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HomeMy Public PortalAbout020_015_Historical Society Vii' (7 City of Tybee Island Community Services Contract Award Fiscal Year 2015-16 wF,rj,.. _r ti f i i '['IYi�tiv'S APPLICATION FOR CASH AWARD This form and all attachments are to be completed and submitted by March 20, 2015 Date: 31 rra I a-0 I5 Organization requesting City of Tybee Island Community Services Contract Award: Name of Organization: -`T' ?e e iS 1c r i 5 rr c.A-[ So I nc- Contact Person: . S.IL rajo ones Address: RD, BOY- 3(D i Elbe s I A-net, 6A. 31 ' Contact Email: + b m-11: h-t hawse t yalwo.cbantact Phone #: g d 2-- 1267- S20/ Is this organization an IRS approved 501(C) 3 Non-Profit? v' Yes No If"yes", please attach your most recent audited financial statement, and a copy of your IRS determination letter. Amount of funds requested: $ OOZ Describe how these funds will be used and how the City and citizens of Tybee Island will benefit: 1 hres a $v rids w; i I bz tA„se.dr +0 r,epI& co +-ham -cenc e, a round iiosh - 54-ad-Jan w ch -13 and &ac ] ())-%+1 n - o +he -reel ce. - r e_ve r no euierrFs. What percentage of these funds will be matched by your organization? 35% 1 ill this event or program bring visitors to Tybee Island in off-peak season r onths' 0ti bu.+ �" t 1; )1 (a c i d 4-0 }-je- out h -U ()t- LA rat H � 0 L R j b e es r e%os -p n .rex eS Safe c•�.net f e- S -P r' U t -o r+n n-d- V 1 '`brS . >>PPiease attach a detailed budget to this request Outrning row the money will be used. P.O.Box 2749-403 Butler Avenue,Tvbee Island,Georgia 31328-2749 (912) 786-4573-FAX(912) 786-9465 www.eityoftybee.orrg /7�4FE+fti-W--- ' ,,tr„ . City of Tybee Island Community Services Contract Award V") Fiscal Year 2015-16 APPLICATION FOR WAIVERS Name of Organization:I-4 )c,rd 14154 -'c-A I _ . -r,ne 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): c4,ivim- 4rh 505 4- r rni t n,�1 T i.e. CUSS0cia. co i-1-11 rep 1rye c rn +b 2_ �c.e.. J CO(,/j6 11 e, +he. L z of per-nr i-}-f- n+vS --cfie. 6 c-i a.4- L4]i -k -Eke- addi4-ion -6 I 511,4- 1 ( r` -- -he. -Ce,rice_ Value of the waivers requested: $ Lia5 rv0 P.O. Box 2749—403 Butler Avenue,Tybee Island,Georgia 31328-2749 (912)786-4573—FAX(912) 786-9465 Nvw'A.c Ityofty'hee.org "h , Affidavit Verifying Status .,. i 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 k -1 p4-1.+e s (printed name of natural person applying on behalf of individual, business, corporation,partnership, or other private entity). 1) 1// 1 am a United States citizen. OR 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 p- • who knowin d willfully makes a false,fictitious,or fraudulent statement or representation in an affidavit shall be guilty of a viola.2 c o C,C e YY `• 6-10-20 of the Official Code of Georgia. c 4 Signature of Applicant 3 11 2-i 1 s* Date ..r..h t5 Printed Name * Alien Registration Number for Non-citizens SUBSC BED AND SW RN BEF RE ME ON THIS THE I DAY OF ,20 16 BONNIE J.NIERS Notary Punk chow Notary Public My Commission Exr �r 6, 2016 My Commission Expires. Note: 0.C.G.R. §50-36-1(e0(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:- Form W.9 Request for Taxpayer Give form to the {Rev October 20041 Identification Number and Certification requester. Do nol D3pnrtrnsrrt or The Treasury send to the IRS. Ir,t•,mal R»w.nuo 6anrice ty N reported on your income tax eturn) & s be-e, T-64 rid i s- ,r i cF I Soc-E e4tj, 3cr 0- Bus name,if diffe=rent from above g a© individual/ El i� Exempt from backup .r' Check appropriate box: Q Sole proprietor �Comoratlon I I Partnership Q Other ■ _ !�c?3 I I withholding C ;_ ' d Ss umber, atmet, and apt.or suite no. Requester's name and address(optional.' _u 0. . x 3(o(v 3 a fl edd►n Dr. City,state,and ZIP code k `- bee- Ia n d (iPr r 3 13 a-8 m List a ount numbert i here(optional) C..% Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box.The TIN provided must match the name given on Line 1 to avoid Social security number backup withholding. For individuals.this is your social security number(SSN). However.for a resident I I # 14 II_ alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number(EIN). If you do not have a number. see How to get a TIN on page 3. or Note,If the account is in more than one name, see the chart on page 4 for guidelines on whose number Employer identification number to enter. I O 9 1. 0 0 r Part II Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me), and 2. I am not subject to backup withholding because: (a) I am exempt from backup withholding. or(b) I have not been notified by the Internal Revenue Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends.or(c)the IRS has notified me that i am no longer subject to backup withholding, and 3. I am a U.S_person(including a U.S. resident alien). Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return_ For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement(IRA), and gene payr�e other than Interest and dividends,you are not required to sign the Certification, but you must provide your correct Tittl a'the ins ions on page 4.) Sign signature of Here u.s.pe«srm Date ii. 3)1p.-11 6 12:52 PM Tybee Island Historical Society 03/19/15 Profit & Loss Prey Year Comparison Accrual Basis January through December 2014 Jan-Dec 14 Jan-Dec 13 $Change %Change Ordinary Income/Expense Income 4000•Admission 694,500.00 686,134.86 8,365.14 1.2% 4100•Retail Sales 434,424.73 421,341.31 13,083.42 3.1% 4200•Contributions 7,421.38 14,413.58 -6,992.20 -48.5% 4300•Grants 16,125.00 16,125.00 0.00 0.0% 4400-Memberships 17,252.00 21,555.37 -4,303.37 -20.0% 7500 •Machine Income -304,00 790.50 -1,094.50 -138.5%© 7530•Miscellaneous Income -199.11 227.52 -426.63 -187.5% 7540•Historic Signs Misc.Income 225.00 385.00 -160.00 -41.6% 7541 •Special Events 22,465.75 28,443.49 -5,977.74 -21.0% 7550•Other Income 4,176.16 6,075.93 -1,899.77 -31.3% 7570.Interest Income 0.00 1,520.64 -1,520.64 -100.0% Total Income 1,196,086.91 1,197,013.20 -926.29 -0.1% Cost of Goods Sold 5000-Cost of Goods Sold 213,080.19 193,456.32 19,623.87 10.1% Total COGS 213,080.19 193,456.32 19,623.87 10.1% Gross Profit 983,006.72 1,003,556.88 -20,550.16 -2.1% Expense 6000•Advertising&Publicity 38,005.37 37,518.26 487.11 1.3% 6025-Cash Over/Short -164.28 -16.81 -147.47 -877.3% 6050.Credit Card Comm.&Bank Fees 21,511.72 22,136.17 -624.45 -2.8% 6055-Direct deposit fees 112.60 152.05 -39.45 -26.0% 6060.Depreciation Expense 66,000.00 78,554.00 -12,554.00 -16.0% 6070• Dues&Subsriptlons 525.00 1,829.00 -1,304.00 -71.3% 6080-Insurance 143,358.37 92,124.64 51,233.73 55.6% 6140-Interest 14,198,58 14,319.10 -120.52 -0.8% 6150.Miscellaneous Expenses 1,597.55 290.08 1.307.47 450.7% 6175•Charitable Donations 3,175.02 436.87 2,738.15 626.8% 6200•Office Expense 18,358.43 17,929.63 428.80 2.4% 6260•Payroll Salaries&Wages 399,575.27 469,578.27 -70,003.00 -14.9% 6270-Payroll Taxes 29,749.64 34,602.08 -4,852.44 -14.0% 6275•Pension Plan-SEP Contribution 6,690.00 16,130.94 -9,440.94 -58.5% 6290•Professional Fees 14,775.00 2,250.00 12,525.00 556.7% 6300•Program Expenses 10,322.15 18,568.07 -8,245.92 44.4% 6330•Taxes and Licenses 1,180.70 331.04 849.66 256.7% 6350• Repairs&Maintenance 185,481.81 66,971.74 118,510.07 177.0% 6400.Shop Expense 11,927.62 7,894.85 4,032.77 51.1% 6490.Storage Rental 5,196.38 4,615.00 581.38 12.6% 6500•Training&Travel 2,408.76 3,372.69 -963.93 -28.6% 6600•Utilities 41,667.81 35,210.57 6,457.24 18.3% Total Expense 1,015,653.50 924,798,24 90,855.26 9.8% Net Ordinary Income -32,646.78 78,758.64 -111,405.42 -141.5% Net Income -32,646.78 78,758.64 -111,405.42 -141.5% Page 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 Sarah Jones (printed name of natural person applying on behalf of f individual, business, corporation, partnership, or other private entity). 1) X I am a United States citizen. OR 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 p who_knowingly and willfully makes a false,fictitious, or fraudulent statement or representation in an affidavit shall be gu' of a violation Code Section 16-10-20 of the Official Code of Georgia. Signature of Applicant 3---1 -lc Date Printed Name *Alien Registration Number for Non-citizens SUBSCRIBED AND SW R BEFO ME ON THIS THE_ DAY OF � kr)1_71%.,..A-4L, Notary Public My Commission Expires: 171-44,....1- 6 i ( /'f Note: G.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: Savannah Restoration, Inc. Post Office Box 9351 Savannah, Georgia 31412 Telephone: (912) 234-1878 Fax: (912) 234-1617 March 13, 2015 Tybee Island Historical Society Attn: Sarah Jones 30 Meddin Drive Tybee Island, Georgia 31328 Estimate for Fence Replacement Demolition $ 8,000.00 Dumpsters Debris Removal (Old fence) Rentals New Pickett Fencing $ 37,000.00 Supply and install new 4 foot picket fencing around entire lighthouse to replace the existing fence with 4"x4" @ 6' on centers and 2 horizontal 2"x4". Painting Prime and paint 2 coats on fence and electrical conduit. $ 8,000.00 Note: Lumber prices are guaranteed for 90 days Price subject to soil condition Total Estimate $ 53,000,00 Thank you for the opportunity to hid on your work ENERGY ELECTRIC Orifice_912-352-1912 Post Office Box 14347 Fax:912-352-1930 Savannah, Georgia 31416 TYBEE LIGHTHOUSE FENCE LIGHTING: 11 MARCH 2015 -PROVIDE 40 LED 2 HEAD FLOOD LIGHTS WITH MOUNTING J BOXES -FIXTURES TO BE MOUNTED ON FENCE 4X4 POSTS -1/2 INCH PVC CONDUIT TO BE RUN ON SURFACE OF 2X4 THAT RUNS BETWEEN POSTS -CONDUIT CAN BE PAINTED BY OTHERS -LIGHTS TO BE CONTROLED BY SWITCFIES AT POWER SOURCE -FIXTURE PRICE BASED ON PREPAY ORDER CONTRACT PRICE: $13810.00 -1,4_4i_ a'_.431 ,-„L _ Budget Cash Flow 74-(4—.61.Aee—ed �--f--C / 2014 Proposed 2014 Actual 2015 Proposed Admission $ 600,000.00 $ 694,500.00 $ 700,000.00 Retail Sales $ 420,000.00 $ 434,424.73 $ 435,000.00 Contributions $ 5,000.00 $ 7,421.38 $ 5,000.00 Grants 5 16,000.00 $ 16,125.00 $ 16,000.00 Memberships 5 20,000.00 $ 17,252.00 $ 15,000.00 Machine Income $ 1,500.00 $ (304.00) $ 500.00 Miscellaneous Income $ 500.00 $ (199.11) $ 250.00 Historic Signs Misc Income $ 225.00 $ 200.00 Special Event Income 5 36,500.00 $ 22,266.47 $ 30,000.00 Interest Income $ 100.00 $ - $ 50.00 Other Income $ 4,176.16 $ 2,000.00 Total Income $ 1,099,600.00 $ 1,195,887.63 $ 1,204,000.00 Cost of Goods $ 180,000.00 $ 213,215.00 $ 180,000.00 Total Profit $ 919,600.00 $ 982,672.63 $ 1,024,000.00 Advertising and Publicity $ 38,000.00 $ 38,630.36 $ 43,000.00 Cash Over/Short $ (163.71) Credit Card Comm&Bank Fees $ 20,000.00 $ 21,511.72 $ 23,000.00 Direct Deposit Fees $ 150.00 $ 112.60 5 200.00 Dues&Subscriptions $ 1,500.00 $ 970.00 $ 1,200.00 Insurance $ 135,000.00 $ 143,358.37 $ 160,000.00 Interest $ 16,300.00 $ 15,441.64 $ 14,250.00 Miscellaneous $ 1,500.00 $ 1,597.55 $ 1,500.00 Charitable Donations $ 500.00 $ 3,175.02 $ 16,000.00 Office Expense $ 19,000.00 $ 19,598.73 $ 2.0,000.00__ Payroll Salaries and Wages $ 422,000.00 $ 399,575-27 $ 462,726.00 Payroll Taxes $ 33,000.00 $ 29,749.65 $ 35,400.00 Pension $ 6,200.00 $ 6,690.00 $ 7,000.00 Professional Fees $ 5,000.00 $ 14,775.00 $ 23,000.00 Program Expenses $ 24,000.00 $ 10,322.15 $ 20,000.00 Taxes and Licenses $ 150.00 $ 1,180.70 $ 1,500.00 Repairs and Maintenance $ 225,000.00 $ 185,604.12 $ 140,000.00 Shop Expense $ 10,000.00 $ 12,919.16 $ 18,000.00 Storage Rental $ 4,800.00 $ 5,196.38 $ 6,000.00 Training and Travel $ 4,300.00 $ 2,408.75 $ 3,500.00 Lltilites $ 40,000.00 $ 44,499.26 $ 50,000.00 Subtotal Normal Op. Expenses $ 1,006,400.00 $ 957,152.73 $ 1,046,276.00 Principal on Loan $ 28,969.00 $ 29,803.70 $ 81,020.00 Capital Improvements $ - $ - $ 45,000.00 Total Expenses $ 1,035,369.00 $ 986,956.43 $ 1,172,296.00 Cash Flow $ (115,769.00) $ (4,283.80) $ (148,296.00) NOTE: Deprecation for P&L $ 66,000.00 $ 66,000.00 $ 66,000.00 -,-. I Internal Revenue Service Department at the Treasury , . i internal Revenue Service Qua lity Review Staff/Taxpayer Assistance 1/4- District / 1 Director P. O. Box 3.055, Room 1007 101 Marietta- Street . . niaceam.//zoem Allan tai Georgia 30370; T._ I 1 ‘ / ° PO Rox '366 i --ryge‹ Refer Rely to: QRS:EO:TPA:1007 • if • 4, -Date: MAR 2. 7 1988 7 ' Er AJ: 60-0/9/00 8 ni'7-- F r= lui ,5-62<f)e9e)//7e9 Mtv '- ,Dear Sir or Madam: This is in response to your request for confirmation of your exemption frotra Federal income tax. • You were recognized as an organization exempt.frcut Federal income ta-%r Under_section- 501(c)-(3,) of the IrrteimarRelienue Code by our letter of -ruiue 1 /97 6 - You uere further determined not to be a private foundation within the weaning of section 509(a) of the Code because you are an organization c-scribed in sections 170C6Yiket)Cv1) 4,02 99 c96,j, contributions to you are deductible as provided in section 170 of the Code. The tax eXempt status recognized by our letter referred to above is currently in effect and will remain in effect until terminated, =dined or revoked ' by the Internal Revenue Service. Any change in your purposes, character, or method or operation nust be reported to us so we way consider the effect of the change on your exempt status. You trust also report any change in your name and address_ Thank you for your copperation- . Sincerely Yours, . itbz, a-ek EkemPT doe 8 • \ ° \ - / r. ' • -, A.s c