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HomeMy Public PortalAboutTybee Arts Association l„ tiff° ,` �i tip o -! b Cony off'Tybee Island Commazalty ServLees Ceu:Inlet Award ]F'nsezl Year 2M3=114 Lap[PLZC ITECK FOR CAS Mr-\MIL This form is to be compieted and submitted to Finance ;iith your budget request. Date: 4/Zoio Organization r-.luest ng Clty of Ty.,_- Hsl.,11.1 Community Services Contract Award: Name of Organization: ive)tE_ is -PK-Ssoc_o a ®• Contact Person: SA A Pt r-rt-k-Pc- C L R.Es ao a 3 Address: Pc) tae x „,/344 --(7,,, %s 3 5=.8 Contact Finaii:Sa,tna.tnANto Q\aar P Contact Phone #: q1 a - 78G - 4 55 e 0.5 -u`t'Ct, • re.-k' e e 4o 4 ° ,Ca ° 3 -7 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 ERS determination letter and a copy of your current budget detailing the {Canned use for the awarded funds. Amount of funds requested: $ 6/000' Describe how these funds will be used and how the City and citizens of Tybee Island \:./ill benefit: fL-tG. v4C -PA c�G�- -a- 8t- r0--� Bow 4r [E�. ® ��, cam" 1a s44-7-,x\cr l 0- r S 1"7-'1/L..01.,..D O•8 c =n ,,c7-ro c.-..S 1 ..0.4,1- E.i_5 e_Pe L- M.Oto Fi.c A-�:o S � i cr,e_ �i�-'� 5o t ,s n kG r co RoL a , S Nv Pc2ooCE && STUJ€ )a),„ - ,9�-t 0S �,2. $ o Zop a A1 A Fero (4 �s rptox.1ac� i .: ''a ' 3 • • • - `?.� -'- a Ce 1-0 5) ®H -7 C-A-rn t--('-- -----. What percentage of these funds will be matched by your organization? 4& p og bring Tybee ? Will this event or r ray�� bri visitors to T ee island in off-peak season or months? `ul -1-i d-F3 c.-'cc >o v 5 7A , -po LA.-e_17. 3 a -t2c ss. ,,,e[!mac, �‘__- >>L7Daese F._, F,cch a detEHed budget to thls o-eques ouUnii nz ihoeu r.:he mornsu Toiiii 1;,a :sad. ..---p. S. =k2).51— C-OT C-L-■. >S-17 '..- 6 '1-F1.1■ CD 1.1—r e....c -r- (>,.LL. (3-1,), _ '4..e;) °F.z.-1-=-L. ics,i ■ • li City of Tybee isilEmd Ce.=nnnun ty SeTvnces Cozarn°Eet AvvEzd 71scEfl Ye 27 2013-1l Date: ) ®ii . �--- n Name of Organization: y l A S SSA l Ada O 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): . t ©Ni1. P °S +o-Lo-t Sc- _ (.&& Ci' A-F G-r . f OTC: - DIWrS ��e cl • C r iLi W cYKAl_�ZS l ou ecA Son ; -P--,v) V t l�t awl<, rVl A°■N 4 -Nl A-f C GSAG�.$6)c.,oS. 5a LPG 1L D✓ L1���Sa's �- �_e / fir a r�a �r.1-r of - o�J S aT�� Ga��n� 7 1FL.,Al' V n s ° . n'1-&t-c5 asaa.. �6 . 10 ZA Cad i ct='>i2eM A"Gr�—P P-2-K.SaPL WAU. 77 pPt-*I NoaNI- .c�a S Tiete's 7A-nfl e .ate s'�.,,, b -arc)a e.A-e ;,4,s_AG-W i,-— F-1-05A I L q IW0-) W.�A. a c c,,1 c-e ja�+S.7-, -. 1-�-'�a c CAD o (tkrs 2>- ga d e P . 11....'Y L. . ,)zP f7A-0aL To � . ce..9-rr -(mss r -AT p„.( e... >%r .( GiNl� N,A4. 6--us a5Seirpm— 5,-.4.,,,fr .N'arr* -A1-, w1A-er.g.*_, sms..._. Sir.L---u Lb sa.--s, .%-ria —',1.1' ("1-.( '''''f---- LP' SGS a 1-4 as2 ® L.� c-Q--M, ®cam ^. 3> '6F-. u.G rr t.... -77 51 - - (. ,. FOP 1:› -may 1Laa, ocr, 7-7. 6n�� 'coa • - `- Value of the wavers rec ested: $ ' ni c----- ,e, / Affidavit Verifying Status \ti' ai-1' TOT 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�� m h- � (�g.� (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 v. lation of Code Section 16-10-20 of the Official Code of Georgia. nV 4t22C (‘ Signature of Applicant I3 Date I / r, Sara r::. Printed Name Notary Public, Caa ham County,GA My Commission Expires May 17,2016 *Alien Registration Number for Non-citizens SUBSCRIIRD AND SWORN BEFORE ME ON THIS THE c>gt DAY OF pe D C% ,20 13 Notary Public ∎.) Lu Q�G LIN(V-(-011.0(1)44 My Commission Expires: £1 171 ((Q 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 identing number below: IRS letter Sable.IPS leder Fnanz Sara McClelland csoramuldendebellsout,net. 0/79/2013 10341PAI To:Samantha Claw<samantMarlDbAsourknet, /4,5011013) INTERNAL REVENUE SERVICE DEPARTMENT OF THE TREASURY DISTRICT DIRECTOR P. D.-80X 2508 4 'CINCINNATI, OH 45201 4 , Employer Identification Number: 58-2274131 Date: JUL 611.11. 1997 317126679 TYBEE ARTS ASSOCIATION INC Contact Person: PO Box 2344 D. A. DOWNING TYREE ISLAN0, -GA 21228-2344 Contact Telephone Number: (513) 241-5199 Accounting Period Ending: December 31 Foundation Status Classification: 50(a)(2) Advance Ruling Period Ilnegins: July 24. 1996 Advance Ruling Period Ends.: December 31, 2000 . Addendum Applies: Yes • Dear Applicant: 8aued en information you supplied/ and assum-ing your operations will be as stated in your application for recognition of exemption, we have determined you are exempt from federal income tax under section 501(a) of the Internal Revenue Code as an organization described in section 501(c)(2), Because you are a niiy created organization we are not now making a final determ;nation of your foundation status under section 5,)9(a) of the Code, However, we have determined that you can reasonably expect to be a publicly supported organization described in section 509(a)(2). Accordingly, during an advance ruling period you kill be treated as a pnblicly supported organization, aid riot as a private foundat;on_ flu advance ruling period begins and ends on the dates shown above. Within 90 days after the end of your advance ruling period, you must send as the information necded to determine whether yea have met the require- ., ments of the applicable support test during the advance ruling period_ If you establish that you have been a publicly supported oroanization, we iii II classi- fy you as a section 509(a)(1) or 509(o)(2) ordan-ization as long as you continue to meet the requirements Of the applicable support test. If you do not meet the pat it support requirements during the advance rull'ig period l we will ciassify you as a private foundation for future periods_ Also, if we classify you as a private foundation, we wil: treat you as a private foundation from your beginning date for purposes of section 507(d) and 4940. Grantors and contributors may rely on our determination that you arc not a- private foundation until 90 days after the end of your advance ruling period. 11 you send us the required information within the 90 days4 gran-tors and contributors may continue to rely or the advance determination until we make a final determ:natioh of your foundation status, lf publish a notica in the Internal Revenue Bulletin stating that we - . Latter 104f (DO/CO) _ . -- 4)( . _ . of2 4/29/2013 11:50 PM 8:43 PM Tybee Arts Association 04/29/13 Profit & Loss Accrual Basis January through December 2012 Jan-Dec 12 Ordinary Income/Expense Income Event Income Advertisment in Programs 500.00 Performance Income 3,825.00 Total Event Income 4,325.00 Other Types of Income Donations 339.85 Membership Dues 2,345.00 Miscellaneous Revenue 2,511.46 Total Other Types of Income 5,196.31 Proceeds from Art Show Art Show Raffles 289.00 Art Shows-Gross Proceeds 28,886.94 Art Shows-Pay-out to Artists -22,996.15 Artist Fees 2,065.00 Total Proceeds from Art Show 8,244.79 Program Income Educational Classes 1,318.50 Total Program Income 1,318.50 Total Income 19,084.60 Gross Profit 19,084.60 Expense Business Expenses Business Registration Fees 125.00 Dues 345.00 Total Business Expenses 470.00 Events Casual Labor 510.00 Costumes 0.00 Entertainment 150.00 Hospitality 903.79 Music/Scripts 35.00 Set Stage 0.00 Total Set 0.00 Supplies for Events 1,636.00 Venue 0.00 Total Events 3,234.79 Facilities and Equipment Repairs&Maintenance-Building 1,363.66 Utilities 1,316.28 Total Facilities and Equipment 2,679.94 Operations Bank Charges 333.00 Merchant Fees 784.69 Postage 84.40 Printing and Copying 75.33 Supplies 3,310.00 Telephone 1,358.65 Website Support 405.41 Total Operations 6,351.48 Page 1 8:43 PM Tybee Arts Association 04/29/13 Profit & Loss Accrual Basis January through December 2012 Jan-Dec 12 Other Types of Expenses Insurance-Liability,D and 0 1,034.00 Other Costs 1,168.05 Total Other Types of Expenses 2,202.05 Total Expense 14,938.26 Net Ordinary Income 4,146.34 Net Income 4,146.34 Page 2 8:58 PM Tybee Arts Association 04/29/13 Profit & Loss Budget Overview Accrual Basis January through December 2013 Jan-Dec 13 Ordinary Income/Expense Income Event Income Advertisment in Programs 1,200.00 Performance Income 14,000.00 Total Event Income 15,200.00 Other Types of Income Grants 5,000.00 Membership Dues 2,500.00 Miscellaneous Revenue 1,000.00 Total Other Types of Income 8,500.00 Proceeds from Art Show Art Show Raffles 100.00 Art Shows-Gross Proceeds 30,000.00 Art Shows-Pay-out to Artists -24,000.00 Artist Fees 2,000.00 Total Proceeds from Art Show 8,100.00 Program Income Educational Classes 1,500.00 Total Program Income 1,500.00 Total Income 33,300.00 Gross Profit 33,300.00 Expense Business Expenses Business Registration Fees 50.00 Dues 350.00 Total Business Expenses 400.00 Charitable Donations 100.00 Contract Services Accounting Fees 500.00 Outside Contract Services 2,000.00 Total Contract Services 2,500.00 Events Advertising 1,000.00 Banners 100.00 Casual Labor 2,000.00 Costumes 1,000.00 Entertainment 500.00 Hospitality 500.00 Music/Scripts 500.00 Permits 200.00 Printing 800.00 Set Stage 3,000.00 Total Set 3,000.00 Supplies for Events 1,000.00 Total Events 10,600.00 Facilities and Equipment Repairs&Maintenance-Building 5,000.00 Utilities 3,000.00 Total Facilities and Equipment 8,000.00 Page 1 8:58 PM Tybee Arts Association 04/29/13 Profit & Loss Budget Overview Accrual Basis January through December 2013 Jan-Dec 13 Operations Bank Charges 300.00 Merchant Fees 1,000.00 Postage 300.00 Printing and Copying 200.00 Supplies 5,000.00 Telephone 1,400.00 Website Support 1,000.00 Total Operations 9,200.00 Other Types of Expenses Insurance-Liability,D and 0 1,050.00 Other Costs 1,200.00 Total Other Types of Expenses 2,250.00 Total Expense 33,050.00 Net Ordinary Income 250.00 Net Income 250.00 Page 2