Loading...
HomeMy Public PortalAbout020_012_Fresh Air Home ti ! ji City of Tybee Island Community Services Contract Award Fiscal Year 2015-16 APPLICATION FOR CASH AWARD This form is to be completed and submitted to Finance with your budget request. Date: :3I i(1/ 15 Organization requesting City of Tybee Island Community Services Contract Award: Name of Organization: h'e5 h Air k 0 ni c.„ Contact Person: LGir-I-.r- Ea,61 Address: I Mays H xr bolfr Cove Say'. a 3 i - ( C Contact Email: e C 31 e n e6 t( Contact Phone #: A 1` --i``f 2 - O r I/ - Loyncast. r) ? t 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: $ 350 , 00 Describe how these funds will be used and how the City and citizens of Tybee Island will benefit: .fee al-tack ed . What percentage of these funds will be matched by your organization? 010 °/o Will this event or program bring visitors to Tybee Island in off-peak season or months? ICS >>Please attach a detailed budget to this request outlining how the money will be used. P.O. Box:749—403 Butler AN enue,Tvlxe Island,Georgia 31328-2749 (912) 786-4573— FAX (912)786-9465 www,cityollybee.org The Fresh Air Home has been in existence on Tybee Island since 1939. Every summer we welcome approximately 360 at-risk children to attend our 10 day overnight beach camp. We enlist a paid full time staff of 27 counselors during this period. While the children are at camp they are exposed not only to Tybee Island and its numerous summer offerings but often this is the first chance these children are able to experience the beach and its natural wonders. We believe that many of our campers return during the year to show their parents all that they have experienced. At least once or twice each week, our campers get to enjoy a cookout on the Pavilion. The counselors grill hotdogs and burgers and there is generally a "Hoe Down" or Talent Show combined on this evening. Due to the weather found at the beach, we are forced to replace our grill almost every 3-4 years. This year we need to purchase a new grill for the cookouts. We would appreciate your help in making this purchase. Char Grill Cooker 22' with cart Sold at Home Depot $389.00 plus tax Thank you for your consideration. Carter Eagle 898-0187 FRESH AIR Hor Tybee Island,Geomia 31328 4!-Wir.'0!,• 'L' f';'', ‘,, r`P' -n--'-' w—,.... f1/7.Iiiii Ytl i 1'T 4 iE uy�+ r irk!. e iw' 1F.M.�t' �� �iY�-�ja3��1Ei'.0 . Dear Friends, In conversation with Melissa Freeman I indicated that we do not have a "current" audited financial statement. Due to our income restrictions, we can not afford to complete an audit but every 15 years. Our next audit will be completed at the close of 2015. 1 am submitting our Financial Statement from 2000. If you have any questions, please feel free to contact me at 898-0187. Thank you for your consideration, Carter Eagle ctitAxviti -Ettt(v-, FROEBEL CIRCLE Founded May 27, 1897 ..-I C m N o nr, V- m � m N r c 1M `T in In ir1 to v pp p O O Q [+ 6 a i1 Ca co m °m in o rrn i 8 4 ri O Q CI C u°1 4 L7 ° °o 001 Co] rm.� p m vi N W n. Oop O o CI1 0 001 .� �Nry Y a N b C a Di 4NN� d LNn LL3 rNri CCy i.-C 0011 O rn co - m CNi 4P n .Ni CI rNw R 0 N N NW 0 f+nn0 CO 4 of Lroi a en m Q nz N pi' N N N 4 N In hi rl q.q. N r. r■[i", N 4f� N N m 4 in in In in in In in In V}in in in in in in in- in in in in in in V?in in in in in in in in in in in in in in in in in in CInOn rg � con .ym NQO iON o rrp m in Di ,mn o o N 0 0 i 0 pp pp '3 4 4 N 4 4 r3 P 6 P .-, H O 41A O hi 4 c0 In hi m ha Ch [hi Qi/ri P 1n- 4m' rte+! 117 f4ri tT V�j M 4 r N V1 O 'P�" CO 6 Cm 90 m 1di cr ,a 1n m '+ Ch o N N w r-1 m hi V m r, CT V i/1 n CO 0 M r a V' N q4 00 At `� N r.e .ti ti rti rI'ni q N E Q 1.2 In.iA VF in 0 in '-R VT VF Vi N in Vx in V!Vs 611 in VT in M ill Va N in in iA in V}in in 4.11-WV i!i VI.Va w 4m 8w o n NI ui 6 d N rri co ri ni -i C m e C p p In 04 p in 1n Vs VI o o p p p a �pj q, in iii An y , O ONO in °m L.N} CO 4 a. 8 .i rrcg N CO °o b O N 4 3 4@ D 0 O O $ 4 u'} 4 O N G C7 0 [S f�+ 4 m o N p CI C 0 m 4 n7 VI .�-r A tri CO )O N 11 N O 0 hi tt1 V iK Ca Vii 0 0 0 cal O 0 vi al O Of G ea N@ CO CO ti R V] Q C V' .13 CO 1i7 61 N r3 P N pp�� V 49 4 N P Y'V '° xn b ha N- N V O Vf p�} VI In rri N C V � N m Od N CQ O Of In CO v V] 4 IC N n et N N N .•1 ,11 M N rr N Q N V1 ha N d N V 1ti LC ITI m 910 N N nt v v in u.�+ .i w{wl ei rl�4 N IN ti_ el 1/4 04 i/1 in in igl0 in 44 0 111 0 41 Vi N on 0 in it.Vi in in t/1 Vi yr io Vi Vl in in VF An iiy W9 N 4/Y in in aA.4 in 4.4 44 iin V}N V}ii1,MY 0 4 �Q7 O~1 d +f1 a E. W r°u Goa ri0i N an 1�8 4 4 C7 P 4 ICA 4 G r-1 N po -, rN•1 6 CIA N 0 NOV ri b O N .N'1 N Or +L 0 o f IN m r N .i R V . . V m PN1 7 al r(v O N ,i5 O~i o V ' - 0 N V �3 4 M 41 S4 r0� 04 9Ii.pi W tha rNH v B .mi In N N 01 N N N n1 DI V CO N V 01 N 6 Q. N Ni M N N N 411 N � f+� !Y N N r! i•1 N N N m .i vn.44pn vs In ip.1/1 i,,- in its +qqn ipn 0 in Wn r}in N I/O 1/4 in in in-en W>in in top in 1n in in 44 44 Va in In i/b N+qn 40 � 6 661 qp 4 qQ 4 4 1�ft 1�Ci rte+i mg qp 0 4p 4 4 Op p O 4p P 4 pp 0 p 4 00 4040000� p4 b Q o 4 4 4 D S ©4 QQ 4 4 4 N Ca OZ. ki5 [V D C} 4 4 4 N CO a W B u0"1 7 Q Q ua'1 S� 4 �i 4sry r i v] CO i+i 1 4 H ,,, W S 8 v. 4 8 O 4 c,hi 13 TA ha's o a N d CD rti L - O N c;O' n N m ri"1L' i°4 ri N .'1 r.CO' iP. ri m i,r �. N y. 0 V1 11 in in in V1 Vi V> i/1 V1 Va VI N M V! An An An K N in N in 4n in 471 V1 VS 5 1.4 V}in N i/4 4r}V6 VF in in Vi if? CJ to iC I Li N In . a g a as ri Vi 2 iu Lt �` c n > a` a 8 % w ro w c a d " m 1 C? co z D r C -0 ? S Nr CU w 4 w m ,ii o X X A eLal 0 2E3 = ; gin a � °y°1 .' � aL 4 D N 3 u 2 t G aO H u x 4 J u U 4� n 4` ILai �c o c a w C o o u+ ee,4 4 A E .. C. c m u `w o '� 0 a 1a c 48 ¢ m as P a` °.3 c Li pa m a a tc c v m o «°' �. a tU C a a 4 r 0 C W yr C..'." C _bp y„,i C of Ii C. C. Vi {:J O. 1/4 1� V U 14 g C N cc C E '� C d C C .0 +a C C a9 EG m C b C . c V y0 .b W Q a _ 1L+1 G m m G C H ..g s mC 04 "" 90 a. W 6 ?- 6 CS -L b,1 i n n C Zy O �C } n V LL C N L C' Y d m L.i C e6 i,,,_+ r R 4+ ❑. L'J sr,cu ;y E d ca C. c O E c n C. c a g 5 g a E N ., a .. C e W a v c ",_' 4i1-..1 -1 L.! A 3 a ,: 7 CO al :} 5 Al E 6 G +++ C c d Z C3 a s O�G +[ rL 1n i` W 2 0 0 C1301331:00 '4 m U U La UJ I.D P I.D. T G C �G cD w N m 2 P t.. 0 z P.Q. Box 1055 District • Atlanta, GA 30370 [Director • • Person to Contact: " N. Isaacs Tr'! . Fr'e M Air Home Tetephcrta Nlumiaer.. • P.O. co m 8696 '(404) 271-4516 S wnnah, •Pa. 31412 �" -.Pieter Reply to: F :7202: • • _ . e Date: • Jan. 30, 19€37 • • • • • • Dear- Sir or Radar= • • This is in response to your request for conf.rrnatiar of -:-°:ur exemption • from Federal income take You T•r°re recognized as an organization exempt from Federal zncoms.tax -?ceder section 501(c)(3) of the Internal Revenue Code by our letter dated - Navomiher 1943 '.: . You were further det, rcitned not to be a nrivr_te foundation within the mean ng of section "f9(a) of the Code because you are an organization described in section 509(ai (2) , Contributions to you are deductible as prr.-idad in section 170 of the Code. The tax exempt stat..ls recognized by our letter referred to above is curr°ntl r in effect and will-remain in effect until t -°-inatedf modified or .revoked by the -Internal Revenue Service. Any change in your piliYosei, ch ' actert or method of operation must be reported tS us so we may consider the effect of ' the change on your exempt. status. rou must aleo report any change in your name and address. Thank you for your, ,cooperation. , -- • • . Sincerely 7/- r.T, ' • • Exempt Or,g nitrations Sec a13 • • • N • • • • _ o FRESH AIR HOME BUDGET 2015 INCOME: Merrill Lynch bank available Balance as of 1/01/15 $ 126,976.00 Campaign 20,000.00 Dues Income 1,000.00 Misc. contributions 12,000.00 Grant/designated Income 10,000.00 Bank Balance of Operating acct. as of 1/01/15 58,291.88 Bank Balance of Payroll acct as of 1/01/15 4,236.33 $ 232,504,21 EXPENSES: Accounting &Auditing 2,000.00 Building Maintenance 13,000.00 Building Repair Designated (Insurance) 24,815.90 Campaign-Mailing/Postage 700.00 Clinic 450.00 Employment/Payroll/Contract Labor 81,200.00 Grant/Designated Expense 11,000.00 Boys Fishing for Toys Expense 2,200.00 Grounds Maintenance 2,500.00 Housekeeping 2,000.00 Insurance 35,000.00 Linens&Clothing 1,000.00 Market Menu 22,000.00 Memorials Expense 200.00 Miscellaneous! Georgia Corporation Registration 30.00 Post Office Box-Eisenhower 92.00 Post Office Box-Tybee 48.00 Safe Deposit Box 35.00 Georgia Historical Society/Record Storage 154.00 Picnic 150.00 Scrapbook 100.00 Flowers 125.00 Chatham County Health 300,00 Nursery 200.00 Office Supplies 500.00 Petty Cash (4 camp sessions) 2,000.00 Printing/Yearbook 150.00 Recreation 2,000.00 Recruitment 150.00 Registration 500.00 Security 550.00 Telephone& Internet 2,000.00 Transportation 4,000.00 Utilities/Garbage 18,000.00 TOTAL BUDGET EXPENSES $ 229,149.90 NET INCOME $ 3,354.31 1,, { ; 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 v E J .,/1+6 k H{ ''(p't"i'iated name of natural person applying on behalf of individual, business. corporation, artnership, 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 Code Section 16-10-20 of the Official Code of Georgia. tapitt4tt Signature of A licant 3 / o 119 Date ir - i F, ) Printed Name c' Alien Registration Number for Non-citizens SUBSCRIBED AND SW*•N BEFORE ME ON THIS_ THE apDAY OF , ,20 f f r ��� SHARO4d S.rrns A"�ER Notary Publ' ;,� eo l .,r Public,C4�atCauntyGMy Commission Expires: y Con ission 'Exp O6G 5, 2015 Note: 0.CG.A. §5O-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 identing number below: