HomeMy WebLinkAbout2003-253L CHILDREN'S SERVICES ADVISORY COMMITTEE
C/O Human Services
1840 2e Street
Vero Beach , Florida 32960-3394
Phone: 561 -567-8000 (Ext. 467 or 524)
Fax: 978-1798
E-Mail: karlsonObcc.co. indian-river.fl . us
Mmastersonebcc. co.indian-river.fl . us
To : Beth Jordan
From : Joyce Johnston-Carl on
Date : September 30 , 2003
Re : Grant Contracts 200 4
The attached is a Children ' s Service Advisory Committee Grant Contract for :
Homeless Assistance Center (HAC)
Please review the insurance certificate and verify that it is adequate by signing on the line
below. Contact me if you have any questions . Thank you.
J Beth Jordan Date
Indian River County Grant Contract
This Grant Contract ("Contract') entered into effective this 1st day of October 2003 by and between
Indian River County , a political subdivision of the State of Florida , 1840 25th Street, Vero Beach FL ,
32960 (" County") and Homeless Assistance Center ( HAC) ("Recipient's ;
of : (Address)
Homeless Assistance Center (HAC)
7154 th Place
Vero Beach , FL 32962
"Assets Build Futures" Program
Background Recitals
A . The County has determined that it is in the public interest to promote healthy children in a
healthy community.
B . The County adopted Ordinance 99- 1 on January 19 , 1999 ("Ordinance") and established the
Children' s Services Advisory Committee to promote healthy children in a healthy community
and to provide a unified system of planning and delivery within which children 's needs can be
identified , targeted , evaluated and addressed .
C . The Children 's Services Advisory Committee has issued a request for proposals from
individuals and entities that will assist the Children's Services Advisory Committee in fulfilling
its purpose .
D . The proposals submitted to the Children 's Services Advisory Committee and the
recommendation of the Children 's Services Advisory Committee have been reviewed by the
County .
E . The Recipient , by submitting a proposal to the Children 's Services Advisory Committee , has
applied for a grant of money ("Grant") for the Grant Period (as such term is hereinafter
defined) on the terms and conditions set forth herein .
F . The County has agreed to provide such Grant funds to the Recipient for the Grant Period (as
such term is hereinafter defined) on the terms and conditions set forth herein .
NOW THEREFORE , in consideration of the mutual covenants and promises herein contained , and
other good and valuable consideration , the receipt and adequacy of which are hereby acknowledged ,
the parties agree as follows :
1 . Background Recitals The background recitals are true and correct and form a material
part of this Contract.
2 . Purpose of Grant The Grant shall be used only for the purposes set forth in the
complete proposal submitted by the Recipient attached hereto as Exhibit "A" and
incorporated herein by this reference (such purposes hereinafter referenced as "Grant
Purposes") ,
3 . Term The Recipient acknowledges and agrees that the Grant is limited to the fiscal
year 2003/2004 CGrant Period") . The Grant Period commences on October 1 , 2003
and ends on September 30 , 2004 .
— 1 —
4 . Grant Funds and Payment The approved Grant for the Grant Period is Fifteen
Thousand Dollars ($ 15 , 000) . The County agrees to reimburse the Recipient from
such Grant funds for actual documented costs incurred for Grant Purposes provided in
accordance with this Contract . Reimbursement requests may be made no more
frequently than monthly. Each reimbursement request shall contain the information , at
a minimum , that is set forth in Exhibit "B " attached hereto and incorporated herein by
this reference . All reimbursement requests are subject to audit by the County . In
addition , the County may require additional documentation of expenditures , as it
deems appropriate .
5 . Additional Obligations of Recipient.
5 . 1 Records , The Recipient shall maintain adequate internal controls in order to
safeguard the Grant . In addition , the Recipient shall maintain adequate records fully
to document the use of the Grant funds for at least three (3) years after the expiration
of the Grant Period , The County shall have access to all books , records , and
documents as required in this Section for the purpose of inspection or audit during
normal business hours at the County's expense , upon five (5) days prior written
notice .
5 .2 Compliance with Laws . The Recipient shall comply at all times with all applicable
federal , state , and local laws , rules , and regulations .
5 . 3 Quarterly Performance Reports. The Recipient shall submit Quarterly Performance
Reports to the Human Services Department of the County within fifteen (15) business
days following : December 31 , March 31 , .lune 30 , and September 30 .
5 . 4 Audit Requirements . If Recipient receives $25 , 000 or more in the aggregate from
all Indian River Coupty government funding sources, the Recipient is required to have
an audit completed by an independent certified public accountant at the end of the
Recipient 's fiscal year. Within 120 days of the end of the Recipient's fiscal year, the
Recipient shall submit the audit to the Indian River County Office of Management and
Budget . The fiscal year will be as reported on the application for funding , and the
Recipient agrees to notify the County prior to any change in the fiscal period of
Recipient . The Recipient acknowledges that the County may deny funding to any
Recipient if an audit required by this Contract for a prior fiscal year is past due and has
not been submitted by May 1 .
5 . 4 . 1 The Recipient further acknowledges that, promptly upon receipt of a
qualified opinion from its independent auditor , such qualified opinion shall
immediately be provided to the Indian River County Office of Management and
Budget . The qualified opinion shall thereupon be reported to the Board of
Commissioners and funding under this Contract will cease immediately. The
foregoing termination right is in addition to any other right of the County to
terminate this Contract.
5 . 4 . 2 The Indian River County Office of Management and Budget reserves
the right at any time to send a letter to the Recipient requesting clarification if
there are any questions regarding a part of the financial statements , audit
comments, or notes.
5 . 5 Insurance Requirements . Recipient shall , no later than September 23 , 2003 ,
provide to the Indian River County Risk Management Division a certificate or
certificates issued by an insurer or insurers authorized to conduct business in Florida
2 -
that is rated not less than category A- : VII by A . M . Best, subject to approval by Indian
River County's risk manager, of the following types and amounts of insurance :
(i) Commercial General Liability Insurance in an amount not less than
$ 1 , 000 , 000 combined single limit for bodily injury and property damage ,
including coverage for premises/operations , products/completed operations ,
contractual liability , and independent contractors;
(ii) Business Auto Liability Insurance in an amount not less than $ 1 , 000 , 000
per occurrence combined single limit for bodily injury and property damage ,
including coverage for owned autos and other vehicles, hired autos and other
vehicles , non-owned autos and other vehicles ; and
(iii) Workers' Compensation and Employer's Liability (current Florida statutory
limit)
5 . 6 Insurance Administration . The insurance certificates, evidencing all required
insurance coverages shall be fully acceptable to County in both form and content ,
and shall provide and specify that the related insurance coverage shall not be
cancelled without at least thirty (30) calendar days prior written notice having been
given to the County . In addition , the County may request such other proofs and
assurances as it may reasonably require that the insurance is and at all times
remains in full force and effect. Recipient agrees that it is the Recipient's sole
responsibility to coordinate activities among itself, the County , and the Recipient's
insurer(s) so that the insurance certificates are acceptable to and accepted by
County within the time limits set forth in this Contract. The County shall be listed as
an additional insured on all insurance coverage required by this Contract, except
Workers ' Compensation insurance . The Recipient shall , upon ten (10) days' prior
written request from the County , deliver copies to the County , or make copies
available for the County's inspection at Recipient's place of business, of any and all
insurance policies that are required in this Contract. If the Recipient fails to deliver or
make copies of the policies available to the County; fails to obtain replacement
insurance or have previous insurance policies reinstated or renewed upon
termination or cancellation of existing required coverages ; or fails in any other regard
to obtain coverages sufficient to meet the terms and conditions of this Contract , then
the County may, at its sole option , terminate this Contract.
5 . 7 Indemnification . The Recipient shall indemnify and save harmless the County , its
agents , officials, and employees from and against any and all claims, liabilities ,
losses , damage , or causes of action which may arise from any misconduct , negligent
act , or omissions of the Recipient, its agents , officers, or employees in connection
with the performance of this Contract.
5 . 8 Public Records . The Recipient agrees to comply with the provisions of Chapter
119 , Florida Statutes (Public Records Law) in connection with this Contract .
6 . Termination . This Contract may be terminated by either party , without cause , upon
thirty (30) days prior written notice to the other party . In addition , the County may
terminate this Contract for convenience upon ten (10) days prior written notice to the
Recipient if the County determines that such termination is in the public interest .
7 . Availability of Funds . The obligations of the County under this Contract are subject
to the availability of funds lawfully appropriated for its purpose by the Board of
County Commissioners of Indian River County .
— 3 —
8 . Standard Terms . This Contract is subject to the standard terms attached hereto as
Exhibit C and incorporated herein in its entirety by this reference .
IN WITNESS WHEREOF , County and Recipient have entered into this Contract on the date
first above written .
INDIAN RIVER COUNTY BOARD OF COUNTY
COMMISS!PNERS
By: _
. enneth R . Macht, firman
Attest : J . K . Barton , Clerk
Deputy Clerk
Approved : C '
mes Cliandler, County Ad istra r
p oved as to form and legal sufficiency:
Marian Fell , Assi unt ttorney
RECIPIENT :
Homeless Assistance Center ( HAC )
7204 th Place
Vero Beach , FL 32962
By : La
0 - &%�
Name
P�TW6!z _
Title
4 -
EXHIBIT A
[Copy of complete proposal/application]
. . _ _ _. .. __ _ .. . .
- 1 -
EXHIBIT B
[From policy adopted by Indian River County Board Of County Commissioners on February 19 ,
2002]
" D . Nonprofit Agency Responsibilities After Award of Funding
Indian River County provides funding to all nonprofit agencies on a reimbursement basis
only .
All reimbursable expenses must be documented by an invoice and/or a copy of the canceled
check . Any expense not documented properly to the satisfaction of the Office of Management &
Budget and/or the County Administrator may not be reimbursed .
If an agency repeatedly fails to provide adequate documentation , this may be reported to the
Board of Commissioners . In the event an agency provides inadequate documentation on a
consistent basis , funding may be discontinued immediately . Additionally , this may adversely
affect future funding requests .
Expenditures may only be reimbursed from the fiscal year for which funding was awarded . For
example , no expenditures prior to October 1st may be reimbursed with funds from the following
year. Additionally , if any funds are unexpended at the end of a fiscal year, these funds are not
carried over to the next year unless expressly authorized by the Board of Commissioners.
All requests for reimbursement at fiscal year end (September 30t) must be submitted on a timely
basis . Each year, the Office of Management & Budget will send a letter to all nonprofit agencies
advising of the deadline for reimbursement requests for the fiscal year. This deadline is typically early
to mid October, since the Finance Department does not process checks for the prior fiscal year
beyond that point.
Each reimbursement request must include a summary of expenses by type . These summaries
should be broken down into salaries, benefits, supplies , contractual services , etc. If Indian River
County is reimbursing an agency for only a portion of an expense (e .g , salary of an employee) , then
the method for this portion should be disclosed on the summary. The Office of Management &
Budget has summary forms available .
Indian River County will not reimburse certain types of expenditures . These expenditure types are
listed below.
a . Travel expenses for travel outside the County including but not limited to ; mileage reimbursement,
hotel rooms , meals , meal allowances, per Diem , and tolls . Mileage reimbursement for local travel
(within Indian River County) is allowable .
b. Sick or Vacation payments for employees . Since agencies may have various sick and vacation
pay policies, these must be provided from other sources .
c. Any expenses not associated with the provision of the program for which the County has awarded
funding .
d . Any expense not outlined in the agency's funding application .
The County reserves the right to decline reimbursement for any expense as deemed necessary . "
- 1 -
EXHIBIT C
STANDARD TERMS FOR GRANT CONTRACT
1 , Notices : Any notice, request, demand , consent, approval or other
communication required or permitted by this Contract shall be given or made
in writing , by any of the following methods : facsimile transmission ; hand
delivery to the other party ; delivery by commercial overnight courier service ;
or mailed by registered or certified mail (postage prepaid) , return receipt
requested at the addresses of the parties shown below:
County : Joyce Johnston-Carlson , Director
Indian River County Human Services
1840 25`h Street
Vero Beach , Florida 32960-3365
Recipient: Sue Rux, Director
Homeless Assistance Center (HAC)
715 4"' Place
Vero Beach , FL 32962
2 . Venue, Choice of Law: The validity , interpretation , construction , and effect
of this Contract shall be in accordance with and governed by the laws of the
State of Florida , only . The location for settlement of any and all claims ,
controversies , or disputes , arising out of or relating to any part of this
Contract, or any breach hereof, as. well as any litigation between the
parties , shall be Indian River County, Florida for claims brought in state
court, and the Southern District of Florida for those claims justifiable in
federal court.
3 . Entirety of Agreement: This Contract incorporates and includes all prior and
contemporaneous negotiations , correspondence , conversations ,
agreements , and understandings applicable to the matters contained herein
and the parties agree that there are no commitments , agreements , or
understandings concerning the subject matter of this Contract that are not
contained herein . Accordingly , it is agreed that no deviation from the terms
hereof shall be predicated upon any prior representations or agreements ,
whether oral or written . It is further agreed that no modification ,
amendment or alteration in the terms and conditions contained herein shall
be effective unless contained in a written document signed by both parties .
4 . Severability: In the event any provision of this Contract is determined to be
unenforceable or invalid , such unenforceability or invalidity shall not affect
the remaining provisions of this Contract, and every other term and
provision of this Contract shall be deemed valid and enforceable to the
extent permitted by law. To that extent, this Contract is deemed severable.
5 . Captions and Interpretations : Captions in this Contract are included for
convenience only and are not to be considered in any construction or
interpretation of this Contract or any of its provisions . Unless the context
- 1 -
indicates otherwise , words importing the singular number include the plural
number, and vice versa . Words of any gender include the correlative words
of the other genders , unless the sense indicates otherwise .
6 . Independent Contractor. The Recipient is and shall be an independent
contractor for all purposes under this Contract. The Recipient is not an
agent or employee of the County , and any and all persons engaged in any
of the services or activities funded in whole or in part performed pursuant to
this Contract shall at all times and in all places be subject to the Recipient' s
sole direction , supervision , and control .
7 . Assignment, This Contract may not be assigned by the Recipient without
the prior written consent of the County .
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Date : 19 / 23 / 2003 Time : 10 : 33 AM To : @ 567 - 1454
Page : 001 - 002
A CORD„
ME
" - - -_ _ ATE (MMIDDIYV)
D
t - t
09 /23/2003 _
- - --- - -- - - ------ - ---- - - --- - - --- - - - -- -- - -- -- - ---- --- - - - - - -- - - - - - - -- -
--
PRODUCER ( 772 ) 567 - 1188 FAX ( M ) 778 - 14 16 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
SCHLITT INSURANCE SERVICES INC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1717 INDIAN RIVER BLVD HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
SUITE 300 COMPANIES AFFORDING COVERAGE
VERO BEACH , FL 32960 COMPANY Scottsdale Insurance Co . --
Attn Lois Robertson Ext 126 A
INSURED COMPANY FWC 1 UA
Homeless Assistance Center , Inc . B
715 4th Place
Vero Beach , FL 32962 COMPANY
C
- - -
_ _ - - - - - - - - - - _ _ . _ _ _ _. .. . ._ _ -. _ .. - -
COMPANY
D
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED , NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
T ' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE : POLICY EXPIRATION COVERED PROPERTY LIMITS
LTR DATE (MMIDD/YY) DATE (MMIDD/YY)
X PROPERTY CP50471952 01/09 / 2003 . 01/09/ 2004 BUILDING s See
CAUSES OF LOSS PERSONAL PROPERTYAttached
BASIC I BUSINESS INCOME S Schedule
BROAD EXTRA EXPENSE I $
ASPECIAL ' !. ` .. - - - - - --- - - - - - - -_ ._ -
BLANKET BUILDING S
EARTHOUAKE
BLANKET PERS PROP S
FLOOD - BLANKET BLDG & PP ! E
S
INLAND MARINE S
TYPE OF POLICY - - --- . -- - --- -
! S
S -
CAUSES OF LOSS S
NAMED PERILS -
g
OTHER -- - -- - -...- - -
IS
CRIME
' S
._. TYPE OF POLICY
S
BOILER S MACHINERY $
X OTHER 6FR13UB5097A24403 07 /29 /2003 ; 07 / 29 / 2004 tach Accident 100900
B Workers Compensation Policy Limit 500 , 00
Each employee 100900
LOCATION OF PREMISESIDESCRIPTION OF PROPERTY
SPECIAL CONDFTIONSIOTHER COVERAGES
FAORONNIE
-
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
Indian River County Board Of 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
County Commissioners BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
1840 25th Street OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES,
Vero Beach , FL 32960 AUTHORIZED REPRESENTATIVE
Jeffrey Schlitt , CPCU/LAR
r _ 1ZLE -
- _ - -
Date : 9 / 23 / 2003 Time : 10 : 33 AM To : @ 567 - 1454
Page : 002 - 002
Homeless Assistance Center , Inc .
Supplement to Certificate of Property Insurance Certificate IN Prop & WC 09/23/2003
SCH UTT INSURANCE SERVICES INC
Property List
Loc # Bldg # Address , County , City , State Zip
00001 00001 715 4th Place
Vero Beach , FL 32962
Covered Property Valuation Causes of Loss Limits Deductible Coins . %
Business Personal Prope RC Special ( Including thef 25 , 000 80
Building MV Special ( Including thef 1409000 80
Loc # Bldg # Address , County , City , State Zip
00002 00001 720 4th Street
Vero Beach , Indian River , FL 32962
Covered Property Valuation Causes of Loss Limits Deductible Coins . %
Building RC Special ( Including thef 470 , 572 19000 80
Business Personal Prope Special ( Including thef 40 , 000 1 , 000 80
ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (MWDD/YY)
04 / 18 / 2003
PRODUCER ( 772 ) 567 - 1188 FAXTHIS GERTIFICAIE IS ISSUED AS7)� TTt: R OF INFORMATION
( 772 ) 778 - 1416 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
SCHLITT INSURANCE SERVICES INC HOLDER. THIS CERTIFICATE DOES NOT AMEND , EXTEND OR
1717 INDIAN RIVER BLVD ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW,
SUITE 300
VERO BEACH , FL 32960 INSURERS AFFORDING COVERAGE
INSURED Homeless Assistance Center , Inc . INSURER A: Royal Insurance Co .
715 4th Place INSURERS: Executive Risk Indemnity
Vero Beach , FL 32962 INSURER C:
INSURER D:
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN , THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS , EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES . AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS .
LTR TYPE OF INSURANCE POLICY NUMBER DATE (MM/DD/YY) DATE (MM/DD/YY) LIMITS
GENERAL LIABILITY R2ST419535 01 / 09 / 2003 01 / 09 / 2004 EACH OCCURRENCE $ 11000100
X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Any one fire) $ 100 0 0
CLAIMS MADE OCCUR MED EXP (Any one person) $ 5100
A PERSONAL & ADV INJURY $ 1 , 0 0 0 , 0 0
GENERAL AGGREGATE $ 3 , 000 , 00 (
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ INCLUDE 1
POLICY PROECT LOC
J
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT $
ANY AUTO (Ea accident)
ALL OWNED AUTOS
BODILY INJURY $
SCHEDULED AUTOS (Per person)
HIRED AUTOS
BODILY INJURY $
NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE $
(Per accident )
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO EA ACC $
OTHER THAN
AUTO ONLY: AGG $
EXCESS LIABILITY 91647767 01 / 18 / 2003 01 / 18 / 2004 EACH OCCURRENCE $
OCCUR EICLAIMS MADE IRECTORS , OFFICERS & AGGREGATE $ 19000 , OOC
B rRUSTEES LIABILITY $
DEDUCTIBLE
X RETENTION $ 2 , 500 $
WORKERS COMPENSATION AND TORY LIMITS ER
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT $
E.L. DISEASE - EA EMPLOYEq $
E.L. DISEASE - POLICY LIMIT 1 $
OTHER 2ST419536 01 / 09 / 2003 01 / 09 / 2004 Aggregate $ 3 , 000 , 000
A on - Profit Each Occurrence $ 1 , 000 , 000
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
ertificate Holder is Additional Insured for General Liability .
CERTIFICATE HOLDER X ADDITIONAL INSURED ; INSURER LETTER A CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
Indian River County BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
1840 2 5th Street OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
Vero Beach , FL 32960 AUTHORIZED REPRESENTATIVE Q / /�
Jeffrey Schlitt , CPCU / LAR / / U / #JjdLl"
c
Internal Revenue Service Department of the Treasury
i
P . O . Box 2508
Cincinnati , OH 45201
Date : August 2, 2001 Person to Contact :
Ms . Dalton 31 -07425
Customer Service Representative
Homeless Assistance Center Inc Toll Free Telephone Number:
2525 Saint Lucie AVE 8 :00 a.m. to 9 : 30 p.m. EST
Vero Beach , FL 32960- 3385 877-829-5500
Fax Number.
513-263-3756
Federal Identification Number:
59-3129752
Dear Sir or Madam :
This letter is in response to the amendment to your organization ' s Articles of Incorporation filed with the state
on July 18 , 2001 . We have updated our records to reflect the name change as indicated above .
Our records indicate that a determination letter issued in August 1992 granted your organization exemption
from federal income tax under section 501 (c) (3) of the Internal Revenue Code . That letter is still in effect.
Based on information subsequently submitted , we classified your organization as one that is not a private
foundation within the meaning of section 509 (a) of the Code because it is an organization described in
section 509 (a) ( 1 ) & 170 (b) ( 1 ) (A) (vi) .
This classification was based on the assumption that your organization ' s operations would continue as stated
in the application . If your organization ' s sources of support , or its character, method of operations , or
purposes have changed , please let us know so we can consider the effect of the change on the exempt
status and foundation status of your organization .
Your organization is required to file Form 990 , Return of Organization Exempt from Income Tax , only if its
gross receipts each year are normally more than $25 , 000 . If a return is required , it must be filed by the 15th
day of the fifth month after the end of the organization' s annual accounting period . The law imposes a
penalty of $20 a day , up to a maximum of $ 10 , 000 , when a return is filed late , unless there is reasonable
cause for the delay.
All exempt organizations (unless specifically excluded) are liable for taxes under the Federal Insurance
Contributions Act (social security taxes) on remuneration of $ 100 or more paid to each employee during a
calendar year. Your organization is not liable for the tax imposed under the Federal Unemployment Tax Act
(FUTA) .
Organizations that are not private foundations are not subject to the excise taxes under Chapter 42 of the
Code . However, these organizations are not automatically exempt from other federal excise taxes .
Donors may deduct contributions to your organization as provided in section 170 of the Code . Bequests ,
legacies , devises , transfers , or gifts to your organization or for its use are deductible for federal estate and
gift tax purposes if they meet the applicable provisions of sections 2055 , 2106 , and 2522 of the Code .
HOMELESS ASSISTANCE CENTER, INC .
7154 1h Place
Vero Beach, FL 32962
( 772 ) 567 - 2766
"ASSETS BUILD FUTURESI "
RFP# 5054
Childrens ' Services Advisory Committee
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.
1 (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 form will result in disqualification.
Handwritten Signature of Authorized Principal (s ) : DATE : Q3
NAME :
TITLE : Cf,(,
NAME OF FIRM/PARTNERSHIP/CORPORATION :
FOR AND ON BEHALF OF THE APPLICANT:
Sworn to and subscribed to
me , a Notary Public , this ' I
day of , 2003 . BYr ,
(SEAL) (TYPE NAME & TITLE )
1*a Pie FAY H. PRADO
a° ' c MY COMMISSION ADD 126400
EXPIRES: June 16, 2006
��rEavd�° eawaa raw Budget rmwv Services
X
t_ .1
e _
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 .
t "asy
1 . This sworn statement is submitted with RFP No , 41M for
u /ISSETS � IUtL. b Fv ; UP_ � 5 (hlLbje& Vs � SFWyiovs & V ) san_ %( CoMo1 { 'TT S ,
2 . This sworn statement is submitted by:
( Name of entity submitting Statement )
whose business address is :
`%lS� q-)w cF, �'�, o Be ,4c+1 ' FL 3 .3 ie, , and
( if applicable )
its Federal Employer Identification Number ( FEIN )
is Lo3ia97s- 2z
( If the entity has no FEIN , include the Social Security Number of the individual
signing this sworn statement
3 . My name is
( Please print name of individual signing )
and my relationship to the entity named above is
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
L
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
which statement applies . ]
X Neither 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
l
A
(signatu )
(date )
STATE OF L 0 is y4
COUNTY OF blhih71 OAA Vr
The foregoing instrument was acknowledged before me this 13+ day of
20D3 , by Sisk t2 Lj Y , who is personally
known to Yne or who has produced as
identification .
NOTARY PUBLIC
SIGN : .
PRINT : pP- A� U
State of Florida at Large
My Commission Expires :
( Seal ) ro1.a.?u�c FAY H. PRADO
* * MY COMMISSION # DD 126400
A' EXPIRES: June 16, 20D6
orf Of K Bonded Thm "at Notary SeMces
XIV
SUPPORTING DOCUMENTS CHECKLIST
RFP 5054
X Cover Page
X 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
Most Recent Annual Report (if available)
�l 501 (C)(3 ) IRS Exemption Letter
Articles of Incorporation
_ Agency' s Bylaws
Agency' s written policy regarding Affirmative Action
X _ Proof of Goals and Outcomes Workshop Attendance
XV
Indian River Board of County Commissioners
184025 th Street
Vero Beach , FL 32960
AUTHORIZATION FOR RELEASE OF INFORMATION
Indian River County and Homme GG Assistance Qpn (Agency/ Individual
are in the process of negotiation of a contract for
RED # SDS4
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 k{omLLLss �ssts' -iWeC
Print name
Name Employee Providing authorization S' -(! F. �k
Print name
Signature ( in blue ink) ._.
Date � *7 /03
XI
T
ORGANIZATION : Homeless Assistance Center, Inc .
PROGRAM : "Assets Build Futures"
FUNDER: Children ' s Services Grant
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 Pa e #
X TABLE OF CONTENTS (Check list) 1 & 2
X COVER PAGE (with signatures) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . 3
A. ORGANIZATION CAPABILITY (one page maximum)
X 1 . Mission and Vision of organization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . 4
X 2 . Summary of expertise, accomplishments, and population served . . . . . . . . . . . . . . . . 4
B. PROGRAM NEED STATEMENT (one page maximum)
X 1 . Program Need Statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
X 2 . Programs that address need and gaps in service . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . 5
C. PROGRAM DESCRIPTION (two pages maximum)
X1 . Funding priority . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . 0 . . . . . . . . 6
X 2 . Description of program activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . 0 . . . . . . . . . 6
X 3 . Evidence that program strategy will work . . . . . . . . . . . . 0 . 0 . . . . . . . . . . . . . . . .
. . . . . . . . . . . . 6
X4 . Staffing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . 0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
X 5 . Awareness of program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . 0 . . . . 0 . . . . . . . . 7
X 6 . Accessibility of program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . 7
X D. MEASURABLE OUTCOMES (two pages maximum) . . . . . 4 . . . . . . . . . . . . . . . . . . . 8
X E. COLLABORATION (one page maximum) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . 9
F. PROGRAM EVALUATION (two pages maximum)
X1 . Demographics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . 0 . . . . . . . . . . . . . . . . . . . . . . . . 10
X2 . Measures . . . . . . . . . . . . . . . 0 . . . . . . . . . . . . . . . . . . . . . . . . . . . M
. . 0 . - . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
X3 . Reporting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I I . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
X G. TIMETABLE (one page maximum) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . 12
H. UNDUPLICATED CLIENT COUNT
X 1 . Projections by Location . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . I . . . . . . . . . . . . . . . . I . . . 13
X 2 . Projections by Age Group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . 13
1
1
a
X 1 . Budget Narrative Worksheet . 14- 17
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . .
X 2 . Total Agency Budget . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . 18
X 3 . Total Program Budget . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . 19
X 4 . Funder Specific Budget . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . 20
X 5 . Explanation for Variances — Total Program Budget . . . . . 4 . . . . . . . . . . . . . . . . . . . . . . .
. . . . 21
X 6 . Explanation for Variances — Funder Specific Budget . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . 22
-- J. FUNDER SPECIFIGADDITIONAL SHEETS n/a
X K. APPENDIX n/a
2
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Organizational Name: Homeless Assistance Center, Inc .
Program Title: "Assets Build Futures"
Funder: Children Services Grant
PROGRAM COVER PAGE
Organization Name : Homeless Assistance Center, Inc .
Executive Director : Sue Rux E-Mail : SLRHome@aol . com
Address : 715 4h Place Phone : (772)- 567-2766
Vero Beach, FL 32962 Fax : (772)-5674454
Program Director : Sue Rux E-Mail : SLRHome@aol . com
Address : 715 4a` Place Phone : (772)- 567-2766
Vero Beach, FL 32962 Fax : (772)- 567- 1454
Program Title: "Assets Build Futures"
Priority Need Area Addressed: Mental Wellness Issues and Parental Support & Education
Program Description : To provide art therapy (RB-050), child development classes (PH-610 . 150) and
parenting skills development (PH-610 . 680) for children of homeless families residing in a homeless
shelter (BH- 180 . 850) and family transitional unit (BY- 180-950) which focuses on building a positive
identity for and with their children . The arts component, provided by a visual artist, provides a means for
self-expression and promoting the confidence to channel emotions positively . The child development and
parenting components, provided by a child development specialist, provides guidance and instruction on
strengthening positive relationships between parent and child .
Amount Requested from Funder for 2003/04 : $271098 . 00
Total Proposed Program Budget for 2003 /04 : $333798 . 00
Percent of Total Program Budget : 80 . 2%
Current Funding (2002/03 ) : $25100 . 00
Dollar increase/(decrease) in request : $273098 . 00
Percent increase/ decrease in request : 8 . 3 %
Unduplicated Number of Children to be served Individually : 50
Unduplicated Number of Adults to be served Individually : 38
Unduplicated Number to be served via Group settings : -0-
Total Program Cost per Client : $384 . 07
Will these funds be used to match another source? NO
If yes, name the source : N/A
Amount : $271098 . 00
The Organization 's Board of Directors has approved this application on (date). ___
Fer , uson Peter Jr
Name of President/Chair of the Board ignat e
Sue Rux ' L
Name of Executive Director/CEO Signature
[ 3 ]
f
Organization Name : Homeless Assistance Center
Program Title : " Assets Build Futures"
Funder: Children Services Grant
PROPOSAL NARRATIVE
Please respond to each question in the allotted space for each section. In responding to each
section of the proposal narrative, please retain the section-label and/or question you are
addressing . Type using 12 pt . Font on 8 '/s X 11 paper and number each page . These directions
and the graphic boxes may be deleted if space is needed .
A. ORGANIZATION CAPABILITY
1 . Provide the mission statement and vision of your organization.
The mission of the Homeless Assistance Center, Inc . (HAC) is to provide opportunities for
homeless individuals and families to end homelessness by achieving self- sufficiency through
education, living wages, and permanent housing .
2. Provide a brief summary of your organization including areas of expertise,
accomplishments and population served.
The RAC has developed from a grassroots organization, from incorporation in 1992, to an
organization, which provides emergency, transitional, and rental housing programs to
homeless individuals and families . During the last year RAC has accomplished the
following :
• Provided emergency housing for 182 homeless people ( 14 families, 150 adults, 32
children)
• Provided rental assistance to 176 homeless people ( 44 families, 60 adults, 116 children)
• Completed construction of a 3800 sq . ft . transitional housing unit which will house 16
families a year, opening June 2003
• Acquired a grant to establish management information system in collaboration with the
Treasure Coast Homeless Services Council .
* Received and implemented a therapeutic art program for homeless children
4
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Organization : Homeless Assistance Center
Program Name: "Assets Build Futures"
Funder: Children Services Grant
Be PROGRAM NEED STATEMENT (Entire Section B not to exceed one page)
1 . a) What is the unacceptable condition requiring change? b) Who has the need ?
C) Where do they live? d) Provide local, state or national trend data, with reference
source, that corroborates that this is an area of need.
It is estimated there are over a million children homeless in America. In Indian River
County, it is estimated there are 457 homeless daily of which 46% are homeless families .
More than 25 % of homeless children have experienced homelessness more than once .
Homeless families are the fastest growing population of homeless nationally and
locally.
According to a 1999 study of "Homeless in America : A Children ' s Story" conducted by The
Institute for Children & Poverty, homelessness for children is often an extended period of time in
their life which is fraught with educational and emotional setbacks that last for years . Nationwide
1 in 5 homeless school aged children repeat classes . The educational levels are lowered due to
excessive transfers, high absenteeism, under educated parents, and chronic homelessness .
Approximately 47% suffer depression, anxiety, display aggressive behaviors and are taunted by
their peers for being homeless .
The 2000 "Homeless Education Program", sponsored by the Broward County School District
and funded by the McKinney Homeless Assistance Act of 1990 identified for educators the
visible symptoms and behaviors of homeless students . The program documents that such
children display low self-esteem; are either withdrawn and listless or hostile and aggressive ; are
emotionally needy; are old beyond their years ; feel unsafe in their environments; and feel shame
at where they live. In addition to educational setbacks there are development delays which
augment feelings of failure .
The experiences of living in "fractured families" consumed with the family stress of poverty,
living in a homeless center, unemployment and/or low wages, and the uncertainty of the future
also causes hopelessness, fear, insecurity, and anxiety in children. Families often do not have the
energy nor resources to nurture their children or provide positive reinforcement and
developmental experiences which build self-esteem and resiliency .
2. a) Identify similar programs that are currently serving the needs of your targeted
population ; b) Explain how these existing programs are under-serving the targeted
population of your program .
The only other local program, which is similar to providing services for homeless children
and families, is the Samaritan Center, a local transitional housing program. However,
community studies conducted by, the Treasure Coast Homeless Services Council verifies that
the need for services for these children and families is far greater than the availability of
services to meet their needs . The HAC programs provide capacity for services .
5
Organization Name: Homeless Assistance Center
Program Name : " Assets Build Futures"
Funder: Children ' s Services Grant
C. PROGRAM DESCRIPTION (Entire Section C, I — 6, not to exceed two pages)
1 . List Priority Needs area addressed.
Mental Wellness Issues and Parental Support & Education
2. Briefly describe program activities including location of services.
Art therapy will be available 3 hrs . a week for 48 weeks of art class . Activities will be
focused on visual art activities of various art forms such as : drawing, sculptures, sewing,
painting, craft projects, clay, and art activities, which facilitate self-expression.
Child development classes (held with children) and parenting skills development classes (held
with parents) will occur in 12 week units for 1 'h hrs . per class (four 12 week groups) . Ten hours
a week will be designated to individual family and child sessions focused on specifically
identified behavioral issues and identified activities, which build positive relationships between
parent and child . Child development and parenting skills classes will focus on such areas as :
building mutual respect; managing difficult behaviors; developing boundaries ; reinforcement
focused on building self- esteem in children and developing positive parent/child relationships .
The majority of groups & activities will occur at HAC facilities although there may be occasions
for field trips to supplement class activity . Parents and children will be engaged in grant group
and/or individual activities within the first week of entering a residential program for homeless
families . Follow-up support for families involved in the transitional housing program, and where
possible, the emergency housing program will ocur as families obtain permanent housing .
3. Briefly describe how your program intends to address the stated need/problem .
Include reference to any studies or evidence that indicate proposed strategies are
effective with target population.
Since 1990, the Search Institute has focused on the development of "healthy communities,
healthy youth" through their research and implementation of programs which promote the 40
developmental assets of children. These assets, which include building external assets (support,
empowerment, boundaries & expectations, constructive use of time) and internal assets
commitment to learning, positive values, social competencies, positive identity) are the building
blocks of healthy development of young people to grow up healthy, caring and responsible . The
HAC proposed program for homeless children and families is designed to impact the internal
asset of developing positive identity in children through achieving personal power, self-esteem, a
sense of purpose and a positive view of one ' s future .
6
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Organization Name : Homeless Assistance Center
Program Name : Assets Build Futures
Funder: Children ' s Services Grant
4. List staffing needed for your program, including required experience and estimated
hours per week in program for each staff member and/or volunteers (This section
should conform with the information in the Position Listing on the Budget Narrative
Worksheet).
Staffing required for program implementation include an art instructor with a background in art
and working with special needs children and a child development specialist with a Ph . D . in
Education. The Executive Director, MSW, will provide on-going supervision of the staff and
program activities . Instructor/Artist, Debbie Fox, would return to conduct the art program and
Dr . Beverly Whitely would serve as the Child Development Specialist .
5. How will the target population be made aware of the program ?
Homeless Families are referred to RAC either through self - referral, local community agencies
or word of mouth. Families entering the program, complete a comprehensive assessment and
individual case plan, which identifies specific goals and objectives and the various individual and
family needs which impact the family and causes them to be homeless . Issues which are common
need areas include : employment, mental health, substance abuse, debt, legal issues,
transportation, family support and housing . Other needs are identified which impact the
unification and/or reunifacation of the family as a unit such as parenting skills, special needs of
children, school, and relationships within the family .
As families enter residential programs, they will be made aware of, and be required to participate
in, the available family programs such as identified in this proposal . Families will receive an
orientation to these programs as a part of their assessment and plan development process .
6. How will the program be accessible to target population (i.e. location, transportation,
hours of operation)?
The majority of group and individual activities will be accessible to homeless families at the
residential facility, however, some field trips may be included . Individual and group
activities will be made available when the children are ( i . e . after school and weekends) and
when the parents are ( evenings, weekends, and/or throughout the day) . No transportation is
required since the majority of the activities occur on the residential premises .
7
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Homeless Assistance Center - - Assets Builds Futures
D . MEASURABLE OUTCOMES (Entire Section D not to exceed two pages)
OUTCOMES ACTIVITIES
Add all the elements or the Measurable Outcome (s) Add the tasks to accomplish the Outcome(s)
Improve parenting techniques and methods • Participation in an asset based
parents can use for building self-esteem in their parenting skills training class
children, ages 0- 15 , by 75% in six months as weekly for 12 weeks conducted by the
measured by pre-test/post-test of group Child Development Specialist .
material . Baseline will be pre-test on class • Identification of individual problem
content . behaviors and/or sources of conflict
between parent and child with
implementation of new methods as
identified by the Child Development
Specialist and the parent(s) to manage
conflict and improve parent/child
relationships .
Increase experiences between parent(s) and • Identification and implementation of
child(ren) which build positive relationships weekly free or low cost activities which
and increase self-esteem in their child(ren), promotes fun, recreation and positive
ages 6- 15 , by 75 % in six months as measured reinforcement of quality time spent
through individual counseling sessions twice a between parent(s) and child(ren) .
week with the parent(s) and/or child(ren)
Baseline will be the initial individually
reported problem areas as identified by
parent(s) and/or child(ren) with the Child
Development Specialist at time of program
entry .
Increase self-esteem of homeless children, ages • Provide 48 hours of art therapy
6- 15 , by 75% in six months as reported by activities, 24 hours of Child Witness
parents, children, and/or staff. Baseline will be Group for families experiencing
self-assessment by child " About Me" domestic violence, and 192 hours of
child centered support groups focused
on skills and activities that promote
personal power and control, self-
esteem, a sense of purpose and goal
setting for the future . Activities to be
conducted by art instructor and Child
Development Specialist, and Mental
Health Association staff.
8
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Homeless Assistance Center - - Assets Build Futures
E. COLLABORATION
Collaborative Agency Resources provided to the program
Provides two 12 hours of training through their " Child
Mental Health Association Witness Program" which helps children build positive
relationships, developing personal safety plans, handling
threatening situations.
Provides food and snacks to children and families
Treasure Coast Food Bank residing at the Homeless Center
Through the school liaison for homelessness, they
Indian River School District provide school supplies, assistance with school
enrollments or transfers, assists with obtaining free
and/or reduced lunch program and serves as a resource
for solving other problems which arise with homeless
children in the school.
9
f
k
Homeless Assistance Center - - Assets Build Futures
F. PROGRAM EVALUATION (Entire Section F not to exceed two pages)
1 . DEMOGRAPHICS : What information (data elements) will you need to collect in order
to accurately describe your target population including demographics (age, gender and
ethnic background) required by the funder in Section H? What are the pieces of
information that qualify them for your target population ? How do you document their
need for services or their "unacceptable condition requiring change" from Section B19.
Program experience during the last year has demonstrated that nearly every child residing in
the homeless shelter environment displays some of the emotional and/or behavioral issues
previously discussed in Section B . Parents appear to welcome any support and guidance staff
can offer regarding parenting issues .
* * * * * SEE # 2 (BELOW) for data collection. * * * * *
2. MEASURES : What data elements will you need to collect to show that you have
achieved (or made progress toward ) your Measurable Outcomes in Section D? What
tools or items are you using as measures (grades, survey scores, attendance, absences,
skill levels) for your program ? Are you getting baseline information from a source on
your Collaboration List in Section E ? Are there results from your Activities in Section
D that need to be documented ? How often do you need to collect or follow- up on this
data?
ITEM MEASURES FREQUENCY
Child name, age, sex, race, Enrollment Forms Upon intake
gender, school, county
Parenting Skills Development Pre-Post Test Beginning & End of
Groups
Problem Behavior(s) Behavior Issues Checklist I " week in residence
Problem Behavior Plans Child Development Plan I " week in residence
Behavior Management Observations & Progress Notes Weekly
Art Class Outcomes Art Therapy Logs Weekly
Participation levels Attendance Logs Each class meeting
Self-esteem issues "About Me" Assessment Beginning & End—
Child Development
Groups
10
Homeless Assistance Center - - Assets Build Futures
3. REPORTING: What will you do with this information to show that change has
occurred ? How will you use or present these results to the consumer, the funder, the
ill you use this information to improve your
program , and the community? How w
program ?
Results of the program will be shared with the funder, through the monitoring and reporting
process . A final report will be shared with the staff and Board of directors which shows the
results and outcomes learned from grant implementation. On-going information is shared
with parents as part of their involvement in the process. The experiences and results of the
program will be used to continue to develop and/or improve services of the program to
homeless children and their families during their stay in residence . It is the hope that some
lasting results will be gained by parents and their children which will improve the overall
health, strength and functioning of the family as a support system.
11
Homeless Assistance Center — Assets Builds Futures
G. TIMETABLE Section G not to exceed one page)
1 . List the major action steps, activities or cycles of events that will occur within the
program year. New programs should include any start-up planning that may occur
outside the funding year. In completing the timetable, review information detailed in
prior sections.
Month/Period Activities
September * Pre Planning of Parenting Skills Classes & Child Development
Classes .
* Current population of families assessed & Child Development Plans
Established .
*Enrollment Forms for Art Classes Complete .
October-December * Series # 1 -Parenting Skills & Child Development Classes
Pre-Test Administered for Parenting Classes .
" About Me" Assessments with Children .
On-going weekly art classes .
On-going weekly parent/child enrichment activities .
Post-Tests .
January-March * #2-Parenting Skills & Development Classes
Pre-Test Administered for Parenting Classes .
"About Me" Assessments with Children .
On-going weekly art classes .
On-going weekly parent/child enrichment activities .
Post-Tests .
April-June * Series #3 -Parenting Skills & Development Classes
Pre-Test Administered for Parenting Classes.
"About Me" Assessments with Children.
On-going weekly art classes .
On-going weekly parent/child enrichment activities .
Post-Tests.
July- September * Series #4-Parenting Skills * Development Classes
Pre-Test Administered for Parenting Classes .
" About Me" Assessments with Children.
On-going weekly art classes .
On-going weekly parent/child enrichment activities .
Post-Tests .
Accommodations will be made to enroll new parents and children to
appropriate activities as they become residents of HAC .
12
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A �
Homeless Assistance Center - - Assets Build Futures
Type the Organization and Program Name
UNIFORM GRANT APPLICATION
BUDGET NARRATIVE WORKSHEET
IMPORTANT: The Budget Narrative should provide details to justify the amount requested in each line item of the budget for
your program. From this worksheet, your figures will be linked to the Total Agency Budget, Total Program Budget and Funder
Speck Budget Forms.
AGENCY/PROGRAM NAME : HOMELESS ASSISTANCE CENTER
FUNDER : CHILDREN ' S SERVICES GRANT
; CAUTION : Do not enter any figures where a cell is colored in dark blue - Formulas and/or links are in place. Gray areas should
;
The used for calculations and to write information only.
_ - -
`RMYUS ONL Pro used Total program Funder S ecific Total A enc
Am
REVENUES AGENCY 115E ONLY �p03 "`J Specific• Agency
MM DE Budget Budget Budget
1 Children's Services Council-St Lucie
2 Children's Services Council-Martin
3 Children's Services Council-Okeechobee
4 Advisory Committee-Indian River
5 United Wayst Lucie County
6 United Way -Martin County
7 United Way -Okeechobee County
8 United Way-Indian River County
9 Department of Children & Families
10 County Funds 33, 798 . 04 27, 098. 04 110 , 708 . 00
11 Contributions-Cash 352, 700 . 00
12 Program Fees 0. 00
13 Fund Raising Events-Net 30, 000. 00
14 Sales to Public - Net 0. 00
15 Membership Dues 0. 00
16 Investment Income 600.00
17 Miscellaneous 11000.00
18 Legacies & Bequests 10, 000. 00
19 Funds from Other Sources 1009000. 00
20a Reserve Funds Used for Operating 0. 00
20b In-Kind Donations ( Not included in total) 0. 00
21 TOTAL REVENUES
(doesn't include line 20b) l $33 ,798.04 $27 ,098.04 $6059008.00
A B C D
EXPENDITURES GRAY ARM FOR Proposed Total Program Funder Specific Total Agency
AGENCY USE W&Y
(SNOW CALCN.AT10 M Budget Budget Budget
22 Salaries - (must complete chart on next page) 19,860.00 15, 360.00 352 ,542.00
Salary 19680
23 FICA - Total salaries x 0.0765 7.65% 11175. 04 1 , 175.04 26, 969. 46
24 Retirement - Annual pension for qualified staff 31500. 00
25 Life/Health - Medical/Dental/Short-term Disab. 38,431 .00
Workers Compensation - # employees x rate
26 16 employees x 1295.25 19201 . 75 1 . 201 .75 20, 724. 00
Florida Unemployment - # projected
27 employees x $7, 000 x UCT-6 rate = 0% 0%
14
5/15/2003
Homeless Assistance Center - - Assets Build Futures
Type the Organization and Program Name
SALARIES A
Gross Annual portion of Salary on Proposed C Funder % of Gros Annual
POSITION LISTING Salary Program Specific Budget Salary Requested(CIA)
Position Tide / Total HtsAvk (Agency)
Example: Executive Director / 40 hrs 70s000. 001 100000. 00 52000. 00 714%
Executive Director / 40 hrs 45,000.00 21700. 00 0.00%
Accounting/Budget/16-18 hrs . 16,220.00 0. 00%
Fundraising and Development/ 40 hrs. 38,000.00 0. 00%
Resident Manager/ 40 hrs . 32.000.00 0 .00%
Case Manager/ 40 hrs 29,800.00 11800. 00 0 .00%
Residential Case Worker 1/ 40 hrs 17,680.00 0.00%
Residential Case Worker II/ 40 hrs 17,680.00 0.00%
PT Care Worker/ 32 hrs 14, 144.00 0. 00%
PT Care Worker/ 24 hrs 10,608.00 0.00%
PT Care Workers/ 16 hrs 71072.00 0.00%
Housing Mgm't. Spec./40 hrs 30,000.00 0.00%
Housing Specialistl 30 hrs . 207925.00 0.00%
Employee Mgm't Spec/ 30 hrs 20,925.00 0.00%
Children's Svc Specialist/ 16 hrs @48 wks . 15,360.00 15, 360 . 00 15 , 360 . 00 100 . 00%
Cook/ 40 hrs 19,448 .00 0 . 00%
Clerical Support/ 40 hrs . 17.680.00 0 . 00%
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
Remaining positions throughout the agency
Total Salaries $352, 542 .00 $197860.00 $ 15, 360 .00
FRINGE BENEFITS DETAIL A
F G
Funder Specific Budget Funder B D E
P g Pension Worker's Unemployme Total Fringes Funder
Column C only, from line 22 to 27) Specific FICA 7. 65% (A x %) Health Ins. Compens. nt Compens. Specific
Position Title / Total Hrs/wk Budget
Example: CaseManager140hrs 5, 000. 00 382. 50 200. 00 500. 00 300. 00 200. 00 1, 582. 50
Executive Director / 40 hrs 0 . 00 0.00 0.00
Accounting/Budget/16-18 hrs . 0 .00 0.00 0 .00
Fundraising and Development/ 40 hrs . 0.00 0.00 0.00
Resident Manager/ 40 hrs . 0.00 0.00 0. 00
Case Manager/ 40 hrs 0.00 0.00 0-00
Residential Case Worker 1/ 40 hrs 0.00 0.00 0. 00
Residential Case Worker II/ 40 hrs 0 .00 0.00 0.00
PT Care Worker/ 32 hrs 0 . 00 0 .00 0.00
PT Care Worker/ 24 hrs 0. 00 0 .00 0.00
PT Care Workers/ 16 hrs 0 . 00 0.00 0.00
Housing Mgm't . Spec ./40 hrs 0 .00 0. 00 0.00
Housing Specialist/ 30 hrs . 0. 00 0.00 1 0.00
Employee Mgm't Spec/ 30 hrs 0.00 0.00 0 . 00
Children 's Svc Specialist/ 16 hrs @48 wks . 15 . 360 .00 1 . 175 . 04 19201 .75 2 . 376 .79
Cook/ 40 hrs
0.00 0.00 0 . 00
Clerical Support/ 40 hrs . 0 .00 0.00 0 . 00
0
0.00 0 .00 0 .00
0
0.00 0.00 0.00
0
0.00 0 .00 1 0 .00
0
0.001 0 .001 0.00
Total Funder Request Fringe Benerits $ 15, 360. 001 $1 , 175. 041 $0.001 $0 . 00 $19201 .75 $0.00 1 $27376. 79
15
5/15/2003
Homeless Assistance Center - - Assets Build Futures
Type the Organization and Program Name
A B C D
EXPENDITURES GRAY AREAS FOR Proposed Total Program Funder Specific Total Agency
ACAMY
SHOW DETAIL Tu Budget Budget Budget
Travel-Daily 11200 . 00
# of Staff x average # of miles/wk x 50 wks x $
= Estimated Daily Travel/Mileage Reimb.
Travel/Conferences/Training 19500. 00
• National Conference (cost per staff)
• Training/Seminar (cost per staff)
• Other Trainings (cost of travel, lodging,
registration, food)
Office Supplies/Program 21000. 00 21000. 00 69000. 00
Office supplies (monthly average x 12 months
= estimated cost of office supplies based on
present history.
Telephone 200 . 00 81745 . 00
• # Phone lines x average cost per month x 12
months = local phone cost
• Average long distance calls x 12 months =
Estimated cost of long distance
Postage/Shipping 31800 . 00
• Quarterly Mailing of Newsletter
• Special events, etc ,
• Bulk mailings - appeals
Utilities 19000. 00 269000. 00
• Electricity ($ x 12 months)
• Water/Sewer ($ x 12 months)
• Garbage ($ x 12 months)
Occupancy (Building & Grounds) 11500. 00 11500. 00 91800. 00
• Mortgage/Rent ($ x 12 months)
• Janitorial ($ x 12 months)
• Grounds Maint. ($ x 12 months)
• Real Estate Taxes
Printing & Publications 500. 00 6 ,000 .00
Quarterly Newsletter ($ x 4)
Letterheads, Envelopes, etc .
Fundraising materials
Other
Subscription/Dues/Memberships 300. 00
Membership to National Organization
Dues
Subscriptions to Newspapers/magazines, etc.
Insurance 361 . 25 361 . 25 17 ,632 . 00
Directors/Officers Liab.
Commercial/General Insurance
Bond Ins.
Auto Insurance
Equipment:Rental & Maintenance 500. 00 31500. 00
• Copier lease ($ x 12 months)
• Meter lease ($ x 12 months)
• Copier Maintenance ($ x 12 months)
• Computer Maintenance ( $ x 12 months)
• Other
Advertising 300. 00
• Newspaper ads
• Fundraising ads/promotions
• Other (vacancies)
Equipment Purchases :Capital Expense 71623. 00
• Computer/monitor (# x $)
• Laser Printer
Homeless Assistance Center - - Assets Build Futures
Type the Organization and Program Name
41 Professional Fees (Legal, Consulting ) 7, 800 . 00
• Legal advice ( estimated #hrs x $)
• Consultant fees 144 hr @$25 hr
• Other 60 hr prep @ $ 15 hr
42 Books/Educational Materials 500. 00
Bookstvideos
Materials ($ x staff)
43 Food & Nutrition 149500. 00
Meals ( # meals x clients x 5days x 50 wks)
Snacks
44 Administrative Costs 121141 . 54
Admin. Cost (% of total budget)
45 Audit Expense 7, 500. 00
Independent Audit Review
46 Specific Assistance to Individuals 91000. 00
• Medical assistance
• Meals/Food
• Rent Assistance
• Other
47 Other/Miscellaneous 11000. 00 13000 . 00 19500. 00
• Background check/drug test
• Other
48 Other/Contract 4, 500. 00 49500. 00 17 , 500. 00
Sub-contract for program services
49 TOTAL EXPENSES $33,798.04 $27,098 .04 $6059008.00
5/15/2003
17
Homeless Assistance CenterftQmg ww° og� wff* Assets Build Futures
UNIFORM GRANT APPLICATION
TOTAL AGENCY BUDGET
AGENCYIPROGRAM NAME :
FY 01102 FY 02103 FY 03/04 % INCREASE
FYE_0613012002 FYE 6/30/2003 FYE 06/30/2004 CURRENT VS.
NEXT FY BUDGET
A B C D
ACTUAL TOTAL PROPOSED Ica. C<a. Byca. e
REVENUES BUDGETED BUDGETED
1 Children's Services Council-St. Lucie 0.00 #DIV/0!
2 Children's Services Council-Martin 0.00 #DIV/0 !
3 Children's Services Council-Okeechobee 0.00 #DIV/O!
4 Advisory Committee-Indian River 0.00 #DIV/0!
s United Wa St. Lucie County 0.00 #DIV/0!
s United Way-Martin County 0.00 #DfV/0!
7 United Way-Okeechobee County 0.00 #DIV/0!
s United Way-Indian River County 0.00 #DIV/0 !
9 Department of Children & Families 80,485.40 110,140.00 0.00 -100 .00%
10 County Funds 50,000.00 559336.00 110,708.00 100 .07%
11 Contributions-Cash 3119823.00 309,938.00 3525700.00 13 .80%
12 Program Fees 0.00 #DfV/0!
13 Fund Raising Events-Net 14,832.00 25,000.00 30,000.00 20.00%
14 Sales to Public-Net 0.00 #DIV/0!
is Membership Dues 0.00 #DIV10!
1s Investment Income 11125.69 600.00 E:#DIVE/O !
17 Miscellaneous 187.36 11000.00 is L acies & uests 10 ,000.00 DIV/0!
19 Funds from Other Sources Salvation Arm 25,000.00 1009000.00 300 .00%
20a Reserve Funds Used for Operating 0.00 #DIV/0!
20b In-Kind Donations (Not ncWded6, taa) 0.00 MV/O!
21 TOTAL 458,453.45 525y414.00 605,008.00 15.15%
EXPENDITURES
22 Salaries 240,406.00 276,299.00 352,542.00 27.59%
23 FICA 18,371 .00 21 ,136.87 26 ,969.46 27.59%
24 Retirement 39500.00 39500.00 0.00%
25 Life/Health 25,761 .00 20,625.00 38,431 .00 86.33%
26 Workers Compensation 79302.00 20,000.00 20,724.00 3 .62%
27 Florida Unemployment 0.00 0.00 #DIV/01
26 Travel-Daily 69073.00 800.00 1 ,200.00 50.00%
29 Travel/Conferences/Training 85.00 500.00 19500.00 200.00%
30 Office Supplies 29504.00 31980.00 67000.00 50.75%
31 Telephone 9,380.00 69745.00 89745.00 29.65%
32 Postage/Shipping 17567.00 1 ,455.00 31800 .00 161 . 17%
33 Utilities 24,427.00 189905.00 26 ,000 .00 37 .53%
34 Occupancy Buildin & Grounds 13,333.00 59000.00 9 ,800.00 96 .00%
35 Printing & Publications 39312.00 1 ,000.00 61000 .00 500 .00%
36 Subscription/Dues/Memberships 695.88 500.00 300.00 -40.00%
37 Insurance 10,330.00 109556.00 179632.00 67.03%
39 E ui ment:Rental & Maintenance 47206.00 69540.00 31500.00 46 .48%
39 Advertising 19538.19 19000.00 300 .00 -70 .00%
4o Equipment Purchases :Ca ital Expense 11 ,211 .05 20,000.00 71623 .00 -61 .89%
41 Professional Fees ( Legal , Consulting) 80.00 10,800.00 71800 .00 -27.78%
42 Books/Educational Materials 500.00 #DIV/0!
43 Food & Nutrition 79766.00 89500.00 14,500.00 70 .59%
44 Administrative Costs 21779.68 5,673.13 12, 141 .54 114.02%
45 Audit Expense 51500.00 69000.00 7 , 500 .00 25.00%
46
Specific Assistance to Individuals 41054.00 59,000.00 91000.00 -84.75%
47 Other/Miscellaneous 12,899.00 11500.00 88 .37%
49 Other/Contract 49000.00 17,500.00 337 .50%
49 TOTAL 4009681 .80 525,414.00 605,008.00 15. 15%
so REVENUES OVERT UNDER EXPENDITURES 1 579771 .65 0.00 0 .00 .14.29%
18
S'1520M
Homeless Assistance Cent erj;� f, .wp.. .. Assets Build Futures
UNIFORM GRANT APPLICATION
TOTAL PROGRAM BUDGET
AGENCYIPROGRAM NAME:
FY 01102 FY 02103 FY 03/04 % INCREASE
FYE FYE 06/30/03 FYE_ 06/30/04 CURRENT VS.
NEXT FY BUDGET
A B C D
ACTUAL TOTAL PROPOSED (coL CsoL BycoL e
REVENUES BUDGETED BUDGETED
1 Children's Services Council-St Lucie 0 .00 #DIV/0!
2 Children's Services Council-Martin 0.00 #DMO!
3 Children's Services Council-Okeechobee 0.00 #DIV/01
4 Advisory Committee-Indian River 0 .00 #DIV10!
s United Way-St Lucie County 0.00 #DIV/0!
6 United Way-Martin County 0 .00 #DIV/0!
7 United Way-Okeechobee County 0.00 #DMO !
a United Way-Indian River County 259000.00 27,098 .04 8 .39%
9 Department of Children & Families 0 .00 #DIV10 !
10 County Funds #DIV/0!
11 Contributions-Cash 0.00 #DMO !
12 Program Fees 0.00 #DIV10!
13 Fund Raising Events-Net 71420.00 69700.00 -9.70%
14 Sales to Public-Net 0.00 #DIV/0!
is Membership Dues 0 .00 #DIV/0!
16 Investment Income 0 .00 #DIV/0!
17 Miscellaneous 0 .00 #DIV/0!
18 Legacies & Bequests 0 .00 #DIV10 !
18 Funds from Other Sources 0 .00 #DIV/0!
20a Reserve Funds Used for Operating 0 .00 #DIV10 !
20b In-Kind Donations /nwlwwaaain7w7d) 0.00 #DIV/0 !
21 TOTAL 0.00 329420.00 33,798.04 4. 25%
EXPENDITURES
22 Salaries 22,815.00 19,860 .00 -12.95%
23 FICA 19175.04 #DIV/0!
24 Retirement 0.00 #DIV/O!
26 Life/Health 0.00 #DIV/0!
26 Workers Compensation 17201 .75 #DIV/0!
27 Florida Unemployment 0.00 #DMO!
2E Travel-Dail 0.00 #DIV/0!
29 Travel/Conferences/Training 800.00 0.00 -100.00%
30 Office Supplies 3,200.00 29000 .00 -37. 50%
31 Telephone 400.00 200 .00 -50.00%
32 Postage/Shipping 0 .00 #DIVIO !
33 Utilities 81 .00 11000.00 1134.57%
34 Occupancy (Building & Grounds 29160.00 1 ,500.00 -30.56%
36 Printing & Publications 800.00 500.00 -37.50%
36 Subscription/Dues/Memberships 0.00 #DMO!
37 Insurance 164.00 361 .25 120 . 27%
38 E ui ment:Rental & Maintenance 500 .00 #DIV10!
39 Advertising 0 .00 #DIV10!
40 Equipment Purchases:Ca ital Expense 0 .00 #DIV/0 !
41 Professional Fees (Legal, Consulting) 0 .00 #DIV/0 !
42 Books/Educational Materials 0 .00 #DIV10!
43 Food & Nutrition 0.00 #DIV10 !
44 Administrative Costs 0.00 #DIV/0!
46 Audit Expense 0.00 #DIV/0!
46 Specific Assistance to Individuals 0.00 #DIV/0!
47 Other/Miscellaneous 2,000.00 1 ,000 .00 -50.00%
49 Other/Contract 41500 .00 #DfV/0!
49 TOTAL 0.00 32,420.00 339798 .04 4.25%
60 REVENUES OVER/ UNDER EXPENDITURES 0.00 0.00 0 .00 #DIV10 !
19
575d103
r
Homeless Assistance Center - - Assets Build Futures
Type the Organization and Program Name
UNIFORM GRANT APPLICATION
FUNDER SPECIFIC BUDGET
PROGRAM EXPENSES
AGENCY/PROGRAM NAME :
FUNDER : A B c
FY 03/04 FY 03/04 % INCREASE
TOTAL FUNDER TOTAL VS ,
PROGRAM SPECIFIC FUNDER REQUEST
BUDGET BUDGET (col. B/col. A)
EXPENDITURES
22 Salaries 191860 .00 159360 . 00 77 . 34%
23 FICA 19175.04 1 , 175.04 100 .00%
24 Retirement 0 .00 0 .00 #DIV/0 !
25 Life/Health 0 .00 0 .00 #DIV/0 !
26 Workers Compensation 13201 .75 19201 .75 100 .00%
27 Florida Unemployment 0 .00 0 .00 #DIV/0 !
28 Travel-Daily 0 .00 0 .00 #DIV/0 !
29 Travel/Conferences/Training 0 .00 0 .00 #DIV/0 !
30 Office Supplies 29000 .00 2 ,000 .00 100 .00%
31 Telephone 200 . 00 0 .00 0 .00%
32 Postage/Shipping 0 .00 0 .00 #DIV/0 !
33 Utilities 19000 .00 0 .00 0 .00%
34 Occupancy ( Building & Grounds 11500 .00 19500 .00 100 .00%
35 Printing & Publications 500 .00 0 .00 0 . 00%
36 Subscri tion/Dues/Membershi s 0 .00 0 . 00 #DIV/0 !
37 Insurance 361 . 25 361 .25 100 .00%
38 E ui ment: Rental & Maintenance 500 .00 0 .00 0 .00%
39 Advertising 0 . 00 0 .00 #DIV/0 !
4o Equipment Purchases : Ca ital Expense 0 .00 0 .00 #DIV/0 !
41 Professional Fees ( Legal , Consulting ) 0 .00 0.00 #DIV/0 !
42 Books/Educational Materials 0 .00 0 .00 #DIV/0 !
43 Food & Nutrition 0 .00 0 .00 #DIV/01
44 Administrative Costs 0 . 00 0 .00 #DIV/0 !
45 Audit Expense 0 .00 0 .00 #DIV/0 !
46 Specific Assistance to Individuals 0 .00 0 .00 #DIV/01
47 Other/Miscellaneous 19000 .00 1 ,000 .00 100 .00%
48 Other/Contract 4, 500 .00 47500 .00 100 .00%
49 TOTAL $ 33 , 798 .04 $277098 .04 $0 . 80
��
20
Homeless Assistance Center - - Assets Build Futures
Type the Organization and Program Name
UNIFORM GRANT APPLICATION
EXPLANATION FOR VARIANCES OF 15% OR MORE
TOTAL PROGRAM BUDGET
AGENCY/PROGRAM NAME : HOMELESS ASSISTANCE CENTER
FUNDER : CHILDREN'S SERVICES GRANT
LINE ITEM EXPLANATION FOR VARIANCE
#DN/0!
#DIV/0!
#DIV/0!
#DN/O!
#DIVIO!
#DN/0!
#DIV/0!
#DIVIO!
#DIVIO!
#DIV/01
#DIV/0!
#DIVIO!
#DIVIO!
#DIVIO!
#DIVIO!
#DMO!
#DIVl0!
#DIVIO!
#DIVIO!
#DIVIO!
#DIV/0!
#DIVIO!
#DIVIO!
#DMO!
#DIV/0!
#DIVIO!
Utilities were partially covered in total lease payment in the pevious program , under current program. applicant has to cover all
utilities
!ltilit!es as the facility is owned by the applicant
#DMO!
Insurance Premium for Profesional liability has increased because of terrorism coverage
#DNI01
#DIVIO!
#DNI01
#DIVIO!
#DN/01
#DMO!
#DIVIO!
#DIVIO!
#DIV/0!
#DIVIO!
21
5/152003
r
Homeless Assistance Cente � ofgan® A. �nd
em�u Build Futures
UNIFORM GRANT APPLICATION
EXPLANATION FOR VARIANCES OF 15% OR MORE
FUNDER SPECIFIC BUDGET
AGENCYIPROGRAM NAME :
FUNDER :
LINE ITEM EXPLANATION FOR VARIANCE
Salaries To Fund Child Development Specialist Position to meet the anticipated 100% increase in clients served by 7/01 /03
FICA To fund FICA for new Child Development Specialist Position
MON/Ol
#DIV/O!
Workers Compensation HAC is can only obtain coverage through FWCJUA which is very expensive: figure is based on a pro rata share.
#DN/0!
#DN/0!
#DIVI01
Office Supplies Nature of Position and Client Base are different between the two Programs
#DNIO! Anticipate additional expense for supplies for a client base that is expected to double by 7/01 /03
Occupancy 8uildin & Grounds Total Capacity for the Homeless Assistance Center will have more than doubled from 6/30/02 to 7/01 /2003
MDN/0!
Insurance Premium for Profesional liability has increased because of terrorism coverage
#ON/0!
#DN/O!
#DN/O!
#DIV/0!
#DN/0!
#DIV/O!
#DIV/0!
#DN/0!
Tor provide for a contingency for unanticipated costs due to doubling in capacity and client base—total funder request is only
<5% of
Other/Miscellaneous total agency budget
OtherlContrad Based on the estimated cost of a child's art instructor and materials she provides for one full year.
5/1512003 22
HOMELESS ASSISTANCE CENTER
OFFICERS & DIRECTORS — 2002/03
President — Ferguson Peters Jr.
1 st Vice President — Frank Fagan
2nd Vice President — Doug Jordan
Treasurer — Richard Fava
Secretary — Donald Murray
Directors .
Elizabeth Atwan
Edward Barrett
Michael Catanzaro
Joseph DiLuciano
Brennan Egan
Don Evers, Jr.
Rosalie Hakker
Mariana Nigh
Richard Schlitt
Tom Tierney
Ellen Walker
Sue Rux — Executive Director
2525 St . Lucie Avenue, Vero Beach, FL 32960 • (561 ) 567-2766 • Fax ( 561 ) 567- 1454
lull
HOMELESS ASSISTANCE CENTER, INC .
Financial Statements
June 30, 2002
(With Independent Auditors' Report Thereon)
Morgan • Jacoby • Thurn • Boyle
j & Associates , P.A.
Certified Public Accountants
September 12 , 2002
Board of Directors
Homeless Assistance Center, Inc .
Ladies and Gentlemen :
We have audited the financial statements of the Homeless Assistance Center, Inc .
(Organization) for the year ended June 30, 2002, and have issued our report thereon
dated September 12 , 2002 . In planning and performing our audit of the financial
statements of the Organization we considered internal control in order to determine our
auditing procedures for the purpose of expressing our opinion on the financial statements
and not to provide assurance on internal control . The maintenance of adequate internal
control designed to fulfill control objectives is the responsibility of management .
Because of inherent limitations in any system of internal control, errors or fraud may
nevertheless occur and not be detected . Also , controls found to be functioning at a point
in time may later be found deficient because of the performance of those responsible for
applying them, and there can be no assurance that controls currently in existence will
prove to be adequate in the future as changes take place in the organization .
During the audit we noted certain matters involving the internal control structure and
other operational matters that are presented for your consideration. These comments
and recommendations, all of which have been discussed with the appropriate members
of management, are intended to improve the internal control structure or result in other
operating efficiencies and are as follows .
Formalize Accounting for Grants
The Organization is the beneficiary of certain U. S . Department of Housing and Urban
Development contracts and Florida Department of Children and Families contracts
wherein the grant recipients are Indian River County and Indian River Homeless
Services Council , Inc . , as agents on behalf of the Organization . Statement of Financial
Accounting Standard No . 136, Transfers of Assets to a Not-for-Profit- Organization or
Charitable Trust That Raises or Holds Contributions for Others, requires that grants and
donations held by others on behalf of the Organization be recorded as contributions in
the period they are determined . Therefore, we recommend the Organization record such
contracts and grants when they are committed and approved by the respective agencies .
Improve Accounts Payable Listing
The Organization ' s accounts payable detail listing as of June 30, 2002 contains several
small negative balances , due in part to incorrect postings of invoices or payments
relating to credit card payables and notes payable . We recommend the Organization
eliminate automatic entries for notes payable and accounts payable and investigate the
negative balances for proper treatment.
700 - 20th Street • Vero Beach, Florida 32960 • Phone 561 - 562 -4158 • Telefax 561 - 563 -2024
loll
Page 2
Allocate Debt Payments
The Organization ' s payments on certain notes payable were recorded as reductions of
principal on the related debt without allocation of a portion of the payments to interest
expense . We recommend the Organization record payments of principal and interest in
accordance with the related notes payable amortization tables .
Disposition of Prior Year Comments and Recommendations
During our audit of the 2001 financial statements , we noted certain matters involving
internal control that we reported in our letter dated August 31 , 2001 . A summary of
those comments and the Organization ' s resolution follows :
• Develop Formalized Accounting of Restricted Funds — we recommended that the
Organization develop and maintain an ongoing analysis of restricted fund activity to
ensure proper accountability of all restricted funds . The Organization developed an
analysis during the year ended June 30, 2002 .
• Maintain Donor Documentation — we recommended the Organization obtain
documentation of donor intent in situations where such intent has been
communicated verbally . The Organization obtained documentation of donor intent
during the year ended June 30, 2002 .
• Strengthen Bank Reconciliation Controls — we recommended the Organization ' s
executive director review monthly bank reconciliations . In addition, we
recommended old reconciling items be investigated and resolved on a timely basis .
We noted these conditions had improved during the ' year ended June 30, 2002 )
however, we noted additional dated reconciling items in the June 30, 2002 bank
reconciliation which should be investigated and resolved on a timely basis .
These conditions were considered in determining the nature, timing, and extent of the
audit tests applied in our audit of the 2002 financial statements, and this report does not
affect our report on these financial statements dated September 12 , 2002 . We have not
considered internal control since the date of our report .
This report is intended solely for the information and use of the board of directors,
management, and others within the organization.
Very truly yours,
AJ
y ,
1
HOMELESS ASSISTANCE CENTER, INC .
Table of Contents
June 30 , 2002
Page
Independent Auditors ' Report 1
Statement of Financial Position 2
Statement of Activities 3
Statement of Cash Flow 4
Notes to Financial Statements 5 - 12
V
1
Morgan * Jacob Thum • Boyle
lulj & Associates , P.A.
Certified Public Accountants
Independent Auditors ' Report
The Board of Directors
Homeless Assistance Center, Inc . :
We have audited the accompanying statement of financial position of the Homeless Assistance
Center, Inc . , as of June 30 , 2002 , and the related statements of activities and cash flows for the
year then ended . These financial statements are the responsibility of the Organization ' s
management. Our responsibility is to express an opinion on these financial statements based on
our audit.
We conducted our audit in accordance with auditing standards generally accepted in the United
States of America. 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 examining, 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 evaluating the overall financial statement
presentation. We believe that our audit provides 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 the Homeless Assistance Center, Inc. as of June 30 , 2002 , and the
changes in its net assets and its cash flows for the year then ended in conformity with accounting
principles generally accepted in the United States of America.
The financial statements include certain prior-year summarized comparative information in total
but not by net asset class . Such information does not include sufficient detail to constitute a
presentation in conformity with generally accepted accounting principles . Accordingly, such
information should be read in conjunction with the Organization ' s financial statements for the
year ended June 30 , 2001 , from which the summarized information was derived.
MORE; spy, 7RN l59>y�
September 12 , 2002 ,
except for note 11 ,
as to which the date is
September 19 , 2002
700 - 20th Street • Vero Beach, Florida 32960 • Phone 561 - 562 -4158 • Telefax 561 - 563 -2024
2
HOMELESS ASSISTANCE CENTER, INC.
Statement of Financial Position
June 30 , 2002
(with summarized information as of June 30 , 200 1 )
Assets
Temporarily All Funds Combined
Unrestricted Restricted 2002 2001
Current assets :
Cash and cash equivalents $ 67 ,232 485828 116 , 060 64 ,401
Accounts receivable (note 3 ) 50 , 896 - 50, 896 241159
Prepaid insurance 2 , 809 - 25809 6 , 756
Leasehold interest (note 5 ) - - - 2 , 116
Total current assets 120 , 937 485828 1693765 975432
Assets restricted to investment in building
fund (note 9) - 389 ,637 3895637 143 ,005
Property and equipment, net (note 4) 6213530 - 621 , 530 297 , 501
Leasehold interest (note 5 ) - - - 629 , 588
Other assets 21221. . - 2 , 221 2 ,438
Total assets $ 744 , 688 438 ,465 11183 , 153 1 , 169 , 964
Liabilities and Net Assets
Current liabilities :
Note payable to bank (note 6) 203000 - 20 , 000 -
Current installments of long-term debt
(note 6) 5 , 926 - 55926 -
Accounts payable and accrued
expenses 24 , 619 - 241619 95764
Due to clients 54533 - 5 , 533 3 , 743
Total current liabilities 56 , 078 - 56 , 078 13 , 507
Long-term debt (note 6) 17 , 185 - 17 , 185 -
Totalliabilities 73 ,263 - 73 ,263 13 , 507
Net assets :
Unrestricted 6715425 - 671 ,425 3585197
Temporarily restricted (note 9) - 438 , 465 4389465 798 ,260
6715425 438 ,465 1 , 109 , 890 1 , 156 , 457
Commitment (note 7)
Total liabilities and net assets $ 744 , 688 438 ,465 1 , 183 , 153 1 , 169 , 964
See accompanying notes to financial statements .
s
3
HOMELESS ASSISTANCE CENTER, INC .
Statement of Activities
Year ended June 30 , 2002
(with summarized information for the year ended June 30 , 200 1 )
Temporarily All Funds Combined
Unrestricted Restricted 2002 2001
Revenues and other support :
Contributions (note 9) $ 2051545 50 , 568 2563113 1 , 080 , 901
Fundraising income 703522 - 705522 138 , 598
Grants (notes 8 and 9 ) 316 , 845 493 , 568 810 ,413 128 ,284
Interest and miscellaneous income 11710 - 1 , 710 11 , 863
5945622 5443136 11138 , 758 1 , 359 , 646
Net assets released from restrictions
(note 9) 274 , 343 (274 , 343 ) - -
Total revenues and other support 8685965 269 , 793 1 , 138 , 758 1 , 359 , 646
Expenses (note 10) :
Salaries and related expenses 2925563 - 292 , 563 254 , 641
Fundraising 195381 - 19 , 381 181408
Temporary housing 28 , 381 - 28 , 381 -
Client expenses 123576 - 125576 145532
Occupancy 565718 - 56 , 718 455214
Repairs and maintenance 135333 - 13 , 333 6 , 353
Utilities 25 , 591 - 25 , 591 171139
Insurance 17 , 632 - 17 , 632 7 , 953
Depreciation 163687 - 16 , 687 61565
Supplies and postage 45469 ' - 4 , 469 12 ,461
Telephone 9, 107 - 9 , 107 7 ,220
Automobile 2 , 716 - 2 , 716 41690
Equipment rent 63698 - 6 , 698 6 , 557
Advertising 13567 - 15567 1 , 318
Professional fees 7, 190 - 7 , 190 115681
Interest expense (note 6) 2, 118 - 21118 906
Miscellaneous expenses 5 , 943 - 5 , 943 81298
Loss on disposal of assets 678 - 678 782
Total expenses 523 , 348 - 523 , 348 424 , 718
Transfer of leasehold interests (note 5 ) (32 , 389) (6294588) 661 977) -
Change in net assets 3132228 (359, 795 ) (46 , 567) 934 ,928
Net assets at beginning of year 358 , 197 798 , 260 1 , 156 ,457 221 , 529
Net assets at end of year $ 671 ,425 438 ,465 1 , 109 , 890 1 , 156 ,457
See accompanying notes to financial statements .
4
HOMELESS ASSISTANCE CENTER, INC.
Statement of Cash Flows
Year ended June 30 , 2002
(with summarized information for the year ended June 30 , 2001 )
2002 2001
Cash flows from operating activities :
Change in net assets $ (463567) 934 , 928
Adjustments to reconcile change in net assets to net cash
provided by operating activities :
Contributions restricted for long-term investment (50 , 568 ) ( 110055603 )
Leasehold interest rental expense 525684 285007
Depreciation expense 165687 65565
Loss on disposal of assets 678 782
Transfer of leasehold interests 661 , 977 —
(Increase) decrease in accounts receivable (26 , 737) 57 , 346
(Increase) decrease in prepaid insurance 33947 (3 , 618)
(Increase) decrease in other assets 217 (23088 )
Increase in accounts payable and accrued expenses 14 , 855 35788
Increase in due to clients 11790 21667
Net cash provided by operating activities 628 , 963 22, 774
Cash flows from investing activities :
Increase in assets restricted to investment in building fund (246 , 632) (423353 )
Purchase of fixed assets (348 , 906) (292 ,081 )
Net cash used by investing activities595 538 ) (334 ,434)
Cash flows from financing activities :
Proceeds from restricted contributions — 345 , 892
Advances from line of credit 20 ,000 203000
Repayments of line of credit — (20 ,000)
Repayments of long-term debt ( 1 , 766) —
Net cash provided by financing activities 18 , 234 345 , 892
Net increase in cash and cash equivalents 51 , 659 34 ,232
Cash and cash equivalents at beginning of year 64 ,401 30 , 169
Cash and cash equivalents at end of year $ 116 , 060 64 ,401
Supplemental data:
Non cash investing and financing activities :
Gift of leasehold interest $ — 659 , 711
Fixed assets acquired with long-term debt $ 24 , 877 —
Interest paid $ 2 , 118 906
See accompanying notes to financial statements ,
5
HOMELESS ASSISTANCE CENTER, INC .
Notes to Financial Statements
June 30 , 2002 and 2001
(1) Organization
The Homeless Assistance Center, Inc . (Organization) was incorporated in 1992 and is a
tax-exempt organization under Internal Revenue Code Section 501 (c) (3 ) . The
Organization was formed as the result of a non-funded mandate to establish community-
based collaborative efforts on behalf of the homeless in each Department of Children and
Families district in the State of Florida.
(2) Summary of Significant Accounting Policies
(a) Basis of Presentation
The Organization follows Statement of Financial Accounting Standards (SFAS ) No .
117, Financial Statements of Not-for-Profit- Organizations, which requires that
resources be classified for reporting purposes into three net asset categories . Those
categories include temporarily restricted , permanently restricted, and unrestricted
net assets as follows :
Unrestricted — Represents the portion of expendable funds that are available for
support of operations . Funds designated by the Board for specific purposes are also
reported as unrestricted net assets since the Board has the ability to release any
restrictions on these funds .
Temporarily Restricted — Represents the portion of expendable funds that are
restricted by the grantor or donor as to the way they may be utilized . The
Organization primarily uses this classification to account for donations received for
the capital expansion campaign, and the Temporary Financial Assistance for the
Homeless Program .
Permanently Restricted — Represents funds that must be maintained by the
Organization in perpetuity. During 2002 and 2001 , the Organization had no funds
required to be accounted for under this classification .
(b) Revenue Recognition
All contributions/donations are considered available for unrestricted use unless
specifically restricted by the donor. Contributions/donations are considered
temporarily restricted if a donor imposes a restriction that may be satisfied by the
passage of time or the actions of the Organization . A permanently restricted
contribution/donation stipulates that the contribution/donation be maintained
permanently but may allow the organization- to use all or part of the income derived
from the underlying asset for unrestricted purposes . When a donor 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 .
(Continued)
i
6
HOMELESS ASSISTANCE CENTER, INC .
Notes to Financial Statements
The Organization follows SFAS No . 136 , Transfers of Assets to a Not-for-Profit-
Organization or Charitable Trust That Raises or Holds Contributions for Others,
which requires that cash or other financial assets the Organization receives from a
donor and agrees to hold and subsequently transfer to another organization, are
recognized at fair value as liabilities instead of contribution revenue . In addition,
grants and donations held by others on behalf of the Organization are recorded as
contributions in the period they are determined .
(c) Cash Equivalents
For purposes of the statements of cash flows , the Organization considers all highly
liquid debt instruments purchased with original maturities of three months or less to
be cash equivalents .
(d) Property and Equipment
Property and equipment are recorded at cost for purchased items and fair value for
contributed items . Maintenance, repairs , and minor renewals are charged to
expense as incurred. Depreciation is provided using the straight-line method over
the estimated lives indicated below.
Years
Buildings and improvements ' 30
Leasehold improvements 30
Vehicles 7
Furniture and fixtures 7
Computer equipment 5
(e) Use of Estimates
The preparation of financial statements in conformity with accounting principles
generally accepted in the United States of America requires management to make
estimates and assumptions that affect the reported amounts of assets and liabilities
and disclosure of contingent assets and liabilities at the date of the financial
statements and the reported amounts of revenues and expenses during the reporting
period. Actual results could differ from those estimates .
(� Concentrations of Credit Risk
Financial instruments that potentially subject the Organization to concentrations of
credit risk consist principally of cash investments , pledges receivable, and assets
restricted to investment in building fund. Cash balances maintained in financial
institutions may at times be in excess of the FDIC limit. The Organization has not
experienced any losses on such amounts and does not believe it is exposed to any
significant risk with respect to such balances .
(Continued)
t
7
HOMELESS ASSISTANCE CENTER, INC.
Notes to Financial Statements
As of June 30 , 2002 and 2001 , uninsured investments in money market funds
included in cash and cash equivalents and assets restricted to investment in building
fund totaled $ 139 , 582 and $ 194 , 821 , respectively .
The Organization had no significant concentrations of credit risk with respect to
pledges receivable and collateral is not required to support pledges receivable .
(g) Prior Period Information
The financial statements include certain prior-year summarized comparative
information in total but not by net asset class . Such information does not include
sufficient detail to constitute a presentation in conformity with generally accepted
accounting principles . Accordingly, such information should be read in conjunction
with the Organization ' s financial statements for the year ended June 30 , 2001 , from
which the summarized information was derived .
(3) Receivables
As of June 30 , 2002 and 2001 , the Organization ' s contributions receivable totaling
$ 50 , 896 and $ 23 ,484 , respectively, consisted of unconditional pledges for which the
Organization anticipates full collection .
(4) Property and Equipment
As of June 30 , 2002 and 2001 , the components of the Organization ' s property and
equipment were as follows :
2002 2001
Land $ 140 , 600 65 , 000
Buildings and improvements 442 , 564 183 , 927
Leasehold improvements — 29, 991
Vehicles 11 ,211 —
Furniture and equipment 375422 26 , 035
Computer equipment 15 , 844 61427
647 ,641 311 , 380
Less accumulated depreciation 26 , 111 13 , 879
$ 621 , 530 297 , 501
(Continued)
r
8
HOMELESS ASSISTANCE CENTER, INC .
Notes to Financial Statements
(S) Leasehold Interest
Effective November 1 , 2000 , the Organization received contributions of leasehold rights
for a building for a thirty-year term . The Organization ' s rent under a signed lease
agreement is $ 1 per year. The present value of the fair market rent over the lease term,
which amounts to $ 659 , 711 , was determined using an 8 % discount rate, and has been
recognized as temporarily restricted support. The leasehold interests as of June 30 , 2001
are classified as follows :
Future leasehold rights $ 631 , 704
Less current portion 2 , 116
Leasehold interest — noncurrent $ 629 , 588
On May 7 , 2002 , the Organization vacated this building and the lease was assigned to
the Indian River Homeless Services Council, Inc . Accordingly, the Organization
charged off the related leasehold interest of $ 629 , 588 and leasehold improvements of
$ 32 ,389 as a transfer to the Indian River Homeless Services Council , Inc .
(6) Note Payable and Long- Term Debt
The Organization has a line of credit arrangement with a bank for borrowings of up to
$ 20,000 , bearing interest at prime, and expiring August 31 , 2002 . The balance
outstanding as of June 30 , 2002 was $ 20 , 000 and no balance was outstanding as of June
30, 2001 . Interest expense was $ 641 and $ 906 for the years ended June 30, 2002 and
2001 , respectively.
The Organization ' s long-term debt as of June 30, 2002 was as follows :
2002
Term loan payable in monthly installments of $ 265 , $
including interest at 9 . 75 °/x , through May 14 ,
2005 , secured by vehicle with a book value of
$ 111211 8 , 046
Term loan payable in monthly installments of $ 180,
including interest at 11 % , through February. 3,
2006 , secured by equipment with a book value
of $ 6 , 366 65477
Term loan payable in monthly installments of $ 191 ,
including interest at 6 . 75 % , through November
152006 84588
23 , 111
Less current maturities of long-term debt 54926
Long-term debt $ 17, 185
The aggregate maturities of long-term debt for the five years ending June 30 , 2007
follows : 2003 , $ 5 , 926 ; 2004 , $ 6, 505 ; 2005 , $ 6,453 ; 2006 , $ 3 , 362 ; and 2007, $ 865 .
(Continued)
f
9
HOMELESS ASSISTANCE CENTER, INC.
Notes to Financial Statements
(7) Lease Commitments
The Organization leased an administrative building from the County of Indian River,
Florida for a term of thirty years through 2030 . The rent under the lease is $ 1 per year.
The lease was assigned to Indian River Homeless Services Council , Inc . on May 7,
2002 . See note 5 .
During 2002 , the Organization leased a vehicle and certain office equipment under
operating leases . Future minimum payments under these leases as of June 30 , 2002 are
as follows : 2003 , $ 3 , 600 ; 2004, $ 3 ,600 ; and 2005 , $ 1 , 800 .
Rent expense under these leases totaled $ 7 , 273 and $ 21 , 458 for years ended June 30 ,
2002 and 2001 , respectively .
(8) Unrestricted Grant Revenue
Unrestricted grant revenue during the years ended June 30, 2002 and 2001 follow :
2002 2001
Homeless challenge grant $ 180 , 000 —
Indian River County 55 ,424 53 , 503
Emergency shelter grant 45 , 111 —
Department of Children and Families 125000 123660
Federal Emergency Management 23 , 375 75880
Other 935 —
$ 316 , 845 74 , 043
During the year ended June 30, 2002 , the Organization received a $ 180, 000 Homeless
Challenge grant from the Florida Department of Children and Families (DCF) for the
purpose of purchasing land and a building adjacent to the Organization' s homeless
shelter. The property serves as the Organization ' s administrative offices and provides
additional parking for the shelter.
During the years ended June 30 , 2002 and 2001 , the Organization received grants from
the Board of County Commissioners of Indian River County , Florida that provided
funding for certain operational expenses of up to $ 50, 000 each during the fiscal years
ending September 30, 2002, 2001 and 2000 . Actual amounts expended and available for
reimbursement during the years ended June 30 , 2002 and 2001 amounted to the
following :
2002 2001
Fiscal September 30 , 2002 grant $ 40,315 —
Fiscal September 30 , 2001 grant 15 , 109 345891
Fiscal September 30 , 2000 grant — 18 , 612
$ 55 ,424 53 , 503
(Continued)
10
HOMELESS ASSISTANCE CENTER, INC .
Notes to Financial Statements
During the year ended June 30, 2002 , the Organization received a $ 75 , 000 reimbursable
Emergency Shelter grant from DCF for the purpose of providing funding for staff
salaries , furnishings and equipment for the Organization' s homeless shelter. The
Organization had received $45 , 111 through June 30, 2002 for reimbursement of eligible
expenditures under the grant.
During the years ended June 30 , 2002 and 2001 , the Organization received funds from
DCF through grants that provided up to a total of $ 12,660 each. Actual amounts
expended and reimbursed during the years ended June 30 , 2002 and 2001 amounted to
$ 12 , 000 and $ 12 , 660 , respectively .
During the years ended June 30 , 2002 and 2001 , the Organization earned funds from the
Federal Emergency Management Agency through grants that provided $ 23 , 375 and
$ 7, 880 respectively, for supporting shelter operations .
(9) Temporarily Restricted Net Assets
Temporarily restricted net assets as of June 30 , 2002 and 2001 are available for the
following specific purposes .
2002 2001
Building fund $ 389, 637 774 , 709
Temporary Financial Assistance for the Homeless — 105131
Housing and support services case worker 12 , 140 13 ,420
Furnishings and equipment 36 , 688 —
Total $ 438 , 465 798 ,260
Temporarily restricted assets at June 30, 2002 consist of cash and cash equivalents
totaling $ 89 , 185 and contributions receivable totaling $ 349,280 . Temporarily restricted
assets at June 30, 2001 consist of cash and cash equivalents totaling $ 166 , 556 and
leasehold interest totaling $ 631 , 704 . See note 5 regarding the disposition of the leasehold
interest.
Temporarily restricted grant revenue during the years ended June 30 , 2002 and 2001
follows :
2002 2001
Family Options Transitional Housing $ 379 , 903 —
Temporary Financial Assistance for the Homeless 51 , 977 345241
Housing and support services case worker 25 , 000 2000
Furnishings and equipment 36, 688 —
Total $ 493 , 568 54 , 241
(Continued)
i
11
HOMELESS ASSISTANCE CENTER, INC.
Notes to Financial Statements
Temporarily restricted net assets released from donor restrictions by incurring expenses
or by otherwise satisfying restrictions during the years ended June 30 , 2002 and 2001
were as follows .
2002 2001
Building fund $ 1855954 3405972
Continuum of Care — 75865
Temporary Financial Assistance for the Homeless 62, 109 322342
Housing and Support Services Case Worker 26 ,280 11 , 640
Total $ 274 , 343 392 , 819
On July 25 , 2001 , the United States Department of Housing and Urban Development
(HUD) awarded a Supportive Housing Grant (Grant) to the Indian River Homeless
Services Council, Inc. and Indian River County, Florida (County) , which was accepted
and executed on August 7 , 2001 . The underlying project of the Grant, named "Family
Options Transitional Housing Program" is the Organization' s shelter located in Vero
Beach, Florida. Total funding to the County under the Grant amounts to $ 293 , 898 , of
which $ 230 , 741 relates to rehabilitation of the shelter ' s building, $49 , 162 is for support
services at the shelter, and $ 13 , 995 is for administrative costs incurred by the County
during the rehabilitation project. The Grant requires community matching in order to
receive funding from HUD . The matching component currently consists of an allocation
of $ 100 ,000 in funding under the County ' s State Housing Initiatives Program (SHIP ) , a
$ 100,000 donation made to the Center during the year ended June 30 , 2000 , and
approximately $43 , 000 in other donations (of which the Organization has committed
$ 40,000) . The County ' s SHIP award establishes certain monitoring requirements, in
addition to HUD monitoring, and a lien on the Organization' s property for a term of
fifteen years through July 2017. Upon completion. of the project ' s rehabilitation phase ,
the improvements will be turned over to the Organization. The Organization is required
to operate the improvements in accordance with the HUD contract during the fifteen year
period or is subject to reversion features which would require a return of the Grant
proceeds and/or County SHIP proceeds .
During the year ended June 30, 2002 , the Organization received $ 130, 623 in Grant
funding for waste water and other land improvement construction at the Organization ' s
homeless shelter, which was required prior to commencing further construction noted
above . As of June 30 , 2002 , the Organization has recorded a contribution receivable of
$ 349,280 as beneficiary of the Grant.
During the year ended June 30, 2000, the Organization received a contract from the
Florida Coalition for the Homeless , Inc . for the purpose of assisting homeless families of
Indian River, St. Lucie, Martin, and Okeechobee Counties in obtaining safe, affordable
housing under the Temporary Financial Assistance for the Homeless Program . During
the years ended June 30, 2002 and 2001 , the Organization received funding of $ 51 , 977
and $ 34 ,241 , respectively. As of June 30 , 2001 , the Organization had received funding of
$ 10 , 131 under this grant which was to be disbursed during the year ended June 30 , 2002 .
This contract was completed during the year ended June 30 , 2002 .
(Continued)
12
HOMELESS ASSISTANCE CENTER, INC .
Notes to Financial Statements
During the years ended June 30 , 2002 and 2001 , the Organization received $ 25 , 000 and
$ 20, 000 , respectively, in private grants for the purpose of funding a housing and support
services case worker . The amounts earned as of June 30 , 2002 and 2001 amounted to
$ 12 , 860 and $ 6 , 580 , respectively .
During the year ended June 30 , 2002 , the Organization received a $ 36 , 688 private grant
for the purpose of purchasing various furnishings and equipment for the Organization ' s
homeless shelter. The grant was unexpended as of June 30 , 2002 .
(10) Functional Expenses
The Organization provides assistance services to poverty level and homeless individuals ,
consisting of food and clothing distribution, hot showers and laundry facilities , crises
intervention and referral, as well as dormitory space for the homeless .
Expenses incurred were for the following :
2002 2001
General community support $ 362 , 518 3215401
General and administrative 96 , 503 73 , 699
Fundraising 64 , 327 29 ,618
$ 523 , 348 4241718
(11) Subsequent Events
In July 2002 , the Organization received a $ 25 ,000 grant from Indian River County for the
purpose of providing a children arts program. In addition, in September 2002 , Indian
River County renewed its operational grant for $ 55 , 336 . The grants run from October 1 ,
2002 to September 30, 2003 .
On August 19 , 2002 , the Organization received a $ 75 , 000 grant from DCF for the
purpose of providing rental assistance to homeless families in DCF District 15 . The grant
provides funding on a reimbursement basis and expires on June 30 , 2003 .
HUD has awarded an additional $210 , 191 grant, named "Family Options Transitional
Housing Supportive Services Team," to the Indian River Homeless Services Council , Inc .
and Indian River County, Florida for the purpose of providing additional funding for
supportive services staff for the Organization' s homeless shelter (see note 9) . The
contract for this grant was approved by HUD in August 2002 and approved by Indian
River County on September 3 , 2002 . The Organization has committed a total of $ 40 , 000
over the next three years in matching funds that are required under the contract.
On September 19 , 2002, the Organization forwarded $ 40 ,000 to Indian River County to
fulfill the required matching under the $293 , 878 HUD contract discussed in note 9 .
On August 31 , 2002 , the Organization' s line of credit arrangement was renewed for
$ 70 ,000 and extended to August 31 , 2003 .
A - AV1 � -� 4 + Fpm
fk
TAX RETURN FILING INSTRUCTIONS
FORM 990
FOR THE YEAR ENDING
JUNE . . . 3. o. .< . . . . 2. 0. 0. 2. . . . . . .
Prepared for
HOMELESS ASSISTANCE CENTER , INC .
715 4TH PLACE
VERO BEACH , FL 32962
Prepared by
MORGAN , JACOBY , THURN , BOYLE & ASSOC PA
700 20TH ST
VERO BEACH , FL 32960
Amount due NOT APPLICABLE
or refund
Make check NOT APPLICABLE
payable to
Mail tax return
and check (if INTERNAL REVENUE SERVICE CENTER
applicable) to OGDEN , UT 84201 - 0027
Return must be
mailed on FEBRUARY 18 , 2003
or before
Special
Instructions THE RETURN SHOULD BE SIGNED AND DATED .
100941
07- 18-01
TAXPAYER' S RO z
Return of Organization Exempt From Income Tax OMB No. 1545-0047
Form 990 Under section 501 (c ) , 527 , or 4947 ( a )( 1 ) of the Internal Revenue Code ( except black lung 2001
Department of the Treasury benefit trust or private foundation ) Open to Public
Internal Revenue Service ► The organization may have to use a copy of this return to satisfy state reporting requirements. Inspection
A For the 2001 calendar year, or tax year period beginning JUL 1 f 2001 and ending JUN 3 0 2002
B Check if please C Name of organization D Employer identification number
applicable: use IRS
Address label or
® change print orHOMELESS ASSISTANCE CENTER INC . 59 - 3129752
lhanrne ge tsee Number and street (or P.O. box if mail is not delivered to street address ) Room/suite E Telephone number
aretur 715 4TH PLACE 772 - 567 - 2766
return Specific
Final Instruc-
�return tions. rER
or town, state or country, and ZIP + 4 F Accounting method : ® Cash Accrual
Amended Other
=return O BEACH FL 32962 5 �� ►
a Application • Section 501 ( c )( 3) organizations and 4947( a )( 1 ) nonexempt charitable trusts H and I are not applicable to section 527
organizations.
pending 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: N A H( b ) If "Yes; enter number of affiliates ►
H( c ) Are all affiliates included? N / A Yes No
J Organization type (check only one) ► ® 501 (c ) ( 3 ) (insert no.) = 4947(a )( 1 ) or Q 527 ( If °No," attach a list )
K Check here Pilo- = if the organization ' s gross receipts are normally not more than $25,000. The H( d ) Is this a separate return
filed by an or-
organization need not file a return with the IRS; but if the organization received a Form 990 Package ganization covered by a group rulin
? Yes ® No
in the mail, it should file a return without financial data. Some states require a complete return . I Enter 4 -di it GEN ►
M Check ► 1=1 if the organization is not required to attach
L Gross receipts: Add lines 6b , Sb, 9b, and 10b to line 12 ► 1 , 1121021 * Sch. B (Form 990, 990 -EZ, or 990-PF).
Part I Revenue, Expenses , and Changes in Net Assets or Fund Balances
1 Contributions, gifts, grants, and similar amounts received:
a Direct public support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . la 229f376 *
b Indirect public support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . 1 b
c Government contributions ( grants) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. is 810r413 .
d Total (add lines 1a through 1c )
(cash $ 1 , 0 3 9 , 7 8 9 . noncash $ ) .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 d 1
, 039t789 *
2 Program service revenue including government fees and contracts (from PartVII , line 93 ) . . . . . . . . . . . 2
3 Membership dues and assessments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
4 Interest on savings and temporary cash investments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1 4 1 710 .
5 Dividends and interest from securities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . 5
6 a Gross rents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . 6a
b Less: rental expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 . . . . . . . . . . . . . . . . . .
. . . . . . . . 6b
c Net rental income or ( loss ) (subtract line 6b from line 6a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . .
. . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . 6c
'c 7 Other investment income ( describe ► 7
m 8 a Gross amount from sale of assets other A Securities 8 Other
tx than inventory 8a
b Less: cost or other basis and sales expenses . . . . . . . . . 8b 678
.
c Gain or ( loss ) (attach schedule ) . . . . . . . . . . . . . . . . . . . . . . . . . . . 8c < 678 .
d Net gain or ( loss ) (combine line 8c, columns (A) and ( B )) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .STMT . . . 1. . . . Sd < 678 . >
9 Special events and activities (attach schedule )
a Gross revenue ( not including $ 0 . of contributions
reported on line 1a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . 4 . . . . 9a 701522 ,
b Less: direct expenses other than fundraising expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I 9b
c Net income or ( loss ) from special events ( subtract line 9b from line 9a ) . . . _ _ . . . . . . SEE , . STATEMENT . . . 2. . . . 9c 7
0 5 2 2 .
10 a Gross sales of inventory, less returns and allowances . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I10a
b Less: cost of goods sold . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . 10b
c Gross profit or ( loss ) from sales of inventory (attach schedule ) ( subtract line 10b from line 10a) 10c
11 Other revenue (from Part VII , line 103 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 . . .
. . . . . :. . . . . . . . . . . . . . . . . . . . . . . . . . - . . . . . . . . . . . . . . . 11
12 Total revenue add lines id 2 31 4 5 6c 7 8d 9c 10c and 11 . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 1 111 1 343
.
13 Program services (from line 44, column ( B )) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . 13 798 967
.
14 Management and general (from line 44, column (C )) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. 14 253 953
.
CIL 15 Fundraising ( from line 44, column ( D ) ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 125 302
.
X 16 Payments to affiliates (attach schedule ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
17 Total expenses add lines 16 and 44 column A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 1 178 f 222
.
18 Excess or (deficit) for the year ( subtract line 17 from line 12 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . 18 < 66 879 . >
N
y 19 Net assets or fund balances at beginning of year (from line 73, column (A)) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . 19 1 , 134 , 917 .
Zu) 20 Other changes in net assets or fund balances (attach explanation ) 20 0 .
21 Net assets or fund balances at end of year combine lines 18, 19, and 20 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . 21 1 1 068 038
.
123001
01 -04-02 LHA For Paperwork Reduction Act Notice , see the separate instructions Form 990 (2001 )
TANCE CENTER HOMELESI
Form 990 (200 1) HOMELESS ASSISTANCE CENTER , INC . __ 59 - 3129752 Paget
(( Pa�nt IItatement ot All organizations must complete column (A ). Columns ( B ), ( C), and ( D ) are required for section 501 ( c ) (3
) and
Functional EX enses 4 organizations and section 4947(a) ( nonexempt charitable trusts but optional for others.
Do not include amounts reported on line (B ) Program ( C ) Management ( D ) Fundraising
6b, 8b, 9b, 10b, or 16 of Part 1. (A) Total services and eneral
22 Grants and allocations (attach schedule ) . . . . . . . . . . . .
cash $ 15 , 799 . noncash $ 22 15 , 799 * 15 7 9 9 . S TATEMENT 6
23 Specific assistance to individuals (attach schedule ) 23
24 Benefits paid to or for members (attach schedule ) 24
25 Compensation of officers, directors, etc. . . . . . . . . . . . . 25 42 , 000 * 12 1600 * 2 9 4 0 0 . 0
.
26 Other salaries and wages . . 26 202f293 * 139 565 . 42f493 * 20 235 .
27 Pension plan contributions 27
28 Other employee benefits . . . . . . . . . . . . . . . . . . . . . . 28
29 Payroll taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 44 , 685o 30 , 833
* 9 384 . 4 468 .
30 Professional fundraising fees 30
31 Accounting fees . . . . . .
, . , . . . .
31 7 r 715 . 5 323 e 1 620 * 772 .
32 Legal fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
33 Supplies . . . . . . . . . . . . . . . . . . . . . . . 33 3 383 a 2 444 e 636 . 303 e
34 Telephone . . . . . . . . . . . . . . . . . . . . 34 6 838 a 4 f 718 . 1 t 436 * 684 .
35 Postage and shipping . . . . . . . 35 1 104 . 762 . 232 . 110 .
36 Occupancy . . . . . . . . . . . . . . . . . . . . 36 742 838 a 512 781 * 15 5 845 * 7 4 212 .
37 Equipment rental and maintenance 371 20 032 * 13 1 822 0 4 207 * 2 003 o
38 Printing and publications 38 463 * 320 . 970 460
39 Travel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
40 Conferences, conventions, and meetings . . . . . . . . . . . . 40
41 Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
42 Depreciation, depletion, etc. (attach schedule ) _ . . 42 16 f 6 8 7 e 11 514 . 3 504 e 1 f 6 6 9
.
43 Other expenses not covered above ( itemize ):
a 43a
b 43b
c 43c
d 43d
e SEE STATEMENT 3 43e 72 , 267a 48 , 486o 2 , 981al 20 , 800o
44 Total functional expenses (add lines 22 through 43)
Organizations completing columns (B)-(D), carry these 44 1 17 8 2 2 2 . 798t967 * 2 5 3 9 5 3 . 125f302 *
totals to lines 13 - 15 . . . . . . . . . . . . . . . . . . . . . . .
Joint Costs . Check ► E] if you are following SOP 98-2.
Are any joint costs from a combined educational campaign and fundraising solicitation reported in (B ) Program services? ► = Yes ®
No
If "Yes; enter (i ) the aggregate amount of these joint costs $ ; ( ii ) the amount allocated to Program services $ ;
( iii ) the amount allocated to Management and Qeneral $ and iv the amount allocated to Fundraising
Part III I Statement of Program Service Accomplishments
What is the organization 's primary exempt purpose? ► SEE STATEMENT 4
Program Service
Expenses
All organizations must describe their exempt purpose achievements in a clear and concise manner. State the number of clients served, publications issued,
etc. Discuss (Required for 501(cX3) and
achievements that are not measurable. (Section 501(cX3) and (4) organizations and 4947(aX1) nonexempt charitable trusts must also enter the amount of grants
and (4) orgs., and 4947(aX1)
allocations to others.) trusts; but optional for others.)
a SEE STATEMENT 5
Grants and allocations 798 , 967 *
b
Grants and allocations
C
Grants and allocations $
d
Grants andallocations $
e Other program services attach schedule ( Grants and allocations $
f Total of Program Service Expenses (should equal line 44 column ( B ) Program services ) ► 798 , 967
*
123011 2 Form 990 (2001 )
01 -02-02
Form 990 ( 2001 ) HOMELESS ASSISTANCE CENTER INC* 59 - 3129752 Page 3
Part IV Balance Sheets
Note : Where required, attached schedules and amounts within the description column (A) ( B )
should be for end-of-year amounts only. Beginning of year End of year
45 Cash - non- interest-bearing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . 64 401 . 45 116 f 060 .
46 Savings and temporary cash investments . . . , . . . _ . . . . . . . . . . . . . . . . . . . . . . . 14 3 0 0 5 .
46 389 , 637a
47 a Accounts receivable47a
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b Less: allowance for doubtful accounts 47b 47c
48 a Pledges receivable
b Less: allowance for doubtful accounts 48b 48c
49 Grants receivable49
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 . . . . . . . . . . . . . . . . . . . . . . . .
50 Receivables from officers, directors, trustees,
andkey employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . 50
N
w 51 a Other notes and loans receivable 51 a
N . . . . . . . . . . . . . . . . . . . . . . . .
Q b Less: allowance for doubtful accounts . . . . . . . . . . I . . . . . . . 51b 51c
52 Inventories for sale or use 52
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . .
53 Prepaid expenses and deferred charges . . . . . . . . . . . . . . . . . . . . . . . . .
54 Investments - securities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ► Cost FMV 54
55 a Investments - land, buildings, and
equipment: basis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55a
b Less: accumulated depreciation . . . . . . . . . . . . . . . . . . . . . . . . . . . 55b 55c
56 Investments - other56
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . .
57 a Land, buildings, and equipment basis . . . . . . . . . . . . . . . . . . . . 57a 6
b Less: accumulated depreciation . . . . . .STMT . . . 7. . . . 57b 26 111 . 2 9 7 5 0 1 . 57c 621 , 530a
58 Other assets ( describe ► SEE STATEMENT 8 ) 6 3 4 14 2 . 58 2 r 221 .
59 Total assets add lines 45 through 58 must equal line 74 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
139 , 049 * 59 11129 , 448 *
60 Accounts payable and accrued expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 . . . . . . . . . . . . . . . . . . . .
. . . . . . 389 . 60
61 Grants payable . . . . . . . . . . . . . . . . . . . . . . . . . . 4 . . . . . .
v 62 Deferred revenue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . 62
a
63 Loans from officers, directors, trustees, and key employees . . . . . . . . . 63
J 64 a Tax-exempt bond liabilities4 . 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . 64a
b Mortgages and other notes payable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 . . . . . . . . . . . . . . . . .
. . . . . . . . . 64b 43 111 .
65 Other liabilities (describe ► DUE TO CLIENTS ) 31743 * 65 5 533 .
66 Total liabilities add lines 60 through 65 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 . . . . . . . . . . . . . . . .
. . . . . . . . 4 13 2 . 66 61 , 410o
Organizations that follow SFAS 117 , check here ► ® and complete lines 67 through
69 and lines 73 and 74.
67 unrestricted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . 336 657 67 629 573
m 68 Temporarily restricted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . 798 260 . 68 438 465 *
M 69 Permanently restricted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . 69
Organizations that do not follow SFAS 117 , check here ► 0 and complete lines
LL 70 through 74.
.oN. 70 Capital stock, trust principal, or current funds70
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
H71 Paid-in or capital surplus, or land, building, and equipment fund
W
71
a 72 Retained earnings, endowment, accumulated income, or other funds
. . . . . . . . . . . . . . . . . . . . . • 72
Z 7*3 Total net assets or fund balances (add lines 67 through 69 OR lines 70 through 72;
column (A) must equal line 19; column ( B ) must equal line 21 ) . . . . . . . . . . . . . . . . . . . . . . . . . 1 , 134 , 917
. 73 1 0 6 8 0 3 8 .
74 Total liabilities and net assets / fund balances (add lines 66 and 73 ) 1 , 139 , 049 * 74 1 , 129
, 448 *
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.
123021
01 -02-02 3
Form990 2001 HOMELESS ASSISTANCE CENTER INC . 59 - 3129752 Page
Part IV-A Reconciliation of Revenue per Audited Part IV-B Reconciliation of Expenses per Audited
Financial Statements with Revenue per Financial Statements With Expenses per
Return Return
a Total revenue, gains, and other support a Total expenses and losses per
per audited financial statements . . . . . . . . . . . . . . . . . . ► a 1 138 1 758 . audited financial statements _ . . . . . . .
. . . . . . . . . . . . . ► a 1 , 185 , 325 .
b Amounts included on line a but not on
b Amounts included on line a but not on line 17, Form 990:
line 12, Form 990: ( 1 ) Donated services
( 1 ) Net unrealized gains and use of facilities . _ _ $
on investments . . . . . . $ ( 2 ) Prior year adjustments
(2 ) Donated services reported on line 20,
and use of facilities , . . $ Form 990 . . . _ . . . _ . $
(3 ) Recoveries of prior ( 3 ) Losses reported on
year grants . . . . . . . . . . . . $ line 20, Form 990
(4 ) Other (specify): ( 4 ) Other (specify):
STMT 9 $ 27 , 415 . STMT 10 $ 7 , 103 .
Add amounts on lines ( 1 ) through ( 4) . . . . . . . . . ► b 27 , 415a Add amounts on lines ( 1 ) through ( 4 ) .
. . . . . . . . ► b 7 , 103 *
c Line a minus line . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ► e 1 111 343 . c Line a minus line .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . No- c 1 178 t 222 .
d Amounts included on line 12, Form d Amounts included on line 17, Form
990 but not on line a : 990 but not on line a :
( 1 ) Investment expenses ( 1 ) Investment expenses
not included on not included on
line 6b , Form 990 . . . $ line 6b, Form 990 . . . $
(2 ) Other (specify): (2 ) Other (specify):
Add amounts on lines ( 1 ) and (2 ) . . . . . . . . . . . . . . . ► d 0 . Add amounts on lines ( 1 ) and (2 ) _ . . .
. _ . _ . . . . . . _ ► d 0 .
e Total revenue per line 12, Form 990 a Total expenses per line 17, Form 990
(line c plus line d) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . e 1 111 343 . ( line c plus line d)
. . . . . . . . . . . . . . 11� 1 e 1 178 222 .
Part V I List of Officers , Directors, Trustees , and Key Employees (List each one even if not compensated. )
(B ) Title and average hours (C ) Compensation ( D ) Contributions to (E ) Expense
e ployee benefit
(A) Name and address per week devoted to ( If not paid. , enter plans & deferred account and
position .0 - com ensation other allowances
—
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - -
SEE STATEMENT 11 42f000 * 0 . 0 .
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
V
J
V
J
75 Did any officer, director, trustee, or key employee receive aggregate compensation of more than $ 100,000 from your organization and all related
organizations, of which more than $ 10,000 was provided by the related organizations? If "Yes," attach schedule . Pop- EJ Yes ®
No Form 990 ( 2001 )
Form 990 (200 1 ) HOMELESS ASSISTANCE CENTER INC* 59 - 3129752 Page 5
Part VI I Other Information IYes No
76 Did the organization engage in any activity not previously reported to the IRS? If "Yes," attach a detailed description of each activity
. . . . . . . . . . . . 76 X
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.
78 a Did the organization have unrelated business gross income 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? . . . . . . . . . . . . . . . . . . . . . . . . NIA . . . .
. . . . . 78b
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
79 Was there a liquidation , dissolution, termination, or substantial contraction during the year? . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . 79 X
If "Yes,` attach a statement
80 a 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 t X
b If `Yes; enter the name of the organization ►
and check whether it is 0 exempt OR 0 nonexempt
81 a Enter direct or indirect political expenditures. See line 81 instructions . . . . . . . . . . . . . . I 81a 1 0 .
b Did the organization file Form 1120-POL for this year? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 . . . . . . . . . . . . . . . 81b X
82 a 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 not include this amount as revenue in Part I or as an
expense in Part II . (See instructions in Part 111 .) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I
82b N / A
83 a Did the organization comply with the 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? N /A . . . . . . . . . 83b
84 a Did the organization solicit any contributions or gifts that were not tax deductible?
b If `Yes; did the organization include with every solicitation an express statement that such contributions or gifts were not
tax deductible?
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 lobbying expenditures of $2,000 or less? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
. . . . . . . N /A . , . . . . . . , 85b
If "Yes" was answered to either 85a 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 N / A
d Section 162 (e ) lobbying and political expenditures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85d N
/ A
e Aggregate nondeductible amount of section 6033(e )( 1 )(A) dues notices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
85e N / A
f Taxable amount of lobbying and political expenditures (line 85d less 85e ) . . . . . . . . . 85f N / A
g Does the organization elect to pay the section 6033 (e) tax on the amount in 85f? . . . . . . . . . . . . . . . . . . . . . . . . . . . . N /A
. . . , _ _ . . . 85
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) organizations. Enter: a Initiation fees and capital contributions included on line 12 . . . . . . . . . . . 86a N
/ A
b Gross receipts, included on line 12, for public use of club facilities . . . . . . . . . . . . . . . . . . . . 86b N / A
87 501 (c)(12) organizations. Enter: a Gross income from members or shareholders . . . . . . . . . . . . . . . . . . . . . . . . . . . 87a N
/ A
b Gross income from other sources. (Do not net amounts due or paid to other sources
against amounts due or received from them. ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87b
N / A
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 IX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88
X
89 a 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 .
b 501 (c)(3) and 501 (c)(4) organizations. 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 transaction89b X
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
c Enter: Amount of tax imposed on the organization managers or disqualified persons during the year under
sections4912, 4955, and 4958 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 . . . . . . . . . . . ► 0 .
d Enter. Amount of tax on line 89c, above, reimbursed by the organization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . pop0
90 a List the states with which a copy of this return is filed ► FLORIDA
b Number of employees employed in the pay period that includes March 12, 2001 . . . . . . . . . . . . . 0 . . 4 . . . . . . 90b 11
91 The books are in care of Pop- JIM ALS I P Telephone no. ► 772 - 567 - 2766
Located at ► 715 4TH PLACE VERO BEACH FL ZIP + 4 ► 32962
92 Section 4947(a)(1) nonexempt charitable trusts filing Form 990 in lieu of Form 1041 - Check here . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 . . . . . 10-
and
and enter the amount of tax-exempt interest received or accrued during the tax year . . ► 192 I N / A
1 - 2--02
123041
5 Form 990 (2001 )
O1 -0
I �
Form 990 (2001 ) HOMELESS ASSISTANCE CENTER INC . 59 - 3129752 Page
Part VII I Analysis of Income - Producing Activities (See Specific Instructions on page 32. )
Note : Enter gross amounts unless otherwise Unrelated business income Excluded by section 512 , 513 , or 514 ( E )
indicated. (A) ( B ) EP ( D ) Related or exempt
Business Amount s;on Amount
93 Program service revenue: code code function income
a
b
C
d
e
f Medicare/Medicaid payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
g Fees and contracts from government agencies . . . . . . . . . . . .
94 Membership dues and assessments
. . . . . . . . . . . . . . . . . . . . . . . .
95 Interest on savings and temporary
cash investments 1 710 .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
96 Dividends and interest from securities
. . . . . . . . . . . . . . . . . . . . .
97 Net rental income or ( loss) from real estate:
a debt-financed property . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b not debt-financed property . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4 . . . . . . .
98 Net rental income or ( loss ) from personal property . . . . .
99 Other investment income
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
100 Gain or (loss ) from sales of assets
other than inventory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . < 678
. >
101 Net income or ( loss) from special events . . . . . . . . . . . . . . . . . . 7 0 5 2 2 "
102 Gross profit or ( loss) from sales of inventory . . . . . . . . . . . .
103 Other revenue:
a
b
C
d
e
104 Subtotal (add columns (B ), (D ), and (E ) ) . . . . . . . . . . . . . . . . . . 0 . 0 . 71 , 554 *
105 Total (add line 104 , columns ( B), ( D), and (E ) ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ► 71 , 554
.
Note : Line 105 plus line 1d, Part 1, should equal the amount on line 12, Part L
Part'Vill Relationship of Activities to the Accomplishment of Exempt Purposes ( See Specific 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
V exempt purposes (other than by providing funds for such purposes ).
HE ORGANIZATION IS DEDICATED TO END HOMELESSNESS THROUGH PROVIDING
OR THE IMMINENT NEEDS OF THE INDIGENT IN CONCERT WITH OFFERING
ONTINUED EDUCATION AND SKILLS NECESSARY TO DEVELOP HEALTHY LIFESTYLES
Part IX Infonnation Regarding Taxable Subsidiaries and Disregarded Entities (See Specific Instructions on page 33. )
A 8 C D E
Name, address, and )EIN of corporation, Percentage of Nature (C) ( D )
Total income End -of-year
partnership, or disregarded entity ownership interest assets
N / A %
Part x I Information Regarding Transfers Associated with Personal Benefit Contracts (See Specific Instructions on page 33. )
(a ) Did the organization, during the year, receive any funds, directly or indirectly, to pay premiums on a personal benefit contract? . . .
. . . . . . . . . 0 Yes ® No
(b ) Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? 0 Yes ®
No
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note : if " Yes " to b file Form 8870 and Form 4720 see instructions).
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge
and belief, it is true,
correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Please � _ ,a„ ' .1 �`'c�^ F
r .
Sign ! r`e,.._ e
Here ' Signature of ' er Date ' Type or print name and title
Preparer's Date Check if Preparer' s SSN or PTIN
Paid Z „ 7" o 3 self
signature employed ► 0
Preparer's FirrWsname (or
Use Only yours if MJA Y , THURN , BOYLE & . AS SOC PA EIN ►
self-employed), ' 7H S
123161 address, and
01 -02-02 ZIP + 4 VM
AC FL 32960 Phone no. ► 772 562 - 4158
6 Form 990 (2001 )
r ,
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 application for each retum .
• If you are filing for an Automatic 3 - Month Extension , complete only Part I and check this box . . . . . . .
. . . . . . . . . . . . . 10- Q
• 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 ll unless you have already been granted an automatic 3-month extension on a previously filed
Form 8868.
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 t 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 HOMELESS ASSISTANCE CENTER , INC . 159 - 3129752
File by the Number, street, and room or suite no. If a P.O . box, see instructions .
due date for : 715 4th Place
filing your
return. See City, town or post office, state, and ZIP code. For a foreign address , see instructions .
instructions. . Vero Beach , FL 32962
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-EZ ❑ 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 organization 's four digit Group Exemption Number (GEN ) If this is
for the whole group , check this box ► ❑ . If it is for part of the group , check this box ► ❑ and attach a list 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 February 17 . , 20 03
to file the exempt organization return for the organization named above . The extension is for the organization 's return for:
► ❑ calendar year 20 — or
► ❑X tax year beginning July 1 , 20 01 and ending June 30 , 20 02 _
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 . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ none
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 . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . $ none
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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . $ none
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 belief, it is Uue,
correct, and complete, and that I am authorized to prepare this form .
Signature ► Title ► v �" Dale ► k��
For Paperwork Re u lice, a Instruction Form 8868 ( 12-2000)
ISA
STF FED9056F. 1
r ,
SCHEDULE A Organization Exempt Under Section 501 (c) (3) OMB No. 1545-0047
(Form 990 or 990- EZ) ( Except Private Foundation ) and Section 501 ( e ) , 501 (f) , 501 (k ) ,
501 ( n ) , or Section 4947( a )( 1 ) Nonexempt Charitable Trust 200
Department of the Treasury Supplementary Information " (See separate instructions .)
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
HOMELESS ASSISTANCE CENTER INC . 59 . 3129752
Part F 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 ( b ) Title and average hours (d) Contributions to ( e ) Expense
per week devoted to ( c ) Compensation plans & deferred account and other
more than $50,000 position compensation allowances
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Total number of other employees paid
over $50,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . .► 0
Pait I1 I Compensation of the Five Highest Paid Independent Contractors for Professional Services
(See page 2 of the instructions. 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
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Total number of others receiving over
$50,000 for professional services . . . . . . . . . . . . . . . . . . . . . . . ► 0
LHA For Paperwork Reduction Act Notice , see the Instructions for Form 990 and Form 990 -EZ- Schedule A ( Form 990 or 990 -EZ) 2001
123101
12 -29-01 7
Schedule A (Form 990 or 990-EZ) 2001 HOMELESS ASSISTANCE CENTER INC , 59 - 3129752 Page 2
Part III 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 or incurred in connection with the
lobbying activites ► $ $ ( Must equal amounts on line 38 , Part VI-A ,
or line i of Part VI -B . ) 1 X
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, or 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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . .
b Lending of money or other extension of credit? . . . . . . . . . . . . . . . . . . 2b X
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
c Furnishing of goods, services, or facilities? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 . . . . . . . . . . . . . . . . . . . . . . . . 2c X
d Payment of compensation ( or payment or reimbursement of expenses if more than $ 1 ,000 )? . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2d X
e Transfer of any part of its income or assets? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . 2e X
3 Does the organization make grants for scholarships, fellowships, student loans, etc.? ( See Note below. ) . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 X
4 Do you have a section 403(b ) annuity plan for your employees? . _ . . . . . . . . . . . . . . . . . . . . . . . . . .
Note : Attach a statement to explain how the organization determines that individuals or organizations receiving grants or loans
from it in furtherance of its charitable programs "qualify " to receive payments.
Part IV I Reason for Non- Private Foundation Status (See pages 3 through 6 of the instructions. )
The organization is not a private foundation because it is: ( Please check only ONE applicable box. )
5 ED A church, convention of churches, or association of churches. Section 170(b )( 1 )(A)( i).
6 El A school. Section 170(b )( 1 )(A) ( ii ). (Also complete Part V.)
7 0 A hospital or a cooperative hospital service organization. Section 170(b )( 1 )(A)( iii).
8 ED A Federal, state, or local government or governmental unit. Section 170(b )( 1 )(A)(v).
9 El A medical research organization operated in conjunction with a hospital. Section 170(b )( 1 )(A)(iii). Enter the hospital's name , city
,
and state ►
10 0 An organization operated for the benefit of a college or university owned or operated by a governmental unit Section 170(b )( 1 )(A)(
iv).
(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 Q A community trust Section 170(b )( 1 )(A)(vi). (Also complete the Support Schedule in Part IV-A )
12 0 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 0 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. )
(b ) Line number
( a ) Name ( s ) of supported organization(s ) from above
14 An organization organized and operated to test for public safety. Section 509(a)( 4 ). (See page 6 of the instructions.)
Schedule A ( Form 990 or 990-EZ) 2001
123111
01 -07-02
8
Schedule A (Form 990 or 990 -EZ ) 2001 HOMELESS ASSISTANCE CENTER INC . 59 - 3129752 Page 3
Pact IV-A Support Schedule (Complete only if you checked a box on line 101 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. 868 , 422o
(Do not include unusual grants. See
line 28.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
e. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1281284 * 385r354 * 167 145 . 187 , 639 *
16 Membership fees received . . . . . . . . .
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 . . . . . . . . . . . .
18 Gross income from interest,
dividends, amounts received from
payments on securities loans (sec-
tion 512(a)( 5 )), rents, royalties, and
unrelated business taxable income
(less section 511 taxes) from
businesses acquired by the
organization after June 30, 1975 8 8 0 3 . 1 , 708 * 6 5 . 351 . 10t927 *
19 Net income from unrelated business
activities not included in line 18
20 Tax revenues levied for the organization ' s
benefit and either paid to it or expended
on its behalf
21 The value of services or facilities
furnished to the organization by a
governmental unit without charge.
Do not include the value of services
or facilities generally furnished to
the public without charge . _ . . . . . . . . . .
22 Other income. Attach a schedule. Do not SEE STATEMENT 12
include gain or (bss) from sale of capital
assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137 , 816 * 44 , 162 * 35 053 . 6 450
. 223 , 481a
23 Total of lines 15 through 22 2741903 * 431 224 . 202 263 . 194 r 440 . 1 r 102r8300
24 Line 23 minus line 17 . . . . . . . . . . . . . . . 274r903 * 431 , 224a 202 263 . 194 , 440 * 1 , 102 ,
830o
25 Enter 1 % of line 23 . . . . . . . . . . . . . . . . . . 21749 * 4 312 . 2 , 023a , 1 r 944 e
26 Organizations described on lines 10 or 11 : a Enter 2% of amount in column (e), line 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . ► 26a 22 , 057
.
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 return . Enter the total of all these excess amounts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . ► 26b 243 , 595
.
c Total support for section 509(a)( 1 ) test: Enter line 24 , column (e) . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . ► 26c 1 10 2 8 3 0 .
d Add: Amounts from column (e) for lines: 18 10 , 6 2 7 . 19
22 223 , 481a 26b 243 , 595 * ► 26d 478 003 a
e Public support ( line 26c minus line 26d total) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ► 26e 6 2 4 8 27 .
f Public support percentage line 26e numerator divided by line 26c denominator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . ► 26f 5 6 . 6 5 6 7 %
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 adisqualified person.' Do not file this list with your return . Enter
the sum of such amounts
for each year: N / A
(2000) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ( 1999) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . ( 1998 ) ( 1997)
b For any amount included in line 17 that was received from each peson ( other than Odisqualified 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 (21 enter the sum of these differences (the excess amounts ) for each year. N / A
(2000) . . . . . . . . . . . . . . . . . . . . 4 . . . . . . . . . . . . . . . . . . ( 1999 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . ( 1998 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ( 1997 )
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
c Add: Amounts from column (e ) for lines: 15 16
17 20 21 ► 27c N / A
d Add: Line 27a total and line 27b total 110- 27d N / A
e Public support (line 27c total minus line 27d total) , ► 27e N A
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . .
f Total support for section 509 (a)(2 ) test: Enter amount on line 23, column (e ) . . . . . . . . . ► 27f N / A
g Public support percentage (line 27e (numerator) divided by line 27f (denominator)) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. ► 27 N / A %
h Investment income percentage line 18 column a numerator divided by line 27f denominator ► 27h N / A %
28 Unusual Grants: For an organization described in line 10, 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
return . Do not include these grants in line 15.
NONE
123121 12 -29-01 9 Schedule A ( Form 990 or 990 -EZ ) 2001
� ' r
Schedule A (Form 990 or 990 -EZ) 2001 HOMELESS ASSISTANCE CENTER INC * 59 - 3129752 Page 4
=part Private School Questionnaire (See page 7 of the instructions. ) N / A
(To be completed ONLY by schools that checked the box on line 6 in Part IV)
Yes No
29 Does the organization have a racially nondiscriminatory policy toward students by statement in its charter, bylaws, 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? 31
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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 staff? . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32a
b Records documenting that scholarships and other financial assistance are awarded on a racially nondiscriminatory basis? . . . . . . . . . . . . . . .
. . . . . . . . . 32b
c Copies of all catalogues, brochures, 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? . . . . . . . . . . . . . . 4 . . . .
. . . . . . 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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33c
d Scholarships or other financial assistance? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33d
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
e Educational policies? . . . . . . . . . . . . . . . . . . . . . . . . 4 . . 33e
. . . . . . . . . . . . . . . . . .
f Use of facilities? . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . .
gAthletic 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 )
34 a Does the organization receive any financial aid or assistance from a governmental agency? . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . 44 . . . . . . . . . . , , . . . - . . - . . . _ . . 34a
b Has the organization 's right to such aid ever been revoked or suspended? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34b
If you answered 'Yes" to either 34a or b , please explain using an attached statement
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 explanation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Schedule A ( Form 990 or 990 -EZ) 2001
123131
12-29-01
10
Schedule A (Form 990 or 990-EZ) 2001 HOMELESS ASSISTANCE CENTER INC - 59 - 3129752 Page 5
Part VI -A Lobbying Expenditures by Electing Public Charities (See page 9 of the instructions. ) N / A
(To be completed ONLY by an eligible organization that filed Form 5768 )
Check ► a if the organization belongs to an affiliated group . Check ► b 0 if you checked " a " and "limited
control" provisions apply.
Limits on Lobbying Expenditures Affiliated )group To be completed for ALL
(The term "expenditures" means amounts paid or incurred. ) totals electing organizations
N / A
36 Total lobbying expenditures to influence public opinion (grassroots lobbying ) , - , , , - _ - , . - „ , 36
37 Total lobbying expenditures to influence a legislative body (direct lobbying ) - - - - - - - - - - - - - - - - - - - - - - - - - - „ - - 37
38 Total lobbying expenditures (add lines 36 and 37 ) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - „ - , , ,
, 38
39 Other exempt purpose expenditures - - - - - - - - - - - - - - - - - - - - - - - - - „ - - - - - „ - , - , - , , , - - - - - - - - - . . . . . . - - . . -
- - , _ . . . . . . . . . . . . . . . 39
40 Total exempt purpose expenditures (add lines 38 and 39) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . 40
41 Lobbying nontaxable amount. Enter the amount from the following table -
If the amount on line 40 is - The lobbying nontaxable amount is -
Not over $500,000 20% of the amount on line 40
Over $500,000 but not over $ 1 ,000,000 - - , - , - - - - - - - $ 100,000 plus 15% of the excess over $500,000 -Over $ 1 ,000,000 but
not over $ 1 ,500,000 . . . . . . . . . $ 175 ,000 plus 10% of the excess over $ 1 ,000,000 , - - „ - - , - 41
Over $ 1 ,500,000 but not over $ 17,000,000 $225,000 plus 5% of the excess over $ 1 ,500,000
Over $ 17,000,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1 ,000,000
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
42 Grassroots nontaxable amount (enter 25% of line 41 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
43 Subtract line 42 from line 36. Enter -0- if line 42 is more than line 36 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
44 Subtract line 41 from line 38. Enter -0- if line 41 is more than line 38 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - - - - 44
Caution : If there is an amount on either fine 43 or line 44, you must file Form 4720.
4-Year Averaging Period Under Section 501 ( h )
(Some organizations that made a section 501 ( h ) election do not have to complete all of the five columns
below. See the instructions for lines 45 through 50 on page 11 of the instructions. )
Lobbying Expenditures During 4-Year Averaging Period N / A
Calendar year ( or (a ) ( b ) (c ) ( d ) ( e )
fiscal year beginning in ) ► 2001 2000 1999 1998 Total
45 Lobbying nontaxable
amount . . . . . . . . . . . . . . . . . . . . . . . . 0 .
46 Lobbying ceiling amount
150% of line 45(e )) . . . . . . . . . 0 .
47 Total lobbying
expenditures . . . . . . . . . . . . . . . . . . 0
48 Grassroots nontaxable
amount . . . . . . . . . . . . . . . . . . . . . . . . 0 .
49 Grassroots ceiling amount
150% of line 48 ( e )) . . . . . . . . . ;. 0 .
50 Grassroots lobbying
expenditures . . . . . . . . . . . . . . . . . . 0
Part W13 Lobbying Activity by Nonelecting Public Charities
(For reporting only by organizations that did not complete Part VI -A) (See page 12 of the instructions- ) N / A
During the year, did the organization attempt to influence national, state or local legislation , including any attempt to
Yes No Amount
influence public opinion on a legislative matter or referendum, through the use of.
a Volunteers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b Paid staff or management ( Include compensation in expenses reported on lines through h . ) . . . . . . . . - . . . . . . . . . . . . . . . . . .
. . . .
- - - - -
c Media advertisements - , - - - - „ - - - - - - - - - - - - - - -
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
dMailings to members, legislators, or the public - - - „ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
e Publications, or published or broadcast statements
f Grants to other organizations for lobbying purposes - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
g Direct contact with legislators, their staffs, government officials, or a legislative body
h Rallies, demonstrations, seminars, conventions, speeches, lectures, or any other means . . . . . . . . . - - - - . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .
i Total lobbying expenditures (Add linesc through h . ) . . . . . . . . . . . . . . . - . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . - - . . . . - . . . . . . 0
If "Yes” to any of the above, also attach a statement giving a detailed description of the lobbying activities.
1229 01 Schedule A ( Form 990 or 990 -EZ) 2001
A A f% I ri ri r) A A I A 0 LN Q C! A Q Q T 0 4KTrrT7V TJOMTPT . qP Q 1
11
1
r
Schedule A (Form 990 or 990-EZ) 2001 HOMELESS ASSISTANCE CENTER INC* 59 - 3129752 Page 6
Part Vil 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 ( ii ) X
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . .
b Other transactions:
(i ) Sales or exchanges of assets with a noncharitable exempt organization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b( i ) X
( ii ) Purchases of assets from a noncharitable exempt organization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . „ .
. . . . . . . . . . . . . . . . . . . . . I . . . . 4 . . . . . . . . . . . . b ( ii ) X
( iii ) Rental of facilities, equipment, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b ( iii ) X
(iv) Reimbursement arrang e ments . . . . . . . . . . . . . b (iv ) X
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..
(v) Loans or loan guarantees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . b (v) X
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . .
(vi ) Performance of services or membership or fundraising solicitations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . b (vi ) X
c Sharing of facilities, equipment, mailing lists, other assets, or paid employees c X
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 (d ) the value of the goods, other assets, or services received: N / A
( a ) ( b ) (c ) ( d )
Line no. Amount involved Name of noncharitable exempt organization Description of transfers, transactions , and sharing arrangements
52 a 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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 r Yes ® No
. .
b If "Yes; complete the following schedule: N / A
( a ) ( b ) (c )
Name of organization Type of organization Description of relationship
12329 01 Schedule A ( Form 990 or 990- EZ) 2001
12
Schedule B Schedule of Contributors OMB No. 1545 -0047
(Form 990, 990-EZ, or
990-PF) Supplementary Information for 200
Department of the Treasury line 1 of Form 990, 990-EZ and 990-PF (see instructions)
Internal Revenue Service
Name of organization Employer identification number
HOMELESS ASSISTANCE CENTER INC . 59 - 3129752
Organization type (check one) :
Filers of: Section:
Form 990 or 990-EZ ® 501 (c)( 3 ) (enter number) organization
4947(a)(1 ) nonexempt charitable trust not treated as a private foundation
527 political organization
Form 990-PF E-1 501 (c)(3) exempt private foundation
4947(a)(1 ) nonexempt charitable trust treated as a private foundation
501 (c)(3) taxable private foundation
Check if your organization is covered by the 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-EZ, or 990-PF that received , during the year, $5 ,000 or more (in money or property) from anyone
contributor. (Complete Parts I and II .)
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)(v) 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 I and II .)
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 I , 11 , and III .)
El 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,
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
nonexclusively 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-P17.
Schedule B ( Form 990 , 990-EZ , or 990 -PF ) (200 1 )
123451 12-29-01
Schedule 8 (Form 990, 990-EZ, or 990-PF) (2001 ) Page 1 to 1, of Part I
Name of organization Employer identification number
HOMELESS ASSISTANCE CENTER INC . 59 - 3129752
Part I Contributors (See Specific Instructions .)
(a) (b) (c) (d)
No. Name, address and ZIP + 4 Aggregate contributions Type of contribution
1 COMMUNITIES FOUNDATION OF TEXAS Person
Payroll
4605 LIVE OAK STREET $ 25 , 000o Noncash 0
(Complete Part II if there
DALLAS TX 75204 - 7099 is a noncash contribution .)
(a) (b) (c) (d)
No. Name, address and ZIP + 4 Aggregate contributions Type of contribution
2 JOHN ' S ISLAND FOUNDATION Person Eil
Payroll 0
PO BOX 8323 $ 3 6 , 6 8 8 . Noncash E-1
(Complete Part II if there
VERO BEACH , FL 32964 is a noncash contribution .)
(a) (b) (c) (d)
No. Name , address and ZIP + 4 Aggregate contributions Type of contribution
3 JOHN ' S ISLAND COMMUNITY SERVICE LEAGUE Person
Payroll
PO BOX 8133 $ 25 , 0000 Noncash El
(Complete Part II if there
INDIAN RIVER SHORES , FL 32963 is a noncash contribution .)
(a) (b) (c) (d)
No. Name, address and ZIP + 4 Aggregate contributions Type of contribution
4 ETHEL KENNEDY FOUNDATIONPerson
Payroll
271 JOHN ' S ISLAND DRIVE $ 60 , 000 * Noncash El
(Complete Part II if there
VERO BEACH , FL 32963 is a noncash contribution .)
(a) (b) (c) (d)
No. Name, address and ZIP + 4 Aggregate contributions Type of contribution
5 PIERCE LEO W & MARJORIE Person
Payroll 0
443 SILVER MOSS DR $ 31 , 485 * Noncash 0
(Complete Part II if there
VERO BEACH , FL 32963 is a noncash contribution .)
(a) (b) (c) (d)
No. Name, address and ZIP + 4 Aggregate contributions Type of contribution
Person F1
Payroll
$ Noncash 0
(Complete Part II if there
is a noncash contribution .)
123452 12-29-01 14 Schedule B ( Form 990 , 990 -EZ , or 990 - PF ) (200 1 )
4562 OMB No. 1545 -0172
Form Depreciation and Amortization 2001
( Rev. March 2002) (Including Information on Listed Property) 990
Department of the Treasury Attachment
Internal Revenue Service ► See separate instructions. ► Attach to your tax return. Sequence No. 67
Name(s) shown on return Business or activity to which this form relates Identifying number
HOMELESS ASSISTANCE CENTER INC . FORM 990 PAGE 2 59 - 3129752
Part I I 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 instructions for a higher limit for certain businesses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . 1 24 , 0006
2 Total cost of section 179 property placed in service (see instructions) . . . . . . . . . . . . . . . . . . . . . . • • . . . . . . . _
. . . . . . _ . . . . . . . 2
3 Threshold cost of section 179 property before reduction in limitation3 $200 , 000
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4 Reduction in limitation . Subtract line 3 from line 2 . If zero or less , enter -0- . . . . . . . . . . . . . . . . . . . . . . . . 4 . 4
5 Dollar limitation for tax year. Subtract line 4 from line 1 . 11 zero or less enter -0-. If married Ii inq separately, see instructions . .
5
6 (a) Description of property (b) Cost (business use only) (c) Elected cost
7 Listed property. Enter amount from line 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . • . . . . . . 7
8 Total elected cost of section 179 property . Add amounts in column (c) , lines 6 and 7 . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . 8
9 Tentative deduction . Enter the smaller of line 5 or line 8 , • • . • . . . , . _ • . . - • . . . . . , _ _ , - • . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . 4 . . . . . . . . . . . . . . . . - . . . 9
10 Carryover of disallowed deduction from line 13 of your 2000 Form 4562 . . . . . . . . . . . . . . . . . . . . . . . . . . • • • • . . . . .
. . . • . . . . . . . . . . . . . . 4 . . . . . , 10
11 Business income limitation . Enter the smaller of business income (not less than zero) or line 5 „ . . . . . . . . . . . . . „ • „ • • 11
12 Section 179 expense deduction . Add lines 9 and 10, but do not enter more than line 11 . . . . . . . . . . . . . . . . . . . . . . . . . •
. . . . . . . . . . 12
13 Carryover of disallowed deduction to 2002 . Add lines 9 and 10, less line 12 . . . . . . . . . . . . 100- 1 13
Note: Do not use Part It or Part ll/ below for listed property. Instead, use Part V.
Part II Special Depreciation Allowance and Other Depreciation Do not include listed property.
14 Special depreciation allowance for certain property (other than listed property) acquired after September 10, 2001 (see instructions) . . . .
. . . . . . . - . . . . . . . . . 14
15 Property subject to section 168(f)(1 ) election (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 . . .
. . . . . . . . . . . . . . . . . . . . . . . q . . . . . . . . . . 15
16 Other depreciation includin ACRS see instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 --- 16 , 687o
Part . 1111 MACRS Depreciation Do not include listed property. ) (See 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 168(1)(4) to group any assets placed in service during the tax
year into one or more general asset accounts check here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . 4 . . . . . ►
Section B - Assets Placed in Service During 2001 Tax Year Using the General Depreciation S stem
(b) Month and (c) Basis for depreciation (d) Recovery
(a) Classification of property year placed (business/investment use period (e) Convention (t) Method (g) Depreciation deduction
in service only - see instructions)
19a 3-year property
b 5• ear property
C 7-year property
d 10• ear property
e 15 ear property
f 20 ear property
25 ear property 25 yrs . S/L
/ 27 .5 vrs . MM S/L
In Residential rental property
/ 27 .5 yrs . MM S/L
/
i Nonresidential real property 39rs . MM S/L
/ MM S/L
Section C - Assets Placed in Service During 2001 Tax Year Using the Alternative Depreciation System
20a Class life S/L
b 12 ear 12 yrs, S/L
c 40 ear / 40 yrs. MM S/L
Parti ` Summary (See 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. . . . . . . . . . . 4 . . . . . . . . . .
22 16 , 687 ,
23 For assets shown above and placed in service during the current year, enter the
portion of the basis attributable to section 263A costs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
23
116251
03-21 -02 LHA For Paperwork Reduction Act Notice, see separate instructions . Form 4562 (2001 ) (Rev . 3-2002)
27
Form 4562 (2001 ) (Rev . 3-2002) Page 2
Pate VLis ted 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)
through (c) of Section A, all of Section 8, and Section C if applicable.
Section A - Depreciation and Other Information (Caution: See instructions for limits for passenger automobiles. )
24a Do you have evidence to support the business/investment use claimed? 0 Yes El No 24b If "Yes , m is the evidence written? 0
Yes El No
(a) (b) Date (c) (d) (e) M (g) (h ) W
Type of property placed in Business/ Cost or Basis for depreciation Recovery Method/ Depreciation Elected
(list vehicles first ) service investment other basis (businessfinvestment period Convention deduction section 179
so pmentaae use only) cost
25 Special depreciation allowance for listed property acquired after September 10, 20011
and used more than 50% in a qualified business use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . 25
26 Property used more than 50% in a qualified business use:
%
%
%
27 Property used 500/6 or less in a quallified business use :
S/L -
% S/L -
% S/L -
28 Add amounts in column (h) , lines 25 through 27 . Enter here and on line 21 , page 1 28
29 Add amounts in column (i) , line 26 . Enter here and on line 7 , page 1 . . . . . . . . . . . . 29
Section B - Information on Use of Vehicles
Complete this section for vehicles 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 if you meet an exception to completing this section
for
those vehicles .
(a) (b ) (c) (d) (e) (f)
30 Total businessAnvestment miles driven during the Vehicle Vehicle Vehicle Vehicle Vehicle Vehicle
year (do not include commuting miles ) . . . . . . . . . . . . . . . . . .
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 use Yes No Yes No Yes No Yes No Yes No Yes No
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 .
37 Do you maintain a written policy statement that prohibits all personal use of vehicles, including commuting , by your Yes No
employees? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
38 Do you maintain a written policy statement that prohibits personal use of vehicles , except commuting , by your
employees? See instructions for vehicles used by corporate officers, directors , or 1 % or more owners
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
39 Do you treat all use of vehicles by employees as personal use?
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
40 Do you provide more than five vehicles to your employees, obtain information from your employees about
the use of the vehicles , and retain the information received ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
41 Do you meet the requirements concerning qualified automobile demonstration use?
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . .
Note: If your answer to 37, 38, 39, 40, or 41 is " Yes, " do not complete Section B for the covered vehicles.
Part VI I Amortization
(a) (b) (c) (d) (e) (f)
Description of costs OatearnortzaGOn Amortizable Code Amortization Amortization
begins I unt section period or percentage for this year
42 Amortization of costs that begins during your 2001 tax year:
43 Amortization of costs that began before your 2001 tax year . . . . . . . . . . . . . . . . . 43
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
44 Total . Add amounts in column (f) . See instructions for where to report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
Form 4562 ( 2001 ) (Rev. 3 -2002 )
116252
03-20-02
28
2001 DEPRECIATION AND AMORTIZATION REPORT
FORM 990 PAGE 2 990
Reduction In
Asses Date Line Unadjusted Bus % Basis - Basis For Accumulated Current Amount Of
No. Description Acquired Method Life No. Cost Or Basis Excl ITC, 17% Depreciation Depreciation Sec
179 Depreciation
Salvage
14 STREET LAND 031901L 65 , 000 . 65 , 000 . 00
2 UILDING 031901SL 30 . 0016 126 , 743 . 126 , 743 . 1 , 056 . 4 , 225
.
3 ARPET & INSTALLATION 031901SL 7 . 00 16 21853 . 2 , 853 . 102 . 408 .
4 LEANING 031901SL 7 . 00 16 900 . 900 . 32 . 129 .
5 ONSTRUCTION 031901SL 30 . 0016 21 , 513 . 211513 . 179 . 717 .
6 LECTRIC 031901SL 30 . 0016 2 , 138 . 2 , 138 . 18 . 71 ,
7 IRE EQUIPMENT 031901SL 7 . 00 16 11561 . 11561 . . 56 . 223 .
WAS HOOKUP & INSTALL 031901SL 30 . 0016 461 . 461 . 4 . 15 .
9INSPECTION 031901SL 30 . 0016 1 , 425 . 1 , 425 . 12 . 48 ,
10 ISC 031901SL 3060.016 311 . 311 . 3 . 10 .
11DUCT CLEANING 031901SL 30 . 0016 61260 . 6 , 260 . 52 . 2090
12PAINTING 031901SL 30 . 0016 9 , 300 . 9 , 300 . 78 . 310 .
13 EST CONTROL 031901SL 30 . 0016 180 . 180 , 2 , 6 .
14PLUMBING 031901SL 30 . 001 .6 41486 . 4 , 486 . 37 . 150 .
15SECURITY SYSTEM 031901SL 7 . 00 16 2 , 387 . 2 , 387 . 85 . 341 .
16SIGN 031901SL 30 . 0016 350 . 350 . 3 . 12 .
17TELEPHONE 031901SL 7 . 00 16 1 , 093 . 1 , 093 . 39 . 156 .
18TOILETS 031901SL 30 . 0016 1 428 . 428 . 4 . 14 .
128102
. 10-03-01 (D) - Asset disposed
15
2001 DEPRECIATION AND AMORTIZATION REPORT
FORM 990 PAGE 2 990
Asset Reduction In
ss Description Date Method Life Nae Unadjusted Bus % Basis - Basis For Accumulated Current Amount
Of
Acquired Cost Or Basis Excl ITC, 179, Depreciation Depreciation Sec 179 Depreciation
Salvage
19 AND IMPROVEMENTS 031901SL 15 . 0016 150 . 150 . 3 . 10 .
204ST STOVE 031901SL 7 . 00 16 3 , 711 . 31711 . 133 . 530 .
21TOILETS 031901SL 30 . 0016 237 . 2379 2 . 8 .
22TELEPHONE 031901SL 7 . 00 16 21651 . 21651 . 95 . 379 .
23COMPUTER CART 062097SL 5 . 00 16 119 . 119 . 97 . 22 .
( D ) HP OFFICE JET
24 AX / PRINTER 081897SL 5 . 00 1. 6 500 . 500 . 384 . 50 .
25COMPUTER 122998SL 5 . 00 16 11600 . 11600 . 800 . 320 .
26COMPUTER 122998SL 5 . 00 16 11400 . 11400 . 700 . 280 .
27COMPUTER 052199SL 5 . 00 16 849 . 849 . 354 . 170 .
28COMPUTER 042000SL 5 . 00 16 1 , 860 . 11860 . 465 . 372 .
29COMPUTER EQUIPMENT 042501SL 5 . 00 16 98 . 98 . 3 . 20 .
30 ( D ) REGRIGERP,TOR 0, 63094SL 7 , 00 16 300 . 300 . 214 . 0 .
31 ( D ) FREEZER 063094SL 7 . 00 16 300 . 300 . 214 . 0 .
32 ( D ) FREEZER080194SL 7 . 00 16 200 . 200 . 143 . 2 .
33APPLIANCES 092895SL 7 . 00 16 11989 . 1 , 989 . 1 , 420 . 284 .
34LINENS 092895SL7 . 00 , 16 723 . 723 . 516 . 103 .
36 FOLDING CHAIRS 112995SL 7 . 00 16 100 . 100 . 71 . 14 .
373 DESKS 10710196SL PAID 116 1 100 . 100 . 70 . 14 .
129102
10-03-01
(D) • Asset disposed
16
2001 DEPRECIATION AND AMORTIZATION REPORT
FORM 990 PAGE 2 990
Reduction In
Asset Date Line Unadjusted Bus % Basis - Basis For Accumulated Current Amount Of
N� Description Acquired Method Life No. Cost Or Basis Excl ITC, 179, Depreciation Depreciation Sec 179
Depreciation
Salvage
38HUTCH , 3 TV ' S 120196SL 7 . 00 16 240 . 240 . 154 . 34 .
39KITCHEN UTENSILS 010197SL 7 . 00 16 300 . 300 . 189 . 43 .
40COPIER 010197SL 7 . 00 16 800 . 800 . 504 . 114 .
412 DESKS , S FILE CABINETS 010697SL 7 . 00 16 11000 . 11000 . 631 . 143 .
42WASHER , DRYER 080497SL 7 . 00 16 699 . 699 . 383 . 100 .
43ALCOHOL SCREENER 030798SL 7 . 00 16 325 . 325 . 150 . 46 .
442 CHAIRS O41798SL 7 . 00 16 170 . 1700 77 . 24 .
45CONFERENCE TABLE 041798SL 7 . 00 16 170 . 170 , 77 . 24 .
46APPLIANCES , DW , ETC 042798SL 7 . 00 16 390 . 390 . 177 . 56 .
47BUNK BEDS 052098SL 7 . 00 16 2 , 520 . 2 , 520 . 11110 . 360 .
49BBQ 061998SL 7 . 00 16 312 . 312 . 134 . 45 .
50 ( D ) REFRIGERATOR 052199SL 7900 . 16 515 . 515 . 153 . 379
51APPLIANCES 020300SL 7 . 00 16 535 . 535 . 108 . 760
52FURNITURE - ST. LUCIE 0. 22201SL 7 . 00 16 750 , 9 750 . 107 .
54 ( D ) SHADES 022701SL 7 . 00 16 2 , 200 . 2 , 200 . 105 . 157 .
55 ( D;). TELEPHQNE 0 :22 :701SL 7 . 00 ; 16 3 , 516 .
31516 . 167 . 251 .
56 ( D ) AIR CONDITIONER 022701SL 7 . 00 16 3 , 366 . 3 , 366 . 160 . 240 .
57 ( D ) CARPET INSTALLATION 022701SL 17 # 00 116 1 5 691 . 5 , 69191 27191 1 407
.
128102
10-03-01
(D) • Asset disposed
17
2001 DEPRECIATION AND AMORTIZATION REPORT
FORM 990 PAGE 2 990
Reduction In
Asset
Description Date Method Life No Unadjusted Bus % Basis - Basis For Accumulated Current Amount
Of
P Acquired Cost Or Basis Excl ITC, 179, Depreciation Depreciation Sec 179 Depreciation
Salvage
58 ( D ) CLEANING 022701SL 7 . 00 16 700 . 700 . 33 . 50 .
59 ( D ) CONSTRUCTION - CHILDERS 022701SL 30 . 0016 31419 . 31419 . 38 . 57 .
60 ( D ) DOOR 022701SL 30 . 0016 522 . 522 . 6 . 9 .
61 ( D ) ELECTRIC 022701SL 30 . 0 ;016 11465 . 1 , 465 . 16 . 24 .
62 ( D ) INSPECTION 022701SL 30 . 0016 31000 . 31000 . 33 . 50 .
63 ( D ) PAINTING 022701SL 7 . 00 16 41150 . 41150 . 198 . 296 .
64 ( D ) PEST CONTROL 022701SL 30 . 0016 180 . 180 . 2 . 3 .
65 ( D ) PLUMBING 022701SL 30 . 0016 1 , 195 . 1 , 195 . 13 . 20 .
66 ( D ) SECURITY SYSTEMS 022701SL 7 . 00 16 1 , 828 . 11828 . 87 . 131 .
6. 7 ( D ) ,LAND _ IMPROVEMENTS 022701SL 30 . 0016 425 . 425 . 5 . 7 .
68 ( D ) PAINTING 022701SL 7 . 00 16 3 , 400 . 31400 . 162 . 243 .
69 ( D ), TELEPHONE 022701SL 30 . 0016 650 . 650 . 7 . 11 .
74 AWN MOWER 043092SL 7 . 00 16 133 . 133 . 133 . 0 .
75FURNITURE 060192SL 7 . 00 16 900 . 900 . 900 . 0 .
76DESK , FILE CABINETS 070193SL 7 . 00 16 250 . 250 . 250 . 0 .
ELL SOUTH PHONE ADAPTOR
77 , . INS,TALLATI .QN _ COSTS Q62702SL 7 . 00 16 1:. 1_ 947 : 1 1 , , 947 : 0 .
78 ELLSOUTH TELEPHONE 072401SL 7 . 00 16 355 . 355 . 46 .
7 .9WASHER 0 ,62702SL 7 . 00 . 16 1 517 . , 517 $ 1 1 F 0 .
• 126102
10-03-01 (D) Asset disposed
18
2001 DEPRECIATION AND AMORTIZATION REPORT
FORM 990 PAGE 2 990
Reduction In
Asset Date Line Unadjusted Bus % Basis - Basis For Accumulated Current Amount Of
No. Description Acquired Method Life No, Cost Or Basis Excl ITC, 179, Depreciation Depreciation Sec
179 Depreciation
Salvage
80DRYER 062702SL 7 . 00 16 487 . 487 . 0 .
81REFRIGERATOR 062702SL 7 . 00 16 487 . 487 . 0 .
82FREEZER 062702SL 7 . 00 16 737 . 737 . 0 .
83DISHWASHER 062702SL 7 . 00 16 847 . 847 . 0 .
84STEAM TABLE 063002SL 7 . 00 16 890 . 890 . 0 .
ACK DOOR & :INSTALLATION
85, COSTS 083101SL 30 . 0016 1 , 423 . 1 , 423 . 40 .
86KITCHEN REMODELING COSTS 062602SL 30 . 0016 12 , 170 . 12 , 170 . 0 .
87SEWER SYSTEM IMPROVMENTS 011702SL 30 . 0016 1311712 . 1311712 . 1 , 829 .
88 ORD VAN 063002SL 7 . 00 16 11 , 211 . 111211 . 0 .
89 ELL COMPUTER 10220. 1 L 5 . 00 16 , 1 , 444 . 1 , 444 . 193 .
90COMPUTER EQUIPMENT 012402SL 5 . 00 16 215 . 215 . 18 .
91 UICKBOOKS 013002 L 5 . 00. 16 250 . 250 . 21 .
92 RD DRIVE 021402SL 5 . 00 16 263 . 263 . 22 .
93SAM ' S COMPUTER . EQUIPMENT 021402SL 5 . 00 16 800 . 800 . 67 .
94 ITA COPIER 012802SL 5 . 00 16 61945 . 6 , 945 . 579 .
TTRESSES & BEDDING
95EQUIPMENT 030502SL 7 . 00 . 16 . 7_ 1, 767 . , 7 , 767 . 370 .
96SEWER INSTALLATION COSTS 011702SL 30 . 0016 9 , 688 . 91688 . 135 .
974; , PLACE ' :BUILDING.. 042:402SL 30 . 0016 1 104 400 * 1 1 1 104f100 * 1 1 580 .
128102
10-03-01 (D) • Asset disposed
19
2001 DEPRECIATION AND AMORTIZATION REPORT
FORM 990 PAGE 2 990
Reduction In
Asset Date Line Unadjusted Bus % Basis - Basis For Accumulated Current Amount Of
No, Description Acquired Method Life No. Cost Or Basis Excl ITC, 179, Depreciation Depreciation Sec 179
Depreciation
Salvage
98MIRACLE RECREATION 062602SL 7 . 00 16 51016 . 5 , 016 . 0 .
1004 PLACE LAND 042402L 75 , 600 . 75 , 600 . 0 .
* TOTAL 990 PAGE 2 DEPR 6851163 . 0 . 685 , 163 . 13 , 879 . 0 . 16 , 687 .
' 129102
10-03-01 (D) • Asset disposed
20
- HOMELESS ASSISTANCE CENTER , INC . 59 - 3129752
FORM 990 GAIN ( LOSS ) FROM SALE OF OTHER ASSETS STATEMENT 1
DATE DATE METHOD
DESCRIPTION ACQUIRED SOLD ACQUIRED
VARIOUS SALES VARIOUS VARIOUS PURCHASED
GROSS COST OR EXPENSE NET GAIN
NAME OF BUYER SALES PRICE OTHER BASIS OF SALE DEPREC OR ( LOSS )
0 . 678 . 0 . 0 . < 678 . >
TO FM 990 , PART I , LN 8 678 . 0 . 0 . < 678 . >
FORM 990 SPECIAL EVENTS AND ACTIVITIES STATEMENT 2
GROSS CONTRIBUT . GROSS DIRECT NET
DESCRIPTION OF EVENT RECEIPTS INCLUDED REVENUE EXPENSES INCOME
VARIOUS FUNDRAISING 701522 . 701522 . 701522 .
TO FM 990 , PART I , LINE 9 701522 . 701522 . 70 , 522 .
FORM 990 OTHER EXPENSES STATEMENT 3
( A ) ( B ) ( C ) ( D )
PROGRAM MANAGEMENT
DESCRIPTION TOTAL SERVICES AND GENERAL FUNDRAISING
MISC 35 , 068 . 341373 . 471 . 224 .
INSURANCE 111953 . 81248 . 21510 . 11195 .
VEHICLES 21801 . 21801 .
ADVERTISING 1 , 375 . 11375 .
OTHER PROFESSIONAL
FEES 11689 . 11689 .
FUNDRAISING EXPENSES 191381 . 191381 .
TOTAL TO FM 990 , LN 43 721267 . 481486 . 21981 . 201800 .
21 STATEMENT ( S ) 1 , 21 3
HOMELESS ASSISTANCE CENTER , INC . 59 - 3129752
FORM 990 STATEMENT OF ORGANIZATION ' S PRIMARY EXEMPT PURPOSE STATEMENT 4
PART III
EXPLANATION
TO PROVIDE FOR THE IMMINENT NEEDS OF THE INDIGENT AS WELL AS EDUCATION AND
SKILLS NECESSARY TO DEVELOP HEALTHY LIFESTYLES .
FORM 990 STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS STATEMENT 5
DESCRIPTION OF PROGRAM SERVICE ONE
FOOD , CLOTHING , SUPPLIES , MEDICAL TRANSPORTATION , HOUSING
ASSISTANCE , UTILITIES , EMERGENCY LODGING , LOANS , COUNSELING ,
FINANCIAL ASSISTANCE , EMPLOYMENT , EDUCATION , REHABILITATION ,
PHONE , MAIL DROP , OPERATING FACILITY .
GRANTS EXPENSES
TO FORM 990 , PART III , LINE A 798 , 967 •
FORM 990 CASH GRANTS AND ALLOCATIONS STATEMENT 6
DONEE ' S
CLASSIFICATION DONEE ' S NAME DONEE ' S ADDRESS RELATIONSHIP AMOUNT
VARIOUS INDIGENTS NONE 151799 .
TOTAL INCLUDED ON FORM 990 , PART II , LINE 22 15 , 799 .
FORM 990 DEPRECIATION OF ASSETS NOT HELD FOR INVESTMENT STATEMENT 7
COST OR ACCUMULATED
DESCRIPTION OTHER BASIS DEPRECIATION BOOK VALUE
4 STREET LAND 651000 . 0 . 65 , 000 .
BUILDING 1261743 . 51281 . 121 , 462 .
CARPET & INSTALLATION 21853 . 510 . 21343 .
CLEANING 900 . 161 . 739 .
CONSTRUCTION 211513 . 896 . 20 , 617 .
ELECTRIC 21138 . 89 . 2 , 049 .
FIRE EQUIPMENT 11561 . 279 . 11282 .
22 STATEMENT ( S ) 41 51 6 , 7
2001 . 08000 HOMELESS ASSISTANCE CENTER , HOMELESI
L ( S ) LNHYIHL�rSS £ Z
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l V
HOMELESS ASSISTANCE CENTER , INC . 59 - 3129752
FORD VAN 11 , 211 . 0 . 111211 .
DELL COMPUTER 11444 . 193 . 11251 .
COMPUTER EQUIPMENT 215 . 18 . 197 .
QUICKBOOKS 250 . 21 . 229 .
HARD DRIVE 263 . 22 . 241 .
SAM ' S COMPUTER EQUIPMENT 800 . 67 . 733 .
MITA COPIER 6 , 945 . 579 . 61366 .
MATTRESSES & BEDDING EQUIPMENT 7 , 767 . 370 . 7 , 397 .
SEWER INSTALLATION COSTS 91688 . 135 . 91553 .
4 PLACE BUILDING 1041400 . 580 . 1031820 .
MIRACLE RECREATION 51016 . 0 . 51016 .
4 PLACE LAND 751600 . 0 . 751600 .
TOTAL TO FORM 990 , PART IV , LN 57 6471641 . 261110 . 621 , 531 .
FORM 990 OTHER ASSETS STATEMENT 8
DESCRIPTION AMOUNT
DEPOSITS 21221 .
LEASEHOLD INTEREST 00
TOTAL TO FORM 990 , PART IV , LINE 58 , COLUMN B 21221 .
FORM 990 OTHER REVENUE NOT INCLUDED ON FORM 990 STATEMENT 9
DESCRIPTION AMOUNT
LOSS ON ASSET SALES 678 •
ACCRUAL TO CASH CONVERSION 261737 .
TOTAL TO FORM 990 , PART IV - A 271415 .
FORM 990 OTHER EXPENSES NOT INCLUDED ON FORM 990 STATEMENT 10
DESCRIPTION AMOUNT
LOSS ON ASSET SALE 678 •
ACCRUAL TO CASH CONVERSION 61425 .
TOTAL TO FORM 990 , PART IV - B 71103 .
24 STATEMENT ( S ) 7 , 81 9 , 10
09240114 781701 HOMELESS 2001 . 08000 HOMELESS ASSISTANCE CENTER , HOMELESI
HOMELESS ASSISTANCE CENTER , INC . 59 - 3129752
FORM 990 PART V - LIST OF OFFICERS , DIRECTORS , STATEMENT 11
TRUSTEES AND KEY EMPLOYEES
EMPLOYEE
TITLE AND COMPEN - BEN PLAN EXPENSE
NAME AND ADDRESS AVRG HRS / WK SATION CONTRIB ACCOUNT
SUSAN RUX EXECUTIVE DIRECTOR
117 HINCHMAN AVENUE 40 42 , 000 . 0 . 0 .
SEBASTIAN , FL 32958
ROSE SPYTEK TREASURER / SECRETARY
1540 19TH AVE SW 0 . 0 . 0 . 0 .
VERO BEACH , FL 32962
DON MURRAY DIRECTOR
4626 PEBBLE BAY EAST 0 . 0 . 0 . 0 .
VERO BEACH , FL 32963
FERGUSON PETERS DIRECTOR
PO BOX 4366 0 . 0 . 0 . 0 .
VERO BEACH , FL 32964
ROBERT MCNALLY DIRECTOR
522 BAY DRIVE 0 . 0 . 0 . 0 .
VERO BEACH , FL 32963
RICHARD SCHLITT DIRECTOR
1830 COMMERCE AVE 0 . 0 . 0 . 0 .
VERO BEACH , FL 32960
ELIZABETH ATWAN DIRECTOR
4100 N . HUTCHINSON ISLAND 0 . 0 . 0 . 0 .
VERO BEACH , FL 34949
DON EVERS DIRECTOR
411 INDIES DRIVE 0 . 0 . 0 . 0 .
VERO BEACH , FL 32963
FRANK FAGAN DIRECTOR
721 SHADY LAKE LANE 0 . 0 . 0 . 0 .
VERO BEACH , FL 32963
RICHARD FAVA PRESIDENT
1560 ST . DAVID ' S LANE 0 . 0 . 0 . 0 .
VERO BEACH , FL 32967
MICHAEL CATANZARO DIRECTOR
30 CARIBE WAY 0 . 0 . 0 . 0 .
VERO BEACH , FL 32963
25 STATEMENT ( S ) 11
HOMELESS ASSISTANCE CENTER , INC . 59 - 3129752
JOSEPH D ' LUCIANO DIRECTOR
1816 MOORINGLINE DRIVE 0 . 0 . 0 . 0 .
VERO BEACH , FL 32963
DOUG JORDAN DIRECTOR
5400 N . A1A 0 . 0 . 0 . 0 .
VERO BEACH , FL 32963
JOHN ORCUTT DIRECTOR
4655 PEBBLE BAY SOUTH 0 . 0 . 0 . 0 .
VERO BEACH , FL 32963
TOM TIERNEY DIRECTOR
5070 N . A1A SUITE 200 0 . 0 . 0 . 0 .
VERO BEACH , FL 32963
BRENNAN EGAN DIRECTOR
6110 A1A 0 . 0 . 0 . 0 .
VERO BEACH , FL 32963
TOTALS INCLUDED ON FORM 990 , PART V 421000 . 0 . 0 .
SCHEDULE A OTHER INCOME STATEMENT 12
2000 1999 1998 1997
DESCRIPTION AMOUNT AMOUNT AMOUNT AMOUNT
1371816 . 441162 . 351053 . 61450 .
TOTAL TO SCHEDULE A . LINE 22 1371816 . 441162 . 351053 . 61450 .
26 STATEMENT ( S ) 11 , 12
) 9240114 781701 HOMELESS 2001 . 08000 HOMELESS ASSISTANCE CENTER , HOMELESI
Homeless Assistance Center, Inc .
59 -3129752
2001 Form 990
STATEMENT TO ELECT OUT OF BONUS DEPRECIATION
The taxpayer hereby elects to not deduct the additional 30 % bonus depreciation as provided for by the Job
Creation and Worker Assistance Act of 2002 .
This election is effective for all applicable classes of property placed in service during the current year.
r
f
A B c H Homeless Assistance
1 Center
2 2002 2003 FY 2004
3 REVENUES ACTUAL BUDGET BUDGET
4
5 Grants Opei^ating Budget
6 Gov't
7 Restricted 1359909 165 ,500 222 ,300
8 Non Gov't
9 Restricted 170 ,640 90,000 281000
10
7T Total Grants 306,549 255,500 2509300
12
13 Fund Raisin
14 Events 14,832 50,000 50,000
15
16 ITotal Fund Raising 14,832 50,000 50 ,000
17
18 Direct Contributions
19 Mail Campaigns 559690 108 , 772 1001000
20 Direct Solictation 85,493 9000 170,000
21 All Other 21 , 166 541700
22
23 Total Direct Contributions 141 ,183 219,938 324,700
24
25 ITotal Revenues 4629564 525,438 625,000
26
27 EXPENSES
28
29 Salaries
30 Executive Director 42,000 42,000 45 ,000
31 Accounting/Budget 21 ,508 143000 16 ,220
32 Fin . Sec. Coordinator 229373 38 ,000 38 ,000
33 Residential Mgr 261290 24, 168 32 ,000
34 Case Manager 26,000 27,500 30,000
35 Residential Care Worker 1 17,901 172680 18 ,746
36 Residential Care Worker 2 19 , 337 171680 17,680
37 PT Care Worker (80%) 91800 13 ,260 14, 144
38 PT Care Worker (60% ) 101680
39 PT Care Worker (20%) 71500 71072 7,072
40 PT Child Care Worker 31275 3 ,313
41 Family Case Mgr. 14,536 14,839
42 Housing Mgmt. Spec.(FT) 30 ,000
43 Housing Spec. (PT) 209925
44 Employee M mt. Spec. (PT) 20,925
45 Children's Svc. Specialist 30 ,000
46 Cook 18 ,997 1 %448 19,448
47 Clerical Support 10,889 17,680 17 ,680
481 Gross Pay 2401406 256,640 3681520
49
50 Company Payroll Taxes 183371 21 , 137 28 , 192
51 Health Benefits 25, 761 20,625 389431
52 Workers Comp. Ins . 71302 20,000 20 ,724
53
54 Total Pay & Benefits 291 ,840 318,402 4559867
55
561 Other Expenses
57 Rental Assistance 56 ,250
58 Fund Raising Expenses 19 ,381 25,000 20 ,000
59 Marketing and Printing 61000
60 Insurance 10,330 10,556 17,632
61 Fees - Acc't, Prof. , & Other 26 ,595 10,800
62 Office Supplies 21504 31980 29500
63 Postage 11567 11455 31800
64 Telephone 91380 61745 6 ,745
65 Utilities 24,427 18 ,905 26 ,000
66 Equipment & Maintenance 41206 61540 31500
67 Maintenance & Repair 13 ,333 51000 61800
68 Vehicle - Van Expense 3,490 31700 3 ,000
69 Mileage Expense 21583 11200 11200
70 Residential Supplies 4 ,054 21750 6 ,000
71 Staff Development 11500
72 IHUD Matching 13,000
73 Food 71766 81500 81500
74 Other Expenses 5 ,763 12,899 15 ,000
75 Contingency 11479 6,800 17, 156
76
77 Total Other Expenses 1089784 190,075 169 ,133
78
79 Total Expenses 4009624 508 ,477 625,000
80
81 Income/(Loss) 61 ,940 16,961 0
82
11 :09 AM HOMELESS ASSISTANCE CENTER
05/15/03 Balance Sheet
Accrual Basis As of April 30 , 2003
Apr 30, 03
ASSETS
Current Assets
Checking/Savings
1100 • Bank
1102 • Client Savings 111983 .61
1104 • General Account
1110 • Rental Assistance 161827.83
1104 • General Account - Other 15,750.07
Total 1104 • General Account 32,577.90
1106 • Petty Cash 200.00
1107 • Savings-Money Market
Restricted 63, 188. 14
Unrestricted 307075.96
1107 • Savings-Money Market - Other -30,615. 13
Total 1107 . Savings-Money Market 62,648.97
1108 • Tax Liability Account 130.43
Total 1100 • Bank 107,540. 91
Total Checking/Savings 107 , 540.91
Accounts Receivable
1250 • HUD Receivable 389, 280.00
Total Accounts Receivable 389,280.00
Other Current Assets
1306 • Prepaid Maintenance 262.50
1307 • Prepaid Security 760 .88
1400 • Utility Deposit 21221 .53
1410 • Gift Certificates 24.03
1500 • Prepaid Insurance 11 ,990.85
Total Other Current Assets 15,259 . 79
Total Current Assets 512,080.70
Fixed Assets
715- 4th Place
1607 • Building 104,400 •00
1650 • Building Improvements 37619. 73
Total 715- 4th Place 108,019.73
Building 4th Street
1600 - Building 126,742.88
1601 . Appliances 11 ,828.34
1602 • Building Improvements 91 ,409.03
1603 • Land Improvements 140 ,012. 25
1604 • Land 140,600.00
Total Building 4th Street 510,592.50
1606 • Acc. Dep. - Other -40,387.66
1700 • Program Furniture & Equipment 33,222.89
1701 * Computer Equipment 8189924
1702 • Vehicle 11 ,211 .05
1703 • Copier 6 ,944. 50
1704 • Equipment & Fixtures 51016.40
Total Fixed Assets 643,518.65
TOTAL ASSETS 11155,599.35
LIABILITIES & EQUITY
Liabilities
Current Liabilities
Accounts Payable
2000 • Accounts Payable 1 ,465.66
Total Accounts Payable 11465.66
Page 1
11 :09 AM HOMELESS ASSISTANCE CENTER
05/15/03 Balance Sheet
Accrual Basis As of April 309 2003
Apr 30, 03
Credit Cards
2010 • Home Depot 561 .32
2020 • Sam's 605. 19
2030 • Staples 343.48
2040 a Texaco 152.46
2050 • Walmart 60.38
2060 • Bank One -600.00
Total Credit Cards 1 . 122.83
Other Current Liabilities
2100 • Payroll Liabilities 520.05
2102 • Federal Withholding -152.66
2103 • Medicare Employee -10.78
2104 • Social Security Employee -41 .08
2600 • Due to/(from) Clients 113713. 14
Total Other Current Liabilities 12,028.67
Total Current Liabilities 14,617 . 16
Long Term Liabilities
2501 • Notes Payable - IRNB 51093.47
2502 a Public Bank 51974.08
2503 • Utility Agreement 6,984. 85
Total Long Term Liabilities 181052 .40
Total Liabilities 321669.56
Equity
3900 • Retained Earnings 111091890.61
Net Income 13 ,039. 18
Total Equity 11122,929 .79
TOTAL LIABILITIES & EQUITY 19155,599,35
Paoe 2
HOMELESS ASSISTANCE CENTER
ORGANIZATIONAL CHART
BOARD OF DIRECTORS
EXECUTIVE DIRECTOR
Sue Rux
FINANCIAL SECURITY
PROJECT COORDINATOR
Dick Van Mele
FINANCIAL
MANAGER
Jim Alsi
CHILDRENS
SERVICES
PROGRAM STAFF
CLERICAL
SUPPORT
Marlene Kane
CASE MANAGERS
Carol Zomak-Residential Case Manager
RESIDENTIAL MANAGER
David Cooper
COOK
Richard
Caruso
RESIDENTIAL CARE
WORKERS
Hourly Shift Supervisors
Dorothy Little-Johnson
Paul Sofield
Amber Ross(PT)
Carlos Vazquez(PT)
Caroline Anderson(PT)
5/03
ARTICLES OF AMENDMENT 4011e e5 ,
to O�Is
vF
ARTICLES OF INCORPORATION
of 00
Coalition for the Homeless of Indian River County , Inc .
(present name)
Pursuant to the provisions of section 617. 1006, Florida Statutes, the undersigned Florida
nonprqfit corporation adopts the following articles of amendment to its articles of incorporation.
FIRST : Amendment(s) adopted: (INDICATE ARTICLE NUMBER(S) BEING AMENDED, ADDED OR
DELETED. )
Article I - Corporate Name
The name of the corporation is changed to
HOMELESS ASSISTANCE CENTER , INC .
SECOND : The date of adoption of the amendment(s) was : May 1 , 2001
THIRD : Adoption of Amendment (CHECK ONE)
® The amendment(s) was(were) adopted by the members and the number of votes
cast for the amendment was sufficient for approval.
❑ There are no members or members entitled to vote on the amendment. The
amendment(s) was(were) adopted by the board of directors .
i ature of Chairm , V ce Chairman, President or other officer
Richard is Van Mele
Typed or printed name
Board President June 30 , 2001
Title Date
HOMELESS ASSISTANCE CENTER , INC .
715 4TH Place , Vero Beach , Florida 32962
Serving District 15 of the State of Florida
Department of Children and Families
Indian River County
St . Lucie County
Martin County
Okeechobee County
BYLAWS
FEBRUARY , 2003
BYLAWS - HOMELESS ASSISTANCE CENTER, INC.
February, 2003
TABLE OF CONTENTS
Page
Article I – Definitions and Statement of Purpose
1 . 1 Definitions 1
1 . 2 Statement of Purpose 2
Article II - Corporate Offices
2 . 1 Corporate Offices 2
Article III - Corporate Property
3 . 1 Property 3
Article IV — Board of Directors
4 . 1 Qualifications 3
4 . 2 General Duties, Responsibilities and Powers
3
4 .3 Number 3
4 . 4 Term of Office 3
4..5 Regular Meetings 4
4 . 6 Special Meetings & Telephone Usage
4
4 . 7 Resignations of Directors 4
4 :8 Removal of Directors
4
4 . 9 Filling of Vacancies of Directors 4
4 . 10 Elections at Annual Meetings
4
4 . 11 Board Action Without Meeting 4
4 . 12 Compensation 4
Article V -Officers : Powers, Duties and Responsibilities
5 . 1 Officers of the Board of Directors 5
5 .2 Election of Officers 5
5 . 3 Term of Office 5
5 . 4 Removal of Elected Officers $
5 . 5 Filling Vacancies of Elected Officers 5
5 . 6 President 5
5 . 7 First Vice President 6
5 . 8 Second Vice President 6
5 . 9 Secretary 6
BYLAWS - HOMELESS ASSISTANCE CENTE3R, INC.
February, 2003
TABLE OF CONTENTS
Page
Article V -Officers : Powers, Duties and Responsibilities (continued)
5 . 10 Treasurer 6
5 . 11 Administrative Officers 6
5 . 12 Bonds of Officers 7
Article VI - Committees
6 . 1 Committees 7
6 .2 Executive Committee 7
6 . 3 Standing Committees 8
6 .4 Ad hoc Committees 9
Article VII - Advisory Board
7 . 1 Function and General Powers 9
7 .2 Meetings and Notice 9
Article VIII - Bylaw Amendments, Rules, Policies and Procedures
8 . 1 Amendments 10
82 Rules, Policies mid Procedures .10
Article IX - Miscellaneous
9 . 1 Fiscal Year and Method of Accounting 10
9 .2 Signature of Negotiable Instruments 10
9.3 Deposits 10
9..4 Compensation .to Others than Employees _or Board .Members 11
9 . 5 Contracts 11
9 . 6 Books and Records 11
9 . 7 Corporate Seal 11
9 . 8 Annual Report 11
9 . 9 Employees I1
Article X - Conflicts of interest
10 . 1 In General 11
102 Policies and Procedures 11
10 .3 Where a Known Conflict of Interest Exists 12
Article XI - Indemnification
11 . 1 Indemnification of Board Members , Officers and Others 12
Article XII - Dissolution of Corporation 13
12 . 1 Dissolution
Y
BYLAWS - HOMELESS ASSISTANCE CENTER , INC
February, 2003
ARTICLE I
DEFINITIONS AND STATEMENT OF PURPOSE
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 .
1 . 1 . 1 Advisory Board
A body of individuals, appointed by the Board of Directors, whose members advise the
Board of Directors on matters concerning the operation of the Corporation, [including,
but not limited to] long range planning and financial security .
1 . 1 .2 Articles of Incorporation
The document incorporating the Corporation which was filed with the Secretary of State
for the State of Florida in Tallahassee, Florida on the 12th day of November, 1991 at 8 : 43
a. m . and any amendments thereto .
1 . 1 .3 Board
The Board of Directors of the Corporation .
1 . 1 .4 Bylaws
The Bylaws of the Corporation , except where reference is specifically made to the
Bylaws of another entity or unit.
1 . 1 .5 _ Corporation
Homeless Assistance Center, Inc . , a State of Florida not-for-profit Corporation was
formed pursuant to Florida Statutes , Chapter 617 , 1990 Supplement . Any questions
concerning interpretation of the Corporation's Bylaws shall be resolved by reference to
the aforementioned Florida Statutes .
1 . 1 .6 Director
An individual who is currently a voting member of the Board of Directors of the
Corporation .
1 . 1 .7 Ma " ori
Fifty-one percent (51 %) of the voting directors as described in Article V, infra.
1 . 1 .8 Officer One or more of the positions as described in Article V, infra.
1 . 1 .9 Quorum
The presence of at least 50% of the Directors shall constitute a quorum, and the act of a
majority of the Directors present shall be the act of the Board of Directors . In the absence
of a quorum, a majority of the Directors present may adjourn the meeting, from time to
time during the meeting, until a quorum is present. When a quorum is obtained, any
business may be transacted which might have been transacted at the meeting as originally
called . In the event a majority of the Directors elects to continue a meeting without a
quorum, any transaction of business shall not be ratified until the next meeting where a
quorum
1
� y
BYLAWS - HOMELESS ASSISTANCE CENTER , INC
February , 2003
exists and the subject items requiring a majority vote shall be the first order of business at
that meeting .
1 . 1 . 10 State
The state of incorporation of the Corporation ( State of Florida), unless otherwise
specifically indicated .
1 . 1 . 11 Tax Identification Number
The Corporation is duly qualified to accept donations and has been registered with a Tax
Identification Number (59-312-9752) .
1 .2 STATEMENT OF PURPOSE
The purpose of the Corporation shall be as set forth below.
1 .2. 1 The Corporation shall work toward the elimination of homelessness in District 15 of the
State of Florida Department of Children and Families . District 15 includes Indian River
County, St . Lucie County, Martin County and Okeechobee County, or as amended .
1 .2 .2 The Corporation shall operate exclusively for the benefit of, to perform the functions of
and to carry out the purposes of the Homeless Assistance Center, Inc . The Corporation is
a Florida not-for-profit corporation duly qualified as a federally tax-exempted public
charity pursuant to the laws and regulations of the United States Internal Revenue Code,
26 U . S . C . 501 (c ) 3 , as amended .
1 .2 J The Corporation shall seek and sponsor specific projects consistent with Corporate causes
and shall cooperate with other persons and organizations lawfully engaged in activities
consistent with the Corporation's purposes .
1 .2 .4 The Corporation shall receive property (real, personal or mixed) by way of gift, purchase,
grant, devise, will or otherwise and shall hold, use , maintain, lease, donate, pledge,
encumber, loan, sell, convey or otherwise dispose of all such property in furtherance of
the objectives and purposes of the Corporation . Marketable securities shall be sold
within 5 business days after they are received .
1 .2 . 5 The Corporation shall engage in any lawful act or activity for which a State of Florida not-
for-profit corporation may be organized .
1 .2 . 6 The Corporation shall have an annual financial audit conducted by a reputable CPA firm .
ARTICLE II
CORPORATE OFFICES
2 . 1 CORPORATE OFFICES
The Corporation shall have and continuously maintain a registered office in the State and a
registered agent whose office shall be identical with such registered office.
2
y
BYLAWS - HOMELESS ASSISTANCE CENTER, INC .
February, 2003
ARTICLE III
CORPORATE PROPERTY
3. 1 PROPERTY
All property received by the Corporation, whether by gift ,bequest, devise or otherwise, shall be
used exclusively to promote, carry on and further the activities, objectives and purposes set forth
in these Bylaws .
ARTICLE IV
BOARD OF DIRECTORS
4. 1 QUALIFICATIONS
Directors shall be at least age eighteen ( 18) . Participation and appointment of any Director shall
be approved by a majority vote of the Board .
4.2 GENERAL DUTIES. RESPONSIBILITIES AND POWERS
All Corporate duties, responsibilities and powers shall be vested in and may be exercised by the
Board of Directors, except as otherwise expressly provided by the laws of the State and/or the
United States, the Articles of Incorporation or the Bylaws . The Board of Directors shall establish
policy for the Corporation and direct its activities through Officers and Committee Chairs
appointed from the ranks of its Directors, except that the fundamental and basic purpose of the
Corporation as expressed by the Articles of Incorporation shall not thereby be changed .
4.3 NUMBER
There shall be no less than ten ( 10) and no more than twenty-one (2 1 ) members of the Board of
Directors unless increased from time to time by amendment of the Bylaws by a majority of the
voting members .
4.4 TERM OF OFFICE
Directors shall be elected by a majority of the voting Board of Directors at the May Annual
Meeting each year and shall hold office for a term of one ( 1 ) year, unless sooner dies, resigns, is
removed or becomes disqualified . Each term begins July 1 and ends June 30 . Directors shall not
serve more than six (6) consecutive terms . Any director who shall have served as such for six (6)
consecutive full terms shall be ineligible for re-election for a period of one ( 1 ) year immediately
following expiration of the director' s sixth full term .
3
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BYLAWS - HOMELESS ASSISTANCE CENTER , INC
February, 2003
4.5 REGULAR MEETINGS
Regular Meetings of the Board of Directors shall be held monthly at a day, time and place
designated by an action of the -board. The -location ofthese Meetings shall be at the Corporation's
Administrative offices, unless the Board of Directors determines another location. Regular
Meetings shall be held with formal notice .
4.6 SPECIAL MEETINGS AND TELEPHONE USAGE
Special Meetings of the Board of Directors may be called at any time by the Board President. or
by any three (3 ) voting directors, at such time and place and for such specific purposes as shall be
stated in the call thereof. Notice of Special Meetings (including the date, time, place and purpose)
shall be given by the director(s) calling such meeting no less than twenty-four [24] hours prior to
the date on which the meeting is to be held . Such notice shall be given by facsimile, delivered
personally or by telephone . Board directors may participate in all meetings and be considered
present via speaker telephone or conference call arrangements for a telephone meeting, when the
board determines use of the telephone is necessary . Notice is waived by attendance at a meeting .
4.7 RESIGNATIONS -OF DIRECTORS
Any Director may resign at any time either by oral tender of resignation at any Board of Directors
meeting or by -written notice thereof given to the Corporation's President or Secretary . Any such
resignation shall take effect at the time specified in the notice of resignation; unless otherwise
specified, the acceptance of such resignation shall not be necessary to make it effective .
4.8 REMOVAL OF DIRECTORS
Any Director may be removed at any time, with or without cause, by a majority vote of the full
board at a Regular or Special Meeting of the Board of Directors . Any Director who accrues three
(3 ) consecutive absences without excuse may be removed .by .a majority vote .of the fall .baarj ..
4. 9 FILLING OF VACANCIES OF DIRECTORS
In the case of any increase in the number of Directors or of any vacancy caused by death,
resignation or removal , the additional Directors) shall be elected by majority vote at the next or
any Regular Meeting or at a Special Meeting called for that purpose. The term of any Director
elected to fill any such vacancy shall continue until the next Annual Meeting of the Corporation .
Such term shall not be included in the calculation of the maximum of six (6) consecutive terms as
Director as set forth in Section 4 . 4 , supra.
4. 14 ELECTIONS AT ANNUAL .MEETINGS
Directors shall be elected by a majority vote of the voting directors present at each Annual
Meeting. Directors shall be nominated by -the Nominating Committee, -or -by -petition often
percent ( 10%) of the Corporation's directors which petition shall be filed with the Board of
Directors at least one ( 1 ) month prior to the date of the Annual Meeting. Directors shall take
office on July 1 after election .
4. 11 BOARD ACTION WITHOUT MEETING
The Corporation President may, at any time, instruct the Corporate Secretary to secure a vote by
telephone .poll of the Board of Directors, with the subject of the poll to be written out and read
verbatim to each Director. The resulting vote shall be presented and recorded as the first order of
.business .at .the .next Regular .Meetingof .the Board .of .-Directors .
4. 12 ,C IQWENSATION
Directors shall not receive any compensation for serving as Directors, except they may receive
reimbursement for reasonable expenses incurred by them in the performance of their duties, as
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BYLAWS — HOMELESS ASSISTANCE CENTER, INC
February, 2003
shall be determined by the Board of Directors . Proper receipts must be presented for
reimbursement .
ARTICLE V
OFFICERS : POWERS, DUTIES AND RESPONSIBILITIES
5. 1 OFFICERS OF THE BOARD OF DIRECTORS
The Officers of the Board of Directors of the Corporation shall be a President, First Vice
President, Second Vice President, Secretary and Treasurer . The Board of Directors may also elect
one or more other Officers as from time to time may appear necessary or advisable for the
conduct of the Corporation's affairs . The Board of Directors shall direct the activities of the
Officers .
5.2 ELECTION OF OFFICERS
Following the election of Board members at each Annual Meeting, Officers of the Board of
Directors shall be elected from among the newly elected Board members by majority vote .
5.3 TERM OF OFFICE
Each Officer shall hold office for one ( 1 ) year, commencing July 0 . unless terminated sooner as
a result of death, resignation, removal or disqualification . Each Officer may be re-elected to the
same office position no more than two (2) consecutive full terms ; although said Officer may be
elected to another of the office positions following a two-year consecutive full term in one
position. An Officer who -has served two (2) consecutive full terms in the same office position is
ineligible for re-election to that same office for a period of one ( 1 ) year following expiration of
the Officer's second full term .
5.4 REMOVAL OF ELECTED OFFICERS
Any Officer may be removed at any time, with or without cause, by majority vote of all Board of
Directors at the next or any Regular Meeting or at a Special Meeting called for that purpose . Any
.action for removal shall .proceed .only following notice by the Board .of Directors .to .the said
Officer at least seven (7) days prior to the meeting at which action is to be instituted .
5.5 FILLING VACANCIES OF ELECTED OFFICERS
In the case of any vacancy which may occur in any office as a result of death, resignation or
removal, the Board of Directors shall elect a successor by majority vote at the next or any
Regular Meeting or at a Special Meeting called for that purpose . The term of any Officer elected
to fill any such vacancy shall continue until the next Annual Meeting of the Corporation . Such
term shall not be included in the calculation of the maximum of two (2) consecutive terms as
Officer in that particular office position asset forth in Section 5 . 3 , supra.
5. 6 PRESIDENT
The President of the Board of Directors shall preside at all meetings of the members and Board of
Directors at which the President is present and shall rule on all matters of order and procedure at
such meetings . The President shall be responsible for the supervision of the affairs of the
Corporation and the implementation of the policy directives of the Board of Directors, and
perform such other duties as are incident to the office of the President. The President or his or her
designee .shall be the .official .spokesperson .of the Corporation, unless otherwise .determined by
the board . The President shall be the Chairperson of the Executive Committee and serve as ex-
officio member of all -standing and ad hoc committees of the -Corporation .
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BYLAWS - HOMELESS ASSISTANCE CENTER , INC
February , 2003
5.7 FIRST VICE PRESIDENT
The First Vice President of the Board of Directors shall perform the duties of the President in the
President's absence or at the President's direction. Unless otherwise specified in the Bylaws, the
First Vice President shall appoint the Chairpersons of all Standing Committees and shall be the
Chairperson of the Nominating Committee .
5.8 SECOND VICE PRESIDENT
The Second Vice President of the Board of Directors shall perform the duties of the President in
the absence of the President and the First Vice President or at their direction . The Second Vice
President shall act as the liaison between the Advisory Board and the Board of Directors .
5.9 SECRETARY
The Secretary of the Board of Directors shall give notice of all meeting of the members and the
Board of Directors, except as otherwise provided, and shall keep and attest true records of all
proceedings . In the Secretary's absence from any such meeting, the Assistant Secretary, if any, or
a chosen temporary Secretary shall record the proceedings . The Secretary shall have dominion
and control over the Corporate Book, including Articles of Incorporation, Bylaws and approved
minutes of all 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 shall
generally perform all the duties normally associated with the office of Secretary of a corporation .
The Secretary shall distribute minutes of each meeting to all Board members at least seven (7)
days prior to the next subsequent Regular Meeting and, following approval of said minutes at the
next subsequent meeting, shall retain said minutes in the Corporate Book .
5. 10 TREASURER
The Treasurer of the Board of Directors shall have the care and custody of all funds, securities
and assets of the Corporation. The Treasurer shall keep all books of account relating to the
Corporation's business and shall render a statement of the Corporation's financial condition at
each Regular Meeting of the Board of Directors and at each Annual Meeting . The Treasurer shall
review, on a weekly basis, a summary report of all expenses paid by the Executive Director on
behalf of the Corporation . The Treasurer shall ensure that no funds are issued without proper
receipts . The Treasurer shall be the Chairperson of the Finance & Development Committee .
5. 11 ADMINISTRATIVE OFFICERS
The Administrative Officers of the Board of Directors shall include an Executive Director. The
Corporation may, at the discretion of the Board of Directors, have additional Administrative
Officers including, but not limited to, one or more additional Assistant Directors .
5. 11 . 1 EXECUTIVE DIRECTOR
The position of Executive Director shall be filled by a majority vote of the Board of Directors .
The Corporation's Executive Committee shall have the responsibility of creating the Executive
Director's position description, which shall be subject to the approval of the Board of Directors .
The Executive Director shall report to the Board of Directors as a whole, and shall be subject to
an annual performance evaluation by the Executive Committee . The Executive Director shall be
responsible for the day-to- day operation of the Corporation and shall make recommendations and
provide a monthly report to the Board of Directors regarding the operation of the Corporation .
The Executive Director shall be an advisor to the Board of Directors and not a member of the
Board .
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BYLAWS — HOMELESS ASSISTANCE CENTER, INC.
February, 2003
The Executive Director ' s authority, duties and responsibilities shall be governed by
and limited to the aforementioned position description. The general scope of
authority, duties and responsibilities shall be as follows :
(A) Ensure that all required positions within the Corporation including, but not
limited to . Case Worker/Administrator, Bookkeeper and Shift Supervisors are
staffed with competent individuals . In that regard, the Executive Director shall
have the authority to employ or terminate the employment of staff personnel for
positions so provided in the Corporation's budget. All staff personnel, including
any Assistant Directors, shall report to the Executive Director, who shall be
responsible for conducting and maintaining records of annual performance
reviews , unless otherwise determined by the board for special projects .
(B ) Ensure that all required financial, tax, statistical and other reports are timely filed
and promptly reported .
(C) Ensure that all expenditures are governed by and within the constraints of the
Corporation's current budget. In that regard, the Executive Director shall be
responsible for approving all Corporation expenditures subject to the
aforementioned budgetary constraints . Any expenditures beyond the scope of the
Corporation's budget shall require prior approval by a majority vote of the Board
of Directors . In the event of extenuating emergency circumstances where prior
approval by the Board of Directors is not possible, prior approval by a majority
vote of the Executive Committee shall suffice . Such Executive Committee
approval may be obtained by telephone vote, if necessary .
(D) Ensure that all expenditures, with the exception of payroll, are substantiated with
an invoice or receipt.
5. 12 BONDS and INSURANCE FOR DIRECTORS and OFFICERS
The Board shall secure the fidelity of all Officers and Directors and employees by obtaining
Liability insurance and/or fidelity coverage for all such Officers , Directors and employees, when
it is deemed necessary by the Board . Premiums for said bonds and insurance shall be paid by
Corporate funds .
ARTICLE VI
COMMITTEES
6. 1 COMMITTEES
The Board of Directors may, at any time deemed necessary, add, change the membership of or
terminate the existence of any Committee by resolution adopted by a majority vote . The
Chairperson of any Committee shall be a current member of the Board of Directors . Committee
members may include individuals who are not members of the Board of Directors . Each
Committee shall propose work programs of their own design, subject to approval and
modification by a majority vote of the Board of Directors . Committee reports shall be submitted
to the Board of Directors at each Regular Meeting .
6.2 EXECUTIVE COMMITTEE
The Executive Committee shall consist of the President, First Vice President, Second Vice
President, Secretary, Treasurer and chairpersons of all Standing Committees and such other
Board directors as appointed by the Board . The President shall be the Chairperson of the
Executive Committee .
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BY-LAWS — HOMELESS ASSISTANCE CENTER, INC.
February, 2003
6.2. 1 AUTHORITY AND FUNCTIONS OF THE EXECUTIVE COMMITTEE
When the Board of Directors 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 . The Executive Committee shall have the authority to approve
emergency expenditures by a majority vote of the Executive Committee, which vote may
be taken by telephone poll of the entire Committee and which shall be presented as the
first order of business at the next Regular Meeting . The Executive Committee shall create
and update, subject to the approval of the Board of Directors, the position description of
the Executive Director. The Executive Committee shall be responsible for recruiting and
screening candidates to fill the Executive Director' s position and recommend a candidate
to the fill the position . The Executive Committee shall not fill vacancies on the Board of
Directors or any Committee thereof and may not adopt, amend or repeal the Bylaws .
6.2 .2 MEETINGS AND NOTICE
The Executive Committee shall meet at the request of the Chairperson of the Executive
Committee when, from time to time , meetings are required . Notice of an Executive
Committee meeting ( including the date, time, place and purpose) shall be given by the
Chairperson of the Committee no less than forty-eight (48 ) hours prior to the date on
which the meeting is to be held . Such notice shall be given by facsimile, delivered
personally, by telephone or by E-mail when appropriate . [ Directors may participate in
all meetings and be considered present via speaker telephone or conference call
arrangements for a meeting, when the board determines use of the telephone is
necessary. ] Notice may be waived by attendance at the meeting .
6.3 STANDING COMMITTEES
At the first Regular Meeting following the Annual Meeting, the Board President and First Vice
President shall , unless otherwise specified, appoint Chairpersons and members for the following
Standing Committees .
6.3 . 1 Operations Committee
The Operations Committee shall be responsible to assist the Executive Director with
oversight of current agency programs and / or related program administration and / or
staffing grants, shall create, update and maintain administrative and program policies and
procedures, and have oversight of program development planning. President or the
president ' s designee shall be the chairperson of the Operations Committee .
6.3.2 Marketing Committee
The Marketing Committee shall be responsible for public relations, community relations,
marketing and fundraising at events . Fundraising events shall be coordinated with the
Finance & Development Committee who has the primary responsibility for fundraising.
The Committee shall strive, through all forms of media, to promote better public
perceptions and understanding of the Corporation and its core mission to help the
homeless become self sufficient.
6.3 .3 Finance & Development Committee
The Finance & Development Committee shall have the primary responsibility for
obtaining funds and establishing mechanism for obtaining funds necessary to secure the
effective short and long term operations of the Corporation . The Finance & Development
Committee shall be responsible for recommendations regarding the financial policies of
the Corporation, reviewing and recommending the Corporation's annual budget, and for
such other financial duties as may be assigned by the Board of Directors . The Treasurer
shall be the Chairperson of the Finance & Development Committee .
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February, 2003
6.4 AD HOC COMMITTEES
The Board of Directors may establish Ad Hoc Committees as needed to further the purposes of
the Corporation. A By-Laws Committee shall be established every two [2] years to review the
bylaws and recommend changes to the Board of Directors .
The By-Laws may be change only by a 50% or more vote of all members of the Board of
Directors at a monthly Board of Directors meetings .
ARTICLE VII
ADVISORY BOARD
7A FUNCTION AND GENERAL POWERS
The Advisory Board shall advise the Board of Directors on matters concerning the operation, long
range planning -and financial security of the Corporation. The members of the Advisory Board
shall advise the Board or Directors but shall not be members of the Board and have no voting
authority . The .members of the Advisory. Board shall be .appointed .by a majority vote of the .Board
of Directors and shall be compensated only to the extent members of the Board of Directors are
compensated. The President shall .act as liaison between .the Advisory Board .and .the Board of
Directors and shall coordinate the efforts of the Advisory Board. At each Annual Meeting, the
Second Vice President shall report the prior year's activities of the Advisory Board .
7.2 MEETINGS AND NOTICE
The Advisory Board shall meet at such times as deemed necessary by the Board of Directors, but
no less than one ( 1 ) time per year within thirty (3 0) days prior to the Annual Meeting. The
President shall call the meetings of the Advisory Board and shall give appropriate notice
(including the date, time and place) to all Advisory Board members at least ten ( 10) days prior to
the date of the meeting. The appropriate notice may be by facsimile, personal delivery, e-mail or
telephone call . In the event the purpose of the meeting is considered to be of an emergency nature,
notice (including the date, time and purpose) may be given by facsimile, personal delivery, e-mail
or telephone call no later than twenty four [24] hours prior to the date of the meeting.
9
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BYLAWS — HOMELESS ASSISTANCE CENTER, INC
February, 2003
ARTICLE VIII
BYLAW AMENDMENTS, RULES , POLICIES AND PROCEDURES
8. 1 AMENDMENTS
The power to make, alter, amend or repeal the Corporation Bylaws shall be vested in the Board of
Directors of the Corporation . Proposals for such changes, additions or deletions shall be
submitted in writing to the Secretary for immediate distribution to the Board of Directors at least
five [5] business days before a regular monthly meeting at which the Board may take action .
8. 1 . 1 Voting Requirement
Approval of any changes , additions or deletions to the Bylaws shall require a majority
vote of all Board of Directors .
8.2 RULES . POLICIES AND PROCEDURES
The Board of Directors may adopt, amend or repeal rules, policies and procedures for the
management of the internal affairs of the Corporation (as described in the Corporation's Policy
and Procedure Manual) and the governance of its Officers, agents , Committee members and
employees .
ARTICLE IX
MISCELLANEOUS
9. 1 FISCAL YEAR AND METHOD OF ACCOUNTING
The fiscal year of the Corporation shall be July I ` through June 30`b of each year. The accrual
method of accounting shall be the method used by the Corporation . The Corporation shall have
an annual audit performed by an independent accredited CPA accounting firm . The annual audit
shall be completed, reviewed and approved by the Board of Directors at their October board
meeting each year.
9.2 SIGNATURE OF NEGOTIABLE INSTRUMENTS
All bills, notes, checks or other instruments for payment of money shall be signed by the
Executive Director as he or she is authorized to do so as set forth in these Bylaws or by resolution
of the Board of Directors . In the event the Executive Director is not available to execute the
aforesaid instruments, the Corporation's Board Treasurer or officer[s] of the board shall have the
authority to execute these documents subject to the same restrictions as are hereby imposed upon
the Executive Director. Signature cards for the Corporation' s financial accounts shall include the
names of all members of the Executive Committee, the Executive Director or as designated by the
board. The Executive Director, through the Corporation's Comptroller, shall be responsible for
ensuring that the applicable signature cards are kept up to date .
9.3 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 of Directors may,
from time to time, designate and upon such terms and conditions as shall be fixed by the Board.
All deposits shall be made by someone other than the person preparing said deposit[s] . The
person making said deposit[s] shall be designed by the Executive Director or the Executive
Committee . The Executive Director may be the person making deposit[s] .
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BYLAWS — HOMELESS ASSISTANCE CENTER, INC.
February, 2003
9.4 COMPENSATION TO OTHERS THAN EMPLOYEES OR BOARD MEMBERS
The 'Board of Directors may make such contracts and employ such agents, brokers and attorneys,
as it deems necessary or appropriate to accomplish the Corporation ' s purposes . Directors and
Officers and firms and corporation in which Directors and Officers are interested, may be parties
to such contracts and may be employed . Any _person, firm or corporation with which the
Corporation makes any such contract, or which it so employs, may be paid reasonable
compensation for performing such contracts or -rendering such services . There shall be no
reimbursement or compensation without proper receipts .
9.5 CONTRACTS
The Board of Directors 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 . Such authority may be general or confined to
specific instances .
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 and .proceedings of the Corporation. Such books and records shall be
open to inspection by the director [s] of the Corporation at any reasonable time .
9.7 CORPORATE SEAL
The seal -of the Corporation shall be circular in form and bear the name of the Corporation, words
and figures indicating incorporation in the State, and the year of incorporation .
9.8 ANNUAL REPORT
The President shall cause a Corporation Annual Report to be submitted to the Board of Directors
each year at the annual meeting.
9.9 EMPLOYEES
The Board of Directors may employ such personnel, including a full-time Executive Director, as
it deems necessary or desirable for the efficient operation of the Corporation. 14o employee of the
Corporation will be a member of the Board of Directors . In the event a Director becomes an
employee, he or she will immediately tender resignation from the Board .
ARTICLE X
CONFLICTS OF INTEREST
10. 1 IN GENERAL
At the Annual Meeting, following election to the Board of Directors, each Director shall execute
the Corporation's General 'Statement of Lack of Conflict of Interest. During the course of each
Director's term of office, circumstances may arise which may result in a specific conflict of
interest. Such specific conflicts of interest may include, but are not limited to, a possible
significant financial or influential interest in the outcome of a Board decision .
10.2 POLICIES AND PROCEDURES
The Board of Directors may adopt, amend or repeal policies or procedures regarding any issues
concerning conflicts of interest. These policies may include, but are not limited to, requirements
11
BYLAWS - HOMELESS ASSISTANCE CENTER, INC .
February, 2003
and procedures regarding [a] regular annual statements, and [b] periodic supplemental
statements by members of the Board of Directors or its Officers, Advisory Board,
professional advisors, key
employees and other Corporation officials which shall disclose any existing and/or potential
conflicts of interest, (b) limitations on permitted external positions and interests, and (c)
corrective action with respect to transgressions of such policies .
10.3 WHERE A KNOWN CONFLICT OF INTEREST EXISTS
Where a known conflict of interest exists or arises which concerns any member of the Board of
Directors, any contract or transaction shall be authorized or entered into by the Corporation only
after all of the following conditions are satisfied .
10.3 . 1 Full and Complete Disclosure of the Conflict of Interest by the Interested Party
The interested party shall, in good faith, fully and completely disclose the nature of the conflict
( including all relevant and material facts known by the interested party) to the Board of Directors
prior to the time the Board decides to enter into the said contract or transaction . Such disclosure
shall be reflected in the minutes .
10.3 .2 Assurance by the Interested Party that the Contract or Transaction is Fair
The interested party shall, in good faith, assure the Board of Directors (prior to the time the
Board decides to enter into the said contract or transaction) that the proposed contract or
transaction is fair and reasonable to the Corporation . Such assurance shall be reflected in the
minutes .
10.3 .3 Absence of the Interested Party from Board Discussion or Voting
The interested party shall not be present during any discussions by the Board of Directors or
during the vote concerning whether or not to approve the contract or transaction .
10.3 .4 Voting Requirements
Authorization to enter into the said contract or transaction shall be by a vote of a majority [at
least two-thirds (2/3 ) ] of non-interested party or parties . The interested party [s] , while not
eligible to vote on the subject matter, shall be counted among the voting directors [ members of
the Board of Directors] that constitute a quorum.
ARTICLE XI
INDEMNIFICATION
11 . 1 INDEMNIFICATION OF BOARD MEMBERS. OFFICERS AND OTHERS
The Corporation shall indemnify any current or former Board member. Officer, agent or
employee against all judgments, fines, settlement amounts, and reasonable costs and expenses
(including attorney fees) actually and necessarily incurred in connection with any claim (civil or
criminal) asserted by an action in court or otherwise, including any appeal therein, by reason of
such person being or having been a Board member, Officer, agent or employee of the
Corporation and performing activities within the scope of their services to the Corporation. This
indemnification shall be to the same extent permitted, and in the manner prescribed, by the
Florida Not-For-Profit Corporation Act. Such indemnification shall not apply in an action by, or
in the right of, the Corporation . Such indemnification shall not extend to matters in which such
Director, Officer, agent, or employee is adjudged to have breached his or her duty to the
Corporation . Such right of indemnification shall not be deemed exclusive of any other rights to
which such Director, Officer, agent, or employee may be entitled by Florida Statutes , apart from
the foregoing provisions 1213 , or as amended .
12
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BYLAWS - HOMELESS ASSISTANCE, CENTER, INC.
February, 2003
ARTICLE XII
DISSOLUTION OF CORPORATION
12. 1 DISSOLUTION
Upon dissolution of the Corporation, all assets shall first be applied to the liquidation of existent
obligations . Any other assets, except as required by law and with the consent of the Board of
Directors, shall be donated to such other organization(s) whose purpose is consistent with the
purposes of this Corporation .
13
HOMELESS ASSISTANCE CENTER, INC .
Personnel Policies
July , 2001
r'
r
SECTION I — EMPLOYMENT PROCEDURES
A. Classes of Employment
Full-time employees are all employees who are hired to work a 40 hour week, excluding
lunch periods.
Part-time employees are all employees who are hired to work less than a 40 hour week.
B . Selection of Employees
All employees will be hired by the Executive Director. All applications for employment
shall stay on file for a total of ninety (90) days . Applicants are to submit a resume and
complete an Employment Application.
�L C . Equal Opportunity Employment (FF14em 1VCr10A1 /"dcicY" )
The Homeless Assistance Center provides an equal employment opportunity to all
individuals, regardless of their race, religion, sex, marital status, age, national origin or
handicap. All employment related decisions will be made solely upon the one ' s ability to
perform the functional requirements of the job.
D . Hiring Practices
Personnel will be selected on their ability to carry out the duties contained in the agency
job description. Applicants selected for positions will be informed of employment by a
letter stating the starting date, working hours, immediate supervisor, rate of pay, position
title, and the type of benefits the employee will be eligible for. The letter will come from
the Executive Director. A copy of the Personnel Policies will be provided at the time of
employment .
New employees are to complete all necessary paperwork including the completion of
W-4 and I-9 Forms on the first day of employment. New employees will participate in an
orientation to their position by their immediate supervisor.
The recruitment, selection and hiring of the Executive Director is handled by the
Executive Committee of the Board of Directors. The employment letter, which outlines
the benefits and details of employment shall come from the Board President .
E. Certifications/Licenses
All employees who work directly with clients will be expected to complete First Aide and
CPR Certification. Upon completion of training, the employee is to provide a copy of the
certification of completion for their personnel file. Certifications are to be kept up to date
and are the responsibility of the employee to renew. All employees who drive the agency
1
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HOMELESS ASSISTANCE CENTER
Carol Zomok, Residential Case Manager for the Homeless Assistance Center,
attended the Goals Workshop on May 19, 2003 for Sue Rux, Executive Director.
The Workshop was from 14 p. m. and was held at 2525 St. Lucie Avenue.
. LL�- `� a7 43
Sue Rux — Executive Director Date
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AUTHORt2ED REPRE6ENTATIVE
ACORD25 (2DOt108) lJeffrey Schlitt , CPCU/LAR
IDACORC CORPORATION 18811: