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20140416BudgetWorkshopNonprofit
Table of Contents 000_000_20140416BudgetWorkshopNonProfit 1 010_010_Non profit 2 2013-14 2 020_010_American Legion 3 030_010_Friends of Tybee Theater 6 040_010_Historical Society 9 050_010_Islands Feral Cat Project 13 060_010_Marine Science Center 15 070_010_SEABAR 22 080_010_Tybee Beach Bum Parade 36 090_010_Tybee Irish Heritage 39 100_010_Tybee MLK Parade 46 110_010_Tybee MRS 51 120_010_Yeepies 53 AGENDA BUDGET WORKSHOP OF THE TYBEE ISLAND CITY COUNCIL APRIL 16, 2014 I. Non-profit Organization for Community Service Contract Awards 1 American Legion Post 154 2 Friends of Tybee Post Theater 3 Historical Society 4 Islands Feral Cat Project 5 Marine Science Center 6 SEABAR 7 Tybee Beach Bum Parade 8 Tybee Irish Heritage 9 Tybee MLK Parade 10 Tybee MRS 11 Yeepies IL Adjournment *PLEASE NOTE: Citizens wishing to speak on items listed on the agenda,other than public hearings, should do so during the citizens to be heard section. Citizens wishing to place items on the council meeting agenda must submit an agenda request form to the Clerk of Council's office by Wednesday at noon,eight days prior to the scheduled meeting. Agenda request forms are available outside of the Clerk's office at City Hall and at www.cityoftybee.org. I THE VISION OF THE CITY OF TYBEE ISLAND "is to make Tybee Island the premier beach community in which to live, work,and play." 41 THE MISSION OF THE CITY OF TYBEE ISLAND "is to provide a safe,secure and sustainable environment by delivering superior services through responsible planning,preservation of our natural and historic resources,and partnership with our community to ensure economic opportunity,a vibrant quality of life,and a thriving future." 20140416BudgetWorkshopNonProfit Page 1 of 55 20140407/jrl 0 V1 U O ,1 '6 O 4 > 1a o m Q N O O O O O O 0 Ln N N V1 O O O O d V1 e"I y y C C C C C T 4 > 7 c-1 N O l ei ,a s N N N > CL ▪ h O O O 3 O O O O 0 i V1 ei • O i O O O O Vf M > O1 O O) > O O^ co O cr N ca ,-1 cr N N 01 l0 N o N 00 -a O O ,--1 3 O ▪ Q -1.1 O L N f.0 U CU 00 0 M rr O c-1 O O —. M O C O M O M O O O ci O C > LID c-1 c-I ci \ el L > U 6 0 04'r art ++ 0 O O O 0 O O O v) O O co O O O O O ci ,-1 = O O O o O O� 0l c▪ v o o U' 0 1n co N in Vl N Cr) -1 e N N eI CO U N O O O O O O O O O 0 O O O O O O O O O 0 O O V1 O N O Li.; O O N ey 3 O O N V) ci O N V1 .1- V1 M < N V) -1 N N O CO N N ,-1 ei C N R LS" V1 M is 0 N N y c-1 N V1 U 0 0 0 0 0 0 0 0 0 0 0 y, O O O O O O O O O O 0 t y O O O O O O O O O O O M 3 O 0 O OU O 0 00 U' 0 V1 ,-1 1a a O U aJ N O ci O ci M V1 N c-1 N N CL ci M M 00 N M V1 O 00 c-1 lD N V1 N ci M d' O 0l l0 c-1 C O V1 ci 0 O lD co M ci Lo c1 d' N 0 co co iri p O1 lD N N CO a Cr) a Cr) M Tr Ct ',Zr 00 V ci t O V1 •7 al V1 U1 CO O V1 lD V1 O O N O Q S ■ lD l0 4 l0 c+'1 A l0 l0 l!1 l0 l0 4 4 l0 l0 H Vl 00 CO (N CO ,1 VD 00 00 LC) CO 00 00 ,-1 00 00 O N N N N N N l0 N N LE) N N 00 d" N N H I- CU W W in Q y) N Vl Vl Q l0 N N ei N Q .a N Ql M (MUD M O 00 M N O) N H CO V) ,-1 00 N W Cr) N l0 e I N ei Cr N V) N W U Q X X X Z X X X X X X X X = X Z (Q 0 0 0 0 0 0 0 0 0 0 0 0 1— 0 0 L m m m —' m CO m m on m m m u- 00 C O_ LL O_ N LL O_ LL LL LL LL LL LL 000- N O V g G1 o v c� U o O O E o 41 O O L E a V U N y ci v O v c �?+ — M v o l E v ° ° OU ., o co •� W ON OV 7 C E L (0 U : U Q L OJ Z a1 p vii O i E E p N '� C EJ >_ Vt 0 — Y 0) t0 o1 E V' O E7 O O N 0J of C co O m O L c0 O .� 0 N Y J = C w a v t v V Cr v N a1 E yvi �a1 f0 X01 f0 C W 01 t n aJ w E -0 . - - H U E U v C z CC O 1W,) 0 .. = o 1 w CU z O a Q = 2 N z v) 2 0 0 U w C7 +° W OH 0 w Q 00 U J = U m 2 •RS G O J rN Z w K CC Q O V- w Q aQ V m 0 r w W Y K D_ W 0 >- F w 0 00 Y CC L Y CO J LL = w 2 Q Q 0 J Q J LL W W U Y W O0 m Z Q N Q = Y Z W �, co = Z O J m U Q w vQi v~i a o g O o z Q ? m 2 0 1- CL C z O CL J o Z I CC U z o -13 C j o. = O) 0 0 U 2 Q 00 Z Uc 0 w HvU) z F 0 G W :.� 0 > O Z Q '!) U 0 Q1 Z w w Q U U = w Q U O 0 u " LL U-0 • O co W Q O W 00>` O v1 H N Q Q Y Z Z J LL J Z J 44— z , 0 0 0 2 Q v) H U ` Q J LL w 0 u = ,./., W m Q 2 w Ul z w w w w w w ,+z�'20140416Buc t WGor hrtplUnlerot w ¢ > w w i P�g DWeL 6#55 20140407/jrl U Q CO LL l7 = N - H H H H H H >- N City of Tybee Island Community Services Contract Award. Fiscal Year 2014-15 APPLICATION FOR CASH AWARD This form is to be completed and submitted to Finance with your budget request. uctc.t. 3—Li Organization requesting City of Tybee Island Community Services Contract Award: Name of Organization: Ana(Car., /&in 1(21A4— / V V. Contact Person: Address: O Icy I T. 6e5 ('s l G4 ( 3 0-2 Contact Email: '` 9(0,- � '� � Contact Phone #: Is this organization an IRS approved 501(C) 3 Non-Profit? Yes No If'yes", please attach your most recent audited financial statement, a copy of your IRS determination letter and a copy of your current budget detailing the planned use for the awarded funds. Amount of funds requested: $ Describe how these funds will be used And how the City and citizens of Tybee Island will benefit: ith a/v.4 (...‘de AS/fr2:,..5 ', " -(41" 'Ct Opera_41.-„ ( ct,J Ire i(E,1 krt. Of iC m ZP 'L` 1-‘ 0 [ c e6-0-6A p_ep 4141 o c r • S CP T L CU ) What percentage of these funds will be matched by your organization? /C161 ; Will this event or program bring visitors to Tybee Island in off-peak season or months? >>Please attach a detailed budget to this request outlining how the money will be used. P.O.Box 2749—403 Butler Avenue,Tybee Island,Georgia 31328-2749 20140416BudgetWorkshopNonProfit Page 3 of 55 20140407/jrl t14.°l `'"rte _titi: City of Tybee Island Community Services Contract Award =f'' Fiscal Year 2[114-15 ...‘blorportot, APPLICATION FOR WAIVERS Date: 3 ,14 --1 V Name of Organization: f4' Q/i (c 1- ( Pc--)62 is f Provide detail on any waivers (i.e. free or reduced parking, rent or utilities) or City services (he. number of hours of security, city worker clean-up, trash and/or recycle bins, building maintenance and upkeep, etc.) that you plan to request for your event(s): / t/ce`i5- 4_5 - , - ems--a ` , , , c_ s LA,if 6-6---s „ p.n. . i -- il -r r r ►X &s 0_ li---Lt A)z-i-rilf,_ 0.--4- k.)r, Q 0 4 . , C-,--itc-re ., K;c6' iLl-rt kir A.)0 C o f ` 0_ .1- 1 )t c cL N-1a_S r i t i 4% 6 l-iC 1 A 0 ,-c r k) D e 0 (- Value of the waivers requested: $ /?% v P.Q.Box 2749—403 Butler Avenue,Tybee Island,Georgia 31328-2749 20140416BudgetWorkshopNonProfit Page 4 of 55 20140407/jrl Affidavit Verifying Status 1 for City Public Benefit Application By executing this affidavit under oath,as an applicant for a City of Tybee Island,Georgia,Business License or Occupation I a. Certificate,AIcohol.License,Taxi Permit,Contract,or other public benefit as referenced in O.C.G.A. Section 50-36-1,1 am stating the following with respect to my application of a City of Tybee island: • Business License or Occupational Tax Certificate, • Alcohol License. (circle all that apply) • Taxi Permit_ • Contract • Community Services Contract Award for (printed name of natural person applying on behalf or individual, business,, corporation,partnership, or other private entity). 1) t/ I am a United States cruzet. OR P I 2) _ 1 am a legal permanent resident 18 years of age or older or I am an otherwise qualified alien or non-immigrant under the Federal Immigration and Nationality Act, 18 years of age or older and lawfully present in the United States. * In making the above representation under oath. I understand that any person who knowingly and wiilf i lv makes a false. fictitious. or fraudulent statement or representation in an affidavit shall be guilty of a violation of Code Section 16-10-20 of the Official Code of Georgia. Signature of Applicant Date j� ( ' V (L -••r- iJ 6'-�"-- Printed Nye *Alie gistrtraattio(n Number for Non-citizens SUt3S7PDAYQP , . 1/VT ED AN S ,4 BEM 'ME ON TH THE '/ , - - *Notary Publ i I _,,,,,,_,,,,,,4,_�- -414 SHARON S.SHAVER Notary Public,Chatham County, GA My Commission Expires Dec. 5, 2015 My Commission Expires: Note: 0.GG.A. §50-36-1(e)(2) requires that aliens under the federal Immigration and Nationality Act, Title 8 U.S.C, as amended, provide their alien registration number. Because legal permanent residents are included in the federal definition of"alien", legal permanent residents must also provide their alien registration number. Qualified aliens that do not have an alien registration number may supply another identifying number below: 20140416BudgetWorkshopNonProfit Page 5 of 55 20140407/jrl il ` City of Tybee Island Community Services Contract Award I) 444,!,\ F Fiscal Year 2014-15 APPLICATION FOR CASH AWARD This form is to be completed and submitted to Finance with your budget request. Date: ! 4 ' it3 mitt" Organization requesting City ,,of Tybee Island Community Services Contract Award: Name of Organization: raldniive 1 rile 71i'Irt i Contact Person: -. 1H' ri47 _ Address: Q if 7 / 9,- ff,4 ' Contact Email: *rrey%• :- ' Contact Phone #: fI 6t /ff r v 1 Non-Profit? 'Yes No Is this organization an IRS approved tC} 3 Non-Pro o 5f7 � If"yes", please attach your most recent audited financial statement, a copy of your IRS determination letter and a copy of your current budget detailing the planned use for the ' awarded funds. - I Amount of funds requested: $ iv 7 -�'. Describe how these funds will be used and how the City and citizens of Tybee Island will benefit: el .Ile — 57, IA/6' A/ ,/the i7 ,e) A Pv -- 5 , - c'/f Q4//, --61 " .h,� • 0 (4)C ,,) �-. 41- - / f ,,fici - ,, . eme A ,7 , ir What percentage of these funds will be matched by your organization? g7' Will this event or program bring visitors to Tybee Island in off-peak season or months? kii p 9 g Y >>Please attach a detailed budget to this request outlining how the money will be used P.O. Box 2749—403 Butler Avenue,Tybee Island,Georgia 31328-2749 (912)7861573—FAX(912) 786-9465 20140416BudgetWorkshopNonProfit wwwilaii378fifyWee.org 20140407/jrl _ �� City of Tybee Island Community Services Contract Award � , Fiscal Year 2014-15 APPLICATION FOR WAIVERS Date: /� Name of Organization: 4 t r fh 44'9/6'1 Provide detail on any waivers (i.e. free or reduced parking, rent or utilities) or City services (i.e. number of hours of security, city worker clean-up, trash and/or recycle bins, building maintenance and upkeep, etc.) that you plan to request for your event(s): 9 fag— //10.6 /944 ibigie. -''' q41 419. . „i"M iye4--- .2,) 0 Irep& 47.;,( ida, - k--c7/ .,, kr,4 14‘?e6/1/V1:611 re:75; if sedieop (igorex. ,/e/re 1 Ilive, /Peal /7;//7,,lee_... eti2die ?,,) iii,,,e9 kile/W Aii276X Yi,,Pr'nfrAfifr ZW17/1 aoz,4z___,-' 067 Value of the waivers requested: $ f r �G P.O. Box 2749=403 Butler Avenue,Tybee Island,Georgia 31328-2749 (912)786-4573—FAX(912)786-9465 20140416BudgetWorkshopNonProfit WWWP+ f3flfyWee.org 201 40407/jrl i*/*. p Affidavit Verifying Status for City Public Benefit Application By executing this affidavit under oath,as an applicant for a City of Tybee Island,Georgia,Business License or Occupation Tax Certificate,Alcohol License,Taxi Permit,Contract,or other public benefit as referenced in O.C.G.A. Section 50-36-1, I am stating the following with respect to my application of a City of Tybee Island: • Business License or Occupational Tax Certificate, • Alcohol License, (circle all that apply) • Taxi Permit, • Contract • Connmuni ,derv- -s Co , ct Award for r jr Z - (printed name of natural person applying on behalf of individual, business, corporation,partnership, or other private entity). 1) V"I am a United States citizen. OR 2) - I am a legal permanent resident 18 years of age or older or I am an otherwise qualified alien or non-immigrant under the Federal Immigration and Nationality Act, 18 years of age or older and lawfully present in the United States. * In making the above representation under oath, I understand that any person who knowingly and willfully makes a false, fictitious, or fraudulent statement or representation in an affidavit shall be guilty of a violation of .de Section 16-10-20 of the Official Code of Georgia. i Aw. f :r Si '' eo ' pp " .,. / 1 Date _ --Niue _.._._ V1 Printed Name *Alien Registration Number for Non-citizens SUBSCRIBED AND S ORN BEFORE ME ON THIS THE fa DAY OF ,20/" Notary Public u.L LEANER Notary Public,Chatham County Grk My Commission Expires: v /�f(Q hfr *Commission Excires Ort 1f3 2016 7" Note: O:C G.A. §50-36-I(e)(2)requires that aliens under the federal Immigration and Nationality Act, Title 8 US.C, as amended, provide their alien registration number. Because legal permanent residents are included in the federal definition of"alien", legal permanent residents must also provide their alien registration number. Qualified aliens that do not have an alien registration number may supply another identing number below: 20140416BudgetWorkshopNonProfit Page 8 of 55 20140407/jrl b Ar City of Tybee Island Community Services Contract Award Fiscal Year 2014-15 ,.,. Mfr S l'R APPLICATION FOR CASH AWARD This form is to be completed and submitted to Finance with your budget request. Date: aLiji Lt Organization requesting City of Tybee Island Community Services Contract Award: Name of Organization: /IL 5 1 8 c tar A-11 Contact Person: boyil >1, � r 5 rac r_ Address: , O . i6 a ro ( r nd, i- . i 3a 1 Contact Email: b On n w -h+ ' ('s rJ .Contact Phone #: l 2-- 7N6 - 5E0/ Ccam, Is this organization an IRS approved 501(C) 3 Non-Profit? Yes No If"yes", please attach your most recent audited financial statement, a copy of your IRS determination letter and a copy of your current budget detailing the planned use for the awarded funds. Amount of funds requested: $ . 5 Cr ?) Describe how these funds will be used and how the City and citizens of Tybee Island will benefit: irrybwr M IN+ r + ham e.•cpcgr t �,5 o-E +k•.e. 1-4 6e e 151a nd L 014 haws Q- 0-- ei I GZ ry rvtic� r--JC What percentage of these funds will be matched by your organization? Will this event or program bring visitors to Tybee Island in off-peak season or months? t/• 5 »Please attach a detailed budget to this request outlining how the money will be used. P.O.Box 2749—403 Butler Avenue,Tybee Island,Georgia 31328-2749 (912) 786-4573—FAX(912) 786-9465 20140416BudgetWorkshopNonProfit wwwitity8ftfyike.org 20140407/jrl internal Revenue Service Department ot the Treasury ,. / Internal Revenue Service 7 District . Quality Review Staff/Taxpayer Assistance \- / / Director P. 0. Box .1055, Room 1007 101 Marietta Street , i :" ■ Atlantai Georgia 30370: 1-71ge M a s'e am Acoe i 4 ,4,',0 44?• a Pox '366 -ryge< 27.74,,id G-n 3/3Lpgi , , Refer Rely to: QRS:EO:TPA:1007 V ' nate" MAR 2 7 1989 ETAI; 6-7---0/9/00 8 . F :. „Dear Sir or Madam: This is in response to your request for confirmation of your exemption frcmFederal income tax. • You N.iere recognized as an organization exempt frcrri Federal incca-e. tax PL-4. --section,... - 591-(o-}-(3)- of tbe internal Revenue Code by our letter of "Tu me / 19 7 (ap. . You Isere further determined not to be a private foundation within the meaning of section 509(a) of_. the Code because you are an organization described in sections 170(630361.Kvi..) /7 A.42 S99 69 Csd, $ 1 Contributions to ycc are deductible as provided in section 170 of the Ccde. The tax exempt status recognized by our letter referred to above is currentlY' in effect and will remain in effect until termipated, modified or revoked by the Internal Revenue Service. Any change in your purposes, character, or method or operation most be reported to us so we may consider the effect of the change on your exempt status. You must also report any change in your name and address. Thank you for your cooperation. Sincerely yours, . . ALZ,Z6LJ alk E k e hl 197 nes 041 A,rsz,R;,4".;O A?), bec5 k Ocic/e, I • \ \ . / \ 20140407/rf/ . Page 10 of 55 20140416BudgetVVorkshopNonProfit 2:28 PM Tybee Island Historical Society 03113/14 Profit & Loss Accrual Basis January through December 2013 Jan-Dec 13 Ordinary income/Expense Income 4000•Admission 686,354.86 4100•Retail Sales 421,031.63 4200•Contributions 14,614.73 4300•Grants 16,125.00 4400•Memberships 21,555.37 Total Income 1,159,681.59 Cost of Goods Sold 5000•Cost of Goods Sold 190,071.58 Total COGS 190,071.58 Gross Profit 969,610.01 Expense 6000•Advertising&Publicity 37,518.26 6025 Cash Over/Short -16.81 6050•Credit Card Comm.&Bank Fees 22,136.17 6055•Direct deposit fees 152.05 6060•Depreciation Expense 66,000.00 6070•Dues&Subsriptions 1,829.00 6080•Insurance 100,963.31 6140•Interest 14,319.10 6175•Charitable Donations 436.87 6200.Office Expense 17,929.63 6260•Payroll Salaries&Wages 468,645.91 6270-Payroll Taxes 35,271.88 6290•Professional Fees 2,250.00 6300•Program Expenses 22,596.13 6330•Taxes and Licenses 120.83 6350•Repairs&Maintenance 66,971.74 6400•Shop Expense 8,638.60 6.490•Storage Rental 4,615.00 6500•Training&Travel 3,372.69 6600•Utilities 35,210.57 Total Expense 908,960.93 Net Ordinary Income 60,649.08 Other Income/Expense Other Income 7500• Machine Income 1,054.50 7530• Miscellaneous Income 612.52 7545•Special Event Income 38,287.28 7570•Interest Income 141.15 Total Other Income 40,095.45 Net Other Income 40,095.45 Net Income 100,74433 20140416BudgetWorkshopNonProfit Page 11 of 55 20140407/jrl Page 1 09:41811M Tybee Island Historical Society T) Ut de'' Accrual Basis Profit& Loss `�\(11 January through Dace 2013 D. V 2013 Budget 2013 Actual 2014 Budget(Proposed) Ordinary Income/Expense Income 4000•Admission 600,000.00 686,354.86 600,000.00 4100•Retail Sales 408,000.00 421,031.63 420,000.00 4200•Contributions 4,000.00 14,614.73 5,000.00 4.300•Grants 16,125.00 16,125.00 16,000.00 4400-Memberships 16,000.00 21,555.37 20,000.00 7500-Machine Income 2,500.00 1,054.50 1,500.00 7530•Miscellaneous income 612.52 500.00 7545•Special Event Income 25,000.00 38,287.28 36,500.00 7570-Interest Income 7,500.00 141.15 100.00 Total Income 1,079,125.00 1,199,777.04 1,099,600.00 Cost of Goods Sold 5000•Cost of Goods Sold 178,000.00 190,071.58 180,000.00 Total COGS 178,000.00 190,071.58 180,000.00 Gross Profit 901,125,00 1,009,705.46 919,600.00 Expense 6000•Advertising&Publicity 35,000,00 37,518.26 38,000.00 6025•Cash OverfShort - -16.81 - 6050•Credit Card Comm.&Bank Fees 13,500.00 22,136.17 20,000.00 6055•Direct deposit fees 152.05 150.00 6060•Depreciation Expense 66,000.00 66,000.00 66,000.00 6070•Dues&Subsrlptions 1,000.00 1,829.00 1,500.00 6080•Insurance 110,000.00 100,963.31 135,000.00 6140•Interest 14,319.10 14,319.10 16,300.00 6150 Miscellaneous 1,500.00 0.00 1,500.00 6175•Charitable Donations 250.00 436.87 500.00 6200•Office Expense 15,000.00 17,929.63 19,000.00 6260•Payroll Salaries&Wages 450,000.00 468,645.91 422,000.00 6270•Payroll Taxes 34,425.00 35,271.89 33,000.00 6275 Pension 10,000,00 1,066.15 1,375.00 6290•Professional Fees 3,500.00 2,250.00 5,000.00 6300•Program Expenses 25,000.00 22,596.13 24,000.00 6330•Taxes and Licenses - 120.83 150,00 6350•Repairs&Maintenance 50,000.00 43,715.63 50,000.00 6400-Shop Expense 18,000.00 8,638.60 10,000.00 6490-Storage Rental 3,900.00 4,615.00 4,800.00 6500•Training&Travel 2,000,00 3,372.69 4,300.00 6600•Utilities 40,000.00 35,210.57 40,000.00 Total Expense 893,394.10 886,770.98 892,575.00 Net Ordinary Income 7,730.90 122,934,48 27,025,00 Other Income/Expense Major Repairs/Capital Improvements 150,000.00 23,256.10 175,000.00 Total Other Expense 150,000.00 23,256.10 175,000.00 Net Income-Per P&L -142,269.10 99,678.38 -147,975.00 Other Cash Expenditures Principal on Loans 30,949.82 26,177.41 28,969.00 Battery Habersham-Legal 7,981.50 Add Back Depreciation 66,000.00 66,000.00 66,000.00 Cash Flow (107,218.92) 131,519.47 (110,944.00) 20140416BudgetWorkshopNonProfit Page 12 of 55 20140407/jrl Page 1 of 1 r r City of Tybee Island Community Services Contract Award Fiscal Year 2014-15 APPLICATION FOR CASH AWARD This form is to be completed and submitted to Finance with your budget request. Date: ,....3)/21/1 Orgarlization requesting City of Tylxze Island Community Se " es • sir• Award: Name of Organization:, - L 17(71_5 -;, t/ Contact Person: L n J -,/ e- "T y Address: I a (// .._ — Contact Email:°i i ' earn C ° "® Contact Phone #: (1r2 ) S?7-7 .kJ Is this organization an IRS approved 501(C) 3 Non-Profit? i Yes No If'yes", please attach your most recent audited financial statement, a copy of your IRS determination letter and a copy of your awrent budget the planned use for the awarded funds. Amount of funds requested: � � Deccribe tow these t will be used and how the Oty and citiz- of Tybee Island will ne e it: ,r- _ Ca fir" ' 55S _ , 3 IF f' I mo' Cd 0 ----, c12 ghre4-51 L ( t it at_ e zto7 if - it A . e A / A - -1.../-5 ., *-P,t .0 Ili/e i , ::_di 14-- 4IF et 7° A , ' 4.--‘iffiffilffiliMMIsnrff -6,5e. '. - 4: 'Ili What percentage of these funds will be matched by your organization? Xt7z-L--- _, L Will this event or program bring visitors to Tybee Island in off-peak season or months? i =r, attach a detailed budget to this request outlining how the money will be used 20140416BudgetWorkshopNonProfit Page 13 of 55 20140407/jrl ,vt ik Affidavit Verifying Status for City Public Benefit Application By executing this affidavit under oath,as an applicant for a City of Tybee Icbind,Georgia,Business License or Occupation Tax Certificate,Alcohol License,Taxi Permit,Contract,or other public benefit as referenced in O.C.O.A.Section 50-36-1,I am stating the following with respect to my application of a City of Tybee Island: ' Business License or Occupational Tax Cie, ' Alcohol License, (circle all that apply) • Taxi Permit, • Contract ▪ Community Services Contract Award for (printed name of natural person applying on behalf of individual;business; corporation,partnership,or other private entity). 1) I am a United States citizen. OR 2) I am a legal permanent resident 18 years of age or older or I am an otherwise qualified alien or non-immigrant under the Federal Immigration and Nationality Act, 18 years of age or older and lawfully present in the United.States. * In making the above representation under oath,I understand that any person who knowingly and willfully makes a false,fictitious,or fraudulent statement or representation in an affidavit shall be guilty of a violation of Code Section 16-10-20 of the Official Code of Georgia 40 116 41,6--- 171/7 / Date Printed t r *Alien Registration Number for Non-citizens SUB :ED AND SW BEFORE ME ON TH1 THE �` DAY OF .�,20/ Notary Public &iL: A4 . My Co" i i� 'fxpires: Notary Public,Chatham County GA My Commission Expires May 22,2016 Note: 0.C G.A. §5036-1(e)(2)requires that aliens wider the federal Immigration and Nationality Act, Title 8 U.S.C,as amended provide their alien registration number. Because legal permanent residents are included in the federal definition of-alien", legal permanent residents must also provide their alien registration number. Qualified aliens that do not have an alien registration number may supply another identifying number below: 20140416BudgetWorkshopNonProfit Page 14 of 55 20140407/jrl It City of Tybee Island Community Services Contract Award Fiscal Year 20 14-15 APPLICATION FOR CASH AWARD This form is to be completed and submitted to Finance with your budget request. Date: March 14, 2014 Organization requesting City of Tybee Island Community Services Contract Award: Tybee Island Marine Science Center Maria Procopio, executive director PD Box 1879, 1510 Strand Avenue, Tybee Island, GA 31328 Maria @TybeeMarineScience.org, 912-786-5917 Is this organization an IRS approved 501(c)3 Non-Profit? _X Yes No If"yes", please attach your most recent audited financial statement, a copy of your IRS determination letter and a copy of your current budget detailing the planned use for the awarded funds. Amount of funds requested: $33,000.00 Describe how these funds will be used and how the City and citizens of Tybee Island will benefit: The City of Tybee Island's grant will be support the delivery of our educational programming and go toward recovering the$33,000 we paid to replace the building's HVAC system. Our mission is to cultivate responsible stewardship of coastal Georgia's natural resources through education, conservation, and research. We offer year-round programming for island visitors,school and scout groups--on the beach, in the marsh,on the water, in the classroom, and the Coastal Georgia Gallery. The funds and services the city provides the center,support the delivery of marine science-based education programs to a range of audiences coming to Tybee Island from across the country. PROGRAMS OFFERED Following is an overview of the marine science-based programs we offer to the public and groups. 1 20140416BudgetWorkshopNonProfit Page 15 of 55 20140407/jrl Island Visitor Programs: • Coastal Georgia Gallery—The gallery is open daily from 10 am. to 5 p.m. to the general public. Throughout the day,educators are stationed in the gallery to interpret exhibits and deliver cart-programs. • Our Walks, Talks& Treks program offers Beach Walks, Turtle Talks, Whale Tales, Shark Jaws, Marsh Treks, and Jelly Jive—scheduled throughout the week during season (the public may request a program outside of a regularly scheduled time-slot and we will comply based on educator availability)and by request off-season. • Sea Camp: Coastal Kids Ocean Adventure—during the summer,we offer eight sessions of week-long children's sea camps based on age groupings. Group Programs: • Coastal Classroom—for school groups from Pre-K to college •Authenic Coastal Experience—for non-school groups • Barrier Island Patch Program—for Boy and Cub Scouts • Coastal Georgia Badge Program—for Girl Scouts • Oceanography Merit Badge Program—for Boy Scouts • Floating Classrooms—for all group audiences • Sidewalk to the Sea—for Title I elementary school students, K-6 • Coastal Scientist Levels I, II, Ill—for 21st Century students. • Group Gallery Admissions-for groups that elect to visit the gallery rather than participate in a program. Sponsored Programs: Groups financially unable to access our programs,such as the Fresh Air Home, girls and boys clubs, and disabled children and adult care centers, participate in"Sponsored" programs for a reduced or waived fee. Sidewalk to the Sea: Connecting City Kids with Coastal and Offshore Environments: The City of Tybee Island is a partner in our Sidewalk to the Sea,which gives students Savannah's Title I elementary schools an opportunity to participate in marine science-based field activities and provides students with access and exposure to their coastal and offshore environments. Each year,students participate in a three-hour program of coastal science fun and learning on Tybee Island at the science center,creating a connection to the coast throughout their childhood that will predispose them toward an informed and active stewardship as an adult. Lastly,we provide community outreach programs to the public at a variety of events on and off-island. How the city and citizens of Tybee Island directly or indirectly benefit; In 2013,the science center had almost exactly 47,587 program participants. 2 20140416BudgetWorkshopNonProfit Page 16 of 55 20140407/jrl Economic Impact: -The island's tourism efforts benefit. The science center is both a draw to the island,and a significant enhancement to the visitor experience. - In 2013,we held our 7th annual Tybee Turtle Trot-5k Beach Run and Sea Turtle Release, a fundraiser that supports our sea turtle conservation work, which drew over 700 participants and their families. Additionally, people visited the island to just to wow at the after-event sea turtle release. - Participants trade with island businesses. - Participants are significant contributors to the city's parking revenue. Environmental Impact: -We have stewardship strands throughout all of our educational programming on the marine ecosystems of coastal Georgia, Strand content includes; • Pollution Pick-Ups • Storm Drains and Fish, • Water Quality: Pollution in Storm Drains • Stewardship: Fishing Gear • Stewardship: Pollution Timeline • Water Quality: Lifter • Stewardship: Plastic Pollution Fostering an understanding and appreciation of the impact humans have on the barrier islands benefits Tybee and all of Georgia's barrier Islands. -Through our Lights Out! program, the center develops and distributes educational materials on the problem with artificial light on the beach during sea turtle nesting season that supports the city ordinance section 3-230. -The center manages the Tybee Island Sea Turtle Project, an island conservation program that protects nesting sea turtles and their hatchlings. In 2013, volunteers donated 757 hours to the project. -Annually, we provide training that supports the enforcement of the city's live animal removal ordinance to staff members of the Tybee Island Police Department and Ocean Rescue. Community Pride: Since 1987,the science center has served citizens throughout Georgia through our conservation efforts, exhibits, classroom, and field-based educational programs. Our work is recognized as an effective and important educational resource for all of coastal Georgia's natural resources and issues. 3 20140416BudgetWorkshopNonProfit Page 17 of 55 20140407/jrl Organizational history of City Grant funds: 2001 $31,406.33 2002 $29,423.97 2003 $56,600.00 2004 $56,250.00 2005 $47,762.00 2006 $56,842.00 2007 $45,000.00 2008 $43,500.00 2009 $41,500.00 2010 $37,350.00 2011 $33,615.00 2012 $25,212.00 2013 $25,212.00 What percentage of this grant will be matched by your organization: 100 % Will this event or program bring visitors to Tybee Island in off-peak season or months? Yes, the science centers "season" has expanded over the last three years and we have high participation from February to November. Our program participant numbers grow each year: PROGRAM PARTICIPATION NUMBERS BY PARTICIPANT TYPE TYPE 2013 Group Programs 9,066 Gallery Admissions 26,143 Beach Walks 687 Marsh Treks 198 Turtle Talks 91 Sea Camp 104 Sidewalk 5,508 Sponsored Programs 175 TOTAL 41,972 Outreach 5,606 TOTAL 47,578 Documents included with this request: •Application for Waivers •Affidavit • IRS Determination Letter • 2014 Budget Projection • 2013 Statement of Financial Statements a>Please attach a detailed budget to this request outlining how the money will be used. 4 20140416BudgetWorkshopNonProfit Page 18 of 55 20140407/jrl 6,5/ ^ r City of Tybee Island Community Services Contract Award rl, Fiscal Year 2014-15 APPLICATION FOR WAIVERS Tybee Island Marine Science Center Date: March 14, 2014 Provide detail on any waivers (i.e. free or reduced parking, rent or utilities) or City services (i.e. number of hours of security, city worker clean-up, trash and/or recycle bins, building maintenance and upkeep, etc.) that you plan to request for your event(s): ITEMISERVICE AMOUNT NOTES In 2001,Canady,Richbourg&Company,the center's auditors, Building Rent $33,840.00 booked an estimated in-kind rental at 2,820 square feet x$12.00 per square foot.This amount is noted in subsequent audits to date. This is how I estimated: Less 31 free parking days in December,three are 334 potential Parking Spaces(3) 0 parking days.334 x 3 spaces=1,002 x$18.50=$18,537.00 I'm guessing for accurate budgeting,the seasons are then prorated "April to August"then"September to March."Please advise. • Parking Decals Seasonal(5) 0 I don't know how to account for the cost of a seasonal decal,since they are not available to the public. Please advise. Parking Decals-Annual(5) _50G$t1 Five decals at$100 each Parking Placards(7) 0 I don't know how to account for the cost of a parking placard.Please advise. Joe Wilson keeps records on DWP's maintenance of the building. Building Maintenance 0 . Value of the waivers requested: $ ro tV7 P.O.Box 2749—403 Butler Avenue,Tybee Island,Georgia 31328-2749 (912)786-4573—FAX(912)786-9465 www.cityoftybee.org 20140416BudgetWorkshopNonProfit Page 19 of 55 20140407/jrl x,,, 11i° .a .-,:-: , : ji City of Tybee Island Community Se-vices Contract Award Fiscal Year 2012-13 APPLICATION FOR WAIVERS Tybee Island Marine Science Center Date: March 24, 2012 Provide detail on any waivers (i.e. free or reduced parking, rent or utilities) or City services (i.e. number of hours of security, city worker clean-up, trash and/or recycle bins, building maintenance and upkeep, etc.) that you plan to request for your event(s): ITEMISERVICE AMOUNT NOTES !01,Canady,Richbourg&Company,the center's auditors, Building Rent $33,840.00 boa>�-d an estimated in-kind rental at 2,820 square feet x$12.00 per •uare foot.This amount is noted in subsequent audits to date. This is how I estimated: ,three are 334 potential Parking Spaces(3) 0 parking days..334"x 3 spaces= 1,002 x$1& C�!-$1-87.5-3-7-01T 3(os° — t 7-go -Do r I`m guessing for accurate budgeting,the seasons are then prorated "April to August"then"September to March."Please advise. Parking Decals-Seasonal(5) -7: I don't know how to account for the cost of a seasonal decal,since they are not available to the public.Please advise. Parking Decals Annual(5) Five decals at$180 each F Parking Placards(7) 0 I don't know how to account for the cost of a parking placard Please /d - advise. Joe Wilson keeps records on DWP's maintenance of the building.I Building Maintenance 1...000 r0 think that 2011 maintenance activity data is probably is a good standard from which to estimate and plan. Value of the waivers requested: $ l f?2 [ 70/0P9 p.(). ti.,. 2749 —4113 littler Avenue. Tv bee Island.Georgia 31328-2749 1912) 786--1*73 - FAX 40121 7 86-9465 AN NA 1A.eiia oft)'bee.org 20140416BudgetWorkshopNonProfit Page 20 of 55 20140407/jrl }M:tg:e.ri. li, J--. Affidavit Verifying Status for City Public Benefit Application By executing this affidavit under oath,as an applicant for a City of Tybee Island,Georgia,Business License or Occupation Tax Certificate,Alcohol License,Taxi Permit,Contract,or other public benefit as referenced in O.C.G.A. Section 50-36-1,I am stating the following with respect to my application of a City of Tybee Island: • Business License or Occupational Tax Certificate, • Alcohol License, (circle all that apply) • Taxi Permit, • Contract • Community Services Contract Award for (printed name of natural person applying on behalf of individual, business,corporation,partnership, or other private entity). 1) _ I am a United States citizen. OR 2) I am a legal permanent resident 18 years of age or older or I am an otherwise qualified alien or non-immigrant under the Federal Immigration and Nationality Act, 18 years of age or older and lawfully present in the United States. * In making the above representation under oath, I understand that any p- on who knowingly and willfully makes a false, fictitious,or fraudulent statement or representation in an affidavit shall be guilty o a violation of Code Section 16-10-20 of the Official Code of Georgia. Signat e of A s,+ icant 3-1 r I Date ntlir i ". 1 p 10 Printed Name * Alien Registration Number for Non-citizens R . . SUBSC S AND ''oi .EFO's` ME ON S THE DAY O' '..�f > i�A 20 111 � 1 e Notary Public ��, .L y L .,� ,G SHARON S.SHAVER Notary Public,Chatham County,GA My Commission Expires: My Commission Expires Dec, 5, 2015 Note: Q.C.G.A. 5§50-36-1(e)(2) requires that aliens under the federal Immigration and Nationality Act, Title 8 U.S.C,, as amended, provide their alien registration number. Because legal permanent residents are included in the federal definition of"alien", legal permanent residents must also provide their alien registration number. Qualified aliens that do not have an alien registration number may supply another identifying number below: 20140407/ 20140416BudgetWorkshopNonProfit Page 20140407/y1 • I City of Tybee Island Community Services Contract Award sir f� Fiscal Year 2014-15 APPLICATION FOR CASH AWARD This form is to be completed and submitted to Finance with your budget request. Date: March 31, 2014 Organization requesting City of Tybee Island Community Services Contract Award: Name of Organization TYBEE SEABAR INC. Tybee Pirate Fest October 9,10,11,12, 2014 Contact Person: Steven Kellam Address: P.O. Box 1970 Contact Email: tybeepiratefest @aoLcom Contact Phone #: (912) 713-5466 Is this organization an IRS approved 501(C) 3 Non-Profit? Yes X No If"yes", please attach your most recent audited financial statement, a copy of your IRS determination letter and a copy of your current budget detailing the planned use for the awarded funds. Amount of funds requested: $ 0 Describe how these funds will be used and how the City and citizens of Tybee Island will benefit: What percentage of these funds will be matched by your organization? N/A Will this event or program bring visitors to Tybee Island in off-peak season or months? Yes >>Please attach a detailed budget to this request outlining how the money will be used. P.O. Box 2749—403 Butler Avenue,Tybee Island,Georgia 31328-2749 (912)786-457 r 4i,V " 12) 786-9465 20140416BudgetWorkshopNonProfit Page 22 of 55 20140407/jrl WW4L. Oyu I:: rg (s ,s____ a 1 City of Tybee Island Community Services Contract Award Fiscal Year 2014-1.5 f (, �`. APPLICATION FOR WAIVERS Date: March 31, 2014 Provide detail on any waivers (i.e. free or reduced parking, rent or utilities) or City services (i.e. number of hours of security, city worker clean-up, trash and/or recycle bins, building maintenance and upkeep, etc.) that you plan to request for your event(s): 1. Waiver4ny Building and Zoning fees that may occur. (Tents, Stage, Bouncy Houses, Rides etc.) 2. Seabar request free use of South Beach Parking Lot for event, and North Beach Lot from 11am- 4pm for parade. 10 free parking passes for the crew from October 6-15, 2014 . 3. Waiver DPW fees for 25 trash cans, 25 Recycling containers, Barricades, and roping off for parade. Clean streets after parade and during the event. Change flags at 7 flags park (flags will be provided by SEABAR.) Remove and replace (20) Parking stops in the South Beach Parking Lot . 4. Waiver all Tybee Police fees for parade and street patrol during event. . Value of the waivers requested: $ P.O. Box 2749—403 Butler Avenue,Tybee Island,Georgia 31328-2749 (912) 786-4573 1'C. ( 12) 786-9465 20140416BudgetWorkshopNonProfit Page 23 of 55 20140407/jrl R'R'�►.4:, `per 2014 PIRATES FEST BUDGET INCOME Alcohol/Beer Sales 18,000 Coca Cola Sales 3,200.00 Merchandise/T-Shirts 10,000.00 Parade Entry Fees 1,100.00 Sponsorships 49,000.00 Ticket Sales 65,000.00 Rides 4,000.00 Event Booth 14,000.00 TOTAL INCOME 164,300.00 COST OF GOODS SOLD Cost of Alcohol/Beer 5,500.00 T-Shirts/Hats/mist. 9,000.00 TOTAL OF COST OF GOODS SOLD 14,500.00 GROSS PROFIT 149,800.00 EXPENSES Advertising/Marketing 5,000.00 Chiidrens Events Entertainment 8,000.00 Petting Zoo 1,450.00 Decorations 1,000.00 Stage 3,156.00 Prizes and Giveaways 200.00 TOTAL CHILDRENS EVENTS 13,806.00 Parade Setup and Decorations 500.00 Give-away Merchandise 500.00 TOTAL PARADE 1,000.00 Entertainment Cost 35,000.00 Administrative Costs Printing/Postage 1,000.00 Posters/Banners/Badges 500 Insurance 4,884.00 20140416BudgetWorkshopNonProfit Page 24 of 55 20140407/jrl Licenses& Permits 300 Sales Tax 2,300.00 Bank or Creditcard Fees 200.00 City Fees 3,200.00 Office Supplies 1,000.00 TOTAL ADMINISTRATIVE 13,384.00 Site Preparation Restrooms 2,200.00 Sound 4,000.00 Lighting 3,000.00 Chairs&Tables 500.00 Generators/Cables 10,000.00 Tents 28,000.00 Stage 3,000.00 Fence/Post/Ties 800.00 Video/Projector 2,400.00 Site Materials 1,500.00 Decorations 1,500.00 Equipment Rental 1,000.00 Labor-Casual 2,000.00 TOTAL SITE PREPARATION 59,900.00 Misc. Event Cost Security 2,200.00 Golf Carts 600.00 Labor For The Event 6,500.00 Van/Food/Roams 1,500.00 Photographer 750.00 Prize Money 200.00 Radio Rental 205.00 Trolley 1,000.00 Storage 1,000.00 Ice 750.00 Contingency 7,000.00 TOTAL MISC. EXP. 21,705.00 TOTAL EXPENSES 142,795.00 SURPLUS/DEFICIT 5.00 20140416BudgetWorkshopNonProfit Page 25 of 55 20140407/jrl Affidavit Verifying Status for City Public Benefit Application By executing this affidavit under oath,as an applicant for a City of Tybee Island,Georgia,Business License or Occupation Tax Certificate,Alcohol License,Taxi Permit,Contract,or other public benefit as referenced in O.C.G.A.Section 50-36-1,I am stating the following with respect to my application of a City of Tybee Island: • Business License or Occupational Tax Certificate, • Alcohol License, (circle all that apply) • Taxi Permit, • Contract • Community Services Contract Award for Steven.Kellam (printed name of natural person applying on behalf of individual, business, corporation,partnership, or other private entity). 1) X 1 am a United States citizen. OR 2) I am a legal permanent resident 18 years of age or older or I am an otherwise qualified alien or non-immigrant under the Federal Immigration and Nationality Act, 18 years of age or older and lawfully present in the United States. * In making the above representation under oath, I understand that any person who knowingly and willfully makes a false, fictitious,or fraudulent statement or representation in an affidavit shall be guilty of a vio on I Code Sectio 16-10-20 of the Official Code of Georgia. ♦���'r` ,111 /Iii,,,I1 afore of .rl'rcant r /// March 31 2014 410. 10104 .rtP Date `` °� r9s Steven Kellam �` '@ AUGUST �o ry �° Printed Name 22 q 2015 ,-Nr Q®' *Alien Registration Number for Non-citizens SUBSCR�r • � : 'IRE ME ON THIS THE L 14-I ,{:+y,l.0 20/a/ • Notary Public / _ - 1 My Commission Expires: / Note: O.C.G.A. §50-36-40(2) requires that aliens under the federal immigration and Nationality Act, Title 8 U.S.C., as amended provide their alien registration number. Because legal permanent residents are included in the federal definition of"alien", legal permanent residents must also provide their alien registration number. Qualified aliens that do not have an alien registration number may supply another identjing number below: 20140416BudgetWorkshopNonProfit Page 26 of 55 20140407/jrl is ,, City of Tybee Island Community Services Contract Award V Fiscal Year 2014-15 APPLICATION FOR CASH AWARD This form is to be completed and submitted to Finance with your budget request. Date: March 31, 2014 Organization requesting City of Tybee Island Community Services Contract Award: Name of Organization TYBEE SEABAR INC. Tybee Mardi Gras February 14, 2015 Contact Person: Steven Kellam Address: P.Q. Box 1970 Contact Email: bee iratefest aol.com Contact Phone #: (912) 713-5466 Is this organization an IRS approved 501(C) 3 Non-Profit? Yes X No If"yes", please attach your most recent audited financial statement, a copy of your IRS determination letter and a copy of your current budget detailing the planned use for the awarded funds. Amount of funds requested: $ 0 Describe how these funds will be used and how the City and citizens of Tybee Island will benefit: What percentage of these funds will be matched by your organization? N/A Will this event or program bring visitors to Tybee Island in off-peak season or months? Yes »»Please attach a detailed budget to this request outlining how the money will be used. P.Q.Box 2749-403 Butler Avenue,Tybee Island,Georgia 31328-2749 (912) 786-4573 c , 786-9465 20140416BudgetWorkshopNonProfit P alyie.org 20140407/y1 c\N„, k City of Tybee Island Community Services Contract Award x. ., ` Fiscal Year 2014-15 APPLICATION FOR WAIVERS Date: March 31, 2014 Provide detail on any waivers (i.e. free or reduced parking, rent or utilities) or City services (i.e. number of hours of security, city worker clean-up, trash and/or recycle bins, building maintenance and upkeep, etc.) that you plan to request for your event(s): 1. Waiver any Building and Zoning fees that may occur. (Tents, Stage, etc.) 2. Seabar request free use the Roundabout and 20 parking Spots in the South End Parking Lot 3. Waiver DPW fees for 10 trash cans, 10 Recycling containers, Barricades, and roping off for parade. Clean streets after parade and event. 4. Waiver all Tybee Police fees for parade and street patrol. Value of the waivers requested: $ P.Q.Box 2749—403 Butler Avenue,Tybee Island,Georgia 31328-2749 (912) 786-4573—FAX 912)786-9465 20140416BudgetWorkshopNonProfit ww !CliRtilti org 20140407/jrl 2015 MARDI GRAS BUDGET INCOME Sponsorships 6,000.00 Merchandise/T-Shirts 2,500.00 Beer/Food 3,000.00 Parade 750.00 TOTAL INCOME 12,250.00 COST OF GOODS SOLD T-Shirts/Hats/misc. 1,500.00 Beer/Food 1,500.00 TOTAL OF COST OF GOODS SOLD 3,000.00 GROSS PROFIT 9,250.00 EXPENSES Entertainment and Stage Cost 6,500.00 TOTAL ADMINISTRATIVE 1,750.00 TOTAL MISC. EXP. 750.00 TOTAL EXPENSES 9,000.00 SURPLUS/DEFICIT 250.00 20140416BudgetWorkshopNonProfit Page 29 of 55 20140407/jrl Affidavit Verifying Status for City Public Benefit Application By executing this affidavit under oath,as an applicant for a City of Tybee Island,Georgia, Business License or Occupation Tax Certificate,Alcohol License,Taxi Permit,Contract,or other public benefit as referenced in O.C.G.A. Section 50-36-1, I am stating the following with respect to my application of a City of Tybee Island: • Business License or Occupational Tax Certificate, • Alcohol License, (circle all that apply) • Taxi Permit, • Contract • Community Services Contract Award for Steven Kellam (printed name of natural person applying on behalf of individual, business, corporation,partnership, or other private enti),). 1) X 1 am a United States citizen. OR 2) - I am a legal permanent resident 18 years of age or older or I am an otherwise qualified alien or non-immigrant under the Federal Immigration and Nationality Act, 18 years of age or older and lawfully present in the United States. * In making the above representation under oath, I understand that any person who knowingly and willfully makes a false, fictitious,or fraudulent statement or representation in an affidavit shall be guilty of a violac.n of Code Section 1 10-20 of the Official Code of Georgia. �� ,1 01111111100, . V� A. ®��� �®� PAT] ∎•/ice •re of Appli t -VA.°0 ', • 01. March 31.2014 AUGUST: = Date 0 22 = Steven Kellam °•n 2015 .� Printed Name .211)Y4 ono;: ��! Y'p�'�.``�� *Alien.Registration Number for Non-citizens SUBSCRIBED AND SWORN BEFORE ME ON THIS THE r_ 2 DAY OF A G ,20 Jq _. Notary Publi ureic • Jr, My Commission Expires: C2/45— Note: O CCG.A. §50-36-1(e)(2) requires that aliens under the federal Immigration and Nationality Act, Title 8 US C., as amended, provide their alien registration number. Because legal permanent residents are included in the federal definition of"alien", legal permanent residents must also provide their alien registration number. Qualified aliens that do not have an alien registration number may supply another identifying number below: 20140416BudgetWorkshopNonProfit Page 30 of 55 20140407/jrl (\\\ &t . ,,i City of Tybee Island Community Services Contract Award Fiscal Year 2014-15 f 1 yh\' APPLICATION FOR CASH AWARD This form is to be completed and submitted to Finance with your budget request. Date: March 31, 2014 Organization requesting City of Tybee Island Community Services Contract Award: Name of Organization TYBEE SEABAR (Third Friday Fireworks) On the third Friday of every month Contact Person: Steven Kellam Address: P.O. Box 1970 Contact Email: tvbeeDiratefest @aoi.com Contact Phone #: (912) 713-5466 Is this organization an IRS approved 501(C) 3 Non-Profit? Yes X No If"yes", please attach your most recent audited financial statement, a copy of your IRS determination letter and a copy of your current budget detailing the planned use for the awarded funds. Amount of funds requested: $ 0 Describe how these funds will be used and how the City and citizens of Tybee Island will benefit: What percentage of these funds will be matched by your organization? N/A Will this event or program bring visitors to Tybee Island in off-peak season or months? Yes »»Please attach a detailed budget to this request outlining how the money will be used. P.O. Box 2749—403 Butler Avenue,Tybee Island,Georgia 31328-2749 (912)786-4573—FAX(912) 786-9465 20140416BudgetWorkshopNonProfit � 5 20140407/y1 WWW. r o e.org City of Tybee Island Community Services Contract Award Fiscal Year 2014-15 APPLICATION FOR WAIVERS Date: March 31, 2014 Provide detail on any waivers (i.e. free or reduced parking, rent or utilities) or City services (i.e. number of hours of security, city worker clean-up, trash and/or recycle bins, building maintenance and upkeep, etc.) that you plan to request for your event(s): 1. Waiver any Building and Zoning fees that may occur. 2. Seabar request Parkin' in the emer■en Parkins area near pier two s•cis for Falcon Fireworks and two spots for event staff. 3.Waiver DPW fees for normal street and beach clean up after a fireworks event, street sweeper etc.. Value of the waivers requested: $ P.Q. Box 2749—403 Butler Avenue,Tybee Island,Georgia 31328-2749 (912) 786-4573—FAX(912)786-9465 20140416BudgetWorkshopNonProfit WwW WitNe.Drg 20140407/jr1 2014-15 THIRD FRIDAY BUDGET INCOME Sponsorships 55,000.00 TOTAL INCOME 55,000.00 GROSS PROFIT 55,000.00 EXPENSES Advertising/Marketing 6,000 Fireworks and Setup Cost 42,000,00 ADMINISTRATIVE COST AND INS. 4,000.00 TOTAL MISC. EXP. 3,000.00 TOTAL EXPENSES 55,000.00 SURPLUS/DEFICIT 0.00 20140416BudgetWorkshopNonProfit Page 33 of 55 20140407/jrl a. ellkeN. Affidavit Verifying Status ▪^' for City Public Benefit Application By executing this affidavit under oath,as an applicant for a City of Tybee Island,Georgia,Business License or Occupation Tax Certificate,Alcohol License,Taxi Permit,Contract,or other public benefit as referenced in O.C.G.A.Section 50-36-1,I am stating the following with respect to my application of a City of Tybee Island: • Business License or Occupational Tax Certificate, • AlcohoI License, (circle all that apply) • Taxi Permit, • Contract • Community Services Contract Award for Steven Kellam (printed name of natural person applying on behalf of individual, business, corporation,partnership, or other private entity). 1) _X_ I am a United States citizen. OR 2) I am a legal permanent resident 18 years of age or older or I am an otherwise qualified alien or non-immigrant under the Federal Immigration and Nationality Act, 18 years of age or older and lawfully present in the United States. * In making the above representation under oath,I understand that any person who knowingly and willfully makes a false, fictitious, or fraudulent statement or representation in an affidavit shall be guilty of a violation of Code Section 16-10-20 of the Official Code of Georgia. V %Nsoliililiiiii,� :_aArt "/ ' ' r�\p P_Ar]"° 114, �vww o Applicant ,,,,°�`, ,•1SSIOIv..1 n S. T°®,® 'P,cr�° March 31,2014 Q'9 AUGUST Date ...=.* : 22 . - Steven Kellam °,ny 2015 _r 2015 o Printed Name 1. 1..P)./ sf�`�/TY" +� �1� *Alien Registration Number for Non-citizens SUBSCRIBED ANI NRN` i BEFORE ME ON THIS THE,;/ DAY OF /11:0 7444 _---�20/ I , Notary Purl' My Commission Expires: 9,/7 #/ Note: 0.C.G.A. §50-36-1(e)(2) requires that aliens under the federal Immigration and Nationality Act, Title 8 U.S.C., as amended, provide their alien registration number. Because legal permanent residents are included in the federal definition of"alien", legal permanent residents must also provide their alien registration number. Quaked aliens that do not have an alien registration number may supply another ident f ing number below: 20140416BudgetWorkshopNonProfit Page 34 of 55 20140407/jrl ▪ 1120 U.S. Corporation Income Tax Return OMBNo.1545-0123 ;. ,perVnent of the Treasury For calendar year 2013 or tax year beginning ,2013,ending .20 0 Internal Revenue Service e. Information about Form 1120 and its separate instructions Is at www.trs.govirorm1120. A Checi<.d: Name -... B Employer identification number TYBEE SEABAR INC 46-3157703 1a Consolidated return ii TYPE Number,street,and room or state no.If a P.O.bore,see instructions. C Date incorporated (attach Form 851) b dated recur coma- ❑ OR STEVEN KELLANM 07-07-2013 dated return 2 Personal horng co. PRINT PO BOX 19 7 0 t ) (arson Pii) . ❑ d Total assets see Instructions) 3 Personal servfee ogre. 9I--� City or town.state,or province,country and ZIP or foreign postal code (see instructions) • • Li 4 Schedule M-3 attached ❑ Tybee Island GA 31328 $ E Check if: (1) XI Initial return (2) U Final return (3) U Name change (4) 1]Address change 1a Gross receipts or sales 1 a 157, 313 b Returns and allowances lb 607 c Balance.Subtract fine lb from lane la lc 156, 706 2 Cost of goods sold(attach Form 1 125-A) 2 15, 169 3 Gross profit.Subtract line 2 from line lc 3 141, 537 a E 4 Dividends(Schedule C,line 19) 4 s 5 interest = - 5 6 Gross rents'p} • • • 6 7 Gross royalties ;-:. .-.. 7 8 Capital gain net income(attach Schedule D(Form 1120)) .. . 8 9 Net gain or(loss)from Form 4797,Part II,line 17(attach Form 4797) 9 •10 Other income(see instructions-attach statement) 10 11 Total income. Add lines 3 through 10 ► i i 141, 537 12 Compensation of officers(see instructions-attach Form 1125-E) I. 12 IA• 13 Salaries and wages(less employment credits) . . . . . f . . . , . . . . . . 13 s14 Repairs and maintenance '";.,,V.," • ,E1k;.Y ;; 14• 15 Bad debts 15 S' 16 Rents 16 c •, o m en 17 Taxes and licenses ``E`s`_ ATT CSL _ _ . . 17 7,228 c 18 Interest .fn;«:<. 18 a 19 Charitable contributions 19 E 20 Depreciation from Form 4562 not claimed on 125-A or elsewhere on return(attach Form 4562) 20 6 21 Depletion 21 c 22 Advertising 22 1, 180 0 0 23 Pension.profit-sharing.etc.,plans 23 '• 24 Employee benefit programs . - ., 24 e 25 Domestic production activities deducfl'o L ,ch F rrn 8903) 25 S 26 Other deductions(attach state Statement.#5. 26 138, 761 co 27 Total deductions, Add finest th } . 6 t► 27 147, 169 a 28 Taxable income bet lnet o r to 3ieductlon and special deductions.Subtract line 27 from line 11 28 (5, 632) 29a Net operating 4 ed •`` (s �"-,i t&lions) . . . . . . . . . . . 29a• o m b Special deductlo Y Jjine 20) 29b c Add lines 29a 29 _r.; 29c 30 Taxable i dmie. Subtra 29c from line 28(see instructions) 30 (5, 632) t .:: r}, 1:r fl 31 Total tak(Schedule ` rt I,line 11) 31 0 8 i 32 Total pa .- is and rIt dable credits(Schedule J,Part It,line 21) 32 I▪ r 33 Estimat='4< } .- s ee instructions).Check if Form 2220 is attached . . . . . . . . . . `f ❑ 33 5 a 34 Amount owed:Lfae32 is smaller than the total of lines 31 and 33,enter amount owed 34 a 35 Overpayment.If line 32 is larger than the total of lines 31 and 33,enter amount overpaid 35 36 Enter amount from line 35 you want Credited to 2014 estimated tax l• I Refunded ll• 36 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 sign is true,cork.and complete.Declaration of preparer(other than taxpayer)is lased on all information of which preparer has any knowledge. May the IRS discuss this return Here STEVE KELLAM PRESIDENT with the preparer shown below Signature of officer Date / Title (see instructions)?bons)? ❑Yin E No Print/Type preparers name Preparer's signs -/ � /� ire Ch ii PTIN Paid ALFRED WAITE ALFRED W• 03-09-2014 self-employed P00319099 Preparer Firms name t. ACCOUNTANTS ON TYBEE non's EIN 1 38-3752435 Use Only Firm's address >. 204 SUITE E FIRST ST PO BOX 1925 Phone no. Tybee Island GA 31328 (912) 786-0878 For Paperwork Reduction Act Notice,see separate Instructions. Form 1120(2013) EtA 20140416BudgetWorkshopNonProfit Page 35 of 55 20140407/jrl •.t; oNy `y' City of Tybee Island Community Services Contract Award ti Fiscal Year 2014-15 ..,,f)to APPLICATION FOR CASH AWARD This form is to be completed and submitted to Finance with your budget request. Date: 2-15-14 Organization requesting City of Tybee Island Community Services Contract Award: Name of Organization: Tybee Beach Bum Parade Contact Person: Jack Boylston Address: PO Box 895 Contact Email: itybeejack©Iive.com_ Contact Phone #: 912-658-8134 Is this organization an IRS approved 501(C) 3 Non-Profit? Yes X No If"yes please attach your most recent audited financial statement, a copy of your IRS determination letter and a copy of your current budget detailing the planned use for the awarded funds. Amount of funds requested: $ 0 Describe how these funds will be used and how the City and citizens of Tybee Island will benefit: What percentage of these funds will be matched by your organization? Will this event or program bring visitors to Tybee Island in off-peak season or months? >>Please attach a detailed budget to this request outlining how the money will be used. P.O. Box 2749—403 Butler Avenue,Tybee Island,Georgia 31328-2749 (912)786-4573—FAX (912) 786-9465 20140416BudgetWorkshopNonProfit vov1►'.Fl ee3 te°�7i� ,org 20140407/jrl co p:7-6-, rye-. 4rf?:" _ City of Tybee Island Community Services Contract Award Fiscal Year 2014-15 rte e APPLICATION FOR WAIVERS Tybee Beach Bum Parade Date: 2-15-14 Provide detail on any waivers (i.e. free or reduced parking, rent or utilities) or City services (i.e. number of hours of security, city worker clean-up, trash and/or recycle bins, building maintenance and upkeep, etc.) that you plan to request for your event(s): _Police, traffic control, street safety barriers, clean-up, etc. Value of the waivers requested: $ 1,000.00 p.o. Box 2749—403 Butler Avenue,Tybee Island,Georgia 3I323-2749 (912) 786-4573--FAX(912) 786-9465 20140416BudgetWorkshopNonProfit ��,�`.�F,� e���} org 20140407/jrI ' 4,4`' t%, Affidavit Verifying Status ',: .:- for city Public Benefit Application By executing this affidavit under oath,as an applicant for a City of Tybee Island,Georgia, Business License or Occupation Tax Certificate,Alcohol License,Taxi Pen-nit,Contract, or other public benefit as referenced in O.C.G.A. Section 50-36-1, I am stating the following with respect to my application of a City of Tybee Island: • Business License or Occupational Tax Certificate, • Alcohol License, (circle all that apply) • Taxi Permit, • Contract IX Community Services Contract Award for Jack Boylston (printed name of natural person applying on behalf of individual, business, corporation,partnership, or other private entity). 1) X I am a United States citizen. OR 2) I am a legal permanent resident 18 years of age or older or I am an otherwise qualified alien or non-immigrant under the Federal Immigration and Nationality Act, 18 years of age or older and lawfully present in the United States. * In making the above representation under oath, I understand that any person who knowingly and willfully makes a false, fictitious, or fraudulent statement or representation in an affidavit shall be guilty of a violation of Code Section 16-10-20 of the Official Code of Georgia. i Signat 0 licant /4" 4" Date Jack Boylston Printed Name * Alien Registration Number for Non-citizens SUB _ e:DAN .y'N BEFOR/ EON THIS TH - bAI ti 1 _ 20 .. i f {-1-,1,___ SHARON S.SHAVE Aii I'>> Notary v . 1L Notary Public,Chatham County,GA Commission Expires Dec. 5. 2015 My Commission Expires: Note: 0.C.G.A. §50-36-I(e)(2) requires that aliens under the.federal Immigration and Nationality Act, Title 8 U.S.C.`., as amended, provide their alien registration number. Because legal permanent residents are included in the federal definition of"alien", legal permanent residents must also provide their alien registration number. Qualified aliens that do not have an alien registration number may supply another identifying number below. 20140416BudgetWorkshopNonProfit Page 38 of 55 20140407/jrl :0,Z3Ef:" 1,Sj� fir. � r r, p ' °', :-, i ' City of Tybee Island Community Services Contract Award <, y4. Fiscal Year 2012-13 rly 4,t,,,_ APPLICATION FOR CASH AWARD This form is to be completed and submitted to Finance with your budget request. Date: °�'" �(/'1 f Organization requesting City of Tybee Island Community Services Contract Award: Name of Organization: `r':1<t-�- f;�, 1.)L- 174/F4/4,,e e eilG /e-/ Contact Person: c•4 k"- Address: /61 .2.,J /4 Contact Email: ,YE., e- -e e e/l' 6 ,,/fir,V TContact Phone #: (9/ 7 'f" .1 Is this organization an IRS approved 501(C) 3 Non-Profit? Yes No If"yes", please attach your most recent audited financial statement, a copy of your IRS determination letter and a copy of your current budget detailing the planned use for the awarded funds. Amount of funds requested: $ // - 1 . F Describe how these funds will be used and how the City and citizens of Tybee Island will benefit: -e i7 evz.� �L.1 f(-r ,/t/'e g Z,f L{- " i , /T7 erl /J ,'f! 4.- Ai4e,ls.. /../ -L.-t�)`-, // / GC £ v Lam,- r,tom.''''''r WI e-ii✓ il `) What percentage of these funds will be matched by your organization? /11‘2 Will this event or program bring visitors to Tybee Island in off-peak season or months? AC/ , ,+3_a >>Please attach a detailed budget to this request outlining how the money will be used. P.G.Box 2749—403 Butler Avenue,Tybee Island,Georgia 31328-2749 20140416BudgetWorkshopNonProfit (912)7$6-4574,ag�' y�f' `12) 786-9465 20140407/jrl www.cityoftybee.org (, a N City of Tybee Island Community Services Contract Award Fiscal Year 2U�2-1 -__Orx T . APPLICATION FOR WAIVERS Date: i 91-7 Provide detail on any waivers (i.e. free or reduced parking, rent or utilities) or City services (i.e. number of hours of security, city worker clean-up, trash and/or recycle bins, building maintenance and upkeep, etc.) that you plan to request for your event(s): ' =, 'I.. //` ( fi 4✓' 't`.1 ") A , Z-A1 f f t,e 17 `/i/e/ frrze' ( i2-) /I/ Pie FZ-dfiKrilj ,,, ifi7,,,,, /-7-7-, /I, 3-A fr ei,„Ai /9,,---->ix,T__ ,,,q,,,,,z_j9E- Value of the waivers requested: $ P.O. Box 2749—403 Butler Avenue,Tybee Island, Georgia 31328-2749 20140416BudgetWorkshopNonProfit (912) 786-457 4,gf C f(Al2)786-9465 20140407/jrl www.cityoftybee.org Affidavit Verifying Status for City Public Benefit Application By executing this affidavit under oath,as an applicant for a City of Tybee Island,Georgia,Business License or Occupation Tax Certificate,Alcohol License,Taxi Permit,Contract,or other public benefit as referenced in O.C.G.A. Section 50-36-1,I am stating the following with respect to my application of a City of Tybee Island: • Business License or Occupational Tax Certificate, • Alcohol License, (circle all that apply) • Taxi Permit, • Contract • Community Services Contract Award for f y f ,r2/rte (printed name of natural person applying on behalf of individual, business, poration,partnership, or other private entity). 1) I am a United States citizen. OR 2) _ I am a legal permanent resident 18 years of age or older or I am an otherwise qualified alien or non-immigrant under the Federal Immigration and Nationality Act, I8 years of age or older and lawfully present in the United States. * In making the above representation under oath, I understand that any person who knowingly and willfully makes a false, fictitious, or fraudulent statement or representation in an affidavit shall be guilty of,violation of Code Section 16-10-20 of the Official Code of Georgia. I, r of Applicant Date Printe. lame *Alien Registration Number for Non-citizens SUBSCRIBED AND SWO BEFORE ME ON TH/IS THE DAY OF �T-i [ —,20 it q Notary Public 1 1 Ldwaik, Adk 4_44, My Commission Expires: KAREN L. FISHER �3t-PubliArCirCounty GA My Commission Note: 0.C.G.A. §SD-36-1(e)(2) requires that Immigration and Nationality Act, Title 8 U.S.C., as amended provide their alien registration number. Because legal permanent residents are included in the federal definition of"alien", legal permanent residents must also provide their alien registration number. Qualified aliens that do not have an alien registration number may supply another identfing number below: 20140416BudgetWorkshopNonProfit Page 41 of 55 20140407/jrl Tybee Island Irish Heritage Celebration March 14, 2015' Estimated Budget and Expenses EXPENSES: Insurance 1,500.00 Advertisement 1,500.00 Bands/Travel 1,500.00 Hospitality/Food 1,000.00 Misc. Expenses 300.00 Expense Total : $5,800.00 INCOME: Entries 1,600.00 Sponsors 2,000.00 City of Tybee Island 1,350.00 Shirt/Hat Sales 850.00 Income Total: $5,800.00 These are the estimated Income and Expenses for the 13th Annual Tybee Island Irish Heritage Parade to be held on Tybee Island Saturday, March 14, 2015. Sincerely, 20140416BudgetWorkshopNonProfit Page 42 of 55 20140407/y1 Tybee Island Irish Heritage Celebration March 14, 2015' Estimated Budget and Expenses EXPENSES: Insurance 1,500.00 Advertisement 1,500.00 Bands/Travel 1,500.00 Hospitality/Food 1,000.00 Misc. Expenses 300.00 Expense Total : $5,800.00 INCOME: Entries 1,600.00 Sponsors 2,000.00 City of Tybee Island 1,350.00 Shirt/Hat Sales 850.00 Income Total: $5,800.00 These are the estimated Income and Expenses for the 13th Annual Tybee Island Irish Heritage Parade to be held on Tybee Island Saturday, March 14, 2015. Sincerely, 20140416BudgetWorkshopNonProfit Page 43 of 55 20140407/jrl . Bahama Joe's 1 nvoice: 85997 pi 7 1 ■ 2008 West Bay Street 'S Savannah, GA 31415 Date Ordered: 2/5/14 912-233-0060 Date Invoiced: 3/5/14 www.bahamajaes.com 512-233-0619 fax Date Due: 3/19/14 Ordered By Phone Fax Email Jay Burke 1 912-667-8382 I jburke @empiredist.net SHIP TO: TYBEE ISLAND PARADE COMMITTEE TYBEE ISLAND PARADE COMMITTEE 10 CAMPBELL AVENUE BAYSTREET TYBEE ISLAND, GA 31328 Customer# PO Number Terms Salesperson Ship Method 2643 1 I On receipt I Ross Mosteller Pickup Design ID Design Title Type 28733 (DP) Irish Heritage 2014 Youth xs s m Ig xi Unit Total Qty Part Number Color Description Adult S M LO XL XXL XXXL Price Price 132 0200 White 6.1 Oz. Ultra Cotton®T-Shirt 12 24 48 48 7.45 983.40 36 G200 2x White 6.1 Oz. Ultra Cotton®T-Shirt 36 9.45 340.20 6 G200_3x White 6.1 Oz, Ultra Cotton®T-Shirt 6 10.45 62.70 36 0240 White 6.1 Oz. Ultra Cotton® Long-Sleeve T- 12 12 12 10.55 379.80 Shirt 24 G240_2x White 6.1 Oz. Ultra Cotton® Long-Sleeve T- 24 12.55 301.20 Shirt 234 Subtotal 2,067.30 Sales Tax 144.71 Shipping Note: Total 2,212,01 Thanks for your order. Prompt payment is noted.We require a 50%non-refundable deposit on all Paid orders and a deposit on all artwork requested.All artwork produced in-house is the property of Bahama Balance 2,212.01 Joe's, Inc, including film positives and electronic files and is exclusively for the purpose of apparel imprinting by Bahama Joe's, Inc. Please call immediately with any discrepancies or damages. Damages are not accepted after 7 days from receipt of order. I have read and understand the terms of sale as outlined above Report Date:3/5/2014 20140416BudgetWorkshopNonProfit Page 44 of 55 20140407/jrl Page# 1/1 A moo® CERTIFICATE OF LIABILITY INSURANCE DATE( �i THIS CERTIFICATE IS ISSUED AS A MATTER Cf INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: lithe certificate holder Is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s), PRODUCER NAI NAVE T Underwriter P.G. BOX 2020 P NHo r�ct] (800) 824-1740 IIA1C.Not (256) 769-3017 FLORENCE AL 35630 EMAIL info@nai1982.ccm SAPDRES& { d) INSURERS)AFFORDING COVERAGE NAIL l INSURER A: NAUTILUS INSURANCE COMPANY 17370 - \1( INSURED TYBEE ISLAND IRISH INSURER B: HERITAGE CELEBRATION PARADE INSURER c: . PO BOX 2 314 INSURER D TYBEE ISLAND GA 31328 . INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 00215814 REVISION NUMBER: 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 .MTI.1 RESPECT TO VWI-UCH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ADM SUER POLICY EFF POLICY EXP LIMITS ILTSRR TYPE OF INSURANCE PM VAC POLICY NUMBER IMMECIYYYY) IMFAIOWYYYYI A X COMMERCIAL GENERAL LIASLITY NN407278 3/15/2014 3/16/2014 EACH OCCURRENCE $ 1,000,000 RENTED CLAIMS-MADE © OCCUR _DPRR SEr I $ 10 0./000 ME'DOLP(Any one person) $ 5,000 PERSONAL&APVINJURY S 1, 000,000 GEM'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRO PRODUCTS.COMP/OP AGG $ INCLUDED POLICY JECT LOC OTHER: 3 AUTOPVIO LE UABIUTY OBI SINGLE LIMIT $klent (Ea ANY ALrTC BODILY INJURY(Per person) S ALL CAP.IED SCHEDULED BODILY INJURY(Paraadent( $ AUTOS AUTOS FARED AUTOS NCTCSWNED PROPERTY DAMAGE $ Per accident} i S UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE E DED I R NT1ON$ $ WORKERS COMPENSATION l E I I TH. AND EMPLOYERS LIABILITY Y® ANY PROPRIETOR/PARTNER/EXECUTIVE ILL +I EL EACH ACCIDENT S OFFICER/ME.LEER EXCLUDED? N 1 A (Mandatory b NH) EL DISEASE-EA EMPLOYEE$ If}es,dew under EL DISEASE-POLICY UI14fT $ DESCRIPTION PTION OF OPERATIONS below 1 DESCRIPTION OF OPERATIONS I LOCATIONS!VE-IICLES(ACORA O7,Additional RiansreaseJNedule,may be attached If more s Is required) / p71 CERTIFICATE HOLDER CANCELLATION CITY OF TYBEE ISLAND SHOULD ANY OF THE ABOVE DESCRIBE€?POLICIES Be CANCELLED BEFORE 403 BUTLER AVENUE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN TYBEE ISLAND GA 31328 ACCORDANCE WITH THE POLICY PROVISIONS. AUThOR12ED REPRESENTATIVE .-i 0 •r;: --1 CORPORATION. All rights reserved. ACORD 25(2013104) The ACORD name and logo are registered marl {:: ' (0MNI 7 CERT004-130729I1402241310) 20140416BudgetWorkshopNonProfit Page 45 of 55 20140407/jrl '64 City of Tybee Island Community Services Contract Award r Fiscal Year 2014-15 APPLICATION FOR CASH AWARD This form is to be completed and submitted to Finance with your budget request. Date: / ee,/ /t .2.z9/f' Organization requesting City of Tybee Island Community Services Contract Award: Name of Organization: %yzigesevi, C_ Contact Person: LIL14 7g44,49e€ Address: - .. gryt,474 -veg- /5-Awe, 3/s2 Contact Email: edema 4Q ei4-74.Cb Contact Phone #: 9a- - s./ '-C763c99 77,0",e&-- ieiii.A`frei.19/774giAettir) Is this organization an IRS approved 501(C) 3 Non-Profit? Yes No If"yes", please attach your most recent audited financial statement, a copy of your IRS determination letter and a copy of your current budget detailing the planned use for the awarded funds. Do Amount of funds requested: $ Describe how these funds will be used and how the City and citizens of Tybee Island will benefit: F7.14245. gg L.rte' ter=' f�. eTi • .77 2 ,?eir y 4' Poe 7-Af9 ) ...rte Fyne, f or,oe What percentage of these funds will be matched by your organization? Will this event or program bring visitors to Tybee Island in off-peak season or months? »Please attach a detailed budget to this request outlining how the money will be used. P.Q. Box 2749—403 Butler Avenue,Tybee Island,Georgia 31328-2749 20140416BudgetWorkshopNonProfit (912)786-4574 e 01 912)786-9465 20140407/jrl www.cigortybee.org City of Tybee Island Community Services Contract Award Fiscal Year 2014-15 I APPLICATION FOR WAIVERS Date: ../V R ID, 20/1 Name of Organization: 7-Y8e L Provide detail on any waivers (i.e. free or reduced parking, rent or utilities) or City services (i.e. number of hours of security, city worker clean-up, trash and/or recycle bins, building maintenance and upkeep, etc.) that you plan to request for your event(s): v 44r094 666" ' ' , 9 6- Xyra 61''e ' E die4 4— ,4 .1 •f f 0 4 e ' . .• �, 7-hie` X. � . ,' .o ' .v"e J. . r.4 /a, // friVe 4/Ye& - 2 1 e - 20 f .ei.,v1/6 5, ' -779)5 e?4 — ,,, ' 27,1,00 Ar rteito 'ete,i2.4v' /f S tri Tv f'pct ,&z s ' 4j 77,-"ge7-///v. a/,/.1 -77.Aq-P-eer4,,tee 4,01a e-6- 17 9b4-7—did //K 41,72-AX - T % t..cfr retie .� , e' 41M 29,E C, ,e4itr, .va4 eV/O A°1 ' 2 Value of the waivers requested: $ i 000 — P.Q.Box 2749–403 Butler Avenue,Ty(b�ee Island, Georgia 31328-2749 ag 4To 20140416BudgetWorkshopNonProfit (912) 786-457 e ,C. 12)786-9465 20140407/jrl Www.ettyoftybee.org Affidavit Verifying Status for City Public Benefit Application tc By executing this affidavit under oath,as an applicant for a City of Tybee Island,Georgia,Business License or Occupation Tax Certificate,Alcohol License,Taxi Permit,Contract,or other public benefit as referenced in O.C.GA.Section 50-36-1,I am stating the following with respect to my application of a City of Tybee Island: • Business License or Occupational Tax Certificate, • Alcohol License, (circle all that apply) • Taxi Permit, • Contract • Community Services a Award for 3j I I ,R J a ter (printed name of natural person applying on behalf of individual, business, corporation,partnership, or other private entity). 1) j I am a United States citizen. OR 2) I am a legal permanent resident 18 years of age or older or I am an otherwise qualified alien or non-immigrant under the Federal Immigration and Nationality Act, 18 years of age or older and lawfully present in the United States. In making the above representation under oath, I understand that an person who knowingly and willfully makes a false, fictitious,or fraudulent statement or representation in an affidavit shall be - •f a violati•.-o ode Section 16-10-20 of the Official Code of Georgia. 1 =ture of Applicant Date I.'? /4 Printed Name *Alien Registration Number for Non-citizens SUBSCRIpp ANDS O N BEFORE ME ON THIS THE�& DAY OF 02_.r1'1 ,20 r+THIS, Notary Public I (i( . Alf I ' f JE'.+ 1S A. BRYANT My Cotnmiss'Expires: Notary Public.Chatham County GA My Commission Expires May 22,2016 Note: O.C.G.A. §50-36-1(e)(2) requires that aliens under the federal Immigration and Nationality Act, Title 8 U.S.C., as amended, provide their alien registration number. Because legal permanent residents are included in the federal definition of"alien", legal permanent residents must also provide their alien registration number. Qualified aliens that do not have an alien registration number may supply another identifying number below: 20140416BudgetWorkshopNonProfit Page 48 of 55 20140407/jr1 ` : f7 ar 1 _budget-- DPW - Cone/setup - co _ .. ova Pah:02- weava a- Lage.,4parf . - - 1000 o Etwit ltistibratice.(inativt, dollar-64 450 --1:96212., M LIZ si,arts 30o Terbetti* r -r 20140416BudgetWorkshopNonProfit Page 49 of 55 20140407/jrl I Bank of America P.O.Box 15284 Wilmington,DE 19850 Customer service information 1.888.BUSINESS(1.888.287.4637) hlllilllllllIillsielIrllh'IIImilhI'nill1"1"1II'IliIIlllilI AI 0 172 387 838 001793 #601 AV 0.381 R bankofamerica.com Bank of America,NA P.O. Box 25118 TYBEE MLK Tampa, FL 33622-5118 8 5TH ST TYBEE ISLAND,GA 31328-9687 Your Business _ 2ndamer:zals Checking for February 1, 2014 to February 28. 2014 Account number:3340 4025 061 5 TYKES MLK Account summary Beginning balance on February 1, 2014 — _$461.12 #of deposits/credits:0 Deposits and other credits 0.00 #of withdrawals/debits:0 Withdrawals and other debits -0.00 #of items-previous cycle':8 Checks -0.00 #of days in cycle:28 Service fees -0,00 Average ledger balance:5461.12 Ending balance on February 28, 2014 $461.12 'includes checks paid,deposited items&other debits Small Try Intuit® Payroll Services Get quick and secure access to your checking business and payroll accounts all in one place. This IMI* solution to your payroll problems is from a payroll leader in the industry, in partnership with Bank of America. made Call our team of payroll specialists InTUlT Payroll simple at 1.866.543.2808 to learn more. Bann,of Am0=in and the Bank.of America logo aee.registered tradernadcs of the Rank cif Arne, Lerroi o:ien. Intuit and the Intuit lcga nre registered tracicniark'of Intuit,Inc,used ur lice r45 c.A[Al>•1 I AO 1 1 3 r o:' 20140416BudgetWorkshopNonProfit Page 50 of 55 20140407/jr1 PULL:E CYCLE:47 SPEC:0 DELIVERY:P TYPE: IMAGE:A BC:GA Page 1 of 4 . /' ,\ Q ''`1 , K 4' 1 V 1/'' ''„ City of Tybee Island Community Services Contract Award Fiscal Year 2014-15 APPLICATION FOR CASH AWARD This form is to be completed and submitted to Finance with your budget request. Date: - --- �, '0' .ti Organization requesting City of Tybee Island Community Services Contract Award: Name of Organization: (''i S Contact Person: - ' `?'7---', ; Address: +,. L b, _.. ? : 2 Contact Email: _ , ,,„ 'rho-W.'''. , c 4”" Contact Phone #: _ I •) Is this organization an IRS approved 501(C) 3 Non-Profit? X Yes No If"yes", please attach your most recent audited financial statement, a copy of your IRS determination letter and a copy of your current budget detailing the planned use for the awarded funds. Amount of funds requested: $ Sex) Describe how these funds will be used and how the City and citizens of Tybee Island will benefit: • s"O (9-D 1." +41 ' g � t;'-tiJ , TOL.)QAJJ M(i— ;4O P , l, 4- P \.2- .5 2_x50 3-C9 1c ), 1 rs (--15!--,,,i 71J yyt, .e . ,-t191.4.1 E; '‘ Paa ;› What percentage of these funds will be matched by your organization? 0 Will this event or program bring visitors to Tybee Island in off-peak season or months? ,Ear >>' lease attach a detailed budget to this request outlining how the money will be used. P.Q. Box 2749—403 Butler Avenue,Tybee Island,Georgia 31328-2749 (O11\'ISIA_fC'71 T 1 V (O1 1 1, 1QA._O11 20140416BudgetWorkshopNonProfit Page 51 of 55 20140407/jrl Affidavit Verifying Status All for City Public Benefit Application By executing this affidavit under oath,as an applicant for a City of Tybee Island,Georgia,Business License or Occupation Tax Certificate,Alcohol License,Taxi Permit,Contract,or other public benefit as referenced in O_C.G.A.Section 50-36-1,I am stating the following with respect to my application of a City of Tybee Island: ■ Business License or Occupational Tax Certificate, ■ Alcohol License, (circle all that apply) ■ Taxi Permit, ▪ Contract ■ Community Services Contract Award for it-1 12_c (printed name of natural person applying on behalf of individual, business, corporation partnership, or other private entity). 1) I am a United States citizen. OR 2) I am a legal permanent resident 18 years of age or older or I am an otherwise qualified alien or non-immigrant under the Federal Immigration and Nationality Act, 18 years of age or older and lawfully present in the United States. * In making the above representation under oath, I understand that any person who knowingly and willfully makes a false, fictitious, or fraudulent statement or representation in an affidavit shall be guilty of a violation of Code Section 16-10-20 of the Official Code of Georgia. Signature of Applica Date Printed Name *Alien Registration Number for Non-citizens SUBSCRIBED AND SW RN.BEFORE ME ON T lI THE i DAY OF ,20 r JANET R. LEVINER Notary Public,Chatham County Gla. Notary Public ` :"nmmisSin �x�irae. "nia. i My Commission pires: /e/" t " ,(a Note: O.C.G.A. §50-36-1(e)(2) requires that aliens under the federal Immigration and Nationality Act, Title 8 U.S.C., as amended, provide their alien registration number. Because legal permanent residents are included in the federal definition of"alien", legal permanent residents must also provide their alien registration number. Quaked aliens that do not have an alien registration number may supply another ident jing number below: 20140416BudgetWorkshopNonProfit Page 52 of 55 20140407/jrl ,,t; 3 City of Tybee Island Community Services Contract Award Fiscal Year 2014-15 APPLICATION FOR CASH AWARD This form is to be completed and submitted to Finance with your budget request. Date: February 12, 2014 Organization requesting City of Tybee Island Community Services Contract Award: Name of Organization: YEEPIES Contact Person: Bobbie Orr Address: P. O. Box 2843, Tybee Island, GA 31328 Contact Email: _cborr@bellsouth.net Contact Phone #: 786-7486 Is this organization an IRS approved 501(C) 3 Non-Profit? Yes X No If"yes", please attach your most recent audited financial statement, a copy of your IRS determination letter and a copy of your current budget detailing the planned use for the awarded funds. Amount of funds requested: $_899:98 k--s-o, 0 0 -0-"-' Describe how these funds will be used and how the City and citizens of Tybee Island will benefit: $800.00 for supplies, field trips, admission fees, etc., for senior group, packages to soldiers What percentage of these funds will be matched by your organization? none Will this event or program bring visitors to Tybee Island in off-peak season or months? N/A »Please attach a detailed budget to this request outlining how the money will be used. P.O. Box 2749-403 Butler Avenue,Tybee Island,Georgia 31328-2749 20140416BudgetWorkshopNonProfit (912)786-45-Page 53 of 55,12) 786-9465 20140407/jrl WV%s.cit1o1 t 1'ih:e.org ..ynl1l�, Affidavit Verifying Status for City Public Benefit Application By executing this affidavit under oath,as an applicant for a City of Tybee Island,Georgia,Business License or Occupation Tax Certificate,Alcohol License,Taxi Permit,Contract,or other public benefit as referenced in 0_C.G.A.Section 50-36-1,I am stating the following with respect to my application of a City of Tybee Island: • Business License or Occupational Tax Certificate, • Alcohol License, (circle all that apply) • Taxi Permit, • Contract • Comm Service',(Contract Alna ci for Bobbie Orr _ _ (printed name of natural person applying on behalf of individual, business, corporation,partnership, or other private entity). 1) _X I am a United States citizen. OR 2) I am a legal permanent resident 18 years of age or older or I am an otherwise qualified alien or non-immigrant under the Federal Immigration and Nationality Act, 18 years of age or older and lawfully present in the United States. In making the above representation under oath, I understand that any person who knowingly and willfully makes a false, fictitious,or fraudulent statement or representation in an affidavit shall be guilty of a violation of Code Section 16-10-20 of the Official Code of Georgia. Signature of Applicant Bobbie On February 12,2014 Date Bobbie On Printed Name *Alien Registration Number for Non-citizens SUBSCRIBED AND SWORN BEFORE ME ON THIS THE DAY OF February ,2014. r SHARON S.SHAVER Notary Puhli _Miro / Notary Public, Chatham County, GA " . 1—� • - L— My Commission Expires Dec. 5, 2015 My Commission Expires: Note: 0.C.G.A. §50-36-1(e)(2) requires that aliens under the federal Immigration and Nationality Act, Title 8 U.S.C., as amended provide their alien registration number. Because legal permanent residents are included in the federal definition of"alien", legal permanent residents must also provide their alien registration number. Qualified aliens that do not have an alien registration number may supply another identifting number below: 20140416BudgetWorkshopNonProfit Page 54 of 55 20140407/jrl j City of Tybee Island Community Services Contract Award Fiscal Year 2014-45 Yeepies Estimated Budget for Fiscal Year 2014-2015 Supplies $ 250 Field trips 250 Admission Fees 200 Packages to soldiers 150 Total Requested $ 850 P.O. Box 2749—403 Butler AN enue,Tybee Island,Georgia 31328-2749 (912) 786-4573— FAX(912)786-9465 WIA 1, .“I, kr.,1,,kp org 20140416BudgetWorkshopNonProfit Page 55 of 55 201 40407/j rl