HomeMy WebLinkAboutC-8577-1D - Cultural Arts Grants - FY 24-25 - Musical PerformancesW
AN
GRANT AGREEMENT
BETWEEN THE CITY OF NEWPORT BEACH AND
BALBOA ISLAND IMPROVEMENT ASSOCIATION
This Grant Agreement ("Agreement") is entered into this 13th day of March, 2024
("Effective Date"), by and between the City of Newport Beach, a California municipal
corporation and Charter City ("City"), and BALBOA ISLAND IMPROVEMENT
ASSOCIATION, a California nonprofit corporation located at 122 Ruby Avenue, Newport
Beach, California 92662 ("Grantee"). City and Grantee are at times individually referred
to as "Party" and collectively as "Parties" herein.
RECITALS
A. It is the policy of the City Council that the City's budget specifically allows the City
Council to direct revenue towards non-profit agencies, community groups,
community events, or enhancement projects with worthy projects or programs
which the City Council deems beneficial to the residents' quality of life.
B. Grantee requested a grant from the City for musical performances ("Grant
Proposal").
C. The City Council determined the Grant Proposal is for a worthy project that will
benefit the City's residents' quality of life.
D. The City Council approved a grant in the amount of Three Thousand Dollars and
00/100 ($3,000.00) ("Grant Funds") to Grantee pursuant to certain conditions
regarding expenditure, reporting, and accounting requirements.
NOW, THEREFORE, the Parties agree as follows:
1. GRANT
1.1. City awards to Grantee Grant Funds in the amount of Three Thousand Dollars
and 00/100 ($3,000.00) as requested by Grantee in the Grant Proposal attached hereto
as Exhibit A and incorporated herein by reference, or such other amount as authorized
by the City Council.
1.2. Grant Funds shall be disbursed by City to Grantee as follows (select one):
® On or before June 13, 2024.
2. TERM
The term of this Agreement shall commence on the Effective Date and shall
continue in full force and effect until January 30, 2025, unless terminated earlier as
provided herein.
BALBOA ISLAND IMPROVEMENT ASSOCIATION Page 1
3. RESTRICTIONS ON USE OF FUNDS AND OTHER REQUIREMENTS RELATED
TO THE RECEIPT OF GRANT FUNDS
3.1. The Grant Funds are subject to the following expenditure conditions ("Approved
Uses"):
3.1.1. The Grant Funds shall be expended solely for the purposes provided
in Exhibit A;
3.1.2. The Grant Funds shall not be used for any activity that would violate
City, state or federal statutory or decisional law such as regulations affecting non-profit or
tax exempt organizations exempt from taxation pursuant to Section 501(c)(3) of the
Internal Revenue Code; and
3.2. Grantee further warrants to City that the Grant Funds will be spent solely for
the Approved Uses and the Grant Funds shall be used by Grantee during this
Agreement's term otherwise the Grant Funds shall be returned to City, as provided in
Section 5 below.
3.3. Grantee shall conduct background checks for all of its volunteers and
employees who work with minor children in relation to any project described in Grantee's
Grant Proposal. To the extent applicable, Grantee shall provide the City certification that
it has complied with this requirement prior to the receipt of Grant Funds.
4. REPORTING AND ACCOUNTING REQUIREMENTS
4.1. At all times during the term of this Agreement, Grantee shall maintain true,
proper, and complete books, records, and accounts (collectively, "Books and Records")
in which shall be entered fully and accurately all transactions taken with respect to the
operations of Grantee under the Grant Proposal and the expenditure of the Grant Funds.
Grantee shall maintain the Books and Records in accordance with Generally Accepted
Accounting Principles. Grantee shall make available to City such Books and Records
upon City's request.
4.2. If the Grantee has been audited by an independent auditor or has been the
subject of a compliance audit/examination by a grantee or regulatory agency during the
past three years, audit reports and management letters indicating compliance violations,
fraud, illegal acts, material weaknesses in internal control structure or reportable
conditions, in connection with such audits shall be delivered to the City thirty (30) days
prior to the effective date of this agreement. If no audits or events as described above
have occurred during this period, the Grantee shall provide City a written assertion that
no audits or similar examinations have occurred during the three (3) year period and an
assertion that the Grantee is not aware of any events or conditions, described above, or
other information that might reasonable impact City's decision to fund the grant as
requested.
4.3. City reserves the right to designate its own employee representative(s) or its
contracted representative(s) with a Certified Public Accounting firm who shall have the
BALBOA ISLAND IMPROVEMENT ASSOCIATION Page 2
right to audit Grantee's accounting procedures and internal controls of Grantee's financial
systems as they relate to the Grant Proposal and to examine any cost, revenue, payment,
claim, other records or supporting documentation resulting from any items set forth in this
Agreement. Any such audit(s) shall be undertaken by City or its representative(s) at
mutually agreed upon reasonable times and in conformance with generally accepted
auditing standards. Grantee agrees to fully cooperate with any such audit(s).
4.4. This right to audit shall extend during the length of this Agreement and for a
period of three (3) years or longer, if required by law, following the date of any Grant
Funds tendered under this Agreement. Grantee agrees to retain all necessary
records/documentation for the entire length of this audit period.
4.5. Grantee shall, upon conclusion of the event, furnish the City with a Balance
Sheet and Income Statement describing the receipt and disbursement activities of
Grantee with respect to the Grant Funds. In its sole and absolute discretion, the City may
also require Grantee to submit: (i) quarterly check registers and descriptions of each
disbursement; (ii) budget -to -actual -results; and (iii) a statement of position describing the
assets and liabilities associated with the Grant event. All reports, including a post -event
evaluation, shall be due to the City no later than forty-five (45) days following the
conclusion of the event. In the event that an independent audit is conducted, Grantee
shall forward a copy of the audited report to the City for review, including any Management
Letter, Report on Internal Controls, or Reportable Conditions letter generated during the
course of the audit.
4.6. Grantee agrees to exercise prudent financial management processes including
proper oversight of all assets, budget preparation, and timely reporting including budget -
to -actual -comparisons.
4.7. All Approved Uses shall be performed by Grantee or under Grantee's
supervision. Grantee represents that it possesses the professional and technical skills
required to perform the services required by this Agreement, and that it will perform all
services with a standard of care and in a manner commensurate with the community
professional standards and with the ordinary degree of skill and care that would be used
by other reasonably competent practitioners of the same discipline under similar
circumstances.
4.8. If Grantee has supported Political Action Committees(s) (PACs) during the past
three (3) years, the Grantee shall hire an independent auditor to perform limited, agreed -
upon testwork procedures to provide City assurance that City sponsored event profits did
not subsidize the funding of Political Action Committees (PACs) and event proceeds were
adequately segregated from funds used to support PACs. Agreed upon procedures may
include a review of a detail list of the past three (3) years of PAC contributions and
expenditures, including:
a. An identifying donor number, date and amount of each reported
contribution; and
b. A detail of expenditures sufficient enough to determine that the
expenditures were solely for PAC -related expenses; and
BALBOA ISLAND IMPROVEMENT ASSOCIATION Page 3
c. Any retained earnings or fund balance at the end of each fiscal year.
Substantive documentation for the contribution and expenditure should be available upon
request. City shall approve the agreed -upon testwork procedures prior to the
commencement of fieldwork.
5. USE OF GRANT FUNDS
5.1. The Grant Funds shall be used solely by Grantee for the Approved Uses and
for no other use. In the event that the Grant Funds are not used for the Approved Uses
or are not expended by or before January 17, 2025, Grantee shall notify the City in writing,
and shall be obligated to return the Grant Funds to City within thirty (30) days.
5.2. The City's grant contribution shall only be used for non-sectarian purposes.
Grantees shall not use the City's grant contribution, or any portion thereof, for any purpose
that violates local, state, or federal law, including, but not limited to, the Establishment
Clause.
6. INDEMNIFICATION
6.1. To the fullest extent permitted by law, Grantee shall indemnify, defend and hold
harmless City, its City Council, boards and commissions, officers, agents, volunteers, and
employees (collectively, the "Indemnified Parties") from and against any and all claims
(including, without limitation, claims for bodily injury, death or damage to property),
demands, obligations, damages, actions, causes of action, suits, losses, judgments,
fines, penalties, liabilities, costs and expenses (including, without limitation, attorney's
fees, disbursements and court costs) of every kind and nature whatsoever (individually,
a "Claim"; collectively, "Claims"), which may arise from or in any manner relate (directly
or indirectly) to this Agreement (including the negligent and/or willful acts, errors and/or
omissions of Grantee, its principals, officers, agents, employees, vendors, suppliers,
consultants, subcontractors, anyone employed directly or indirectly by any of them or for
whose acts they may be liable or any or all of them).
6.2. Notwithstanding the foregoing, nothing herein shall be construed to require
Grantee to indemnify the Indemnified Parties from any Claim arising from the sole
negligence or willful misconduct of the Indemnified Parties. Nothing in this indemnity shall
be construed as authorizing any award of attorney's fees in any action on or to enforce
the terms of this Agreement. This indemnity shall apply to all claims and liability
regardless of whether any insurance policies are applicable. The policy limits do not act
as a limitation upon the amount of indemnification to be provided by Grantee.
7. GRANTEE INDEPENDENCE
In the performance of this Agreement, the Grantee, and the agents and employees of
Grantee, shall act in an independent capacity and are not officers, employees or agents
of the City. The manner and means of performing the Approved Uses are under the
control of Grantee, except to the extent they are limited by statute, rule or regulation and
the expressed terms of this Agreement. Nothing in this Agreement shall be deemed to
BALBOA ISLAND IMPROVEMENT ASSOCIATION Page 4
constitute approval for Grantee or any of Grantee's employees or agents, to be the agents
or employees of City. Grantee shall have the responsibility for and control over the means
of performing the Approved Uses, provided that Grantee is in compliance with the terms
of this Agreement. Anything in this Agreement that may appear to give City the right to
direct Grantee as to the details of the performance or to exercise a measure of control
over Grantee shall mean only that Grantee shall follow the desires of City with respect to
the results of the Approved Uses.
8. PROHIBITION AGAINST TRANSFERS
Grantee shall not assign, sublease, hypothecate or transfer this Agreement or any of the
services to be performed under this Agreement, directly or indirectly, by operation of law
or otherwise without prior written consent of City. Any attempt to do so without written
consent of City shall be null and void.
9. NOTICES
9.1. All notices, demands, requests or approvals to be given under this Agreement
shall be given in writing and conclusively shall be deemed served when delivered
personally or on the third business day after the deposit thereof in the United States mail,
postage prepaid, first class mail, addressed as hereinafter provided.
9.2. All notices, demands, requests or approvals from Grantee to City shall be
addressed to the City at:
Attn: Library Services Director
Library Services Department
City of Newport Beach
100 Civic Center Drive
Newport Beach, CA 92660
9.3. All notices, demands, requests or approvals from City to Grantee shall be
addressed to Grantee at:
Attn: Penny Rodheim
BALBOA ISLAND IMPROVEMENT ASSOCIATION
P.O. Box 64
Newport Beach, CA 92662
10. TERMINATION
10.1. Termination for Cause. Grantee shall be in default if Grantee fails or refuses
to perform any duty required by the Agreement or performs in a manner inconsistent with
the terms, conditions and restrictions in this Agreement. In such event, City shall give
Grantee, thirty (30) days written notice to cure, if the default can be cured and City shall
be entitled to terminate this Agreement if Grantee has not cured the default within the
thirty (30) day cure period. City shall be entitled to immediately terminate this Agreement
if the default cannot be cured through corrective action. If terminated for cause, Grant
BALBOA ISLAND IMPROVEMENT ASSOCIATION Page 5
Funds shall be returned to the City pursuant to Section 5. This Agreement is made on an
annual basis, and as such is subject to non -renewal at its termination.
10.2. Termination without Cause. City may terminate this Agreement at any time
with or without cause upon seven (7) days written notice to Grantee, any remaining Grant
Funds in Grantee's possession at the time of termination shall be returned to City
pursuant to Section 5.
10.3. Specific Performance. Grantee agrees that the City has the legal right, and all
necessary conditions have been satisfied, to specifically enforce Grantee's obligations
pursuant to this Agreement.
11. STANDARD PROVISIONS
11.1. Recitals. City and Grantee acknowledge that the above Recitals are true and
correct and are hereby incorporated by reference into this Agreement.
11.2. Compliance With all Laws. Grantee shall at its own cost and expense comply
with all statutes, ordinances, regulations and requirements of all governmental entities,
including federal, state, county or municipal, whether now in force or hereinafter enacted.
11.3. Waiver. A waiver by either Party of any breach, of any term, covenant or
condition contained herein shall not be deemed to be a waiver of any subsequent breach
of the same or any other term, covenant or condition contained herein, whether of the
same or a different character.
11.4. Integrated Contract. This Agreement represents the full and complete
understanding of every kind or nature whatsoever between the parties hereto, and all
preliminary negotiations and agreements of whatsoever kind or nature are merged herein.
No verbal agreement or implied covenant shall be held to vary the provisions herein.
11.5. Conflicts or Inconsistencies. In the event there are any conflicts or
inconsistencies between this Agreement and the Grant Proposal or any other
attachments attached hereto, the terms of this Agreement shall govern.
11.6. Interpretation. The terms of this Agreement shall be construed in accordance
with the meaning of the language used and shall not be construed for or against either
party by reason of the authorship of the Agreement or any other rule of construction which
might otherwise apply.
11.7. Amendments. This Agreement may be modified or amended only by a written
document executed by both Grantee and City and approved as to form by the City
Attorney.
11.8. Severability. If any term or portion of this Agreement is held to be invalid, illegal,
or otherwise unenforceable by a court of competent jurisdiction, the remaining provisions
of this Agreement shall continue in full force and effect.
11.9. Controlling Law And Venue. The laws of the State of California shall govern
this Agreement and all matters relating to it and any action brought relating to this
BALBOA ISLAND IMPROVEMENT ASSOCIATION Page 6
Agreement shall be adjudicated in a court of competent jurisdiction in the County of
Orange, State of California.
11.10. Equal Opportunity Employment. Grantee represents that it is an equal
opportunity employer and it shall not discriminate against any contractor, employee or
applicant for employment because of race, religion, color, national origin, handicap,
ancestry, sex or age or any other impermissible basis under law.
11.11. No Attorneys Fees. In the event of any dispute or legal action arising under
this Agreement, the prevailing party shall not be entitled to attorney's fees.
11.12. Counterparts. This Agreement may be executed in two (2) or more
counterparts, each of which shall be deemed an original and all of which together shall
constitute one and the same instrument.
[SIGNATURES ON NEXT PAGE]
BALBOA ISLAND IMPROVEMENT ASSOCIATION Page 7
IN WITNESS WHEREOF, the Parties have caused this Agreement to be executed
on the dates written below.
APPROVED AS TO FORM:
CITY ATTORNEY'S OFFICE
Date: 511312'-1
By:
A, ron C. Harp 3����aaDcr
City Attorney
ATTEST: Date: 'r . o a
By:
6k4
Leilani I. Brown
City Clerk
PC-%,
O :,< i
IIo
CITY OF NEWPORT BEACH,
A California municipal corporation
Date: 3/4,7-0 Zy
Melissa Hartson
Library Services Director
GRANTEE: BALBOA ISLAND
IMPROVEMENT ASSOCIATION, a
California nonprofit corporation
Date: , ?-,ki-A4
By: X/Z
Tehry; Jan
Chief ESE
cutive Officer
Date: /20
By:
Susan Pearl
Secretary
[END OF SIGNATURES]
Attachment: Exhibit A - Grant Proposal
BALBOA ISLAND IMPROVEMENT ASSOCIATION Page 8
Exhibit A
BALBOA ISLAND IMPROVEMENT ASSOCIATION Page A-1
Newport Beach City Arts Commission
NEWPORT BEACH CITY ARTS COMMISSION
2023-2024 CULTURAL ARTS GRANT APPLICATION
(Applications must be typed or word -processed- you may reformat on the computer as long as it
appears the same: i.e, use Times New Roman 12 point and the same pagination.)
Balboa Island Improvement Association (BIIA)
Popular Name of Organization
Balboa Island Improvement Association 95-6085806
Legal Name (if different) Federal Tax ID No.
PO Box 64
Mailing Address
Newport Beach, CA 92662-0064
City Zip
Penny Rodheim 71.4-357-9842
Contact Name Telephone
penny(a boats4rent.com http://www.balboaislandnb.org
FAX e-mail Web Site
Balboa Island, Newport Beach, Southern California
Geographical Area Served
Have you received a City of Newport Beach Cultural Arts Grant before? Yes
Year organization was founded 1952 Number of paid staff 0 # of active volunteers 150
Total amount requested: (from request line of project budget) S 3,000
Estimated number of people in Newport Beach that the proposed project(s) will serve: 2,800 +
CULTURAL ARTS GRANT APPLICATION
1. Briefly describe below your organization's purpose, mission, and goals,
2.
I. Purpose: Music walks us through life, and we believe we have found the right step. Therefore,
we propose to continue to provide musical productions that enhance activities for the citizens of
Newport Beach, young and old alike, and surrounding areas through the presentation of the
Balboa Island Classical Concert Series. These concerts will be held at St. John Vianney Chapel at
314 Marine, Balboa Island. These performances provide citizens with low cost, quality
performances in an intimate setting. In addition the BIIA offers free Summer Concerts at Balboa
Park, across from Beck Center on Agate. Both venues provide an outreach to all, neighbors and
families, within Newport Beach, as well as visitors.
2. Mission: The mission of the Balboa Island Improvement Association (BIIA) classical arts
campaign is to promote a sense of community while enhancing the island's beauty, safety,
livability and preserving its unique culture.
3. Goals: BMA's goal for 2024 is to continue to showcase the cultural tradition of the community by
presenting world -class musical performances performed by regional, classical musicians, as well
as, offering free summer concerts in the park. The summertime venue continues to offer popular,
contemporary entertainment in the community setting of Balboa Park, located on Agate, adjacent
to Beek Center. Since the BIIA is a non-profit organization, the goal. is not fundraising, but to
produce high quality performances with a variety of musical styles for the residents of Balboa
Island, Newport Beach and visitors alike.
A. Identify and describe why there is a need in the Newport Beach Community for your proposed
project/program.
Newport Beach is a city of many villages, each unique in their own way. What brings pride to
each village is a sense of bonding within. Offering the residents the opportunity to come together
to celebrate legendary music at affordable prices only enhances the pride and bonding that makes
our community stronger.
B. Describe how you have determined that your organization is the best organization for the proposed
project/program.
The 2024 season will be the ninth year of outstanding concert performances and Summertime venues.
The positive, immediate verbal feed -back from attendees indicates the appreciation and need for a
continuation of this local program. Also, the BIIA continues to have the support of the local merchants
who help sponsor these programs by allowing promotional materials in their stores and also provide a
source for ticket sales. The fact that this successful project is all volunteer quantifies the support of the
community.
2
3. Describe the specific project/program that will be funded by a cultural grant.
Moving forward, we would like to continue to ,provide another series of concerts and continue to promote
appreciation of music plus enhance community and family togetherness with the Summer Concerts.
There are two venues. St. John Vianney Chapel at 314 Marine Avenue on Balboa Island. The Chapel
maximum is 172 persons. The second is Balboa Park on Agate, directly adjacent to the Beek Center. The
park attendance is an estimate as the concert is free and held on the park grass. Estimated attendance per
concert is 150 persons. The following are the proposed performances for 2024.
Date of Concert
Event Name
Location
Attendance
February 13, 2024
Classical Concert
St. John Vianney Chapel
160
May 14,2024
Classical Concert
St. John Vianney Chapel
150
July 16, 2024
Classical Concert
St. John Vianney Chapel
150
August 02, 2024
Concerts in the Park
Carol Beek Center
200
August 09, 2024
Concerts in the Park
Carol Beek Center
200
August 16, 2024
August 23, 2024
Concerts in the Park
Concerts in the Park
Carol Beek Center
Carol Beek Center
200
200
August 30, 2024
Concerts in the Park
Carol Beek Center
200
Oct 22, 2024
Classical Concert
St. John Vianney Chapel
160
December 3, 2042 Classical Concert St. John Vianney Chapel 160+
A minimum of (5) Classical and (5) Concerts in the Park is the planned program. The locations and
attendance are expected to be similarly supported by the community.
These concerts are NOT fundraising events. They are purely to promote the music, arts and culture within
the city of Newport Beach. The classical concert ticket price has increased to $20 per person due to an
overall increase in costs of production. The summer concerts are free. All ticket monies go to
compensate the musicians and to offset the project/program costs and promotional materials. To offset
these costs we are requesting grant funds of $3.000, The project clearly requires additional underwriting
for which an outreach patronage program is voluntary.
Is this a new or existing X proj ect/program?
4. Define or describe the segment of the population in Newport Beach that you intend to serve by your
project/program. Include such things as age, location, numbers served, etc.
We will continue to serve ALL members of our community, young and young at heart, living on Balboa
Island, Newport Beach and the surrounding communities. Although the concerts are often attended by
repeat audiences, we know that a significant number are new to each performance, thereby increasing the
yearly outreach. Along with the popular Summer in the Park concerts we expect to reach 2,800 people.
5. Complete the project budget form. Address only the budget -for the specific project, not your annual
operating budget. For multi -project proposals, please duplicate and fill out a budget for each project.
Please annotate the budget at the bottom if there are details (such as a breakdown of personnel or a
marketing budget) critical to the proposal.
PROJECT BUDGET 2024 Funding from the Match Funding from the BIIA
City of Newport Beach
EXPENSES -Personnel
Artistic
0
All Volunteer
Administrative
0
All Volunteer
Technical Production
0
All Volunteer
EXPENSES-O eratin
Facility Expense/Space Rental
0
$ 0
Marketing
0
$1500
Production/Exhibition
Expense
0
$1000
Touring/Presentation Expense
0
0
Educational Materials
0
$1000
Transportation
0
$ 200
Equipment Piano rental approx.
0
$1800
Other (if greater than 10%,
annotate below) Musician Fees
0
$7500
TOTAL
$3000 Arts Commission $13,000
6. Describe the expected quantifiable outcomes of your project/program and how you will evaluate the
results. Be very specific in addressing the ways that you will determine that your project/program met
the needs that you identified and accomplishes the goals you set out to achieve (i.e. you provide 50
hours of musical instruction and instruments to the 100 children at Newport Elementary school as
measured by music store rental receipts and logs of instructors.)
The Classical Concerts and Free Summer Concerts bring the community together, The success of this is
measured by the repeat patronage. Increased ticket sales and support of the classical concerts at St. John
Vianney's Chapel is testimony to the quality and popularity of these concerts. The free Summer Concerts
at Balboa Park on Balboa Island continue to have great attendance as witnessed by the amount of lawn
chairs straddling the park 24 hours prior to each event. There is no shortage of family fun, and healthy
entertainment. Offering a safe venue for families and neighbors is priceless.
In addition, we have received local merchant feedback as to the increase in business on Balboa Island, for
dining and shopping on the nights these events are featured. The concerts are providing an economic
benefit not only to the merchants through dining and shopping but to the city of Newport Beach. The
increased revenues ultimately benefit us all.
4
7. Attachments Requested
Please do not send material in excess of what is requested; it will not be seen by the Arts Commission.
• A list of Board Members and their affiliations
• Terry Janssen
President
Volunteer
• Dan Abbott
Vice-president
Volunteer
• Vicki Hale
Treasurer
Volunteer
• Sue Pearl
Secretary
Volunteer
A recent list of individuals, corporations and foundations that provide organizational support- not
to exceed one page.
St. John Vianney's Chapel - Venue for the concerts
Balboa Island Museum - Ticket Sales; also the location for the after- concert reception
Fields Piano Rentals - Piano delivery and pick up from chapel, as needed
Volunteers - Minimum of 15 volunteers who design posters, programs, sell
tickets, seat guests and provide support at reception per concert
• If you area 501(c) (3) organization attach a copy of your IRS determination letter (or your fiscal
agent's) indicating tax exempt status. ( See attachment)
• One brochure and/or one press clipping. Do not send photos, videos, CDs or any other extraneous
material. It will not be presented to the Arts Commission.(See Attachment)
8. Please complete this operating budget form for 2024. This is not the
project/program budget for which you are applying, but your overall organizational budget.
You may annotate at the bottom if there are details critical to the proposal.
BHA OPERATING BUDGET
7.071 Rudaet friierrentl 1 2024 Rudoet (nrniected)
I. Income cash only
Contributed(Memberships)
$110,000
$ 120,000
Earned(Underwriting)
$ 60,000
$ 70,000
Total Income
$170,000
$190,000
II. Ex enses
Program
$140,000
$145,000
General and Administrative
$ 81000
$ 7,000
Marketing and Development
$19,000
$ 15,000
5
Total Expenses 1 $167,000 J $167,000 1
III.Operating Surplus/Deficit
Income minus Expenses)
A
0
IV. Fund Balance at
$13,000
$23,000
Beginning of Year
V. Accumulated Surplus
(Deficit)
$13,000
$23,000
Add lines III and IV
VI. In -Kind Contributions
(attach schedule if greater than
$1,000
$1,000
10% of total income
9. 1 verify that the information submitted in this application is true and correct to the best of my
knowledge.
Name A'6A1,VV Title 1F//,4 i�i/zcec9�
Signature Date &�