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Home My Public Portal About020_024_Tybee Island Maritime Academy • •. _ I • City of Tybee Island Community Services Contract Award Fiscal Year 2015-16 r CATION FOR CASH AWARD This form and all attachments are to be completed and submitted by March 20, 2015 Date: February 26, 2015 Organization requesting City of Tybee Island Community Services Contract Award: Name of Organization: Tybee Island Maritime Academy Contact Person: Carolyn K Jurick/Patrick Rossiter Address: Box 1519 Tybee Island, GA 31328 Contact Email: Ckjurick @comcast.net Contact Phone #: 912-395-4060/ 404-312-5617 Is this organization an IRS approved 501(C) 3 Non-Profit? XYes No If"yes", please attach your most recent ,.udited financial statement, and a copy of your IRS determination letter. Amount of funds requested: $ _ 19722.56 Describe how these funds will be used and how the City and citizens of Tybee Island will [3enefit: Tybee Island Maritime Academy opened the 2013-2014 school year with 144 students. Each student had a laptop. This has been very important to our students' learning as they use the laptop for assessments, in lieu of textbooks, documentation of project presentations, learning, etc. In the 2014-2015 school year we added 94 students. The increase in enrollment required us to seek additional classroom space and to purchase another 32 unit COW (computers on wheels). Maximum capacity for COWS is 36 laptops so additional computers were purchased to fill existing COWs. Students currently share laptops. The TIMA Teaching Model requires that each child has a computer in order to maximize instruction and learning. We need two more COWs plus 12 laptops for each of our students to have a laptop at school. We are asking for you to help by giving us the funds for one of the COWs. Rai 27414 -- 403 Butkr Avenue,Ty bee i siund.Georgia 313214-2-44 (412► 7N6-4573 - FAX(912)786-0465 .11.%,.c st tiRybec.nrk I fI City of Tybee Island Community Services Contract Award Fiscal Year 2015-16 Tybee Island Maritime Academy is so popular that we reached our 5 year goal of enrollment at the end of one year. We anticipate that we will have 251 students provisionally accepted for the 2015-2016 school year and a waitlist of 85. Many young families are looking for homes on Tybee and some have already moved here. They cite the school as the reason for the move. The school brings and breathes a new life into our community. There has been much support from our wonderful community. The school has a wonderful reputation and the city and its citizens are given the credit for it. The school has become an integral part of Tybee Island. What percentage of these funds will be matched by your organization? 100% Will this event or program bring visitors to Tybee Island in off-peak season or months? Tybee Island Maritime Academy has a dedicated group of parents and volunteers that come to Tybee frequently to support their children's education. Tybee business benefit from the influx of people throughout the year. »Please attach a detailed budget to this request outlining how the money will be used. Budget for Tybee Island Maritime Academy Technology Line Item Description Quantity Cost 1 The Whole Cow(includes 32 Lenova laptops) 1 $20,87350 2 Microsoft Office 2013 32 $1,706.56 Total $22,580.06 I, N ■ • • • C • • • tii ! f ? O.flh1 i7 �' 'D l w 0 V !jr w g^ 0'. l O CD n fJ co .•. pr I'D 0 2 0 cD R O v O FE Or ia ft fn cr ID - rU 0 Sri - `C D ET L7, '0 C 11.1 VD r+ r : i 911 9 zu NJ to . 5 oa u.) C W 1 n W Ct p i-� -1 Q 4�G f-- Lu uri 'b WG INTERNAL+ RED SERVIcE DEPART OF THE TREASURY P. O. BOX 2508 CINCINNATI, OR 45201 Employe- Identification Number: 45-1500099 Date: FED 2 2012 nom_ 17053231368011 --YSEE ISLAND CHARTER SCHOOL Contact Person: 1105 LAUREL AVE GAYLE M ADAMS IDf 95073 •s:xk3EE ISM, GA 31328 Contact Telephone Number: {8T'7) 829-5500 Accounting Period Ending: June 30 Public Charity status: 110(b) (1.) (A) (ii) Form 990 Required: . . - Yes- - - Effective Date of Exemption: march 28, 2011 Contribution. Deductibility: Yes Addendum Applies: Yes Dear Applicant: We are pleased to inform you that upon review of your application for tax exempt status we have determined that you are exempt from Federal income tax under section 501(c) (3) of the Internal Revenue Code, Contributions to you are deductible under section_ 170 of the Code. You are also qualified to receive tax deductible bequests, devises, transfers or gifts under section 2055, 2106 or 2522 of the Code. Because this letter could help resolve any questions regarding your exempt status, you should keep it in your permanent records. Organizations exempt under section 5011c) (3) of the Code are further classified as either public charities or private foundations. We determined that you are a public cbsr.ity under the Code section(s) listed the heading of this letter. Please see enclosed Publication 4221. 70, Compliance Guide for 501(0) (3) Public — Char5 es,- for some helpful_ infr--ration about your responsibilities exempt organization, Sincerely, iOr c'71, Lois G. Lrerer Director, Exempt Organizations Enclosures Publication 4221-PC Letter 947 (DO/CG) g Give Form to the Form + £" +�� for Taxpayer a�i�� requester. 60®t (Rev.December 2014) identification Number and Certification renu s to the IRS. Oepartma t of the Treasury internal Revenue Service 1 Name(as shown on your income tax return).Name is required on this line;do not leave this line blank. Tybee Island Charter School dab Tybee Island Maritime Academy ni 2 Business name/disregarded entity name,it different from above m C7i c3 Check appropriate box for federal tax classification;check only one of the following seven boxes: 4 Exemptions(codes apply only to o ❑Individual/501e proprietor or [ C Corporation ❑ S Corporation ❑ Partnership ❑Tmstlestate certain entities,not individuals;see single-member LLC instructions on page 3): a a Limited liability company.Enter the tax classification C=C corporation,S--S corporation,Pe-partnership)► Exempt payee code(if any) 0 M5+ P Y• { rp � Note.For a single-member LLC that is disregarded,do not check LLC;check the appropriate box in the line above for Exemption from FATCA reporting C y the tax classification of the single-member owner. code(if any) e ❑Other(see instructionsy■ (Applies es accounts�wields`'�'@ 1.1.5.1 tt _ 5 Address(number,street,and apt or suite no.) Requester's name and address(optional) • PO Box 1519 6 City,state,and ZIP code Tybee Island,GA 31328 7 List account number(s)here!optional Part I Taxpayer Identification Number(TIN) Enter your TIN in the appropriate box.The TEN provided must match the name given on line 1 to avoid Social security number backup withholding.For individuals,this is generally your social security number(SSN).However,fora resident 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. Of Note.If the account is in more than one name,see the instructions for line 1 and the chart on page 4 for I Employer rctent:ficadden number guidelines on whose number to enter. 45 _ 1500099 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 lam no longer subject to backup withholding;and 3. I am a U.S.citizen or ether U.S.person(defined below);and 4.The FATCA code(s)entered on this form(if any)indicating that I am exempt from FATCA reporting is correct. 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 generally,payments other than interest and dividends,you are not required to sign the certification,but you must provide your correct TIN.See the instructions on page 3. Sign Signature ' r`' ,r Here ts.s.persona-n " ell Date -}�.. General Instructions •Form 1098(home mortgage Interest).1098 1E(student loan interest),1098-T (tuition) Section references are to the Internal Revenue Code unless otherwise noted. •Form 1099-C(canceled debt) Future developments.Information about developments affecting Form W-9(such •Form 1099-A(acquisition or abandonment of secured property) as legislation enacted after we release it)is at www.irs.govlfw9. Use Form W-9 only if you are a U.S.person(including a resident alien),to Purpose of Form provide your correct TIN. An individual or entity(Form W-9 requester)who is required to file an information if you do not return Form W-9 to the requester with a TIN,you might be subject return with the IRS must obtain your correct taxpayer identification number{TIN) to backup withholding.See What is backup withholding?on page 2. which may be your social security number(SSN),individual taxpayer identification By signing the filled-out form,you: number(ITIN),adoption taxpayer identification number(ATIN) or employer 1.Certify that the TiN you are giving is correct(or you are waiting for a number identification number(EiN),to report on an information return the amount paid to to be issued), you,or other amount reportable on an information return.Examples of information returns include,but are not limited to,the following: 2.Certify that you are not subject to backup withholding,or •Form 1099-INT(interest earned or paid) 3.Claim exemption from backup withholding if you are a U.S.exempt payee_If •Fart 1099-DIV(dividends,including those from stocks or mutual funds) applicable,you are also certifying that as a U.S.person,your allocable share of { 9 any partnership income from a U.S.trade or business is not subject to the •Form 1099-MISC(various types of income,prizes,awards,or gross proceeds) withholding tax on foreign partners'share of effectively connected income,and •Form 1099-B(stock or mutual fund sales and certain other transactions by 4.Certify that FATCA code(s)entered on this form(if any)indicating that you are brokers) exempt from the FATCA reporting,is correct.See What is FATCA reporting?on •Form 1099-S(proceeds from real estate transactions) page 2 for further intormation. •Forum 1099-K(merchant card and third party network transactions) Cat.No.10231 X Form W-9(Rev.12-2014)