • • ,�€r `z ez � z �' „gam �c • - 11 111 • • • - 111 111 11 1 . 1 • ' • 1 - :..� • - 11 111 � r��� '•r �:� � � .p._ *i�.��� .:`'�'� �,� .t� ��'� ��z� 4 • - 111 111 • r • - 11 • 11 1 . 1 • w 1 ' , • 1 - • :.. IN 111 • - 11 1 11 • . • • a 1 • 1 111 � 1 1 1 • • 1 - - � r - 11 1 11 �� '� c ��`s �� �� �� ������'���yu.,��� lal zzg BE • • - - • • - • . - • - • 1 � �-.+3 � � ���c "`..,rs����� ..,os�- ,�<`�`' •v�r'�.�z,T "v �,my =w ,{"�`,`,.�i "•$, a^` - • - • • YI 111 • • • • • � • r • • • • • r. t: • - polo 1 ' • F ��L'D r3"e-�"�wp '$ w. t� � t 4� w s` .�"-.�' :? "2, ` #� s»zC,X i'.P ` �`� • F "^-i �F We • • • 2'a `°s`' �"'-,"$�""^„x' • 1 ' • ` ��`� � ,d" � K $.'+'`�*, �' ,m �'r � -J`g �.,•`.k'-�' '`�4'° dux' � 'S'€'3 C` <,u�'�e� � s`'�` j � ��a��,. �"-t.�"`�'�'.• �� „'''�� �'��s'�. mow„' � s�',�" " ^�.��� � '�"r'.� � -�- �``" � �s,".��L �-�,� �- • • 1 • 1 16 8010 02/07/2003 12:12 PM ScheduleA (Form 990 or 990-EZ) 2001 SUBSTANCE ABUSE COUNCIL - 0202835 0202835 Page s Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations (See page 12 of the instructions.) 51 Did the reporting organization directly or indirectly engage in any of the following with any other organization described in section 501 (c) of the Code (other than section 501 (c)(3) organizations) or in section 527, relating to political organizations? a Transfers from the reporting organization to a noncharitable exempt organization of: Yes No (i) Cash 51a(i) X (ii) Other assets a n X . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Other transactions: . . . . . . . . . . . . . . . . (I) Sales or exchanges of assets with a noncharitable exempt organization b i X (i i) Purchases of assets from a noncharitable exempt organization Iii X . . . (iii) Rental of facilities . . . . . . . . . . . .. . . . . . . : . . . . . . , equipment, or other assets . iii X . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (iv) Reimbursement arrangements iv X . . . . . . . . . . 0 . . . . . : . . . . . . . . . . . . . . . . . (v) Loans or loan guarantees . by X (vi) Performance of services or membership or fundraising solicitations b qL X c Sharing of facilities, equipment, mailing lists other assets or Paid employees Xc . . . . . . . . . . . d If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the fair market value of the goods, other assets, or services given by the reporting organization. If the organization received less than fair market value In any transaction or sharing arrangement show in column the value of the goods, other assets, or services received: (a) (b) . (c) (d) Line no. Amount inwhved Name of nonchar table exem' 'pt omanization Desaioon of transfers transactions, and sharing arrangements .1N/A 52a 'Is the organization directly or indirectly affiliated with, or related to, one or more tax"exempt organizations described in section 501 (c) of the Code (other than section 501 (c)(3)) or in section 527? ► Q Yes ® No b If "Yes," com tete the following schedule: (a) (b) (c) Name oro anization Type of organization Description of relationsN N/A DAA Schedule A (Form 990 or 990-EZ) 2001 8010 02/07/2003 12: 12 PM Schedule B (Form 990, 990-EZ, Schedule of Contributors OMB No. 1545-0047 or 990-PF) 2001 Internal� �nu�e SrvicTreasury line 1 of Form 990, 990-EZ Information 0-PF seer instructions Name of organization SUBSTANCE ABUSE COUNCIL Employer identification number OF INDIAN RIVER COUNTY INC . 165 - 0202835 Organization type (check one) : Filers of: Section: Form 990 or 990-EZ ® 501 (c) ( 3 ) (enter number) organization Q4947(a)(1 ) nonexempt charitable. trust not treated as a private foundation 527 political organization Form 990-PF .501 (c)(3) exempt private foundation a4947(a)(1 ) nonexempt charitable trust treated as a private foundation 501 (c)(3) taxable private foundation Check if your organization is covered by General rule or a Special rule. (Note. Only a section 501 (c)(7), (8), or (10) organization can check box(es) for both the General rule and a Special rule-see instructions.) General Rule- . . ® For organizations filing Form 990, 990-F2,. or 990-PF that received, during the year, $5,000 or more (n money or property) from any one contributor. (Complete Parts I and 11.) Special Rules- For a section 501 (c)(3) organization filing Form 990, or Form 990-EZ, that met the 33 1 /3% support test of the regulations 'under sections 509(a)(1 )/170(b)(1 )(A)(v1) and received from any one contributor, during the year, a contribution of the greater of $5,000 or 2% of the amount on line 1 of these forms. (Complete Parts 1 and 11.) For a section 501 (c)(7) , (8) , or (10) organization filing Form 990, or Form 990-EZ, that received from any one contributor, during the year, aggregate contributions or bequests of more than $1 ,000 for use exclusively for religious, charitable, scientific, literary, or educational purposes, or the prevention of cruelty to children or animals. (Complete Parts 1, il, and 111 .) QFor a section 501 (c)(7), (8) , or (10) organization filing Form 990, or Form 990-EZ, that received from any one contributor, during the year, some contributions.for use exclusively for religious, charitable, etc., purposes, but these contributions did not aggregate to more than $1 ,000. (If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the Parts unless the General rule applies to this organization because it received nonexclusivety religious, charitable, etc. , contributions of $5,000 or more during the year.) Caution: Organizations that are not covered by the General rule and/or the Special rules do not file Schedule B (Form 990, 990-EZ, or 990-PF), but they must check the box in the heading of their Form 990, Form 990-EZ, or on line 1 of their Form 990-PF, to certify that they do not meet the filing requirements of Schedule B (Form 990, 990-EZ, or 990-PF). Schedule B (Form 990, 990-EZ, or 99"F) (2001 ) DAA Vu . V W" I I16ww� . .v' . u. Schedule B Form 990, 990-EZ, or 990-PF 2001 Pae 1 to 1 of Part I Name of organization SUBSTANCE ABUSE COUNCIL Employer identification number 165 - 0202835 Part 1 Contributors (See Specific Instructions . ) (a) (b) (c) (d) No. Name, address and ZIP + 4 Aggregate contributions T e of contribution 1MR FRANCIS SMITHERS Person Payroll . . O , BOX 218 $ . . . . . . . . . . . . 1.0 .01. 0 00. Noncash VERO BEACH FLORIDA 32970 (Complete Part II ff there is . . . . . . . ! . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . a noncash contribution.) (a) (b) c (d) No. Name address and ZIP + 4 O Aggregate contributions Type of contribution 2WARREN SCHWERIN Person 890 SEAWARD DRIVE Payroll � . . . . . . - . . . . . a0 , 000 Noncash . (Complete Part 11 if there is VERO: BEACH , r FLORIDA 32963 . . . . . . . . . . . . . . . . . a noncash contribution.) (a)' . (b) (c) (d) No. Name address and ZIP + 4 Aggregate contributions Type of contribution 3 UNITED - wAY OF INDIAN RIVER COUNTY Person Payroll . . . . . . . . . . . . .. . . . . $ • . . . . . . . . 4 0 , 4 1 9 Noncash (Complete Part II if there is . . . . . . . . . . . . . . . : . . . : : : a noncash contribution.) No. (b) (c) (d) Name address and ZIP + 4 Aggregate contributions Tyrie of:corrtribution . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Person . Payroll . . . . . . . . . . . : . . . . . . . . . . . . . . . . . . . . $ Noncash (Complete Part 11 if there is . . . . . . . a noncash contribution .) T77 b) (c) (dl ss and ZIP + 4 A ate contributions T of contribution . . . . . . . . . . . . . . : Person Payroll . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Noncash (Complete Part II if there is . . . . . . . a noncash contribution .) (a) (b) Vic) (d) No. Name, address and ZIP + 4 A re ate contributions T of contribution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Person Payroll . . . . . . . . . . . . . . . . . $ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Noncash (Complete Part II if there is . . a noncash contribution. ) DAA Schedule B (Foran 99o, 990-Fl, or 990-PF) (2001 ) 8010 02/07/2003 12:12 PM Depreciation and Amortization OMB No. 1545-0172 Form 4562 (Rev. March 2002) ( Including Information on Listed Property) 2001 Department of the Treasury Attachment 67 Internal Revenue Service 10' See se ►rate instructions. Attach to our tax return. Sequence No. Name(s) shown on return SUBSTANCE ABUSE COUNCIL Identifying number OF INDIAN RIVER COUNTY INC . 65 - 0202835 Business or activity to which this form relates INDIRECT DEPRECIATION Pam 4f Election To Expense Certain Tangible Property Under Section 179 Note : If you have any listed property, Complete Part V before you complete Part I . 1 Maximum amount. See page 2 of the instructions for a higher limit for certain businesses 1 $241000 2 Total cost of section 179 property placed in service (see page 3 of the instructions) . . . . . . . . . . . . . . 2 3 Threshold cost of section 179 property before reduction in limitation . . .. . . . 000 . . . . . . . . . . . . . . . . . . . . 3 $. . . . . . . . . . . . . . . . . . . 4 Reduction in limitation. Subtract line 3 from line 2. If Zero or less, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . 4 5 . Dollar limitation for tax year. Subtract line 4 from line 1 . If zero or less, enter -0-. If married filing rat , see pg. 3 of the Instr.5 a Description of b Cost business use on c Elected cost 6 7 Listed property. Enter the amount from line 29 7 8 Total elected cost of section 179 property. Add amounts in column (c), fines 6 and 7 g . . . . . . . . . . . . 9 9 ' Tentative deduction. Enter the smSilter of line 5 or line 8 . . . . . . . . . .`. . . . . . : . . . . . . . . . . 10 10 . Carryover of disallowed deduction from line 13 of your 2000 Form 4562 11 Business income limitation. Enter the smaller of business income (not less than zero) or line 5 (see instructions) 11 12 Section 179 expense deduction. Add lines 9 and 101 but do not enter more than line 11 12 13 Carryover of disallowed deduction to 2002. Add lines 9 and 10less line 12 ► FITE Note: Do not use Part II or Part III below for listed property, Instead use Part V. SWON cial De reciation Allowance and Other Depreciation Do not include :listed prope 14 Special depreciation allowance for certain property (other than listed property) acquired after Sept ' 10, 2001 (see pg. 3 of the instr.) 14 898 15 Property subject to section 168(f)(1 ) election (see page 4 of the instructions is. Other depreciation (including ACRS see page 4 of the instructions) 1s 15 717 MACRS Depreciation (Do not include listed property ) (See page 4 of the instructions ) Section A ' 17 MACRS deductions for assets . placed in service in tax years beginning before 2001 17 . . . . . . . . . . . . . . 18 If you are electing under section 1680(4) to group any assets placed in service during the fax year into one or more cieneral asset accounts, check here Section B-Assets Placed in Service During 2001 Tax Year Using the General Depreciation System {a) Classification of (b) Month and (c) Basis for depreciation d) Recovery property year placed in (businessfinvestment use (e) Convention (f) Method (g) Depreciation deduction serwce on -see instnicti period 19a 3-year property b 5 ear pro rty c .7- ear rorty d 10-year property e 15-year property f 20 ear property 25 ear 2ropertyx 25 S/L h Residential rental 27.5 MM S/L 2roperty 27.5 yrs. MM S/L I Nonresidential real 39 yrs. MM S/L 2ropertyMM S/L Section C-Assets Placed in Service During 2001 Tax Year Usinthe Alternative Depreciation System 20a Class life MW S/L b 12- ear 12 yrs. S/L C 40 ear 40 MM S/L a ly- Summa See page 6 of the instructions . 21 Listed property. Enter amount from line 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 22 Total . Add amounts from line 12, lines 14 through 17, lines 19 and 20 in column (g), and line 21 . Enter here and on the appropriate lines of your return . Partnerships and S corporations-see instr. . _ . . . . . . . . 22 16r615 23 For assets shown above and placed in service during the current year, enter the ortion of the basis attributable to section 263A costs 23 For Paperwork Reduction Act Notice, see separate instructions. Form 4362 (2001 ) (Rev. 3-2002) DAA 8010 02/07/2003 12:12 PM SUBSTANCE ABUSE COUNCIL 65 - 0202835 Form 4562 (2001 ) (Rev. 3-2002) Page 2 �ai'1 Listed Property (Include automobiles, certain other vehicles, cellular telephones , certain Computers , and property used for entertainment, recreation , or amusement.) Note: For any vehicle for which you are using the standard mileage rate or deducting lease expense, complete only 24a 24b columns a throw h Ll of Section A all of Sggtion SectionB and Section C if applicable. Section A-0e reciation and Other Information Caution : See page 8 of the instructions for limits for passenger automobiles. 24a Do you have evidence to support the businessrnvestment use claimed? Yes No 24b If Yes," is the evidence written? Yes No (a ) (b) (c) Type of prop. Date placed in Busn.finvest Cost (or other Basis for depreciation Recovery Method/ De lh) (1) (list vehicles service use ry Depreciation Elected first basis (business/investment period Convention deduction . section 179 percentage use only) 25 Special r poperiy acquired after September 10, 2001depreciation allowance for listed cost, and used more than 50% in aualifiied business use see page 7 of the instructions) 28 26 Pro used more than 50% in a ual red business use see 7 of the instructions 27 Pro used 50% or less in a oualified business use see paqe 7 of the Instructions): S/L- S/L- . 28 Add amounts in column (h), lines 25 through 27. . Enter here and on line 21 , page 1 728 29 Add amounts in column i line 26. Enter here and on line 7 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . Section B-Information on Use of Vehicles Complete this section forYehicles used by a sole proprietor; partner, or other "more than 5% owner," or related person. If you provided vehicles to your employees, first answer the questions in Section C to see V meet an exce to can this section for those vehicles. 30 Total business/investrnent miles driven during , '(a) (b) (c) (� (e). Mthe year (do not include commuting miles- Vehicle 1 Vehicle 2 Vehicle 3 Vehicle 4 Vehicle 5 Vehicle 6 . see page 2 of the instructions) 31 Total commuting miles driven during the year 32 Total other personal (noncommuting) miles driven 33 Total miles driven during the year. Add lines 30 through 32 34 Was the vehicle available for personal Yes No Yes No Yes No Yes No Yes No Yes No use during off-duty hours? . . . 35 Was the vehicle used primarily by a more than 5% owner or related person? . . . . . . . . . . . 36 Is another vehicle available for Personal use? Section C Questions for Employers Who Provide Vehicles for Use by Their Employees Answer these questions to determine if you meet an exception to completing Section B for vehicles used by employees who are not more than 5% owners or related persons see pa 8 of the instructions). Yes No 37 Do you maintain a written policy statement that prohibits all personal use of vehicles, including commuting, by your employees? 38 Do you maintain a written policy statement that prohibits o ' ' e . ? . ' . ' . ' ' . . • ' • • • ' p personal use of vehicles, except commuting, by your employees? See page 8 of the instructions for vehicles used by corporate officers, directors, or 1 % or more owners 39 Do you treat all use of vehicles by employees em to as personal use? . . . . . . . . . . • • . . . 40 Do you provide more than five vehicles to your employees, obtain information from. your em I . . . . . . . . . Y P oY� about . . . . . the use of the vehicles, and retain the information received? 41 Do you meet the requirements concerning qualified automobile demonstration use? (See page 9 of the instructions.) Note: If our answer to 37, 38, 39, 40 or 41 is "Yes " do not con fete Section B for the covered vehicles. ` n Amortization MW (a) (b) (c) (d) Amortization (� Description of costs Date amortization Amortizable Code period ti Amortization for begins amount section rcenta a this year 42 Amortization of costs that ins Burin our 2001 tax ear see a e 9 of the instructions 43 Amortization of costs that began before your 2001 tax year43 337 44 Total. Add amounts in column . See page 9 of the instructions for . . . . DAA where to report 44 337 Form 4562 (2001 ) (Rev. 3-2002) E UBSTANCE ABUSE COUNCIL 2/7/2003 12 : 12 PM 835 Federal Statements 0/2002 Statement 1 - Form 990 Line 10c - Sales of Inventory Gross Gross Description Sales COGS Profit SALE OF DRUG TESTING KITS $ 8 , 132 $ 3 , 748 $ 41384 TOTAL $ 8 , 132 $ 31748 $ 4 ; 384 1 8010 SUBSTANCE ABUSE COUNCIL 2/7/2003 12 : 12 PNI 65-0202835 Federal Statements FYE : 9/30/2002 Statement 2 -_ Form 990, Part 11 , Line 43 - Other Functional Expenses Total Program Mgt & Fund- Description Expenses Service General Raising EXPENSES CONTRACT LABOR 39, 120 . 39 , 120 PROFESSIONAL FEES 33. 4 252 82 INSURANCE 5 , 698 51492 1172 3 PROFESSIONAL DEVELOPMENT 16 , 641 16 , 641 ' MEMBERSHIP 125 125 MISCELLANEOUS 914 141 • 773 SUBSCRIPTIONS 599 . 599 FUNDRAISING 10 , 083 10 08 TOTAL $ 73 , 514 $ 61 , 771 $ 1 , 626 $ 10 ., 11 . Gad Statement 3 Form 990, Part III Line a - Statement of Program Service Accomplishments . THE SUBSTANCE ABUSE COUNCIL IS AN INFORMATION AND REFERRAL . ORGANIZATION . THE COUNCIL ' S PRIMARY OBJECTIVE IS TO EDUCATE AND TO AID IN THE PREVENTION OF ALCOHOL AND OTHER .DRUG ABUSE : 2-3 8010 SUBSTANCE ABUSE COUNCIL 2/7/2003 12 : 12 PM 65-0202835 Federal Statements FYE : 9/30/2002 Statement 4 - Form 990, Part IV, Line 58 - Other Assets Beginning End of Description of Year Year SECURITY DEPOSIT $ 2 . 1574 $ 21574 TOTAL . $ 2 , 574 $ 2 , 574 Statement 5 - Form 990, Part IV, Line 65 - Other Liabilities Beginning End of Description of Year Year NOTES PAYABLE $ 11659 ' . $ TOTAL $ - 11659 $ 0 4-5 8010 SUBSTANCE ABUSE COUNCIL 2/7/2003 12 : 12 PM 65-0202835 Federal Statements FYE : 9/30/2002 Statement 6 - Form 990 Part MA - Other Revenue Included in Financial Statements Description Amount EXPENSES NETTED AGAINST INCOME FOR SPECIAL EVENTS $ 3 , 748 TOTAL $ 31748 Statement 7 - Form 990 Part IV-B - Other Ex enses Included in Financial Statements Description Amount EXPENSES NETTED AGAINST INCOME ON TAX . RETURN $ 31748 TOTAL $ 3 , 748 Statement 8 - Form 990 Part V = List of Officers Directors Trustees and Key Employees Name Address Average Title Hours Compensation - Benefits Expenses - TRAVIS ESLINGER VERO BEACH , FL BOARD 5 . JOAN GENTGEN VERO BEACH , FL BOARD 5 . PAUL GRAVES VERO BEACH , FL BOARD 5 FRED JONES VERO BEACH , FL BOARD 5 DONALD MCCARTHY VERO BEACH , FL BOARD 5 JIM MCKEE VERG BEACH , FL BOARD 5 ' DAVID MORGAN VERO BEACH , FL BOARD 5 MARIANA NIGH VERO BEACH , FL BOARD 5 BECHIE SELPH VERO . BEACH , FL BOARD 5 C.HARLENE TARDI VERO BEACH , _ FL BOARD 5 VIRGINIA WELTON VERO BEACH , FL BOARD 5 SCOTT TAYLOR VERO BEACH , FL BOARD 5 DR . PAUL BAKULE VERO BEACH , FL BOARD 5 JEFFREY BARTON VERO BEACH , FL BOARD 5 BRUCE COLTON VERO BEACH , FL BOARD 5 DR , ROGER DEARING VERO BEACH , FL BOARD 5 JIM GABBARD VERO BEACH , FL BOARD 5 6-8 8010 SUBSTANCE ABUSE COUNCIL 2/7/2003 12 : 12 PM 65-0202835 Federal Statements FYE : 9/30/2002 Statement 8 - Form 990 Part V - List of Officers Directors Trustees and Key Employ... (continued ) Name Address Average Title Hours Compensation Benefits Expenses DIAMOND LITTY VERO BEACH , FL BOARD 5 JUDGE MARC CIANCA VERO BEACH , FL BOARD 5 HARRY OFF UTT , C . P . A . VERO BEACH, . FL , BOARD 5 SHERIFF . ROY RAYMOND VERO BEACH ,. FL BOARD 5 BONNIE SWANSON VERO BEACH - FL BOARD 5 CAPT .. . BILL MCMULLENVERO BEACH , FL BOARD 5 TOM WHITE VERO BEACH , FL BOARD 5 i j 8 8010 SUBSTANCE ABUSE COUNCIL 02/07/2003 12 : 12 PM 65- 0202835 Federal Asset Report FYE : 9/30/2002 Indirect Depreciation Date Bus Sec Sec Asset Description In Service Cost % 179 168 ( k) Basis Per Conv Meth ' Prior Current sear GDS Property: 39 COMPUTER 11 /20/01 1 ,700 1339 1 ,360 5 HY 20ODB 0 . 0 40 COMPUTER 6/21 /02 12500 300 1 ,200 5 HY20ODB 0 0 41 COMPUTER 8/23/02 1 ,288 257 1 ,030 5 HY 200DB 0 0 4,488 897 32590 0 0 Other De reciation : I VIDEO 10/01 /96 4,890 0 4,890 5 MO S/L 47890 0 2 VIDEOS 1 /31 /98 11525 . 0 1 ,525 5 MO S/L 1 , 118 305 3 COMPUTER 1 /31 /97 2,646 0 21646 7 MO S/L 1 ,784 378 4 COMPUTER 1/31 /97 2,646 0 27646 7 . MO S/L 1 ,784 378 5 HP LASERJET 1 /24/97 780 0 7807 MO S/L 520 111 6 PORTABLE COMPUTER 8/18/98 . 31447 0 3 ,447 7 MO S/L 11559 492 7 COMP & MONITOR 10/14/98 . 1 ,870 0 10870 7 MO SIL 801 267 8 TV/VCR 10/12/94 300 0 300 5 MO S/L 300 0 9 SHARP FAX MACHINE 9/04/96 217 0 217 5 . MO S/L 217 0 12 4DR FILE CABINET 1 /18/98 373 0 373 5 MO S/L 247 75 13 TOSHIBA COPIER 10/01 /96 1 ,400 0 1 ,400 5 MO &L 1 ,400 0 14 HP PRINTER 8/27/96 199 0 199 5 MO SIL 199 0 15 MOBILE CHALL. EQUIP, 6/17/99 4,751 0 4 ,751 5 MO S/L 2,217 950 16 CIMTEC COMPUTER 8/14/00 12100 0 . 1 , 100 7 MO S/L 183 157 17 DESK 3/10/00 661 0 661 5 MO S/L 209 132 18 TABLES 3/10/00 954 0 954 5 MO S/L 302 191 19 EXEC . OFFICE FURNITURE 6/28/00 5 ,954 0 5,954 5 ' MO S/L 11488 1 , 191 20 1999 FORD VAN 1 /15/00 25 ,434 0 25 ,434 5 MO S/L 8,902 52087 21 COMPUTER 6/12/00 970 0 970 7 . ' MO S/L 185 139 22 TELEPHONE SYSTEM 1 /15/97 1 ,070 0 1 ,070 5 MO S/L 12017 54 23 CHAIRS 5/15/97 978 0 978 5 MO S/L 864 . 114 24 CHAIRS 5/15/98 19050 0 1 ,050 5 MO S/L 717 210 25 TELEPHON 7/15/98 375 0 375 5 MO S/L 244 75 26 PHONES 5/15/99 115 0 115 5 MO S/L 56 23 27 HP 6P PRINTER 5/30/99 500 0 500 5 MO S/L 233 100 28 CHAIRS 6/ 15/99 , 990 0 990 5 MO S/L 462 198 29 LATERAL FILES 5/15/99 796 0 796 5 MO S/L 385 159 30 CHAIRS 12/15/98 502 0 502 5 MO S/L 284 100 31 PHONES 10/ 15/98 330 0 1830 5 MO S/L 198 66 32 LATERAL FILES 6/15/99 2,032 0 2,032 5 MO S/L, 948 406 33 HP PRINTER 7/15/99 499 0 499 5 MO S/L 225 100 34 COMPUTER 11/04/00 2,450 0 , 25450 7 MO S/L 321 350 35 COPIER 1 /31 /01 13 ,408 . 0 13 ,408 5 MO S/L 1 ,788 22682 36 COMPUTER 10/11 /00 . 2, 158 0 . . 2, 158 7 MO S/L 308 308 37 OFFICE FURNITURE 10/11 /00 4, 118 0 4 , 118 5 MO S/L 824 824 42 SOFTWARE 3/27/02 569 0 569 3 MO S/L : 0 95 Total Other Depreciation 922057 0 92,057 . 37, 179 15 ,717 Total ACRS and Other Depreciation 922057 0 92,057 37, 179 15,717 8010 SUBSTANCE ABUSE COUNCIL 65-0202835 Federal Asset Report 02/07/2003 12 : 12 PM FYE : 9/30/2002 Indirect Depreciation . AssetDate Bus Sec . Sec Descri tion In Service Cost % 179 168( k) Basis Per Conv Meth Prior Current - - Amortization : 38 DESK TOP PUBLISHING 10/02/00 14010 0 _ 1 ,010 3 MOAmort . 337 337 0 1 ,010 337 337 -- Grand Totals 97,555 897 96,657 Less: Dispositions 0 0 0 37;516 16 ,054 Net Grand Totals0555 1 0 897 96,657 37 516 16,054 � �� �� 8010 01 /27/2003 3:56 PM Form 8868 Application for Extension of Time To File an (December 2000) Exempt Organization Return OMB No. 1545-1709 Department of the Treasury Internal Revenue service ► File a separate a0plication for each return . • If you are filing for an Automatic 3-Month Extension, complete only Part 1 and c(leck this box ► . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • If you are filing for an Additional (not automatic) 3-Month Extension, complete only Part II (on page 2 of this form). Note: Do not complete Part II unless you have already been granted an automatic 3-month extension on a previously filed Form 8868. .Part I Automatic 3-Month Extension of Time- Only submit original (no copies needed ) Note : Form 990-T corporations requesting an automatic 6-month extension-check this box and complete Part I only ► . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . All other corporations (including Form 990-C filers) must use Form 7004 to request an extension of time to file income tax returns. Partnerships, REMICs and trusts must use Form 8736 to request an extension of time to file Form 1065 1066 , or 1041 . Type or Name of Exempt Organization Employer identification number print SUBSTANCE ABUSE COUNCIL File by the OF INDIAN RIVER COUNTY 165 - 0202835 due date for Number, street, and room or suite no. If a P.O . box, see instructions. filing your 2501 2 7TH AVENUE A- 7 return. See instructions. City, town or post office, state, and ZIP code. For a foreign address , see instructions. VERO BEACH FL 32960 Check type of return to be filed (file a separate application for each return ): Form 990 . Form 990-T (corporation) Form 4720 Form 990-BL Form 990-T (sec. 401 (a) or 408(a) trust) Form 5227 Form 990-E7 Form 990-T (trust other than above) Form 6069 Form 990-PF Form 1041 -A Form 8870 • If the organization does not have an office or place of business in the United States, check this box ► • If this is for a Group Return, enter the organ'ization's four digit Group Exemption Number (GEN) If this is for the whole group, check this box ► 0 . if it is for part of the group, check this box ► and attach a fist with the names and EINs of all members the extension will cover. 1 I request an automatic 3-month (6-month , for 990:T corporation) extension of time until . . 5 / 3. 5/ 03 , to file the exempt organization return for the organization named above. The extension is for the organization's return for. ► calendar year — or ► tax year beginning 10 / OIL01 , and ending _ 9 / 3OL02 2 If this tax year is for less than 12 months, check reason: Initial return Final return Change in accounting period 3a If this application is for Form 990-BL, 990-PF, 990-T, 4720, or 6069, enter the tentative tax, less any nonrefundable credits. See instructions $ . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b if this application is for Form 990-PF or 990-T, enter any refundable credits and estimated tax payments made. Include any prior year overpayment allowed as a credit $ c Balance Due. Subtract line 3b from line 3a. Include your payment with this form, or, if required , deposit with FTD coupon or, if required, by using EFTPS (Electronic Federal Tax Payment System). See instructions $ Signature and Verification Under penalties of perjury, I declare that I have examined this form , Including accompanying schedules and statements, and to the best of my knowledge and bellef)t belief) is true , corr ct, and cofnpiete , and that I am authorized to prepare this form. JAN 2 9 2003 Signature ► T'itte ► 7PA Date ► For Paperwork Reduction Act Not'rK see Instruction Form 8868 ( 12-2000) e RE : MK / 8010 / SUBSTANCE Page: 1 SAC new 2002 May 27, 2003 Income Statement For the Six Months Ending March 31 , 2003 Current Month Current Month Year to Date Annual Budget Actual Budget Actual Budget Revenues Garnishment fee to Council 4 .00 0 .00 49 .00 0.00 United Way 5 ,333 . 34 39333 . 33 22,000.04 199999 .98 United Way-Dasie Hope 31333 .34 31333 .34 105000.02 109000.02 Character Counts Program 0.00 0.00 4, 100.00 4, 100.00 Fundraising General 2 ,647 . 32 0 .00 2,997 .32 500 .00 Golf Tournament 0.00 0.00 4,887 .00 5 ,000.00 Drug Screen Kits 745 . 00 666.67 32328 .00 4,000.02 Steps to Freedom 154 .50 154.50 772 .50 927 .00 TARGET Troupe Fundraisers 12874 . 67 583 .33 52227 .67 3 ,499 .98 Tobacco Violators Grant Income 345 .00 58 .33 520.00 349.98 Adult Court Ordered Program 125 .00 333 .33 1 ,224 .00 1 ,999 .98 Program AWARE 1 ,230 .00 1 ,000 .00 4,775 .00 61000.00 Right Choice 5 , 189 . 86 3 ,750 .00 22, 199 .69 22 ,500 .00 TIPS Grant 12356 . 15 12666 .67 9,544 .41 10,000.02 Adult Memberships 0 .00 541 .67 41860.00 3 ,250 .02 Children and Familes Lifeskill 61250 . 18 69250.00 379501 .08 379500.00 Dasie Hope Program 71171 .07 32750.00 52,621 .42 22,500.00 Dasie Hope relief 0.00 0 .00 6, 170.00 0.00 dasie Hope Fundraising 1 ,342 .00 0.00 11342 .00 0.00 PREVENT Grant 62836 .41 5 ,333 . 33 269699 .44 319999 .98 Anti Drug Abuse Grant 19763 . 52 12666 . 67 10,689 . 12 10,000.02 Tobacco Grant 2 , 139 .90 19666 .67 5 ,964 . 88 109000.02 Lifeskills Grant 42019 . 04 21916 .67 17,658 .78 179500.02 Teen STEP Grant 11 ,475 .35 6,333 . 33 32,068 . 18 372999.98 HIV Grant 11 ,401 . 77 10, 166 .67 62 , 187 .02 612000.02 Law-Drug Forfeiture Fund MACE 4, 131 .00 0 .00 4, 131 .00 41000.00 John's Island Community Servic 0.00 0 . 00 12 ,000.00 12,000.00 Contributions 0.00 375 .00 19801 .03 2,250.00 Drug Free Workplace Fees 0. 00 41 .67 0 .00 250.02 Total Revenues 78 ,868 .42 53 ,921 . 18 3679318 .60 339, 127 .06 Cost of Sales Total Cost of Sales 0 .00 0.00 0 .00 0.00 Gross Profit 78 ,868 .42 532921 . 18 3672318 .60 339, 127 .06 Expenses Salaries Substance Abuse SAC 5 ,774 . 83 62206 . 50 32,831 . 13 372239.00 Salaries PREVENTProgram 13145 . 83 21291 .67 3 ,205 .49 13 ,750.02 Salaries Anti Drug Admn Grant 1 ,266 .66 1 ,266 .67 75899 .96 7,600.02 Salaries Tobacco 12291 . 50 21288 .00 5,413 .50 13 ,728 .00 Salaries Lifeskills 52983 .00 3 ,861 . 00 30,717 . 53 23 , 166 .00 Salaries HIV TARGET 8 ,345 . 73 61458 .33 56,502 .00 382749 .98 Salaries Right Choice 1 ,531 .24 1 ,500 .00 9, 187 .44 9,000.00 Salaries- Dasie Hope 42691 . 50 3 ,916 .67 24,233 .48 23 ,500 .02 Salaries- DJJ 2,291 . 66 22291 .67 12 ,783 .26 13 ,750.02 Salaries TIP's 0 .00 12250. 00 0.00 7,500.00 Fundraising Expense 0 .00 0 .00 4,200.00 0.00 Right Choice Contract Labor 19470 .00 12091 . 67 69000.00 6,550.02 Contract Labor Tobacco Violato 100 .00 50 .00 150 .00 300.00 Contract Labor Chaacter Counts 2 , 500 . 00 0 .00 14,500 .00 15 ,000.00 Contraact Labor Program AWARE 720 . 00 500 .00 22430.00 3 ,000.00 For Management Purposes Only Page: 2 SAC new 2002 May 27, 2003 Income Statement For the Six Months Ending March 31 , 2003 Current Month Current Month Year to Date Annual Budget Actual _ Budget Actual Budget Contract Labor PREVENT 300 .00 125 .00 11740.00 750.00 Contract Labor DJJ 240 .00 180 .00 2,206 .33 1 ,080.00 Contract Labor Lifeskills 19250.00 416 .67 3,500.00 2,500.02 Contract Labor-Dasie 1 ,800 .00 0.00 1 ,800.00 0.00 Employee Benefits SAC 110. 52 725 .00 31970.95 4,350.00 Employee Benefits PREVENT 0.00 0 .00 487 . 83 600.00 Employee Benefits Anti Drug Ad 0.00 25 .00 0.00 150.00 Employee Benefits-Lifeskilis 43 .92 254 . 17 819 .60 12525 .02 Employee Benefits HIV TARGET 0.00 475 .00 39037 .00 29850.00 Employee Benefits Right Choice 0.00 225 .00 1 ,800.00 19350.00 Employee Bebefits Dasie 0.00 79 . 17 0.00 475 .02 Employee Benefits DJJ 68 .74 200 .00 19868.74 19200.00 FICA Substance Abuse SAC 0.00 0 .00 <445.00> 0.00 MEDICARE SAC 187 .71 403 .00 892 . 15 29418 .00 MEDICARE Prevent Program 16 .61 0.00 39.93 0.00 Medicare Lifeskills 47 .29 0 .00 245 .84 0.00 Medicare HIV TARGET 84 .20 0 .00 498.32 0.00 Medicare Right Cho 44 .40 0 .00 270.03 0.00 Medicare-Dasie Hope 46 . 50 0.00 324 .65 0.00 Medicare DJJ 33 .22 0.00 211 .24 0.00 Retirement account 286 . 36 345 . 50 11718 . 16 2,073 .00 Social Security SAC 801 . 80 15722 .92 41084 .32 10,337 .52 Social Security Prevent 71 .04 0 .00 236 .34 0.00 Social Security Lifeskills 202 .24 0.00 11109 . 52 0.00 Social Security HIV TARGET 359 .98 0 .00 27130.47 0.00 Social Security Right Cho 189 . 88 0.00 12150 .26 0.00 Social Security Dasie 202 . 21 0 .00 1 ,391 .56 0.00 Social Seurity DJJ 142 .08 0 .00 903 .42 0.00 Professional Fees SAC 70.00 0 .00 41718 .00 11333 .34 Professional Fees Prevent 0 .00 10. 83 0.00 64.98 Professional Fees "Character" 0.00 0 .00 100.00 0.00 Professional Fees HIV 0.00 10.42 0.00 62 . 52 Profess Subscriptions SAC 30.00 50 .00 60.00 300.00 Profess Subscriptions Prevent 0.00 0.00 469 .40 0.00 Supplies & Materials SAC 32091 . 74 500 .00 69879 . 17 39000.00 Supplies LST 1 ,285 .00 16 .67 1 ,293 .42 100.02 Pager 0 .00 150 .00 523 .40 900.00 Supplies & Materials PREVENT 703 .98 12750 .00 29526 . 59 10,500 .00 Supplies Tobacco 0 .00 208 .33 191 .79 1 ,249.98 Supplies C .Counts 0.00 0 .00 759 .97 0.00 183 . 23 0 .00 2,961 .55 0.00 Supplies Supplies -DJJ 102 .43 0.00 102 .43 0.00 Supplies HIV TARGEt 38 .47 1 ,000 .00 6,093 .02 69000.00 Supplies Right Choice 338 . 26 166.67 885 .07 10000.02 Supplies Dasie Hope 29698 .96 500.00 6 ,554 .76 3 ,000.00 Supplies LST 253 . 33 41 .67 270.90 250.02 Telephone SAC 764 . 76 333 .33 1 ,323 .51 19999.98 Telephone PREVENT 339 .45 166 .67 2 ,471 .56 1 ,000.02 Telephone HIV 425 .77 166 .67 2 ,462 .78 1 ,000.02 Telephone-Dasie 133 .75 125 .00 368 .28 750.00 Postage SAC 392 . 16 41 .67 11496 .64 250 .02 Postage Prevent 0 .00 41 .67 33 .29 250.02 Postage HIV TARGET 0.00 41 .67 4 . 10 250.02 Insurance office/liability SAC 1 ,718 . 55 58 .33 21123 . 87 349 .98 Insurance office/ Prevent 0 . 00 41 .67 0 .00 250.02 Insurance -Van 893 . 50 500 .00 11733 .03 39000.00 For Management Purposes Only Page: 3 SAC new 2002 May 27, 2003 Income Statement For the Six Months Ending March 31 , 2003 Current Month Current Month Year to Date Annual Budget Actual Budget Actual Budget Insurance office/ HIV TARGET 0.00 41 .67 128 .67 250.02 Office Rent SAC 999.00 989 .00 6,046.95 59934.00 Office Rent Prevent 540.00 540 .00 3 ,240.00 3 ,240.00 Office Rent HIV TARGET 390.00 390.00 2 ,340.00 22340.00 Workers Comp Ins, 0.00 330.67 2,652 .67 1 ,984.02 Equip Rent & Repair SAC 469. 75 41 .67 664 .71 250.02 Equip Rent & Repair Prevent 0.00 33 .33 126.99 199 .98 Equip Rent & Repair 202 . 19 0. 00 803 .70 0.00 Equip Rent & Repair HIV TARGET 0.00 41 .67 304.00 250.02 Utilities SAC 34 . 84 125 .00 615 .88 750.00 Utilities Prevent 96 .32 83 . 33 294 . 12 499.98 Utilities HIV TARGET 32 .96 125 .00 481 .35 750.00 . . Utilities Dasie 196 .43 125 .00 506.22 750.00 Bank Fees & Credit Card Fees 70.09 0.00 202 . 84 0000 General Education Materia SAC 0.00 0.00 525 .00 0,00 Professional Development SAC 11724.40 166 .67 2 ,723 . 68 1 ,000.02 Professional Development HIV 325 .00 41 .67 365 .00 250.02 Profession Devlop Right Choice 0.00 83 .33 0 .00 499 .98 Professional DevelopmentLifesk 0.00 83 .33 372. 84 499.98 Staff & Volunteer Devel . SAC 209 . 71 458 . 33 19440. 13 21749.98 Staff & Volunteer Dev. Target 0.00 2 ,200 .00 19.77 2,200.00 Staff & Volunteer Dev C.Counts 0.00 0 .00 955.00 0,00 Staff & Volunteer Dev. PREVENT 15 .00 41 .67 89.68 250.02 Staff & Volenteer Devl-Dasi 39. 84 0.00 505.45 0.00 Printing SAC 0 .00 583 . 33 0.00 32499.98 Printing Prevent 218 .00 666 .67 971 .34 4,000.02 Printing Right Choice 0.00 41 .67 0.00 250.02 Adverising PREVENT 325 .00 166 .67 21344 .73 11000.02 Travel & Conference SAC 1 ,707.20 558 . 33 51405 . 19 39349.98 Travel & Conferences Prevent 199 .01 66 . 67 3 , 103 .07 400.02 Travel & Conference Tobbaco 141 . 23 83 .33 381 .06 499 .98 Travel & Conference LST 205 .03 83 . 33 1 ,066 .48 499 .98 Travel & Conf HIV TARGET 1 ,346 . 56 250 .00 2,835 . 81 19500.00 Travel & Conf Right Choice 66 . 99 66 .67 484.06 400.02 Travel & Conferences DJJ 89 . 50 87 . 50 781 . 13 525 .00 Travel & Conferences- TIPS 0.00 0 .00 410.75 0.00 Specific Assistance 1 ,000 .00 0 .00 11145 .00 0.00 Specidfic Assistance-Dasie Hop 0.00 0 .00 41150.00 0.00 Awards & Grants C. Counts 0 .00 0.00 600.00 0.00 Awards & Grants SAC 0 .00 166 . 67 342 .00 1 ,000.02 Luncheon Expenses 0.00 166 .67 0.00 1 ,000.02 Candy Expense 0 .00 83 .33 140. 14 499.98 Drug Screening Kits 12066 .00 416 .67 39530.00 21500.02 Total Expenses 68 ,814 .04 53 ,498 . 73 345,547 .39 3269925 .72 Net Income $ 10,054 . 38 $ 422 .45 $ 21 ,771 .21 $ 12,201 .34 For Management Purposes Only SAC new 2002 Balance Sheet March 31 , 2002 ASSETS Current Assets Citrus Bank-Checking $ <29276 . 87> Petty Cash 120.00 IRNB Savings General 25238 . 13 IRNB Savings PREVENT 31300.00 IRNB Savings Youth Programs 100. 00 IRNB Savings Vocelle 245 . 00 IRNB Savings Golf Tournament 482 .31 IRNB Savings C. Counts 89246 . 15 IRNB C.0 Health Promotion 764 . 74 IRNB UW One Time Grant 1998 317 .06 IRNB TARGET Fundraising <60 .00> IRNB C.CYouth Recognition 293 .94 IRNB-Dasie Hope Center 441 . 04 A/R Grant PREVENT 41238 .03 A/R Grant ADMIN 1 ,698 .94 A/R Tobacco Grant 62034 .41 A/R Grant RIGHT CHOICE 32598 .31 A/R Grant HIV TARGET 119303 .68 A/R Grant Steps to Freedom 309.00 A/R Grant Lifeskills 4, 197 . 97 A/R Grant Teen STEP 51069 .08 A/R Children and Familes Life 18,750. 51 A/R School Board Tobacco Grant 42080.00 Deposits Security 29573 . 82 Total Current Assets 76,065 .25 Property and Equipment Computer Equipment 149036 .92 Computer Equipment 31668 . 97 Computer Equipment 21060 . 79 Software 19578 .40 Video's 49890 .00 Video's 1 ,525 . 00 Furniture & Equipment 407966 .96 Furniture & Equipment 604 . 80 Vehicles 27,234 .60 Accum Deprec-Equipment < 149527 .32> Accum Deprec-Equipment <296 . 54> Accum . Deprec. Vehicles <8 ,901 .90> ACC DEPREC VIDEOS <6,008 .40> Accum. Depreciation Computers <7 , 176 .43 > Accum. Depreciation Computers <269 .49> Amortization- Software <336 .50> Total Property and Equipment 59,049 .86 Other Assets Total Other Assets 0 .00 Total Assets $ 135 , 115 . 11 LIABILITIES AND CAPITAL Current Liabilities Unaudited - For Management Purposes Only SAC new 2002 Balance Sheet March 31 , 2002 Federal W/H Tax Payable $ 21970 .65 FICA Tax Payable 3 ,399 .50 Medicare Tax Payable 636 .70 Midicare Tax Pay Right Cho 180 .00 Retire Deduction Payable 22213 .02 Health Payroll Deduction 151 .90 Payroll Dec United Way 461 . 50 accrued vacation 91218 . 12 Garnishment 975 .00 Deferred Golf Revenue 14,050.00 Loan IRNB 1 ,658 .83 Total Current Liabilities 359915 .22 Long-Term Liabilities Total Long-Term Liabilities 0 .00 Total Liabilities 35 ,915 .22 Capital <41112 .39> Fund Balance-General 3 ,440 .52 Fund Balance-Plant & Eq . 13 ,440 ,52 Beginning Balance Equity Retained Earnings 93 ,566 .68 Net Income <3 ,444 .92> Total Capital 992199 . 89 Total Liabilities & Capital $ 135 , 115 . 11 Unaudited - For Management Purposes Only Substance Abuse Council Organizational Chart Advisory Board Board of Directors Indian River Board of County Commissioners Committees Anti-Drug Abuse Grant Executive Director Information Prevention Program Specialist Coordinator MACE PREVENT SAC LST Teen STEP PREVENT HN TIP' s Dasie Hope Coordinator Coordinator Program Coordinator Program Coordinator C'nordinstnr r:acPwnrkPr Program Program (2) LST Peer Educator Assistant Assistant Assistant Educators Executive Capital Community Education Membership Budget & Committee Campaign & Relations Finance Special Events - Gf 3TMENT OF THE TREASURY DISTRICT DIRECTOR 401 We PEACHTREE ST . NW ATLANTA + GA 30365 27 1995 Employer Identification Humber : 0 . teo J A N 65 - 0202s36 Casa Number : 535009038 SUBSTANCE ABUSE COUNCIL OF INDIAN Contact Person : RIVER COUNTY INC LORETTA HAMILTON PO BOX 6460 Contact Telephone Numbers. VERO 6EACHs FL 32961 - 6460 ( 404 ) 331 - 0927 Our Letter Dated : April 259 1991 Addendum Appliess No Dear- Applicanti This modifies our letter of the above date in which we stated that you would be treated as an organization that is not a private foundation until the expiration of your advance ruling period . Your exempt status under section 501 ( a ) of0the Internal Revenue Code as an . organization described In section 501 ( c ) ( 3 ) is still in effect . Based on the , information you submitteds we have determined that you are not a private foundation within the meaning of section 509 ( a ) of the Code because you are an organization of the type described in section . 509 ( a ) ( 1 ) and 170 ( b ) ( 1 ) ( A ) ( vi ) . Grantors and contributors may rely on this determination unless the Internal Revenue Service publishes notice to the contrary . Homevers if you lose your section 609 ( a ) ( 1 ) statusw a grantor or contributor may not rely on this determination if he or she was in part responsible fors or was aware ofs the act or failure to ' act , or the substantial or mater IaI c hange on the part of the organization that resulted in your loss of such statust or if he or she acquired knowledge that the Internal Revenue Service had given notice that you would no longer be classified as a section 509 ( a ) ( 1 ) organization . If we have indicated in the heading of this letter that an addendum applies + the addendum enclosed is an integral part of this letter . Because this letter could help resolve any questions about your private foundation status + pleas * keep it in your permanent records . t If you have any questi6ns , . pleas * contact the person H hose name and telephone number are shown above . Sincerely yoursr Wo, C�.a Nelson A . Brooke District Director i Flonda Department of • CHARLESBRONSON, • • Tallahassee., Florida Division of Consumer services March 27, 2002407 > ? Tallahassee, 1 : 11 Phone. 14WO-BELP-FLA ra Refer P SUBSTANCE ABUSE COUNCIL OF INDIAN r . s COUNTY POST OFFICE BOX 6460 . . : • ' . 1 REGISTRATION NUhfflE&* EXPIRATION DATE: February 24, 2003 Dear Sir or Pffie abovemnarned orgainzatio&sponsor has corriplied with the registration "kiments of Chapter 496, Florida Statutes, the Solicitadon of Contributions Act. T'his registration is valid for one year and must be renewed prior to the registr"ahon expuaton date mchcaW above. A COPY OF TTUS LEWER SHOULD BE RETAENED FORYOURRECORDS . In order to ensure that your file is mnplcte� please provide a copy of your Intemal Revenue Service tax return for your fiscal year ending on SEPTEMBER 30, 2001 prior to mAY 15, 2002. If you prefer, you may coiriplete and return the enclosed forin. Thank you for your cooperation. If we may be of furthff assistance, please, lot us know. sincerely, CHARLESH. BRONSON COMMISSIONER • • r Lark Daughtry Replatory CWsultant April 3 , 1990 ARTICLES OF INCORPORATION OF SUBSTANCE ABUSE COUNCIL f ' OF INDIAN RIVER COUNTY, INC . y. . 4 4 . We , THE UNDERSIGNED , hereby associate ourselves for the p rpose of forming a Florida Corporation not - for - profit pur6uant to Chapter 6173 Florida Statutes and certify as follows : ARTICLE 1 . 1 The name of the Corporation is : SUBSTANCE ABUSE COUNCIL OF INDIAN RIVER COUNTY , INC . ARTICLE II 2 . 1 The duration df this Corporation shall be perpetual unless dissolved by law or by overt action of th.is Corpdratlion and 4t shall have an ' effective date _ commencing on the filing of thesCArticles with the. L. . Secretary of State . t: ARTICLE 111 3. 1 The purposes of this Corporation are the prevention of any illegal or inappropriate use of drugs or controlled substances and the mitigation of alcohol abuse in Indian River County , thereby improving the health , safety and welfare of the individual , tthe family and the community . The Corporation shall : A. Identify and monitor the scope of the substance use and abuse problems in Indian River County , B . Identify , assess and coordinate the existing resources within Indian River County which provide education , prevention , inter - vention and treatment , and identify the need for additional programs and materials . C . Disseminate information gathered to make the community aware of the problems and the resources - available . D . Identify and encourage volunteer participation in meeting the mission and goals of this Corporation . 1 April 3 , 1990 E . Identify and obtain appropriate funding resources available to this Corporation . F . Support law enforcement and judicial activities relevant to substance abuse , including prevention and rehabilitation . G . Support effective community prevention , treatment and after- care relevant to substance abuse . 3 . 2 No substantial part of the activities of the , Corporation shall consist of the carrying on of propaganda , or otherwise attempting to influence legislation within the meaning of Section 501 ( c ) ( 3 ) of the Internal Revenue Code , nor shall the Corporation participate in or intervene in any political campaign on behalf of any candidate for public off ice . 3 . 3 This Corporation is not organized for the pecuniary profit of its directors , officers. or members ; nor may it issue stock nor declare nor distribute dividends , and no part of its net income shall inurto the benefit of any such persons ; and any balance of money or assests remain - ing after full payment of corporate obligations of all and any kind shall be devoted soley to the charitable , educational and benevolent purposes of the Corporation . ARTICLE IV 4. 1 This Corporation shall be governed by and operated in accord = ance with the provisions of its by - laws , existing law and these Articles . 4. 2 This Corporation shall have all the powers granted by Section 517 . 021 F . S . and at common law which are not in conflict with these Articles , including , but not limited to , the power to : a . Defend itself , its directors , officials or agents , 4kn its corporate name . b . Levy membership dues and charges . c . Engage legal counsel . d . May serve as committee ( s ) for Indian River County if duly appointed as such by the county authority having power to make such appointment ( s ) . 4. 3 All funds and title of all properties acquired 5y this Corpor; tion and the proceeds thereof shall be held only for its not - for- 2 April 3 , 1990 profit purposes , in accordance with law . 4. 4 The statement in 3 . 1 above shall be construed as a statement of both purposes and powers , and not as restricting or limiting in any way the general powers of this Corporation , or their exercise or enjoyment , as they are expressly or implicitly granted by the laws of the State of Florida . ARTICLE V 5 . 1 The conditions of membership shall be stated in the by - laws of the Corporation . ARTICLE VI 6 . 1 The initial principal office of this Corp ., ration shall be : SUBSTANCE ABUSE COUNCIL OF INDIAN RIVER COUNTY , IN " , 1055 20th Street Vero Beach , Florida 32960 6 . 2 This Corporation may change its principal office and transact business at such other locations within or without the State of Florida as shall from time to time be designated by the board of directors . ARTICLE VII 7. 1 The names and addresses of the incorporators and initial directors are as follows : NAME ADDRESS Kenneth Macht 22 Tarpon Drive , Vero Beach , FL 32960 James Gabbard 1055 20th Street , Vero Beach FL 32960 Gary Wheeler 525 Gull Wing Drive ; a Vero Beach, FL 32960 ARTICLE Vlll 8 . 1 The activities of the Corporation shall be managed by a board of directors . The number of directors , not less than three ( 3 ) persons , to constitute the whole board shall be fixed by the by - laws from time to time . The by - laws shall also specify the number of directors necessary to constitute a quorum . 3 April 3 , 1990 8 . 2 Succeeding board of directors shall be elected by the members in the manner specified from time to time in the by - laws and shall hold office until their successors are respectively elected or qualified . The by - laws may classify directors as to term of office . 8 . 3 Acts approved by a majority of the directors present and voting at any meeting of the board of directors at which a quorum has been established shall constitute the acts of the board unl :Fss a larger percent - age vote is required by these Articles or the by - laws . 8 . 4 One or more committees may be designated by the by - laws , or by resolution ( s ) of the board , with specified name ( s ) to have and exercise , only to the extent provided in each designation , the powers of the board of directors in the management of the activities and affairs of the Corporation . 8 . 5 The board of directors shall elect from among its members such officers as the by - laws may specify who shall , subject to the provisions of law , have such titles and exercise such duties as the by - laws may provide . 8 . 6 No director or officer of the Corporation shall receive compensation for service in such capacity to the Corporation . 8 . 7 The board of directors is expressly authorized to make , amend or repeal the by - laws in accordance with the terms therefor specified in the by - laws at the time of such board action . 8 . 8 The Corporation may by its by - laws confer powers upon its board of directors in addition to those stated above and expressly conferred by law , provided that the board shall not exercise any power or authority conferred herein or by statute exclusively upon the members . �%RTICLE IX 9 . 1 This Corporation shall have the power to indemnify any person made party to any threatened , pending or completed action, suit or proceeding , whether civil , criminal , administrative or investigative , and whether or not brought by or in the right of this Corporation , brought to impose any liability or penalty on such person , for an act or acts that have been or alleged to have been committed ( including alleged or actual omissions or failures to act ) by such person , except as constitutes gross negligence or willful misconduct , in such persons capacity as a director, officer or agent of this corporation . 9 . 2 The indemnification as provided in 9 . 1 may be against judgements , fines , reasonable attorney fees , actually and necessarily 4 April 3 , 1990 incurred as a result of such action , suit or proceeding , including any appeal thereof . 9 . 3 This Corporation may pay such expenses , including attorney fees , in advance of the final disposition of any action , suit or proceeding , upon the preliminary determination of the correctness of such person ' s conduct as required by law and upon receipt of any undertaking satis - factory to the board of directors by or on behalf of such person to repay such amount , unless it shall ultimately be determined that such person is entitled to indemnification by this Corporation for such expense . ARTICLE X 10 . 1 Reference herein made to gender or number shall be taken to mean masculine or feminine , singular or plural , wherever the context of circumstances so require . 10 . 2 In selection of officers , directors, agents or employees and in carrying out the purposes of this Corporation , there shall be no discrimi nation as to race , creed , religion or sex . 10. 3 On dissolution , all property of the Corporation , from what - ever source arising, shall be distributed to such organizations as are described in Section 501 ( c ) ( 3 ), of the Internal Revenue Code and are exempt from tax by virtue of Section 501 ( x ) , of the Internal Recenue Code , or corresponding provisions of any subsequent Federal tax laws, as the Board of directors of the Corporation shall determine . 10 . 4 Any amendment ': o the articles of incorporation shall be approved by two - thirds ( 2 / 3 ) of ;Lwhe votes which at any time are authorized to be cast by all of the members . ARTICLE XI 11 . 1 This Corporation names the following Resident Agent to accept service of process within the State of Florida : John M . Dob i s 1055 20th Street Vero Beach , FL 32960 5 April 3 , 1990 IN WITNESS WEREOF, the undersigned , being the incorporators hereinbefore named , subscribed their names respectively to these Articles of Incorporation of the SUBST NCE ABUSE COUNCIL OF INDIAN RIVER COUNTY, INC_, a corporation t - for - profi , on thisday of April , 1990, By Kennet Macht By Jaq bbar By ry Wheeler STATE OF FLORIDA ] CUONTY OF INDIAN RIVER ] 1 hereby certify that on this day , before me , personally appeared Kenneth Macht to me known to be the person described in and who executed the foregoing Articles of Incorporation and he acknowledged before me that he executed the same for the purposes therein expresed . Witness hand and official seal in the County and State last aforesaid this ay of April , 1990 _ Q e tar Public , State of Florida at Large . Notary Pulifir, State of Florida My commission expire : my Commission Expires Aug. 26, . 1992 Bonded T6ru Troy Faia • 4uurWOf IPP ' . y 6 April - 3 , 1990 ACCEPTANCE OF DESIGNATION OF RESIDENT AGENT The undersigned hereby accepts the designation of registered agent on be half of the SUBSTANCE ABUSE COUNCIL OF INDIAN RIVER COUNTY, I NC . J hn M . Dobis STATE OF FLORIDA ] COUNTY OF INDIAN RIVER ] hereby certify that on this day , before me , personally appeared John M. Dobis to me known to be the person described in and who executed the foregoing Acceptance of Designation of Resident Agent and he acknowledged before me that he executed the same -.* or the purpose therein expressed . Witness my hand and official seal in the County and State last aforesaid this day of April . , 1990 . ota Puc , State of Florida at rge . - Notory Po6rc, state of Florid@ My commission expires : My Commission Expires ktI9. 16; 1992 7 Revised August, 2002 BYLAWS OF SUBSTANCE ABUSE COUNCIL OF- INDIAN RIVER COUNTY, INC . ARTICLE I Section 1 . 1 — Definitions . The terms set forth below shall have the following meanings unless otherwise required by the context in which they may be used . Advisory Board . The term "Advisory Board " shall mean a body whose members advise the Board of Directors on matters including the coordination of drug abuse efforts undertaken with funds provided by the Anti-Drug Abuse Act of 1988 and other similar legislation . Articles of Incorporation . The term "Articles of Incorporation" shall mean the Articles of Incorporation of the Corporation filed with the Secretary of State of Florida on the day of , 199 , and any amendments thereto. Board . The term "Board " shall mean the Board of Directors of the Corporation . B aws . The term "Bylaws" shall mean the Bylaws of the Corporation except where reference is specifically made to the bylaws of another entity or unit. Chair- The term "Chair" shall mean the Chairperson of the Board of the Substance Abuse Council . Corporation . The term "Corporation" shall mean Substance Abuse Council of Indian River County, Inc. , a Florida corporation not for profit. Council- The term "Council'" shall mean the Substance Abuse Council Director. The term "Director" shall mean an individual who is a Director of the Corporation as described in Article IV. Maori . The term "Majority" shall mean fifty-one percent (51 %) of the applicable total number. - i - Revised August, 2002 Members . The term "Members" shall mean an individual who is a Member of the Corporation as described in Article III , Officer. The term "Officer" shall mean one or more of the positions as provided in Article VI . State. The term "State" shall mean the State of incorporation of the corporation unless otherwise specifically indicated . _Section 1 .2 — Statement of Purpose The purpose of the Corporation shall be: 1 .2-1 . To operate exclusively for the benefit of, to perform the functions of and to . cant' out the purposes of the Substance Abuse Council of Indian River County, a Florida not for profit corporation which is qualified as a federally tax exempted public charity by virtue of Section 501 (c)(3) and 509 (a) ( 1 ) or (2 ) of the Internal Revenue Code of 1954 , as amended , and at the discretion of the Corporation 's Board of Directors, to support, benefit, or cavy out the purposes of other not for profit entities organized for charitable, scientific, or educational purposes; provided that each such entity is an organization described in Section 501 (c)(3) of the Internal Revenue Code of 1954 , as amended, its regulations or the corresponding provision of any applicable future United States Internal Revenue law or regulations .(hereinafter collectively referred to as the "Code") and in Section 509 (a)( 1 ) or (2) of the Code, and further provided that the Corporation shall be operated , supervised or controlled in connection with each supported organization within the meaning of Section 509 (a)(3) of the Code (hereinafter referred to as "Supported System Members), 1 . 2-2 . To, itself, operate exclusively for charitable , scientific and/or educational purposes an in furtherance of such charitable , scientific and/or educational purposes, causes and objectives now or at any time hereafter fostered by the Substance Abuse Council of Indian River County; 1 .2-3 . To enhance the quality of life and benefit the inhabitants of Indian River County-, -Fa and the inhabitants of the surrounding areas by all methods appropriate to the objectives of this Corporation ; 1 .24 . To receive by way of gift, purchase , grant, devise , will or otherwise , property, real , personal or mixed and to hold , use, maintain , lease , donate , pledge , encumber, loan , sell , convey and otherwise - 2 - Revised August, 2002 dispose of all such property in furtherance of the objectives and purposes of this Corporation ; 1 . 2-5 . To do and perform any and all acts or services that may be incidental or necessary to cavy out the above purposes ; and 1 . 2-6 . To engage in any lawful act or activity for which a not for profit corporation may be organized under the laws of Florida , subject to the limitations set forth in Section 1 .2 of this Article I . Section 1 .3 — Powers . Except as limited by the Articles of Incorporation or these Bylaws , the Corporation shall have and exercise such powers in furtherance of its purposes as are now or may hereafter be granted by the Florida Not For Profit Corporation Act. ARTICLE II CORPORATE PROPERTY AND OFFICES Section 1 .2 — Property. All property received by the Council , whether by gift, bequest, devise or otherwise, shall be used exclusively to promote, cavy on and further the activities , objectives and purposes set forth in these Bylaws. Section 2 .2 — Offices . The Corporation shall have and continually maintain in the State a registered office and registered agent (whose office shall be identical with such registered office) and may have such other offices within or outside of the State as the Board may from time to time determine . ARTICLE Ili MEMBERSHIP Section 3 . 1 — Categories and Identification . There shall be two (2) categories of membership: Voting Members and Nonvoting Members. 3 . 1 - 1 Voting Members . The Voting Membership of the Corporation shall consist of all duly elected members of the Board of the Corporation . 3 . 1 -2 Nonvoting Members . The Nonvoting Members of the Corporation shall be a member for the calendar year in which those Members have made a financial contribution to the Corporation or any affiliate organization . 3 . 1 -3 Honorary Members . Honorary Members are those individuals who have given outstanding service to the Corporation , and who receive approval for Honorary - 3 - Revised August, 2002 Membership by a three-fourths (3/4 ) vote of all of the members of the Board of the Corporation . Section 3 . 2 - -Place of Meeting All meetings of the members of the Council , whether for the election of directors or otherwise , shall be held at such places as may be fixed by the Board , or as shall be specified or fixed in the respective notice , or waivers of notice thereof, or in the vote of adjournment, as the case may be . Section 3 .3 — Annual Meetings The Annual Meeting of the voting members shall be held within 150 days from the first of each calendar year, or, if such day shall be a legal holiday, then on the next succeeding day not a legal holiday. The Annual Meeting of the voting members may be held concurrently with the Annual Meeting of the Board . Section 3 .4 — Special Meetings Special meetings of the members may be called at any time by the Chair, or by any five voting members, at such time and place and for such purposes as shall be stated in the call thereof. Section 3 . 5 — Notice of Meetings Except as otherwise required by law, the Secretary shall give public notice of all meetings of the voting members. Section 3 .6 — Removal of Members . Any voting member may be removed, with or without cause , at any time, by a majority of the votes which at any time are authorized to be cast by all members. The vacancy caused by any such removal may be filled by the voting members at such meeting or at any subsequent meeting . Section 3.7 — Resignations. Any member of the Council may resign at any time either by oral tender of resignation at any meeting of the members or by giving written notice thereof to the Secretary of the Council . Such resignation shall take effect at the time specked . ARTICLE IV BOARD OF DIRECTORS Section 4. 1 — General Powers . All corporate powers shall be vested in and may be exercised by the Board , except as otherwise expressly provided by law or in the Article of Incorporation or in the Bylaws . The Board shall make appropriate delegations of authority to the Officers and , to the extent permitted by law, by appropriate resolution , the Board may authorize one or more Board Committees to act on it's behalf when it is not is session . Section 4 .2 - Number. Election and Term of Office The number of directors shall be no less than nine (9) and no more than twenty-one (21 ) unless increased from time to time, by amendment of the Bylaws by the voting - 4 - Revised August, 2002 members . The directors shall be elected at the Annual Meeting by the voting members in each year, and shall hold office for a one year term , unless sooner dies , resigns , is removed or becomes disqualified . Any director who shall have served as such for four (4) consecutive full terms , shall be ineligible for re- election for a period of one ( 1 ) year immediately following expiration of his fourth full term . Council members shall be given sixty (60) days notice prior to the Annual Meeting , of vacating positions . Any council member wishing to be a candidate for election to the Board shall put such request in writing and file same with the office of the Executive Director, in person or by mail , at least thirty (30) days prior to the annual meeting . Section 4 .3 — Regular and Special Meetings . Regular meetings of the Board may be held without call or formal notice at such places and at such times as the Board may determine by vote . Special meetings of the Board may be held at such places and at such times as the Chairman , or any five of the directors may determine. Notice of special meetings shall be sent to all directors by facsimile , or be delivered personally, or by telephone , no less than forty-eight hours before the day on which the meeting is to be held . Any member of the Board may waive notice of any meeting . The attendance of a member of the Board at any meeting shall constitute a waiver of notice of such meeting , except where a member of the Board attends a meeting for the express purpose of objecting to the transaction of any business on the grounds that the meeting is not lawfully called or convened . Neither the business to be transacted at, nor the purpose of any regular or special meeting of the Board , need to be specified in the waiver of notice of such meeting . Section 4 .4 — Quorum and Manner of Acting . The presence of a majority of the directors shall constitute a quorum, and the act of a majority of the directors present shall be the act of the Board . In the absence of a quorum, a majority of the directors present may adjourn the meeting , from time to time, until a quorum is present. Section 4 .5 — Procedure . The Board may adopt its own rules of procedure which shall not be inconsistent with the Articles of Incorporation , these Bylaws or applicable law. In the absence of the Board of adopting its own special rules of procedure as provided for herein , Robert's Rules of Order shall serve as the rules of procedure to be followed . Section 4 .6 — Resignations . Any director of the Council may resign at any time either by oral tender of resignation at any meeting of the Board or by written notice thereof given to the Secretary of the Council . Section 4 .7 — Removal of Directors . Any director may be removed , either with or without cause , at any time, by a majority of the votes which at any time are authorized to be a cast by voting members . Any director who accrues three (3) consecutive unexcused absences shall be automatically removed . The - s - Revised August, 2002 vacancy caused by such removal may be filled at the next meeting or any subsequent meeting of the Board of DireGtefs. The term of a director appointed pursuant to this section shall continue until the next annual meeting of the Council . Section 4 . 8 — Filling of Vacancies Not Caused by Removal . In case of any increase in the number of directors , or, of any vacancy caused by death , or resignation , removal or becomes disqualified the additional director or directors may be elected , or as the case may be, the vacancy or vacancies may be filled , either (a) by the Board at any regular meeting , or at a special meeting called for the purpose, by the affirmative vote of the majority of the directors then in office. The term of a director appointed pursuant to this section shall continue until the next annual meeting of the Council . ARTICLE V ADVISORY BOARD Section 5 . 1 — General Powers . The Advisory Board shall advise the Board on matters involving the coordination of drug-abuse efforts undertaken with funds provided by the Anti-Drug Abuse Act of 1988 and other legislation of similar and consistent purpose. Section 5.2 — Composition . The membership of the Advisory Board shall include at a minimum the following persons or their authorized designee , unless these persons or their authorized designee are presented on the Board : Chief Circuit Judge; State Attorney; Public Defender Sheriff; Chief of Police of each municipality within the county or a Chief of Police designated by those Chiefs of Police as their representatives Jail Administrator Cleric of the Court; Superintendent of Education , A representative of a local drug treatment program, appointed by the Chairman with approval of the Board as well as any other individual necessary to conform with the requirements of the Anti-Drug Abuse Act of 1988 or other legislation of similar and consistent purpose . Members of the Advisory Board may also be members of the Board of Directors . Section 5. 3 — Frequency of Meetings . The Advisory Board shall meet at least two (2 ) times each year and in addition as deemed necessary by the Board of Directors . ARTICLE VI COMMITTEES Section 6 . 1 — Committees . The Board may at any time , by resolution adopted by a majority of the Board , designate , change the membership of or terminate the existence of any committee or committees , including an executive and nominating committee . Each such committee shall have such name and - 6 - Revised August, 2002 shall have and may exercise such powers of the Board in the management of the business and affairs of the Council , including the power to authorize the seal of the Corporation to be affixed to all papers which may require it, as from time to time may be determined by resolution adopted by a majority of the whole Board of Directors . Section 6 .2 — Standing Committees . There shall be six (6 ) standing committees created by the Board : Executive Committee; Capital Campaign and Special Events; Community Relations; Education ; Membership and Budget and Finance . The Chair shall appoint the committee chairs with the approval of the Board . In the case of the Capital Campaign and Special Events Committee , the Executive Committee of the Board shall serve as Chairman . Standing Committees will from time to time evaluate the effectiveness of their activities and make recommendations to the Board . 6 .2- 1 EXECUTIVE COMMITTEE (A) Composition and Election . The Board , by resolution adopted by a majority of the members of the Board , may create an Executive Committee . The membership of the Executive Committee shall consist of the Chair, the Vice Chair, the Treasurer, the Secretary, Executive Director and such other Board members as appointed by the Chair. The Chair shall be the Chair of such Board Committee . (B) Authority and Functions. When the Board is not in session, the Executive Committee shall have and exercise all of the authority of the Board in the management of the Corporation, except as such authority is limited by statute or by resolution creating or otherwise controlling the Executive Committee. 6.2-1 . 1 CAPITAL CAMPAIGN AND SPECIAL EVENTS, COMMUNITY RELATIONS , EDUCATION , MEMBERSHIP and BUDGET AND FINANCE COMMITTEES (A) The remaining standing committees shall be composed of not less than three (3) members . Each committee shall develop guidelines as it may deem appropriate for the conducts of its activities . (B) The responsibilities of each of these standing committees shall be as follows : Capital Campaign and Special Events: To devise and organize methods for raising capital—Moneys established to Revised August, 2002 be capital moneys shall be maintained in a separate account bearing that denotation . 1 . Community Relations : To develop methods whereby the Council can (i) promote its goals within the community (ii) work together with other community agencies . 2 . Education : (i) To identify target populations and develop new programs based upon needs assessment data , (ii) to evaluate the Council 's ongoing substance abuse programs . 3 . Budget and Finance : (i) To Make recommendations regarding the financial policies of the Council , (ii) to review and recommend the annual budget of the Council , (iii) to carry out other financial duties as may be assigned by the Board of Directors . 4 . Membership - To develop methods to solicit and acquire new members committed to assisting the Council attain its goals. Section 6 .3 - Ad Hoc Committees . The Board shall establish Ad Hoc Committee as deemed necessary. The Nominating Committee shall be an Ad Hoc committee that shall meet as often as deemed necessary and to effectuate the slate of officers for the Annual Meeting . The responsibility of the Nominating Committee shall be to identify talented individuals with the capacity to make meaningful contributions as a member of the Board . At least one ( 1 ) member of the Nominating Committee shall have served on the nominating committee in the previous term . The Past Chair may serve as Chair. Section 6 .4 - Additional or Combination of Board Committees. 6 .4A Additional Board Committees (A) Composition and Election . The Board , by resolution adopted by a majority of its members may create one or more additional Board Committees consisting of at least three members of the Board . The Chair shall appoint the members of the Board who are to serve as the member of - 8 - Revised August, 2002 the Committee, one of whom shall be designated by the Chair as Chair of the Committee . (C ) Powers and Functions . The resolution creating an additional Board Committee shall designate the authority of the Board which such Board Committee shall have and exercise when the Board is not in session and the functions such Board Committee shall discharge . 6 .4-2 Combination of Board Committees. If the Board determines that one or more of the Board Committees should not exist, the Board shall assign the functions of such Board Committee to a new or existing Board Committee or to the Board as a whole . ARTICLE VII OFFICERS : POWERS AND DUTIES Section 7. 1 — Officers of the Board . The officers of the Board shall be a Chair , Vice Chair, Secretary and Treasurer. The Board may also elect one or more assistant secretaries , one or more assistant treasurers, and such other officers as from time to time may appear to be necessary or advisable in the conduct of the affairs of the council . Section 7.2 — Term of Office. So far as practicable , all officers shall be elected at the Annual Meeting of the Board in each year, and each officer shall hold office until the Annual Meeting thereof in the next subsequent year and until his successor is chosen , unless he sooner dies, resigns, is removed or becomes disqualified . Section 7 .3 — Removal of Elected Officers. Any officer may be removed at any time, either with or without cause, by the affirmative vote of a majority of the whole Board , at any meeting thereof. Section 7.4 — Vacancies . If any vacancy occurs in any office, the Board of Directors may elect a successor to fill such vacancy for the remainder of the term . Section 7 .5 Chair The — Chair shall preside at all meetings of the members and directors at which the Chair is present. The Chair shall have . general power to appoint, remove and fix (subject to the approval of the Board the compensation of the Executive Director. The Chair shall perform other such duties from time to time as assigned by the Board or these Bylaws. The Chair shall appoint the chairs of all standing committees. _ g _ Revised August, 2002 Section 7 . 6- Vice Chairman . The Vice Chairman shall perform the duties of the Chairman in the absence of the Chair. Section 7 .8 - Secretary. The Secretary shall give notice of all meetings of members and of the Board , except as otherwise provided , and shall keep and attest true records of all proceedings . In his absence from any such meeting , the assistant secretary, if any, or a chosen temporary secretary, shall record the proceedings . The Secretary shall have charge of the corporate seal and shall have authority to attest any and all instruments or writings to which the same may be affixed and generally shall perform all the duties normally associated with the office of Secretary of a Corporation . Section 7 . 9 - Treasurer. The Treasurer shall have the care and custody of all monies , funds and securities of the Council and shall cause to be deposited all funds of the council in and with such depositories as the Board may direct. The Treasurer shall keep all books of account relating to the business of the Council and shall render a statement of the Council's financial condition whenever required to do so by the Board or the Chair. Section 7 . 10 = Administrative Officers The Administrative Officers of the Corporation shall include an Executive Director, and the Corporation may, at the discretion of the Board , have additional Administrative Officers including, without limitation, one or more additional assistant directors . 7. 10. 1 Executive Director. The Executive Director shall be responsible for the day to day operation of the Council and shall make recommendations to the Directors regarding the operation of the Council's goals and objectives. Unless otherwise speed , authority shall be limited to the following , (A) All required financial , tax, and other reports be filed timely and reported promptly, (B) All expenditures shall be governed by the Council's current budget, (C) All expenditures , with the exception of payroll, require an invoice/receipt, (D) The Executive Director shall be responsible for approving all expenditures up to $5,000 in accordance with the approved budget.. Any expenditure over $5 ,000 shall require prior approval by the Board . - i0 - Revised August, 2002 (E ) The Executive Director shall maintain statistics on the number of population served through the Council 's outreach and other programs . ( F ) Shall have signature authority in application and execution of grants and contracts . (G ) The Executive Director shall have general power to appoint, remove and fix employment and the compensation of all employees (subject to the approval of the Board ). The Executive Director shall perform other such duties as assigned by the Board . Section 7 . 11 — Bonds of Officers . The Board may secure the fidelity of any or all Officers by bond or otherwise, in such terms and with such surety or sureties , conditions , penalties or securities as shall be required by the Board. The premium or premiums for such bond or bonds shall be paid out of the Corporate funds of the Corporation . ARTICLE VIII COMPENSATION Section 8 . 1 — General . The Board may make such contracts and employ such agents , brokers and attorneys as it deems necessary or appropriate to the accomplishment of the council purposes. When authorized by the Board , committees appointed pursuant to Section 5. 1 of the Bylaws , or the officers of the Council , may likewise make such contracts or employ such agents, brokers and attorneys . Directors and officers, and firms and corporations in which directors and officers are interested , may be parties to such contracts and may be so employed . Any person , firm or corporation with which the Council makes any such contract, or which it so employs , may be paid reasonable compensation for performing such contracts or rendering such services; provided , however, that nothing in this section shall be constructed to limit the powers which the Board or committees appointed by the Board , or the officers of the Council would have absent this section . ARTICLE IX MISCELLANEOUS Section 9 . 1 - Fiscal Year. The fiscal year of the Council shall be October 1 through September 30. Section 9 .2 - Signature of Negotiable Instruments . All bills , notes , checks or other instructions for payment of money shall be signed or countersigned by such officers and in such manner as from time to time may be prescribed by the Board . Revised August, 2002 Section 9 . 3 — Contracts . The Board may authorize any Officer or agent of the Corporation , in addition to the Officers so authorized by these Bylaws , to enter into any contract or execute any instrument in the name of and on behalf of the Corporation , and such authority may be general or confined to specific instances . Section 9 .4 — Deposits . All funds of the Corporation shall be deposited from time to time to the credit of the Corporation in one or more such banks, trust companies or other depositories as the Board may from time to time designate, upon such terms and conditions as shall be fixed by the Board . The Board may from time to time authorize the opening and keeping , with any such depository as it may designate , or general and special bank accounts and may make such special rules and regulations with respect thereto , not inconsistent with the provisions of these Bylaws , as it deems necessary. Section 9. 5 — Gifts . The Board may accept on behalf of the Corporation any contribution , gift, bequest or devise for and consistent with the general purposes , or for any consistent with any specific purpose, of the Corporation . Section 9 .6 — Books and Records . The Corporation shall keep correct and complete books and records of account and shall also keep records of the actions of the Corporation , which records shall be open to inspection . by the Membership of the Corporation and members of the Board at any reasonable time. Section 9 . 7 — Annual Report. The Chair shall cause an Annual Report to be submitted to the Board no later than 150 days after the close of each fiscal year of the Corporation . Section 9 .8 — Fiscal Year. Accounting Election . The fiscal year of and method of accounting for the Corporation shall be as the Board shall at any time determine . Section 9 .9 — Notice 9 .9A EFFECTIVE DATE. Unless othermise specified herein , any notice required or permitted to be given pursuant to the provisions of the Articles of Incorporation , these Bylaws , or applicable law, shall be in writing , shall be sufficient and effective as of the date personally delivered or, if sent by mail , on the date deposited with the United States Postal Service, prepaid and addressed to the intended receiver at such receiver's last known address as shown in the records of the Corporation . - 12 - Revised August, 2002 9 . 9-2 WAIVER OF NOTICE . Whenever any notice is required to be given under the provisions of the Florida General Corporation Act or Florida Not for Profit Corporation Act or under the provisions of the Articles of Incorporation , these Bylaws , or applicable law, a waiver thereof in writing signed by the persons entitled to such notice , whether before or after the time stated therein , shall be deemed equivalent to the giving of such notice . The attendance of a member at any meeting shall constitute a waiver of notice of such meeting , except where a member attends a meeting for the express purpose of objecting to the transaction of any business on the ground that the meeting is not lawfully called or convened . Section 9 . 10 Indemnification of Members of the Board Officer and Others. The corporation shall indemnify any member of the Board or Officer or former member of the Board or Officer for expenses and costs (including attome) 's fees) actually and necessarily incurred thereby in connection with any claim asserted by action in court or otherwise , by reason of such person being or having been such member of the Board or Officer, except in relations to matters as to which such person shall have been guilty of negligence or misconduct with respect to the matter in which indemnity is sought, and to the extent permitted by the provisions of the Florida Not For Profit Corporation Act. By order of the Board , the Corporation may, under comparable terms and limitations, indemnify employees and agents of the Corporation with respect to activities within the scope of their services as members of Board Committees , Officers or other officials of the Corporation . Section 9 . 11 — Revocability of Authorizations . No authorization, assignment, referral or delegation of authority by the Board to any committee, Officer, agent or other official of the Corporation , or any other organization which is associated or affiliated with , or conducted under the auspices of the Corporation shall preclude the Board from exercising the authority required to meet its responsibility. The Board shall retain the right to rescind any such authorization , assignment, referral or delegation at its sole discretion . Section 9 . 12 — . Emaloyees of the Corporation . The Board of Diresters may employ such personnel , including a full time Executive Director, as it deems necessary or desirable for the efficient operation of the Corporation. Section 9. 13 — Conflict of Interest. Except for contracts and transactions between the Corporation and any of its affiliate organizations of any contract or other transaction between the Corporation and one or more of the members of the Board or Officers , or between the Corporation and any other corporation , firm , association or other entity in which one or more of the members of the Board or Officers are members of the board , trustees , or officers or have a significant financial or influential interest, shall be authorized or entered into by the Corporation only after all of the following conditions are met: - 13 - Revised August, 2002 9 . 13A The relevant and material facts as to such member of the Board 's or Officer' s interest in such contract or transaction and as to any common directorship , trusteeship , officership or financial or influential interest were disclosed in good faith , in advance , by such member of the Board or Officer to the Board , and such facts are reflected in the minutes of the Board Meeting ; and 9 . 13-2 The relevant and material facts known to such interested members of the Board or Officer with respect to such contract or transaction which might reasonably be constructed to be adverse to the Corporation's interest were disclosed in good faith in advance by such member of the Board or Officer to the Board , and in such facts are reflected in the minutes of the Board meeting ; and 9 . 13-3 Such interested member of the Board or Officers has, as determined by the judgement of the Board : (i) made the disclosures and fully responded to questions conceming the matter referred to in A and B above ; (ii) fully met the burden of proof that the contract or transaction is fair and reasonable to the Corporation at the time such contract or transaction is authorized ; and (iii ) not otherwise significantly influenced the action of the Board with respect to the contract or transaction ; and all such determinations by the Board are reflected in the minutes of the Board Meeting ; and 9 . 134 The Board authorized such contract or transaction by a vote of at least two thirds (2/3) of the members of the Board present at a meeting at which a quorum was present, and such interested member of the Board or Officer, who may be counted in determining the presence of a quorum, was not counted in determining the two-thirds (2/3). 9 . 13-5 Such interested member of the Board or Officer was not present during the Boards deliberation nor at such time as the vote was taken . 9 . 13=6 The Board may adopt conflict of interest policies for the Corporation including without limitation , requirements and procedures with respect to: ( 1 ) regular annual statements and periodic supplements thereto by members of the Board , Officers, professional advisors , key employees and other officials of the Corporation , disclosing any existing and potential dualities of interest; (2) limitations on permitted - 14 - Revised August, 2002 external positions and interests ; and (3 ) corrective action with respect to transgressions of such policies . Section 9 . 14 - Seal . The seal of the Corporation shall be in such form as may be adopted by the Board . Section 9 . 15 - Amendments . The power to make , alter, amend or repeal the Bylaws shall be vested in the Board of the Corporation . The Bylaws of the Council may be altered in any manner not inconsistent with the Articles of Incorporation of the Council or any provision of law upon approval of: 9 . 15 . 1 By approval at any meeting of the where such number of directors present at such meeting as shall constitute a majority of the whole Board . 9 . 15 . 2 The notice of any such meeting of the voting members or directors shall include the form of the proposed change to the Bylaws. Section 9 . 16 - Rules . The Board may adopt, amend or repeal rules (not inconsistent with these Bylaws) for the management of the internal affairs of the Corporation and the governance of . its Officers, agents, Board Committees and employees . Section 9 . 17 - Gender and Number. Whenever the context requires , the gender of all words used herein shall include the masculine , feminine and neuter, and the number of all words shall include the singular and plural thereof. Section 918 - Articles and Other Headings . The Articles and other headings contained in these Bylaws are for the reference purposes only and shall not affect the meaning or interpretation of those Bylaws. SECRETARY'S CERTIFICATE THIS IS TO CERTIFY that the foregoing Amended and Restated Bylaws of the Substance Abuse Council of Indian River County, have been duly adopted by the Board at a meeting thereof held on August 27 .2002 .. IN WITNESS WHEREOF , the undersigned , duly elected and acting Secretary of the Corporation has signed this certificate and affixed the seal of the Corporation hereon this 27th day of August. 2002 . Secretary - i5 - substance Abuse Council :. of Indian River County - education awareness prevention referral Board of Directors RobertLouis Apdle Capt. Bill Brunner DavisChief Hugh Cox iiames Travis ' TO : ChildrenAdvisoryComnuttee Jack Fdzharris From : Colette HeK • • Executive Director Joan Gentgen • , , 00 William Hanlks Corporal Fred Jones Re: objective Measurement WOT hop Karen McHenry 1 - Carol Molloy . . • David. . • . Please • . 1 of • . 1 • Measurable _ 1 Mariana Nigh ed by the United Way on outcomes M.P.O. David Shapiro January 28 ,2003 at the / County1 Megan CharleneTarch VirginiaWelton Advisory Board Dr. Paul Bakule JudgeJeffrey Barton Marc Cianca GabbardBruce Colton Dr, Roger Dearing Chief James Judge Diamond Capt Bill McMullen HarryOffuttCPA Sheriff Roy Raymond Zonnie Swanson TomWhite The Honorable J • • - 1989-1996 2501 27th Avenue. Suite A-7 Vero Beach, FL 32960 Phone770-4811 Fax ( 7721 r • - • Q111 A 9WRQUIAM education awareness - prevention referral Board of Directors Louis Aprile Capt Bill Brunner Rev, Robert Cosmas Chief Hugh Cox Jiames Davis Travis Eslinger To : Children Services Advisory Committee Jack Fitzharris From: Colette Heid, LAPP, Executive Director Joan Gentgen William Hanlon Date : May 27 , 2003 Corporal Fred Jones Re : Objective Measurement Workshop Karen McHenry DetSteve Marcinik Carol Molloy Judge David Morgan please accept this as a statement of attendance of the Goals and Measurable Mariana Nigh Beckie Selph Outcomes Workshop . I attended the workshop offered by the United Way on Mp.O. David Shapiro January 28 ,2003 at the Indian River County Library. Megan Scott CharleneTardi Virginia Welton Advisory Board Dr. Paul Bakule Jeffrey Barton Judge Marc Cianca Bruce Colton Dr. Roger Dearing Chief James Gabbard Judge Paul B. Kanarek Diamond Litty Capt Bill McMullen HarryOffutt, CPA Sheriff Roy Raymond .Bonnie Swanson Tom White The Honorable Judge LB. "Buck" Vocelle 1989-1996 A Ih Wq M•MY 2501 27th Avenue, Suite A-7 Vero Beach, FL 32960 Phone ( 772) 770-4811 Fax ( 772) 770-4822 � b 5 + a n ce ACA 5' C C V 1'1 Gt 1 SUPPORTING DOCUMENTS CHECKLIST RFP 5054 Cover Page ►✓ Application List of current officers and directors Latest Financial Audit Report & Management Letter that conforms with the AICPA Audit Guide ✓Most recent IRS Form 990, including all schedules �✓ Most recent Internal Financial Statement (i . e. : Balance Sheet and Operating Budget �✓ Staff Organizational Chart 1' Most Recent Annual Report (if available) ✓ 501 (C)(3 ) IRS Exemption Letter Articles of Incorporation Agency' s Bylaws Agency' s written policy regarding Affirmative Action Proof of Goals and Outcomes Workshop Attendance XV Indian River Board of County Commissioners 1840 25t' Street Vero Beach , FL 32960 AUTHORIZATION FOR RELEASE OF INFORMATION Indian River County and Substance Abuse Council of IRC (Agency/Individual are in the process of negotiation of a contract for the Children Services Advisory Committee Grant Application . Indian River County is authorized to make an investigation of the Agency/ Individual regarding its experience and qualifications . The Agency/Individual authorized the release of all relevant information concerning prior services furnished , contracts and background information of the Agency/Individual . The Agency/Individual authorizes any individual or organization that is in possession of relevant factual contract and background information , to release such data to Indian River County in response of the County' s request. When an individual employee of the Agency signs Authorization for Release of Information , such individual authorizes the County to obtain relevant background information concerning such employee ' s criminal record , if any, and such other information that may be relevant to employee ' s good character and work experience . Authorization is given here by the Agency/Individual and such employees who execute this authorization with the understanding and limitation that Indian River County will utilize the information obtained for the purposes set forth herein and that such information shall not be disclosed to third parties except as provided by law. Name Agency/ Individual Substance Abuse Council of IRC Print name Name Employee Providing authorization Colette Heid Executive Director Pri me Signature ( in blue ink) 2Z 4 Date XI SWORN STATEMENT UNDER SECTION 105 . 08 , INDIAN RIVER COUNTY CODE , ON DISCLOSURE OF RELATIONSHIPS THIS FORM MUST BE SIGNED IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICER AUTHORIZED TO ADMINISTER OATHS . 1 . This sworn statement is submitted with RFP No . 5054 for S. hi IArrw z5 ryices A wss © q C �6c 2 . This sworn statement is submitted by : u1os4- anc. e- Abusc C,oync i j o kG ( Name of entity submitting Statement) whose business address is : I FL 32 (76Z) and (if applicable ) its Federal Employer Identification Number ( FEIN ) is & �S — 4 Z 02 63S ( If the entity has no FEIN , include the Social Security Number of the individual signing this sworn statement 3 . My name is (20 ( Pleas-}e- print name of individual signing ) and my relationshi to the entity named above is E�LL �, f4 Tl fPc,+or . 4 . 1 understand that an "affiliate" as defined in Section 105 . 08 , Indian River County Code , means : The term "affiliate" includes those officers , directors , executives , partners , shareholders , employees , members , and agents who are active in the management of the entity . XII 5 . 1 understand that the relationship with a County Commissioner or County employee that must be disclosed as follows : Father, mother, son , daughter, brother, sister, uncle , aunt, first cousin , nephew , niece , husband , wife , father-in-law , mother-in-law, daughter- in-law , son - in -law , brother-in -law , sister- in -law, stepfather, stepmother, stepson , stepdaughter, stepbrother, stepsister, half brother, half sister, grandparent , or grandchild . 6 . Based on information and belief, the statement which I have marked below is true in relation to the entity submitting this sworn statement . [Please indicate 7applies . ]whichtement ither the entity submitting this sworn statement , nor any officers , directors , executives , partners , shareholders , employees , members , or agents who are active in management of the entity , have any relationships as defined in section 105 . 08 , Indian River County Code , with any County Commissioner or County employee . The entity submitting this sworn statement , or one or more of the officers , directors , executives , partners , shareholders , employees , members , or agents , who are active in management of the entity have the following relationships with a County Commissioner or County employee : Name of Affiliate Name of County Commissioner Relationship or entity or employee XIII (s ' nature ) (date ) STATE OF Floc i ala COUNTY OF �� � i 0. � r rfQ ►' The foregoing instrument was acknowledged before me this 28 day of /N AY , 20 03 , by (201614e YQ i el , who is personally known to me or who has produced as identification . NOTARY PUBLIC SIGN : PRINT : 'bevekil T3 . lorvrts State of Florida at Large My Commission Expires : (Seal ) so ` "'' BEVERLY B. NORRIS *: MY COMMISSION # CC 976202 EXPIRES: October 19, 2004 '%�;oF F�°P` Bonded Thru Noiely runic Underwriters XIV NOT FOR PROFIT AGENCY CERTIFICATION The County of Indian River requires, as a matter of policy, that any Consultant or firm receiving a contract or award resulting from the Request for Qualifications issued by the County of Indian River, Florida , shall make certification as below. Receipt of such certification , under oath, shall be a prerequisite to the award of contract and payment thereof. I (we) hereby certify that if the contract is awarded to me, our firm , partnership, or corporation , that no members of the elected governing body of Indian River County, nor any professional management, administrative official or employee of the County, nor members of his or her immediate family, including spouse , parents, or children , nor any person representing or purporting to represent any member or members of the elected governing body or other official , has solicited, has received or has been promised , directly or indirectly, any financial benefit, including but not limited to a fee , commission , finder's fee , political contribution , goods or services in return for favorable review of any Proposal submitted in response to the Request for Qualifications or in return for execution of a contract for performance or provision of services for which Proposals are herein sought. The undersigned certifies that he/she is a principal or officer of the firm applying for consideration and is authorized to make the above acknowledgments and certifications for and on behalf of the applicant. The undersigned certifies that the Applicant has not been convicted of a public entity crime within the past 36 months, as set forth in Section 287. 133, Florida Statutes. Failure to sign this fonn will result in orsgualftabon. Handwritten Signature of1Authorized 'Principal(s) : NAME : 0o le l �c 1 -e f cL 7i:2 .2 D3 TITLE: E Xe G U 7l V2 l l Yeti fo r NAME OF FIRM/PARTNERSHIP/CORPORATION: StA -s a ncet- Abuse, (2ovnc4 . 1 of SRC FOR AND ON BEHALF OF THE APPLICANT: Sworn to and subscribed to me, a Notary Public, this 29day of Ngq 2003. BY: atoL `3orr ► s (SEAL) (TYPE NAME & TITLE) BEVEMY COMMISSION LY B. # CC NO176202 EXPIRES: October 19, 2004 ' 98HIM fhFU N81IFy PARS btld€rwdtere X Substance Abuse Council of Indian River County Life Skills Training Program Children 's Services Advisory Committee ORGANIZATION : Substance Abuse Council of Indian River County PROGRAM : Life Skills Training Program TABLE OF CONTENTS Please "X" the parts of the grant application to indicate they are included. Also, please put the page number where the information can be located. X Section of the Proposal Page # TABLE OF CONTENTS (Check list) COVER PAGE (with signatures) , 3 A. ORGANIZATION CAPABILITY (one page maximum) 1 . Mission and Vision of organization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 2 . Summary of expertise, accomplishments , and population served . . . . . . . . . . . . . . . . 4 B. PROGRAM NEED STATEMENT (one page maximum) 1 . Program Need Statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 2 . Programs that address need and gaps in service . . 0 0 0 goo 0 09 0 of 0 0 0 so 0 00 9 90 0 of a 00 0 000 5 C. PROGRAM DESCRIPTION (two pages maximum) 1 . Funding priority . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 2 . Description of program activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 3 . Evidence that program strategy will work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 7 4 . Staffing . . . . a so * * * * * * * so 6 a * * so * , , * , , a of 0 00 100 # 00 0 * a 0 # 4 890 0004 00048 * as 00004 7 5 . Awareness of program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 6 . Accessibility of program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 7 D. MEASURABLE OUTCOMES (two pages maximum) . , . . 0049 fee@ * $ * 49999 # 4600 8-9 E. COLLABORATION (one page maximum) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 0 0 0 8 . 0690 10 F. PROGRAM EVALUATION (two pages maximum) 1 . Demographics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 2 . Measures . . . . a a * 0 , 0 a a 0 6 0 0 a d 0 0 0 0 a a 11 3 . Reporting . a . . . . a . . . * ago * , * * . . . . 0 0 . . . . . a a ' . 0 0 , 0 0 0 0 a 0 0 0 0 , 0 V 0 0 0 0 , 0 , 0 9 0 0 0 t 9 go 12 G. TIMETABLE (one page maximum) 13 H. UNDUPLICATED CLIENT COUNT 1 . Projections by Location . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . . . . . . . . . . . . . . . . . . . . . . . . . . 14 2 . Projections by Age Group . . . . . . . . , ' , , , 14 I. BUDGET FORMS 1 . Budget Narrative Worksheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 0000 6 . 0 . . . . . . . . 15 2 . Total Agency Budget . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 1 Substance Abuse Council of Indian River County Life Skills Training Program Children's Services Advisory Committee 3 . Total Program Budget. . . 0 1 1 1 0 1 1 1 1 a I 1 0 0 0 0 1 1 1 1 1 0 0 0 a a 0 0 a 0 wo a 1 0 9 0 1 0 a 0 1 1 0 1 1 0 0 20 4 . Funder Specific Budget. 21 5 . Explanation for Variances — Total Program Budget . . 22 6 . Explanation for Variances — Funder Specific Budget . 23 J. FUNDER SPECIFIC/ADDITIONAL SHEETS K. APPENDIX 2