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Home My WebLink About102213 CC AgendaIn compliance with the Americans with Disabilities Act, if you need special assistance to participate in this meeting, please contact the office of the City Clerk (951) 694-6444. Notification 48 hours prior to a meeting will enable the City to make reasonable arrangements to ensure accessibility to that meeting [28 CFR 35.102.35.104 ADA Title II] AGENDA TEMECULA CITY COUNCIL A REGULAR MEETING CITY COUNCIL CHAMBERS 41000 MAIN STREET OCTOBER 22, 2013 — 7:00 PM At approximately 9:45 P.M., the City Council will determine which of the remaining agenda items can be considered and acted upon prior to 10:00 P.M. and may continue all other items on which additional time is required until a future meeting. All meetings are scheduled to end at 10:00 P.M. Next in Order: Ordinance: 13-06 Resolution: 13-54 CALL TO ORDER: Mayor Mike Naggar Prelude Music: The Inland Valley Youth Symphony String Quartet Invocation: Pastor Luke Kirkendall of Southwest Christian Church Flag Salute: To be announced ROLL CALL: Comerchero, Edwards, Roberts, Washington, Naggar PRESENTATIONS/PROCLAMATIONS General Federation of Women's Clubs (GFWC) — Advocates for Children Week Proclamation Certificates of Appreciation to Community Action Patrol Volunteers PUBLIC COMMENTS A total of 30 minutes is provided so members of the public may address the City Council on items that appear within the Consent Calendar or a matter not listed on the agenda. Each speaker is limited to three minutes. If the speaker chooses to address the City Council on an item listed on the Consent Calendar or a matter not listed on the agenda, a Request to Speak form must be filled out and filed with the City Clerk prior to the City Council addressing Public Comments and the Consent Calendar. Once the speaker is called to speak, please come forward and state your name for the record. For all Public Hearing or Council Business items on the agenda, a Request to Speak form must be filed with the City Clerk prior to the City Council addressing that item. Each speaker is limited to five minutes. 1 CITY COUNCIL REPORTS Reports by the members of the City Council on matters not on the agenda will be made at this time. A total, not to exceed, 10 minutes will be devoted to these reports. CONSENT CALENDAR NOTICE TO THE PUBLIC All matters listed under Consent Calendar are considered to be routine and all will be enacted by one roll call vote. There will be no discussion of these items unless Members of the City Council request specific items be removed from the Consent Calendar for separate action. 1 Standard Ordinance and Resolution Adoption Procedure RECOMMENDATION: 1.1 Motion to waive the reading of the text of all ordinances and resolutions included in the agenda. 2 Action Minutes RECOMMENDATION: 2.1 Approve the action minutes of October 8, 2013. 3 List of Demands RECOMMENDATION: 3.1 Adopt a resolution entitled: RESOLUTION NO. 13- A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF TEMECULA ALLOWING CERTAIN CLAIMS AND DEMANDS AS SET FORTH IN EXHIBIT A 4 Meeting Schedule for City Council Meetings for the month of December 2013 RECOMMENDATION: 4.1 Direct the City Clerk to cancel the December 24, 2013 City Council Meeting and perform the appropriate postings and noticing requirements of the Government Code. 2 5 Memorandum of Understanding — Labor Agreement RECOMMENDATION: 5.1 Approve a three-year Memorandum of Understanding (MOU) Labor Agreement, in substantially the form attached hereto, effective July 1, 2013 through June 30, 2016, between the City and the general employees represented by the California Teamsters Public, Professional, and Medical Employees Union Local 911. 6 Acceptance of Equipment and Notice of Completion for the Theater Energy Efficient Lighting, PW12-18 RECOMMENDATION: 6.1 Accept the purchase and delivery of energy efficient lighting equipment from Sacramento Theatrical Lighting, Ltd., for the Theater Energy Efficient Lighting Project, PW12-18, as complete; 6.2 Direct the City Clerk to file and record the Notice of Completion. 7 Acceptance of Improvements and Notice of Completion for the Citywide Slurry Seal Fiscal Year 2012-13, PW12-23 RECOMMENDATION: 7.1 Accept the construction of the Citywide Slurry Seal Fiscal Year 2012-13, PW12- 23, as complete; 7.2 Direct the City Clerk to file and record the Notice of Completion, release the Performance Bond, and accept a three-year Maintenance Bond in the amount of 10% of the contract amount; 7.3 Release the Labor and Materials Bond seven months after filing of the Notice of Completion if no liens have been filed. 8 Sixth Amendment to the Professional Engineering Services Agreement with RBF Consulting for design of Interstate 15/State Route 79 South Ultimate Interchange, PW04-08 RECOMMENDATION: 8.1 Approve the Sixth Amendment to the Agreement for Professional Engineering Services with RBF Consulting for design of Interstate 15/State Route 79 South Temecula Parkway Ultimate Interchange, increasing the contingency amount by $200,000; 8.2 Increase the City Manager's authority to approve Extra Work Authorizations by $200,000. 3 RECESS CITY COUNCIL MEETING TO SCHEDULED MEETINGS OF THE TEMECULA COMMUNITY SERVICES DISTRICT, THE SUCCESSOR AGENCY TO THE TEMECULA REDEVELOPMENT AGENCY, THE TEMECULA HOUSING AUTHORITY, AND THE TEMECULA PUBLIC FINANCING AUTHORITY 4 TEMECULA COMMUNITY SERVICES DISTRICT MEETING Next in Order: Ordinance: No. CSD 13-01 Resolution: No. CSD 13-05 CALL TO ORDER: President Jeff Comerchero ROLL CALL: DIRECTORS: Edwards, Naggar, Roberts, Washington, Comerchero CSD PUBLIC COMMENTS A total of 30 minutes is provided so members of the public may address the Board of Directors on items that appear within the Consent Calendar or a matter not listed on the agenda. Each speaker is limited to three minutes. If the speaker chooses to address the Board of Directors on an item listed on the Consent Calendar or a matter not listed on the agenda, a Request to Speak form must be filled out and filed with the City Clerk prior to the Board of Directors addressing Public Comments and the Consent Calendar. Once the speaker is called to speak, please come forward and state your name for the record. For all Public Hearing or District Business items on the agenda, a Request to Speak form must be filed with the City Clerk prior to the Board of Directors addressing that item. Each speaker is limited to five minutes. CSD CONSENT CALENDAR NOTICE TO THE PUBLIC All matters listed under Consent Calendar are considered to be routine and all will be enacted by one roll call vote. There will be no discussion of these items unless Members of the Temecula Community Services District request specific items be removed from the Consent Calendar for separate action. 9 Action Minutes RECOMMENDATION: 9.1 Approve the action minutes of October 8, 2013. CSD DIRECTOR OF COMMUNITY SERVICES REPORT CSD GENERAL MANAGER REPORT CSD BOARD OF DIRECTORS REPORTS CSD ADJOURNMENT Next regular meeting: Tuesday, November 12, 2013, at 5:30 PM, for a Closed Session, with regular session commencing at 7:00 PM., City Council Chambers, 41000 Main Street, Temecula, California. 5 SUCCESSOR AGENCY TO THE TEMECULA REDEVELOPMENT AGENCY — no meeting TEMECULA HOUSING AUTHORITY — no meeting TEMECULA PUBLIC FINANCING AUTHORITY — no meeting 6 RECONVENE TEMECULA CITY COUNCIL CITY COUNCIL BUSINESS 10 Community Service Funding Program for Fiscal Year 2013-14 RECOMMENDATION: 10.1 Review and approve the Fiscal Year 2013-14 Community Service Funding Program grants pursuant to the attached spreadsheet outlining the Ad Hoc Subcommittee's recommendation of $75,562 to 17 organizations, which includes an appropriation of $5,562 to the Community Service Funding Program from the General Fund available fund balance. 11 Declaration of Intention to Conditionally Vacate a portion of Jedediah Smith Road and setting a Public Hearing thereon RECOMMENDATION: 11.1 Adopt a resolution entitled: RESOLUTION NO. 13- A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF TEMECULA DECLARING ITS INTENTION TO CONDITIONALLY VACATE A PORTION OF JEDEDIAH SMITH ROAD AND SETTING A PUBLIC HEARING THEREON DEPARTMENTAL REPORTS 12 Community Development Department Monthly Report 13 Police Department Monthly Report 14 Public Works Department Monthly Reports CITY MANAGER REPORT CITY ATTORNEY REPORT ADJOURNMENT Next regular meeting: Tuesday, November 12, 2013, at 5:30 PM, for a Closed Session, with regular session commencing at 7:00 PM, City Council Chambers, 41000 Main Street, Temecula, California. 7 NOTICE TO THE PUBLIC The agenda packet (including staff reports) will be available for public viewing in the Main Reception area at the Temecula Civic Center (41000 Main Street, Temecula) after 4:00 PM the Friday before the City Council meeting. At that time, the agenda packet may also be accessed on the City's website — www.cityoftemecula.orq — and will be available for public viewing at the respective meeting. Supplemental material received after the posting of the Agenda Any supplemental material distributed to a majority of the City Council regarding any item on the agenda, after the posting of the agenda, will be available for public viewing in the Main Reception area at the Temecula Civic Center (41000 Main Street, Temecula, 8:00 AM — 5:00 PM). In addition, such material will be made available on the City's website — www.cityoftemecula.orq — and will be available for public review at the respective meeting. If you have questions regarding any item on the agenda for this meeting, please contact the City Clerk's Department, (951) 694- 6444. 8 PRESENTATIONS The City of Temecula PROCLAMATION WHEREAS, the General Federation of Women's Clubs (GFWC) is dedicated to strengthening communities and enhancing the lives of others through volunteer service; and WHEREAS, GFWC members actively educate, advocate, and engage in projects concerning the well-being of children via health, social, and safety programs, by working to ensure children are protected from harmful situations and encourage healthy physical and emotional lifestyles; and WHEREAS, GFWC Temecula Valley Woman's Club is a non-profit organization of women dedicated to raising funds and donating their time and enthusiasm to many community programs, projects, and charities within the Temecula Valley, among them advocating for children; and WHEREAS, Temecula Valley Women's Club recognizes that child trafficking is becoming an increasingly severe problem affecting the children in our valley; and WHEREAS, during the fourth week of October, GFWC and its affiliated local club, Temecula Valley Women's Club, stands with parents, grandparents, educators, and community leaders in raising awareness of the increasing problem of child trafficking. NOW, THEREFORE, I, Michael S. Naggar, on behalf of the City Council of the City of Temecula, hereby proclaim the fourth week of October, 2013 to be "GFWC Advocates for Children Week" IN WITNESS WHEREOF, I have hereunto set my hand and caused the Seal of the City of Temecula to be affixed this twenty-second day of October, 2013. Michael S. Naggar, Mayor Susan W. Jones, MMC, City Clerk City of Temecula Certificate of Appreciation Presented on behalf of the City Council and the citizens' of the City of Temecula to: Jerry Beja We appreciate your devotion to our community by volunteering your time and talents as a member of the Community Action Patrol; assisting the Temecula Police Department in keeping Temecula a safe, family -friendly community. IN WITNESS WHEREOF, I have hereunto affixed my hand and official seal this twenty- second day of October, 2013. Michael S. Naggar, Mayor Susan W. Jones, MMC, City Clerk City of Temecula Certificate of Appreciation Presented on behalf of the City Council and the citizens' of the City of Temecula to: Len Borok We appreciate your devotion to our community by volunteering your time and talents as a member of the Community Action Patrol; assisting the Temecula Police Department in keeping Temecula a safe, family -friendly community. IN WITNESS WHEREOF, I have hereunto affixed my hand and official seal this twenty- second day of October, 2013. Michael S. Naggar, Mayor Susan W. Jones, MMC, City Clerk City of Temecula Certificate of Appreciation Presented on behalf of the City Council and the citizens' of the City of Temecula to: Rich Cattivera We appreciate your devotion to our community by volunteering your time and talents as a member of the Community Action Patrol; assisting the Temecula Police Department in keeping Temecula a safe, family -friendly community. IN WITNESS WHEREOF, I have hereunto affixed my hand and official seal this twenty- second day of October, 2013. Michael S. Naggar, Mayor Susan W. Jones, MMC, City Clerk City of Temecula Certificate of Appreciation Presented on behalf of the City Council and the citizens' of the City of Temecula to: John Contabile We appreciate your devotion to our community by volunteering your time and talents as a member of the Community Action Patrol; assisting the Temecula Police Department in keeping Temecula a safe, family -friendly community. IN WITNESS WHEREOF, I have hereunto affixed my hand and official seal this twenty- second day of October, 2013. Michael S. Naggar, Mayor Susan W. Jones, MMC, City Clerk City of Temecula Certificate of Appreciation Presented on behalf of the City Council and the citizens' of the City of Temecula to: Greg Eastwood We appreciate your devotion to our community by volunteering your time and talents as a member of the Community Action Patrol; assisting the Temecula Police Department in keeping Temecula a safe, family -friendly community. IN WITNESS WHEREOF, I have hereunto affixed my hand and official seal this twenty- second day of October, 2013. Michael S. Naggar, Mayor Susan W. Jones, MMC, City Clerk ► City Council and the Temecula to: City of Temecula Certiflcate o Appreciation Presented on behalf of the citizens' of the City of Hank We appreciate your devotion to our community by volunteering Community Action Patrol; assisting the Temecula Police family -friendly community. your time and talents as a member of the Department in keeping Temecula a safe, IN WITNESS WHEREOF, I have hereunto affixed my hand and official seal this twenty- second day of October, 2013. Michael S. Naggar, Mayor Susan W. Jones, MMC, City Clerk City of Temecula . . Certiflcate of Appreciation Presented on behalf of the City Council and the citizens' of the City of Temecula to: Ray We appreciate your devotion to our community by volunteering your time and talents as a member of the Community Action Patrol; assisting the Temecula Police Department in keeping Temecula a safe, family -friendly community. IN WITNESS WHEREOF, I have hereunto affixed my hand and official seal this twenty- second day of October, 2013. Michael S. Naggar, Mayor Susan W. Jones, MMC, City Clerk City of Temecula Certificate of Appreciation Presented on behalf of the City Council and the citizens' of the City of Temecula to: Nathan Holland We appreciate your devotion to our community by volunteering your time and talents as a member of the Community Action Patrol; assisting the Temecula Police Department in keeping Temecula a safe, family -friendly community. IN WITNESS WHEREOF, I have hereunto affixed my hand and official seal this twenty- second day of October, 2013. Michael S. Naggar, Mayor Susan W. Jones, MMC, City Clerk City of Temecula Certificate of Appreciation Presented on behalf of the City Council and the citizens' of the City of Temecula to: Rich Insalaco We appreciate your devotion to our community by volunteering your time and talents as a member of the Community Action Patrol; assisting the Temecula Police Department in keeping Temecula a safe, family -friendly community. IN WITNESS WHEREOF, I have hereunto affixed my hand and official seal this twenty- second day of October, 2013. Michael S. Naggar, Mayor Susan W. Jones, MMC, City Clerk City of Temecula Certiflcate of Appreciation Presented on behalf of the City Council and the citizens' of the City of Temecula to: Tom Kelemen We appreciate your devotion to our community by volunteering your time and talents as a member of the Community Action Patrol; assisting the Temecula Police Department in keeping Temecula a safe, family -friendly community. IN WITNESS WHEREOF, I have hereunto affixed my hand and official seal this twenty- second day of October, 2013. Michael S. Naggar, Mayor Susan W. Jones, MMC, City Clerk City of Temecula Certiflcate o Appreciation Presented on behalf of the City Council and the citizens' of the City of Temecula to: Terry We appreciate your devotion to our community by volunteering your time and talents as a member of the Community Action Patrol; assisting the Temecula Police Department in keeping Temecula a safe, family -friendly community. IN WITNESS WHEREOF, I have hereunto affixed my hand and official seal this twenty- second day of October, 2013. Michael S. Naggar, Mayor Susan W. Jones, MMC, City Clerk City of Temecula Certiflcate of Appreciation Presented on behalf of the City Council and the citizens' of the City of Temecula to: Gerry Krinsky We appreciate your devotion to our community by volunteering your time and talents as a member of the Community Action Patrol; assisting the Temecula Police Department in keeping Temecula a safe, family -friendly community. IN WITNESS WHEREOF, 1 have hereunto affixed my hand and official seal this twenty- second day of October, 2013. Michael S. Naggar, Mayor Susan W. Jones, MMC, City Clerk City Council and the Temecula to: Navalta your time and talents as a member of the Department in keeping Temecula a safe, IN WITNESS WHEREOF, I have hereunto affixed my hand and official seal this twenty- second day of October, 2013. City of Temecula Certiflcate o Appreciation Presented on behalf of the citizens' of the City of Michelle We appreciate your devotion to our community by volunteering Community Action Patrol; assisting the Temecula Police family -friendly community. Michael S. Naggar, Mayor Susan W. Jones, MMC, City Clerk City of Temecula Certificate of Appreciation Presented on behalf of the City Council and the citizens' of the City of Temecula to: Don Petryca We appreciate your devotion to our community by volunteering your time and talents as a member of the Community Action Patrol; assisting the Temecula Police Department in keeping Temecula a safe, family -friendly community. IN WITNESS WHEREOF, I have hereunto affixed my hand and official seal this twenty- second day of October, 2013. Michael S. Naggar, Mayor Susan W. Jones, MMC, City Clerk City of Temecula Certificate of Appreciation Presented on behalf of the City Council and the citizens' of the City of Temecula to: Ellen Petryca We appreciate your devotion to our community by volunteering your time and talents as a member of the Community Action Patrol; assisting the Temecula Police Department in keeping Temecula a safe, family -friendly community. IN WITNESS WHEREOF, 1 have hereunto affixed my hand and official seal this twenty- second day of October, 2013. Michael S. Naggar, Mayor Susan W. Jones, MMC, City Clerk City of Temecula Certificate of Appreciation Presented on behalf of the City Council and the citizens' of the City of Temecula to: Ed Rushing We appreciate your devotion to our community by volunteering your time and talents as a member of the Community Action Patrol; assisting the Temecula Police Department in keeping Temecula a safe, family -friendly community. IN WITNESS WHEREOF, I have hereunto affixed my hand and official seal this twenty- second day of October, 2013. Michael S. Naggar, Mayor Susan W. Jones, MMC, City Clerk City of Temecula Certificate of Appreciation Presented on behalf of the City Council and the citizens' of the City of Temecula to: Morgan Sawyer We appreciate your devotion to our community by volunteering your time and talents as a member of the Community Action Patrol; assisting the Temecula Police Depai tiuent in keeping Temecula a safe, family -friendly community. IN WITNESS WHEREOF, I have hereunto affixed my hand and official seal this twenty- second day of October, 2013. Michael S. Naggar, Mayor Susan W. Jones, MMC, City Clerk City of Temecula Certiflcate of Appreciation Presented on behalf of the City Council and the citizens' of the City of Temecula to: Rand Stolp We appreciate your devotion to our community by volunteering your time and talents as a member of the Community Action Patrol; assisting the Temecula Police Department in keeping Temecula a safe, family -friendly community. IN WITNESS WHEREOF, I have hereunto affixed my hand and official seal this twenty- second day of October, 2013. Michael S. Naggar, Mayor Susan W. Jones, MMC, City Clerk City of Temecula Certiflcate of Appreciation Presented on behalf of the City Council and the citizens' of the City of Temecula to: Jim Thompson We appreciate your devotion to our community by volunteering your time and talents as a member of the Community Action Patrol; assisting the Temecula Police Department in keeping Temecula a safe, family -friendly community. IN WITNESS WHEREOF, I have hereunto affixed my hand and official seal this twenty- second day of October, 2013. Michael S. Naggar, Mayor Susan W. Jones, MMC, City Clerk City of Temecula Certiflcate o ppA reciation Presented on behalf of the City Council and the citizens' of the City of Temecula to: Mary We appreciate your devotion to our community by volunteering your time and talents as a member of the Community Action Patrol; assisting the Temecula Police Department in keeping Temecula a safe, family -friendly community. IN WITNESS WHEREOF, I have hereunto affixed my hand and official seal this twenty- second day of October, 2013. Michael S. Naggar, Mayor Susan W. Jones, MMC, City Clerk CONSENT CALENDAR Item No. 1 Item No. 2 ACTION MINUTES TEMECULA CITY COUNCIL A REGULAR MEETING CITY COUNCIL CHAMBERS 41000 MAIN STREET OCTOBER 8, 2013 — 7:00 PM 5:45 P.M. — The City Council convened in Closed Session in the Canyons Conference Room on the third floor of the Temecula City Hall concerning the following matters: 1) The City Council will meet in closed session with its designated representatives to discuss labor negotiations pursuant to Government Code Section 54957.6. The City's designated representatives are: City Manager Aaron Adams, Special Labor Relations Counsel Jeff Freedman, City Attorney Peter Thorson, Assistant City Manager Greg Butler, Director of Finance Jennifer Hennessy, Sr. Management Analyst Heidi Schrader, and Sr. Human Resources Analyst Isaac Garibay. The employee organization is the California Teamsters Public, Professional and Medical Employees Union Local 911. Council Member Comerchero participated in Closed Session via teleconference from J.W. Marriott, 1331 Pennsylvania Avenue NW, Washington, DC 20004. Public Information concerning existing litigation between the City and various parties may be acquired by reviewing the public documents held by the City Clerk. At 5:45 P.M., Mayor Mike Naggar called the City Council meeting to order and recessed to Closed Session to consider the matters described on the Closed Session agenda. The City Council meeting convened at 7:00 P.M. CALL TO ORDER: Mayor Mike Naggar Prelude Music: Anna Stone, Alexa Willis, Fiona Harley, and Ron Lycan Invocation: Pastor Bill Cate of Trinity Lutheran Church Flag Salute: Paul Jones ROLL CALL: Comerchero, Edwards, Roberts, Washington, Naggar PRESENTATIONS/PROCLAMATIONS Eastern Municipal Water District Presentation Action Minutes 100813 1 PUBLIC COMMENTS The following individuals addressed the City Council: • Wendy Bankston • JudyZulfigar • Gillian Larson • Rose Corona • Leland Mark • Wayne Hall CITY COUNCIL REPORTS CONSENT CALENDAR 1 Standard Ordinance and Resolution Adoption Procedure — Approved Staff Recommendation (4-0-1, Council Member Comerchero absent) Council Member Roberts made the motion; it was seconded by Council Member Edwards and electronic vote reflected approval with one absence. RECOMMENDATION: 1.1 Motion to waive the reading of the text of all ordinances and resolutions included in the agenda. 2 Action Minutes — Approved Staff Recommendation (4-0-1, Council Member Comerchero absent) Council Member Roberts made the motion; it was seconded by Council Member Edwards and electronic vote reflected approval with one absence. RECOMMENDATION: 2.1 Approve the action minutes of September 24, 2013. 3 List of Demands — Approved Staff Recommendation (4-0-1, Council Member Comerchero absent) Council Member Roberts made the motion; it was seconded by Council Member Edwards and electronic vote reflected approval with one absence. RECOMMENDATION: 3.1 Adopt a resolution entitled: RESOLUTION NO. 13-53 A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF TEMECULA ALLOWING CERTAIN CLAIMS AND DEMANDS AS SET FORTH IN EXHIBIT A Action Minutes 100813 2 4 City Treasurer's Report as of August 31, 2013 — Approved Staff Recommendation (4- 0-1, Council Member Comerchero absent) Council Member Roberts made the motion; it was seconded by Council Member Edwards and electronic vote reflected approval with one absence. RECOMMENDATION: 4.1 Approve and file the City Treasurer's Report as of August 31, 2013. 5 Pechancia Pu'eska Mountain Day Holiday Observance and Temporary Street Closures — Approved Staff Recommendation (4-0-1, Council Member Comerchero absent) Council Member Washington made the motion; it was seconded by Council Member Edwards and electronic vote reflected approval with one absence. RECOMMENDATION: 5.1 Approve, plan, and conduct community event activities and temporarily close certain streets for the following special event: PECHANGA PU'ESKA MOUNTAIN DAY 6 Sponsorship Agreement for Bike 365 for the Temecula Valley Century — Approved Staff Recommendation (4-0-1, Council Member Comerchero absent) Council Member Roberts made the motion; it was seconded by Council Member Edwards and electronic vote reflected approval with one absence. RECOMMENDATION: 6.1 Approve an Event Sponsorship Agreement with Bike 365 for city -support costs in the amount of $5,560, and in -kind promotional services for $10,415, for the 2013 Temecula Valley Century. 7 Agreement with Environmental Science Associates (ESA) for the preparation of a Supplemental Environmental Impact Report (EIR) for the Temecula Valley Hospital Heliport Relocation — Approved Staff Recommendation (4-0-1, Council Member Comerchero absent) Council Member Roberts made the motion; it was seconded by Council Member Edwards and electronic vote reflected approval with one absence. RECOMMENDATION: 7.1 Approve an Agreement with Environmental Science Associates (ESA) for $99,460, for the preparation of a Supplemental Environmental Impact Report (EIR), for the Temecula Valley Hospital Heliport Relocation. RECESS At 7:43 P.M., the City Council recessed and convened as the Temecula Community Services District Meeting. At 7:49 P.M., the City Council resumed with the remainder of the City Council Agenda. Action Minutes 100813 3 RECONVENE TEMECULA CITY COUNCIL CITY COUNCIL BUSINESS 9 Appointment of an Ad Hoc Subcommittee for Winchester Hills — Council Member Edwards made the motion to appoint Council Member Naggar and Council Member Roberts to serve on the Winchester Hills Ad Hoc Subcommittee; it was seconded by Council Member Roberts and electronic vote reflected approval with one absence and one abstention (3-0-1-1) Council Member Washington did not participate in the discussion of this item and left the dais. As mentioned at the September 24, 2013 City Council Meeting, Council Member Washington is a co-signer on a home mortgage for a relative and Council Member Comerchero has an investment property near the area of property, however, both are more than 500 feet away from this area of property. Under the Fair Political Practices Act, legally they do not have a conflict but it is within their discretion to not participate to avoid the appearance of a conflict. RECOMMENDATION: 9.1 Appoint two members of the City Council to serve on the Winchester Hills Ad Hoc Subcommittee. CITY MANAGER REPORT CITY ATTORNEY REPORT City Attorney Thorson announced there was no reportable action from Closed Session under the Brown Act. ADJOURNMENT At 7:53 P.M., the City Council meeting was formally adjourned to Tuesday, October 22, 2013, at 5:30 PM, for a Closed Session, with regular session commencing at 7:00 PM, City Council Chambers, 41000 Main Street, Temecula, California. Michael S. Naggar, Mayor ATTEST: Susan W. Jones, MMC City Clerk [SEAL] Action Minutes 100813 4 Item No. 3 Approvals City Attorney Finance Director City Manager CITY OF TEMECULA AGENDA REPORT TO: City Manager/City Council FROM: Jennifer Hennessy, Finance Director DATE: October 22, 2013 SUBJECT: List of Demands PREPARED BY: Pascale Brown, Accounting Manager Jill Dickey, Accounting Assistant RECOMMENDATION: Adopt a resolution entitled: RESOLUTION NO. 13- A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF TEMECULA ALLOWING CERTAIN CLAIMS AND DEMANDS AS SET FORTH IN EXHIBIT A BACKGROUND: All claims and demands are reported and summarized for review and approval by the City Council on a routine basis at each City Council meeting. The attached claims represent the paid claims and demands since the last City Council meeting. FISCAL IMPACT: All claims and demands were paid from appropriated funds or authorized resources of the City and have been recorded in accordance with the City's policies and procedures. ATTACHMENTS: 1. Resolution 2. List of Demands RESOLUTION NO. 13- A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF TEMECULA ALLOWING CERTAIN CLAIMS AND DEMANDS AS SET FORTH IN EXHIBIT A THE CITY COUNCIL OF THE CITY OF TEMECULA DOES HEREBY RESOLVE AS FOLLOWS: Section 1. That the following claims and demands as set forth in Exhibit A, on file in the office of the City Clerk, has been reviewed by the City Manager's Office and that the same are hereby allowed in the amount of $5,689,858.38.. Section 2. The City Clerk shall certify the adoption of this resolution. PASSED, APPROVED, AND ADOPTED by the City Council of the City of Temecula this 22nd day of October, 2013. Michael S. Naggar, Mayor ATTEST: Susan W. Jones, MMC City Clerk [SEAL] STATE OF CALIFORNIA ) COUNTY OF RIVERSIDE ) ss CITY OF TEMECULA ) I, Susan W. Jones, MMC, City Clerk of the City of Temecula, do hereby certify that the foregoing Resolution No. 13- was duly and regularly adopted by the City Council of the City of Temecula at a meeting thereof held on the 22nd day of October, 2013, by the following vote: AYES: COUNCIL MEMBERS: NOES: COUNCIL MEMBERS: ABSENT: COUNCIL MEMBERS: ABSTAIN: COUNCIL MEMBERS: Susan W. Jones, MMC City Clerk CITY OF TEMECULA LIST OF DEMANDS 09/26/2013 TOTAL CHECK RUN $ 3,195,060.74 10/03/2013 TOTAL CHECK RUN 2,080,603.97 09/26/2013 TOTAL PAYROLL RUN: 414,193.67 TOTAL LIST OF DEMANDS FOR 10/222013 COUNCIL MEETING: $ 5,689,858.38 DISBURSEMENTS BY FUND: CHECKS: 001 GENERAL FUND $ 1,871,736.66 135 BUSINESS INCUBATOR RESOURCE 206.28 140 COMMUNITY DEV BLOCK GRANT 1,305.70 165 SARDA AFFORDABLE HOUSING 5,296.23 170 MEASURE A FUND 32,005.00 190 TEMECULA COMMUNITY SERVICES DISTRICT 151,746.91 192 TCSD SERVICE LEVEL B 154.99 194 TCSD SERVICE LEVEL D 1,835.41 196 TCSD SERVICE LEVEL "L" LAKE PARK MAINT. 5,223.00 197 TEMECULA LIBRARY FUND 47,959.94 210 CAPITAL IMPROVEMENT PROJECTS FUND 2,880,729.53 300 INSURANCE FUND 4,611.01 320 INFORMATION TECHNOLOGY 153,949.19 330 SUPPORT SERVICES 19,811.12 340 FACILITIES 52,643.36 375 SUMMER YOUTH EMPLOYMENT PROGRAM 28.06 380 SARDA DEBT SERVICE FUND 1,100.00 501 SERVICE LEVEL"C"ZONE 1 SADDLEWOOD 1,157.56 502 SERVICE LEVEL"C"ZONE 2 WINCHESTER CREEK 1,115.47 503 SERVICE LEVEL"C"ZONE 3 RANCHO HIGHLANDS 59.87 504 SERVICE LEVEL"C"ZONE 4 THE VINEYARDS 227.22 505 SERVICE LEVEL"C"ZONE 5 SIGNET SERIES 1,770.27 506 SERVICE LEVEL"C"ZONE 6 WOODCREST COUNTRY 538.03 507 SERVICE LEVEL"C"ZONE 7 RIDGEVIEW 573.42 508 SERVICE LEVEL"C"ZONE 8 VILLAGE GROVE 4,511.64 509 SERVICE LEVEL"C"ZONE 9 RANCHO SOLANA 96.84 510 SERVICE LEVEL"C"ZONE 10 MARTINIQUE 601.50 511 SERVICE LEVEL"C"ZONE 11 MEADOWVIEW 80.34 512 SERVICE LEVEL"C"ZONE 12 VINTAGE HILLS 5,335.34 513 SERVICE LEVEL"C"ZONE 13 PRESLEY DEVELOP. 4,874.48 514 SERVICE LEVEL"C"ZONE 14 MORRISON HOMES 4,345.80 515 SERVICE LEVEL"C"ZONE 15 BARCLAY ESTATES 243.10 516 SERVICE LEVEL"C"ZONE 16 TRADEWINDS 1,227.66 517 SERVICE LEVEL"C"ZONE 17 MONTE VISTA 65.90 518 SERVICE LEVEL"C"ZONE 18 TEMEKU HILLS 4,113.35 519 SERVICE LEVEL"C"ZONE 19 CHANTEMAR 200.26 520 SERVICE LEVEL"C"ZONE 20 CROWNE HILL 7,156.51 521 SERVICE LEVEL"C"ZONE 21 VAIL RANCH 2,704.44 522 SERVICE LEVEL"C"ZONE 22 SUTTON PLACE 130.15 523 SERVICE LEVEL"C"ZONE 23 PHEASENT RUN 8.16 524 SERVICE LEVEL"C"ZONE 24 HARVESTON 297.73 525 SERVICE LEVEL"C"ZONE 25 SERENA HILLS 1,236.09 526 SERVICE LEVEL"C"ZONE 26 GALLERYTRADITION 87.95 527 SERVICE LEVEL"C"ZONE 27 AVONDALE 1,397.21 528 SERVICE LEVEL"C"ZONE 28 WOLF CREEK 1,041.04 529 SERVICE LEVEL"C"ZONE 29 GALLERY PORTRAIT 124.99 $ 5,275,664.71 CITY OF TEMECULA LIST OF DEMANDS 001 GENERAL FUND $ 254,945.27 140 COMMUNITY DEV BLOCK GRANT 1,695.34 165 SARDA AFFORDABLE HOUSING 5,578.98 190 TEMECULA COMMUNITY SERVICES DISTRICT 103,237.44 192 TCSD SERVICE LEVEL B 240.89 194 TCSD SERVICE LEVEL D 2,192.10 196 TCSD SERVICE LEVEL "L" LAKE PARK MAINT. 480.58 197 TEMECULA LIBRARY FUND 1,366.34 300 INSURANCE FUND 3,999.58 320 INFORMATION TECHNOLOGY 20,563.16 330 SUPPORT SERVICES 7,652.27 340 FACILITIES 9,421.54 375 SUMMER YOUTH EMPLOYMENT PROGRAM 230.74 501 SERVICE LEVEL"C"ZONE 1 SADDLEWOOD 95.13 502 SERVICE LEVEL"C"ZONE 2 WINCHESTER CREEK 63.86 503 SERVICE LEVEL"C"ZONE 3 RANCHO HIGHLANDS 75.61 504 SERVICE LEVEL"C"ZONE 4 THE VINEYARDS 13.80 505 SERVICE LEVEL"C"ZONE 5 SIGNET SERIES 153.67 506 SERVICE LEVEL"C"ZONE 6 WOODCREST COUNTRY 27.87 507 SERVICE LEVEL"C"ZONE 7 RIDGEVIEW 39.48 508 SERVICE LEVEL"C"ZONE 8 VILLAGE GROVE 260.88 509 SERVICE LEVEL"C"ZONE 9 RANCHO SOLANA 2.72 510 SERVICE LEVEL"C"ZONE 10 MARTINIQUE 11.87 511 SERVICE LEVEL"C"ZONE 11 MEADOWVIEW 8.06 512 SERVICE LEVEL"C"ZONE 12 VINTAGE HILLS 174.17 513 SERVICE LEVEL"C"ZONE 13 PRESLEY DEVELOP. 37.15 514 SERVICE LEVEL"C"ZONE 14 MORRISON HOMES 21.51 515 SERVICE LEVEL"C"ZONE 15 BARCLAY ESTATES 18.79 516 SERVICE LEVEL"C"ZONE 16 TRADEWINDS 43.35 517 SERVICE LEVEL"C"ZONE 17 MONTE VISTA 3.73 518 SERVICE LEVEL"C"ZONE 18 TEMEKU HILLS 161.32 519 SERVICE LEVEL"C"ZONE 19 CHANTEMAR 86.36 520 SERVICE LEVEL"C"ZONE 20 CROWNE HILL 234.00 521 SERVICE LEVEL"C"ZONE 21 VAIL RANCH 395.61 522 SERVICE LEVEL"C"ZONE 22 SUTTON PLACE 9.48 523 SERVICE LEVEL"C"ZONE 23 PHEASENT RUN 10.42 524 SERVICE LEVEL"C"ZONE 24 HARVESTON 222.59 525 SERVICE LEVEL"C"ZONE 25 SERENA HILLS 71.71 526 SERVICE LEVEL"C"ZONE 26 GALLERYTRADITION 3.27 527 SERVICE LEVEL"C"ZONE 27 AVONDALE 10.42 528 SERVICE LEVEL"C"ZONE 28 WOLF CREEK 328.16 529 SERVICE LEVEL"C"ZONE 29 GALLERY PORTRAIT 4.45 414,193.67 TOTAL BY FUND: $ 5,689,858.38 apChkLst Final Check List Page: 1 09/26/2013 12:27:41PM CITY OF TEMECULA Bank : union UNION BANK OF CALIFORNIA Check # Date Vendor Description Amount Paid Check Total 2270 09/26/2013 010349 CALIF DEPT OF CHILD SUPPORT PAYMENT: PAYMENT SUPPORT 2273 10/03/2013 000389 NATIONWIDE RETIREMENT OBRA- PROJECT RETIREMENT: SOLUTION PAYMENT 2274 09/26/2013 000194 IC MA RETIREMENT -PLAN I C MA RETIREMENT TRUST 457: 303355 PAYMENT 160599 09/26/2013 013367 ACTIVE MICRO INC misc tools & equip: PW traffic div 1,592.76 1,592.76 3,547.36 3,547.36 5,195.88 5,195.88 135.71 135.71 160600 09/26/2013 001517 AETNA BEHAVIORAL HEALTH, July Employee assistance prgm 664.40 LLC Aug Employee assistance prgm 664.40 Sep Employee assistance prgm 664.40 1,993.20 160601 09/26/2013 003951 ALL AMERICAN ASPHALT STP NTC:THOMAS WHEDON -164,170.00 CONST:PAVE REHAB Aug Const:pavement rehab:ynez rd 1,264,638.48 160602 09/26/2013 014531 ALLEN EMBROIDERY SERVICE embroidery for uniform shirts:B &S Dept 317.52 160603 09/26/2013 016065 AMERICAN DIGITAL CORPORATON July managed information tech svcs 9,000.00 May -Jun ADC eng svcs Sep managed information tech svcs Aug ADC engineering svcs July ADC engineering svcs Aug managed information tech svcs 160604 09/26/2013 007513 ATTAR, AMER ee computer purchase program 160605 09/26/2013 004757 AUTO MALL COLLISION repair to Ford expedition:DC Gallegos CENTER 160606 09/26/2013 009597 BALL, DIANE Reimb:uniforms:code enf 160607 09/26/2013 008868 BANK OF SACRAMENTO retention:pave rehab-r.vista/R.J.Noble 160608 09/26/2013 003215 BARCLAYS LAW PUBLISHERS Title 19 regulation docs: Prevention Title 19 regulation docs: Prevention 160609 09/26/2013 004262 BIO-TOX LABORATORIES DUI & DRUG SCREENINGS:POLICE DUI & drug screenings:Police DUI & drug screenings:Police 1,184.00 9,000.00 814.00 2,969.56 9,000.00 1,343.92 881.17 197.60 45,978.81 154.75 1,100,468.48 317.52 31,967.56 1,343.92 881.17 197.60 45,978.81 27.35 182.10 483.00 2,552.80 771.00 3,806.80 Pagel apChkLst Final Check List Page: 2 09/26/2013 12:27:41PM CITY OF TEMECULA Bank : union UNION BANK OF CALIFORNIA (Continued) Check # Date Vendor Description Amount Paid Check Total 160610 09/26/2013 001035 C R & R INC Sep trash hauling services 160611 09/26/2013 003138 CAL MAT 160612 09/26/2013 004248 CALIF DEPT OF JUSTICE-ACCTING 160613 09/26/2013 000131 CARL WARREN & COMPANY INC 160614 09/26/2013 016064 CDCE, INC. 160615 09/26/2013 005311 CERTIFIED POOL WATER SPCL. asphalt material:citywide street repairs asphalt material:citywide street repairs asphalt material:citywide street repairs Aug DUI & drug screenings:Police Aug Claim adjuster services medical equip supplies: Medics AUG SWIMMING POOL MAINT SVCS:CRC &TES Aug water fountain maint:civic ctr/town AUG FOUNTAIN MAINT SVCS:TOWN SQL decorative fountain maint svcs:civ ctr 160616 09/26/2013 014726 CHAPTER 13 STANDING TRUSTEE PAYROLL DEDUCTION: TRUSTEE PAYMENT 160617 09/26/2013 005585 CHING, MARIA Reimb:uniforms:code enf 160618 09/26/2013 015263 CITY OF EL CAJON san diego emp rel consortium 13/14 160619 09/26/2013 016209 CLASSIC BILLIARD SERVICE, re -felting of 3 pool tables:MPSC LLC 160620 09/26/2013 004405 COMMUNITY HEALTH COMMUNITY H EALTH CHARITIES: CHARITIES PAYMENT 160621 09/26/2013 012401 COMPRESSED AIR breathing air maint: Sta 92 SPECIALTIES INC 160622 09/26/2013 000442 COMPUTER ALERT SYSTEMS Alarm svcs:police old town storefront 160623 09/26/2013 002945 CONSOLIDATED ELECTRICAL DIST. 160624 09/26/2013 013379 COSSOU, CELINE misc electrical supplies: var parks misc electrical supplies: var parks TCSD Instructor Eamings TCSD Instructor Eamings 160625 09/26/2013 001264 COSTCO WHOLESALE supplies: college fair event 9/21 261.01 261.01 162.50 153.03 454.83 770.36 2,030.00 2,030.00 2,299.92 2,299.92 376.40 376.40 1,025.00 550.00 350.00 666.23 2,591.23 182.77 182.77 191.11 191.11 1,700.00 1,700.00 1,334.40 1,334.40 44.00 44.00 1,480.94 1,480.94 75.00 75.00 86.40 77.76 164.16 157.50 122.50 280.00 798.92 798.92 Page2 apChkLst Final Check List Page: 3 09/26/2013 12:27:41PM CITY OF TEMECULA Bank : union UNION BANK OF CALIFORNIA (Continued) Check # Date Vendor 160626 09/26/2013 004192 DOWNS COMMERCIAL FUELING INC 160627 09/26/2013 002390 EASTERN MUNICIPAL WATER DIST Description Amount Paid Check Total Fuel for city vehicles:PW land dev 196.62 Fuel for city vehicles:PW Traffic Fuel for city vehicles:PW CIPAnd dev Fuel for city vehicles:PW, TCSD Fuel for city vehicles:PW Maint Fuel for city vehicles:B & S Dept Fuel for city vehicles:Code Enf, TCSD Fuel for city vehicles:Police 541.08 376.75 2,513.42 1,394.45 472.48 406.42 86.34 Sep water meter:39569 Seraphina Rd 1,389.05 Sep water meter:Murr hot springs rd Sep water meter:Murr hot springs rd Sep water meter:39656 Diego Dr 160628 09/26/2013 013723 ENTECH NORTHWEST INC Aug noise & air quality analysis:arbor 160629 09/26/2013 016313 EYE CARE FOR ANIMALS - Police K-9 eye exam : Astin UPLAND 31.10 158.38 228.25 5,987.56 1,806.78 2,790.00 2,790.00 75.75 75.75 Pages apChkLst Final Check List Page: 4 09/26/2013 12:27:41PM CITY OF TEMECULA Bank : union UNION BANK OF CALIFORNIA Check # Date Vendor 160630 09/26/2013 003347 FIRST BANKCARD CENTER (Continued) Description Amount Paid Check Total 000747 AMERICAN PLANNING PR 2014APA award program 95.00 ASSOCIATION 000175 GOVERNMENT FINANCE JH Finance officers assn:budget doc bk 90.00 OFFICERS 006952 PAYPAL JH verisign pay0ow pro transaction 59.95 000154 C S M F O JH CIP BUDGET APPLICATION FEE 150.00 000154 C S M F O JH AOB BUDGET APPLICATION FEE 150.00 012084 SAFARI BOOKS ONLINE, LLC MH Safari tech book:info tech 299.00 013338 APPLE STORE MH comp equip & supplies:IT, Library 185.12 013338 APPLE STORE MH comp equip & supplies:GB 758.32 008567 GODADDY.COM INC. MH Domain name registration 63.86 008567 GODADDY.COM INC. MH Ping bike trails website 234.46 016351 HCC SPECIALTY MH misc supplies:team pace 109.00 007282 AMAZON.COM, INC KH Books:Library 122.76 005119 ROCKHURSTUNIV KH Rockhurst Univ:seminar 258.00 CONTINUING EDUC 000198 INTL COUNCIL OF SHOPPING AA ICSC annual mbrshp:CD 100.00 006952 PAYPAL KH verisign payfiow pro transaction 50.00 KH admin svc chg 74.82 AA pmt reversal adj 172.69 AA admin svc chg 19.71 015639 REZA CAFE AA refreshments:city attorney mtg 8/27 67.65 015639 REZA CAFE AA refreshments:city attorney mtg 8/27 8.01 002995 MYRON MANUFACTURING AA misc promo items:eco dev 664.39 CORP 015409 UC BERKELEY CALIF PUBLIC SJ traing bk ee pension reform:HR 28.03 014466 REDHAWK PIZZA LLC SJ MEAL:CLOSED COUNCIL MTG 8/27 185.16 011736 TEMECULA TROPHY INC SJ engraving/framing svcs:council 8.10 013338 APPLE STORE KH misc comp equip & supplies 74.52 015247 FAMOUS DAVE'S SJ MEAL:CLOSED COUNCIL MTG 8/13 259.09 001526 MICHAELS STORES INC SJ Commission recognition:supplies 41.96 015356 SMARTY HADA PARTYCOM SJ Commission recognition:supplies 275.31 010321 FINESTATION ERY.COM SJ Commission recognition:supplies 112.40 Page4 apChkLst 09/26/2013 12:27:41PM Final Check List CITY OF TEMECULA Page: 5 Bank : union UNION BANK OF CALIFORNIA Check # Date Vendor 006952 000293 010514 013112 160631 09/26/2013 011145 PAYPAL STADIUM PIZZA INC CAMPINI'S ITALIAN DELI SAN DIEGO VENTURE GROUP FOSTER, JILL CHRISTINE 160632 09/26/2013 002982 FRANCHISE TAX BOARD 160633 09/26/2013 016184 FUN EXPRESS, LLC 160634 09/26/2013 010326 G E MOBILE WATER, INC 160635 09/26/2013 013552 GANDS PRODUCTIONS LLC 160636 09/26/2013 000177 GLENNIES OFFICE PRODUCTS INC 160637 09/26/2013 009608 GOLDEN VALLEY MUSIC SOCIETY 160638 09/26/2013 003792 GRAINGER 160639 09/26/2013 003592 GRANITE CONSTRUCTION COMPANY 160640 09/26/2013 008081 HALL & FOREMAN INC 160641 09/26/2013 001135 HEALTHPOINTE MEDICAL GROUP INC 160642 09/26/2013 010210 HOME DEPOT SUPPLY INC, TH E 160643 09/26/2013 004406 IGOE & COMPANY INC 160644 09/26/2013 011228 INLAND PLANNING AND DESIGN INC (Continued) Description Amount Paid Check Total KH verisign payfiow pro transaction AA summer youth prgm event 8/8 AA refreshments:city attorney mtg 8/13 AA seminar 9/19:eco dev:CW TCSD instructor earnings TCSD instructor earnings TCSD instructor earnings TCSD instructor earnings SUPPORT PAYMENT: PAYMENT MISC SUPPLIES:MPSC MISC SUPPLIES:MPSC MISC SUPPLIES:MPSC water filtration parts: Sta 73 Settlement:Country...Merc 9/21 misc ofc supplies:eco dev Settlement:Italian lyricism 9/7 MISC STAGE SUPPLIES:THEATER MAINT PRESSURE WASHER PART: FOC AUG CONST:MAIN ST BRIDGE REPLACEMENTS AUG ENG/DESIGN SVCS:OT STORM DRAIN Aug Pre -employment physicals:HR Jun misc maint supplies:old town SEP FLEX BENEFIT PLAN PMT AUG CONSULT SVCS:JEFFERSON CORRIDOR 168.80 77.73 77.25 50.00 352.80 200.20 200.20 168.00 138.43 492.78 144.12 122.40 63.73 844.12 109.73 311.50 89.14 87.24 616,904.58 1,250.00 25.00 2,047.68 160.00 5,091.09 921.20 138.43 759.30 63.73 844.12 109.73 311.50 176.38 616,904.58 1,250.00 25.00 2,047.68 160.00 1,100.00 1,100.00 Pages apChkLst Final Check List Page: 6 09/26/2013 12:27:41PM CITY OF TEMECULA Bank : union UNION BANK OF CALIFORNIA (Continued) Check # Date Vendor 160645 09/26/2013 014692 JOHNSON, BARBARA KATH LEEN 160646 09/26/2013 016221 JULIE B QUILTING 160647 09/26/2013 003046 K F R O G 95.1 FM RADIO 160648 09/26/2013 000209 L & M FERTILIZER INC 160649 09/26/2013 012945 LABELLE- MARVIN INC 160650 09/26/2013 016347 LEGGO, NANCY 160651 09/26/2013 004813 M & J PAUL ENTERPRISES INC 160652 09/26/2013 016112 MDE GROUP, INC. 160653 09/26/2013 015259 MERCURY DISPOSAL SYSTEMS, INC. 160654 09/26/2013 015925 MT ZION HOUSE OF PRAYER 160655 09/26/2013 005333 NATIONAL ASSOC CITIZENS -PATROL 160656 09/26/2013 015164 NATURES IMAGE, INC 160657 09/26/2013 014894 OLDTOWN SWEET SHOP 160658 09/26/2013 002105 OLDTOWN TIRE & SERVICE 160659 09/26/2013 002344 OSVOLD, HEIDA 160660 09/26/2013 010338 POOL & ELECTRICAL PRODUCTS INC Description Amount Paid Check Total TCSD Instructor Eamings TCSD Instructor Eamings D EPOSIT:QU ILT COLLECTION EXHIBIT:TVM 7/10-8/30 advertising:hot summer nights equipment maintenance: Sta 73 AUG SLURRY SEAL MATERIAL TESTING refund: Annie: 8570.301 jumpers:hot summer nights 2013 AUG CONST:GOHS TENNIS COURT household battery recycling prgm household battery recycling prgm household battery recycling prgm refund:sec dep:rm rental:MPSC citizen patrol conf:ZacharyCAP 10/5 AUG ENVIRO MITIGATION:FVP OVERCROSSING logo mold:economic development veh maint/repairs:pw parks & facilities VEHICLE REPAIR & MAINT:SENIOR CTR VEHICLE REPAIR & MAINT:SENIOR CTR veh maint/repairs:pw parks & facilities Reimb:uniforms:B&S Dept misc pool supplies/chemicals:var pools 537.60 285.00 1,720.00 1,720.00 143.94 143.94 32,005.00 32,005.00 178.12 178.12 1,246.00 1,246.00 60,492.00 60,492.00 108.68 161.88 160.36 430.92 200.00 200.00 120.00 120.00 1,452.95 1,452.95 401.38 401.38 464.57 143.49 27.51 761.61 1,397.18 49.10 49.10 136.09 136.09 336.00 201.60 285.00 Pages apChkLst Final Check List Page: 7 09/26/2013 12:27:41PM CITY OF TEMECULA Bank : union UNION BANK OF CALIFORNIA (Continued) Check # Date Vendor Description Amount Paid Check Total 160661 09/26/2013 013721 PROP ET DISTRIBUTORS INC PET WASTE BAGS: VARIOUS PARKS 2,586.95 160662 09/26/2013 004457 R J NOBLE COMPANY Aug Const:pavement rehab rancho vista 873,597.35 160663 09/26/2013 000262 RANCHO CALIF WATER Aug var water meters:TCSD & PW 89.59 DISTRICT 160664 09/26/2013 015917 RHAPSODY IN TAPS, INC. 160665 09/26/2013 016335 RIVERA, JACLYN 160666 09/26/2013 000353 RIVERSIDE CO AU DITOR 160667 09/26/2013 012251 ROTH, DONALD J. 160668 09/26/2013 008529 SHERIFFS CIVIL DIV- CENTRAL 160669 09/26/2013 009213 SHERRY BERRY MUSIC 160670 09/26/2013 016346 SHERWOOD, LEANN 160671 09/26/2013 009746 SIGNS BYTOMORROW 160672 09/26/2013 000537 SO CALIF EDISON Aug var water meters Aug various water meters Aug var water meters:TCSD svc lev C Aug var water meters:TCSD svc lev C Aug var water meters:Fire Stns Aug var water meters:TCSD & PW Aug water meter: 29119 Margarita Rd Aug water meter:41951 Moraga Rd Aug var water meter:30875 Rancho vista theater performance 10/4-5 refund:sec dep:rm rental:Harveston Aug parking citation assessments 2,586.95 873,597.35 354.62 2,295.00 23,179.25 24,633.58 534.97 74.81 237.40 1,697.82 453.76 53,550.80 15,000.00 15,000.00 200.00 200.00 6,090.34 6,090.34 TCSD Instructor Eamings 441.00 TCSD Instructor Eamings 378.00 819.00 SUPPORT PAYMENT: PAYMENT 300.00 300.00 Settlement:Jazz at the Merc 9/19 593.00 593.00 refund: terrific tappers: 1920.301 65.00 65.00 public notice posting srvcs:planning 163.95 163.95 Aug 2-28-331-4847:32805 Pauba LS-3 96.35 Aug 2-33-357-5785:44747 Redhawk 33.42 Aug 2-30-099-3847 29721 Ryecrest 25.75 Aug 2-30-296-9522:31035 Rancho vista 352.45 Aug 2-26-887-0789 various mtrs 3,072.23 Aug 2-00-397-5059:33340 Camino piedra 7,899.49 Sep 2-34-624-4452 Stn 95 1,334.66 160673 09/26/2013 001212 SO CALIF GAS COMPANY Aug 015-575-0195-2:32211 Wolfvly rd Aug 055-475-6169-5:PHBSP 112.89 12,814.35 181.55 294.44 Page:7 apChkLst Final Check List Page: 8 09/26/2013 12:27:41PM CITY OF TEMECULA Bank : union UNION BANK OF CALIFORNIA (Continued) Check # Date Vendor Description Amount Paid Check Total 160674 09/26/2013 008337 STAPLES BUSINESS MISC OFC SUPPLIES:POLICE OLD 125.39 ADVANTAGE TOWN MISC OFC SUPPLIES:POLICE MALL OFC 232.04 misc office supplies:police old town 99.42 MISC OFC SUPPLIES:CITY CLERK 64.27 misc office supplies :HR Dept 40.71 misc office supplies :HR Dept 64.12 misc office supplies :H R Dept 11.25 misc office supplies :HR Dept 29.64 misc office supplies:human services 3.77 misc office supplies:human services 219.84 mics office supplies: Theater 45.14 misc office supplies:TCSD Admin 61.73 MISC OFC SUPPLIES:CRC & SKATE PAR 53.20 MISC OFC SUPPLIES:CRC & SKATE PAR 2.87 MISC OFC SUPPLIES:CRC & SKATE PAR 150.63 misc office supplies: Medics 54.41 CREDIT:MISC OFC SUPPLIES:THEATER -19.04 misc office supplies:theater 19.04 credit:misc office supplies:tcsd -8.08 misc office supplies:tcsd 8.08 misc office supplies: Medics 114.15 misc office supplies: Medics 19.05 supplies:children's museum 141.37 misc office supplies:human services 37.80 misc office supplies:human services 4.04 misc office supplies:TCSD Admin 47.97 misc office supplies:TCSD Admin 47.48 misc office supplies:TCSD Admin 37.15 1,707.44 160675 09/26/2013 016284 STEVE ADAMIAK GOLF TCSD instructor earnings 315.00 315.00 INSTRUCTION 160676 09/26/2013 016334 STOKER, JAMILA refund:sec dep:rm rental:Harveston 200.00 200.00 160677 09/26/2013 016165 STRAND, DIANE Sep video production svcs:eco dev 850.00 850.00 160678 09/26/2013 003677 TEMECULA MOTORSPORTS Veh repair&maint:police motorcycles 474.06 474.06 LLC 160679 09/26/2013 010493 TEMECULATOWNE CENTER Oct Lease payment: pd mall ofc 1,458.33 1,458.33 ASSOC LP 160680 09/26/2013 000515 TEMECULA VALLEY CHAMBER 13-141st qtr:operating agrmnt:eco dev 33,750.00 33,750.00 OF Pages apChkLst Final Check List Page: 9 09/26/2013 12:27:41PM CITY OF TEMECULA Bank : union UNION BANK OF CALIFORNIA (Continued) Check # Date Vendor 160681 09/26/2013 010046 TEMECULA VALLEY CONVENTION & 160682 09/26/2013 005970 TEMECULA VALLEY PLAYERS 160683 09/26/2013 016311 TIERCE, NICHOLAS 160684 09/26/2013 010276 TIME WARNER CABLE 160685 09/26/2013 013078 TOROK, LORI A. Description Amount Paid Check Total July'13 Bus. Impry District Asmnts Settlement:Sound of Music 9/15 graphic design services:Theater Sep high speed internet Stn 92 Sep high speed internet:32211 Wolfvly Temecula Presents:dance lectures 127,330.73 12,773.06 127,330.73 12,773.06 3,690.00 3,690.00 49.95 95.48 625.00 145.43 625.00 160686 09/26/2013 000161 TYLER TECHNOLOGIES, INC permitting & land mgmt software 4,500.00 permitting & land mgmt software 82,316.20 86,816.20 160687 09/26/2013 002702 U S POSTAL SERVICE Aug'13 postage meter deposit 3,425.26 3,425.26 160688 09/26/2013 014413 U.S. DEPARTMENT OF US DEPARTMENT OF EDUCATION: 251.10 251.10 EDUCATION PAYMENT 160689 09/26/2013 000325 UNITED WAY UNITED WAY CHARITIES: PAYMENT 160690 09/26/2013 004261 VERIZON 25.00 25.00 Aug xxx-0073 gen usage 110.12 Sep xxx-8165 alarm lines:enterprise cir 98.39 208.51 160691 09/26/2013 004789 VERIZON Sep Internet svcs:Civic Center 289.99 Sep Internet svcs: Library 174.99 Sep Internet svcs:Tem PD DSL 49.99 514.97 160692 09/26/2013 000348 ZIGLER, GAIL Reimb:Halloween carnival supplies 130.92 130.92 999640 09/20/2013 016303 CHAVEZ, BRENDA refund:music for young child:1126.302 69.00 69.00 999641 09/20/2013 016319 DAVIS, RYAN refund:sec dep:rm rental:Harveston 200.00 200.00 999642 09/20/2013 016322 FANTO, KENDRA refund:junior golf clinic:1502.301 130.00 130.00 999643 09/20/2013 016306 KODAMA, SUZANNE refund:music for young child:1126.302 69.00 69.00 999644 09/20/2013 016320 O'BRIEN, DEVA refund:music for toddlers:1125.302 22.40 22.40 999645 09/20/2013 016309 VEGA, EUSTOLIA OROSCO refund:swim lessons: 5201.203 45.00 45.00 Page9 apChkLst Final Check List Page: 10 09/26/2013 12:27:41PM CITY OF TEMECULA Bank : union UNION BANK OF CALIFORNIA (Continued) Check # Date Vendor Description Amount Paid Check Total 999646 09/20/2013 016321 THRIFT, PRESTON refund:sec dep:rm rental:Harveston 999647 09/20/2013 016318 YEHLING, JOY refund: lost mats: library 150.00 150.00 61.95 61.95 Grand total for UNION BANK OF CALIFORNIA: 3,195,060.74 Page:10 apChkLst Final Check List Page: 11 09/26/2013 12:27:41PM CITY OF TEMECULA 105 checks in this report. Grand Total All Checks. 3,195,060.74 Page:11 apChkLst Final Check List Page: 1 10/03/2013 12:49:27PM CITY OF TEMECULA Bank : union UNION BANK OF CALIFORNIA Check # Date Vendor Description Amount Paid Check Total 2271 10/03/2013 000444 INSTATAX (EDD) STATE DISABILITY INS PAYMENT 21,713.48 21,713.48 2272 10/03/2013 000283 INSTATAX (IRS) FEDERAL INCOME TAXES PAYMENT 76,922.30 76,922.30 2275 10/03/2013 001065 NATIONWIDE RETIREMENT NATIONWIDE RETIREMENT PAYMENT 11,914.01 11,914.01 SOLUTION 2276 10/03/2013 000246 PERS (EMPLOYEES' PERS ER PAID MEMBER CONTR 143,920.87 143,920.87 RETIREMENT) PAYMENT 160693 10/03/2013 000733 ABBEY PARTY RENTS rental equip:high hopes prgrm 723.65 723.65 160694 10/03/2013 015083 AIR GAS USA, LLC misc stage supplies: Theater 25.53 25.53 160695 10/03/2013 014695 ALL AMERICAN BICYCLE MAINT:TEMECULA POLICE 6.48 6.48 MOTORSPORTS, INC 160696 10/03/2013 006915 ALLIES PARTY EQUIPMENT RENTAL EQUIPMENT:COLLEGE FAIR 9/21 EQUIP RENTAL:HOT SUMMER NIGHTS 8. rental equip:MPSC anniversary event 160697 10/03/2013 004422 AMERICAN BATTERY signal batteries:pw traffic div CORPORATION 160698 10/03/2013 004240 AMERICAN FORENSIC NURSES OCT STAND BY FEE:POLICE (AFN) 160699 10/03/2013 014235 AND ALL THAT JAZZ TCSD Instructor Eamings TCSD Instructor Eamings 4,127.00 485.76 131.67 481.68 4,744.43 481.68 1,248.00 1,248.00 318.50 409.50 160700 10/03/2013 013950 AQUA CHILL OF SAN DIEGO water filter sys maint:fnance 27.00 drinking water sys:senior center 33.48 drinking sys maint:civ ctr/senior ctr 176.04 160701 10/03/2013 004307 ARCH CHEMICALS, INC. WATER MAINT SVCS:HARV 3,900.00 LAKE/DUCK POND 160702 10/03/2013 011954 BAKER &TAYLOR INC Books:Library Books:Library Books:Library 160703 10/03/2013 015592 BAMM PROMOTIONAL staff uniforms:IT Dept PRODUCTS, INC 160704 10/03/2013 013482 BAS SECURITY Sep security:harveston lake park 728.00 236.52 3,900.00 2,278.60 1,265.20 371.21 3,915.01 977.77 977.77 1,428.00 1,428.00 Pagel apChkLst Final Check List Page: 2 10/03/2013 12:49:27PM CITY OF TEMECULA Bank : union UNION BANK OF CALIFORNIA (Continued) Check # Date Vendor 160705 10/03/2013 004040 BIG FOOT GRAPHICS 160706 10/03/2013 014284 BLAKELYS TRUCK SERVICE Description Amount Paid Check Total TCSD instructor earnings TCSD instructor earnings TCSD instructor earnings veh repairs & maint: pw street maint veh repairs & maint: pw street maint veh repairs & maint: pw street maint 160707 10/03/2013 003455 BROADCAST MUSIC INC annual music license fee 378.00 280.00 693.00 454.30 264.00 57.18 1,351.00 775.48 783.00 783.00 160708 10/03/2013 004462 C D W GOVERNMENT INC misc supplies:info tech 729.00 small tools & equip: library 763.71 WIFI ACCESS POINTS: FIRE STN 95 554.56 WIFI ACCESS POINTS: FIRE STN 95 674.15 2,721.42 160709 10/03/2013 003138 CAL MAT asphalt material:citywide street repairs 453.34 453.34 160710 10/03/2013 014273 CALIFORNIA PROPERTY Jun relocation services:PW CIP div 1,575.00 1,575.00 160711 10/03/2013 010514 CAMPINI'S ITALIAN DELI refreshments:Teen CERT class 10/6 282.75 282.75 160712 10/03/2013 004971 CANON FINANCIAL SERVICES, OCT COPIER LEASES:CIVIC CENTER 3,004.54 3,004.54 INC 160713 10/03/2013 016354 CARIS, JULIE reimb:health & wellness fair supplies 359.89 359.89 160714 10/03/2013 000912 CITY CLERKS ASSN OF CALIF CCAC wkshp 10/24-25:ER, JD 400.00 400.00 160715 10/03/2013 003997 COAST RECREATION INC PLAYGROUND EQUIP PARTS:VAR 1,699.40 1,699.40 PARKS 160716 10/03/2013 013379 COSSOU, CELINE TCSD Instructor Eamings 171.50 TCSD Instructor Eamings 220.50 392.00 160717 10/03/2013 001264 COSTCO WHOLESALE MISC SUPPLIES:HUMAN SVCS DIV 286.12 MISC SUPPLIES:HUMAN SVCS DIV 285.31 571.43 160718 10/03/2013 016208 CREATIVE MAD SYSTEMS, INC. MATERIALS:C. MUSEUM EXHIBIT 4,500.00 4,500.00 160719 10/03/2013 011870 CRIME SCENE STERI-CLEAN, TRAUMA CLEAN UP 750.00 750.00 LLC SVC:PD:#TE132580133 160720 10/03/2013 014364 CUNNINGHAM, GRISELDA TCSD Instructor Eamings 140.00 140.00 CLEMENTINA Page2 apChkLst Final Check List Page: 3 10/03/2013 12:49:27PM CITY OF TEMECULA Bank : union UNION BANK OF CALIFORNIA (Continued) Check # Date Vendor Description Amount Paid Check Total 160721 10/03/2013 001393 DATA TICKET, INC. AUG PARKING CITATION PROCESSING:POLICE 160722 10/03/2013 002990 DAVID TURCH &ASSOCIATES AUG-SEP FED. LEGISLATIVE CONSULT:CM 160723 10/03/2013 002528 EAGLE GRAPHIC CREATIONS personalized awards:eco dev INC 160724 10/03/2013 004829 ELLISON WILSON ADVOCACY OCT STATE LEGIS CONSULTING LLC SVCS:CM 160725 10/03/2013 011202 EMH SPORTS USA, INC TCSD instructor earnings TCSD instructor earnings TCSD instructor earnings 1,572.35 1,572.35 7,000.00 7,000.00 131.76 131.76 3,500.00 3,500.00 154.00 294.00 392.00 840.00 Pages apChkLst Final Check List Page: 4 10/03/2013 12:49:27PM CITY OF TEMECULA Bank : union UNION BANK OF CALIFORNIA (Continued) Check # Date Vendor 160726 10/03/2013 001056 EXCEL LANDSCAPE INC Description Amount Paid Check Total misc landscape maint svcs: var parks irrigation repair svcs: vail ranch slope irrigation repairs: vail ranch slope misc landscape maint svcs: var parks irrigation repair: vintage hills slope misc landscape maint svcs: var parks irrigation repair: vintage hills slope misc landscape maint svcs: var parks irrigation repair: wolf creek slope irrigation repair: mirada slope misc landscape maint svcs: var parks misc landscape maint svcs: var parks irrigation repair: saddlewood slope misc landscape maint svcs: var parks misc landscape maint svcs: var parks IRRIGATION REPAIR SVCS:VAIL RANCH misc landscape maint svcs: var parks misc landscape maint svcs: var parks misc landscape maint svcs: var parks irrigation repair srvcs: villages slope irrigation repair svcs: villages slope irrigation repair svcs: tradewinds slope misc landscape maint svcs: var parks irrigation repair:winchester creek slope misc landscape maint srvcs: var parks misc landscape maint svcs: var parks misc landscape maint svcs: var parks misc landscape maint svcs: var parks irrigation repair svcs: vail ranch slope irrigation repair svcs: vail ranch slope irrigation repairs: vail ranch slope misc landscape maint svcs: var parks irrigation repair svcs: villages slope irrigation repair:vintage hills slope IRRIGATION REPAIR SVCS:VAIL RANCH misc landscape maint svcs: var parks irrigation repair: martinique slope IRRIGATION REPAIR SVCS:VAIL RANCH irrigation repair: harveston slope irrigation repair: villages slope misc landscape maint svcs: var parks irrigation repair srvcs: wolf creek irrigation repair: overland training ctr 160727 10/03/2013 000165 FEDERAL EXPRESS INC Sep Express mail services Jul -Sep Express mail services 221.72 263.86 221.72 112.41 397.99 322.05 324.72 407.72 412.65 236.89 382.34 157.32 108.85 330.48 259.18 336.74 357.00 143.90 104.40 339.43 262.79 124.38 479.90 112.72 221.53 261.24 53.16 100.98 221.72 100.03 221.72 255.68 332.03 305.64 320.96 409.85 195.99 221.72 121.46 236.22 418.72 307.01 167.33 65.85 10,894.15 140.27 206.12 Page4 apChkLst Final Check List Page: 5 10/03/2013 12:49:27PM CITY OF TEMECULA Bank : union UNION BANK OF CALIFORNIA (Continued) Check # Date Vendor 160728 10/03/2013 009097 FULL COMPASS SYSTEMS 160729 10/03/2013 003946 GT ENTERTAINMENT Description Amount Paid Check Total soundAighting/misc supplies:theater BALLOON DECORATIONS:WELLN ESS FAIR 9/28 160730 10/03/2013 013076 GAUDET, YVONNE M. TCSD instructor earnings 160731 10/03/2013 015451 GREATAMERICA FINANCIAL SVCS 160732 10/03/2013 014402 GROEPPER, BROOKE ELIZABETH OCT COPIER LEASES:CIVIC CENTER, TVE2 OCT COPIER LEASES:CIVIC CENTER, T\ Oct copier leases:civic center, TVE2 446.00 446.00 150.00 150.00 215.60 215.60 1,341.70 520.09 289.44 2,151.23 TCSD instructor earnings 154.00 TCSD instructor earnings TCSD instructor earnings TCSD instructor earnings 1,108.80 714.00 2,268.00 4,244.80 160733 10/03/2013 016361 GUERRERO, MARIA refund:sec dep:rm rental:CRC 200.00 200.00 160734 10/03/2013 016356 HALL, CYNTHIA E refund:sec dep:rm rental:Harveston 200.00 200.00 160735 10/03/2013 000186 HANKS HARDWARE INC misc hardware supplies:sports prgm 2.32 2.32 160736 10/03/2013 004188 HARRIS&ASSOCIATES AUG CONST MGMT SVCS:FV 171,685.49 171,685.49 INTERCHG 160737 10/03/2013 004811 HEWLETT PACKARD printers:server for Library:IT 404.20 404.20 160738 10/03/2013 013695 INLAND EMPIRE SHRED IT 160739 10/03/2013 006914 INNOVATIVE DOCUMENT SOLUTIONS 160740 10/03/2013 001407 INTER VALLEY POOL SUPPLY INC 160741 10/03/2013 003296 INTL CODE COUNCIL shred services:Police 9/16 15.00 shred services:Police 9/9 15.00 shred services:records division 60.00 shred services:records division 15.00 shred services:records division 16.73 121.73 AUG COPIER 708.50 MAINT/REPAIR/USAGE:CITYW ID E AUG COPIER MAINT/REPAIR/USAGE:CIT 5,118.23 5,826.73 pool supplies: var swimming pools 802.84 pool supplies: var swimming pools 663.94 1,466.78 2013 code books: Prevention 226.83 226.83 160742 10/03/2013 003266 IRON MOUNTAIN OFFSITE offsite media storage:records 557.79 557.79 Pages apChkLst Final Check List Page: 6 10/03/2013 12:49:27PM CITY OF TEMECULA Bank : union UNION BANK OF CALIFORNIA (Continued) Check # Date Vendor Description Amount Paid Check Total 160743 10/03/2013 001186 IRWIN, JOHN TCSD instructor earnings 235.20 235.20 160744 10/03/2013 012285 JOHNSTONE SUPPLY HVAC SUMP PUMPS: CIVIC CENTER 920.19 920.19 160745 10/03/2013 003046 K F R 0 G 95.1 FM RADIO 8/26-9/01 advertising:hot summer nights 250.00 250.00 160746 10/03/2013 015081 KIDD BIOLOGICAL, INC Consulting svcs:NFCU project 5,250.00 5,250.00 160747 10/03/2013 000209 L & M FERTILIZER INC misc small tool parts: erosion control 720.04 misc small tool parts: erosion control 230.43 950.47 160748 10/03/2013 001085 L N CURTIS & SONS Fire rescue equip supplies 29.16 29.16 160749 10/03/2013 007188 LAERDAL MEDICAL CORP. 160750 10/03/2013 014817 LAPP, JEREMY SCOTT 160751 10/03/2013 016363 LIBRADO, KRISTEN 160752 10/03/2013 003726 LIFE ASSIST INC 160753 10/03/2013 014228 LSK, LLC 160754 10/03/2013 013982 MCI COMM SERVICE 160755 10/03/2013 003782 MAIN STREET SIGNS CPR Class supplies: Medics 487.08 CPR Class supplies: Medics Settlement:Cabaret...Merc 9/29 refund:sec dep:rm rental:Harveston emergency medical supplies: Medics OCT FACILITY LEASE PMT:HARVESTON Sep xxx-0346 general usage Sep xxx-0714 gen usage:PD mall alarm misc street signs: pw street maint div misc street signs: pw street maint div misc street signs: pw street maint div misc street signs: pw street maint div 160756 10/03/2013 015955 METRO FIRE & SAFETY, INC. REPLACE NON COMPLIANT FIRE SUPPRES.:CRC 160757 10/03/2013 016358 METRO PCS refund: conditional use permits 160758 10/03/2013 007669 MILES, KATRINA 160759 10/03/2013 012962 MILLER, MISTY TCSD Instructor Eamings TCSD Instructor Eamings TCSD Instructor Eamings 178.20 665.28 723.00 723.00 150.00 150.00 437.79 437.79 4,993.56 4,993.56 30.34 31.09 61.43 81.00 2,863.89 295.92 140.40 1,550.00 1,325.50 3,381.21 1,550.00 1,325.50 87.50 87.50 367.50 294.00 661.50 Pages apChkLst 10/03/2013 12:49:27PM Final Check List CITY OF TEMECULA Page: 7 Bank : union UNION BANK OF CALIFORNIA Check # Date Vendor 160760 10/03/2013 001986 MUZAK LLC 160761 10/03/2013 002925 NAPAAUTO PARTS 160762 10/03/2013 016360 NEBSHAU INC 160763 10/03/2013 008820 NEIGHBORS NEWSPAPER 160764 10/03/2013 006721 OFFICEMAX NORTH AMERICA, INC. 160765 10/03/2013 002105 OLD TOWN TIRE & SERVICE 160766 10/03/2013 002105 OLD TOWN TIRE & SERVICE 160767 10/03/2013 002105 OLD TOWN TIRE & SERVICE 160768 10/03/2013 013198 ORTENZO-HAYES, KRISTINE 160769 10/03/2013 004538 PAU LEY EQUIPMENT COMPANY 160770 10/03/2013 002354 POSITIVE PROMOTIONS INC 160771 10/03/2013 003155 PRICE CHOPPER INC 160772 10/03/2013 016362 PRIME CARE OF TEMECULA INC 160773 10/03/2013 014494 R & R CONTROLS, INC 160774 10/03/2013 002072 RANCHO CALIF WATER DIST-FEES 160775 10/03/2013 000947 RANCHO REPROGRAPHICS (Continued) Description Amount Paid Check Total Oct dish network programing:foc Oct dish network programing:foc misc veh parts/supplies:pw street maint refund: sprinkler permits advertising:quilt show 2013 COPY PAPER: CENTRAL SERVICES City Vehicle Maint Svcs:PW Parks Maint City Vehicle Maint Svcs:TCSD City Vehicle Maint Svcs:PW Parks Maint City Vehicle Maint Svcs:PW Street Maint City Vehicle Maint Svcs:PW Parks Maint CITY VEHICLE MAINT SVCS:FIRE PREV TCSD Instructor Eamings TCSD Instructor Eamings TCSD Instructor Eamings TCSD Instructor Eamings TCSD Instructor Eamings TCSD Instructor Eamings Equipment rental:code enforce 7/4 Educational handouts: Medics Wristbands:csd special events refund:sec dep:rm rental:CRC hvac energy control upgrades:var sites Plan ck deposit:F.V. Pkwy Intrchg REPROGRAPH IC SRVCVS:PAVE REHAB Reproduction srvcs:butterfield rd ext 55.00 128.31 66.94 359.00 250.00 4,318.27 460.07 37.34 535.72 88.43 143.35 80.00 877.80 485.80 399.00 877.80 882.00 763.00 192.50 95.90 68.48 200.00 756.00 500.00 48.60 183.31 66.94 359.00 250.00 4,318.27 1,033.13 231.78 80.00 4,285.40 192.50 95.90 68.48 200.00 756.00 500.00 10.80 59.40 Page:7 apChkLst Final Check List Page: 8 10/03/2013 12:49:27PM CITY OF TEMECULA Bank : union UNION BANK OF CALIFORNIA (Continued) Check # Date Vendor Description Amount Paid Check Total 160776 10/03/2013 000418 RIVERSIDE CO CLERK & ntc/determination:Mrr Crk Bridge-Ovrind 50.00 50.00 RECORDER 160777 10/03/2013 014027 RIVERSIDE CO ECO DEV Jul-Sept'13 staffing:library 41,860.00 41,860.00 AGENCY 160778 10/03/2013 000411 RIVERSIDE CO FLOOD Inspection deposit:Main Street Bridge 1,000.00 1,000.00 CONTROL 160779 10/03/2013 000406 RIVERSIDE CO SHERIFFS Salute to Heroes 9/14 patrol srvcs 853.32 DEPT 7/1-24/13 law enforcement 1,328,817.57 1,329,670.89 160780 10/03/2013 001365 RIVERSIDE COUNTY OF RENEW PERMIT: CRC 674.00 674.00 160781 10/03/2013 000220 ROBINSON PRINTING & CREATIVE AOB tab dividers:finance dept 525.96 Print & prep budget docs:finance dept 208.44 CIP tab dividers:finance dept 527.04 1,261.44 160782 10/03/2013 001048 ROSAS CANTINA RESTAURANT Refreshments:teen CERT class 10/5 270.13 270.13 160783 10/03/2013 012251 ROTH, DONALD J. TCSD Instructor Eamings 157.50 157.50 160784 10/03/2013 002226 RUSSO, MARYANNE TCSD Instructor Eamings 423.50 TCSD Instructor Eamings 415.80 839.30 160785 10/03/2013 013651 SAN DIEGO DAILY Advertising:economic development 6,000.00 6,000.00 TRANSCRIPT 160786 10/03/2013 000278 SAN DIEGO UNION TRIBUNE 8/29/13-8/28/14 subscr:Pln 3486456 180.92 180.92 160787 10/03/2013 009213 SHERRY BERRY MUSIC Jazz © the Merc 9/26 1,008.00 1,008.00 160788 10/03/2013 000645 SMART & FINAL INC Supplies: college fair event 9/21 Supplies: college fair event 9/21 Supplies:High Hopes Program Supplies:Mary Phillips Senior Center Supplies:Mary Phillips Senior Center 629.51 32.92 59.99 78.35 327.10 1,127.87 Pages apChkLst Final Check List Page: 9 10/03/2013 12:49:27PM CITY OF TEMECULA Bank : union UNION BANK OF CALIFORNIA (Continued) Check # Date Vendor 160789 10/03/2013 000537 SO CALIF EDISON Description Amount Paid Check Total Sep 2-27-371-8494:42189 Winchester 42.99 Sep 2-29-953-8082:31523 Wolf vly rd 31.42 Sep 2-30-520-4414:32781 Tem pkwy LS3 952.36 Sep 2-35-074-2847:27495 Enterprise cir w 43.14 Sep 2-19-171-8568:28300 Mercedes St 114.73 Sep 2-18-937-3152:28314 Mercedes 1,266.12 Sep 2-02-351-4946:41845 6th St 2,946.31 Sep 2-29-807-1093:28079 Diaz rd PED 26.41 Sep 2-29-657-2787:41638 Winchester 25.75 Sep 2-29-223-8607:42035 2nd St PED 758.98 Sep 2-31-536-3655:41904 Main St 1,427.38 Sep 2-31-419-2873:43000 Hwy-395 25.58 Sep 2-31-536-3481:41902 Main St 237.74 Sep 2-31-031-2616:27991 Diaz rd PED 26.74 Sep 2-31-282-0665:27407 Diaz rd PED 26.91 Sep 2-34-333-3589:41702 Main St 26.82 Sep 2-35-664-9053:29119 Margarita Rd 461.17 Sep 2-31-912-7494:28690 Mercedes St 1,893.24 Sep 2-35-421-126041955 4th St LS3 19.18 Sep 2-31-031-2616:27991 Diaz rd PED 30.09 Sep 2-25-393-4681:41951 Moraga Rd 867.16 Sep 2-21-981-4720:30153 Tem pkwy tpp 21.77 Sep 2-35-707-0010:33451 s hwy 79 Ped 53.66 Sep 2-35-164-3770:43487 Butterfield stg 28.24 Sep 2-35-164-3663:42335 Meadows pkwy 26.24 Sep 2-35-164-3515:32932 Leena way 26.24 Sep 2-35-164-3242:44270 Meadows pkwy 27.24 Aug 2-29-807-1226:28077 Diaz rd PED 26.57 Sep 2-00-397-5042:43200 bus pk dr #1 4,350.91 Sep 2-32-903-8293:41000 Main St 34,036.76 Aug 2-35-403-6337:41375 McCabe Ct 279.26 Sep 2-28-904-7706:32329 Overland LS3 138.85 Aug 2-31-693-9784:26036 Ynez TC1 481.16 Sep 2-29-933-3831:43230 Bus pk dr 2,606.77 Sep 2-14-204-1615:30027 Front st rdio 55.57 Sep 2-29-224-0173:various fire stns 3,234.59 Sep 2-29-295-3510:32211 Wolf vly rd 2,020.14 Sep 2-31-536-3226:28690 Mercedes 2,296.42 60,960.61 Page9 apChkLst Final Check List Page: 10 10/03/2013 12:49:27PM CITY OF TEMECULA Bank : union UNION BANK OF CALIFORNIA (Continued) Check # Date Vendor 160790 10/03/2013 001212 SO CALIF GAS COMPANY Description Amount Paid Check Total Sep 028-025-1468-3:41375 McCabe Ct Sep 101-525-0950-0:28816 Pujol St Sep 101-525-1560-6:27415 Enterprise cir Sep 095-167-7907-2:30650 Pauba Rd Sep 117-188-6393-6:32131 S Loop rd Sep 055-461-2483-4:40135 Village rd Sep 091-085-1632-0:41951 Moraga rd Sep 021-725-0775-4:Senior Center Aug 125-244-2108-3:Library Sep 129-535-4236-7:Civic Center Line Extension: 28922 Pujol St Sep 181-383-8881-6:Museum Sep 196-025-0344-3:42081 Main Sep 129-582-9784-3:43230 Bus pk dr Sep 133-040-7373-0:Maint Fac Sep 091-024-9300-5:30875 Rancho Sep 026-671-2909-8:Comm Theater 160791 10/03/2013 014783 SOFTRESOURCES, LLC AUG CONSULTANTSRVCS:NEW PERMIT SYS 19.62 22.54 60.26 126.39 49.55 21.56 396.97 71.95 14.79 742.77 591.94 18.67 0.97 35.14 18.67 207.62 22.54 2,421.95 4,550.00 4,550.00 160792 10/03/2013 002503 SOUTH COAST AIR QUALITY FY13/14 emissions fee:stn 84 117.87 FY 13/14 operating fee:stn 84 160793 10/03/2013 006145 STENO SOLUTIONS Aug transcription srvcs:Police TRANSCRIPTION 160794 10/03/2013 016284 STEVE ADAMIAK GOLF TCSD instructor earnings INSTRUCTION 160795 10/03/2013 001546 STRAIGHT LINE GLASS replace pool deck window: ymca 160796 10/03/2013 016352 SUNSHINE HOT DOGS refreshments:TVHS kickoff event 10/18 160797 10/03/2013 013387 SWEEPING UNLIMITED INC Sept sweeping srvcs: parking garage 160798 10/03/2013 011897 TAG/AMS INC Aug DOT random drug testing - HR 160799 10/03/2013 010046 TEMECULA VALLEY FY13/14 operating agmint:eco dev CONVENTION & 160800 10/03/2013 000919 TEMECULA VALLEY UNIFIED TVHS AVID College Excursion Transprt SCHOOL 160801 10/03/2013 010276 TIME WARNER CABLE Oct high speed intemet:civic center 93.74 211.61 681.52 681.52 159.60 159.60 575.25 575.25 200.00 200.00 500.00 500.00 130.00 130.00 45,000.00 45,000.00 500.00 500.00 4,279.22 4,279.22 Page:10 apChkLst Final Check List Page: 11 10/03/2013 12:49:27PM CITY OF TEMECULA Bank : union UNION BANK OF CALIFORNIA (Continued) Check # Date Vendor Description Amount Paid Check Total 160802 10/03/2013 000668 TIMMY D PRODUCTIONS INC DJ & sound srvcs: 9/11 remembrance 2,675.00 2,675.00 160803 10/03/2013 016357 TREMBLAY,, MICHAEL refund: inspection fees 317.00 317.00 160804 10/03/2013 001561 USA MOBILITY WIRELESS INC Sept -Dec paging/rental svcs:PW 95.09 95.09 160805 10/03/2013 004261 VERIZON Sep xxx-5072 general usage 1,880.62 Sep xxx-0074 general usage 2,914.36 Sep xxx-2886 gen usage:Harveston 115.74 Sep xxx-8625 gen usage:Civic Center 98.39 5,009.11 160806 10/03/2013 014486 VERIZON WIRELESS 9/16-10/15 Broadband usage:City 1,107.73 1,107.73 160807 10/03/2013 012292 VIAMEDIA INC Jul advertising:Hot Summer Nights 1,509.00 Aug advertising:Hot Summer Nights 2,012.00 3,521.00 160808 10/03/2013 010283 W B PRODUCTIONS INC Timing srvcs:FIT pgrm finale event 9/8 3,358.75 3,358.75 160809 10/03/2013 006248 WALKER, JESSICA TCSD Instructor Eamings 332.50 332.50 160810 10/03/2013 003730 WEST COASTARBORISTS INC tree trims/removals: var parks & medians 1,190.00 EMERG TREE TRIMS & REMOVALS: VAR 1,302.00 TREE TRIM MAINT SRVCS: CITY RIGHT-( 4,104.00 tree trims/removals: var parks & medians 294.00 tree trims & removals: mirada slope 3,437.00 tree trims & removals: signet series 1,106.00 tree trims & removals: vintage hills 897.00 tree trims & removals: vail ranch slope 483.00 tree trims & removals: presley slope 4,845.00 17,658.00 160811 10/03/2013 016359 WEST COAST SPORTS GROUP refund: conditional use permits 1,684.00 1,684.00 LLC 160812 10/03/2013 006290 WOODCREST VEHICLE Veh repair & maint:temecula police 308.40 308.40 CENTER 160813 10/03/2013 000348 ZIGLER, GAIL Reimb:cancer awareness event supplies 135.02 135.02 999648 09/25/2013 016344 ATVVOOD, LINDA refund: preschool gymastic:1720.301 60.80 60.80 999649 09/25/2013 016345 DOWNING, JOSHUA refund: terrific tappers: 1920.301 65.00 65.00 Page:11 apChkLst Final Check List Page: 12 10/03/2013 12:49:27PM CITY OF TEMECULA Bank : union UNION BANK OF CALIFORNIA (Continued) Check # Date Vendor Description Amount Paid Check Total 999650 09/25/2013 016341 GRIFFITHS, MARY refund: tiny tumble: 1900.301 65.00 65.00 999651 09/25/2013 016343 HAYES, SALEENA refund: terrific tappers: 1925.301 65.00 65.00 999652 09/25/2013 016336 MARTINEZ, JOSE TRINIDAD refund:sec dep:rm rental:Harveston 200.00 200.00 999653 09/25/2013 016342 PADOR, ARDEN refund: terrific tappers: 1925.301 65.00 65.00 999654 09/25/2013 016337 SCHMIDT, RICHEL LE refund:sec dep:rm rental:Harveston 200.00 200.00 999655 09/25/2013 016338 WESTLAKE, CAROLE refund: tour&cooking class: 1010.301 40.00 40.00 999656 09/25/2013 016339 WILLIAMS, VERONICA refund: tots-n-pots: 1360.301 35.00 35.00 999657 09/25/2013 016340 ZARAGOZA, HEATHER refund: tiny tumble: 1900.301 65.00 65.00 999658 09/27/2013 016349 BASCO, KAREN refund: shalloww/a: 3955.302 91.00 91.00 999659 09/27/2013 016348 CONWAY, STEVEN refund: broadwary bound: 1775.301 56.00 56.00 999660 09/27/2013 016350 RATOWSKI, KRISTIN refund: soccer skills: 2202.303 84.00 84.00 Grand total for UNION BANK OF CALIFORNIA: 2,080,603.97 Page:12 apChkLst Final Check List Page: 13 10/03/2013 12:49:27PM CITY OF TEMECULA 138 checks in this report. Grand Total All Checks. 2,080,603.97 Page:13 Item No. 4 Approvals City Attorney Finance Director City Manager CITY OF TEMECULA AGENDA REPORT TO: City Manager/City Council FROM: Susan W. Jones, City Clerk DATE: October 22, 2013 SUBJECT: Meeting Schedule for City Council Meetings for the month of December 2013 RECOMMENDATION: Direct the City Clerk to cancel the December 24, 2013 City Council Meeting and perform the appropriate postings and noticing requirements of the Government Code. BACKGROUND: Since the regularly scheduled second meeting in December falls on Christmas Eve, December 24, 2013, it is proposed that this meeting be cancelled. FISCAL IMPACT: None ATTACHMENTS: None Item No. 5 Approvals City Attorney Finance Director City Manager CITY OF TEMECULA AGENDA REPORT TO: City Manager/City Council FROM: Greg Butler, Assistant City Manager DATE: October 22, 2013 SUBJECT: Memorandum of Understanding — Labor Agreement RECOMMENDATION: Approve a three-year Memorandum of Understanding (MOU) Labor Agreement, in substantially the form attached hereto, effective July 1, 2013 through June 30, 2016, between the City and the general employees represented by the California Teamsters Public, Professional, and Medical Employees Union Local 911. BACKGROUND: City staff and the general employees, represented by the California Teamsters Local 911, have reached an agreement on a three-year MOU. This three- year MOU will sustain a positive working environment for our employees, which translates into maintaining the highest level of public services that our City residents have come to expect. The main terms of this agreement are as follows: 1. No cost -of -living increases during the three-year term of this agreement. 2. Effective upon Ratification of the MOU, employees will receive a 1% wage increase and pay 1 % of the Public Employee Retirement System (PERS) member contribution. Effective July 1, 2014 employees will receive a 1% wage increase and shall pay an additional 1% of the PERS member contribution for a total of 2%. Effective July 1, 2015 employees will receive a 1% wage increase and shall pay an additional 1 % of the PERS member contribution for a total of 3%. 3. Effective January 1, 2014 increase the contribution toward employee healthcare insurance costs by $75. 4. Increase the Special Merit Pay by $50; which is an effort to recognize and reward employees with sustained superior performance. 5. Establish a one time longevity bonus for those employees that complete 25-years of service with the City. ($1000) 6. Establish a 5% shift differential pay rate for employees required to work split shifts. 7. Conversion of an existing Wellness Reimbursement benefit to an equivalent monthly contribution toward employee healthcare insurance costs ($33/month). 8. The City has also agreed to complete the update of the job classification study and specifications; and review the employee's compensation package twice during the term of this MOU but no financial commitments have been made other than to revisit this issue. In addition to the economic items noted above, the labor negotiation team also reached agreement on numerous other non -economic items ranging from legally mandated language related to the recently adopted Public Employment Pension Reform Act of 2012, (PEPRA) to clarifying the definition of a workweek. FISCAL IMPACT: As is shown in the summary of estimated costs table below there is a minor impact to the City's operating budget in the current fiscal year which is reflected under the MOU year 1 column. Any necessary adjustments to the current year's operating budget will be included with the annual mid -year budget adjustments. Costs associated with Years 2 and 3 of the MOU will be included in future fiscal year operating budgets. MOU Year 1 % Wage Increase 1 % Employee PERS Pickup each year $75 Cafeteria Plan Increase Effective 1/1/14 $50 Special Merit Pay Increase* 25-Year Longevity Pay 5% Shift Differential Pay* Wellness Allowance Converted to Cafeteria (existing budgeted benefit except for 18 positions) SUB -TOTAL Economic Re -Opener" TOTAL Estimated Costs, actual costs likely to be lower ** Future Discretion ESTIMATED COSTS 1 2 3 $36,026 $95,078 $141,618 $76,500 $153,000 $153,000 $7,850* $7,850* $7,850* $0 $5,000 $3,000 $29,270* $29,270* $29,270* $7,200 $7,200 $7,200 $156,846 $297,398 $341,938 $0 $0" $0" $156,846 $297,398 $341,938 ATTACHMENTS: Memorandum of Understanding 1989 v-�, iovs♦'4EVO' MEMORANDUM OF UNDERSTANDING (M.G.U) Between the City of Temecula and the General Employees of the City of Temecula Effective July 1, 2013 Table of Contents Foreword 5 Preamble 5 Article 1 Recognition 5 Article 2 Implementation 5 Article 3 Term 5 Article 4 Authorized Agents 5 4.1 City's Authorized Agent 6 4.2 General Employees Authorized Agent 6 Article 5 City Rights 6 Article 6 Employee Rights 6 Article 7 Union Rights 6 7.1 Agency Shop 6 Union Dues/Agency Fee Collection 7 New Hire Notification 7 Failure to Pay Dues/Fees 7 Religious Exemption 8 Records 8 Rescission of Agreement 8 Indemnification 8 7.2 Bulletin Boards 9 7.3 Union Roster 9 7.4 Employee Representatives 9 7.5 Dues Check offs 9 Article 8 Personnel Files 10 8.1 Derogatory Material 10 8.2 Derogatory Material on File 10 8.3 Customer/Citizen Letters of Commendation 10 Article 9 Seniority 10 Article 10 Compensation Adjustments 10 10.1 Longevity Compensation 11 10.2 Special Merit Pay 11 10.3 Bilingual Pay 11 10.4 Notary Pay 12 Article 11 Holiday Pay 12 11.1 Assigned Schedule for Holiday Pay 12 11.2 Pro -Rated Holiday Pay 12 11.3 Scheduled to Work a Holiday 12 11.4 9/80 Work Plan for Holiday Pay 12 11.5 Floating Holiday 12 Article 12 City Holidays 13 Article 13 Overtime 13 13.1 Work Week 14 13.2 9/80 Work Week 14 13.3 Time Worked 14 13.4 Called Back to Work 14 2 13.5 Assignments 15 Article 14 Overtime Authorization 15 Article 15 Compensatory Time 15 15.1 Accrual 15 15.2 Time Used for Leave 15 15.3 Cash Out 15 Article 16 Call -Out Policy 15 Article 17 Stand-by Pay 16 17.1 Rotation of Storm -Watch Crews 17 17.2 Rotation of Banner Installation/Removal Crews 17 Article 18 Shift Differential Pay 17 Article 19 Clothing Allowance 17 19.1 Uniforms 18 19.2 Care of Uniforms 18 19.3 Wearing of Uniforms 18 19.4 Uniform Replacement 18 19.5 Safety Equipment 18 19.6 Safety Boots/Shoes 18 19.7 Eligible Classifications 18 19.8 Additional Boot Allowance 19 Article 20 Temporary Upgrade 19 Article 21 Probationary Periods 19 21.1 Promotional Probation 20 Article 22 Eligibility for Merit Increases 20 Article 23 Tuition Reimbursement 20 23.1 Required Educational or Training Courses 20 23.2 Training Time 21 23.3 Reimbursement 21 Article 24 Deleted 21 Article 25 Employee Computer Purchase Program 21 Article 26 Safety Programs 22 26.1 Safe Driving Program 22 26.2 Injury and Illness Prevention Plan (IIPP) 23 Article 27 Driver's License Renewal 23 Article 28 Comprehensive Annual Leave Policy 23 28.1 Catastrophic Leave 25 28.2 CAL Time Cash Out 26 Article 29 Bereavement Leave 26 Article 30 Family Care and Medical Leave of Absence (FMLA) 26 Article 31 Jury Duty 36 Article 32 Military Leave 37 Article 33 Leaves of Absence Without Pay 38 33.1 Procedure for Requesting Leave of Absence Without Pay 38 33.2 Procedure for Unforeseen Circumstances 39 Article 34 Cafeteria Plan 39 34.1 Health Coverage 39 34.2 Dental Coverage 39 34.3 Vision Coverage 40 3 34.4 Disability Insurance 40 34.5 Flexible Benefits Program 40 34.6 Retiree Medical, Dental and Vision Premium Reimbursement 40 Article 35 Life Insurance 42 Article 36 Retirement 42 Article 37 Deferred Compensation 43 Article 38 Late Starts 43 Article 39 Rest Periods 43 Article 40 Hours of Work 44 40.1 Participation 44 40.2 Work Period 44 40.3 9/80 Day Off 44 40.4 Alternating Day Off Designation 44 Article 41 Grievance Procedure 44 41.1 Grievance 44 41.2 Representation 45 41.3 Grievance Discussion 45 41.4 Non -Reviewable Grievance 45 41.5 Filing of Grievance 45 41.6 Grievance Time Limits 45 Article 42 Discipline 46 Article 43 Alcohol and Drug Policy 51 Article 44 Reduction of Workforce 51 Article 45 Job Actions 52 Article 46 Americans with Disabilities Act (ADA) 52 Article 47 Classification Studies 53 Article 48 Performing Arts/ Theater Staff 53 Article 49 Posting of Vacancies 53 Article 50 Separability 53 Article 51 Performance Evaluations 54 Article 52 — Personnel Rules and Policies 54 Article 53 - Notice to Meet and Confer on Policy Changes 54 Article 54 - Reporting Outlining Project Employee Hours 55 4 Foreword The Memorandum of Understanding is made and entered into between the City of Temecula (hereinafter referred to as the "City"), and the designated representatives (hereinafter referred to as the "representative") of General Employee Unit of the City of Temecula. Preamble It is the purpose of this Memorandum of Understanding (hereinafter referred to as "Memorandum") to promote and provide for harmonious relations, cooperation, and understanding between the City Management representatives and the General employees covered under this Memorandum; to provide an orderly and equitable means of resolving any misunderstandings or differences which may arise under this Memorandum; and to set forth the agreement of the parties as a result of good faith negotiations regarding wages, hours, and other terms and conditions of employment of the employees covered under this Memorandum. This Memorandum of Understanding is entered into pursuant to the Meyers-Milias-Brown Act (Government Code 3500 et. Seq.) and has been jointly prepared by the parties. Article 1 Recognition The City recognizes California Teamsters Public, Professional, and Medical Employees Union Local 911 (hereinafter referred to as the Union) as the exclusively recognized labor organization representing employees assigned to job classifications as set forth in Appendix "A" of agreement. All bargaining unit employees shall be referred to as Regular employees. All other employees shall be referred to as Non -regular employees. Article 2 Implementation This Memorandum constitutes a recommendation to be submitted to the City Council subsequent to the ratification meeting by Union members. It is agreed that this Memorandum shall not be binding upon the parties either in whole or in part unless and until: The City Council formally acts, by majority vote, to approve and adopt said Memorandum. Article 3 Term The term of this Memorandum shall commence at 12:01 a.m., July 1, 2013, except as expressly provided otherwise in this agreement, when the terms and conditions for its effectiveness, as set forth in Article 2 Implementation, are fully met. This Memorandum shall expire and otherwise be fully terminated at 11:59 p.m., June 30, 2016. Current terms and conditions of work shall remain in full force and effect until such time a successor can be reached or imposed (per Government Code 3500 et. seq.). Article 4 Authorized Agents For the purpose of administering the terms and provisions of this Memorandum: 5 4.1 City's Authorized Agent City's principal authorized agent shall be the City Manager or a duly authorized representative 41000 Main Street, Temecula, CA 92590, (951) 694-6444 except where a particular City representative is specifically designated in connection with the performance of a specific function or obligation set forth herein. 4.2 General Employees Authorized Agent General employees authorized representative or the California Teamsters Public, Professional, and Medical Employees Union Local 911 shall be the duly authorized staff representative (Address: 9900 Flower Street, Bellflower, CA 90706 (562) 595-4518. Article 5 City Rights The rights of the City include, but are not limited to, the exclusive right to determine the mission of its constituent departments, commissions, committees, and boards; set standards of service; to manage the City, schedule working hours; establish, modify or change work schedules or standards; determine the procedures and standards of selection for action; relieve its employees from duty because of lack of work or for other legitimate reasons; maintain the efficiency of operations; determine the methods, means and personnel by which operations are to be conducted; determine the content of job classifications; take all necessary actions to carry out its mission in emergencies; and exercise complete control and discretion over its organization and the technology of performing its work. Article 6 Employee Rights Employees of the City shall have the right to form, join and participate in the activities of employee organizations of their own choosing for the purpose of representation on all matters of employer -employee relations, including but not limited to wages, hours and other terms and conditions of employment. Employees of the City also shall have the right to refuse to join or participate in the activities of employee organizations and shall have the right to represent themselves individually in their employment relations with the City. No employee shall be interfered with, intimidated, restrained, coerced or discriminated against by the City or by any employee organization because of their exercise of these rights. Article 7 Union Rights 7.1 Agency Shop The City of Temecula (City) and Teamsters Local 911, General Employees Bargaining Unit (Union) mutually understand and agree that in accordance with State of California law, per adoption of SB 739, and the Agency Shop election held on January 31, 2002, a majority of the full time, regular employees in classifications represented by the Union voted to be covered by an Agency Shop agreement. As a result of the Agency Shop election, as a condition of continued employment, this Agency Shop agreement hereby requires that all bargaining unit employees: 6 • Elect to join the Union and pay union dues, or • Pay an agency fee for representation, or • With a religious exemption, pay a fee equal to the agency fee to be donated to selected charities. Union Dues/Agency Fee Collection The Finance Department shall deduct union dues, agency fee and religious exemption fees from all employees who have signed a written authorization and a copy of that authorization has been provided to the Finance Department. Employees on disability leave without pay, or employees who earn a salary less than the union deduction shall not have a union dues or agency fee deduction for that pay period. The City will notify the Chief Shop Steward, on a monthly basis, of any status changes in the bargaining unit. The Union shall notify the City of any agency fee payer who elects to only pay fair share fees, the fee equal to direct representation costs as determined by the Union's certified financial report. The Union shall notify the City of the amount of the fair share fee to be deducted from the fair share fee payer's paycheck. New Hire Notification All new hires in the Temecula General Employees Bargaining Unit shall be informed by Human Resources, at the time of hire, which an Agency Shop agreement is in effect for their classification. The employee shall be provided a copy of this agreement, the Memorandum of Understanding and a form, mutually developed between the City and the Union that outlines the employee's choices under the Agency Shop agreement. The employee shall be provided 30 calendar days from the date of hire to elect their choice and provide a signed copy of that choice to the Finance Department. The Union may request to meet with new hires at a time and place mutually agreed upon between the Department Head and the Union. Failure to Pay Dues/Fees Should an employee fail to make an election and provide the City a signed copy of the Agency Shop employee election form, the Union shall notify the City, requesting the employee be terminated from employment for failure to make an election. Within seven (7) working days of each new hire in the bargaining unit, the City shall notify the Union of all new hires, providing the Union the employee's name, classification and date of hire. Union Dues Process Human Resources will schedule a new hire orientation, which will include a meeting with a union shop steward. The Union Steward will instruct the new hire to fill out the Agency Fee Election Form and return it to Human Resources within 30 days of their hire date. If, after 30 days, an employee fails to make an election and provide the city a signed 7 copy of the Agency shop employee election form, Human Resources will notify the Chief Union Steward and the City shall, by default, designate the employee as an agency fee payer. Once defaulted, the City then notifies the Union. The Union then mails the employee their "Hudson Rights". Religious Exemption An employee who is a member of a bona fide religion, body or sect that has historically held conscientious objections to joining or financially supporting a union shall not be required, as a condition of employment, to join the union and pay union dues or pay an agency fee for representation. City understands that the Union claims it is entitled to require employees to show proof of entitlement to religious exemption status. In lieu of union dues or agency fee, the employee claiming religious exemption shall be required to pay a fee equal to the Agency Fee, and those fees shall be remitted by the City, at the choice of the employee, to one of the following non -labor, non -religious charitable organizations: • United Way • Combined Health Agencies (CHA) • Specific charities that are supported by United Way/CHA Records On an annual basis, the Union shall provide the Finance Department a copy of the Union's certified financial report as required by Government Code Section 3502.5 (f). The City shall provide the Union a list of all unit members and dues paying status with each union dues check remitted to the Union. Rescission of Agreement The Agency Shop agreement may be rescinded at any time during the term of the Memorandum of Understanding by a majority vote of all the employees in the bargaining unit. A request for such vote must be supported by a petition containing the signatures of at least thirty (30) percent of the employees in the unit. The election shall be by secret ballot and conducted by California State Mediation and Conciliation and in accordance with state law. Indemnification The Union shall indemnify, defend and hold the City harmless from and against all claims, demands and liabilities and other actions relating to the City's implementation and compliance with this agreement. 8 7.2 Bulletin Boards The Union shall be provided suitable and adequate space on designated City bulletin boards at reasonable work locations for posting information concerning official Union business and activities. All postings shall contain the date of the posting and the identification of the document as a Union sponsored publication. All postings shall be done by an authorized Union representative after the following procedure is followed. Procedure A. All posted materials must be approved by Human Resources. B. Unauthorized materials may not be posted on City bulletin boards. C. Posted materials must be dated by Human Resources and may be removed by Human Resources and/or the Union after ten (10) calendar days. D. The Union may utilize the City's e-mail for bargaining unit communication with prior Human Resources approval. 7.3 Union Roster The Union shall provide and maintain, with the City, a current list of the names and all authorized representatives of the General Employee Unit. 7.4 Employee Representatives Four (4) shop stewards, along with three (3) alternate shop stewards, will be allowed reasonable release time from regularly scheduled duties to attend meet and confer sessions as designated by City Management. Because of the potential impact on the operation of an individual department, the four (4) shop stewards, along with three (3) alternate shop stewards, shall not have more than two (2) absent at one time from the same department. Employee representatives shall receive reasonable release time to investigate and present grievances; and attend Union sponsored training with prior approval from Human Resources (training not to exceed more than 2 times per year). The Union is to meet with the City Manager at least two (2) times per year during the life of this agreement. 7.5 Dues Check offs The City shall deduct from the first paycheck of each month and remit to the Union for the duration of this Agreement no later than approximately the 20th of the month. All such monies that employees individually authorized in writing, such authorizations will comply with appropriate laws and regulations. The Union agrees to indemnify and hold 9 the City harmless against any and all suits, claims, demands and liabilities that may arise out of, or by reason of, any action that shall be taken by the City for the purpose of complying with this Article. Article 8 Personnel Files The official personnel file of each employee shall be maintained in the Human Resources Department. A unit member and/or a Union representative authorized by the member, in writing, may review or obtain copies of material from the employee's file with the exception of material that includes ratings, reports or records which are obtained prior to the employment of the employee involved. 8.1 Derogatory Material Derogatory written materials (generally written reprimands and disciplinary suspension, excluding performance evaluation) shall be removed from an employee's official file in the Human Resources Department, providing there have been no further occurrences of documented violations, at the employee's request. Written reprimands are eligible to be removed, after two (2) years and disciplinary suspension after three (3) years if above criteria have been met. In order for the derogatory written materials to be removed, Human Resources must receive a formal written request from the employee to remove such materials. 8.2 Derogatory Material on File Employees shall be provided a copy of any derogatory material that is to be placed in their official file. 8.3 Customer/Citizen Letters of Commendation All customer or citizen letters of a positive nature and/or any City commendations, letters of achievements and recognition will be placed in the employee's personnel file, at the employee's request. Article 9 Seniority For the purpose of this Memorandum, "seniority" shall mean a bargaining unit member's total continuous length of employment with the City in a regular, allocated position, based on the employee's most recent hire date. Continuous length of employment shall include actual time worked, authorized leave of absence with or without pay, military leave, family leave and injury leave without pay not to exceed one (1) year. Except for military leave, a single injury leave above one (1) year will not be counted for purposes of calculating seniority. Article 10 Compensation Adjustments Wages: one percent across the board increases on each of these three dates: on ratification of 10 the MOU; on July 1, 2014 and on July 1, 2015. The City agrees to a mutual non -binding economic re -opener in November of 2014, any negotiations to be completed by December 31, 2014. The City agrees to a mutual non -binding economic re -opener in the spring of 2015, any negotiations to be completed by June 30, 2015. 10.1 Longevity Compensation Upon completion of ten (10) years of City Service, represented employees will receive a one (1) time lump sum Longevity Bonus of $350. Upon completion of 15 years of City Service, represented employees will receive a one (1) time lump sum Longevity Bonus of $500. Upon completion of 20 years of City Service, represented employees will receive a one (1) time lump sum Longevity Bonus of $750. Upon completion of 25 years of City Service, represented employees will receive a one (1) time lump sum Longevity Bonus of $1,000. 10.2 Special Merit Pay In an effort to recognize and reward sustained superior performance, the City will provide a Special Merit Pay Program to eligible employees. All employees will be eligible for $500 in Special Merit Pay, on their service anniversary date, if they have completed five (5)+ years of service with the City and have a rating of "commendable or outstanding" on three (3) out of their last five (5) annual evaluations. The overall rating category will be used to determine eligibility. The overall rating needs to be commendable or outstanding including + or — in these categories. Combination ratings such as Typically Meets/Commendable (T/C) will not be counted as an eligible rating but a combination of Commendable/Outstanding will qualify. Should there be a change to the rating categories as a result of revisions to the City's Performance Evaluation format, the City agrees to a limited re -opener to discuss needed adjustments to Article 10.2. If an employee's annual evaluation is 90 days overdue and they are eligible for Special Merit Pay, a rating of "commendable or outstanding" will be required on only two (2) out of the employee's last four (4) annual evaluations. The Special Merit Pay will be paid to an eligible employee as soon as practicable following the 90 day period. 10.3 Bilingual Pay Employees who have demonstrated the ability, by passing an annual City administered test, to translate both written and spoken Spanish, will receive $50 per pay period for 11 bilingual compensation. This bilingual compensation is provided as an incentive to recruit and retain bilingual employees in order to ensure that the City provides quality customer service to residents. For the purpose of this policy, the City will provide bilingual compensation to a maximum of two (2) employees in each operating department. If more than two (2) employees are eligible, actual compensation will be awarded based on the two (2) highest scores on the annual City administered test. Based on service level needs, the number of eligible employees can be modified by the City Manager or designee, to meet the City's needs. 10.4 Notary Pay Effective the first full pay period in July 2008 the City will provide $25.00 per pay period to employees who maintain a public notary and who are designated by the City as a Public Notary. Article 11 Holiday Pay 11.1 Assigned Schedule for Holiday Pay Based upon the eligible employee's assigned schedule, they will receive holiday pay for eight (8) or nine (9) hours on the applicable City observed holiday, 11.2 Pro -Rated Holiday Pay Regular part-time employees receive holiday pay on a pro -rated basis based on the number of hours worked. 11.3 Scheduled to Work a Holiday Work on a holiday: if a Regular Non-exempt Employee is required to work on a holiday, then that employee will be paid for the actual hours of work at the rate of one and one half times that employee's regular rate. In addition, the employee will be paid holiday pay in accordance with the above plus shift differential (Article 18). Those employees on stand-by status, who work on a City holiday, should be compensated as outlined in Article 17 (Stand By Pay). 11.4 9/80 Work Plan for Holiday Pay 9/80 Work Plan - Holiday on Employee's Scheduled Day Off: If a holiday occurs on an employee's scheduled day off, the employee will receive an eight (8) or nine (9) hour day off immediately prior to the holiday. 11.5 Floating Holiday Either an eight (8) or nine (9) hour floating holiday is provided at the beginning of each 12 fiscal year. The floating holiday hours will be pro -rated at the time of hire. When using a floating holiday, employee must use the hours in one block. The floating holiday cannot be used to make up time for being short time during a regular workday. The floating holiday needs to be treated as a regular City observed holiday. Article 12 City Holidays Represented employees receive a total of 12 City holidays each calendar year. The City observes the following 11 fixed holidays: New Year's Day Martin Luther King, Jr. Birthday President's Day Memorial Day Independence Day Labor Day Veteran's Day Thanksgiving Day Friday following Thanksgiving Day Y day — Christmas Eve Afternoon Christmas Day Y day — New Year's Eve Afternoon One (1) floating holiday is provided in each of the years during the life of this agreement. This floating holiday may not be carried over year to year. Holidays must be scheduled in advance. Employees will submit, to their supervisor/department director, a first and second request of preference. If denied, employees are allowed to take the holiday at a mutually agreed to later date. Observance: holidays which fall on a Saturday will normally be observed on the preceding Friday, holidays which fall on a Sunday will normally be observed on the following Monday. The City Manager will determine the actual dates on which holidays will be observed each year. In the case of the Y day holiday observances, City facilities will be closed to the public at noon. Eligibility: regular employees who are on paid status for their entire regular work shifts immediately prior to and immediately following the holiday will be paid for the holiday. Article 13 Overtime All employees required to perform in excess of 40 hours in a work week, as defined in Sections 13.1 and 13.2, shall receive compensation at the rate of time and one-half of the employee's regular rate of pay for hours worked in excess of 40 hours. All employees required to perform in excess of 12 hours in a workday shall receive compensation at the rate of double the time of the employee's regular rate of pay for those hours in excess of 12 hours. (Note: Performing Arts/Theater Staff should refer to Article 48 for additional information regarding theater overtime scheduling.) 13 In determining an employee's eligibility for overtime, paid and unpaid time off, as listed below, shall be excluded from the total hours worked. Also excluded are duty free lunches, travel time to and from work, and time spent conducting bona fide volunteer activities. Paid time off includes, but is not limited to, the following: A. Unscheduled Comprehensive Annual Leave B. Unscheduled Compensatory Time C. Administrative Leave D. Jury Duty E. Bereavement Leave F. Military Leave There shall be no pyramiding of overtime, except for shift differential pay, as outlined in Article 18. Hours worked by an employee in any workday or workweek on which premium rates have once been allowed shall not be used again in any other overtime calculation other than computing total actual hours worked. Time worked shall be computed by rounding to the nearest 15 minute increment. As defined, if less than 7 minutes are worked then time worked will be rounded down and if the employee works between 7 and 15 minutes, then time worked will be rounded up. Employees may elect to receive compensation or bank the overtime hours in accordance with Article 15, Compensatory Time. In addition the following provisions apply, 13.1 Work Week Work week defined: for the purpose of computing overtime, the workweek for employees who work the 5/40 schedule is a seven (7) day period beginning at 12:01 a.m. on each Sunday and ending at midnight on each Saturday. 13.2 9/80 Work Week 9/80 work week defined: for the purpose of computing overtime, the work week for employees who work the 9/80 Plan is a seven (7) day period beginning exactly four hours after the start time of the employee's work schedule on the day of the week the employee is scheduled to work eight (8) hours. 13.3 Time Worked Time worked: for purposes of this policy, hours worked include only those hours in which the employee performs services authorized by the City. 13.4 Called Back to Work An employee who is called back to work following the end of their regularly scheduled work shift and proceeds to work more than five (5) consecutive overtime hours shall then be entitled to an eight (8) hour rest period without compensation, upon completion of the assignment and upon leaving the duty station. If the eight (8) hour rest period extends into the employee's next regularly scheduled 14 work shift, the employee shall suffer no loss of pay or accrued leave as a result thereof. As is practical, employees who have earned a rest period shall be relieved at the start of their regular work shift in order to take such rest period. 13.5 Assignments Overtime assignments will be offered through an equitable process. Assignments for scheduled events will first be offered to volunteer(s). Assignments for unscheduled events will be issued based upon qualifications, experience, and resources needed. Article 14 Overtime Authorization No employee shall work overtime unless the working of overtime hours has been specifically authorized in advance, if possible, by the employee's supervisor. Violations of this article can result in disciplinary actions pursuant to Article 42 and the City's Disciplinary Policy. Article 15 Compensatory Time In lieu of receiving overtime pay pursuant to Article 13 (Overtime) and Article 14 (Overtime Authorization) an employee may elect, to receive compensatory time off on a time and one-half basis for each hour worked. Compensatory Time Off is considered permissive leave and, subject to department approval, is consistent with Article 28 (Comprehensive Annual Leave). In addition, the following shall apply regulating the usage of compensatory time off: 15.1 Accrual No employee shall accrue more than 80 hours of compensatory time. 15.2 Time Used for Leave Compensatory Time may be used for leave subject to scheduling in accordance with Article 28 (Comprehensive Annual Leave) of this M.O.U. 15.3 Cash Out All compensatory time that is available to an employee will be cashed out, at full value, and given to the employee within the first full pay period that includes December 1s` The compensatory time cash out will be paid out on a separate check. Under sole discretion of the City Manager, employees may carryover a portion of Compensatory Time that would need to be used within 60 days. Article 16 Call -Out Policy Call -out duty applies to all employees and occurs when any City employee is required to perform services not in conjunction with a regularly scheduled work shift. For the purpose of this policy, there are two types of call -out. The first is when an employee is required to 15 physically leave their residence and report to duty. This is termed, a response call -out. The second type of call -out is termed a non -response call -out and occurs when an employee is telephoned and/or paged and can resolve the problem without having to physically leave their residence and report to work. Employees who are designated as on stand-by status when called out will be compensated from the time they leave their residence to the time that they return to their residence. Employees who are not designated on stand-by status and are called out will receive compensation for the time they leave their residence to the time that they leave the duty station. Employees who have a response call -out will be credited with all hours worked with a minimum of three (3) hours. Any hours worked in excess of the three (3) hours, which includes travel time, will be credited at one and one-half times regular (non -overtime) rate of pay. In addition, Call Out Pay will be paid to employees and cannot be included in any Comp Time bank. Employees who have a non -response call -out will be compensated at one (1) hour of time and one-half, if the non -response call -out occurs between 6:31 a.m. and 12 midnight. If the non - response call -out occurs between 12:01 a.m. and 6:30 a.m., the employee will be compensated at two (2) hours of one and one-half times regular (non -overtime) rate of pay. If applicable, employees are subject to the provisions of Article 13.4 (Overtime) regarding rest periods during call -out situations. Article 17 Stand-by Pay In any situation where an employee has been in a designated "stand-by" status and is to remain on -call, the employee shall be compensated at the rate of $230 for each seven (7) day stand-by period or pro -rated on a daily basis ($32.86/day). Employees who are designated as on stand- by status when called out will be compensated from the time they leave their residence to the time that they return to their residence. Employees may also be designated in stand-by status for individual days and stand-by status can be applied to any City of Temecula employees. Compensation for daily stand-by pay will be computed at 1/7 of the weekly amount described above. Assignments for standby duty will be scheduled on a rotational basis. This 7-day standby period includes "Friday's off" (pursuant to the 9/80 work schedule), as well as weekends and holidays. If applicable, employees are subject to the provisions of Article 13.4 (Overtime) regarding rest periods during stand-by situations. Employees on a "stand by" status shall be required, at all times, to carry a functioning, City provided pager and be able to respond to the page within 15 minutes of being paged. Upon responding to the page, the employee must give an estimated response time to the caller. In addition, employees are expected to maintain a level of fitness for duty that is required for your normal work schedule. Employees officially designated as on stand-by on an officially recognized City holiday will receive an additional $50 for that day. A: Substitution of Standby Duty: Your supervisor must approve all substitutions. There are 16 two (2) types of substitutions related to Standby Duty, as follows: 1. Straight Substitution: You may request that another employee substitute for you, subject to the approval of your supervisor, with at least 48 hours prior notice. Substitutions shall not be assigned between employees. In this instance, the supervisor will, to the extent possible, solicit and assign volunteers through the hat -pick lottery. 2. Emergency Substitution: In an emergency situation (employee or City related), or with less than 48 hours prior notice, your supervisor shall assign a qualified substitute, (including additional employees) to provide standby coverage. In both instances above the substituting employee will receive the appropriate daily rate of 1/7 of weekly amount described above for each standby duty day. 17.1 Rotation of Storm -Watch Crews As employees of the public sector, all City employees are designated as Disaster Service Workers by the California Government Code. In association with this designation, the Public Works Maintenance Superintendent, or their designee, may implement a Storm -Watch Schedule to protect public interests in the event that existing or impending weather conditions and/or reports indicate the potential for flooding or other severe storm related problems exist. 17.2 Rotation of Banner Installation/Removal Crews Pursuant to a quarterly schedule prepared by the Maintenance Superintendent, the Public Works Maintenance Division employees may be assigned to Banner Installation/Removal Crews for special event purposes throughout the year. Article 18 Shift Differential Pay Employees are eligible to receive a 5% shift differential (above their appropriate rate of pay) for all hours worked on Sundays, holidays along with the hours worked between 10 p.m. and 6 a.m. Any overtime worked on Sundays, holidays and the hours between 10 p.m. and 6 a.m. will be based on the shift differential overtime rate. During the term of this agreement, shift differential will be provided to traffic signal staff for all work conducted on Saturdays. The City reserves the right to change how responses are handled relative to traffic signal service needs on weekends. Employees are eligible to receive a 5% split shift differential (above their appropriate rate of pay) for all hours worked in a day where their shift is split into segments with more than two hours between segments. Article 19 Clothing Allowance City uniforms provide easy identification for customers and the public, a professional appearance, and a convenience for City employees. 17 Each field employee, in Public Works and Community Services, is responsible for wearing a City furnished uniform at all times while performing City -related work. 19.1 Uniforms The City shall provide designated field employees with uniforms. The uniforms consist of shirts and pants. The City shall provide laundry service for the uniforms. Departments will annually provide a minimum of five (5) City staff shirts (style determined by individual departments) to field employees in Building and Safety, Code Enforcement, Public Works, TCSD, Signal Technicians and Park Rangers. Department Directors may authorize additional City provided shirts based upon operational needs. In lieu of uniform pants and at the employee's request, jeans will be provided to field employees through the City's uniform company. 19.2 Care of Uniforms Each field employee shall take proper care of uniforms and maintain high standards of personal grooming and neatness. Hair, jewelry and accessories must not impede the safe and efficient execution of their duties. 19.3 Wearing of Uniforms A uniform, or any part of it, shall be worn only during working hours and while traveling between work and home. City uniforms shall not be worn outside of working hours unless authorized by their department. 19.4 Uniform Replacement The City will determine the need for and timing of uniform replacement. 19.5 Safety Equipment The City provides each field employee with appropriate safety equipment, as determined by each supervisor. 19.6 Safety Boots/Shoes Safety boots or shoes as determined by the City shall be worn with the uniform. Ordinarily tennis shoes, sandals, etc., are not permitted without specific department approval for safety reasons. This allowance is $175. The boot allowance will be paid in the first full pay period of July. Employees receiving the boot allowance must wear boots that are appropriate for their duties and said boots must be maintained in a good/safe condition. 19.7 Eligible Classifications Employees in the classification of Building Inspectors, Landscape Inspectors, Public Works Inspectors, and Code Enforcement Officers are eligible for an annual clothing 18 allowance of $125. This allowance is intended to cover the cost of replacing clothes due to field hazards and normal wear and tear. In addition, all field employees are required to wear collared shirts, presentable work pants and applicable safety shoes. The clothing allowance will be given in the first full pay period of July. 19.8 Additional Boot Allowance If field staff require specialized boots or have unusual wear and tear because of work functions (special needs shall be supported with a formal request and appropriate documentation to the supervisor for approval) additional boot allowance may be provided. Article 20 Temporary Upgrade As a result of vacancies, leave of absences or other reasons, it may be necessary to temporarily reassign the duties of an authorized position to another employee. When such assignments require the employee to assume significant additional duties, which are outside the scope of the employee's regular assignment, it is appropriate to adjust the employee's salary to reflect the interim changes. This policy allows the City to temporarily upgrade the affected employee. It shall be the responsibility of the Department Supervisor to notify Human Resources, in writing, to implement the temporary upgrade for any affected employee. Human Resources will, in turn, notify the union when a temporary upgrade is initiated and/or terminated. Approval required: with the approval of the City Manager, an employee may be temporarily appointed to a higher level classification to perform additional duties on an interim basis provided that: A. The higher level position is vacant and is approved by the City Manager for new or continued staffing, B. the duties of the higher level position are outside of the scope of the employee's current classification as determined by the City Manager, or a designee, C. the vacancy is expected to continue for at least 15 business days, but not longer than one (1) calendar year, and, D. the employee possesses the minimum qualifications or the requisite knowledge, skills and abilities to perform the work of the higher classification. Salary: the salary of an employee in a Temporary Upgrade Assignment shall be adjusted by approximately 5% or to the minimum rate of the temporary classification, whichever is greater, for the period of the temporary assignment. Effective Dates: the City Manager, or a designee, shall establish the effective dates of a Temporary Upgrade Assignment. In addition, the employee assigned to perform the duties of a higher classification shall not serve for more than 180 calendar days in a higher classification unless the vacancy is created by extended leave approved by the City Manager pursuant to Article 33 (Leaves of Absence without Pay) of this M.O.U. Article 21 Probationary Periods 19 All appointments, excluding promotional appointments, shall be subject to a probationary period of not less than one (1) year of full time employment in the position. An employee on their original probation shall receive an evaluation at three (3) months, six (6) months and nine (9) months. The City can extend probation for a maximum of six (6) months. Employees will successfully pass probation if no extension is implemented and if no evaluation is provided by the last day of the probationary period. Passing probation is also not contingent on an employee receiving a probationary evaluation on time. 21.1 Promotional Probation Promotional probationary appointments shall be subject to a probationary period of not less than six (6) months of full time employment in the position. During the probation period, the employee may be rejected at any time regardless of service without the right of a hearing or appeal. Any employee rejected during a promotional probation to which they have been promoted shall be reinstated to a position in the class from which they were promoted unless they were discharged for cause from the City. Article 22 Eligibility for Merit Increases Each probationary or regular employee will be considered for, but is not guaranteed, a merit adjustment annually at their regular or adjusted anniversary date. Merit adjustments (based upon performance and the policy as stated in the Performance Evaluation and Compensation System-PEACS) may be denied, deferred for future consideration, or granted at .5, 1, or 1.5 step intervals, at the Department Director's discretion and subject to City Manager's approval. In addition, it is agreed that during the life of this agreement, supervisors and managers agree to conduct annual evaluation meetings within 30 days of the employee's anniversary date. Regular and Promotional Probationary employees are eligible for merit adjustments at or near the completion of their one (1) year of continuous service and at the employee's annual anniversary date thereafter, provided that the employee is not a Y-Rated employee or at the maximum rate for their salary range. Approved merit adjustments will be retro-active to the official evaluation due date. Article 23 Tuition Reimbursement When an employee is ready to enroll in classes that they would like to receive tuition reimbursement for, they must first submit a tuition reimbursement pre -approval form to their supervisor. If approved, the supervisor, in turn, would submit the pre -approval form to Human Resources for consideration. As a condition of being reimbursed, the employee agrees to continue employment with the City for one (1) year past the date of the receipt of the reimbursement. If the employee leaves the City, the amount of the reimbursement will be due to the City. Reimbursement is limited to no more than $1,200 for training or educational expenses in any one (1) fiscal year. Additional funds may be approved on appeal to the City Manager. 23.1 Required Educational or Training Courses 20 Any educational or training course that is a requirement for continuation of employment or is an identified part of a job evaluation shall be paid for by the City. Any other educational or training course that is job related shall, if prior approval for reimbursement is given by the City Manager or a designee, be reimbursed 100% after successful completion. All college or other graded classes shall require a minimum grade of a "C" in order to receive such reimbursement. Books or other materials shall only be paid for if some defined benefit can be shown to the City (i.e. books become part of the City reference library). Once the employee has received their official course grade, they then attach appropriate receipts and proof of grades to the City's Tuition Reimbursement form, complete the employee portion, have their Supervisor/Department Director complete their portion and submit the completed packet to Human Resources. Once reviewed and approved by Human Resources, the approved packet is submitted to the Department of Finance for processing. The employee will receive their approved tuition reimbursement amount on the next payroll cycle. 23.2 Training Time In general, training time during working hours shall be considered part of the job. Non - mandatory training after hours shall be considered voluntary, and no additional pay, overtime or compensatory time shall be given by the City, unless advanced special written approval is granted. Study time shall be considered completely voluntary. 23.3 Reimbursement Although the City applauds employees for their efforts in pursuit of additional education, the City shall not pay for educational degrees or for education in general, but will only reimburse employees for required or job -related classes and training. No reimbursement shall occur if an educational class does not provide a benefit to the City. The only exception to this is the City will reimburse employees for three (3) general education classes, over the life of this agreement, as long as the classes are a part of a degree or certificate program. These three (3) classes must be approved, in advance, as required by this policy. There is no mileage reimbursement for travel to and from educational classes. Required forms must be completed and necessary documentation (receipts and grades) must be provided, in order to receive reimbursement. Final and conclusive determinations of the reimbursement amount shall be made by the City Manager after review of the request and recommendations by the Department Director and the Human Resources Administrator. Article24 Deleted Article 25 Employee Computer Purchase Program This program allows employees to borrow, at no interest, up to $2,000 to purchase a personal computer, iPad, and similar "computer tablet" devices, with a loan repayment plan of up to 24 months. An employee may only have one loan outstanding at any time. 21 To qualify for the program, employees must be regular, full-time/part-time employees and have successfully passed their one (1) year probationary period. Employees must also elect to purchase a computer/equipment system that is capable of running Microsoft Office Suite, (i.e. Word, Excel, PowerPoint etc.) Loans can be received by either Reimbursement of Costs or Direct Payment to Vendor (see Employee Computer Purchase Program Administrative Guideline for further details). Repayment will be made through equal biweekly payroll deductions over a maximum period of up to 24 months. At the time of submittal, employees have the option to request a 12 month loan. Repayment in full will be accepted at any time, without penalty to the employee. Loan repayment shall commence within two to four weeks of receiving disbursement. In the event of termination of employment for any reason, the entire unpaid balance shall immediately be due and payable, without notice. Any remaining unpaid balance shall first be deducted from the final paycheck. In the event the final paycheck is not sufficient to pay off the principal sum, then any resultant balance must be paid, in full, with other resources of the borrower. Article 26 Safety Programs 26.1 Safe Driving Program Full-time benefited employees, who are assigned to a to a City vehicle, are eligible to participate in the Safe Driving Award Program. Employees assigned to pool vehicles do not qualify. Eligible employees must not have been in any "preventable" vehicle accidents during any given full fiscal year. An accident is defined as: any event involving a City vehicle resulting in or causing personal injury or damage to any person, object, or property in an amount exceeding $150 in total damages. The City Safety Committee will determine whether the accident was "preventable" or "non -preventable". Preventable — the driver failed to do everything possible to prevent the accident, including anticipating the hazard and applying the appropriate defensive driving procedures. Non -Preventable — the driver did everything possible to prevent the accident, including anticipating the hazard and applying the appropriate defensive driving procedures. Qualifying employees are recognized and receive awards after one (1) year and then in five (5) year increments thereafter. When an employee is notified by the Department of Motor Vehicles that their Class driver's license is about to expire, the employee needs to follow the DMV instruction for Class A renewals. Once the renewal process is completed, proof of the renewal (Medical Examiner Certificate) needs to be submitted to Human Resources for verification purposes. 22 26.2 Injury and Illness Prevention Plan (IIPP) It is the intention of the City of Temecula to maintain a safe and healthy work environment for all employees. This Injury and Illness Prevention Plan (IIPP) was designed to promote a safe work environment. To meet this goal, it shall be the policy of the City of Temecula to give precedence to safety above expediency of any operation and to comply with established state laws and City ordinances and standards. Continued efforts in safety education, field operational review, working condition safety and accident prevention analysis, in conjunction with active participation by supervisors and employees, will ensure a successful Injury and Illness Prevention Plan (IIPP). Article 27 Driver's License Renewal It is the employee's responsibility to carry a valid driver's license when driving a City vehicle or on City business. For California Commercial driver's licenses (A & B), renewal requirements, DMV fees, physicals and training are to be paid by the City. Release Time: For the purposes of obtaining and/or renewing a Class A Driver's Licenses, pursuant to the scope of responsibilities within their classification specification and upon supervisory approval, employees are provided release time to process paperwork at the DMV. Paid release time shall not be granted if the employee's license has already expired. Article 28 Comprehensive Annual Leave Policy The intent of this policy is to ensure that all employees have an adequate amount of time off each year for rest and relaxation, personal business or personal/family illness. Regular employees earn Comprehensive Annual Leave from the date of hire. Employees who are paid for less than 80 hours in a pay period will earn Comprehensive Annual Leave credits on a pro -rated basis for that pay period. The accrual rate for non-exempt (hourly) employees is as follows: Annual Hours of Biweekly Maximum Increment Annual Leave Accrual Rate Accumulation Hire date 152 5.846 304 hours 2-4 years 168 6.462 336 hours 4-6 years 208 8.000 416 hours 6-8 years 224 8.615 448 hours 8-10 years 240 9.231 480 hours 10+ years 264 10.154 528 hours 15+ years 264 10.154 640 hours The accrual rate for exempt employees is as follows: Annual Hours of Biweekly 23 Maximum Increment Annual Leave Accrual Rate Accumulation Hire date 168 6.462 336 hours 2-4 years 184 7.077 368 hours 4-6 years 224 8.615 448 hours 6-8 years 240 9.231 480 hours 8-10 years 256 9.846 512 hours 10+ years 280 10.769 560 hours 15+ years 280 10.769 640 hours Annual leave accrual: annual leave will be earned on a prorated rate each pay period. Maximum balance: the maximum accrued unused Comprehensive Annual Leave accumulation, which an employee may have at any one time, is two (2) times the employee's annual accrual. However, the City Manager may grant an employee, on a case by case basis, the ability to accrue annual leave above two (2) times the annual accrual limit for good cause shown. Requesting time off: a leave request form is to be submitted by the employee and approved by the employee's supervisor prior to the leave commencing. In the event of an unforeseen absence, the employee shall contact their immediate supervisor or representative as directed by the Department Director within 30 minutes of the start of their normal scheduled shift. If a regular employee requests specific days off at least six weeks in advance, and if that request is otherwise proper under this Article, that time shall be considered locked and cannot be displaced by a non -regular employee seeking to take the same time off. Scheduling: the scheduling of Comprehensive Annual Leave shall be determined by the employee's supervisor based upon: first, the needs of the City; second, the employee's request; and then seniority. Departments will determine a schedule as to when they will route their departmental vacation calendar. Employees with greater seniority, within the department, will be given the first opportunity to select their vacation. If after the needs of the City and the employee's request have been taken into consideration, and two (2) employees have requested the same period of time off, which will cause a staffing conflict within the same job area or function, seniority will be used as the determining factor as to who will receive the requested time off. However, if the same staffing conflict arises the following year, and seniority was used as the basis for resolving that conflict in the previous year, the employee granted that time off in question the previous year will not be granted the same period of time off in the subsequent year only. A leave request form needs to be submitted by the employee and approved by the employee's supervisor prior to the leave commencing. Scheduled CAL Leave needs to be approved 48 hours in advance by the employee's supervisor. If a CAL Leave request is submitted less than 48 hours in advance, the supervisor is under no obligation to approve the CAL Leave request. Supervisors shall return the time off request form to the employee, with their signature approval, within a reasonable time which is outlined in the policy below. The supervisor is encouraged to make their decision within 24 hours of the request; however, in the event that additional time is needed, this decision should be generally made within five (5) business days. If the request is submitted less than 48 hours prior to the specified time off, the supervisor will be under no 24 compulsion to approve the request based on the MOU language. The above noted turnaround time for this approval is also important when considering an employee's request for multiple time -off requests over the course of a year. This can become important in light of the seniority clause in Article 9 of the MOU. The MOU and current City policy do not require an employee to have a designated number of CAL hours available in order to take scheduled time off. However, the employee must have enough hours in their CAL Leave bank, to cover their leave request, before the scheduled leave commences. If there are insufficient CAL hours in the employee's bank when the scheduled time off is about to commence, the supervisor may use their authority to cancel the abovementioned scheduled time off. If the requested leave is relating to a personal issue, the employee has the option of stating personal for the reason and the supervisor need not ask for a more detailed explanation. The supervisor can offer the City's Employee Assistance Program (EAP) if deemed appropriate. Management can only strongly encourage that an employee keep a "safe" number of hours on the books in the case of unforeseen needs or to satisfy the time needed to get through a disability elimination period, illness or personal leave. Legitimate leave of absences such as workers' compensation, disability, or extended illness should not be factored in when approving/disapproving time -off requests. In addition, the City encourages communication between employees and their supervisor and it is acceptable for the employee and the supervisor to agree on a conditional approval of vacation time and that the terms of this conditional approval are documented on the Leave Form. In lieu of a Grievance Procedure (Article 41), any disputes that arise out of the scheduling of CAL time, will be handled by Human Resources. The determination of Human Resources will be final and no formal grievance may be filed in CAL scheduling. Holidays during Comprehensive Annual Leave: City holidays which occur during an employee's Comprehensive Annual Leave are not deducted from Comprehensive Annual Leave balance. Separation of employment: upon separation from employment with the City, an employee shall be entitled to cash out their remaining Comprehensive Annual Leave balance at their regular, non -overtime rate of pay. 28.1 Catastrophic Leave Upon approval by the City Manager, or designee, employees may donate a maximum of 16 hours (if 120 hours remain in donating employee's CAL bank) to a fellow employee in the event of a medical emergency to the employee or an immediate family member of the employee. (Refer to Article 29, Bereavement Leave, for definition of family member.) A "medical emergency" is defined as a serious medical condition that would require the prolonged absence of the employee from duty and would result in a substantial loss of income to the employee because the employee would have and would be required to exhaust all of their available paid leave. In addition, the City has the right to request a 25 doctor's note to verify the medical emergency. The City will pool all hours that are donated and employees, who are eligible for the donation, will receive said donation from the pool. The maximum donation to individual employees is 160 hours per fiscal year. 28.2 CAL Time Cash Out In June, employees may cash out CAL Time under the following criteria: A. May cash out up to a maximum of 120 hours. B. Must maintain a balance of 120 hours after cash out is taken. C. Must have taken at least 80 hours of CAL Time during the fiscal year. The CAL Time Cash Out will be provided by the end of the fiscal year on a separate check. The CAL Time Cash Out pay period will be determined by the City's Finance Department, in accordance with the ending of the fiscal year. Article 29 Bereavement Leave The City recognizes the importance of providing employees time off to mourn and take care of any details relating to the death of a member of their immediate family. Employees may also use CAL time in conjunction with bereavement leave. Employees may receive a maximum of three (3) business days for bereavement of an individual who is a member of the employee's immediate family or of other similar relation as determined by the City Manager. If an employee must travel more than 500 miles, one way, to attend a funeral, the employee is eligible for five (5) business days of bereavement leave. A. For the purposes of this policy, immediate family (including natural, step or in-laws) shall be defined as spouse, registered domestic partner, mother, father, sister, brother, daughter, son and grandparents. B. A leave request form must be completed by the employee and approved by their supervisor. Depending upon circumstances, employees can submit bereavement leave and Comprehensive Annual Leave (CAL) requests after the employee returns to work. In addition, the supervisor may require verification that bereavement leave was warranted. Article 30 Family Care and Medical Leave of Absence (FMLA) I. Statement of Policy To the extent not already provided for under current leave policies and provisions, the City will provide family and medical care leave for eligible employees as required by 26 state and federal law. The following provisions set forth certain rights and obligations with respect to such leave. Rights and obligations which are not specifically set forth below are set forth in the Department of Labor regulations implementing the Federal Family and Medical Leave Act of 1993 ("FMLA"), and the regulations of the California Family Rights Act ("CFRA"). Unless otherwise provided by this article, "Leave" under this article shall mean leave of absence pursuant to the FMLA and CFRA. II. Definitions A. "12-Month Period" means a rolling 12-month period measured backward from the date leave is taken and continuous with each additional leave day taken. B. "Single 12-month period" means 12-month period which begins on the first day the eligible employee takes FMLA leave to take care of a covered service member and ends 12 months after that date. C. "Child" means a child under the age of 18 years of age, or 18 years of age or older who is incapable of self care because of a mental or physical disability. An employee's child is one for whom the employee has actual day-to-day responsibility for care and includes, a biological, adopted, foster or step -child. A child is "incapable of self care" if he/she requires active assistance or supervision to provide daily self care in three or more of the activities of daily living or instrumental activities of daily living —such as, caring for grooming and hygiene, bathing, dressing and eating, cooking, cleaning, shopping, taking public transportation, paying bills, maintaining a residence, using telephones and directories, etc. D. "Parent" means the biological parent of an employee or an individual who stands or stood in loco parentis (in place of a parent) to an employee when the employee was a child. This term does not include parents -in-law. E. "Spouse" means a husband or wife as defined or recognized under California State law for purposes of marriage. F. "Domestic Partner," as defined by Family Code §§ 297 and 299.2, shall have the same meaning as "Spouse" for purposes of CFRA Leave. G. "Serious health condition" means an illness, injury impairment, or physical or mental condition that involves: 1. Inpatient Care (i.e., an overnight stay) in a hospital, hospice, or residential medical care facility, including any period of incapacity (i.e., inability to work, or perform other regular daily activities due to the serious health condition, treatment involved, or recovery therefrom); or 2. Continuing treatment by a health care provider: A serious health condition involving continuing treatment by a health care provider includes any one or more of the following: 27 a) A period of incapacity (i.e., inability to work, or perform other regular daily activities) due to serious health condition of more than three consecutive calendar days, and any subsequent treatment or period of incapacity relating to the same condition, that also involves: i. Treatment two or more times within 30 days of the first day of incapacity, unless extenuating circumstances exist, by a health care provider, by a nurse or physician's assistant under direct supervision by a health care provider, or by a provider of health care services (e.g., a physical therapist) under orders of, or on referral by a health care provider. The first in -person treatment visit must take place within seven days of the first day of incapacity; or ii. Treatment by a health care provider on at least one occasion which must take place within seven days of the first day of incapacity and results in a regimen of continuing treatment under the supervision of the health care provider. This includes for example, a course of prescription medication or therapy requiring special equipment to resolve or alleviate the health condition. If the medication is over the counter, and can be initiated without a visit to a health care provider, it does not constitute a regimen of continuing treatment. b) Any period of incapacity due to pregnancy or for prenatal care. (This entitles the employee to FMLA leave, but not CFRA leave. Under California law, an employee disabled by pregnancy is entitled to pregnancy disability leave.) c) Any period of incapacity or treatment for such incapacity due to a chronic serious health condition. A chronic serious health condition is one which: i. Requires periodic visits (defined as at least twice a year) for treatment by a health care provider, or by a nurse or physician's assistant under direct supervision of a health care provider; ii. Continues over an extended period of time (including recurring episodes of a single underlying condition); and iii. May cause episodic rather than a continuing period of incapacity (e.g., asthma, diabetes, epilepsy, etc.). Absences for such incapacity qualify for leave even if the absence lasts only one day. d) A period of incapacity which is permanent or long term due to a condition for which treatment may not be effective. The employee or family member must be under the continuing supervision of, but 28 need not be receiving active treatment by, a health care provider. e) Any period of absence to receive multiple treatments (including any period of recovery therefrom) by a health care provider or by a provider of health care services under orders of, or on referral by, a health care provider, either for restorative surgery after an accident or other injury, or for a condition that would likely result in a period of incapacity of more than three consecutive calendar days in the absence of medical intervention or treatment. H. "Health Care Provider" means: 1. A doctor of medicine or osteopathy who is authorized to practice medicine or surgery by the State of California; 2. Individuals duly licensed as a physician, surgeon, or osteopathic physician or surgeon in another state or jurisdiction, including another country, which directly treats or supervises treatment of a serious health condition; 3. Podiatrists, dentists, clinical psychologists, optometrists, and chiropractors (limited to treatment consisting of manual manipulation of the spine to correct a subluxation as demonstrated by X-ray to exist) authorized to practice in California and performing within the scope of their practice as defined under California State law; 4. Nurse practitioners and nurse -midwives and clinical social workers who are authorized to practice under California State law and who are performing within the scope of their practice as defined under California State law; 5. Christian Science practitioners listed with the First Church of Christ Scientist in Boston, Massachusetts; and 6. Any health care provider from whom an employer or group health plan's benefits manager will accept certification of the existence of a serious health condition to substantiate a claim for benefits. I. "Covered active duty" means: in the case of a member of a regular component of the Armed Forces, duty during the deployment of the member with the Armed Forces to a foreign country, or (2) in the case of a member of a reserve component of the Armed Forces, duty during the deployment of member of the Armed Forces to a foreign country under a call or order to active duty under certain specified provisions. J. "Covered Service member" means: (1) a current member of the Armed Forces, including a member of the National Guard or Reserves, who is undergoing medical treatment, recuperation, or therapy, is otherwise in outpatient status, or is otherwise on the temporary disability retired list, for a serious injury or illness; 29 or (2) a veteran who is undergoing medical treatment, recuperation, or therapy, for a serious injury or illness and who was a member of the Armed Forces, including a member of the National Guard or Reserves, at any time during the period of five years preceding the date on which the veteran undergoes that medical treatment, recuperation, or therapy. K. "Outpatient Status" means, with respect to a covered service member, the status of a member of the Armed Forces assigned to either: (1) a military medical treatment facility as an outpatient; or (2) a unit established for the purpose of providing command and control of members of the Armed Forces receiving medical care as outpatients. L. "Next of Kin of a Covered Service member" means the nearest blood relative other than the covered service member's spouse, parent, son, or daughter, in the following order of priority: Blood relatives who have been granted legal custody of the covered service member by court decree or statutory provisions, brothers and sisters, grandparents, aunts and uncles, and first cousins, unless the covered service member has specifically designated in writing another blood relative as his or her nearest blood relative for purposes of military caregiver leave under the FMLA. M. "Serious Injury or Illness" (1) in the case of a member of the Armed Forces, including a member of the National Guard or Reserves, means an injury or illness that was incurred by a member in the line of duty on active duty in the Armed Forces (or existed before the beginning of the member's active duty and was aggravated by service in the line of duty on active duty in the Armed Forces) and that may render the member medically unfit to perform the duties of the member's office, grade, rank, or rating; or (2) in the case of a veteran who was a member of the Armed Forces, including a member of the National Guard or Reserves, at any time during the period of five years preceding the date on which the veteran undergoes that medical treatment, recuperation, or therapy, means a qualifying injury or illness that was incurred by the member in the line of duty on active duty in the Armed Forces (or existed before the beginning of the member's active duty and was aggravated by service in the line of duty on active duty in the Armed Forces) and that manifested itself before or after the member became a veteran. III. Reasons for Leave Leave is only permitted for the following reasons: 1. The birth of a child or to care for a newborn of an employee; 2. The placement of a child with an employee in connection with the adoption or foster care of a child; 3. Leave to care for a child, parent, spouse, or registered domestic partner who has a serious health condition; 30 4. Leave because of a serious health condition that makes the employee unable to perform the functions of his/her position; 5. Leave for a "qualifying need" may be taken arising out of the fact that an employee's spouse, registered domestic partner, son, daughter, or parent is on active military duty or has been notified of an impending call or order to active duty in support of a contingency operation involving the United States Armed Forces; or 6. Leave to care for a spouse, registered domestic partner, son, daughter, parent, or "next of kin" service member of the United States Armed Forces who has a serious injury or illness incurred in the line of duty while on active military duty or existed before the beginning of the member's active duty and was aggravated by service in the line of duty on active duty in the Armed Forces) (this leave can run up to 26 weeks of unpaid leave during an employee's 12-month period) (under the FMLA only, not the CFRA). IV. Employees Eligible for Leave An employee is eligible for leave if the employee: 1. Has been employed for at least 12 months; and 2. Has worked for at least 1,250 hours during the 12-month period immediately preceding the commencement of the leave. V. Amount of Leave Eligible employees are entitled to a total of 12 workweeks (or 26 weeks to care for a covered service member) of leave during any 12-month period. Where FMLA leave qualifies as both military caregiver leave and care for a family member with a serious health condition, the leave will be designated as military caregiver leave first. A. Minimum Duration of Leave If leave is requested for the birth, adoption or foster care placement of a child of the employee, leave must be concluded within one year of the birth or placement of the child. In addition, the basic minimum duration of such leave is two weeks. However, an employee is entitled to leave for one of these purposes (e.g., bonding with a newborn) for at least one day, but less than two weeks duration on any two occasions. If leave is requested to care for a child, parent, spouse, or the employee him/herself with a serious health condition, there is no minimum amount of leave that must be taken. However, the notice and medical certification provisions of this policy must be complied with. B. Spouses Both Employed By the City of Temecula 31 In any case in which a husband and wife both employed by the City are entitled to leave, the combined number of workweeks of leave to which both may be entitled may be limited to 12 workweeks during any 12-month period if leave is taken for the birth or placement for adoption or foster care of the employees' child (i.e., bonding leave). In any case in which a husband and wife both employed by the City are entitled to leave, the combined number of workweeks of leave to which both may be entitled may be limited to 26 workweeks during any 12-month period if leave is taken to care for an injured service member. Except as noted above, this limitation does not apply to any other type of leave under this policy. VI. Employee Benefits While on Leave Leave under this policy is unpaid. While on leave, employees will continue to be covered by the City of Temecula group health insurance to the same extent that coverage is provided while the employee is on the job. Employees shall be responsible for the continuation of City of Temecula provided health care insurance premiums if on a Leave for more than the 12 weeks specified by the law. Employee contribution rates are subject to any change in rates that occurs while the employee is on leave. If an employee fails to return to work after his/her leave entitlement has been exhausted or expires, the City shall have the right to recover its share of health plan premiums for the entire leave period, unless the employee does not return because of the continuation, recurrence, or onset of a serious health condition of the employee or his/her family member which would entitle the employee to leave, or because of circumstances beyond the employee's control. The City shall have the right to recover premiums through deduction from any sums due to the City (e.g. unpaid wages, vacation pay, etc.). Employees will not be required, but may use at their option, all accrued Comprehensive Annual Leave time for Leave while under the care of a health care provider or if taken to care for an injured service member. Employees shall retain the status of employee while on Leave. However, a Leave used in conjunction with any other FMLA leave of absences, which exceeds 24 weeks, shall result in an adjustment to the employee's Comprehensive Annual Leave and salary review date. VII. Substitution of Paid Accrued Leaves While on leave under this policy, as set forth herein, an employee may elect to concurrently use paid accrued leaves. Similarly, the City may require an employee to concurrently use paid accrued leaves after requesting FMLA and/or CFRA leave, and may also require an employee to use FMLA concurrently with a non-FMLA/CFRA leave 32 which is FMLA/CFRA-qualifying. A. Employee's Right to Use Paid Accrued Leaves Concurrently with Family Leave Where an employee has earned or accrued paid CAL time, administrative leave, or compensatory time, that paid leave may be used concurrently for all or part of any (otherwise) unpaid leave under this policy. Use of CAL time does not extend the leave beyond the 12 weeks specified by law. B. City's Right to Require an Employee to Use Paid Leave When Using FMLA/CFRA Leave Employees may exhaust their accrued leaves concurrently with FMLA/CFRA leave to the same extent that employees have the right to use their accrued leaves concurrently with FMLA/CFRA leave. 1. Employees are required to use accrued compensatory time earned in lieu of overtime earned pursuant to the Fair Labor Standards Act. VIII. Medical Certification Employees who request leave for their own serious health condition or to care for a child, parent, registered domestic partner, or a spouse who has a serious health condition must provide written certification from the health care provider of the individual requiring care if requested by the City of Temecula. If the leave is requested because of the employee's own serious health condition, the certification must include a statement that the employee is unable to work at all or is unable to perform the essential functions of his/her position. Employees who request leave to care for an injured service member who is a child, spouse, registered domestic partner, parent, or "next of kin" of the employee must provide written certification from a health care provider regarding the injured service member's serious injury or illness. The first time an employee requests leave because of a qualifying exigency, an employer may require the employee to provide a copy of the covered military member's active duty orders or other documentation issued by the military which indicates that the covered military member is on covered active duty or call to active duty status in a foreign country, and the dates of the covered military member's active duty service. A copy of the new active duty orders or similar documentation shall be provided to the employer if the need for leave because of a qualifying exigency arises out of a different active duty or cal to active duty status of the same or a different covered military member. A. Time to Provide A Certification 33 When an employee's leave is foreseeable and at least 30 days notice has been provided, if a medical certification is requested, the employee must provide it before the leave begins. When this is not possible, the employee must provide the requested certification to the City within the time frame requested by the City (which must allow at least 15 calendar days after the employer's request), unless it is not practicable under the particular circumstances to do so despite the employee's diligent, good faith efforts. B. Consequences for Failure to Provide an Adequate or Timely Certification If an employee provides an incomplete medical certification the employee will be given a reasonable opportunity to cure any such deficiency. However, if an employee fails to provide a medical certification within the time frame established by this policy, the City may delay the taking of FMLA/CFRA leave until the required certification is provided. C. Second and Third Medical Opinions If the City has reason to doubt the validity of a certification, the City may require a medical opinion of a second health care provider chosen and paid for by the City. If the second opinion is different from the first, the City may require the opinion of a third provider jointly approved by the City and the employee, but paid for by the City. The opinion of the third provider will be binding. An employee may request a copy of the health care provider's opinions when there is a recertification. D. Intermittent Leave or Leave On A Reduced Leave Schedule If an employee requests leave intermittently (a few days or hours at a time) or on a reduced leave schedule to care for an immediate family member with a serious health condition, the employee must provide medical certification that such leave is medically necessary. "Medically necessary" means there must be a medical need for the leave and that the leave can best be accomplished through an intermittent or reduced leave schedule. IX. Employee Notice of Leave Although the City recognizes that emergencies arise which may require employees to request immediate leave, employees are required to give as much notice as possible of their need for leave. If leave is foreseeable, at least 30 days' notice is required. In addition, if an employee knows that he/she will need leave in the future, but does not know the exact date(s) (e.g. for the birth of a child or to take care of a newborn), the employee shall inform his/her supervisor as soon as possible that such leave will be needed. Such notice may be orally given. If the City determines that an employee's notice is inadequate or the employee knew about the requested leave in advance of the request, the City may delay the granting of the leave until it can, in its discretion; adequately cover the position with a substitute. For foreseeable leave due to a qualifying exigency, an employee must provide notice of the need for leave as soon as practicable, regardless of how far in advance such leave 34 is foreseeable. X. Reinstatement upon Return From Leave A. Right to Reinstatement Upon expiration of leave (no more than 12 weeks or 26 weeks for military situations), an employee is entitled to be reinstated to the position of employment held when the leave commenced, or to an equivalent position with equivalent employment benefits, pay, and other terms and conditions of employment. Employees have no greater rights to reinstatement, benefits and other conditions of employment than if the employee had been continuously employed during the FMLA/CFRA period. If a definite date of reinstatement has been agreed upon at the beginning of the leave, the employee will be reinstated on the date agreed upon. If the reinstatement date differs from the original agreement of the employee and City the employee will be reinstated within two business days, where feasible, after the employee notifies the employer of his/her readiness to return. B. Employee's Obligation to Report Periodically On His/Her Condition Employees may be required to periodically report on their status and intent to return to work. This will avoid any delays to reinstatement when the employee is ready to return. C. Return to Work Certification As a condition of reinstatement of an employee whose leave was due to the employee's own serious health condition, which made the employee unable to perform his/her, job, the employee must obtain and present a certification from their health care provider that the employee is able to resume work. Failure to provide such certification will result in denial of reinstatement. XI. Required Forms Employees must fill out the following applicable forms in connection with leave under this policy: 1. "Request for Family or Medical Leave Form" prepared by the City to be eligible for leave. 2. Medical certification —either for the employee's own serious health condition or for the serious health condition of a child, parent, spouse or registered domestic partner. 3. Authorization for payroll deductions for benefit plan coverage continuation; and 4. Certification to return work from appropriate health care provider. 35 30.1 Pregnancy Leave A pregnant employee shall be entitled to a leave of absence without pay for up to four (4) months so long as the employee's attending physician certifies that she is physically unable to work due to pregnancy, childbirth or related medical condition. During said leave of absence without pay, the employee has the option of using CAL time. In addition, employees who are out on Pregnancy Leave will also be placed on FMLA. Their Pregnancy and FMLA Leaves will run concurrently. Upon expiration of the approved leave, the employee shall be reinstated to her former position or to a comparable one if the former position is abolished during the period of leave and the employee would otherwise not have been laid off. The comparable position is one having similar terms of pay, location, job content and promotional opportunities. Prior to the employee being reinstated, the department director may require a statement from the attending physician that the employee is physically capable of resuming the regular duties of her position. Failure to return to work after the authorized four (4) month leave period causes the employee to have no reinstatement rights. An employee who plans to take such a leave should give reasonable notice of the date the leave shall commence and the estimated duration of the leave. Female employees shall be reasonably accommodated for conditions related to pregnancy, childbirth or related medical conditions if the employee requests an accommodation with the advice of her healthcare provider. Article 31 Jury Duty The City encourages employees to serve as jurors when called upon to do so. When an employee serves on jury duty or is called to testify on a case involving official City business, the employee receives full pay from the City (Government Code Section 1230). However, if an employee is testifying on a civil/criminal case that does not involve official City business, then the employee is required to utilize any accrued Comprehensive Annual Leave (CAL) time that the employee has available. Employees are not required to submit, to the City, any compensation received from the court for serving as a juror. If an employee is called to report to jury duty, the employee shall obtain a "Jury Attendance Certification" form from the court upon dismissal by the judge. The "Jury Duty Certification" form must be attached to the employee's timesheet for verification of jury duty attendance by payroll. Because the time on the "Jury Attendance Certification" form provided by the court and the actual time the employee is released from the jury pool and/or leaves the courthouse may differ, the employee must handwrite the actual time of release on the form. The time should be noted upon instruction from their supervisor or designee to either return to work or be released from work. Jury Duty attendance shall be recorded on the timesheet under the code for jury duty regardless of whether the employee is instructed to return to work or not. When an employee receives an initial summons to report for jury duty, the employee must provide a copy of the summons to his or her supervisor immediately_upon receipt, regardless of whether s/he is called to serve. It is the responsibility of each supervisor to record the employee's absence for jury duty in a manner similar to that used to record the employee 36 absences (i.e. department calendar, weekly staff agenda). If an employee needs to appear in court regarding a personal situation or is summoned to report to the court for a civil or criminal case that does not involve official City business then the employee is required to utilize available Comprehensive Annual Leave (CAL) time. A leave request form must be submitted and approved by the supervisor prior to the leave commencing. Approved personal leave (CAL) time shall be recorded on the timesheet under the code for CAL time. Defining "Practical" Return to Full Duty When released early, which is defined as more than two hours remaining in the business day, from any day of jury duty, the employee shall contact his/her supervisor, or designee, to determine if it is practical to return to full duty. In determining whether an employee shall return to work following the completion of jury duty for that day, reasonable consideration shall be given to such factors as: courthouse delays, parking conditions, travel time, and a rest period. If two (2) hours or less are remaining in the City's standard business day (8 a.m. to 5 p.m.), the employee does not need to contact their supervisor or return to work. Employees are not required to report to work at the City each day prior to reporting to the court for jury duty unless the report time after 12 noon is ordered. Supervisor Determination If upon discussion with the supervisor or designee it is determined that it is NOT practical for an employee to return to full duty that day, the supervisor's written release stating "not practical to return to full duty", along with the supervisor's initials and date, must be noted on the employees "Jury Attendance Certification" form and attached to their timesheet. Article 32 Military Leave The City recognizes the importance of allowing employees time off to serve in the U.S. Armed Forces. This policy allows for employees to take time necessary for the defense of our country. Military leave shall be granted in accordance with the provisions of state and federal law. An employee requesting leave for this purpose shall provide their department director and Human Resources, whenever possible, with a copy of the military orders specifying the dates, site and purpose of the activity or mission. Within the limits of such orders, the department director may determine when the leave is to be taken and may modify the employee's work schedule to accommodate the request for leave. Upon completion of military service, the employee will be reinstated with full seniority to their former position or to a comparable position, if application for reemployment is made within 90 calendar days of release from the service or related hospitalization. An employee who is a member of the National Guard or of a reserve component of the U.S. Armed Forces shall, upon furnishing a copy of the official orders or instructions, be granted a military training leave. Training leaves will not, except in an emergency, or in the event of extenuating circumstances, exceed two (2) weeks per year, plus reasonable travel time. Upon 37 presentation of a military pay voucher or endorsed orders, employees will receive full pay for up to 30 calendar days within one (1) fiscal year. If the leave is greater than 30 days, then the employee may utilize accrued Comprehensive Annual Leave time. If the employee is placed on active duty, the City is required, by law, to return the employee to the same classification, upon the employee's return to City service. The military leave policy has been extended, for those employee's called to active duty as follows: A. With appropriate documentation, the City will pay the difference between the City employee's salary and the employee's military pay, and; B. The difference in salary will be paid for the entire duration of active duty. Article 33 Leaves of Absence Without Pay This provision applies to leaves, which are not covered by other provisions within the MOU. Leave of Absence Without Pay is to be used for the purpose of unforeseen circumstances or other situations where leave is requested by the employee. The unforeseen circumstances under this type of leave do not relate to FMLA or pregnancy leaves of absences. In all cases, Leaves Without Pay must be approved by the City Manager or designee, and do not continue accrual of benefits. Employees should refer to Human Resources for specific details. 33.1 Procedure for Requesting Leave of Absence Without Pay The Department Director, subject to the approval of the City Manager, may grant requests for Leave of Absence Without Pay. Employees generally provide a minimum of two (2) weeks' notice, in writing, to request a Leave of Absence Without Pay. Employees must give reasonable notice, to their Department Director, before returning to work. The maximum leave which may be taken is six (6) months at the sole discretion of the City Manager. In extreme cases, and at City Manager's approval, the maximum leave may be extended beyond six months. Employees shall not accrue Comprehensive Annual Leave time if on a Leave of Absence Without Pay in excess of five (5) business days. Employees may be required to exhaust their Comprehensive Annual Leave prior to commencing Leave of Absence Without Pay status, except as provided in the Family Care Leave Policy and Holiday Pay Policy. Employees shall be responsible for the continuation of City provided health care insurance premiums if on Leave of Absence Without Pay for more than two (2) monthly premium payment periods. 38 Employees shall retain the status of employee while on Leave of Absence Without Pay. However, a Leave Without Pay which exceeds 30 days shall result in an adjustment to the employee's salary and Comprehensive Annual Leave accrual review dates. 33.2 Procedure for Unforeseen Circumstances Requests for Leave of Absence Without Pay may be granted, at the discretion of the City Manager, for prolonged illness or personal reasons, including disabilities not related to worker's compensation. The above procedures will apply to a requested Leave of Absence Without Pay with the exception of providing a two (2) week minimum notice. Employees who request a Leave of Absence Without Pay for illness or personal reasons must provide a written notice of such leave as far in advance as possible. In addition, the City may require a doctor's certification or other official documents in order to verify legitimacy of the employee's request. Article 34 Cafeteria Plan The City agrees to contribute a $1,123 allotment per month for benefit utilization by each represented employee effective July 1, 2013, which shall be increased by $75 to a total of $1,198 allotment per month on January 1, 2014. Consistent with past practice, this payment includes the PERS statutory minimum payment for each calendar year of this Agreement for both active employees and annuitants (retirees). This allotment must be applied to all mandatory benefits as determined by the City. The first day of the month following the date of hire an employee, upon proper application and acceptance, shall be covered under mandatory benefits as set forth in the contract between the City and the carrier(s). The employee can then apply the remainder to optional benefits as described below or take the remainder in cash. The Union agrees to meet and confer with the City over any state or federally mandated changes in benefits that occur during the term of this agreement. In addition, City agrees to include two (2) shop stewards as part of the formal Benefit Committee that meets to discuss annual changes in any health and welfare benefit proposal for the next plan year. The benefit committee will meet prior to the start of the open enrollment period to educate employees on benefits provided during the upcoming plan year. 34.1 Health Coverage During the life of this agreement, the City agrees to continue offering the PERS Health Plan. Employees can opt out of the City provided medical plan if proof of outside medical coverage is provided. The City agrees to meet with the Benefit Committee to discuss any changes in the PERS Health Plan prior to open enrollment. 34.2 Dental Coverage During the life of this agreement, the City agrees to continue to offer dental coverage to represented employees. The City agrees to meet with the Benefit Committee, comprised 39 of representatives from each unit, prior to selection of the dental plan for the respective Plan Year. 34.3 Vision Coverage During the life of this agreement, the City agrees to continue to offer vision coverage to represented employees. The City agrees to meet with the Benefit Committee prior to selection of the vision care plan for the respective Plan Year. 34.4 Disability Insurance The City will offer short-term and long-term disability insurance to represented employees. The City agrees to meet with the Benefit Committee prior to selection of short-term and long-term disability insurance. The STD disability insurance elimination period of 0 - 7 calendar days for accident/in-patient hospitalization; and the STD disability insurance elimination period of 7 -14 calendar days for illness and outpatient procedures. Employees should refer to Human Resources regarding specific details on short term and long term disability coverage's. 34.5 Flexible Benefits Program The City will continue to offer, as long as lawfully permitted, a Flexible Benefits Program during the term of this agreement in accordance with applicable IRS statutes in order to provide employees the greatest possible tax benefit. Included in the Flexible Benefits Program are reimbursement accounts for medical, dental and vision plan deductibles and co -payments; and other health care expenses not covered by existing medical and dental vision coverage. An additional element of the program includes reimbursement of child/dependent care. 34.6 Retiree Medical, Dental and Vision Premium Reimbursement The City will provide medical, dental and vision benefits, for eligible employees and their spouse, upon retirement from the City of Temecula, as follows: A. Eligible retired employees are those employees that were hired or rehired on or before June 30, 2005 and have, upon retirement, completed a minimum of 12 years of cumulative service to the City of Temecula in a regular, benefited position status; who retire from the City of Temecula on or after July 1, 2003; and who have enrolled in coverage under the City's medical, dental and vision plans as provided in Sections 34.1, 34.2 and 34.3 of this agreement, during the appropriate Open Enrollment (prior to the employee's designated calendar year of retirement) and also in accordance with CaIPERS standards. Part-time, regular, benefited employees shall also be eligible provided that total service in Temecula, as defined by PERS, meets the required minimum for this benefit and if they meet the other criteria set forth in this article. If a retired Temecula employee reinstates to a regular benefited position with any 40 California PERS Agency, including the City of Temecula, this benefit will be discontinued and will not be reinstated. The only exception to this rule shall be in the event of a Reduction in Workforce and the employee had been re-employed by the City of Temecula pursuant to Article 44 of this M.O.U. B. Retirement from the City of Temecula shall be defined as a PERS service or industrial disability retirement, and employee must be eligible for such retirement at the time of or within 120 days of separation from City service. The date of eligibility shall be the employee's official CaIPERS retirement date. C. Employees who have retired prior to the effective date of this M.O.U. will be eligible for this benefit in accordance with the terms of the agreement at time of retirement. D. Eligible City of Temecula employees (as defined above), who retire during the term of this M.O.U. will be eligible for a reimbursement, for monthly premiums (not including co- payments, prescriptions, and other non -premium expenses) purchased and paid for by them, of up to the current monthly cafeteria plan allotment, for continued medical, dental and vision coverage as provided for in sections 34.1, 34.2 and 34.3 of this agreement. This payment will begin within 30 days of the employees PERS retirement, and upon written notice from the employee and verification of current payment amounts and will continue through the term of this agreement. E. The amount of actual payment will be based on proof of continued medical, dental or vision insurance and verification of the payment amount. Be advised — the PERS medical premium on a PERS retiree's check is the premium amount AFTER the City of Temecula's mandatory employer contribution has been deducted. Therefore, the City will be calculating the reimbursable amount based on the AFTER the mandatory employer contribution rate established by PERS annually. In addition, the maximum amount of payment will include any mandatory medical payments made by the City. If employee moves from PERS service area, and coverage under the City's medical, dental, and/or vision plans is not available, employee may request that an alternate medical, dental, and/or vision plans be approved by the City, if allowed by law. Coverage is limited to employee, and if applicable, to spouse. The medical, dental, and/or vision insurance benefits will continue for eligible employees, even after the employee qualifies for Medicare coverage. Medicare supplemental coverage and related premiums will be set in accordance with CaIPERS benefit standards. The existing Dental and Vision benefit plans only allow continuation of coverage for retirees for 18 months, after retirement. Following this time period, it is the retiree's responsibility to enroll in dental and vision coverage of their choice. In order to receive reimbursement (not to exceed the monthly allotment), the retiree needs to submit proof of coverage annually to the City's Director of Human Resources. By January 31st of each year, for all coverage's which are outside the PERS medical plan service area, eligible retired employees, or their authorized legal representative, must submit, to the City's Director of Human Resources, proof of coverage and the premium amount for the upcoming year. If this request is not received by January 31st, payments will not be made until the request is received, for that year. Retroactive payments will not be made if the employee 41 fails to submit this information on a timely basis. It is the responsibility of the retired employee to notify the Director of Human Resources of any changes in premium amounts or change in status. This benefit will discontinue upon the death of the retired City employee. Article 35 Life Insurance The first day of the month following date of hire an employee, upon proper application and acceptance by the insurance carrier, shall be covered under a group life insurance plan for the amount of $50,000. Voluntary Life Insurance will be available to employees (outside the City's Section 125 Cafeteria Plan) at no cost to the City. Article 36 Retirement The City has established a multi -tiered retirement benefit. Pursuant to the Public Employment Pension Reform Act of 2012, (also known as "PEPRA", Assembly Bill 340), those who first become employed by the City on or after January 1, 2013, and who are "new members" as that term is defined in PEPRA, shall be subject to a third tier Public Employees Retirement System (PERS) formula of 2% @ age 62, and a benefit based on the highest 36 months of employment. New members shall pay their entire PERS member contribution by payroll deduction at a rate set by PERS at 50% of normal cost as that term is defined in PEPRA. For 2013, that percentage is 6.75%. New members shall also be subject to all other applicable provisions of PEPRA. This retirement formula shall be known as Tier 3. The City's second -tier PERS retirement formula of 2% @ age 60 applies to employees hired on or after September 24, 2011 as allowable by law. Highlights include the following: • A three-year final compensation • Annual 2% COLA • Post -Retirement Survivor Allowance • Fourth Level of 1959 Survivor's Benefit • Military Service Credit as Public Service The City's first tier PERS retirement formula of 2.7% @ age 55 applies to employees hired prior to September 24, 2011 as allowable by law. Highlights include the following: • One-year final compensation • Annual 2% COLA • Post -Retirement Survivor Allowance • Fourth Level of 1959 Survivor's Benefit • Military Service Credit as Public Service. For retirement tiers 1 and 2 employees shall pay percentages of their PERS member 42 contribution as follows: one percent on ratification of this MOU; one additional percent, for a total of 2%, effective July 1, 2014; one additional percent, for a total of 3%, effective July 1, 2015. The City agrees to continue to pay the balance of the Member Contribution (EPMC), required by the Public Employee's Retirement System to maintain the current level of benefits for employees covered by this Memorandum during the term of this agreement. Benefited City employees are not covered under Social Security (1.45% Medicare only). Survivor Benefits: The City of Temecula's PERS 1959 Survivor Benefit coverage (Government Code section 21574) is a higher level of cash benefit paid to survivors of an employee who dies prior to retirement. The City provides Level 4 of PERS' Survivor Benefit. Article 37 Deferred Compensation The City shall provide for a Deferred Compensation Plan which may be utilized by any employee on an optional basis. The City reserves the right to accept or reject any particular plan and to impose specific conditions upon the use of any plan. Such plan shall be implemented without cost to the City. New members as defined in PEPRA shall not be eligible for this deferred compensation benefit. Article 38 Late Starts An employee, who is tardy to work or upon returning from break or lunch, shall be docked pay at the discretion of the Department Director or designee(s). Such docking shall be rounded to the nearest 15 minute increment. However, if the employee is tardy for a period of less than 7 % minutes, then no docking of pay shall occur. If the employee is tardy between 7 % and 15 minutes, then a full 15 minutes shall be docked. An employee and their department manager, upon mutual agreement, may make up late time by either coming in early, staying late, or shortening their lunch hour (lunch hours can only be shortened if employee is on a 1 hour a day lunch schedule) to make the time up. It is understood the time to be made up must be made up within the same 7 day work period the late time occurred, that no overtime will result from making up late time, and that there shall be no disruption to City services or operations. In addition, no provisions of this article are subject to the grievance procedure. Finally, an employee may be disciplined for continued late starts. Article 39 Rest Periods All represented employees may take, for each full eight (8) or nine (9) hour shift worked at the direction of the respective department, a 15 minute break each four or 4 % -hour period. Rest and lunch periods must be arranged with your supervisor and are intended to be uninterrupted time. Employees working in the field shall take, at the direction of the department, rest periods nearby the work site. Rest periods/meals are for the good of the employee, but periods cannot be used to make up for other lost time or to arrive at work late or leave work early. Exceptions to this rule must be with supervisory approval. Rest periods are not cumulative. In the event the employee is called off their lunch break because of an emergency or if the department schedules a hands-on mandatory lunch meeting, the employee is entitled to be compensated for this time. 43 Article 40 Hours of Work The City has an absolute right to assign work schedules for City employees. If the City proposes to change the work schedule of a classification or an employee in a classification, represented by the Union, the City will provide the employee and Union with a written notice which will include the valid business need for the schedule modification. Such written notice will be provided at least ten (10) business days in advance of any change. During the term of this agreement, the City will continue to offer the 9/80-work schedule as defined below: A 9/80 Work Plan is a work schedule whereby employees work 80 hours in a nine (9) day rather than the traditional ten (10) day period. 40.1 Participation Participation in the plan is on a City wide basis. Employees have the option of participating in the 9/80 Work Plan if the Department Director has agreed and the affected classification is eligible based upon the scheduling and service needs of the department. Upon Department Director approval, employees may change from a 9/80 or traditional schedule status to the alternate work schedule on a temporary or on -going basis. 40.2 Work Period The 9/80 work week is defined in section 13.2 of this agreement. 40.3 9/80 Day Off Under the 9/80 Work Plan, employees receive one (1) day off every two (2) weeks. 40.4 Alternating Day Off Designation Friday will be the only alternating day off during the week unless modified by the department. Article 41 Grievance Procedure The purpose of this article is to promote improved employer -employee relationships by establishing procedures for appealing management actions. To afford employees, individually or through representation, a systematic means of obtaining further consideration of problems after every reasonable effort has failed to resolve them through discussion. This process is intended to provide settlement of grievances as near as practicable to the point of origin. 41.1 Grievance A grievance is any alleged violation as to the interpretation or application of personnel policies and practices or the application of any negotiated agreement or any law, rule or 44 regulation governing personnel matters for which there is not another administrative appeal process. 41.2 Representation An employee is entitled to representation in the preparation and presentation of a grievance at any step in the grievance procedure. The grievant is entitled to be released from work for a reasonable period of time in order to present the grievance. 41.3 Grievance Discussion An employee or employee representative will be unimpeded and free from restraint, discrimination, interference, or reprisal in seeking appropriate adjustment of a grievance provided, however, that an employee's representative may not participate in an informal discussion with the supervisor as required prior to the filing of a formal written grievance. 41.4 Non -Reviewable Grievance A grievance is not reviewable under this procedure if it is a matter which would require the modification of a policy established by the City Council or by law, or is reviewable under some other administrative procedure and/or rules of the City, such as: A. Employee requested applications for changes in title, job classification or salary. B. Appeals from formal disciplinary action. C. Appeals from work performance evaluations. However, there may be an allowable grievance if a bargaining unit member conducts a formal evaluation of another bargaining unit member. 41.5 Filing of Grievance In order for an employee to file a grievance, the employee must raise the issue with the immediate supervisor or Department Director, in writing, within 15 business days after the employee knew or, by reasonable diligence, should have known of the circumstances giving rise to the grievance and should be subject to all processing set forth herein. 41.6 Grievance Time Limits The time limits set forth in the grievance procedure may be extended by mutual consent of both parties. Step 1 An employee, before reducing the grievance to writing, will take the matter up with their immediate supervisor in an informal conference. The employee and the supervisor are each entitled to the presence of a silent observer. The silent observer for the grievant 45 must be the shop steward for the grievant's appropriate group. An observer that interrupts or participates in the discussion may be excluded from the discussion by either the employee or the supervisor. The supervisor will have five (5) business days to render a decision in writing. Failure of the supervisor to render a decision in writing within five (5) business days, entitles the employee to move the grievance to the next step. Step 2 If the grievance is not settled in Step 1, the employee and their representative, if any, shall within five (5) business days appeal, in writing, to the employee's Department Director. The Department Director shall schedule a meeting, to hear the grievance, which will take place within ten (10) business days from the date the grievance is referred to Step 2. The Department Director shall issue a decision within ten (10) business days. The employee may within five (5) business days move the grievance to Step 3. Failure by the employee to raise the issue to the next level will result in the grievance procedure ending. Final Step If the grievance is not settled in Step 2, the employee and their representative, if any, shall within five (5) business days appeal, in writing, to the City Manager. The City Manager or, if designated, the Assistant City Manager shall schedule a meeting to take place within 15 business days. The City Manager or Assistant City Manager shall have 15 business days to render a decision which will be final and binding. Article 42 Discipline General Statement of Policy: It is the City's belief that rules of conduct are most effective when they are written and communicated to employees and supervisors, consistently enforced, and the difference between major and minor forms of misconduct recognized. The City's goal is to administer discipline on an equitable and corrective basis. Effective discipline reinforces training by identifying rules and their reasons, correcting misconduct or improving job performance, serving as a deterrent through enforcement, and penalizing in relation to the severity of the offense and the employee's past record. In general, the City will not use supporting documents older than three (3) years when considering a disciplinary action. At the request of the employee, Union representation will be provided during investigative conferences that may result in formal discipline. Formal discipline is defined as a minimum of a written reprimand. If the supervisor anticipates that discipline, resulting in a written reprimand or greater discipline will result, the supervisor shall notify the employee that they have a right to request Union representation prior to further discussion of the issue. Definition of Disciplinary Action: "Disciplinary Action" means action taken by the Department Director or designee for disciplinary reasons, pursuant to the City of Temecula Discipline Policy. Such disciplinary actions include: 1) a formal warning, 2) a written reprimand, 3) disciplinary suspension, 4) reduction in pay, 5) demotion, 6) dismissal, or 7) any other action taken for 46 disciplinary purposes. Informal Discussion: Though not a disciplinary action, when a minor job performance problem develops, an informal discussion shall usually occur to assist the employee in clarifying and remedying the problem. An informal discussion is designed to clarify standards, policies and procedures or rules and regulations so that problems are resolved early and thus, the need to utilize disciplinary action may be avoided. Formal Warning: The formal warning shall be given in response to minor misconduct. The warning should be prompt, calm, and constructive, and every effort shall be made for the formal warning to be given in private. The supervisor/department director shall include in the formal warning a review of appropriate department standards and policies, employee performance expected in the future and consequences for failure to correct performance or behavior. A formal warning will be documented in memorandum format by the supervisor/department director and a copy of the formal warning memorandum to the employee. This memorandum does not go into the employee's central personnel file. In addition, the employee may request that a Union representative be present during this process. Written Reprimand: The written reprimand shall be given by the Department Director or designated authority when a formal warning has not succeeded in stopping the misconduct or when the misconduct is considered too serious to warrant a formal warning. Misconduct includes failure to meet City performance standards. The Department Director should first counsel the employee about the misconduct, as if giving a formal warning. At the end of the discussion, if no extenuating circumstances are discovered, the Department Director shall inform the employee that a letter of reprimand shall follow and shall be placed in their central personnel file located in the Human Resources Department. The written reprimand shall include a full, accurate and factual statement of the reason for the reprimand, if applicable, appropriate department standards and policies, employee performance expected in the future, and consequences for failure to correct performance or behavior. The employee and/or their representative has the right to request a meeting with Human Resources to discuss the content of the written reprimand prior to it being placed in the employee's central personnel file. Finally, the employee has the right to attach a written response to the written reprimand to be placed in the employee's central personnel file. Disciplinary Suspension: Disciplinary suspensions without pay are actions which generally deprive an employee of pay for any period up to 30 business days and are usually given when serious misconduct or repetition of past problems for which the employee has been reprimanded require a strong management response. The nature of the offense, its severity and the circumstances dictate the length of suspension. Recurrence of the same or similar offenses can result in a second or third disciplinary suspension of progressively increased duration or in a dismissal. A disciplinary suspension is given an employee when formal warnings or written reprimands have not been effective, or when the misconduct warrants more than a written reprimand. The City distinguishes between minor disciplinary suspension as one (1) to five (5) business days and major disciplinary suspensions as six (6) to 30 business days. Minor suspensions can be used as steps in progressive discipline. Major suspensions are used as steps in progressive discipline. Major suspensions are used as a more severe step in progressive discipline or 47 where the act of misconduct does not warrant dismissal. Department Directors shall institute disciplinary suspensions only after Human Resources and City Manager approval. Reduction in Pay: The reduction of an employee's base pay through the loss of a grade or step is the action given when a disciplinary suspension has not been effective, or when the misconduct is too serious for disciplinary suspension alone. Department Directors shall institute a reduction in an employee's base pay only after Human Resources and City Manager approval. Demotion: The Department Director may demote an employee for disciplinary reasons or because the employee's ability to perform the required duties falls below standards for that position, provided that the employee has been given a reasonable time to improve. Upon request of the employee, and with the consent of the appointing authority, demotion may be made to a vacant position. No employee shall be demoted to a position unless they possess the minimum qualifications for such a position. Department Directors shall institute a demotion only after Human Resources and City Manager approval. Dismissal: Dismissal or involuntary separation of an employee from City employment shall be imposed only when all other disciplinary measures have failed and the employee is deemed beyond rehabilitation or when an act of misconduct is deemed very serious. A career employee may be dismissed by the Department Director for just cause as outlined in these rules. Resignation: An alternative to Disciplinary Action: At times, an employee may offer to resign instead of facing disciplinary action. By doing so, the employee loses the right to appeal. A resignation must be completely voluntary. If the action taken is a written reprimand, disciplinary probation, a disciplinary suspension, a reduction in pay, a demotion, or a dismissal, documentation shall be in accordance with this policy. A copy of all such disciplinary documents shall be placed in the employee's central personnel file located in the Human Resources Department. The employee shall sign and receive a copy of such disciplinary documents. If the employee refuses to sign the statement, that fact should be noted in writing by the supervisor. Actions that are not Appealable: Denial of merit or pay increases, performance evaluations, informal discussions, oral counseling's, and formal warnings. Disciplinary Action Subject to Skelly Procedure: Prior to a disciplinary suspension, a reduction in pay, a demotion, or a dismissal of a career employee for disciplinary purposes, the procedure set forth in this section shall be complied with. Administrative Suspensions with Pay: Pending investigation of an accusation against an employee, the City Manager may approve the temporary suspension of an employee with pay, 48 pending the undertaking or completion of an investigation or opportunity to respond as may be required to determine if any disciplinary action shall be taken. Skelly Procedure: A. Written Notice: The Department Director or designated authority shall give the employee a written notice of the proposed disciplinary action at least ten (10) business days prior to the effective date. The written notice shall be personally delivered to the employee or sent by certified mail to the employee's last known address. The notice should include the following information: 1. A description of the proposed action to be taken and its proposed effective date or dates; 2. The specific grounds and particular facts upon which the action is proposed to be taken; 3. The employee's right to receive a copy of the written materials alleged to support the proposed action; and 4. A statement advising the employee of the right to respond, orally or in writing, and the time period in which to do so. B. Employee Review and Response: The employee shall be given an opportunity to review the documents or materials upon which the proposed disciplinary action is based. Within ten (10) business days after receipt of the written notice, the employee shall have the right to respond to the Department Director, orally or in writing, concerning the proposed action. Failure to respond within the time specified may result in the employee's waiver of their pre -disciplinary procedural rights. By mutual agreement, the specified time period may be extended. C. Department Director Decision: The Department Director or designee shall, within ten (10) business days, provide a written decision to the employee after reviewing the employee's response, if any. The decision shall be personally delivered to the employee or sent by certified mail to the employee's last known address. The decision shall acknowledge the employee's response and shall be dated and signed by the Department Director. If disciplinary action is to be taken, the written response shall include a statement informing the employee of the right to appeal and the time period within which the appeal must be made. If mutually agreed upon, the effective date of any proposed disciplinary action may be postponed to allow the Department Director enough time to adequately review the employee's response before making a decision. D. Appeal of Department Director's Decision: An employee may appeal a Department Director's decision within ten (10) business days of receiving the decision. An appeal shall be accompanied by a copy of the written notice of disciplinary action served on the employee, the Department Director's written decision, a brief statement of the facts and 49 reasons for the appeal and a brief statement of the relief requested. If, within the ten (10) day appeal period, the employee involved does not file an appeal, unless good cause for the failure is shown, the action of the Department Director or designee shall be conclusive. If an employee withdraws the appeal, the employee waives the right to further review. Appeals filed within the ten (10) day requirement shall be handled in accordance with the following provisions: E. Minor Disciplinary Suspension, Reduction in Pay and Demotion: An employee may appeal a disciplinary suspension of five (5) days or less, or a reduction in pay of 5% or less annualized by submitting a written response to Human Resources within ten (10) business days after the employee has received the Department Director's decision. Such an appeal and decision of the matter is based only upon the written record. Human Resources shall render a written decision within ten (10) business days after receipt of the appeal. The City Manager may modify the disciplinary action, but in no event shall have the authority to increase the disciplinary action. The City Manager's written decision is the final and conclusive administrative review. F. Major Disciplinary Suspension, Reduction in Pay, Demotion and Dismissal: Disciplinary suspensions of greater than five (5) days, reductions in pay greater than 5% annualized any demotions from class to class, or a dismissal may be appealed to the City Manager. The City Manager may designate the Assistant City Manager or another person mutually agreed to by the City Manager and the Union, to serve as Hearing Officer who shall determine the hearing procedure. The hearing need not be conducted according to technical rules relating to evidence and witnesses. However, the Hearing Officer shall ensure that the matter before them can be fairly determined on reliable evidence. The Hearing Officer, shall render a written record of their findings, conclusion and decision as soon after the conclusion of the hearing as possible and in no event later than 20 business days after conducting the hearing, unless the parties otherwise agree. The Hearing Officer may modify the disciplinary action, but in no event shall have the authority to increase the disciplinary action. The Hearing Officer's decision on the appeal is final and conclusive administrative review. However, if an employee reports directly to the City Manager, then a hearing officer may be called in, to act as the final level of administrative review. G. Amended Notice of Disciplinary Action: At any time an appeal is submitted for decision, the Department Director or designated authority may, with the consent of the City Manager, amend the disciplinary action or provide a supplemental notice of disciplinary action. A decision not to impose any disciplinary action should be accompanied by a directive from the Department Director to delete all references to the pending action from the employee's personnel file(s). Failure by the Department Director to make further investigations or to provide an additional written answer shall not affect the ability of the City to impose disciplinary action. 50 If the amended or supplemental notice of disciplinary action presents new causes or allegations, the employee shall be afforded a reasonable opportunity to prepare a response, but the employee shall not be required to file a further appeal. Any objections to the amended or supplemental causes or allegations may be made verbally or in writing during the appeal interview. Article 43 Alcohol and Drug Policy It is the policy of the City of Temecula to have a work environment free from the effects of drugs and alcohol. To accomplish this objective, represented employees agree to abide by the City of Temecula Alcohol and Drug Policy over the life of this agreement. Article 44 Reduction of Workforce The City may separate any employee or class of positions without prejudice, because of financial or economic condition of the City, reduction of work, or abandonment of activities. The City shall give such employees not less than two (2) weeks advance notice of separation and the reason therefore. However, no permanent full-time employee shall be separated from a department while emergency, project, probationary, part-time, or temporary employees are employed and serving in the same positions in the department. The order of layoff shall be as follows: Order of Layoff: The order of layoff of career employees shall be made in accordance with a system, which favors retention of the more meritorious employees, based upon evaluation of the following factors in the listed order of importance: A. The three (3) most recent performance evaluation records once finalized and filed in Human Resources. The overall evaluation rating will be utilized for purposes of determining performance. If the overall evaluation rating category includes a combination rating such as Commendable/Outstanding (C/O), the rating will be combined to determine overall performance. Those employees with the lowest overall ratings will be further evaluated in Section B and C, detailed below. Should there be a change to the rating categories as a result of revisions to the City's Performance Evaluation format, the City agrees to a limited re -opener to discuss needed adjustments to Article 44. B. Documented disciplinary actions above the written reprimand level during the preceding 12 months C. Seniority (as defined in Article 9) in relation to the following categories: 1. in the City 2. in the classification 3. in the department. In exceptional circumstances, the City may determine that it is not cost effective to replace specific employees, within a classification, who have received specialized training to perform duties or carry out responsibilities related to a specific department. 51 Re-employment List: The name of every regular employee who is laid off, for longer than one (1) pay period due to a reduction -in -force, shall be placed on the Re-employment List, in order of layoff. Vacancies to be filled within a department shall be offered, first in reverse order of layoff (last employee reduced is first rehired), to individuals named on the Re-employment List who at the time of the reduction -in -force, held a position in the same job classification. The City may also offer voluntary layoff packages to employees. These packages, at the discretion of the City Manager, may provide 90 days of compensation for employees who volunteer to participate in a voluntary reduction of workforce process. Individual names may be removed from the Re-employment List for any of the following reasons: A. The expiration of 12 months from the date of placement on the list. B. Re-employment with the City in a regular full-time position. C. Request in writing to be removed from the list. Status on Re-employment: A regular employee who has been laid off or terminates in lieu of reassignment and is re-employed in a regular position within 12 months from the date of their layoff or termination shall be entitled to: A. Restoration of seniority accrued prior to layoff. B. Credit for all service prior to layoff for the purpose of determining the rate of accrual of Comprehensive Annual Leave (CAL). C. Placement in the salary range as if the employee had been on a leave of absence without pay if they are reinstated to the same job classification. Article 45 Job Actions The Union agrees not to strike or otherwise engage in withholding services or concerted action during the term of this agreement. Also, the City agrees not to lock out the employees. Article 46 Americans with Disabilities Act (ADA) Because the Americans with Disabilities Act (ADA) requires reasonable accommodations for individuals protected under the Act, and because these reasonable accommodations must be determined on an individual case -by -case basis, the parties agree that the provisions of this agreement may be disregarded in order for the City to avoid discrimination relative to hiring, promotions, granting permanency, transfer, layoff, reassignment, termination, rehire, rates of pay, job and duty classification, seniority, leave, fringe benefits, training opportunities, hours of work, or other terms and privileges of employment. The bargaining unit recognizes that the City has the legal obligation to meet with the individual employee to be reasonably accommodated before any adjustment is made in working conditions. The employee's bargaining unit will be notified of these proposed reasonable accommodations prior to implementation by the City. 52 Any reasonable accommodation provided to an individual protected by the ADA shall not establish a past practice, nor shall it be cited or used as evidence of a past practice in the Grievance/Arbitration procedure. Prior to disregarding any provision of this agreement in order to undertake required reasonable accommodations for an individual protected by the Act, the City will provide the business representative of the bargaining unit with written notice of its intent to disregard the provision, and if requested will allow the business representative of the bargaining unit the opportunity to discuss options to disregarding the agreement. Article 47 Classification Studies Classification and compensation plan: Complete classification plan by Late February or Early March 2014. Complete compensation study by June 30, 2014. Further negotiations on classification plan implementation after June 30, 2014. Effective immediately after the agreed upon implementation of the 2012-13 classification and compensation study, the preexisting article 43 from the 2002-05 MOU shall be reinstated in this agreement as article 47. Article 48 Performing Arts/ Theater Staff Represented City employees who work at the City of Temecula Old Town Temecula Community Theater are provided benefits in accordance with the M.O.U. A. Employees are provided Shift Differential in accordance with Article 18 of the M.O.U. B. Employees who do not receive a meal break after the 5th hour shall be compensated at 1.5 times their hourly rate of pay until a meal break is provided, in accordance with Article 40. The City utilizes outside production companies therefore if a meal penalty occurs, employees will be compensated at time and a half by the production company, in accordance with the M.O.U. C. With regards to overtime, all employees shall be compensated in compliance with Article 13 (Overtime) of the M.O.U. D. Employees shall receive an 8 hour rest period between work periods, as outlined in Article 13.4 (Overtime). Article 49 Posting of Vacancies The City will post all bargaining unit vacancies consistent with the MOU. The City agrees to conduct a competitive process for any bargaining unit open position, including promotions, during the life of this agreement. This competitive process does not apply to the classification studies. During the first five working days of posting, only regular employees may submit applications. Thereafter there shall be no restrictions on who may submit applications for a posted position in the bargaining unit. Article 50 Separability If any provision of this agreement shall be declared void or unenforceable by a court of 53 competent jurisdiction, the remaining provisions of this agreement shall remain in full force and effect, except that either party to the agreement may request the other party to meet and confer in regard to amending the agreement to replace the provisions declared void or unenforceable. However, there will be no obligation on either party to agree on a replacement provision. Article 51 Performance Evaluations The established Classification Studies Committee(s) will set up measurable criteria for each classification along with a more detailed definition of each of the five (5) rating levels to create "consistency" in the evaluation process throughout all City departments. All managers will be trained in communication skills and enhance their ability/knowledge to give employees the tools needed to achieve acceptable rating levels and maintain a successful career path. If an employee's overall rating drops two (2) rating levels from one evaluation period to the next evaluation period — the employee has the right to appeal the rating with representation from both the Union and the City Manager's office present. When there is a change with whom a bargaining unit employee reports to, their evaluation for that rating period will be completed in the following manner: a. The evaluation will be completed by the supervisor that had the employee under their supervision the most during that 12-month period. b. The new supervisor will provide input and establish a new set of goals/objectives. c. The employee's evaluation date will not change unless the change to a new supervisor is due to a promotion. Overdue Evaluations An overdue evaluation report will be given to the Union Chief Steward, by Human Resources, on a mutually agreed upon schedule. Human Resources and the Union will work cooperatively to ensure the timely receipt of annual evaluations. At 60 days past the official evaluation due date, the Director of Human Resources will meet with the appropriate Department Director, of the affected employee, at which time a date will be determined to give the evaluation. If an annual evaluation becomes 90 days overdue, an automatic step increase will be given (if applicable). The Union can initiate payment by contacting Human Resources. If an extenuating circumstance exists, the manager will discuss this with the affected employee and will come to a mutually agreed upon extension. If any evaluation becomes 120 days overdue, it may be subject to the Union filing a grievance. Article 52 — Personnel Rules and Policies City shall prepare and submit to the Union for negotiations a draft comprehensive set of Personnel Rules and Policies. Article 53 - Notice to Meet and Confer on Policy Changes The City shall meet and confer on any policy change that comes within the scope of 54 representation under the Meyers-Milias-Brown Act (MMBA). Article 54 - Reporting Outlining Project Employee Hours The City shall provide a quarterly report to Union Leadership, outlining Project Employee Titles, Department, and year-to-date Hours Worked. 55 Title Accounting Assistant Accounting Specialist Administrative Assistant Aquatics Supervisor Assistant Engineer Assistant Planner Associate Engineer Associate Planner Assistant Signal Technician Building Inspector II Business License Specialist / Cashier Central Services Coordinator Central Services Supervisor Code Enforcement Officer Code Enforcement Officer II Community Development Technician Construction Manager Custodian Development Processing Coordinator Facility Services Manager I.T. Specialist Junior Engineer Landscape Inspector Lead Maintenance Worker Maintenance Worker Appendix A Represented Classifications 7/1/13 Title Office Specialist Park Ranger Patron Services Coordinator Public Works Inspector Purchasing Coordinator II Recreation Coordinator Recreation Supervisor Special Projects Engineer Sr. CIP Specialist Sr. I.T. Specialist Sr. Landscape Inspector Sr. Office Specialist Sr. Public Works Inspector Sr. Recreation Coordinator Sr. Signal Technician Theater Technical Coordinator Theater Technical Supervisor 56 Item No. 6 Approvals City Attorney Finance Director City Manager CITY OF TEMECULA AGENDA REPORT TO: City Manager/City Council FROM: Amer Attar, Acting City Engineer DATE: October 22, 2013 SUBJECT: Acceptance of Equipment and Notice of Completion for the Theater Energy Efficient Lighting, PW12-18 PREPARED BY: Judith M. McNabb, Administrative Assistant RECOMMENDATION: 1. Accept the purchase and delivery of energy efficient lighting equipment from Sacramento Theatrical Lighting, Ltd., for the Theater Energy Efficient Lighting Project, PW12-18, as complete; 2. Direct the City Clerk to file and record the Notice of Completion. BACKGROUND: The Old Town Temecula Community Theater's outdated lighting console cueing/programming architecture no longer supported hardware and software updates, which greatly limited a lighting designer's ability to create a vision for the production. New equipment and system offered almost unlimited potential and flexibility. On December 11, 2012, City Council approved an agreement with Sacramento Theatrical Lighting, Ltd. to purchase equipment in the amount of $222,054.45. The Theater Energy Efficient lighting, including Technology and Equipment Upgrade project updated the Theater's lighting console and theatrical lighting fixtures, which include LED sources, and interior house and work lights. It provided significant energy efficiency, which translated into cost savings in energy, labor, and maintenance, making it a viable and "Green" system for many years to come. City staff has completed the installation of the new equipment and the new system is now fully operational. The improvements increased the ability of the City's clients to produce their best possible show, giving them near limitless choices in their artistic vision, and greatly enhancing the experience for the theater patrons. FISCAL IMPACT: The Theater Energy Efficient Lighting, Including Technology and Equipment Upgrade was budgeted within the City's Capital Improvement Program Budget for Fiscal Year 2013-17 and was funded with Development Impact Fees (DIF) — Parks and Recreation. The total cost of the equipment purchased was $222,054.45. There is no fiscal impact as a result of the acceptance of the project and filing the Notice of Completion. ATTACHMENT: Notice of Completion RECORDING REQUESTED BY AND RETURN TO: CITY CLERK CITY OF TEMECULA 41000 Main Street Temecula, CA 92590 NOTICE OF COMPLETION NOTICE IS HEREBY GIVEN THAT: 1. The City of Temecula is the owner of the property hereinafter described. 2. The full address of the City of Temecula is 41000 Main Street, Temecula, California 92590. 3. The Nature of Interest is an Agreement which was awarded by the City of Temecula to Sacremento Theatrical Lighting, Ltd., 950 Richards Boulevard, Sacramento, CA 95811, to perform the following work of improvement: THEATER ENERGY EFFICIENT LIGHTING Project No. PW12-18 4. Said work was completed by said company according to plans and specifications and to the satisfaction of the Director of Public Works of the City of Temecula and that said work was accepted by the City Council of the City of Temecula at a regular meeting thereof held on October 22, 2013. 5. The property on which said work of improvement was completed is in the City of Temecula, County of Riverside, State of California, and is described as follows: 92590. THEATER ENERGY EFFICIENT LIGHTING Project No. PW12-18 6. The location of said property is: 42051 Main Street, Temecula, California Dated at Temecula, California, this 22od day of October 2013 of Council Meeting. City of Temecula Susan W. Jones MMC, City Clerk CAProgram Files (x86)W eevia. ComVDocument ConverterA tempA5294 docx Forth STATE OF CALIFORNIA ) COUNTY OF RIVERSIDE ) ss CITY OF TEMECULA ) I, Susan W. Jones MMC, City Clerk of the City of Temecula, California, do hereby certify under penalty of perjury, that the foregoing NOTICE OF COMPLETION is true and correct, and that said NOTICE OF COMPLETION was duly and regularly ordered to be recorded in the Office of the County Recorder of Riverside by said City Council. Dated at Temecula, California, this 22nd day of October 2013 of Council Meeting. City of Temecula Susan W. Jones MMC, City Clerk CAProgram Files (x86)W eevia. ComVDocument ConverterA temp A5294 docx Forth Item No. 7 Approvals City Attorney Finance Director City Manager CITY OF TEMECULA AGENDA REPORT TO: City Manager/City Council FROM: Amer Attar, Acting City Engineer DATE: October 22, 2013 SUBJECT: Acceptance of Improvements and Notice of Completion for the Citywide Slurry Seal Fiscal Year 2012-13, PW12-23 PREPARED BY: Avlin R. Odviar, Senior Engineer — CIP Kendra Hannah-Meistrell, Associate Engineer - CIP RECOMMENDATION: 1. Accept the construction of the Citywide Slurry Seal Fiscal Year 2012-13, PW12- 23, as complete; 2. Direct the City Clerk to file and record the Notice of Completion, release the Performance Bond, and accept a three-year Maintenance Bond in the amount of 10% of the contract amount; 3. Release the Labor and Materials Bond seven months after filing of the Notice of Completion if no liens have been filed. BACKGROUND: On May 28, 2013, the City Council awarded a construction contract to American Asphalt South, Inc., in the amount of $424,041.40, to complete the Citywide Slurry Seal Fiscal Year 2012-13, PW12-23. The project consisted of cleaning and crack sealing the existing roadway surface, applying slurry, and restoring pavement delineation at various streets within Los Ranchitos, Santiago Ranchos, Santiago Estates, Country Manor Estates, Windsor Crest, Rancho Vista Estates, and Promenade at Temecula. Slurry was used to seal the project roadways against water intrusion and deterioration of the asphalt concrete pavement wearing surface. The Contractor has completed the work in accordance with the approved plans and specifications to the satisfaction of the Director of Public Works/City Engineer. All work will be warranted for a period of three years from September 16, 2013, the date the City obtained "beneficial use" of the project improvements. The retention for this project will be released pursuant to the provisions of Public Contract Code Section 7107. FISCAL IMPACT: The Citywide Slurry Seal Fiscal Year 2012-13, PW12-23 is funded by the Measure A Fund in the Operating Budget. The base amount of the construction contract was $424,041.40, approved contract change orders totaled $76,508.54, which results in the total cost of the project of $500,549.94. ATTACHMENTS: 1. Notice of Completion 2. Maintenance Bond 3. Contractor's Affidavit and Final Release RECORDING REQUESTED BY AND RETURN TO: CITY CLERK CITY OF TEMECULA 41000 Main Street Temecula, CA 92590 NOTICE OF COMPLETION NOTICE IS HEREBY GIVEN THAT: 1. The City of Temecula is the owner of the property hereinafter described. 2. The full address of the City of Temecula is 41000 Main Street, Temecula, California 92590. 3. The Nature of Interest is a Contract which was awarded by the City of Temecula to American Asphalt South, Inc., 14436 Santa Ana Avenue, Fontana, CA 92337 to perform the following work of improvement: CITYWIDE SLURRY SEAL FISCAL YEAR 2012-13 Project No. PW12-23 4. Said work was completed by said company according to plans and specifications and to the satisfaction of the Director of Public Works of the City of Temecula and that said work was accepted by the City Council of the City of Temecula at a regular meeting thereof held on October 22, 2013. That upon said contract The Guarantee Company of North America USA was surety for the bond given by the said company as required by law. 5. The property on which said work of improvement was completed is in the City of Temecula, County of Riverside, State of California, and is described as follows: CITYWIDE SLURRY SEAL FISCAL YEAR 2012-13, Project No. 12-23 6. The location of said property is: Various Streets Citywide, Temecula, California. Dated at Temecula, California, this 22th day of October, 2013 of Council Meeting. City of Temecula Susan W. Jones MMC, City Clerk CAProgram Files (x86)W eevia. ComVDocument ConverterAtemp A5300 docx Forth STATE OF CALIFORNIA ) COUNTY OF RIVERSIDE ) ss CITY OF TEMECULA ) I, Susan W. Jones MMC, City Clerk of the City of Temecula, California, do hereby certify under penalty of perjury, that the foregoing NOTICE OF COMPLETION is true and correct, and that said NOTICE OF COMPLETION was duly and regularly ordered to be recorded in the Office of the County Recorder of Riverside by said City Council. Dated at Temecula, California, this 22th day of October, 2013 of Council Meeting. City of Temecula Susan W. Jones MMC, City Clerk CAProgram Files (x86)W eevia. ComVDocument ConverterAtemp A5300 docx Forth CITY OF TEMECULA, DEPARTMENT OF PUBLIC WORKS BOND NO. 12098464 MAINTENANCE BOND FOR CITYWIDE SLURRY SEAL FISCAL YEAR 2012-13 PROJECT NO. PW12-23 KNOW ALL PERSONS BY THESE PRESENT THAT: American Asphalt South, Inc., 14436 Santa Ana Avenue, Fontana, CA 92337 NAME AND ADDRESS CONTRACTOR'S a Corporation , hereinafter called Principal, and Oil In whether a Corporation, Partnership or individual) The Guarantee Company of North America USA , 1800 Sutter Street, Suite 880, Concord, CA 94520 NAME AND ADDRESS OF SURETY hereinafter called SURETY, are held and firmly bound unto CITY OF TEMECULA, hereinafter called OWNER, in the penal sum of ---Fifty Thousand, Fifty -Four DOLLARS and Ninety -Nine --- CENTS ($50,054.99--- ) in lawful money of the United States, said sum being not less than ten percent of the Contract value payable by the said City of Temecula under the terms of the Contract, for the payment of which, we bind ourselves, successors, and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION is such that whereas, the Principal entered into a certain Contract with the OWNER, dated the 281h day of May , 2013, a copy of which is hereto attached and made a part hereof for the construction of CITYWIDE SLURRY SEAL FISCAL YEAR 2012-13, PROJECT NO. PW12-23. WHEREAS, said Contract provides that the Principal will fumish a bond conditioned to guarantee for the period of three years after approval of the final estimate on said job, by the OWNER, against all defects in workmanship and materials which may become apparent during said period; and WHEREAS, the said Contract has been completed, and was the final estimate approved on September 16 , 2013. NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, that if within one year from the date of approval of the final estimate on said job pursuant to the Contract, the work done under the terms of said Contract shall disclose poor workmanship in the execution of said work, and the carrying out of the terms of said Contract, or it shall appear that defective materials were furnished thereunder, then this obligation shall remain in full force and virtue, otherwise this instrument shall be void. MAINTENANCE BOND Mt3R-1 CCO-002 Revisea 3 Yr Maintenance Bond As a part of the obligation secured hereby and in addition to the face amount specified, costs and reasonable expenses and fees shall be included, including reasonable attorney's fees incurred by the City of Temecula in successfully enforcing this obligation, all to be taxed as costs and included in any judgment rendered. The Surety hereby stipulates and agrees that no change, extension of time, alteration, or addition to the terms of the Contract, or to the work to be performed thereunder, or to the specifications accompanying the same, shall in any way affect its obligations on this bond, and it does hereby waive notice of any such change, extension of time, alteration, or addition to the terms of the Contract, or to the work, or to the Specifications. Signed and sealed this 25th day of September 2013. (Seal) American Asphalt South, Inc. SURETY By: 5 e (NgThe) reere749, (Title) %'Ce A'/e/ APPROVED AS TO FORM: Peter M. Thorson, City Attorney The Guarantee Company of North America USA PRINCIPAL -(Name) Attorney -in -Fact (Title) By: (Name) (Title) Attach Notarial Acknowledgement or Jurat for both the Surety and Principal Signatures MAINTENANCE BOND MBR•2 CCO-002 Revised 3 Yr Maintenance Bond (01TGEUARANTEE The Guarantee Company of North America USA Southfield, Michigan POWER OF ATTORNEY KNOW ALL BY THESE PRESENTS: That THE GUARANTEE COMPANY OF NORTH AMERICA USA, a corporation organized and ex'sting under the laws of the State of Michigan, having its principal office in Southfield, Michigan does hereby constitute and appoint Barbara Mldstokke, Renee Ramsey, Richard W. Pratt, John Hopkins, Elizabeth Collodi, Susan Lee, Barbara Beeny, Nancy Luttenbacher, Phillip O. Watkins, Keith T. Schuler, Jennifer Lelouarn Interwest Insurance Services, Inc. Its true and lawful attorney(s)-In-fact to execute, seal and deliver for and on Its behalf as surety, any and all bonds and undertakings, contracts of indemnity and other writings obligatory in the nature thereof, which are or may be allowed, required or permitted by law, statute, rule, regulation, contract or otherwise. The execution of such instrument(s) in pursuance of these presents, shall be as binding upon THE GUARANTEE COMPANY OF NORTH AMERICA USA as fully and amply, to all intents and purposes, as If the same had been duly executed and acknowledged by its regularly elected officers at the principal office The Power of Attorney is executed and may be certified so, and may be revoked, pursuant to and by authority of Article IX, Section 9.03 of the By -Laws adopted by the Board of Directors of THE GUARANTEE COMPANY OF NORTH AMERICA USA at a meeting held on the 31" day of December, 2003. The President, or any Vice President, acting with any Secretary or Assistant Secretary, shell have power and authority: 1. To appoint Attorneys) -In -fact, and to authorize them to execute on behalf of the Company, and attach the Seal of the Company thereto, bonds and undertakings, contracts of indemnity and other writings obligatory in the nature thereof; and 2. To revoke, at any time. any such Attorney -in -fact and revoke the authority given. except as provided below 3. In connection with obligations in favor of the Florida Department of Transportation only, it is agreed that the power and authority hereby given to the Attorney -in -Fact includes any and all consents for the release of retained percentages andlor final estimates on engineering and construction contracts required by the State of Florida Department of Transportation. It is fully understood that consenting to the State of Florida Department of Transportation making payment of the final estimate to the Contractor and/or its assignee, shall not relieve this surety company of any of its obligations under its bond. 4. In connection with obligations in favor of the Kentucky Department of Highways only, It is agreed that the power and authority hereby given to the Attorney -in -Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner — Department of Highways of the Commonwealth of Kentucky at least thirty (30) days prior to the modification or revocation. Further, this Power of Attorney is signed and sealed by facsimile pursuant to resolution of the Board of Directors of the Company adopted at a meeting duly called and held on the 61h day of December 2011, of which the following is a true excerpt: RESOLVED that the signature of any authorized officer and the seal of the Company may be affixed by facsimile to any Power of Attomey or certification thereof authorizing the execution and delivery of any bond, undertaking, contracts of indemnity and other writings obligatory in the nature thereof, and such signature and seal when so used shall have the same force and effect as though manually affixed. IN WITNESS WHEREOF, THE GUARANTEE COMPANY OF NORTH AMERICA USA has caused this instrument to be signed and , its corporate seal to be affixed by its authorized officer, this 23rd day of February, 2012. g i4 lr' .1 THE GUARANTEE COMPANY OF NORTH AMERICA USA I AIR STATE OF MICHIGAN Stephen C. Ruschak, Vice President County of Oakland On this 23rd day of February, 2012 before me came the individuals who executed the preceding instrument, to me personally known, and being by me duly sworn, said that each is the herein described and authorized officer of The Guarantee Company of North America USA; that the seal affixed to said instrument Is the Corporate Seal of said Company; that the Corporate Seal and each signature were duly affixed by order of the Board of Directors of Cynthia A. Takei Notary Public, State of Michigan County of Oakland My Commission Expires February 27, 2018 Acting in Oakland County Randall Musselman, Secretary IN WITNESS WHEREOF, I have hereunto set my hand at The Guarantee Company of North America USA offices the day and year above written. a- I, Randall Musselman, Secretary of THE GUARANTEE COMPANY OF NORTH AMERICA USA, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney executed by THE GUARANTEE COMPANY OF NORTH AMERICA USA, which is still In full force and effect. IN WITNESS WHEREOF, I have thereunto set my hand and attached the seal of said Company this 25th day of September , 2013 Randall Musselman, Secretary CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County of Butte On September 25, 2013 before me, Elizabeth Collodi, Notary Public (Here insert name and title of the officer) personally appeared Jennifer Lelouarn who proved to me on the basis of satisfactory evidence to be the person(e) whose name(e) is/efe subscribed to the within instrument and acknowledged to me that he/she/':hey executed the same in hie/herAtheir authorized capacity(ies), and that by #is/her/ter signature($ on the instrument the person(e), or the entity upon behalf of which the personfe) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. d-Z-64det% Signature N otaty Public ELIZABETH COLLODI COMM. # 1878873 NOTARY PUBLIC-CALIFORNIA,„ COUNTY OF BUTTE Comm. Expires FEB. 1.2014 ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING THIS FORM Any acknowledgment completed in California must contain verbiage exactly as appears above in the notary section or a separate acknowledgment form must he properly completed and attached to that document. The only exception is if a document is to be recorded outside of California. In such instances, any alternative acknowledgment verbiage as may be printed on such a document so long as the verbiage does not require the notary to do something that is illegal for a notary in California (i.e. certifying the authorized capacity of the signer). Please check the document carefully for proper notarial wording and attach this form if required DESCRIPTION OF THE ATTACHED DOCUMENT Maintenance Bond (Title or description of attached document) American Asphalt South, Inc. (Title or description of attached document continued) Number of Pages 2 Document Date 09/25/13 The Guarantee Company of North America USA (Additional information) CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) ❑ Corporate Officer (Title) ❑ Partner(s) ❑■ Attorney -in -Fact ❑ Trustee(s) ❑ Other • State and County information must be the State and County where the document signer(s) personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s) personally appeared which must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her commission followed by a comma and then your title (notary public). • Print the name(s) of document signer(s) who personally appear at the time of notarization. • Indicate the correct singular or plural forms by crossing off incorrect forms (i.e. he/she/they, is/ere-) or circling the correct forms. Failure to correctly indicate this information may lead to rejection of document recording. • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges, re -seal if a sufficient area permits, otherwise complete a different acknowledgment form. • Signature of the notary public must match the signature on file with the office of the county clerk. +.- Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a different document. '.- Indicate title or type of attached document, number of pages and date. °.- Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer, indicate the title (i.e. CEO, CFO, Secretary). • Securely attach this document to the signed document 2008 Version CAPA 02.10.07 800-873-9865 www.NotaryClasses.com CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT County of -SA eir aei State of California ss. C•=7 On 9/4 personally appeared before me, hJwJ M,/t,i'- /Veil: y Name and Title of Officer (e g , 'Jane Doe. Notary PobTie) RICHARD ENTRIKIN COMM. # 2029943 2 NOTARY PUBLIC - CAUFORMA SAN BERNARDINO COUNTY My Comm. Expires July 13, 2017 Name(s) ol Signer(s) ,X proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/Are subscribed to the within instrument and acknowledged to me that heis.heilbey executed the same in his/I:of/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer Signer's Name: O Individual o Corporate Officer — Title(s): D Partner — 0 Limited 0 General Attorney -in -Fact O Trustee 111 Guardian or Conservator 0 Other: Signer Is Representing: CI 1999 National Notary Association • 9350 De Soto Ave., P.O. Box 2402 • Chatsworth. CA 91313.2402 • wvAy.nalionalnotary org RIGHT THUMBPRINT OF SIGNER! Top ol thumb here -•. Prod. No. 5907 Reorder: Call Tr:A-Free 1-800-876.6827 CALtFOREflb ALL.P (POSE ACKNOWLEDGMENT State of California County of 56. gZ On uzi 7t V Dale <G personally appeared _� SS. 3 before me, _ e-c k i c cc cr N o & ( Name and Tele or 018cer le g 'Jane Doe. Nolary Public") JERI MARIE GRANT COMM. # 2031882 2 NOTARY PUBLIC - CALIFORNIA E SAN BERNARDINO COUNTY My Comm. Expires June 30, 2017 Narrre(s) 01 Signer(s) *proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/sfae/tI ey executed the same in his/beer/tAeir authorized capacity(ies), and that by his/berltb.en signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. OPT!ON.4L LESS my hand and official sell_ 4 AA S grralure of Nolary Pubfc Though the information below is not required by law. it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s): ❑ Partner — 0 Limited 0 General O Attorney -in -Fact ❑ Trustee ❑ Guardian or Conservator O Other: Signer Is Representing: C. 1999 Nalional Nolery Association • 9350 De Solo Ave.. P.O. Box 2402 • Cllalswonb. CA 91313-2402 • www.nalionalnolary org Prod. No. S907 Reorder Call To11•Free 1.800.876.6827 CITY OF TEMECULA, DEPARTMENT OF PUBLIC WORKS CONTRACTOR'S AFFIDAVIT AND FINAL RELEASE CITYWIDE SLURRY SEAL FISCAL YEAR 2012-13 PROJECT NO. PW12-23 This is to certify that L snu« ftse6AA 4,4<, (hereinafter the "CONTRACTOR") declares to the City of Temecula, under oath, that he/she/it has paid in full for all materials, supplies, labor, services, tools, equipment, and all other bills contracted for by the CONTRACTOR or by any of the CONTRACTOR's agents, employees or subcontractors used or in contribution to the execution of its contract with the City of Temecula, with regard to the building, erection, construction, or repair of that certain work of improvement known as CITYWIDE SLURRY SEAL FISCAL YEAR 2012-13, PROJECT NO. PW12-23, situated in the City of Temecula, State of Califomia, more particularly described as follows: �nc.ous Ci 5frseks INSERT ADDRESS OR DESCRIBE LOCATION OF WORK The CONTRACTOR declares that it knows of no unpaid debts or claims arising out of said Contract which would constitute grounds for any third party to claim a Stop Notice against of any unpaid sums owing to the CONTRACTOR. Further, in connection with the final payment of the Contract, the CONTRACTOR hereby disputes the following amounts: Description Dollar Amount to Dispute Pursuant to Public Contract Code §7100, the CONTRACTOR does hereby fully release and acquit the City of Temecula and all agents and employees of the City, and each of them, from any and all claims, debts, demands, or cause of action which .exist or might exist in favor of the CONTRACTOR by reason of payment by the City of Temecula of any contract amount which the CONTRACTOR has not disputed above. Dated: /0/3/( 3 By: CONTRACTOR Signat(ire Jeff Pei U. PrintP. RELEASE R•1 PW52-23 Bid Ooa Item No. 8 Approvals City Attorney Finance Director City Manager CITY OF TEMECULA AGENDA REPORT TO: City Manager/City Council FROM: Amer Attar, Acting City Engineer DATE: October 22, 2013 SUBJECT: Sixth Amendment to the Professional Engineering Services Agreement with RBF Consulting for design of Interstate 15/State Route 79 South Ultimate Interchange, PW04-08 PREPARED BY: Avlin R. Odviar, Senior Engineer — CIP RECOMMENDATION: 1. Approve the Sixth Amendment to the Agreement for Professional Engineering Services with RBF Consulting for design of Interstate 15/State Route 79 South Temecula Parkway Ultimate Interchange, increasing the contingency amount by $200,000; 2. Increase the City Manager's authority to approve Extra Work Authorizations by $200,000. BACKGROUND: On December 16, 2008, the City Council approved the Agreement for the preparation of construction plans, specifications, and estimate (PS&E) for the project. Complex projects, such as this one, that involve coordination and consensus among multiple jurisdictions and private parties are dynamic. The ability to rapidly address scope of work revisions fosters a fast response to change. Approval of this Amendment will minimize delays by providing the City Manager the authority to address necessary increases to the scope of work by an additional $200,000, which is above the previously authorized $385,260. FISCAL IMPACT: The amount of the Agreement, as amended to date, is $3,069,060. With approval, the resulting Agreement amount will be $3,269,060. This project is identified in the City's Capital Improvement Program, Fiscal Years 2014-18. Funding sources include CFD (Crowne Hill), Reimbursement/Other (Morgan Hill), SAFETEA-LU, Senate Bill 621, and TUMF (RCTC). Adequate funds are available in the project design account 210-165-662- 5802 to fund the increase of $200,000. ATTACHMENTS: 1. Sixth Amendment 2. Project Location 3. Project Description SIXTH AMENDMENT TO AGREEMENT FOR PROFESSIONAL ENGINEER SERVICES BETWEEN THE CITY OF TEMECULA AND RBF CONSULTING PW04-08 INTERSTATE-15/STATE ROUTE 79 SOUTH ULTIMATE INTERCHANGE THIS SIXTH AMENDMENT is made and entered into as of October 22, 2013, by and between the City of Temecula, a municipal corporation (hereinafter referred to as "City"), and RBF Consulting, a company of Michael Baker Corporation (hereinafter referred to as "Consultant"). In consideration of the mutual covenants and conditions set forth herein, the parties agree as follows: 1. This Amendment is made with the respect to the following facts and purposes: a. On December 16, 2008, the City and Consultant entered into that certain Agreement entitled "Agreement for Professional Engineer Services between the City of Temecula and RBF Consulting, PW04-08 Interstate-15/State Route 79 South Ultimate Interchange," in the amount of $2,032,600, plus contingency in the amount of $203,260. b. On July 13, 2010, the City and Consultant entered into the First Amendment to that certain Agreement entitled "Agreement for Professional Engineer Services Between the City of Temecula and RBF Consulting, PW04-08 Interstate-15/State Route 79 South Ultimate Interchange," to increase the contingency in the amount of $182,000. c. On April 5, 2011, the City and Consultant entered into the Second Amendment to that certain Agreement entitled "Agreement for Professional Engineer Services Between the City of Temecula and RBF Consulting, PW04-08 Interstate-15/State Route 79 South Ultimate Interchange," to add scope of work, extend the term of the agreement to December 16, 2011, and to increase the payment in the amount of $68,500. d. On December 16, 2011, the City and Consultant entered into the Third Amendment to that certain Agreement entitled "Agreement for Professional Engineer Services Between the City of Temecula and RBF Consulting, PW04-08 Interstate-15/State Route 79 South Ultimate Interchange," to extend the term of the agreement to June 30, 2013. e. On November 13, 2012, the City and Consultant entered into the Fourth Amendment to that certain Agreement entitled "Agreement for Professional Engineer Services Between the City of Temecula and RBF Consulting, PW04-08 Interstate-15/State Route 79 South Ultimate Interchange," to add scope of work, extend the term of the agreement to June 30, 2014, and to increase the payment in the amount of $316,000. f. On August 27, 2013, the City and Consultant entered into the Fifth Amendment to that certain Agreement entitled "Agreement for Professional Engineer Services Between the City of Temecula and RBF Consulting, PW04-08 Interstate-15/State Route 79 South Ultimate Interchange," to add scope of work extend the term of the agreement to June 30, 2015, and to increase the payment in the amount of $266,700. g. The parties now desire to increase the contingency in the amount of $200,000, and to amend the Agreement as set forth in this Amendment. 1 2. Section 5 of the Agreement entitled "PAYMENT" at paragraph "a" is hereby amended to read as follows: "The City agrees to pay Consultant monthly, in accordance with the payment rates and schedules and terms set forth in Exhibit B, Payment Rates and Schedule, attached hereto and incorporated herein by this reference as though set forth in full, based upon actual time spent on the above tasks. Any terms in Exhibit B, other than the payment rates and schedule of payment, are null and void. The Sixth Amendment amount shall not exceed Two Hundred Thousand Dollars ($200,000) for additional work to be defined in Extra Work Authorization(s) for a total Agreement amount of Two Million Six Hundred Eighty -Three Thousand Eight Hundred Dollars ($2,683,800), plus Contingency in the amount of Five Hundred Eighty -Five Thousand Two Hundred Sixty Dollars ($585,260), for a total of Three Million Two Hundred Sixty -Nine Thousand Sixty Dollars ($3,269,060)." 3. Section 5 of the Agreement entitled "PAYMENT" at paragraph "c" is hereby amended to read as follows: "The City Manager may approve additional work up to Five Hundred Eighty -Five Thousand Two Hundred Sixty Dollars ($585,260) as approved by City Council. Any additional work in excess of this amount shall be approved by the City Council." 4. Except for the changes specifically set forth herein, all other terms and conditions of the Agreement shall remain in full force and effect. 2 IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed the day and year first above written. CITY OF TEMECULA RBF CONSULTING (Two Signatures of corporate officers required unless corporate documents authorize only one person to sign the agreement on behalf of the corporation.) By: By: Michael S. Naggar, Mayor Steven B. Burick, Vice President ATTEST: By: By: Susan W. Jones, MMC, City Clerk APPROVED AS TO FORM: By: Peter M. Thorson, City Attorney CONSULTANT James E. McDonald, CEO RBF Consulting Attn: Steven B. Burick, Vice President 14725 Alton Parkway (949) 855-5733 Office (949) 330-4130 Fax burick@rbf.com PM Initials: tr'� Q Date: v �J 3 INTERSTATE-15 / HIGHWAY 79 SOUTH ULTIMATE INTERCHANGE Circulation Project Location Aerial Data - March 2010 Feet 0 265 530 1,060 A 59 Capital Improvement Program. Fiscal Years 2014-18 �vn INTERSTATE-15 1 STATE ROUTE 79 SOUTH ULTIMATE INTERCHANGE CMculuflon Project Project Description: This project includes right-of-way acquisition, design, and construction of a ramp system that will improve access to Interstate 15 from Temecula Parkway/State Route 79 South. The interchange will accommodate traffic generated by future development of the City's General Plan land use as well as regional traffic volume Increases forecasted for the year 2030. This protect Is crucial, as the projected traffic volume Increases currently exceed the capacity of the existing Interchange Improvements constructed by the Riverside County Transportation Department Benefit / Core Value; This project will improve circulation, freeway access, and level of service at the Interstate 15 and Temecula Parkway 1 State Route 79 South Intersection. In addition, this project satisfies the Clty's Core Value of Transportation Mobility and Connectivity. Protect Statute The plans, specifications, and estimates package are currently being prepared for review by California Department of Transportation (Caltrans). Acquisition Is estimated to be complete during fiscal year 2013-14. Construction Is scheduled to start during fiscal year 2014-15, when funding Is avalable. Department: Pubic Works —Account No. 210.165.662 Laval: Prolsct Cod: Prior Tee re Aatuel 64perrdareu Feel VNr Erded2012 2013-14 Carryover Adopted Budget Appropriation 2014-15 2015-16 2016-17 2017-10 Total Project Projected Projected Projected Projected Gaut Administration $ a96.584 $ 100,946 $ 70,000 $ 70,000 $ 68,100 $ 697,832 Acquisition $ 7,413,992 $5,000,000 $ 375,715 $ 12.789,707 Construction $ 104,088 $ 9,100,000 $15,433,000 $ 24,607,088 Camtn4c ion Engineering $ 1,300,003 $ 2,200,000 $ 3,500,000 Design $ 3,220,287 $ 147,22A $ 324,010 $ 2,701,616 MSHCP $ 765,003 $ 706,060 Totals $11,138,961 $6,248,175 $ 779,716 $11,1715,1= $17,661,100 $ - $ - $46,000,942 Sorge of Funds: Prior Yee le Aohral eependtirae Aeon I Year ended2012 2013414 Carryover Adopted 6 owns iApproprwwl Preje led 2016-16 Plolecled 201617 2017-1 t Total Project Projected Protected Caen CFD (Crow no FE) Rylmblrawnenf/ $ 502,211 1 502,211 Other (Moron Fa) $ 1,190,582 $ 1,190,582 SAFETEA.LU $ 1,600,000 $ 1,600,000 Serge Hil 621 $ 4,902,158 $ 5,248,176 $ MI,716 $ 8,460,206 514,470,254 'RIME $ 4,462,000 $ 4,462,000 (RCruC mP)ny $ 5.400,000 $ 5.400,000 TIME (RCn7Fiplonyo TUMF (4C1GAegim)w $ 715,795 $ 7,108,213 $ 7,824,008 Unspecified.) $10,582,887 5 10,562,8E7 Total Funding: $11.136.951 $5,248,175 $ 779,715 $11,175,000 $17,581,109 $ - $ - $48.000,942 Future Operation & 10sfrdsrrncs Costs: 2013-14 2014-11 2016-16 2015-17 2017-11 $ 6.000 $ 6,120 $ $,742 $ 6,367 (1) ThkF (RCTCfCETAP) - Fording is pursuant to RCTC Agreement Mo. 11-72-041-00 ($6r400,000 to deb) (2) TUAF(RCTChtepon)- Fuldhg1e pureuard to RCTC Agreement No. 06-72-506 ($4,452,000) (3) 11.11.F(RCTCAlegion)- 3upplemsni•I funding ell provide the required addaonal funds based on received construoton bids. (4) Project cannot be constructed until a funding source le Identlled. 60 TEMECULA COMMUNITY SERVICES DISTRICT Item No. 9 ACTION MINUTES of October 8, 2013 City Council Chambers, 41000 Main Street, Temecula, California TEMECULA COMMUNITY SERVICES DISTRICT MEETING The Temecula Community Services District Meeting convened at 7:43 P.M. CALL TO ORDER: Vice President Edwards ROLL CALL: DIRECTORS: Edwards, Naggar, Roberts, Washington, Comerchero CSD PUBLIC COMMENTS • Wayne Hall CSD CONSENT CALENDAR 8 Action Minutes — Approved Staff Recommendation (4-0-1, Director Comerchero absent) Director Washington made the motion; it was seconded by Director Roberts; and electronic vote reflected approval with one absence. RECOMMENDATION: 8.1 Approve the action minutes of September 24, 2013. CSD DIRECTOR OF COMMUNITY SERVICES REPORT CSD GENERAL MANAGER REPORT CSD BOARD OF DIRECTORS REPORTS CSD Action Minutes 100813 1 CSD ADJOURNMENT At 7:49 P.M., the Community Services District was formally adjourned to Tuesday, October 22, 2013, at 5:30 PM, for a Closed Session, with regular session commencing at 7:00 PM., City Council Chambers, 41000 Main Street, Temecula, California. Jeff Comerchero, President ATTEST: Susan W. Jones, MMC City Clerk/District Secretary [SEAL] CSD Action Minutes 100813 2 COUNCIL BUSINESS Item No. 10 Approvals City Attorney Finance Director City Manager CITY OF TEMECULA AGENDA REPORT TO: City Council FROM: Aaron Adams, City Manager DATE: October 22, 2013 SUBJECT: Community Service Funding Program for Fiscal Year 2013-14 PREPARED BY: Betsy Lowrey, Sr. Management Analyst RECOMMENDATION: Review and approve the Fiscal Year 2013-14 Community Service Funding Program grants pursuant to the attached spreadsheet outlining the Ad Hoc Subcommittee's recommendation of $75,562 to 17 organizations, which includes an appropriation of $5,562 to the Community Service Funding Program from the General Fund available fund balance. BACKGROUND: The City Council appointed Mayor Mike Naggar and Council Member Chuck Washington to the Fiscal Year 2013-14 Community Service Funding Ad Hoc Subcommittee to allocate grant funds up to $5,000 per non-profit organization that provides community services to the citizens of Temecula. The Community Service Funding Program adopted Fiscal Year 2013-14 budget is $70,000. Community Service Funding Program Applications were mailed or e-mailed with a link to non- profit organizations in the Temecula Valley area including all community -based organizations in the City's database from the last distribution period, as well as those organizations that called or stopped by City Hall requesting an application. In addition to the e-mailing and mailing, advertisements were sent to the local newspapers, and the application and guidelines were posted on the City's website. A total of 31 applications from non-profit organizations were submitted requesting a total of $150,562 in grant funding. The Ad Hoc Subcommittee, along with staff members, reviewed the requests for funding based on criteria previously adopted by the entire City Council to continue to support those non-profit organizations who offer community -wide services such as food, clothing, shelter, and medical care. After review and discussion, the Ad Hoc Subcommittee recommends that 17 organizations receive grant funding up to $5,000 each, totaling $75,562. This includes increasing the Community Service Funding Program Fiscal Year 2013-14 budget of $70,000 by $5,562 to be able to fund all of the Ad Hoc Subcommittee recommendations. FISCAL IMPACT: Funds are available in the Fiscal Year 2013-14 Community Service Funding line item budget in the amount of $70,000. An appropriation of $5,562 from the General Fund available fund balance is necessary in order to fund the Community Service Funding Ad Hoc Subcommittee recommendation totaling $75,562. ATTACHMENTS: 1. Fiscal Year 2013-14 Community Service Funding Program Ad Hoc Subcommittee Recommendation Spreadsheet 2. Fiscal Year 2013-14 Community Service Funding Program Applications CITY OF TEMECULA FY 2013-14 Community Service Funding Program Applications Account No. 001-101-999-5267 APPL NO. 1 NAME OF ORGANIZATION AHEPA TEMECULA CHAPTER NO 536 (AMERICAN HELLENIC EDUCATIONAL PROGRESSIVE ADSSOCIATION PROJECT Temecula International Food & Music Festival on April 5, 2014 at the Temecula CRC 2012-13 AWARD 2013-2014 REQUEST $ 5,000 AdHoc Sub. Committee Recommendation Comments Did not apply last year 2 ALL FROM THE HEART Divine Equine - Horse Therapy for combat veterans Declined $ 5,000 - 3 ALL FROM THE HEART Support Our Troops - Event to be at the Temecula Harley Davidson site on December 7, 2013 Declined $ 5,000 - 4 ALL FROM THE HEART Wheels For Warriors would allow wheelchairs for 17 combat veterans $ 5,000 $ 5,000 $ 5,000 5 ANIMAL FRIENDS OF THE VALLEYS Spay and Neuter Clinic for low income members of the community $ 5,000 — Did not apply last year APPL NO. NAME O. ORGANIZATION PROJ 2012-13 AWARD 2013-2014 REQUEST AdHo Committee Sub.Comments Recommendation 6 ASSISTANCE LEAGUE OF TEMECULA VALLEY (ALTV) Building and Grounds Improvements and Maintenance $ 5,000 $ 5,000 $ 5,000 7 BIRTH CHOICE OF TEMECULA Pregnancy Resource Services for Community $ 000 $ 5,000 $ 5,000 8 BOYS & GIRLS CLUB OF SOUTHWEST COUNTY AM/PM Transportation and Enrichment Program for Low Income Youth $ 5,000 $ 5,000 $ 5,000 9 CANNINE SUPPORT TEAMS Service Dog Training Program for a dog to be placed with Temecula family; likely one of the veterans on PAWS waiting list Declined $ 5,000 N APPL NO. NAME 0 ORGANIZATION PROJ 2012-13 AWARD 2013-2014 REQUEST AdHo Committee Sub.Comments Recommendation 10 CHAPARRAL HIGH SCHOOL FOUNDATION GRAD NIGHT Chaparral High School Grad Night is intended to give several hundred students a safe/memorable experience that keeps them from alternative private parties Declined $ 5,000 11 FINE ARTS NETWORK Performers Connecting with Students or "Show in the Box" designed to bring the performing arts to local public schools. (Requesting coordination for use of CRC/amphitheater.) $ 5 000 N Did not apply last year 12 GOD'S FAN CLUB DBA PROJECT T.O.U.C.H. Transitional and Supportive Housing for homeless including shelter, food, transportation, medication, etc. Declined $ 5,000 13 HABITAT FOR HUMANITY INLAND VALLEY A Brush with Kindness - Offset home repairs to seniors, disabled and low-income homeowners $ 5,000 $ 5,000 $ 5,000 14 HOSPICE OF THE VALLEYS Senior Assistance Program -end of life services $ 5,000 $ 5,000 $ 5,000 APPL NO. NAME OF ORGANIZATION PROJECT 2012-13 AWARD 2013-2014 REQUEST AdHoc Sub. Committee Recommendation Comments 15 MICHELLE'S PLACE BREAST CANCER RESOURCE CENTER Breast Health Assistance for approximately 60 women $ 5,000 $ 5,000 $ 5,000 16 OUR NICHOLAS FOUNDATION Peace of Mind (safety kits for autistic families) $ 5,000 $ 5,000 $ 5,000 17 ROTARY CLUB OF TEMECULA FOUNDATION Holiday Food Baskets project $ 5,000 $ 5,000 Did noteaplylast y 18 ROYAL FAMILY KIDS OF CROSSROADS CHURCH Royal FamilyKids Camp$ y 5 000 Did not apply last year 19 SENIOR CITIZENS SERVICE CENTER OF THE TEMECULA RANCHO AREA, INC. Food Bank project for families, homeless and senior citizens with programs that include Bread, Commodities, Brown Bag, Emergency Food and Pet Food and Holiday Baskets $ 5,000 $ 5,000 $ 5,000 20 SOCIETY OF ST. VINCENT DE PAUL New Refrigerator g $ 3,362 $ 3,362 Did not apply last year APPL NO. NAME O. ORGANIZATION PROJECT 2012-13 AWARD 2013-2014 REQUEST AdHoc u • Committee Recommendation Comments 21 SPECIAL OLYMPICS EY TEMECULA VALLEY Special Olympics Temecula Valley $ 2,500 $ 5,000 $ 2,500 22 SUSAN G. KOMEN INLAND EMPIRE Access to Breast Health Education & Resources - Assist in education and outreach efforts in the City of Temecula - two projectors, two iPads $ 2,200 $ 2,200 Did not apply last year 23 T.E.A.M. Evangelical Assistance Ministries DBA:TEMECULA PANTRY Temecula Pantry - serving food families in need (12% seniors, 30% homeless, 55% families) Declined $ 5,000 24 TEMECULA DOLLARS FOR SCHOLARS (Formerly "Citizens' Scholarship Foundation of Temecula Valley") Temecula Dollars for Scholars Student Scholarships Declined $ 5,000 N 25 TEMECULA SUNRISE ROTARY CLUB Safety Town - creates a small town to teach children hazards... stop signs, traffic lights, pedestrian crossings, etc, with child sized pedal cars Declined $ 5,000 APPL NO. NAME O. ORGANIZATION PROJECT 2012-13 AWARD 2013-2014 REQUEST AdHoc Sub. Committee Recommendation Comments 26 TEMECULA VALLEY GARDEN CLUB To be used towards seeds, materials, plants and fertilizers to be provided to low and moderate income students Declined $ 5,000 27 TVIHA (Temecula Valley Inline Hockey Assoc) Rink improvements at Ronald Reagan and Margarita including lighting, new nets, resurfacing of rink, provide loaner equipment/gear for low income youth $ 5,000 Did not apply last year 28 TEMECULA VALLEY MUSEUM Student Trip Outreach (Providing students field trips to the Temecula Museum) $ 5,000 $ 5,000 $ 2,500 29 TEMECULA VALLEY PEOPLE HELPING PEOPLE 2013 Care to Share Holiday Program -Food on Thanksgiving and gifts to children at Christmas $ 5,000 $ 5,000 $ 5,000 30 VFW POST 4089 TEMECULA VALLEY Food Boxes for Veterans, Families & Seniors $ 5,000 $ 5,000 $ 5,000 APPL NO. NAME OF ORGANIZATION PROJECT 2012-13 2013-2014 Ad Hoc Sub• Committee AWARD REQUEST Recommendation Comments 31 VNW-CIRCLE OF CARE, INC. Food Distribution $ 5,000 $ 5,000 5,000 $ 67,500 $ 150,562 $ 75,562 City of Temecula 2013-14 CS Funding Program APPLICATION NO. 1 CITY OFTEMECULA n8-29-13 A01:36 IN FISCAL YEAR 2013.14 COMMUNITY SERVICE FUNDING PROGRAM APPLICATION (Please Print or Tvoe) RECEIVED 2013-14 Program Subr lesion Deadline: CITY MAN Friday, August 30, 2013 (original, plus one copy) o>>=FIcEAGER'S PROJECT INFORMATION Amount Requested: $ 5, oo o (Maximum allowable $5,000) Project Name: \ M CCU► j `t\Y-W�' j�� I U t%A1 L 0'0 As-Nr' kA V51 Project Start Date: A ti o L 5 + 2014 Project End Date: r 1 L Sa � 12c.) \r- ORGANIZATION INFORMATION Name of Organization: A �A MCC (MA fr\ i I-E. 5 3 Contact Name: 1--EC IQ 51-A v Title/Position: \ �L /� Mailing Address: A G44-1 kU \ `(JO0 `�i , ` ME COLA 1 CA `75cf, Telephone: S n ¶`O Year Organization Founded: 20 to Number of Paid Staff: Vo kit Number of Volunteers: '>)C) Geographic Area(s) Served: M C(3 L A Is this organization incorporated in California as a non-profit organization? euot••xei-s o18`7 Yes No J Effective Date: If "yes" (Must provide a copy of your statement of non- profit status from the State of California): Date of incorporation as a non-profit: Federal identification number: State identification number: If "no"- C. ` OI c1v� -tC \ \ �* D Name of sponsoring organization: ° Federal identification number: State identification number: This application has been authori d by the organization's: Executive Committee Board of Directors Application Page 1 Members -at -Large FY 2012-13 COMPLIANCE REQUIREMENT IF YOUR ORGANIZATION WAS A RECIPIENT OF FUNDING FOR FY 2012-13, PLEASE ATTACH COPIES OF INVOICES, RECEIPTS AND CANCELLED CHECKS TO SUBSTANTIATE THOSE FUNDS RECEIVED AND EXPENDED BY YOUR ORGANIZATION. FINANCIAL STATEMENTS PLEASE ATTACH COPIES OF THE CURRENT BUDGET OF THE ORGANIZATION AND FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT). It does not require a CPA's audit, but please submit if available. MISSION STATEMENT Briefly describe the goals and objectives of your organization and community services it provides. Describe the ways your organization meets the criteria listed on page 2 of the CS Funding Policy. Toe A - A OkriNe_ri «n \-\-J2WQYN;c_ rovtc.S5jUP, 4Sociirccock1) ex_v,\\S C\A ecS s+ani c)t-`4\kok-t iL(1441 ,c 4r(c_ efoMr.:4) t •iJL.kca9.e..icciz L. °t4 LO (;C- t\A ACM Qt Y\CL ACT(P91(- du- O rn �) (`t—S c 01 S T nccki cVva AoAsikc-- IV° in A�,kr «.15cjp •X' n d men � c Y\c ecksiR�v1 e d!r l, tgk ou e\ e 4,10,000 -Vle\e:ICAnlecual wleCO a (c v'm kr iAl 40tACeLoa p rt°__*ZpviA oQS'oAtl_ `c2resL ('S,(Q. vo QeQkf 4\'ejoW e one A-17 AVre 0k'Tem.(ca4t,couv e(Ve u) chriv� I cinS (AI -Wto efintov1c e we \Name, Ck4e< no 'K\evti rescrs V�tc �V _ redAm l .iY\c Ineui ' r\`nv1`th Uj i 5� �ybo (NA n uri2 v\eQA CS PROJECT DESCRIPTION .( oco r frizAlber, actin' vcQ18.,k .1-j V c A\-- `(o \\ QCoke c , eXkiG� c icn �- �y� r �^lV� A- zm� hA- is- Civevy a ki5 \44 Application Page 2 How will your organization use the funding awarded? Describe the project, project objectives, those served, area serviced, and number of volunteers involved. Be specific. Include equipment or services that would be purchased and why. Include a detailed budget and a schedule of significant activities related to this project. You may attach a maximum of one double-spaced typewritten page of information. (Please type or print legibly.) A -C\tve _ --"c.e xt‘.ecijs). \-\!\\t- Wve%-\-A, owaL Q0(Q_ 0\A A-Q k201 I -I rr1-k- E C c Q Vie c% cxyq, vmvOtyy\cAktA 'Di A fA-pl- FD5G , ch.T...1-14-- Ch vi i Vtev ivc -o Scy.Yh .c- f�t;O`MC 2. *\ic r �C),C ScCk 11J \� U\S� l�I,ll,,a. 4*€ @j k Q We w & Q. C'�C tk,_ .e -� R'.- P_ ms con wren u »v Q.(1112. \rAk*(C.. my\c A,0,Aces;Me 7cari fccrCA ;stsccVeac \ it ck , 10Q n�c sri,lc1 X•a rn V atc k 0. k5 CC& Y t(j PS G -\-e US,, \ C- �hq h\l e cow Q.0(ct cent elr,A avy\� c vP p UA---��. reclaik prof CMv- Sifil cc.(4) �a i c r\-- Q o �rrxteC'taTn CAT �A ke- -ems rkiJi�-t P6�P vtk�Qotst �>,�1tiq WV COdlr�C(hir S n q0((Q \'J1, Sok.Psst_c • ?*) r F)sccS GEC (s),mrw.cxi �, ca r ogo 5 C 4 \Sov SAND 1 f200 qr\41(.1, 210O0 ilS *k> C 000 p 'r�. . 7\'1a�n rr 1 E��(C�lc � Oc�O � �� `x� Cd�lsi d�v�r�'1 . Application Page 3 PAST PROJECT BENEFITS If your organization received City of Temecula funding in the previous year, please explain and show how Temecula residents benefited. >�l 1\_)ut A Application Page 4 StGGAT1RE PAGE We hereby certify the information contained k this application is true to the best of our knowledge and belief. PREPARED BY: SIGNATURE: L6---O'J S j Pr I►20S PRESIDENT or AUTHORIZED OFFICER: r>?ers mt. and TITLE (Please Print or Type) G NAME and TITLE (Please Print or Type) SIGNATURE: CAN 1J 4K' ORGANIZATION NAME: It f �� Ply" `T( wt GL�L C -P lc-k 536 MAILING ADDRESS: ��-L, y 7 T O {-f i N TELEPHONE: 0 S i 5„i -'� 0 ��. EMAIL ADDRESS: DATED THIS 2 1- of UG US\-- , 2013 (Date) (Month) BE SURE TO INCLUDE THE ORIGINAL PLUS ONE COPY AND SUBMIT BY AUGUST 30, 2013 TO: Mail Completed Applications to: City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office Post Office Box 9033 Temecula, CA 92589-9033 Or Deliver in jiprson to: City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office 41000 Main Street Temecula, CA 92590 UKULK U SUP R E M E LODGE HEADQUARTERS AMERICAN HELLENIC EDUCATIONAL PROGRESSIVE ASSOCIATION April 9, 2010 Order of AHEPA AHEPA Chapter No. 536 Temecula CA RE: Tax Exemption EIN No. 27-2310287 The Order of AHEPA was exempt under the provision of Section 501 (c) (8) of the Internal Revenue Service Code. Subsequent to the issuance of the letter ruling dated September 28, 1959, the tax law was changed and AHEPA is now tax exempt under Section 501 (c) (10). This exemption applies to all AHEPA subordinate chapters, district lodges and their related activities. The Order of AHEPA is listed as a charitable organization in IRS Publication 78 where it is shown as a central organization holding a group exemption (No.1466). In addition, the Order of AHEPA and subordinate chapters and district lodges are permitted under Section 170 (c)(4) to establish accounts or funds for religious, charitable, scientific, literary or educational purposes or for the prevention of cruelty to children or animals Contributions to the Order of AHEPA or to a chapter or district for any of these purposes are deductible as charitable contributions. Order of AHEPA Chapter No.536 is in good standing with the Order of AHEPA and is part of this exemption. Please advise if additional information is needed. Sincerely, Patrice P. Farish, CPA Controller 1909 Q STREET NW • WASHINGTON, DC 20009 • (202) 232-6300 • FAX (202) 232-2140 Website wwwahepaorg email ahepaeahepaorg ENT OF THE URY IRS INTERNAL REVENUE SERVICERVC CINCINNATI OH 45999-0023 CHAPTER NO 536 40230 AVENIDA ALVARADO TEMECULA, CA 92590 Date of this notice: 04-09-2010 Employer Identification Number: 27-2310287 Form: 5S-4 Number of this notice: CP 575 E For assistance you may call us at: 1-800-829-4933 IF YOU WRITE, ATTACH THE STUB AT THE END OF THIS NOTICE. WE ASSIGNED YOU AN EMPLOYER IDENTIFICATION NUMBER Thank you for applying for an Employer Identification Number (EIN). We assigned you EIN 27-2310287. This EIN will identify you, your business accounts, tax returns, and documents, even if you have no employees. Please keep this notice in your permanent records. When filing tax documents, payments, and related correspondence, it is very important that you use your EIN and complete name and address exactly as shown above. Any variation may cause a delay in processing, result in incorrect information in your account, or even cause you to be assigned more than one EIN. If the information is not correct as shown above, please make the correction using the attached tear off stub and return it to us. Assigning an EIN does not grant tax-exempt status to non-profit organizations. Publication 557, Tax Exempt Status for Your Organization, has details on the application process, as well as information on returns you may need to file. To apply for formal recognition of tax-exempt status, most organizations will need to complete either Form 1023, Application for Recognition of Exemption Under Section 501(c)(3) of the Internal Revenue Code, or Form 1024, Application for Recognition of Exemption Under Section 501(a). Submit the completed form, all applicable attachments, and the required user fee to: Internal Revenue Service PO Box 192 Covington, KY 41012-0192 The Pension Protection Act of 2006 contains numerous changes to the tax law provisions affecting tax-exempt organizations, including an annual electronic notification requirement (Form 990-N) tor organizations not required to file an annual information return (Form 990 or Form 990-EZ). Additionally, if you are required to file an annual information return, you may be required to file it electronically. Please refcr to the Charities & Non -Profits page at www.irs.gov for the most current information on your filing requirements and on provisions of the Pension Protection Act of 2006 that may affect you. To obtain tax forms and publications, including those referenced in this notice, visit our Web site at www.irs.gov. If you do not have access to the Internet, call 1-800-829-3676 (TTY/TDD 1-800-829-4059) or visit your local IRS office. (IRS USE ONLY) 575E 04-09-2010 CHAP 0 9999999999 SS-4 IMPORTANT REMINDERS: * Keep a copy of this notice in your permanent records. This notice is issued only one time and the IRS will not be able to generate a duplicate copy for you. * Use this EIN and your name exactly as they appear at the top of this notice on all your federal tax forms. * Refer to this EIN on your tax -related correspondence and documents. * Provide future officers of your organization with a copy of this notice. If you have questions about your EIN, you can call us at the phone number or write to us at the address shown at the top of this notice. If you write, please tear off the stub at the bottom of this notice and send it along with your letter. If you do not need to write us, do not complete and return the stub. Thank you for your cooperation. Keep this part for your records. CP 575 E (Rev. 7-2007) Return this part with any correspondence so we may identify your account. Please correct any errors in your name or address. CP 575 E 9999999999 Your Telephone Number Best Time to Ca11 DATE OF THIS NOTICE: 04-09-2010 ( ) - EMPLOYER IDENTIFICATION NUMBER: 27-2310287 FORM: SS-4 NOBOD INTERNAL REVENUE SERVICE CINCINNATI 0H 45999-0023 CHAPTER NO 536 40230 AVENIDA ALVARADO TEMECULA, CA 92590 Exempt Organizations Select Check Page 1 of 1 i1IRS Exempt Organizations Select Check Exeunt OCAanizations Select Check Home Tax Period: 2012 (01/01/2012 - 12/31/2012) Employer Identification Numbor (EIN): 27-2310287 Legal Name: ORDER OF AHEPA Mailing Address: 29782 ALYA CT MURRIETA, CA 92683 United States Doing Business As: CHAPTER NO 638 Gross receipts not greater than: 650,000 Organization has terminated: No Principal officer's Name and Address: EVAN VASSILAKIS 29782 Al YA CT MURRIETA, CA 92663 United States Wabaite URL: Related 990-N (ePosfcard) Filings: If the organization has filed additional Forma 990-N (e-Postcards), link(s) to addktonal e-Postcard 88iigs are displayed below. Click on the link(s) to see the Information Included in those fi ing(s). TaxYear201Q Tax Year 2011 E8tom_toSearch Results Return to Search Page http://apps.irs. gov/app/eos/displayEPostcard. do?dispatchMethod=displayEpostInfo&ePostc... 9/5/2013 Banking Summary - YTD 1/1/2013 through 8/28/2013 8/28/2013 Page 1 1 /1 /2013- 8/28/2013 Category EXPENSES Ahepa -120.00 Ahepa Luncheon 187.87 Christos Tsiboukas 530.00 Daughters Of penolope 454.66 Donation To Woman In Greece 182.00 dues -540.00 Dues To Ahepa 520.00 Fantis Foods 537.25 glendi expenses 1,631.42 Glenti At Nicks -4,127.00 New years eve 345.72 Toni Soraci 500.00 TOTAL EXPENSES 101.92 OVERALL TOTAL -101.92 Income/Expense Comparison by Category - YTD 1/1/2012 through 8/28/2013 8/28/2013 Page 1 1/1/2012- 1/1/2013- Amount Category 8/28/2012 8/28/2013 Difference INCOME Uncategorized 5.00 0.00 -5.00 TOTAL INCOME 5.00 0.00 -5.00 EXPENSES Ahepa 440.00 -120.00 560.00 Ahepa Luncheon 0.00 187.87 -187.87 Chapter Expenses 50.47 0.00 50.47 Christos Tsiboukas 0.00 530.00 -530.00 church 950.00 0.00 950.00 Daughters Of penolope 0.00 454.66 -454.66 Donation To Woman In Greece 0.00 182.00 -182.00 DOP 2,581.38 0.00 2,581.38 dues -425.00 -540.00 115.00 Dues To Ahepa 0.00 520.00 -520.00 Dues,misc -335.00 0.00-335.00 Fantis Foods 0.00 537.25 -537.25 Funeral 500.00 0.00 500.00 Gifts Given 250.00 0.00 250.00 Glendi ads revenue, New Years Eve Part -468.00 0.00-468.00 glendi expenses 0.00 1,631.42 -1,631.42 Glenti At Nicks 0.00-4,127.00 4,127.00 Meeting Expenses 70.00 0.00 70.00 New years eve 1,703.56 345.72 1,357.84 Toni Soraci 0.00 500.00 -500.00 travel 300.29 0.00 300.29 TOTAL EXPENSES 5,617.70 101.92 5,515.78 OVERALL TOTAL -5,612.70 -101.92 5,510.78 8/29/13 Pacific Western Bank Account Details for Checking - 1000543395 Available Balance $5,226.69 As Of Date 8/29/2013 Ledger Balance $5,226.69 Interest Rate 0.0000 % Current Balance $5,226.69 Next Day Float $0.00 Last Deposit Amount $60.00 2-Day Float $0.00 Last Statement Date 7/31/2013 3-Day Float $0.00 Account History for Checking - 1000543395 Posted SORTED BY; POST DATE NEWEST ON TOP DEBIT CREDIT BALANCE Regular Check $55.00 $5,226.69 7/2/13 (Check #3096) Regular Deposit $60.00 $5,281.69 6/21/13 Regular Check 6/17/13 (Check #3095) $100.00 $5,221.69 Regular Check $354.66 $5,321.69 6/17/13 (Check #3094) Regular Check 6/13/13 (Check #3093) $331.42 $5,676.35 Regular Check 6/13/13 (Check #3092) $1,300.00 $6,007.77 Regular Deposit 6/13/13 $200.00 $7,307.77 Regular Check $288.00 $7,107.77 6/10/13 (Check #3090) Regular Deposit 5/20/13 $2,202.00 $7,395.77 Regular Check 5/16/13 (Check #3087) $530.00 $5,193.77 Regular Check 5/16/13 (Check #3091) $249.25 $5,723.77 Regular Check $500.00 $5,973.02 5/15/13 (Check #3089) Regular Deposit 5/9/13 $325.00 $6,473.02 Regular Deposit $1,125.00 $6,148.02 5/7/13 Regular Check $95.00 $5,023.02 4/15/13 (Check #3085) Regular Check 4/11/13 (Check #3084) $187.87 $5,118.02 https://secure53.onlineaccessl.cariPacificWesternOnline/Accounts&AccountHistory.aspx 1/3 8/28/13 Pacific Western Bank Regular Check 4/11/13 (Check #3086) Regular Deposit 4/9/13 Regular Deposit 4/9/13 Regular Check 3/25/13 (Check #3083) Regular Deposit 3/19/13 Regular Deposit 3/19/13 Regular Check 2/19/13 (Check #3082) Regular Deposit 2/11/13 Regular Check 2/6/13 (Check #3081) Regular Check 1/28/13 Regular Deposit 1/28/13 Regular Check 1/8/13 (Check #3079) Regular Deposit 1/7/13 Regular Check 1/4/13 (Check #3078) Regular Check 12/31/12 (Check #3077) Regular Deposit 12/27/12 Regular Deposit 12/13/12 Regular Deposit 12/10/12 Regular Check 12/7/12 (Check #3075) Regular Deposit 12/7/12 Regular Check 11/21/12 (Check #3074) Regular Deposit 11/13/12 Regular Check 11/1/12 (Check #3073) $50.00 $320.00 $182.00 $504.00 $604.00 $1,743.72 $500.00 $375.00 $525.00 $55.00 $100.00 $5,305.89 $150.00 $5,355.89 $120.00 $5,205.89 $5,085.89 $125.00 $5,405.89 $120.00 $5,280.89 $5,160.89 $300.00 $5,342.89 $5,042.89 $5,546.89 $60.00 $6,150.89 $6,090.89 $3,006.00 $7,834.61 $4,828.61 $5,328.61 $855.00 $5,703.61 $585.00 $4,848.61 $120.00 $4,263.61 $4,143.61 $600.00 $4,668.61 $4,068.61 $85.00 $4,123.61 $4,038.61 hops://secure53.ontineaccessi.corNPacificWesternOnline/Accounts/AccountHistoryaspx 2/3 8/29/13 Regular Check 10/30/12 (Check #3072) Regular Check 10/25/12 (Check #3049) Regular Check 10/1/12 (Check #3071) Regular Check 9/24/12 (Check #3070) Regular Check 9/19/12 (Check #3068) Regular Check 9/12/12 (Check #3069) Regular Deposit 8/29/12 Regular Check 8/13/12 (Check #3067) Regular Check 7/12/12 (Check #3066) Regular Check 7/9/12 (Check #3064) Regular Check 7/3/12 (Check #3063) Subtotal: Pacific Western Bank $50.00 $4,138.61 $50.00 $4,188.61 $15.00 $4,238.61 $40.00 $4,253.61 $40.00 $4,293.61 $60.00 $4,333.61 $60.00 $4,393.61 $450.00 $4,333.61 $500.00 $4,783.61 $40.00 $5,283.61 $300.29 $5,323.61 $10,495.21 $10,098.00 fittpsJ/secure53.anlineaccessl.com'PacificWesternOnline/Accounts/AccountHistoryaspx 3/3 Banking Summary - 2012 1/1/2012 through 12/31/2012 8/29/2013 Page 1 1/1/2012- Category 12/31/2012 INCOME Uncategorized TOTAL INCOME EXPENSES 5.00 5.00 Ahepa 590.00 Chapter Expenses 50.47 Christmas For Kids -85.00 church 1,050.00 DOP 2,581.38 dues -485.00 Dues,misc -335.00 Festival 110.00 Funeral 500.00 Gifts Given 250.00 Glendi ads revenue, New Years Eve Part -468.00 Meeting Expenses 70.00 Meeting Roorn 50.00 New years eve 443.56 travel 300.29 TOTAL EXPENSES 4,622.70 OVERALL TOTAL -4,617.70 Checking XX3395 8/29/2013 Date Num 1/3/2012 1/5/2012 3040 1/5/2012 3043 1/5/2012 3045 1/5/2012 3047 1/10/2012 3044 1/11/2012 3041 1/11/2012 3042 1/19/2012 3038 1/24/2012 1/30/2012 3039 2/2/2012 3048 2/10/2012 2/17/2012 3050 2/21/2012 3051 2/28/2012 3053 3/1/2012 3052 3/6/2012 3/14/2012 3/14/2012 3054 3/14/2012 3057 3/15/2012 3056 3/20/2012 3/23/2012 3058 4/10/2012 4/13/2012 4/16/2012 3059 5/10/2012 5/29/2012 3061 6/8/2012 6/14/2012 3062 6/28/2012 7/2/2012 3065 7/3/2012 3063 7/9/2012 3064 7/12/2012 3066 8/13/2012 3067 8/29/2012 9/12/2012 3069 9/19/2012 3068 9/24/2012 3070 10/1/2012 3071 10/25/2012 3049 10/30/2012 3072 11/1/2012 3073 11/13/2012 Payee Regular Deposit REF#21 Regular Check Regular Check Regular Check Regular Check Regular Check Regular Check Regular Check Regular Check Regular Deposit Regular Check Regular Check Regular Deposit Regular Check Regular Check Regular Check Regular Check Regular Deposit Regular Deposit Regular Check Check Cashed Regular Check Regular Deposit Regular Check Regular Deposit Estatement Promotion Credit Regular Check Regular Deposit Regular Check Regular Deposit Regular Check Regular Deposit Regular Check Regular Check Regular Check Regular Check Regular Check Regular Deposit Regular Check Regular Check Regular Check Regular Check Regular Check Regular Check Regular Check Regular Deposit Check Register Category New years eve New years eve New years eve New years eve New years eve New years eve New years eve New years eve New years eve Glendi ads revenue, New Ye... New years eve DOP dues Gifts Given Ahepa Chapter Expenses Chapter Expenses dues Dues,misc Ahepa Meeting Expenses Meeting Expenses dues Ahepa dues Ahepa dues Ahepa dues Ahepa Dues,misc church travel Ahepa Funeral church dues Festival Ahepa Ahepa Ahepa Meeting Room Festival church Christmas For Kids Memo new years eve income for entertainment for entertainment to leon for food party expe... to lydia for food prep to christina the waitress to evan for vassilopita to evan for glasses to greek place 200 from ads,240 from due... to Christos grifizas for clean... Share of glendi income to D... dues from members to George Terris dues for five members to zisis for apokries to dimitri thiveos dues dues dues for Zisis for rental space down payment dues from george bitsanis dues for george Bitsanis dues from Vassilios Zachos dues for Vassilios Zachos dues from Tsiboukas dues for Chris Tsiboukas dues from Danny dues for Danny stefanidis 150 from DOP for trip,75 fro... building fund to zachos for trip expenses father andrews dues funeral expenses for Nichol... to st nicholas for church ex... dues from george dimogianis to george barbas for printin... george dimogianis dues father simon dues for george dimogianis to nick angelopoulos for mo... festival ad luncheon christmas dinner for kids do... Page 1 Amount C Balance 390.00 c 10,336.31 -80 00 c 10,256.31 - 50.00 c 10,206.31 -803.56 c 9,402.75 - 350 00 c 9,052.75 80.00 c 8,972.75 - 100.00 c 8,872.75 -30.00 c 8,842.75 -500.00 c 8,342.75 468.00 c 8,810.75 -100.00 c 8,710.75 -2,581.38 c 6,129.37 125.00 c 6,254.37 -250.00 c 6,004.37 -200.00 c 5,804.37 - 30.00 c 5,774.37 -20.47 c 5,753.90 60.00 c 5,813.90 93.00 c 5,906.90 -40.00 c 5,866.90 -50 00 c 5,816.90 -20.00 c 5,796.90 60.00 c 5,856.90 - 40.00 c 5,816.90 60.00 c 5,876.90 5.00 c 5,881.90 -40.00 c 5,841.90 60.00 c 5,901.90 -40.00 c 5,861.90 60.00 c 5,921.90 -40.00 c 5,881.90 242.00 c 6,123.90 500.00 c 5,623.90 300.29 c 5,323.61 - 40.00 c 5,283.61 -500.00 c 4,783.61 -450.00 c 4,333.61 60.00 c 4,393.61 -60.00 c 4,333.61 -40.00 c 4,293.61 - 40.00 c 4,253.61 -15.00 c 4,238.61 - 50.00 c 4,188.61 - 50.00 c 4,138.61 -100.00 c 4,038.61 85.00 c 4,123.61 Checking XX3395 8/29/2013 Date Num 11/21/2012 3074 Regular Check 12/7/2012 Regular Deposit 12/7/2012 3075 Regular Check 12/10/2012 Regular Deposit 12/13/2012 Regular Deposit 12/27/2012 Regular Deposit 12/31/2012 3077 Regular Check 1/4/2013 3078 Regular Check 1/7/2013 Regular Deposit 1/8/2013 3079 Regular Check 1/28/2013 Regular Deposit 1/28/2013 Regular Check 2/6/2013 3081 Regular Check 2/11/2013 Regular Deposit 2/19/2013 3082 Regular Check 3/19/2013 Regular Deposit 3/19/2013 Regular Deposit 3/25/2013 3083 Regular Check 4/9/2013 Regular Deposit 4/9/2013 Regular Deposit 4/11/2013 3084 Regular Check 4/11/2013 3086 Regular Check 4/15/2013 3085 Regular Check 5/7/2013 Regular Deposit 5/9/2013 Regular Deposit 5/15/2013 3089 Regular Check 5/16/2013 3087 Regular Check 5/16/2013 3091 Regular Check 5/20/2013 Regular Deposit 6/10/2013 3090 Regular Check 6/13/2013 Regular Deposit 6/13/2013 3092 Regular Check 6/13/2013 3093 Regular Check 6/17/2013 3094 Regular Check 6/17/2013 3095 Regular Check 6/21/2013 Regular Deposit 7/2/2013 3096 Regular Check Payee Check Register Category Ahepa New years eve New years eve New years eve New years eve New years eve New years eve New years eve New years eve New years eve dues New years eve New years eve dues Donation To Woman In Greece dues Glenti At Nicks Dues To Ahepa Ahepa Glenti At Nicks Ahepa Luncheon Dues To Ahepa Dues To Ahepa Glenti At Nicks Glenti At Nicks Toni Soraci Christos Tsiboukas Fantis Foods Glenti At Nicks Fantis Foods Glenti At Nicks glendi expenses glendi expenses Daughters Of penolope Daughters Of penolope dues Dues To Ahepa Memo petros konstantinopoulos d... new years eve ticket sales new years eve deposit for hall new years eve ticket sales new years eve ticket sales new years eve ticket sales new years eve deposit for hall for DJ new years eve ticket sales to leon for misc expenses Dues from George Barbas to St nicholas church daughters of penelope Dues from ahepa members to christina bartzis for wom... Dues from ahepa members ad money for glenti dues to ahepa dues from coromelas and A... ad money for glenti Ahepa lunchecn expenses dues to District 20 dues to ahepa glenti income glenti income band (4) lambs and grape leaves glenti foods glenti income glenti foods glenti income glenti books glenti expenses glenti share daughters of penelope dues dues to ahepa Page 2 Amount C Balance -55.00 c 4,068.61 600.00 c 4,668.61 -525.00 c 4,143.61 120.00 c 4,263.61 585.00 c 4,848.61 855.00 c 5,703.61 -375.00 c 5,328.61 - 500.00 c 4,828.61 3,006.00 c 7,834.61 -1,743.72 c 6,090.89 60.00 c 6,150.89 - 604.00 c 5,546.89 -504.00 c 5,042.89 300.00 c 5,342.89 - 182.00 c 5,160.89 120.00 c 5,280.89 125.00 c 5,405.89 -320.00 c 5,085.89 120.00 c 5,205.89 150.00 c 5,355.89 -187.87 c 5,168.02 -50 00 c 5,118.02 -95 00 c 5,023.02 1,125.00 c 6,148.02 325.00 c 6,473.02 - 500.00 c 5,973.02 - 530.00 c 5,443.02 - 249.25 c 5,193.77 2,202.00 c 7,395.77 - 288.00 c 7,107.77 200.00 c 7,307.77 -1,300.00 c 6,007.77 -331.42 c 5,676.35 -354.66 c 5,321.69 -100.00 c 5,221.69 60.00 c 5,281.69 -55 00 c 5,226.69 Spending by Category - Last 12 months 8/30/2012 through 8/29/2013 8/29/2013 Page 1 8/30/2012- Category 8/29/2013 Ahepa 30.00 Ahepa Luncheon 187.87 Christmas For Kids -85.00 Christos Tsiboukas 530.00 church 100.00 Daughters Of penolope 454.66 Donation To Woman In Greece 182.00 dues -540.00 Dues To Ahepa 520.00 Fantis Foods 537.25 Festival 110.00 glendi expenses 1,631.42 Glenti At Nicks -4,127.00 Meeting Room 50.00 New years eve -914.28 Toni Soraci 500.00 OVERALL TOTAL -833.08 City of Temecula 2013-14 CS Funding Program APPLICATION NO. 2 CITY OF TEMECUL( RECEIVED AUG 2 9 2013 CITY MANAGER'S FISCAL YEAR 2013-1 4 OFFICE COMMUNITY SERVICE FUNDING PROGRAM APPLJCATION (Please Print or Tvoe) 2013-14 Program Submission Deadline: Friday, August 30, 2013 (original, plus one copy) PROJECT INFORMATION Amount Requested: $ 5.000 Project Name: Divine Equine Project Start Date: January. 2011 (Maximum allowable $5,000) Project End Date: No end in sight - always needed ORGANIZATION INFORMATION Name of Organization: All From the Heart Contact Name: Judy Harter Title/Position: Founder/President Mailing Address: 45696 Creekside Way Temecula, CA 92592 Telephone: 951-440-9051 Year Organization Founded: 2006 Number of Paid Staff: 0 Number of Volunteers: 10 Geographic Area(s) Served: Inland Empire - primarily Temecula veterans Is this organization incorporated in Califomia as a non-profit organization? Yes X No Effective Date: 6/26/2006 If "no": If "yes" (Must provide a copy of your statement of non- profit status from the State of California): Date of incorporation as a non-profit: 6/26/2006 Federal identification number: Name of sponsoring organization: Federal identification number. State identification number: This application has been authorized by the organization's: Executive Committee Board of Directors X Members -at -Large Application Page 1 FY 2012-13 COMPLIANCE REQUIREMENT IF YOUR ORGANIZATION WAS A RECIPIENT OF FUNDING FOR FY 2012-13, PLEASE ATTACH COPIES OF INVOICES, RECEIPTS AND CANCELLED CHECKS TO SUBSTANTIATE THOSE FUNDS RECEIVED AND EXPENDED BY YOUR ORGANIZATION. FINANCIAL STATEMENTS PLEASE ATTACH COPIES OF THE CURRENT BUDGET OF THE ORGANIZATION AND FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT). It does not require a CPA's audit, but please submit if available. MISSION STATEMENT Briefly describe the goals and objectives of your organization and community services it provides. Describe the ways your organization meets the criteria listed on page 2 of the CS Funding Policy. Our Divine Equine mission is to help our PTSD (Post Traumatic Stress Disorder) veterans achieve wellness and peace after returning from combat. PROJECT DESCRIPTION Application Page 2 How will your organization use the funding awarded? Describe the project, project objectives, those served, area serviced, and number of volunteers involved. Be speck. Include equipment or services that would be purchased and why. Include a detailed budget and a schedule of significant activities related to this project. You may attach a maximum of one double-spaced typewritten page of information. (Please type or print legibly.) Horse therapy for combat veterans with PTSD (Post Traumatic Stress Disorder). Our veterans are chosen by the Temecula Veterans Center where they are currently being counseled both in private and in group therapy sessions. We at AFTH provide each veteran with five two hour private sessions with two horses, a therapist and at least one volunteer. Lives are forever changed. The positive results are amazing. This is cutting edge therapy. Please help us help those who served for our freedoms and are battling for their lives after being in combat. Application Page 3 PAST PROJECT BENEFITS If your organization received City of Temecula funding in the previous year, please explain and show how Temecula residents benefited. Application Page 4 SIGNATURE PAGE We hereby certify the information contained in this application is true to the best of our knowledge and belief. PREPARED BY: Judy Harter, President NAME and TITLE (Please Print or Type) SIGNATURE: PRESIDENT or AUTHORIZED OFFICER: Judy Harter, President SIGNATURE: NAME and TITLE (Please Print or Type) ORGANIZATION NAME: All From the Heart MAILING ADDRESS: 45696 Creekside Way Temecula, CA 92592 TELEPHONE: 951-440-9051 EMAIL ADDRESS: judykharter@gmail.com DATED THIS 23rd of August , 2013 (Date) (Month) BE SURE TO INCLUDE THE ORIGINAL PLUS ONE COPY AND SUBMIT BY AUGUST 30, 2013 TO: Mail Completed Applications to: Or Deliver in Person to: City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office Post Office Box 9033 Temecula, CA 92589-9033 City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office 41000 Main Street Temecula, CA 92590 Application Page 5 Or IRS 006222 Department or the Treasury Internal Rtve•se Service OGDEN UT 84201-0038 ALL FROM THE HEART INC X KELLY M DANIELS 27475 YNEZ RD STE 215 TEMECULA CA 92591-4612759 Employer Identification Number: Advance Ruling Period Ends: Person to Contact: Toll Free Telephone Number: Dear Taxpayer: In reply refer to: 0437758652 Mar. 06, 2008 LTR 4180C E0 22-3953079 000000 00 000 00024588 BODC: TE Dec. 31, 2010 K. Wardleigh 1-877-829-5500 This is in response to your Feb. 26, 2008, request for information regarding your tax-exempt status. 0ur records indicate that a determination letter was issued in July 2007, that recognized you as exempt from Federal income tax, and reflect that you are currently exempt under section 501(c)(3) of the Internal Revenue Code. Our records also indicate that you are classified as a public charity under sections 509(a)(1) and 170(b)(1)(A)(vi) of the Code until the advance ruling period ending date shown above. Within 90 days from the end of the advance ruling period, you must submit Form 8734, Support Schedule for Advance Ruling Period, to enable the IRS to determine whether you meet the applicable public charity support tests and make a final determination of your public charity status. Donors may deduct contributions to you as provided in section 170 of the Code. Bequests, legacies, devises, transfers, or gifts to you or for your use are deductible for Federal estate and gift tax purposes if they meet the applicable provisions of sections 2055, 2106, and 2522 of the Code. Grantors and contributors may rely on the determination that you are not a private foundation until 90 days after the end of your advance ruling period. If you submit the required information within 90 days, grantors and contributors may continue to rely on the advance determination until the Service makes a final determination of your public charity status. 0437758652 Mar. 06, 2008 LTR 4180C EO 000000 00 000 00024589 ALL FROM THE HEART INC X KELLY M DANIELS 27475 YNEZ ND STE 215 TEMECULA CA 92591-4612759 If you have any questions, please call us at the telephone number shown in the heading of this letter. Sincerely yours, Deborah Bingham Accounts Management I STATE OF CALIFORNIA FRANCHISETAXBOARD PO SOX 1286 RANCHO CORDOVA CA 95741-1286 August 3, 2009 ALL FROM THE HEART INC NC LESLIE A DOHERTY 29970 TECHNOLOGY DR STE 220-H MURRIETASA CA 92563-2650 Purpose Code Section Form of Organization Accounting Period Ending: Organization Number CHARITABLE 23701d Corporation December 31 2898008 In reply refer to 755:AFF:ARJ EXEMPT ACKNOWLEDGEMENT LETTER This letter acknowledges that the Franchise Tax Board (FTB) has received your federal determination letter that shows exemption under Internal Revenue Code (IRC) Section 501(c)(3). Under California law, Revenue and Taxation Code (R&TC) Section 23701d(c)(1) provides that an organization is exempt from taxes imposed under Part 11 upon submission of the federal determination letter approving the organization's tax-exempt status pursuant to Section 501(c)(3) of the IRC. The effective date of your organization's California tax-exempt status is 06/26/2006. R&TC Section 23701d(c)(1) further provides that the effective date of an organization's California tax-exempt status is the same date as the federal tax-exempt status under IRC Section 501(c)(3). Under R&TC Section 23701d(c), any change to your organization's operation, character, or purpose that has occurred since the federal exemption was originally granted must be reported immediately to this office. Additionally, organizations are required to be organized and operating for August 3, 2009 ALL FROM THE HEART, INC.NC. ENTITY ID : 2898008 Page 2 nonprofit purposes to retain California tax-exempt status. For filing requirements, see FTB Pub. 1068, Exempt Organizations - Requirements for Filing Returns and Paying Filing Fees. Go to our website at ftb.ca.gov and search for 1068. Note: This exemption is for state franchise or income tax purposes only. For information regarding sales tax exemption, contact the State Board of Equalization at 800.400.7115, or go to their website at boe.ca.gov. A JENKINS EXEMPT ORGANIZATIONS BUSINESS ENTITIES SECTION TELEPHONE (916) 845-4605 FAX NUMBER (916) 845-9029 RTF: Exempt Organizations Select Check Page 1 of 1 IRS Exempt Organizations Select Check l=xempt Ornanizations Select Check Horne Organizations Eligible to Receive Tex -Deductible Contributions (Pub. 78 date) - Search Results The following list Includes tax-exempt organizations That are eligible to receive lax -deductible contributions. Click on the "Deductibility Status" column for an explanation of Irri ttations on the dedudmllity of contributions made to different types of tax-exempt organizations. Results are sorted by EIN, To sort results by another category, dick on the Icon next to the column heading for that category. Clicking on that Icon a second time wN reverse the sort order. Chic on a column heading for an explanation of information in that column. 1-1 of 1 results EIN. Legal Name (Doing Business As) 22-3953079 Alt From the Heart Inc. LRetum to Search Results Per Page 25 OK Prey 11-11Next n City. State ...Country Deductibility Status . Munfeta CA United States PC a Prev 11-1 I Next s http://apps.irs,gov/app/eos/pub78Search,do?ein1=223953079&names=&city=&state=CA&c... 9/5/2013 All From The Heart, Inc Profit & Loss January through July 2013 Jan - Jul 13 Ordinary IncomelExpense Income Donations 15,867.47 Earned revenues Interest-savings/short-term inv 35.90 Earned revenues - Other 0.02 Total Earned revenues 35.92 Total Income 15,903.39 Gross Profit 15,903.39 Expense Advertising expenses 242.68 Bank Charges 91.51 Business expenses 490.00 Fund Raising Expenses Wheels for Warriors Wheelchair Repairs 14,030.23 Total Wheels for Warriors 14,030.23 Fund Raising Expenses - Other 1,544.62 Total Fund Raising Expenses 15,574.85 Misc expenses Insurance - non -employee 935.00 Membership dues - organization 230.00 Other expenses 386.00 Misc expenses - Other 110.00 Total Misc expenses 1,661.00 Non -personnel expenses Automobile & Mileage 3,107.78 Equip rental & maintenance 480.00 Postage, shipping, delivery 337.00 Supplies 804.04 Non -personnel expenses - Other 60.00 Total Non -personnel expenses 4,788.82 Other personnel expenses Professional fees - other 3,500.00 Total Other personnel expenses 3,500.00 Veteran Services Equine Therapy 3,800.00 Total Veteran Services 3,800.00 Total Expense 30,148.86 Net Ordinary Income-14,245.47 Other Income/Expense Other Income Fundraising Income Dancing with Star -546.00 Golf 2013 2,743.06 SOT 2012 8,585.00 Total Fundraising Income Total Other Income Net Other Income Net Income 10,782.06 10,782.06 10,782.06 -3,483.41 Page 1 FOR MANAGEMENT PURPOSES ONLY All From The Heart, Inc Balance Sheet As of July 31, 2013 ASSETS Current Assets Checking/Savings Commerce Bank - Operating Total Checking/Savings Total Current Assets TOTAL ASSETS LIABILITIES & EQUITY Equity Unrestrict (retained earnings) Net Income Jul 31, 13 26,009.54 26,009.54 26,009.54 26,009.54 29,472.95 •3,463.41 Total Equity 26,009.54 TOTAL LIABILITIES & EQUITY 26,009.54 Page 1 FOR MANAGEMENT PURPOSES ONLY All From The Heart, Inc Profit & Loss January through December 2012 Jan - Dec 12 Ordinary Income/Expense Income Donations 10,758.28 Earned revenues Interest-savings/short-term Inv 53.09 Total Earned revenues 53.09 Uncategorized Income 18,595.51 Total Income 29,406.88 Gross Profit 29,406.88 Expense Bank Charges 362.24 Fund Ralsing Expenses Wheels for Warriors Wheelchair Repairs 18,986.99 Total Wheels for Warriors 16,986.99 Fund Raising Expenses - Other 100.00 Total Fund Raising Expenses 17,086.99 Misc expenses Insurance - non -employee 809.00 Membership dues - organization 370.00 Other expenses 404.41 Mac expenses - Other 500.00 Total Mac expenses 2,083.41 Non -personnel expenses Automobile & Mileage 2,447.54 Mailing services 47.16 Printing & copying 712.12 Supplies 478.14 Non -personnel expenses - Other 560.00 Total Non -personnel expenses 4,244.96 Other personnel expenses Accounting fees 240.00 Professional fees - other 6,000.00 Total Other personnel expenses Taxes - other Veteran Services Equine Therapy Veteran Services - Other Total Veteran Services Total Expense 6,240.00 35.00 2,800.00 1,773.20 4,573.20 34,625.80 Net Ordinary Income -5,218.92 Other Income/Expense Other Income Fundraising Income Equine Therapy 2012 4,600.00 SOT 2012 7,450.00 WFW 2012 4,553.19 Total Fundraising Income 16,603.19 Total Other Income 16,603.19 Other Expense Fundraising Expense SOT 2011 940.00 SOT 2012 10,311,47 Page 1 FOR MANAGEMENT PURPOSES ONLY All From The Heart, Inc Balance Sheet As of December 31, 2012 ASSETS Current Assets Checking/Savings Commerce Bank - Operating Dec 31,12 29,472.95 Total Checking(Savinya 29,472.95 Total Current Assets 29,472.95 TOTAL ASSETS LIABILITIES & EQUITY Equity Unrestrict (retained earnings) Net Income Total Equity 29,472.95 29,740.15 -267.20 29,472.95 TOTAL. LIABILITIES & EQUITY 29,472.95 Page 1 FOR MANAGEMENT PURPOSES ONLY City of Temecula 2013-14 CS Funding Program APPLICATION NO. 3 RECEIVFn CITY OF TEMECULA AUG ? `l ')111.3 FISCAL YEAR 2013-1 ,4 CITY OFFICE Res COMMUNITY SERVICE FUNDING PROGRAM APPLICATION (Please Print or Type) 2013-14 Program Submission Deadline: Friday, August 30, 2013 (original, plus one copy) PROJECT INFORMATION Amount Requested: $ 5.000 Project Name: Support Our Troops Project Start Date: August 1, 2013 Project End Date: December 7, 2013 (Maximum allowable $5,000) ORGANIZATION INFORMATION Name of Organization: All From the Heart Contact Name: Judy Harter Title/Position: Founder/President Mailing Address: 4569R Craakside Way Tarnecula, CA 92592 Telephone: 951-440-9051 Year Organization Founded: 2006 Number of Paid Staff: 0 Number of Volunteers: 50 Geographic Area(s) Served: Inland Empire Is this organization incorporated in Califomia as a non-profit organization? Yes X No Effedive Date: 6/26/2006 If "yes" (Must provide a copy of your statement of non- profit status from the State of California): Date of incorporation as a non-profit: 6/26/2006 Federal identification number: If "no": Name of sponsoring organization: Federal identification number. State identification number: This application has been authorized by the organization's: Executive Committee Board of Directors X Members -at -Large Application Page 1 FY 2012-13 COMPLIANCE REQUIREMENT IF YOUR ORGANIZATION WAS A RECIPIENT OF FUNDING FOR FY 2012-13, PLEASE ATTACH COPIES OF INVOICES, RECEIPTS AND CANCELLED CHECKS TO SUBSTANTIATE THOSE FUNDS RECEIVED AND EXPENDED BY YOUR ORGANIZATION. FINANCIAL STATEMENTS PLEASE ATTACH COPIES OF THE CURRENT BUDGET OF THE ORGANIZATION AND FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT). It does not require a CPA's audit, but please submit if available. MISSION STATEMENT Briefly describe the goals and objectives of your organization and community services it provides. Describe the ways your organization meets the criteria listed on page 2 of the CS Funding Policy. Our entire city is invited to the "Support Our Troops" event. We have 50-60 volunteers who help us every year, in addition to 40 local families who shop and host our military families. The event is attended by over 1,000 locals, who enjoy free barbeque and family entertainment. We have a five member board of directors who meet once a month. We are in our 11 th year. We are a well established non-profit and everyone is blessed and touched by our special event every year. PROJECT DESCRIPTION Application Page 2 How will your organization use the funding awarded? Describe the project, project objectives, those served, area serviced, and number of volunteers involved. Be specific. Include equipment or services that would be purchased and why. Include a detailed budget and a schedule of significant activities related to this project. You may attach a maximum of one double-spaced typewritten page of information. (Please type or print legibly.) All From the Heart - Support Our Troops 10th Annual event, December 7, 2013 11:00 am - 2:00 pm Quaid Temecula Harley-Davidson, Old Town Temecula. Forty active military families, each with a special circumstance, cancer, missing limbs, PTSD, special needs children, widows, suicide in the family and many other conditions. All families are chosen by the military Family Readiness Officers. We then get the family's Christmas wish list after which 40 local families shop for them. We all come together the morning of the event. There is a military fly -by, presentation of the colors, National anthem is sung, moment of silence, dignitaries share. Then Santa rides in on his Harley and the gift opening begins. There is live rock and roll music. barbeque, vendors (event is 100% sponsored). The event is open to the public. and there is no better way to start the holiday season. Come thank a hero! Application Page 3 PAST PROJECT BENEFITS If your organization received City of Temecula funding in the previous year, please explain and show how Temecula residents benefited. The grant money gifted 25 active military family's members their Christmas wish lists. We spent $100 on each family member. We are gifting 40 families this year! Application Page 4 SIGNATURE PAGE We hereby certify the information contained in this application is true to the best of our knowledge and belief. PREPARED BY: Judy Harter, President SIGNATURE: NAME and TITLE (Please Print or Type) PRESIDENT or AUTHORIZED OFFICER: Judy Harter, President NAME and 11TLE (Please Print or Type) SIGNATURE: ORGANIZATION NAME: All From the Heart MAILING ADDRESS: 45696 Creekside Way Temecula, CA 92592 TELEPHONE: 951-440-9051 EMAIL ADDRESS: judykharter@gmail.com DATED THIS 23rd Of August , 2013 (Date) (Month) BE SURE TO INCLUDE THE ORIGINAL PLUS ONE COPY AND SUBMIT BY AUGUST 30, 2013 TO: Mail Completed Applications to: Or Deliver in Person to: City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office Post Office Box 9033 Temecula, CA 92589-9033 City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office 41000 Main Street Temecula, CA 92590 Application Page 5 jw 006122 IRS Department of the Treasury Interwsl Ravettac Service OGDEN UT 84201-0038 ALL FROM THE HEART INC % KELLY M DANIELS 27475 YNEZ RD STE 215 TEMECULA CA 92591-4612759 In reply refer to: 0437758652. Mar. 06, 2008 LTR 4180C EO 000000 00 000 00024588 BODC: TE Employer Identification Number: Advance Ruling Period Ends: Dec. 31, 2010 Person to Contact: K. Wardleigh Toll Free Telephone Number: 1-877-829-5500 Dear Taxpayer: This is in response to your Feb. 26, 2008, request for information regarding your tax-exempt status. Our records indicate that a determination letter was issued in July 2007, that recognized you as exempt from Federal income tax, and reflect that you are currently exempt under section 501(c)(3) of the Internal Revenue Code. Our records also indicate that you are classified as a public charity under sections 509(a)(1) and 170(b)(1)(A)(vi) of the Code until the advance ruling period ending date shown above. Within 90 days from the end of the advance ruling period, you must submit Form 8734, Support Schedule for Advance Ruling Period, to enable the IRS to determine whether you meet the applicable public charity support tests and make a final determination of your public charity status. Donors may deduct contributions to you as provided in section 170 of the Code. Bequests, legacies, devises, transfers, or gifts to you or for your use are deductible for Federal estate and gift tax purposes if they meet the applicable provisions of sections 2055, 2106, and 2522 of the Code. Grantors and contributors may rely on the determination that you are not a private foundation until 90 days after the end of your advance ruling period. If you submit the required information within 90 days, grantors and contributors may continue to rely on the advance determination until the Service makes a final determination of your public charity status. I . 0437758652 Mar. 06, 2008 LTR 4180C E0 000000 00 000 00024589 ALL FROM THE HEART INC X KELLY M DANIELS 27475 YNEZ RD STE 215 TEMECULA CA 92591-4612759 If you have any questions, please call us at the telephone number shown in the heading of this letter. Sincerely yours, Deborah Bingham Accounts Management I STATE OF CALIFORNIA E TAX BOAAb PO BOX 1286 RANCHO CORDOVA CA 95741-1286 August 3, 2009 ALL FROM THE HEART INC NC LESLIE A DOHERTY 29970 TECHNOLOGY DR STE 220-H MURRIETASA CA 92563-2650 Purpose . Code Section : Form of Organization : Accounting Period Ending: Organization Number . CHARITABLE 23701d Corporation December 31 2898008 In reply refer to 755:AFF:ARJ EXEMPT ACKNOWLEDGEMENT LETTER This letter acknowledges that the Franchise Tax Board (FTB) has received your federal determination letter that shows exemption under Internal Revenue Code (IRC) Section 501(c)(3). Under California law, Revenue and Taxation Code (R&TC) Section 23701d(c)(1) provides that an organization is exempt from taxes imposed under Part 11 upon submission of the federal determination letter approving the organization's tax-exempt status pursuant to Section 501(c)(3) of the IRC. The effective date of your organization's California tax-exempt status is 06/26/2006. R&TC Section 23701d(c)(1) further provides that the effective date of an organization's California tax-exempt status is the same date as the federal tax-exempt status under IRC Section 501(c)(3). Under R&TC Section 23701d(c), any change to your organization's operation, character, or purpose that has occurred since the federal exemption was originally granted must be reported immediately to this office. Additionally, organizations are required to be organized and operating for August 3, 2009 ALL FROM THE HEART, INC.NC. ENTITY ID : 2898008 Page 2 nonprofit purposes to retain California tax-exempt status. For filing requirements, see FTB Pub. 1068, Exempt Organizations - Requirements for Filing Returns and Paying Filing Fees. Go to our website at ftb.ca.gov and search for 1068. Note: This exemption is for state franchise or income tax purposes only. For information regarding sales tax exemption, contact the State Board of Equalization at 800.400.7115, or go to their website at boe.ca.gov. A JENKINS EXEMPT ORGANIZATIONS BUSINESS ENTITIES SECTION TELEPHONE (916) 845-4605 FAX NUMBER (916) 845-9029 RTF: Exempt Organizations Select Check Page 1 of 1 IIRS Exempt Organizations Select Check gxemol Oraanizalions Select Check Home Organizations Eligible to Recelve Tax -Deductible Contributions (Pub. 78 data) - Search Results The following list Includes tax-exempt organizations that are eligible to receive tax-deductible contributions. Click on the "Deductibility Status" column for an explanation of limitations on the deductibility of contributions made to different types of tax-exempt organizations. Results are sorted by EIN. To sort results by another category. dick on the Icon next to the column heading for that category. Clicking on that icon a second time will reverse the sort order. Click on a column heading for an explanation of information in that column. 1-1 of 1 reeutts Legal Name (Doing Business As) All From the Heart Inc. Retum to Search Results Per Page 25 OK City a. Murriela Stale ..Counux CA United States • Prev l 1-1 l Next Dedudibility_Status PC • Prev l 1-1 l Next x http://apps.irs.gov/app/eos/pub78Search.do?ein 1=223953079&names=&city=&state=CA&c... 9/9/2013 All From The Heart, Inc Profit & Loss January through July 2013 Jan -Jul 13 Ordinary Income/Expense Income Donations 15,867.47 Earned revenues Interest-savings/short-term inv 35.90 Earned revenues - Other 0.02 Total Earned revenues 35.92 Total Income 15,903.39 Gross Profit 15,903.39 Expense Advertising expenses 242.68 Bank Charges 91.51 Business expenses 490.00 Fund Raising Expenses Wheels for Warriors Wheelchair Repairs 14,030.23 Total Wheels for Warriors Fund Raising Expenses - Other Total Fund Raising Expenses Mlsc expenses 14,030.23 1,544.62 15, 574.85 Insurance - non -employee 935.00 Membership dues - organization 230.00 Other expenses 386.00 Misc expenses - Other 110.00 Total Misc expenses 1,661.00 Non -personnel expenses Automobile & Mileage 3,107.78 Equip rental & maintenance 480.00 Postage, shipping, delivery 337.00 Supplies 804.04 Non -personnel expenses - Other 60.00 Total Non -personnel expenses 4,788.82 Other personnel expenses Professional fees - other 3,500.00 Total Other personnel expenses 3,500.00 Veteran Services Equine Therapy 3,800.00 Total Veteran Services 3,800.00 Total Expense 30,148.86 Net Ordinary Income -14,245.47 Other Income/Expense Other Income Fundraising Income Dancing with Star -546.00 Golf 2013 2,743.06 SOT 2012 8,585.00 Total Fundraising Income Total Other Income Net Other Income Net Income 10,782.06 10,782.06 10,782.06 -3,463.41 Page 1 FOR MANAGEMENT PURPOSES ONLY All From The Heart, Inc Balance Sheet As of July 31, 2013 ASSETS Current Assets Checking/Savings Commerce Bank - Operating Total Checking/Savings Total Current Assets TOTAL ASSETS LIABILITIES & EQUITY Equity Unrestrict (retained carvings) Net Income Jul 31,13 26,009.54 26,009.64 26,009.54 26,009.54 29,472,95 -3,463.41 Total Equity 26,009.54 TOTAL LIABILITIES & EQUITY 26,009.54 Page 1 FOR MANAGEMENT PURPOSES O*ILY All From The Heart, Inc Profit & Loss January through December 2012 Jan - Dec 12 Ordinary Income/Expense Income Donations 10,758.28 Earned revenues Interest-savings/short-tern Inv 53.09 Total Earned revenues 53.09 Uncategorized Income 18,595.51 Total Income 29,406.88 Gross Profit 29,406.88 Expense Bank Charges 362.24 Fund Raising Expenses Wheels for Warriors Wheelchair Repairs 16,986.99 Total Wheels for Warriors 16,986.99 Fund Raising Expenses - Other 100.00 Total Fund Raising Expenses 17,086.99 Misc expenses Insurance - non -employee 809.00 Membership dues - organization 370.00 Other expenses 404.41 Misc expenses - Other 500.00 Total Misc expenses 2,083.41 Non -personnel expenses Automobile & Mileage 2,447.54 Mailing services 47.16 Printing & copying 712.12 Supplies 478.14 Non -personnel expenses - Other 560.00 Total Non -personnel expenses 4,244.96 Other personnel expenses Accounting fees 240.00 Professional fees - other 6,000.00 Total Other personnel expenses 6,240.00 Taxes - other 35.00 Veteran Services Equine Therapy 2,800.00 Veteran Services - Other 1,773.20 Total Veteran Services 4,573.20 Total Expense 34,625.80 Net Ordinary Income -5,218.92 Other Income/Expense Other income Fundraising Income Equine Therapy 2012 4,600.00 SOT 2012 7,450.00 WFW 2012 4,553.19 Total Fundraising Income 16,603.19 Total Other Income 16,603.19 Other Expense Fundraising Expense SOT 2011 940.00 SOT 2012 10,311.47 Page 1 FOR MANAGEMENT PURPOSES ONLY All From The Heart, Inc Profit & Loss January through December 2012 Jan • Dec 12 Temecula Wine & Music 2012 400.00 Total Fundraising Expense 11,651.47 Total Other Expense 11,651.47 Net Other Income _ _ _ 4,951.72 Net Income-267.20 Page 2 FOR MANAGEMENT PURPOSES ONLY City of Temecula 2013-14 CS Funding Program APPLICATION NO. 4 CITY OF TEMECUL4 CITY MANAGER'S FISCAL YEAR 20 13-1.4 OFFICE COMMUNITY SERVICE FUNDING PROGRAM APPLICATION (Please Print or Tvoe) 2013-14 Program Submission Deadline: Friday, August 30, 2013 (original, plus one copy) PROJECT INFORMATION Amount Requested: $ 5,000 Project Name: Wheels for Warriors Project Start Date: 2010 (Maximum allowable $5,000) Project End Date: No end in sight - always needed ORGANIZATION INFORMATION Name of Organization: Contact Name: Judy Hater Ali From the Heart Title/Position: Founder/President Mailing Address: 45696 Creekside Way Temecula_ CA 92592 Telephone: 951-440-9051 Year Organization Founded: 2006 Number of Paid Staff: 0 Number of Volunteers: 10 Geographic Area(s) Served: Inland Empire Is this organization incorporated in Califomia as a non-profit organization? Yes X No Effective Date: 6/26/2006 If 'yes' (Must provide a copy of your statement of non- profit status from the State of California): Date of incorporation as a non-profit: 6/26/2006 Federal identification number Name of sponsoring organization: Federal identification number: State identification number: This application has been authorized by the organization's: Executive Committee Board of Directors X Mei rs-at-Large Application Page 1 FY 2012-13 COMPLIANCE REQUIREMENT IF YOUR ORGANIZATION WAS A RECIPIENT OF FUNDING FOR FY 2012-13, PLEASE ATTACH COPIES OF INVOICES, RECEIPTS AND CANCELLED CHECKS TO SUBSTANTIATE THOSE FUNDS RECEIVED AND EXPENDED BY YOUR ORGANIZATION. FINANCIAL STATEMENTS PLEASE ATTACH COPIES OF THE CURRENT BUDGET OF THE ORGANIZATION AND FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT). It does not require a CPA's audit, but please submit if available. MISSION STATEMENT Briefly describe the goals and objectives of your organization and community services it provides. Describe the ways your organization meets the criteria listed on page 2 of the CS Funding Policy. To date, we have gifted 172 veterans with refurbished power scooters and wheelchairs. Currently we have 18 veterans waiting for chairs. We are able to serve all of the Inland Empire. We work with the DAV (Disabled American Veterans assocation) to identify the need of our warriors. Most of them have either missing limbs, cancer from Agent Orange , diabetes and other debilitating diseases. Without our gift of independence they are trapped in manual chairs. Independence is a very powerful gift and Wheels for Warriors is a very needed service. PROJECT DESCRIPTION Application Page 2 How will your organization use the funding awarded? Describe the project, project objectives, those served, area serviced, and number of volunteers involved. Be specific. Indude equipment or services that would be purchased and why. Include a detailed budget and a schedule of significant activities related to this project. You may attach a maximum of one double-spaced typewritten page of information. (Please type or print legibly.) We will provide refurbished power wheelchairs or scooters to assist any veteran in need of independence which in turn allows our Veterans the freedom to live life more fully. We do this by accepting and picking up used power wheelchairs and scooters. We refurbish them to their finest quality working with a local vendor, new batteries, etc. and then deliver them to the veterans and provide them with training for the use of the chair. To date we have gifted 172 veterans with independence. We currently have 18 veterans waiting for chairs. We get the chairs refurbished and in the hands of our warriors for under $300 each. A great value! $5,000 would allow us to provide a chair for 17 of our heros. Application Page 3 PAST PROJECT BENEFITS If your organization received City of Temecula funding in the previous year, please explain and show how Temecula residents benefited. We were able to refurbish 8 powerchairs and gift our veterans a more independent lifestye. Lives were changed forever. The need is growing as we identify more veterans. Application Page 4 SIGNATURE PAGE We hereby certify the information contained in this application is true to the best of our knowledge and belief. PREPARED BY: Judy Harter, President NAME and TITLE (Please Print or Type) SIGNATURE: PRESIDENT or AUTHORIZED OFFICER: Judy Harter, President NAME and TITLE (Please Print or Type) SIGNATURE: ORGANIZATION NAME: All From the Heart MAILING ADDRESS: 45696 Creekside Way Temecula, CA 92592 TELEPHONE: 951-440-9051 DATED THIS 23rd EMAIL ADDRESS: judykharter@gmail.com of August (Date) (Month) 2013 BE SURE TO INCLUDE THE ORIGINAL PLUS ONE COPY AND SUBMIT BY AUGUST 30, 2013 TO: Mail Completed Applications to: Or Deliver in Person to: City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office Post Office Box 9033 Temecula, CA 92589-9033 City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office 41000 Main Street Temecula, CA 92590 Application Page 5 006222 IR.S Department of the Treasury Worm! Reveate Service OGDEN UT 84201-0038 ALL FROM THE HEART INC X KELLY M DANIELS 27475 YNEZ RD STE 215 TEMECULA CA 92591-4612759 In reply refer to: 0437758652 Mar. 06, 2008 LTR 4180C EC 000000 00 000 00024588 BODC: TE Employer Identification Number: Advance Ruling Period Ends: Dec. 31, 2010 Person to Contact: K. Wardleigh Toll Free Telephone Number: 1-877-829-5500 Dear Taxpayer: This is in response to your Feb. 26, 2008, request for information regarding your tax-exempt status. Our records indicate that a determination letter was issued in July 2007, that recognized you as exempt from Federal income tax, and reflect that you are currently exempt under section 501Cc)(3) of the Internal Revenue Code. Our records also indicate that you are classified as a public charity under sections 509(a)(1) and 170(b)(1)(A)(vi) of the Code until the advance ruling period ending date shown above. Within 90 days from the end of the advance ruling period, you must submit Form 8734, Support Schedule for Advance Ruling Period, to enable the IRS to determine whether you meet the applicable public charity support tests and make a final determination of your public charity status. Donors may deduct contributions to you as provided in section 170 of the Code. Bequests, legacies, devises, transfers, or gifts to you or for your use are deductible for Federal estate and gift tax purposes if they meet the applicable provisions of sections 2055, 2106. and 2522 of the Code. Grantors and contributors may rely on the determination that you are not a private foundation until 90 days after the end of your advance ruling period. If you submit the required information within 90 days, grantors and contributors may continue to rely on the advance determination until the Service makes a final determination of your public charity status. I • 0437758652 Mar. 06, 2008 LTR 4180C EO 000000 00 000 00024589 ALL FROM THE HEART INC % KELLY M DANIELS 27475 YNEZ RD STE 215 TEMECULA CA 92591-4612759 If you have any questions, please call us at the telephone number shown in the heading of this letter. Sincerely yours, ;Lt4-.aa, el,in.e- Deborah Bingham Accounts Management I STATE OF CALIFORNIA FRANCHISE TAX BOARD PO BOX 1256 RANCHO CORDOVA CA 95741-1286 August 3, 2009 ALL FROM THE HEART INC NC LESLIE A DOHERTY 29970 TECHNOLOGY DR STE 220-H MURRIETASA CA 92563-2650 Purpose Code Section Fora of Organization Accounting Period Ending: Organization Number CHARITABLE 23701d Corporation December 31 2898008 In reply refer to 755:AFF:ARJ EXEMPT ACKNOWLEDGEMENT LETTER This letter acknowledges that the Franchise Tax Board (FTB) has received your federal determination letter that shows exemption under Internal Revenue Code (IRC) Section 501(c)(3). Under California law, Revenue and Taxation Code (R&TC) Section 23701d(c)(1) provides that an organization is exempt from taxes imposed under Part 11 upon submission of the federal determination letter approving the organization's tax-exempt status pursuant to Section 501(c)(3) of the IRC. The effective date of your organization's California tax-exempt status is 06/26/2006. R&TC Section 23701d(c)(1) further provides that the effective date of an organization's California tax-exempt status is the same date as the federal tax-exempt status under IRC Section 501(c)(3). Under RiTC Section 23701d(c), any change to your organization's operation, character, or purpose that has occurred since the federal exemption was originally granted must be reported immediately to this office. Additionally, organizations are required to be organized and operating for August 3, 2009 ALL FROM THE HEART, INC.NC. ENTITY ID : 2898008 Page 2 nonprofit purposes to retain California tax-exempt status. For filing requirements, see FTB Pub. 1068, Exempt Organizations - Requirements for Filing Returns and Paying Filing Fees. Go to our website at ftb.ca.gov and search for 1068. Note: This exemption is for state franchise or income tax purposes only. For information regarding sales tax exemption, contact the State Board of Equalization at 800.400.7115, or go to their website at boe.ca.gov. A JENKINS EXEMPT ORGANIZATIONS BUSINESS ENTITIES SECTION TELEPHONE (916) 845-4605 FAX NUMBER (916) 845-9029 RTF: Exempt Organizations Select Check Page 1 of 1 IRS Exempt Organizations Select Check Exempt Oraantzat j is Select Ctieek Home Organizations EGglbte to Receive Tax -Deductible Contributions (Pub. 78 date) - Search Results The following list Includes tax-exempt organizations that are eligible to receive lax -deductible contributions. Click on the "Deductibility Status" column for an explanation of liniltallons on the deductibility of contributions made to different types of tax-exempt organizations. Results are sorted by EIN. To sort results by another category, dick on the Icon next to the column heading for that category. Clicking on that Icon a second time vat reverse the sort order. Click on a column heading for an explanation of information in that column. 1-1 of 1 results All From the Heart Inc. Return to Search Results Per Page 25 I OK I a Prev 11-1 1 Next» City . State .Country • Deduct blIIlr Status Murrleta CA United States PC c Prev 11-1 'Next » http://apps.irs.gov/app/eos/pub78Search.do?ein1=223953079&names=&city=&state=CA&c... 9/9/2013 All From The Heart, Inc Profit & Loss January through July 2013 Jan - Jul 13 Ordinary Income/Expense Income Donations 15,867.47 Earned revenues Interest-savings/short-term Inv 35.90 Earned revenues - Other 0.02 Total Earned revenues 35.92 Total Income 15,603.39 Gross Profit 15,903.39 Expense Advertising expenses 242.68 Bank Charges 91.51 Business expenses 490.00 Fund Raising Expenses Wheels for Warriors Wheelchair Repairs 14,030.23 Total Wheels for Warriors 14,030.23 Fund Raising Expenses - Other 1,544.62 Total Fund Raising Expenses 15,574.85 Misc expenses Insurance - non -employee 935.00 Membership dues - organization 230.00 Other expenses 386.00 Misc expenses - Other 110.00 Total Misc expenses 1,661.00 Non -personnel expenses Automobile & Mileage 3,107.78 Equip rental & maintenance 480.00 Postage, shipping, delivery 337.00 Supplies 804.04 Non -personnel expenses - Other 60.00 Total Non -personnel expenses 4,788.82 Other personnel expenses Professional fees - other 3,500.00 Total Other personnel expenses 3,500.00 Veteran Services Equine Therapy 3,800.00 Total Veteran Services 3,800.00 Total Expense 30,148.86 Net Ordinary Income-14,245.47 Other Income/Expense Other Income Fundraising Income Dancing with Star -546.00 Golf 2013 2,743.06 SOT 2012 8,585.00 Total Fundraising Income Total Other Income Net Other Income Net Income 10,782.66 10,782.06 10,782.06 -3,463.41 Page 1 FOR MANAGEMENT PURPOSES ONLY All From The Heart, Inc Balance Sheet As of July 31, 2013 Jul 31,13 ASSETS Current Assets CheckinglSavings Commerce Bank - Operating 26,009,54 Total Checking/Savings 28,009.54 Total Current Assets 26,009.54 TOTAL ASSETS 26,009.54 LIABILITIES & EQUITY Equity Unrestrict (retained eamings) 29,472.95 Net Income -3,463.41 Total Equity 26,009.54 TOTAL LIABILITIES & EQUITY 26,009.54 Page 1 FOR MANAGEMENT PURPOSES ONLY All From The Heart, Inc Profit & Loss January through December 2012 Jan-Dec12 Ordinary Income/Expense Income Donations 10,758.28 Earned revenues Interest-savings/short-term Inv 53.09 Total Earned revenues 53.09 Uncategorized Income 18,595.51 Total Income 29,406.88 Gross Profit 29,406.88 Expense Bank Charges 362.24 Fund Raising Expenses Wheels for Warriors Wheelchair Repairs Total Wheels for Warrior: Fund Raising Expenses - Other Total Fund Raising Expenses Mist expenses 16,986.99 16,986.99 100.00 17,086.99 Insurance - non -employee 809.00 Membership dues - organization 370.00 Other expenses 404.41 Misc expenses - Other 500.00 Total Mlsc expenses 2,083.41 Non -personnel expenses Automobile & Mileage 2,447.54 Mailing services 47.16 Printing & copying 712.12 Supplies 478.14 Non -personnel expenses - Other 560.00 Total Non -personnel expenses 4,244.96 Other personnel expenses Accounting fees 240.00 Professional fees - other 6,000.00 Total Other personnel expenses 6,240.00 Taxes - other 35.00 Veteran Services Equine Therapy Veteran Services - Other Total Veteran Services Total Expense 2,800.00 1,773.20 4,573.20 34,625.80 Net Ordinary Income -5,218.92 Other Income/Expense Other Income Fundraising Income Equine Therapy 2012 4,600.00 SOT 2012 7,450.00 WFW 2012 4,553.19 Total Fundraising Income 16,603.19 Total Other Income 16,603.19 Other Expense Fundraising Expense SOT 2011 940.00 SOT 2012 10,311.47 Page 1 FOR MANAGEMENT PURPOSES ONLY All From The Heart, Inc Profit & Loss January through December 2012 Jan - Dec 12 Temecula Wine & Music 2012 400.00 Total Fundraising Expense 11,851.47 Total Other Expense 11,651.47 Net Other Income 4,951.72 Net Income 287.20 Page 2 FOR MANAGEMENT PURPOSES ONLY November 20, 2012 Judy Harter, President ALL FROM THE HEART 45696 Creekside Way Temecula, CA 92592 Dear Ms. Harter: Congratulations on being selected for funding under the fiscal year 2012-13 Temecula Community Service Funding Program. Your organization has been awarded $5,000 to be used to refurbish used power wheelchairs and power scooters and give them to those veterans in need. Your organization must confirm that these funds are expended in accordance with the above -stated purpose by June 30, 2013. Receipts verifying the expenditures of this year's award must be submitted to the City by September 1, 2013. The City may require access to your accounting records in accordance with this policy. If City funds are not expended as stipulated, the funds must be returned to the City. In order to disburse your fiscal year 2012-13 Community Service Funding Program Award, the City requires back-up documentation (specifically copies of invoices, receipts and cancelled checks) to support last year's 2011-12 grant of $5,000. Please submit your back-up documentation to the address below: Mail or hand deliver to: City of Temecula City Manager's Office Attn: Betsy Lowrey 41000 Main Street Temecula, CA 92590 In order for these funds to be released, you must sign below acknowledging the following statement: "We do not discriminate based on race, color, nationality, sex, marital status, disability, religion, or political affiliation." The City fully supports the efforts of your organization and its services to the citizens of Temecula. Sincerely, Betsy Lowrey Sr. Management Analyst ACKNOWLEDGMENT OF FUNDING CONDITIONS (please sign and return this letter as soon as possible): Print Name/Title Authorized Signature/Title Date 3:14 PM WHEELCHAIR CITY 01/28/13 Sales by Customer Detail Accrual Basis January through December 2012 Type Date Num Memo Name Item Qty Sales Price Amount Balance ALL FROM THE HEART nvoice 2/3/2012 3907 DIAGNOSTI... ALL FROM THE HE... SERVIC... 1 0.00 0.00 0.00 nvoice 2/3/2012 3907 12V 35 AH L... ALL FROM THE HE... BATTER... 2 89.99 179.98 179.98 nvoice 2/3/2012 3907 LABOR INST... ALL FROM THE HE... SERVIC... 0.5 45.00 22.50 202.48 nvoice 2/3/2012 3908 DIAGNOSTI... ALL FROM THE HE... SERVIC... 1 0.00 0.00 202.48 nvoice 2/3/2012 3908 12V 35 AH L... ALL FROM THE HE... BATTER... 2 89.99 179.98 382.46 nvoice 2/3/2012 3908 LABOR INST... ALL FROM THE HE... SERVIC... 0.5 45.00 22.50 404.96 nvoice 2/3/2012 3909 DIAGNOSTI... ALL FROM THE HE... SERVIC... 1 0.00 0.00 404.96 nvoice 2/3/2012 3909 12V 35 AH L... ALL FROM THE HE... BATTER... 2 89.99 179.98 584.94 nvoice 2/3/2012 3909 USED TIRES... ALL FROM THE HE... USED E... 2 39.99 79.98 664.92 nvoice 2/3/2012 3909 USED FULL ... ALL FROM THE HE... USED E... 2 19.99 39.98 704.90 nvoice 2/3/2012 3909 PRIDE CHA... ALL FROM THE HE... LESIUR... 1 10.99 10.99 715.89 nvoice 2/3/2012 3909 LABOR ALL FROM THE HE... SERVIC... 0.7 45.00 31.50 747.39 nvoice 2/3/2012 3910 DIAGNOSTI... ALL FROM THE HE... SERVIC... 1 0.00 0.00 747.39 nvoice 2/3/2012 3910 USED TIRES... ALL FROM THE HE... USED E... 2 39.99 79.98 827.37 nvoice 2/3/2012 3910 USED FULL ... ALL FROM THE HE... USED E... 2 19.95 39.90 867.27 nvoice 2/3/2012 3910 USED INVA... ALL FROM THE HE... USED E... 1 40.00 40.00 907.27 nvoice 2/3/2012 3910 LABOR INST... ALL FROM THE HE... SERVIC... 0.5 45.00 22.50 929.77 nvoice 2/3/2012 3911 DIAGNOSTI... ALL FROM THE HE... SERVIC... 1 0.00 0.00 929.77 nvoice 2/3/2012 3911 12V 35 AH L... ALL FROM THE HE... BATTER... 2 89.99 179.98 1,109.75 nvoice 2/3/2012 3911 LABOR INST... ALL FROM THE HE... SERVIC... 0.5 45.00 22.50 1,132.25 nvoice 2/3/2012 3912 DIAGNOSTI... ALL FROM THE HE... SERVIC... 1 0.00 0.00 1,132.25 nvoice 2/3/2012 3912 12V 35 AH L... ALL FROM THE HE... BATTER... 2 89.99 179.98 1,312.23 nvoice 2/3/2012 3912 USED REPL... ALL FROM THE HE... USED E... 1 850.00 850.00 2,162.23 nvoice 2/3/2012 3912 LABOR ALL FROM THE HE... SERVIC... 0.5 45.00 22.50 2,184.73 nvoice 2/3/2012 3913 DIAGNOSTI... ALL FROM THE HE... SERVIC... 1 0.00 0.00 2,184.73 nvoice 2/3/2012 3913 12V 12AH LE... ALL FROM THE HE... BATTER... 2 59.95 119.90 2,304.63 nvoice 2/3/2012 3913 200 X50 (8X2... ALL FROM THE HE... WALKE... 2 29.99 59.98 2,364.61 nvoice 2/3/2012 3913 USED TIRES... ALL FROM THE HE... USED E... 2 29.99 59.98 2,424.59 nvoice 2/3/2012 3913 LABOR INST... ALL FROM THE HE... SERVIC... 1 45.00 45.00 2,469.59 nvoice 2/3/2012 3914 DIAGNOSTI... ALL FROM THE HE... SERVIC... 1 0.00 0.00 2,469.59 nvoice 2/3/2012 3914 12V 35 AH L... ALL FROM THE HE... BATTER... 2 89.99 179.98 2,649.57 nvoice 2/3/2012 3914 USED FULL ... ALL FROM THE HE... USED E... 2 19.95 39.90 2,689.47 nvoice 2/3/2012 3914 PRIDE CHA... ALL FROM THE HE... LESIUR... 1 10.99 10.99 2,700.46 nvoice 2/3/2012 3914 LABOR INST... ALL FROM THE HE... SERVIC... 0.5 45.00 22.50 2,722.96 nvoice 2/3/2012 3915 DIAGNOSTI... ALL FROM THE HE... SERVIC... 1 0.00 0.00 2,722.96 nvoice 2/3/2012 3915 12V 35 AH L... ALL FROM THE HE... BATTER... 2 89.99 179.98 2,902.94 nvoice 2/3/2012 3915 LABOR INST... ALL FROM THE HE... SERVIC... 0.5 45.00 22.50 2,925.44 nvoice 2/3/2012 3916 DIAGNOSTI... ALL FROM THE HE... SERVIC... 1 0.00 0.00 2,925.44 nvoice 2/3/2012 3916 12V 35 AH L... ALL FROM THE HE... BATTER... 2 89.99 179.98 3,105.42 nvoice 2/3/2012 3916 USED EXTE... ALL FROM THE HE... USED E... 1 99.99 99.99 3,205.41 nvoice 2/3/2012 3916 LABOR INST... ALL FROM THE HE... SERVIC... 0.5 45.00 22.50 3,227.91 nvoice 2/6/2012 3924 EXTERIOR L... ALL FROM THE HE... SERVIC... 4.5 45.00 202.50 3,430.41 nvoice 2/6/2012 3924 WIRING HA... ALL FROM THE HE... MSC 1 129.95 129.95 3,560.36 nvoice 2/23/2012 3946 DIAGNOSTI... ALL FROM THE HE... SERVIC... 1 0.00 0.00 3,560.36 nvoice 2/23/2012 3946 12V 35 AH L... ALL FROM THE HE... BATTER... 2 89.99 179.98 3,740.34 nvoice 2/23/2012 3946 USED TIRES... ALL FROM THE HE... USED E... 2 40.00 80.00 3,820.34 nvoice 2/23/2012 3946 USED FULL ... ALL FROM THE HE... USED E... 2 20.00 40.00 3,860.34 nvoice 2/23/2012 3946 PRIDE CHA... ALL FROM THE HE... LESIUR... 1 10.99 10.99 3,871.33 Page 1 3:14 PM 01/28/13 Accrual Basis WHEELCHAIR CITY Sales by Customer Detail January through December 2012 Type Date Num Memo Name Item Qty Sales Price Amount Balance nvoice 2/23/2012 3946 LABOR INST... ALL FROM THE HE... SERVIC... 0.5 45.00 22.50 3,893.83 nvoice 2/23/2012 3947 DIAGNOSTI... ALL FROM THE HE... SERVIC... 1 65.00 65.00 3,958.83 nvoice 2/23/2012 3947 MOTOR ASS... ALL FROM THE HE... LESIUR... 1 599.00 599.00 4,557.83 nvoice 2/23/2012 3947 MOTOR ASS... ALL FROM THE HE... LESIUR... 1 599.00 599.00 5,156.83 nvoice 2/23/2012 3947 LABOR INST... ALL FROM THE HE... SERVIC... 1 45.00 45.00 5,201.83 nvoice 2/23/2012 3948 DIAGNOSTI... ALL FROM THE HE... SERVIC... 1 0.00 0.00 5,201.83 nvoice 2/23/2012 3948 12v 10AH LE... ALL FROM THE HE... BATTER... 2 45.99 91.98 5,293.81 nvoice 2/23/2012 3948 LABOR INST... ALL FROM THE HE... SERVIC... 0.5 45.00 22.50 5,316.31 nvoice 2/23/2012 3949 DIAGNOSTI... ALL FROM THE HE... SERVIC... 1 0.00 0.00 5,316.31 nvoice 2/23/2012 3949 12V 55 AH L... ALL FROM THE HE... BATTER... 2 149.99 299.98 5,616.29 nvoice 2/23/2012 3949 LABOR INST... ALL FROM THE HE... SERVIC... 0.5 45.00 22.50 5,638.79 nvoice 2/23/2012 3950 DIAGNOSTI... ALL FROM THE HE... SERVIC... 1 0.00 0.00 5,638.79 nvoice 2/23/2012 3950 12V 35 AH L... ALL FROM THE HE... BATTER... 2 89.99 179.98 5,818.77 nvoice 2/23/2012 3950 LABOR INST... ALL FROM THE HE... SERVIC... 0.5 45.00 22.50 5,841.27 nvoice 2/23/2012 3951 DIAGNOSTI... ALL FROM THE HE... SERVIC... 1 0.00 0.00 5,841.27 nvoice 2/23/2012 3951 12V 35 AH L... ALL FROM THE HE... BATTER... 2 89.99 179.98 6,021.25 nvoice 2/23/2012 3951 LABOR INST... ALL FROM THE HE... SERVIC... 0.5 45.00 22.50 6,043.75 nvoice 3/1/2012 3965 OUTSIDE SE... ALL FROM THE HE... SERVIC... 1 0.00 0.00 6,043.75 nvoice 3/1/2012 3965 LABOR INFL... ALL FROM THE HE... SERVIC... 0.3 0.00 0.00 6,043.75 nvoice 3/15/2012 3979 USED REPL... ALL FROM THE HE... USED E... 1 850.00 850.00 6,893.75 nvoice 3/29/2012 4005 DIAGNOSTI... ALL FROM THE HE... SERVIC... 1 0.00 0.00 6,893.75 nvoice 3/29/2012 4005 12V 50 AMP ... ALL FROM THE HE... BATTER... 2 298.00 596.00 7,489.75 nvoice 3/29/2012 4005 INSTALLED ... ALL FROM THE HE... SERVIC... 0.5 45.00 22.50 7,512.25 nvoice 3/29/2012 4006 DIAGNOSTI... ALL FROM THE HE... SERVIC... 1 0.00 0.00 7,512.25 nvoice 3/29/2012 4006 12V 35 AH L... ALL FROM THE HE... BATTER... 2 89.99 179.98 7,692.23 nvoice 3/29/2012 4006 LABOR INST... ALL FROM THE HE... SERVIC... 0.5 45.00 22.50 7,714.73 nvoice 3/29/2012 4007 DIAGNOSTI... ALL FROM THE HE... SERVIC... 1 0.00 0.00 7,714.73 nvoice 3/29/2012 4007 12V 35 AH L... ALL FROM THE HE... BATTER... 2 89.99 179.98 7,894.71 nvoice 3/29/2012 4007 LABOR INST... ALL FROM THE HE... SERVIC... 0.5 45.00 22.50 7,917.21 nvoice 3/29/2012 4008 DIAGNOSTI... ALL FROM THE HE... SERVIC... 1 0.00 0.00 7,917.21 nvoice 3/29/2012 4008 USED EXTE... ALL FROM THE HE... USED E... 1 149.00 149.00 8,066.21 nvoice 3/29/2012 4009 DIAGNOSTI... ALL FROM THE HE... SERVIC... 1 0.00 0.00 8,066.21 nvoice 3/29/2012 4009 12V 35 AH L... ALL FROM THE HE... BATTER... 2 89.99 179.98 8,246.19 nvoice 3/29/2012 4009 LABOR INST... ALL FROM THE HE... SERVIC... 0.5 45.00 22.50 8,268.69 nvoice 3/29/2012 4010 DIAGNOSTI... ALL FROM THE HE... SERVIC... 1 0.00 0.00 8,268.69 nvoice 3/29/2012 4010 USED TIRES... ALL FROM THE HE... USED E... 2 29.99 59.98 8,328.67 nvoice 3/29/2012 4010 USED TIRES... ALL FROM THE HE... USED E... 2 29.99 59.98 8,388.65 nvoice 3/29/2012 4010 LABOR ALL FROM THE HE... SERVIC... 0.5 45.00 22.50 8,411.15 nvoice 3/29/2012 4011 DIAGNOSTI... ALL FROM THE HE... SERVIC... 1 0.00 0.00 8,411.15 nvoice 3/29/2012 4011 12V 35 AH L... ALL FROM THE HE... BATTER... 2 89.99 179.98 8,591.13 nvoice 3/29/2012 4011 LABOR INST... ALL FROM THE HE... SERVIC... 0.5 45.00 22.50 8,613.63 nvoice 3/29/2012 4012 DIAGNOSTI... ALL FROM THE HE... SERVIC... 1 0.00 0.00 8,613.63 nvoice 3/29/2012 4012 12V 35 AH L... ALL FROM THE HE... BATTER... 2 89.99 179.98 8,793.61 nvoice 3/29/2012 4012 LABOR INST... ALL FROM THE HE... SERVIC... 0.5 45.00 22.50 8,816.11 nvoice 5/24/2012 4092 DIAGNOSTI... ALL FROM THE HE... SERVIC... 1 0.00 0.00 8,816.11 nvoice 5/24/2012 4092 12V 35 AK L... ALL FROM THE HE... BATTER... 2 89.99 179.98 8,996.09 nvoice 5/24/2012 4092 KEY FOR IN... ALL FROM THE HE... SCOOT... 1 9.99 9.99 9,006.08 nvoice 5/24/2012 4092 LABOR INST... ALL FROM THE HE... SERVIC... 0.5 45.00 22.50 9,028.58 nvoice 5/24/2012 4093 DIAGNOSTI... ALL FROM THE HE... SERVIC... 1 0.00 0.00 9,028.58 Page 2 3:14 PM WHEELCHAIR CITY 01/28/13 Sales by Customer Detail Accrual Basis January through December 2012 Type Date Num Memo Name Item Qty Sales Price Amount Balance nvoice 5/24/2012 4093 12V 35 AH L... ALL FROM THE HE... BATTER... 2 89.99 179.98 9,208.56 nvoice 5/24/2012 4093 KEY FOR FO... ALL FROM THE HE... SCOOT... 1 9.99 9.99 9,218.55 nvoice 5/24/2012 4093 LABOR INST... ALL FROM THE HE... SERVIC... 0.5 45.00 22.50 9,241.05 nvoice 5/24/2012 4094 DIAGNOSTI... ALL FROM THE HE... SERVIC... 1 0.00 0.00 9,241.05 nvoice 5/24/2012 4094 USED FULL ... ALL FROM THE HE... USED E... 2 30.00 60.00 9,301.05 nvoice 5/24/2012 4094 USED CAST... ALL FROM THE HE... USED E... 2 35.00 70.00 9,371.05 nvoice 5/24/2012 4094 LABOR INST... ALL FROM THE HE... SERVIC... 0.5 45.00 22.50 9,393.55 nvoice 5/24/2012 4095 DIAGNOSTI... ALL FROM THE HE... SERVIC... 1 0.00 0.00 9,393.55 nvoice 5/24/2012 4095 12V 18AH LE... ALL FROM THE HE... BATTER... 2 69.95 139.90 9,533.45 nvoice 5/24/2012 4095 LABOR BAT... ALL FROM THE HE... SERVIC... 0.5 45.00 22.50 9,555.95 nvoice 5/24/2012 4096 DIAGNOSTI... ALL FROM THE HE... SERVIC... 1 0.00 0.00 9,555.95 nvoice 5/24/2012 4096 12V 35 AH L... ALL FROM THE HE... BATTER... 2 89.99 179.98 9,735.93 nvoice 5/24/2012 4096 OFF BOARD... ALL FROM THE HE... LEISUR... 1 262.95 262.95 9,998.88 nvoice 5/24/2012 4096 LABOR BAT... ALL FROM THE HE... SERVIC... 0.5 45.00 22.50 10,021.38 nvoice 6/15/2012 4143 Swing Away ... ALL FROM THE HE... MISC 1 550.00 550.00 10,571.38 nvoice 6/15/2012 4143 Wiring ALL FROM THE HE... MISC 1 130.00 130.00 10,701.38 nvoice 6/15/2012 4143 INSTALLATI... ALL FROM THE HE... SERVIC... 1 250.00 250.00 10,951.38 nvoice 6/15/2012 4143 SHIPPING C... ALL FROM THE HE... SERVIC... 1 68.00 68.00 11,019.38 nvoice 6/15/2012 4144 MERITS CH... ALL FROM THE HE... MERITS ... 1 99.99 99.99 11,119.37 nvoice 6/15/2012 4144 12V 18AH LE... ALL FROM THE HE... BATTER... 2 69.95 139.90 11,259.27 nvoice 7/25/2012 4212 IN STORE S... ALL FROM THE HE... SERVIC... 1 0.00 0.00 11,259.27 nvoice 7/25/2012 4212 12V 35 AH L... ALL FROM THE HE... BATTER... 2 89.99 179.98 11,439.25 nvoice 7/25/2012 4212 10 X 3 INNE... ALL FROM THE HE... WALKE... 1 9.95 9.95 11,449.20 nvolce 7/25/2012 4212 INSTALL BA... ALL FROM THE HE... SERVIC... 0.5 45.00 22.50 11,471.70 nvoice 7/25/2012 4213 IN STORE S... ALL FROM THE HE... SERVIC... 1 0.00 0.00 11,471.70 nvoice 7/25/2012 4213 12V 55 AH L... ALL FROM THE HE... BATTER... 2 149.99 299.98 11,771.68 nvoice 7/25/2012 4213 USED INTER... ALL FROM THE HE... USED E... 1 110.00 110.00 11,881.68 nvoice 7/25/2012 4213 INSTALLING... ALL FROM THE HE... SERVIC... 1 45.00 45.00 11,926.68 nvoice 7/25/2012 4214 DIAGNOSTI... ALL FROM THE HE... SERVIC... 1 0.00 0.00 11,926.68 nvoice 7/25/2012 4214 12V 35 AH L... ALL FROM THE HE... BATTER... 2 89.99 179.98 12,106.66 nvoice 7/25/2012 4214 INSTALLING... ALL FROM THE HE... SERVIC... 0.5 45.00 22.50 12,129.16 nvoice 7/25/2012 4216 DIAGNOSTI... ALL FROM THE HE... SERVIC... 1 0.00 0.00 12,129.16 nvoice 7/25/2012 4216 12V 35 AH L... ALL FROM THE HE... BATTER... 2 89.99 179.98 12,309.14 nvoice 7/25/2012 4216 INSTALLING... ALL FROM THE HE... SERVIC... 0.5 45.00 22.50 12,331.64 nvoice 7/30/2012 4224 OUTSIDE SE... ALL FROM THE HE... SERVIC... 1 0.00 0.00 12,331.64 nvoice 7/30/2012 4224 12V 35 AH L... ALL FROM THE HE... BATTER... 2 89.99 179.98 12,511.62 nvoice 7/30/2012 4224 USED FULL ... ALL FROM THE HE... USED E... 1 30.00 30.00 12,541.62 nvolce 7/30/2012 4224 LABOR ALL FROM THE HE... SERVIC... 0.5 45.00 22.50 12,564.12 nvoice 8/3/2012 4232 VISCOLAS H... ALL FROM THE HE... ORTHO... 1 0.00 0.00 12,564.12 nvoice 8/22/2012 4277 OUTSIDE SE... ALL FROM THE HE... SERVIC... 0 0.00 0.00 12,564.12 nvoice 8/22/2012 4277 LABOR ALL FROM THE HE... SERVIC... 0 45.00 0.00 12,564.12 nvoice 9/6/2012 4301 IN STORE S... ALL FROM THE HE... SERVIC... 1 0.00 0.00 12,564.12 nvoice 9/6/2012 4301 12V 35 AH L... ALL FROM THE HE... BATTER... 2 89.99 179.98 12,744.10 nvoice 9/6/2012 4301 LABOR ALL FROM THE HE... SERVIC... 0.5 45.00 22.50 12,766.60 nvoice 9/6/2012 4302 IN STORE S... ALL FROM THE HE... SERVIC... 1 0.00 0.00 12,766.60 nvoice 9/6/2012 4302 12V 35 AH L... ALL FROM THE HE... BATTER... 2 89.99 179.98 12,946.58 nvoice 9/6/2012 4302 ARMREST A... ALL FROM THE HE... LESIUR... 1 59.95 59.95 13,006.53 nvoice 9/6/2012 4302 PRIDE JOYS... ALL FROM THE HE... LESIUR... 1 9.99 9.99 13,016.52 nvoice 9/6/2012 4302 LABOR ALL FROM THE HE... SERVIC... 0.5 45.00 22.50 13,039.02 Page 3 3:14 PM WHEELCHAIR CITY 01/28/13 Sales by Customer Detail Accrual Basis January through December 2012 Type Date Num Memo Name Item Qty Sales Price Amount Balance nvoice 9/6/2012 4303 IN STORE S... ALL FROM THE HE... SERVIC... 1 0.00 0.00 13,039.02 nvoice 9/6/2012 4303 USED FOOT... ALL FROM THE HE... USED E... 2 39.95 79.90 13,118.92 nvoice 9/18/2012 4326 OUTSIDE SE... ALL FROM THE HE... SERVIC... 0 65.00 0.00 13,118.92 nvoice 10/30/2012 4401 IN STORE S... ALL FROM THE HE... SERVIC... 0 0.00 0.00 13,118.92 nvoice 10/30/2012 4401 12V 35 AH L... ALL FROM THE HE... BATTER... 2 89.99 179.98 13,298.90 nvoice 10/30/2012 4401 LABOR - BA... ALL FROM THE HE... SERVIC... 0.5 45.00 22.50 13,321.40 nvoice 12/27/2012 4496 IN STORE S... ALL FROM THE HE... SERVIC... 1 0.00 0.00 13,321.40 nvoice 12/27/2012 4496 12V 35 AH L... ALL FROM THE HE... BATTER... 2 89.99 179.98 13,501.38 nvoice 12/27/2012 4496 USED FULL ... ALL FROM THE HE... USED E... 2 19.95 39.90 13,541.28 nvoice 12/27/2012 4497 IN STORE S... ALL FROM THE HE... SERVIC... 1 0.00 0.00 13,541.28 nvoice 12/27/2012 4497 12V 12AH LE... ALL FROM THE HE... BATTER... 2 59.95 119.90 13,661.18 nvoice 12/27/2012 4497 LABOR - INS... ALL FROM THE HE... SERVIC... 0.5 45.00 22.50 13,683.68 nvoice 12/27/2012 4498 IN STORE S... ALL FROM THE HE... SERVIC... 1 0.00 0.00 13,683.68 nvoice 12/27/2012 4498 12V 18AH LE... ALL FROM THE HE... BATTER... 2 69.95 139.90 13,823.58 nvoice 12/27/2012 4498 LABOR - INS... ALL FROM THE HE... SERVIC... 0.5 45.00 22.50 13,846.08 nvoice 12/27/2012 4499 IN STORE S... ALL FROM THE HE... SERVIC... 1 0.00 0.00 13,846.08 nvoice 12/27/2012 4499 12V 12AH LE... ALL FROM THE HE... BATTER... 2 59.95 119.90 13,965.98 nvoice 12/27/2012 4499 LABOR - INS... ALL FROM THE HE... SERVIC... 0.5 45.00 22.50 13,988.48 nvoice 12/27/2012 4500 IN STORE S... ALL FROM THE HE... SERVIC... 1 0.00 0.00 13,988.48 nvoice 12/27/2012 4500 12V 55 AH L... ALL FROM THE HE... BATTER... 2 169.99 339.98 14,328.46 nvoice 12/27/2012 4500 LABOR - INS... ALL FROM THE HE... SERVIC... 0.5 45.00 22.50 14,350.96 nvoice 12/27/2012 4501 OUTSIDE SE... ALL FROM THE HE... SERVIC... 1 0.00 0.00 14,350.96 nvoice 12/27/2012 4501 12V 35 AH L... ALL FROM THE HE... BATTER... 2 89.99 179.98 14,530.94 nvoice 12/27/2012 4501 LABOR- INS... ALL FROM THE HE... SERVIC... 0.5 45.00 22.50 14,553.44 nvoice 12/27/2012 4496 LABOR - INS... ALL FROM THE HE... SERVIC... 0.5 45.00 22.50 14,575.94 Total ALL FROM THE HEART 14,575.94 14,575.94 TOTAL 14,575.94 14,575.94 Page 4 City of Temecula 2013-14 CS Funding Program APPLICATION NO. 5 RECEIVED CITY OF TEMECUIA FISCAL YEAR 2013.14 COMMUNITY SERVICE FUNDING PROGRAM AI9IggitION (Please Print or Tvoe) 2013-14 Program Submission Deadline: Friday, August 30, 2013 (original, plus one copy) PROJECT INFORMATION Amount Requested: $ 5,000 Project Name: Spay & Neuter Clinic - Animal Friends of the Valleys Project Start Date: 1 /1 /2014 (Maximum allowable $5,000) Project End Date: 4/30/2014 ORGANIZATION INFORMATION Name of Organization: Animal Friends of the Valleys Contact Name: Ellen Bilney Title/Position: Dir. of Development Mailing Address: 33751 Mission Trail, Wildomar, CA 92595 Telephone: 951.471.8344 x218 Year Organization Founded: 1987 Number of Paid Staff: 35 Number of Volunteers: 1,540 Geographic Area(s) Served: Temecula, Murrieta, Lake Elsinore, Wildomar, Canyon Lake, Menifee and unincorporated parts of SW Riverside county. Is this organization incorporated in California as a non-profit organization? If "no": Yes X No Effective Date: 12/1988 If "yes" (Must provide a copy of your statement of non- profit status from the State of California): Date of incorporation as a non-profit: 12/1988 Federal identification number: State identification number: Name of sponsoring organization: Federal identification number: State identification number: This application has been authorized by the organization's: Executive Committee X Board of Directors X Members -at -Large Application Page 1 FY 2012-13 COMPLIANCE REQUJIREMENT IF YOUR ORGANIZATION WAS A RECIPIENT OF FUNDING FOR FY 2012-13, PLEASE ATTACH COPIES OF INVOICES, RECEIPTS AND CANCELLED CHECKS TO SUBSTANTIATE THOSE FUNDS RECEIVED AND EXPENDED BY YOUR ORGANIZATION. FINANCIAL STATEMENTS PLEASE ATTACH COPIES OF THE CURRENT BUDGET OF THE ORGANIZATION AND FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT). It does not require a CPA's audit, but please submit if available. MISSION STATEMENT Briefly describe the goals and objectives of your organization and community services it provides. Describe the ways your organization meets the criteria listed on page 2 of the CS Funding Policy. Animal Friends of the Valleys (AFV) is dedicated to promoting humane care of animals through education and a humane, pro -active animal services program. We are committed to preventing the suffering of animals and to ending pet overpopulation. Although, AFV is contracted with the City of Temecula to provide Animal Control Services, we do much more. Animal Friends of the Valleys has three distinct areas of operation: 1) the Southwest Communities Animal Shelter (operated under an agreement with the 6 cities and unincorporated parts of Riverside County that we serve); 2) Animal Control Contracts and 3) our humane education programs (foster, adoption and spay neuter clinic). The Shelter and Animal Control contracts provide the revenue for the majority of our basic animal welfare programs; however, we are most proud of our humane education and outreach activities. It is through these activities that AFV can best serve the residents of Temecula. Our low cost spay and neuter clinic is now open, and along with our vaccination clinic, provides low cost services to anyone in the valley. Situated around the developing wine country of Temecula, we have a high number of lower income workers (the working poor) who, through lack of education and little discretionary income, often leave their pets unaltered. We have seen through our "Don't Litter, Spay and Neuter" education program that when families are encouraged to alter their animals at low cost, they are less likely to abandon their pets and are more likely to encourage neighbors and friends to spay & neuter their pets as well. We are extremely proud of the success of our grassroots education and outreach programs. Last year our humane education programs reached over 3,200 children. This program continues to grow each year since we began partnering with our local elementary and middle schools. We don't stop when schools ends either. One major success is our summer Furry Friends Kids Camp, which was developed to help foster attitudes of respect, compassion and kindness toward animals in youth aged 5 — 15 years of age. The campers learn good pet care activities, responsibility to their pets and how to be safe around pets. We also conduct monthly low-cost vaccination clinics, senior community visits, daily shelter adoptions, as well as weekly adoption shows in partnership with our local pet supply stores and parks. We have also dramatically increased the number of volunteer foster families we have available. These amazing volunteers take animals that are too young to reared in the shelter, senior pets who need just the right new companion, and other difficult to adopt pets. Foster Families care for these pets in their own homes until the just right new forever family can be found. We are currently fostering an average of 37 animals a month through our all -volunteer Foster Family program. These fostered pets are given the best chances at adoption and are one of our best success stories. Indeed, a large majority of our over 1,500 volunteers live and work in Temecula. PROJECT DESCRIPTION Application Page 2 How will your organization use the funding awarded? Describe the project, project objectives, those served, area serviced, and number of volunteers involved. Be specific. Include equipment or services that would be purchased and why. Include a detailed budget and a schedule of significant activities related to this project. You may attach a maximum of one double-spaced typewritten page of information. (Please type or print legibly.) Animal Friends of the Valleys would utilize the funding provided by the City of Temecula Community Service Funding Program to provide for free spay/neuter "scholarships" for 40 to 60, medium to large sized dogs to low income members of our community at our newly opened Low Cost Spay and Neuter Clinic. Specifically, the funding would be used to cover the spay/neuter costs of newly adopted animals from the Southwest Communities Animal Shelter and for companions dogs that need altering as well. While we have been able to secure low cost, yet highly trained veterinarian services for animals newly adopted from the Southwest Communities Animal Shelter, we find many people chose not to adopt a medium to large size dog because of the increased cost to spay/neuter. Yet, our shelter population consists mostly of large and bully breed dogs. The typical veterinary cost to neuter a 55 pound dog is well over S250, however the same procedures can be done at our clinic for $90. Female dogs can cost an additional $50 or more. The funds would create a first come, first serve scholarship. We have employed an aggressive grassroots strategy to bring awareness of the clinic and to educate the public on the importance of spay and neuter. This outreach has been conducted by a trained group of volunteers who walk in targeted neighborhoods placing educational door hangars, printed both in English & Spanish. We have seen through our "Don't Litter, Spay and Neuter" education program that when families are encouraged to alter their animals at low cost, they are less likely to abandon their pets and are more likely to encourage neighbors and friends to spay and neuter their pets as well. However, even with the low cost of spay and neuter through our clinic we know of several areas where this scholarship would make a significant impact. Specifically, this program would decrease the abundance of bully breed puppies in our lower income neighborhoods. We would be able to provide invoices and proof that all funds for this program were provided to Temecula residents. Additionally, because of our partnership with the Animal Control officers we are able to identify dogs and their owners who could most benefit form this program. We would also be able to complete the project within guidelines because the funding would allow us to offer additional days specifically for individuals within the Temecula area. Our regular outreach, foster, and clinic volunteers would be able to assist in identifying those individuals who could benefit from the program. Should we be awarded the funding we could be ready to roll out an outreach program and begin scheduling pets immediately. Application Page 3 PAST PROJECT BENEFITS If your organization received City of Temecula funding in the previous year, please explain and show how Temecula residents benefited. We have not received prior funding. Application Page 4 SIGNATURE PAGE We hereby certify the information contained in this application is true to the best of our knowledge and belief. PREPARED BY: Ellen Bilney, Director of Development and TITLE (Please Print or Type) SIGNATURE: PRESIDENT or AUTHORIZED OFFICER: Kristine Anderson, President NAME and TITLE (Please Print or Type) SIGNATURE: ORGANIZATION NAME: Animal Friends of the Valleys MAILING ADDRESS: 33751 Mission Trail, Wildomar, CA 92595 TELEPHONE: 951.471.8344 ext. 218 EMAIL ADDRESS: ellen@animalfriendsofthevalleys.com DATED THIS 19th Of August (Date) (Month) , 2013 BE SURE TO INCLUDE THE ORIGINAL PLUS ONE COPY AND SUBMIT BY AUGUST 30, 2013 TO: Mail Completed Applications to: Or Deliver in Person to: City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office Post Office Box 9033 Temecula, CA 92589-9033 City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office 41000 Main Street Temecula, CA 92590 Application Page 5 STATE OF CALIFORNIA FRANCHISE TAX BOARE PO BOX 942857 SACRAMENTO CA 94257-0540 Entity Status Letter Date: 8/20/2013 According to our records, the following entity information is true and accurate as of the date of this letter. Entity ID: Entity Name: ANIMAL FRIENDS OF THE VALLEYS, INC. 1. The entity is in good standing with the Franchise Tax Board. 2. The entity is not in good standing with the Franchise Tax Board. 3. The entity is currently exempt from tax under Revenue and Taxation Code (R&TC) Section 23701 d. 4. We do not have current information about the entity. The above information does not necessarily reflect: • The entity's status with any other agency of the State of California, or other government agency. • If the entity's powers, rights, and privileges were suspended or forfeited at any time in the past, or the entity did business in California at a time when it was not qualified or not registered to do business in California: c The status or voidability of any contracts made in California by the entity at a time when the entity was suspended or forfeited (R&TC Sections 23304.1, 23304.5, 23305a, 23305.1). o For entities revived under R&TC Section 23305b, any time limitations on the revivor or limitation of the functions that can be performed by the entity. Internet and Telephone Assistance Website: ftb.ca.gov Telephone: 800.852.5711 from within the United States 916.845.6500 from outside the United States TTY/TDD: 800.822.6268 for persons with hearing or speech impairments FTB 4263A WEB (NEW 02-2012) Exempt Organizations Select Check Page 1 of 1 IRS Exempt Organizations Select Check Fxemot Organizations Select Check Home Organizations EApible to Receive Tex -Deductible Contribution (Pub. 78 dela) . Search Results The following 1st Includes tax-exempt organizations that are eligible to receive lex•deductlble coMdbutions. CNok on the "Deductibility Status" column for an explanation of limitations on the deductibility of cant ibulons made to different typos of tax exempt organizations. Reside are sorted by EIN. To sod results by another category, dick on the Icon next 10 the column heeding for that category. Clicking on that Icon a second time WI reverse the sod order. Click on a column heeding for an explanation of Information In that column. 14 ell results EIN I.egat Namo (Doing Business As). MImei Nand* d aw Valley Inc -a u Rusks Per Pepe 25 z +3 OK City. State.Countr,);DedudlblyStabor. NMdomar CA United States PC ePrey 11•11Next s a Prev 1141 Next s http://apps.irs.gov/app/eos/pub78Search.do?ein1=330276892&names=&city=&state=CA&c... 9/5/2013 1.101.NDS ()).-1 VA.1.1.1.1'S, ENC. (.1 Noriprulit 1)1TF1) FINANCIAL, ST:VI-FAWN VS JUNE :M. 2012 NI) 2(11 Prudhom, Associates CPAs Mme.A1GPA.CSGPA A Professional Corporation 4346:',S;dcp Pr' ft Sitc22(1 INI)EPEN1)1.1-\ \ DITORS 14.1.;1ORT Animal rriends of the !Ilk:. I !It $1 c. Cortiii.i klVt: .1t1diled 111C inv .‘111111ill ricnd Of 1:alleys, Int:. 1:1 not-iproIi Orpilnivutiona,c1:11-.1utic 311. 2i) 2 and 7111 I. slilkl Sta1ellii2ILIS e.X reli5c;. tirCil•11 !iil V110 :'.C:11-S 11-101)tlY.IC:d. Ilrehe nanci:.:l stulcutent, arc the rosp.?!1,:11.-.ilit:k %0,!ani..":1111.1114 11-L;Wtlik.iliv111. )'1.11- re,pcin.•;ihi1ir:v is to cN press an LJI31fli on thcie tii.i_i1i 1 txt.,“.%.1 on out -audit. eotalito.c.1.1 our ;litchi in tiecordinice v., 'Oh aujiting ueocrall) aceepted in the 1 1111C(..i S17.111.'S I. A nicrica.. 1 Itosc. iniids require t i ‘\-e plan zinc.1 perform the Audit tn obtain rcusuria assuraitce ihutIA beam' the iiiranciai statements ure free of material tuisStaternerrt. :\11 Alidil 111C1uik'S On LI Lct supporting tb riiouul.s ,ii.,:e.losures in Lite financial A:JD:molts. An audit also i Pt:lodes as;icssin,;.... the ;:i.:couniin!;.._ principles uselt mid ;:igitilicant eslimates intik by iwniugen IC111_ :LK %WI Usliiiig Ibe Cric1-1111 lDar-'.:jai IIl irit prescntatior t. thAt otn rt,r our opinion. In out the prescal Fairly in the ItnauciI rosition tif; Aninlal Friends oi lhv Valleys. Inc. its (II hint.. 30. 7.111 2. and ' 1 and the ei);.ifiges in its net aN.-.1.-ts anti IP:: cash rim\ s for the ye;:tr,ilii.;31 ended in conformity ith at:COUltlinq! prineiple:; cneni11> uccep1cL1 in the. I ";tatt.5. tAnlerica. . 7 . .• ./ . - - .-- ...,z-/-.- -- . '-r. (-0,-- --- .5 'ernectila. Culiforni:.i i hveitibcr 1 1.101 1 •; 951 1,76 41,11 • votw pitiOltal'111!:10EiS 1.31A ANIMAL FREFNI )S OF '1'HF VALLEYS, INC. 5'I A I'I:M1'NTS OF POSTl'1()N PINE 3O 2OI2 .ANl}. 2011 ASSETS -01.2 2011 CIRRI-NT ASSETS: Cash and Equivalents 1.014.014 866,582 Acccn►►zts Receivable 256,090 224.492 inventory 5, i Y:5 T()1 AL i't)I(REN! ASS1:1'ti PROPERTY R'T'Y AND 1:QUU11'1v1I:N 1'. Buildings and Improvctuetfts Ego Less: Accttnik,Iatetl Depreciation NET PROPERTY AND 1 QIJIPME,NT 1275.271.091,07.1 315.214 9:0,126 1,245,340 (591.75O) 3O8.762 9 ,0.126 1.238,888 (46i3,456) 653,590 775,432 O 1'1-11:1t ASSETS: Other 641,315 641,315 Deposits 1.944 51' T()'1'AL OTIIGR ASSETS M3:259 641.834 'r(YFAI. ASSETS $ 2.572,128 b 2,508, i40 See notes to financial statements AN! -\.1 HZINlri 1111: VALI LYS, INC ( POSI CliRREN I 1,1ABILITIF.: Aount:.: arid Accrucd pnyable rorlion 1(1)52-(erm Licht f)tic IScrA !LAI. ;R.N.:\ 1 TAP,1111 111)3.1 N ;If current portiOn I 0 FAL 1IABIT...n1t-2.S i 11;1-k:snit:tea No Hooid def:ippioLed liv ITAI. NET ASSETS 01A1, IA1\1111.1.1 1F ANI)'INET ASSF I S.739 I 5K755 1.S9S ;15,007 14.759 • 1.5•1.1.07-; 75 L-198 Ifk72_12ti Sc noIs lu iinancdal statements 78.505 1.175.3NS 754.4:1? •• ANINI. \I_ FRIF:NDS 1111 VS. INC: sTATEmEN-us or 1.1(.:' VI-ARS ENDED .1: INF I cm ”orarilr Resvicled • nrest ric tk.t1 Building Ftillt1 1017 2012 71•01i'l 201 I Rk...strictce. r Unkl 2011 i I IOI I I SUP1)()R71. AND RF.V1.•tili LS: 1)rogiiiril ReVelltICS 4-15.45g S S 443,459 452.73S S ' 452.738 i..7ify : County C OM l'ae IS " .076 .291) . 1.076.'99 1,S 77.6 El) '..877_01. 0 Provision for inenillti• tiimiing 09.337, - (3g.387) I 119.36Iil 1 I 114368) D0.11;:ti. i 011 S 458.451 4.275 442.726 5:31.1:..`1 43.7"..z9 .574.860 Guild Released Iron, Resniel.ions 1.%).7.1 •••'..4-)-;(1'. - :87.; .445 I ritrot. ineorne .1.501 3.501 5.508 5..503 TOTAL, SUPPOR*1 , \ND R.12VI,N1 IF S 2.047.273 i ..... 1 .o5), .:.. .7 91 ,,-.4 4g PROGRAM SERVICE EXFFNSES 2. IV). • • SUPPOR 1 i. MICA' EXPENSEs: Administrative cxpense Fundraising eNpcmc (Gain.);10.:s on di SI()i iI l'ou..,1a-,sets l'OTA1. COSTS ..\ND EX SFS ToTAL EXPENSES ASLWECREASEI NE, r ,\ssas NC E ASSETS. BEGINNING 31 4..-0 f-Ofi 35.010 : 88.649 1..-12:i 1 1)0.07:. N : .; 1 f• gOf X: .94n 84.14q 1.73S 89..3 7 - I 123.: 8.742 8.742 395.50' 1.7325 1Q6.817 741: 12 . 2.81i 1.63 7 ,125 2.882.'451 65.616 63.636 2.2.?9.8.•35 S 2.295.-71 S - s 1.'95.47! 2.48k).27S 1•1.7'.71) 1.f•-', .05 ei 77.744 263.'482 .CI5 1.04 1 S:.*.c I 1,11 Cr, IV: r. KW! 7m d n2 R2\CR,m t /cdm»n F 0d Fund R2 &:@ Eveas Rmmnce In ig Mileage OMB ()tiler (lut$ide Scrbcs Item f± Ra2|I %men «e Salaries Ss.ipplies Ugd7 TOTAL FUNCTIONAL E\ PENSES ANIN1L1R11: DS OP 11I[VAI1VY&1NC. SfA O:2 E\[\0>-H]% iC \I. x m. SES F.ARSI DEp]E\E ¥b2ol2«%D2011 ?To ■rani Cit.; id&d i AdniipiA9e.iy,2 2012 2r,111 7012 S 8.073 S 20.028 173.717 71.611 |.R 279 292 7.230 4I.917 7.D 9%0|R EI|b ;8\ 893 !.3 57.7 34 I90_167 111.050 2% mt ;70 f\287 12g@ K§2 I6.438 0ml 20 1 2 S - S %1 » • !&n2S 173.717 7 1.61 1 15.821 I5.321 1.260 6 747 %2a0 E2 49,391 .(120 g0» 1.116 2.61 /229; 41.114 E59}$1I ;6.2 M »£416 3,363 OLS51 S 2486.135 S 315,Q10 $ 81. m S 2.S83.085 ho ra Services 2;111 | g 80 3.06-1 7.2IQ wk 3&|34 106,100 1.12: ||E617 1.22%73? 1g% y] 96.4Qe G@wQ|md adQg4nitik : m6%e Im3 3)11 2111 2:111 752 S 15.816 - 15.816 I3&4N 136g19 | 50.791 IK»Q 1%r9 8.725 1.1-12 N 7. 7 - 3 4 7.210 7£6 76 55,134 4 2. $ 14 S 1.121 2q7 0.5 1:5.415 11 K7 am‘-)R:.; 1384.475 2la6:3 216.107 q&$ 1.150 109.081 6 -15 S 2.'25.602 5 190.:" $ #.l37 S 2904„S12 . \+ m,e& to A Ay&| q@drlemz FR I 1..N DS OF -I V:‘1.1.1..YS, IN( II y.,;11 FLuwk.; YLAR::•;1-:NON.D.11 Ni. 30. 2012 AND 2011 ()P1:1z, I IN( AC FIVI 1:11-1S: litr.:rease in Nei ;\,sets Adjusinienis lo Reconcile 1;icreas,... in Net Assets C'ontributions received Cor lung-lerin purposes No Cosh Pr ik.;eti I:\ (1 ,sekl Operating Adiviiies: Non -cash kion:Aions Depreciation (Craiiii 1 4 )S*4 on disposol olossoq Incrtnaso in ;\ecount!.: 1eeeival-110 Cher -ease) Decrease in depi*.iis ilncre:v-;c) in inventor.v Increase. (1)ccre.t.,,r ; in i'weounts1):111111c anti Acerned I riercasei I Lleposii:s payahle I 'tie SCI-A NI:T('AS.11 I:1 OWS O'SED IN1 PROVIDED RV ()PLAZA FINK; Ai- [WITH ,s CASH FI ()WS FROM INV !-.S ACTIVITIFS- Acquisitions Ii‘ed Proeecils from .sale of assets N C Atill 1•1.0WS 11817.D IN 1NVCSTINCr A C'llY un ES (ASH11 (VS 1. ROM FINANCING ACTIVITIFS: Po; nicht% on limg-terni debt Proccethz received ror 'tor esnrieni hi buildin,,,z NFI CASH 11,OWS USED 1•I“.)NI 1.11N,A,N(ANG INCREASE IN CASII AND EQUIVALENTS 20 1-, 11 1 o5,J124, 173.7 I 7 (31.59g) (1.--125) (5.175j (211.4-161 1.1/.050i 14.187 203.6-18 (8.139) ,1.275 1. 7 -,y7(,4 012.8001 8.742 I (1(i ,5 10 (1,073 313.315 t ;147.191) t 397301 (X8.52) 43. /.39 (4.1.784) 1.47.432 j12N,860) CASH -I AND EQUIVALENTS AT UEGINNJN( or \TAR 866,582 995.442 CAST! AND F.QIIIVAI.UNTS AT END OF YhAR 1, 1,014.014 S 6.582 See notes to financial siatvrnonts ANIMAL I•Rll•:NI)S O1' TIIL VA1..LL VS. INC 4 f A I vI1-N1 S O1' (':ASI I FLOWS YEARS ENDED .11-NE 0, 2012 AND 2011 SIJ1'I'1_I_I 11•.N FAL INVORI'vIATION of ('AS11 F1.()ww! INFORMATION: CASH PAID FOR INCOME TAXES ('AS! I PAID FOR IrTLRL's'r 2012 2011 )<)'3,964 s1,PPLEMIsNr.Al. S('llls1)171.EOF NON('ASI1 IN1%I SII1�Ci�1 i\.a'�('iN(i AC'7.1`✓1r1LS_ Tlx; OL ,animion purchased property and equipment iri the amount of $52,552 and $441,084 for the years ended Rale 30. 2012 and 2011 respectively. In conjunction with the acquisitions, liabilities were assumed ,as follot�•s: 2012 2011 Fair market valut• or assets actluuiredl $ 52,552 : 441_084 Cash paid for property anti ecI upI1:ent 52,552 3t)7.391 I-inbilitics assumed $ 43.693 See notes to financial stolen-lents ANINIAL FRIVNI)S 11 VAI 1 lz,')S, NC/ FINANCIAI S 1AI 1.:NILN JL'NI.10, nil"! AND ?ill: NO I-SI y (!l• i's;k. c't \AWN Of the littsillt,:SS 1:11QtitIS 4,1 the Valle . the 0q:,.anizz.ttion1 is a nonprofit public benefit organitatior.. incorporateAl in tvlatelt. 1•08.?. 1 he ,41)Vt!i fie and printar:. purpose and mission of the Organization iLo promote. rho humane 1 animals tinottv.h education .aid humane pro- active animal L,vervices program %vithin the Southwcst Riverside County. including the eitie$ Canyon I.a14e_ Wilclomar. Lake Elsinore. klenifce. ivIttrrient and Temecula atirl plOiCCLS related to animal assistatte‘.• in .eneral. ()titer current activities include the constrnelion of an animal shelter as descri1...1,1 heltm, Tittildino und In Seim:mho 2010. it !Icy, Attic ol the art zatintal shelter constructed by the !,otithwest Communities hinaneing Authority iiiiternbcrs include the eottmv of 1:iverstdc and several of filo cities the shekel si::vieefl Ih Urtztt.titization has been euntracted Its provide various annual shelter aciivitics for the 8fielicr. The ()rganialtion continues to raise finds dv.,,signaied for the fund itt order to exercise the option •ztateti itl the ts7mert1 v‘ilh tht: taltrsvir.Tihe kirganiz:ition the ;1111-iii) to pay off the honds prior to maturity. Funds raised for ibe building designated with tompotarily restrietod at assets. I Lie at:cot:Tan> in. financial statements. Basis ni Aecountinu he financial statements: of the OtTanization ha% t. heen prepared on the zweritul basis of aecot nit ing and ;.tccottlittRi) reflect recet\ul,les. pa) ithies and oilier liabilities. l'inoneial Statement Prentation The (*)1ilani7ation has presented itq Itflaneqii S1IILU1C11L ill aeColChlitc:c 1%.*th v,efterally Lk:cert.:LI aveounting principles lin not -Tor -profit oruani.,,ations. Lnder i1iiguidance.. the Organization is required to repoo iitfOrmation It.-Itarding its financial position and acti\-ifies according u' thiet• Ckissl.::-; 'let iissOzz: unrestricted net ass.ets. temporarily tesnieted net nisets., and permanenti:, restricted net as.i. In addition. tho Orvantiath)11 is required to pre5:ent ti statement of cash (lows. ANIMA1, 1:RIEN11S (11 1111. VALLM'S.11\li' NOTES l'i) FIN/',,NCIAl. ATENIF.NTS 2.012 A's1) 7'1)11 1\&)T1L 1-StMMARY 1)1; I At:Cf H IN 1 INii )1 IrIES iConiinued) 1!, ceoun ti_of c ye lit igs. Under generally accepted accounting prineir.le, fir not for profit organizations. amounts received are recorded as unrestricted. teitiporaril I:stride:1. or pertuanently restricted revenues. Support that isrestricted b) the donor is r.-:foited as an increaseili iinrk-!strieted Het iisseis if the restriction l:xpires in the reporting period in which die support is reeogni/.1.x_1. .\11 other duaor- restricied support is reported as an increase in temporarily or pormanen11) teIi C1I itel dependiniz on the. miture of the restrietion. When a resuiction expires. Ilizit is. 'Alien a siipulated lime restrict ion entis ur purpoie re-soli:non is accomplished, temporarily I'L':Sfricto:1 no redassilied to unresnicted net assets and reported in the statement of activities as net iisscts released from restrictions 1 • i inittes l'Riparation of financial statements in acec>rdance \Vial LICCeilk%! accouniiiiiti principles requires n-uinitucinent it) UM: C'SII171:11C'S 01 et.-riaili i.111101_111(,; l•stintates were made hy management regarding useful fives of long-liNed asseis It-lanagetnent also 4.-Aitna1es thin all acevitrils receivable will be received and that an allowance for accountsk aot nece.3sary It is thai cholig: u imaies mar occur in the near term.. 1:vetivi The Organization has in -:dilated subsequent Q.\ cuts through lxk.weniber 13. 2,012, the. ;late iht 002anizatioit's financial sLate•itient::. wen: a‘ziilable for (*ash and Cash kutiivalents 1 hc ()rliani7ation coimitl...IN all highly liquid investments with n nviilirily thr,:e mk)nthy. or less when purchased to he cash cqui‘alenbi. l'roni time to time total cash and casli equivalents dcrosiled with third party financial institutions by the Organization may exceed arstutints not etw•ercili.the Federal 1)epositnry Insurance ('orporation c1:1)1("). li is the c)pinion of loaliOacrocrit thutLbesOlvency of these-financial- instillitionS is tiot of particular concern at this time. •• ..\til'MAI, ['FUNDS ii1; '11!1: VALLEYS. 1tiC. NRIlTS TO I '1NANCiAl S l'ATHNIEN rS NO11: 1-S1.vINI.A.10* (11.: SION11:1C2..N: I At 't'Ot 1\11\16 l'01.1(11-.'; tCotinnuei11 l)1yentory. t 412)1111/AI i1 tIVCJIR+ry lSL I 1ipplics and tabs.!) pts't prat' Lte ls staled z•tt lilt 10'wel' of. COSI titmarket. litti41.in.;:s am.), 1-tittirati1t and equitsrnent s.:apitalived at cosi. It is the iNolit-.). ))1 Inc t.igz4nizata.a.) copittilive expenrlitur...:s for Ilsese itents in excess of S.f.01.). I e.:set attlotalts are ypsalset.i. 1)1..)rs:hz.c.1 prop1/4:113 and etiatrwaerit c:illit1l..e.es.1 tit eA.5s4. oi t.(!uipment uic N.civcied 001)IrlislAti(IITS ai their eciin)aiet-.1 fair Niue. Ruilding:s. anti 1.-quiprnerit art: tie1irt:t.:isile...1 using Ow t.-traitAlit-iitic riled -tot' ;:still)LILCd ti ui 1i:,1S P)1101VS: -10 )eiirs ir-laehinvfv I.-mail-Iva:lit 5-7 year., 1./.....preetation exi)..2a,e for the Cal-S ncling Rate 2011 strid 2,11 I were 77I 7 and SI Ib..-115- contriluted Services Organization doo-n.t I-VClalni7C any support. revenue or exi)ense from ser\-ices contributed Iy volunteers. A substantial ounibci twhinteers havc ,.1trniited iiinc to ibc Organ:7atio1's programs and suporung- se:vices. Niaincnint!, hike be.en Mi.:bided in Int"; fillUnCiat StZThMiS Its; tiortuted serviccs1 no zt.s.tiltibk to toett:airt: the v.al tic i;f Aid) service:i. Other Assets The Org.,ani.r.ation 1-tas inc.:m.1Ni various cohth tor eonsultimt.. iees. permits. archjWcis alai otbet- .zervicess related to its proposed new !lilt Itlinp. I hock. cotsts are reflected •.rt; Idler Assets in the aceoloptin statement Of Financial poi4;1iolt flu calL111 Jane 30. 2.012. In July 2001!,. planti for iltt: 11L3It1l11‘‘,Trtf. donated to !lb: Southwest ( ommunilles Finant'in12. Authority S(.F.,V in accordance with a Memorant.itimol Lihierstanding (NMI)) sig.netl ifl Ft:Inman. 2006. Sec 1.)AI-titer information in Note -1 — Joint PowtIs Authority. I alder certain eireumsiancc.s.ibe C/r&tonitation may be enthIed to full reimbursement of the, costs:. 171.1).: building was completed in Spent er 2010. t:)rganization expense:: advert king cocas as 1 I ire incarred Advertising expense.: outflank(' to $8,073 and S7.523 cittrilig risco' year ended June 30. 2.U1 2011. Amtvl,\1_ I'Iu1:ND or -Fir vAt Nt to 1/1NANCRI. SlAT! .11 NI: .10. 2 AND 2011 NO IF l-it INV\ 1.eN I t.iN1 1 !(..1.,.!%1\ 1 .-",j.'(.•01L !WIN( it • I 1. S tied s) 111COMV. Tht.1. (/Pll6011 1101-11.11-piiAl ilnlailitalicin (Nil if; e>:01gip from inconit: !axes tinder Stn.:lion 3111t0(3,1 of the Internal Revenue Code and did ncii conduct unrelated business. activities. herefore. the k.)manizitlion hat., made no pro% ision for ft:di:tat iti ,Alite income itr....es in the accompanying financial statements. Functional Allocation 01 1.:xpense The ect,:ts olprvividii.01 the VtriU oretvrnim-: :Ind have on ;i Functional hasis in the statement Or functional expens.-zs, ciNs have Ivo) allocated :tom tg iii program:- and siiptiorling Nterliei:$ bILd 01) SEIC'el fie idclaincation. t'onetlillration's ()r,;4;1111:InliOn deriN,2s siy.tthletint re elutes from contnicts with v,711:0Lli; local governments for unirnal control scrvice,t. Loy; or f:.0ine ty till of tht.....ie contracts could have u ittiificant deltirnittal effect on ibc trgartization'c olvratiorm NOTI.2-.1\CCOUVIS RJC1I V Accounts recci% able consists of amounts due from governMon! a rice ind art: striat al ib J111011111 e";pet;ls to (....011el Iroui 011iStanding halaliCeS. cowlidc.rs aeek-nints reeei‘ able to Ile folly collectible at )1.tal-elid. Ack:ordindy. no allowancc F.:corded. N(J•11'.3-1."\N•f.) Organizntion len-ies land from the Hsinote Valley klunicirtal Water District for S2 tler year for n tom' 01 55 year:: endmg 2ti5-i with tin option to renew the tense thr unoilivr 4-1 years under the same terms and conditionh. hi November 20.09. the lb-!,.attr/ntton sublet this Lind to the Southwest Communities Financing Authority ISCF.M., in acAtordance with a Niemoranduin of ikt0(1t in Felirazii. 200b_ for the purpost: ol constructing the new animal sh,c1ter Now 4 bel)w. •1 he kind is sublet for S I per year list a tern! or -40 ears ending 2.038 ‘vith the option UN exteud the lease up to ten years. ANIMAL FRIENDS 01• 'II IF: VALLEYS. INC. NOTES TO I INANCIAI . S•I'A1 I.'sA1l:A1'l'S Jl INE 1i), 2012 AND 2011 1\OIi:_21-.i01N'i' POWERS Al.,_11 Jt;RFFY_111.l.NII)1(AN1)1JV1 ul I!N1)1•:RS I A t)1NCi During the ;ear ended June ,O. 20N06. the Organization Signed a Memorandum of l indcrstanding /mot.i) with the. Sot:ihwest ('omruniticF, 1:in<t1•ic:inu Au(horil CS('I7A). The SCFi\ soli hi>si;I• to 1iln1114:c the C0Ifl1)k•tion of a Bete shelter. The {)r;.':iiDilatiiin luirlie.ipattd in the design and construction of the shelter 1b\• con letill.' the t.'.li`.itinFg design. plans at their own expense. t ipt!n the finalization Oi' the design plans for the Facility, the t)r altix:.iti(!n donated the plans to the sCI•A for use in the construction (NI. the facitttti. SC.) \ "intends to !;rant clear and full title to the new shelter to the Organization upon the retirement of the bondI:l thirty Fiat':). Under certain crr'cun)SI;1 ces. all CO' a {portion or du.: costs or the design 1)liins may. he rt')1T11)IJrsed 1n die i )rv..aoiztuion. The On!ani•7,ltirin's interest in the St.• VA building is curried in Other assets ill (Ile :tcci)nl1)anying stalt:iliclils 11l financi;ll position. /he Soutbwesi Communities Financing Authority (St.'l' A) I:,i:i obtained bonds in order in construct the new shelter. The,: Or . tni•r.;ition has , yci iuci SCI!\ the above mentioned land least. I he lease will revert back It` iJi. OrL_ u)i,:)tiilt, when the bond term expires or 0 11Cr il" curtain conditions exist. Hie t'onstructit)n \tias completed in September - I',l;f:,'1() N('I.A Annually. the SO:'l.:;\ a1)I?loVe:: a shelter operating hudttei anti t1I1ueat4Inc budget among the rtlernbtl' a .t.'nciCS. Members 'A ill 1p;tt the t.)rti:111i7:36h111 the ::ilrtu it 1111/011 11 a110Cait' i to them), in in(lll1hlt 11U)r MOON. ; ll_\' unspent portion of tit': budgeted amount rt•tli be returned to the St'1•:\. or. if mutually agreed upon by thte (CI::` and the Organization. Will 1 . crediti;d toward the nett 1i,ca] year's budget. As of June O. 2012 and .hint' 10, 2.011, ih current',car unspent portion of the: bucl",'1t"d amount was $ `9..387 Anti $1 1 (0ixi5. resp cI vei\ and is recorded as Provision far member funding in the accompanying statemeiitS of activities_ 'I ]lc tonal unspi.ml portion of the htltl:.t't is accumulated and re.r.ided as Due to SCL\ in the accompanying ,statements of lithett:i_tI position in the amount of S I :)8. 55 and 1;1 1 tJ, 6S :1: June 0. 2012 fetid June 30, 2011, respectively. tSO1'i 6 Ll_)1\•(.i-11:12\•t I)I:ii'I ,\rites payable ;ere carried f. face value. Estimating market values, as required by generally nereilteil accounting principles. is not rracii.able since: there 15 no aetive public market. ibr the notes. ANIMAL FRIENDS 01; 1.111 VALLEYS. INC' NOTES TO 11NAKCI.A1. STATENAENTS .11„ !NE Tql, 2012 AND 2011 NO.11.-.: ( - LONG- I 1.1ZN,1 DWI. (('ontinued) During thi: yvar him 30. 2012, the Organization purchased a van. Pertinent inibrmation reg4.1rding notes payable is. as follows: Note pa>able to (iMAC:. due in monthly imtullments $728 with 0i).4) intc.-rest, final payment due April 2016: ecured hy vehicle. 1.17.SS CURREN 1 PORNON NOTE PAYABLE. NET Future maturities of th notes pa) able as at 30. 2012, are folltms: Year 1...nding Juno 3(1 2013 $ 8.73g 2011 -8,739 2015 S..739 2016 7281 2012 2011 $ 33.498 $ 42.237 8.73.9_) (.1085) NOTE 7 _L_S:111cIAL. EVEN.Qi Organi/ation has various fundraising vvents to help fund current operations and building. Funds. The rcvenue and related expenses from such eVC.Itlii fir the year ended Jun 30. 2012 and 2011 were as rollows: Event Pci Parade Wines for Canines Goll*Tournument Other 2012 Rcvcnue EX lenses Nei 2011 Revenlik: 17.,ipenses Nel $ 1.533 $ 12 $ 2.521 S 2,100 S 2(S $1,832 12.307 7.8X2 4.425 25,669 I 5,210 10.459 12,909 5,966 6.943 8,06() 1,382 3,678 4..80 J29j 2.907 lotal $ 32,617 $ 15,821 $ 16,796 $ 3.5,82i) $ 19,go.) $ 1599 Animal Friends of the Valleys, Inc Budget Summary Fiscal Year 2012-2013 Combined Proposed Budget Description & Justificiation 2012-2013 Sheltering Expenditures $ 3,066,417 Sheltering Revenue $ 2,125,795 Capital Reserves $ - Expenditures Exceeding Revenue $ 940,622 Less Kennel Volunteers $ 96,800 Total Cost to SCFA $ 843,822 )PA Funding Wildomar Mitigation Fee Additional Funding $ 849,822 $ (6,000) $ 843,822 Over/(Under) $ Budget Detail Expenditures Fiscal Year 2012-2013 Combined Proposed Budget Description & ]ustificiation 2012-2013 Regular Salaries $ 1,540,500 Executive Director (1) Assistant to Director (1) Program Director (1) Admin. Manager (1) Animal Control Supervisor (1) Animal Control Officers (8) ACO Support (1) Citation Clerk (1.5) Dispatch (2) Kennel Supervisor (1) Vet Tech (2) Kennel Tech (19) Operator (1) Lost/Found Clerk (.5) Web Designer/Offsite Adoption PT (.75) Foster Cordinator (1) Office Clerk Front Office (9) Office Clerk Back Office (2) Donor Recognition (.25) Humane Educator (.5) Public Relations & Fundraising (.5) S/N Transporter PT (.5) Overtime (included above) Payroll Taxes $ 150,000 Benefits/Insurance $ 151,200 Contract Employees 5 33,000 Accounting Services Personnel Totals: $ 1,874,700 $ 6,999 Advertising Animal Food & Litter $ 72,000 Animal Supplies $ 103,500 Vaccines Drugs Supplies License Tags Auto/Truck Expenses $ 125,000 Fuel Maintenance Insurance Towing Depreciation Expense $ 180,000 Dues & Subscriptions $ 1,250 Fundraising $ 33,500 Budget Detail Expenditures Fiscal Year 2012-2013 Combined Proposed Budget Description & ]ustificiation 2012-2013 Insurance $ 30,000 Met/Seminar Conventions $ 8,000 Microchips $ 36,000 Mileage/Gasoline $ 7,500 Miscellaneous Expense $ 6,367 Cash Long Short & Interest Expense Newsletter Expenses $ 24,500 Nonprofit Expenses $ 600 Office Expense $ 74,450 Postage Supplies Bank Fees Operating Animal Supplies $ 26,200 Operating Expenses $ 6,501 Printing Expense Outside Services $ 48,800 Independent Audit License Charge Grooming Services Outside Services -Disposal $ 16,000 Radio & Paging $ 8,500 Rent $ 2,000 Repairs/Maintenance $ 87,350 Shot Clinic Expenses $ 28,200 Advertising Supplies Outside Labor Spay/Neuter Services $ 41,000 Store Supplies $ 12,000 Tax/License/Permits $ 17,000 Computer License Telephone & Utilities $ 159,000 Telephone Electricity Water Internet Security System Teletrac $ 7,500 Uniforms $ 4,500 Vet Services $ 17,500 Sheltering Totals: $ 1,191,717 Total Sheltering Expenses $ 3,066,417 Animal Friends of the Valleys, Inc Budget Detail Revenue Fiscal Year 2012-2013 Combined Proposed Budget Description & )ustificiation 2012-2013 Revenues Adoptions, Adoption Holds, Forfeits $ 167,000 Animal Control Services $ 15,400 Billing Contracts $ 1,246,895 Board Fees $ 38,000 Classroom Rental $ 1,000 Donations $ 174,000 Donations -Counter & Request $ 106,000 Donations -Food & Supplies $ 91,000 Fundraisers $ 62,000 Impound Fees $ 66,500 Kids' Camp $ 4,000 Microchips/Vaccines $ 33,000 Misc. Income $ 10,500 Quarantine & Traps $ 16,500 Retail Store $ 24,000 Services - NonSCFA Member $ 22,000 Shot Clinics $ 48,000 Total Sheltering Revenues $ 2,125,795 City of Temecula 2013-14 CS Funding Program APPLICATION NO. 6 CITY OF TEMECULA RIMMED— AUG 3 0 2011 FISCAL YEAR 2013-14 CITY MA ICE R'S COMMUNITY SERVICE FUNDING PROGRAM APPLICATION (Please Print or Tvoel 2013-14 Program Submission Deadline: Friday, August 30, 2013 (original, plus one copy) PROJECT INFORMATION Amount Requested: $ 5,000.00 (Maximum allowable $5,000) Project Name: ALTV Building and Grounds Improvements and Maintenance Project Start Date: 03 November, 2013 Project End Date: 07 November, 2013 ORGANIZATION INFORMATION Name of Organization: Assistance League of Temecula Valley (ALTV) V Contact Name: Dorcas Shaktman Title/Position: President Mailing Address: 28720 Via Montezuma, Temecula, California, 92590-2510 Telephone: (951) 694-8018 Year Organization Founded: 1989 Number of Paid Staff: zero Number of Volunteers: 196 Geographic Area(s) Served: Temecula & Southwest Riverside County Economic Development Region Is this organization incorporated in California as a non-profit organization? Yes X No Effective Date: 15 June, 1989 1f "no": If"yes" (Must provide a copy of your statement of non- profit status from the State of California): Date of incorporation as a non-profit: 15 June, 1989 Federal identification number: Name of sponsoring organization: n/a Federal identification number: n/a State identification number: n/a This application has been authorized by the organization's: Executive Committee Board of Directors X Members -at -Large Application Page 1 FY 2012-13 COMPLIANCE REQUIREMENT IF YOUR ORGANIZATION WAS A RECIPIENT OF FUNDING FOR FY 2012-13, PLEASE ATTACH COPIES OF INVOICES, RECEIPTS AND CANCELLED CHECKS TO SUBSTANTIATE THOSE FUNDS RECEIVED AND EXPENDED BY YOUR ORGANIZATION. FINANCIAL STATEMENTS PLEASE ATTACH COPIES OF THE CURRENT BUDGET OF THE ORGANIZATION AND FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT). It does not require a CPA's audit, but please submit if available. MISSION STATEMENT Briefly describe the goals and objectives of your organization and community services it provides. Describe the ways your organization meets the criteria listed on page 2 of the CS Funding Policy. ALTV provides human services to disadvantaged families in Temecula and the Southwest Riverside County Economic Development Region. All programs are operated & staffed by ALTV (member) & community volunteers. ALTV's Operation School Bell (OSB) program provides clothing to low-income schoolchildren within the service area. Since 1989, OSB has clothed 23,511 children. ALTV's Operation Community Outreach program employs volunteers to partner with existing community organizations to serve the basic needs of individuals and families in need of critical basic human services. A) ALTV is a 501(c)(3) nonprofit corporation headquartered in Temecula, California. B) ALTV offers essential basic services to any disadvantaged constituents within the local community. C) ALTV has operated continuously since 1989, grown its volunteer base and expanded its service offerings. D) ALTV is recognized in the community for its provision of services to disadvantaged persons, contributions to child welfare and education, and successful operation of its local thrift store. It has been publicly recognized by numerous local, regional and state organizations and governmental bodies each year for many years. E) ALTV engages rigorously in generally accepted accounting principles and prudent fiscal management. F) ALTV is well organized and endured for 24 years with an annually elected board of directors which governs, develops strategic plans and guides the organization and its programs forward within the scope of its mission. G) ALTV annually reports results related to the provision of its services within Temecula, other cities and within Riverside County. This is typically completed in relation to the CDBG grants funding for some ALTV programs. H) ALTV maintains and adheres to a comprehensive non-discrimination policy in all aspects of its efforts. I) ALTV does not require attendance or participation in any political, religious or social activity. J) Current financial statements are attached & independently audited financial statements are produced annually. K) Current annual budget demonstrating prudent use of financial resources is attached. L) ALTV provides services to all disadvantaged community members within the scope of its programs. M) ALTV continually assesses program efficiency, impact, outcome, and beneficiary satisfaction. PROJECT DESCRIPTION Application Page 2 How will your organization use the funding awarded? Describe the project, project objectives, those served, area serviced, and number of volunteers involved. Be specific. Include equipment or services that would be purchased and why. Include a detailed budget and a schedule of significant activities related to this project. You may attach a maximum of one double-spaced typewritten page of information. (Please type or print legibly.) If awarded. this amount will be used in full to complete building and grounds improvements at ALTV's Temecula headquarters and public thrift store location. The improvements will enhance both safety and aesthetics, and ensure compliance with Temecula's Jefferson Avenue Redevelopment Project. Project activities are three -fold: (1) removal of existing exterior building sigaage by volunteersat installation of new. appropriate signage (sufficiently large Street address identification for emergency services t1ersonnel. and identification signage for meeting rooms): (2) y (blue metal portions): and. (3) removal of two large, leaning n Buralyptus trees_o t north side of the building and necessary tree trimming on the west side of tlte_ruilding. WLile_all of these project facets address aesthetic issues proper Sick aids emergency services personnel in tory requirements. and the trees are being removed for safety reasons—Insho.Ltile project beautifies the facility and neighborhood. addresses safety and regulatory issues. increases aid ancccess to the viSitiap rbli rift 'tore and meeting rooms). and increases facility longevity through proper maintenance activities. Multiple written bids were obtained from regional businut facet are detailed in the attached PROJECT BUDGET. Additionally, a timeline, including concurrent services provided by the various contractors, are detailed in the attached SCHEDULE OF SIGNIFICANT EVENTS. The cost of this project, in excess of the S5 000.00 grant amount will be funded_ ALTV seeks the City of Temecula's financial assistance in completing this project. The project's completion will ensure that ALTV may continue to utilize this hDadquarters building meetin t store retail space to aerate necessary income benefitipg many of ALTV's philanthropic programs and disadvantaged persons throughout Temecu Application Page 3 PAST PROJECT BENEFITS If your organization received City of Temecula funding in the previous year, please explain and show how Temecula residents benefited. Last year, ALTV received $5.000.00 in City of Temecula Community Service funding. This grant amount was utilized to repair and resurface the ALTV Thrift Store's 4,000+ sq. ft. "furniture display room." The project included the proper patching and evening of the concrete floor and the application of a colored epoxy finish that is both protective and well suited for high -traffic use. The improvements to the Thrift Store's "furniture display room" enhanced both aesthetics and safety for the general public shopping within the facility. Documentation of the expenditure and completed work were previously provided to the City of Temecula on 13 June, 2013. Overall, this improvement to the thrift store floor space has enabled ALTV provide a safe and more aesthetically -pleasing shopping environment. Such a space permits continued and increased sales of home furnishings which fund ALTV's philanthropic programs serving Temecula and ALTV's entire geographic service area. Application Page 4 SIGNATURE PAGE We hereby certify the information contained in this application is true to the best of our knowledge and belief. PREPARED BY: Dan Somerston, Grant Writer /'l AME and T TLE (Please Print or Type) SIGNATURE: PRESIDENT or AUTHORIZED OFFICER: Dorcas Shaktman, President SIGNATURE: 4(.71/(Ids NAME and TITLE (Please Print or Type) jr IfAIL:41/( ORGANIZATION NAME: Assistance League of Temecula Valley MAILING ADDRESS: 28720 Via Montezuma Temecula, California 92590-2510 TELEPHONE: 951-694-8018 / 951-304-2605 EMAIL ADDRESS: altvgrants(a�gmail.com DATED THIS 30th of August , 2013 (Date) (Month) BE SURE TO INCLUDE THE ORIGINAL PLUS ONE COPY AND SUBMIT BY AUGUST 30, 2013 TO: Mail Completed Applications to: Or Deliver in Person to: City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office Post Office Box 9033 Temecula, CA 92589-9033 City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office 41000 Main Street Temecula, CA 92590 Application Page 5 Exempt Organizations Select Check Page 1 of 1 IRS!Y'• 1 1 W Exempt Organizations Select Check gxemot Organizations Select Check Home Organizations Eligible to Receive Tax -Deductible Contributions (Pub. 78 date) - Search Results The following Ilst includes tax-exempt organizations that are eligible to receive tax-deductible contributions. Click on the "Deductibility Statue" column for an explanation of limitation. on the deductibility of contributions made to different types of tax-exempt organizations. Results are sorted by EIN. To eon results by another category, dick on the Icon next to the column heading for that category. Clicking on that Icon a second lime wIB reverse the sort order. Click on a column heading for an explanation of information in that column. 1.1 o(1 results Assistance League of Temecula Valley Retum to Search Results Per Page 25 OK s Prev l 1-1 l Next r, City. State .Country. Deductibility Status Temecula CA United States PC K Prev l 1-1 l Next http://apps.irs.gov/app/eos/pub78Search.do?ein 1=330360419&names=&city=&state=CA&c... 9/5/2013 STATE OF CALIFORNIA . FRANCHISE TAX BOARD PO BOX 942857 SACRAMENTO CA 94257-0540 Entity Status Letter Date: 8/1/2013 According to our records, the following entity information is true and accurate as of the date of this letter. Entity ID: Entity Name: ASSISTANCE LEAGUE OF TEMECULA VALLEY o a a 0 1. The entity is in good standing with the Franchise Tax Board. 2. The entity is not in good standing with the Franchise Tax Board. 3. The entity is currently exempt from tax under Revenue and Taxation Code (R&TC) Section 23701 d. 4. We do not have current information about the entity. The above information does not necessarily reflect: • The entity's status with any other agency of the State of California, or other government agency. • If the entity's powers, rights, and privileges were suspended or forfeited at any time in the past, or the entity did business in California at a time when it was not qualified or not registered to do business in California: o The status or voidability of any contracts made in California by the entity at a time when the entity was suspended or forfeited (R&TC Sections 23304.1, 23304.5, 23305a, 23305.1). o For entities revived under R&TC Section 23305b, any time limitations on the revivor or limitation of the functions that can be performed by the entity. Internet and Telephone Assistance Website: ftb.ca.gov Telephone: 800.852.5711 from within the United States 916.845.6500 from outside the United States TTY/TDD: 800.822.6268 for persons with hearing or speech impairments FTB 4263A WEB (NEW 02-2012) Internal Revenue : ice Department of the Treasury District Director Dale: Jan. 8. 1990 8mPloyer kdtntinoation Number: ^ma47460419 Period Eadiac F nditionitatatus Classification: 509(a)(2) Advance Ruling Period Ends: May 31, 1994 Person to Contact Julie Phelan Contatt Tstephone Number. (213) 725-6619 Assistance Guild of Temecula Valley PO Box 1212 Temecula, CA 92390 Dear Applicant: Based on information supplied, and assuming 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(c)(3) of the Internal Revenue Code. Because you are a newly created organization. we are not now making a final determination of your foundation status under section 509(a) of the Code. However, we have determined that you can reasonably be expected to be a publicly supported _ organization described in section 509(a)(2)• Accordingly, • g y, you rill be treated as a publicly supported organization, and not as a private foundation, during an advance ruling period. This advance ruling period begins on the date of your inception and ends on the date shown above. r Within 90 days after the end of your advance ruling period, you must submit to us information needed to determine whether you have met the requirements of the applicable support test during the advance ruling period. If you establish that you have been a publicly supported organization, you will be classified as a section 509(a)(1) or 509(0)(2) organization as long as you continue to meet the requirements of the applicable support test. If you do not meet the public support requirements during the advance ruling period, you will be classified as a private foundation for future periods. Also, if you are classified as a private foundation, you will be treated as a private foundation from the date of your inception for purposes of sections 507(d) and 4940. Grantors and donors may rely on the determination that you are not a private foundation,}intil 90 days after the end of your advance ruling period. If you submit the required information within the 90 days, grantors and donors may continue to rely on the advance determination until the Service makes a final determination of your foundation status. However, if notice that you will no longer be treated as a section 509(a)(2) organization is published in the internal Revenue Bulletin, grantors and donors may not rely on this determination after the date of such publication. Also, a grantor or donor may not rely on this determination if he or she was in part responsible for, or was aware of, the act or failure to act that resulted in your loss of section 509(a)(2) status, or acquired knowledge that the Internal Revenue Service had given notice that you would be removed from classification as.a section 509(a)(2) organization. Iowa P.O. Box 2350, Los Angeles. CA 90051 �" `�- �`tNY,+j''.► or your purposes, character, or method of operation Manse, please let t'' know so we can consider the of t of the change on your exempt status and fc lation status. Also, you shouln Lnform us of all changes in your name or address. As of January 1, 1984. you are liable for taxes under the Federal Insurance Contributions Act (social security taxes) on remuneration of $100 or more you pay to each of your employees during a calendar year. You are not liable for the tax imposed under the Federal Unemployment Tax Act (FUTA). Organizations that are not private foundations are not subject to the excise taxes under Chapter 42 of the Code. However, you are not automatically exempt from other Federal excise taxes. If you have any questions about excise, employment, or other Federal taxes, please let us know. Donors may deduct contributions to you as provided in section 170 of the Code. Bequests, legacies, devises, transfers, or gifts to you or for your use are deductible for Federal estate and gift tax purposes if they meet the applicable -provisions of sections 2055, 2106, and,2522 of the Code. You are required to file Form 990, Return of Organization Exempt from Income Tax, only if'your gross receipts each year are normally more than $25,000. If a return is required, it must be filed by the 15th day of the fifth month after the end of your annual accounting period. The law imposes a penalty of $10 a day, up to a maximum of $5,000, when a return is filed late, unless there is reasonable cause for the delay. You are not required to file Federal income tax returns unless you are subject_ to the tax on unrelated business income under section 511 of the Code. If you are subject to this tax, you must file an income tax return on Form 990-T, Exempt Organization Business Income Tax Return. In this letter, we are not determining whether any of, your present or proposed activities are unrelated trade or business as defined in section 513 of the Code. You need en employer identification number even if you have no employees. If an employer identification number was not entered on your application, a number will be assigned to you and you will be advised of it. Please use that number on all returns you file and in all correspondence with the Internal Revenue Service. Because this letter could help resolve any 'questions about your exempt status and foundation status, you should keep it in your permanent records. If you have any questions, please contact the"peraon whose name and telephone number are shown in the heading of this letter. " Sincerely yours, 0 ;) District Director ti Letter 1045(130) (Rey.10-5: Internal Revenue Service Department of the Treasury District Director o.tc SEP 0 2 1992 ASSISTANCE LEAGUE OF TEMECLZA VALLEY P.O. BOX 1212 TEMECULA. CA 92390-0014 -- Dear Taxpayer: Enpbrn.rtt klontification Number. Contact Rose Avilez EOMF COORDINATOR Contact T.I.phon. N,nbar (213) 894-2339 trtt R.mx» Cod. Swotlow.. 6o1(cx3 I Thank you for submitting the information shown below or on the enclosure. We have made It a part of your file. The changes indicated do not adversely affect your exempt status and the exemption letter issued to you continues in effect. Please let us know about any future change in the character. purpose. method of operation, name or address of your organisation. This is a requirement for retaining your '.cmpt StatUS. Thank you for your cooperation. Sincerely yours. k/(.... - yi - - ) Item Chanced From (NAME) P.O. Box 2350, Los Angeles, CA 90053 Assistance Guild of Temecula Valley To (SEE ABOVE) Letter 976(DO) (Rev. 1-87) 11:37 AM 02/14/13 Accrual Basis Assistance League of Temecula Valley Budget Overview 2013 - 2014 June 2013 through May 2014 Jun '13-May 14 Ordinary Income/Expense Income 40000 • Income 40100 • Refunds, Awards, Credits 1,500.00 40300 • Donation Jar Income 750.00 Total 40000 • Income 2,250.00 41000 • Fundraising Revenue 41100 • Fundraising Events 41101 • Car Donation 2,500.00 41102 • Benefit Concert 10,000.00 41103 • Treasure Chest 8.000.00 41104 • Winter Wonderland of Trees 20,000.00 41111 • Other Event Fundraising 15,000.00 Total 41100 . Fundraising Events 55,500.00 41400 • Assisteens Income 550.00 Total 41000 • Fundraising Revenue 56,050.00 46400 • Other Types of Income 46410 • Thrift Shop Sales 389,112.00 46412 • Thrift Shop Sales - Assisteens 22,000.00 46415 - Cash 4 Shoes 7,500.00 46416 • Temecula Recycling 600.00 46430 • Thrift Shop Misc Revenue 2,500.00 Total 46400 - Other Types of Income 421,712.00 43000 • Direct Public Support 43410 • Corporate Contributions 15,000.00 43450 • Individual Contributions 3,000.00 43470 - Donations - Restricted 2,500.00 43480 • Grants 80,000.00 Total 43000 • Direct Public Support 100,500.00 43491 • Gifts in Kind - Goods 43493 • Gifts in Kind - Comm Outreach 2,500.00 43495 • Gifts In Kind - Miscellaneous 1,000.00 43498 • Gifts In Kind - Meeting Room 36,000.00 43499 • Gifts In Kind - Thrift Store 1,000.00 Total 43491 • Gifts in Kind - Goods 40,500.00 45000 • Investments 45030 • Interest -Savings, Short-term CD Total 45000 • Investments 200.00 200.00 Page 1 11:37 AM 02/14/13 Accrual Basis Total Income Cost of Goods Sold 46500 • Cost of Goods Sold 46510 • Thrift Shop Sales Tax Total 46500 • Cost of Goods Sold Total COGS Gross Profit Expense 60900 • Business Expenses 60915 • Bank Service Charge 60930 • Safe Deposit Box 60940 • Fees & Permits Total 60900 • Business Expenses 61000 • Contract Services 61110 • Accounting Fees Total 61000 • Contract Services 62000 • Facilities and Equipment 62200 • Building Repairs & Maintenance 62205 • Chapter House Improvements 62240 • Janitorial Services 62250 • Thrift Shop Equipment 62500 • Real Estate, Personal Prop Tax 62550 • Landscape Maintenance 62555 • Landscape Improvement 62560 • Trash 62570 • Alarm System - Security Assistance League of Temecula Valley Budget Overview 2013 - 2014 June 2013 through May 2014 Jun'13 - May 14 47200 • Membership Income 47230 • Membership Dues 47235 • Active Member 7,500.00 47241 • Community Member 1,000.00 47250 • Sustaining Member 4,000.00 47255 • Active On Limited Service 2,000.00 47260 • PALS Member 1,000.00 47265 • Assisteens Member 2,500.00 Total 47230 • Membership Dues 18,000.00 47300 • December Luncheon 1,500.00 47310 • Xmas Party 1,500.00 47320 • May Luncheon 3,500.00 47330 • Luncheons/Parties/Outside Event 2,000.00 Total 47200 • Membership Income 26,500.00 647,712.00 33,000.00 33,000.00 33,000.00 614,712.00 200.00 90.00 150.00 440.00 11,000.00 11,000.00 15,000.00 4,000.00 10,000.00 3.000.00 12,300.00 2,250.00 3,000.00 3,500.00 1,600.00 Page 2 11:37 AM 02/14113 Accrual Basis Assistance League of Temecula Valley Budget Overview 2013 - 2014 June 2013 through May 2014 62580 • HOA Dues 62590 • Truck 62600 • Utilities 62610 • Electricity 62620 • Gas 62630 • Water Jun '13 • May 14 3,600.00 2,000.00 24,000.00 300.00 3,000.00 Total 62600 • Utilities 27,300.00 Total 62000 • Facilities and Equipment 87,550.00 63000 • Administration 63050 • Education/Orientation 1,000.00 63100 • Postage, Mailing Service 250.00 63200 Printing 63201 • Brochure Printing 2,500.00 63202 • Printing and Copying 2,000.00 Total 63200 • Printing 4,500.00 63300 - Supplies 2,000.00 63400 • Telephone, Telecommunications 4,000.00 63500 • Web Site Maintenance 1,000.00 63600 • Copier Rental and Maintenance 3,500.00 Total 63000 • Administration 16,250.00 64100 • Insurance 64120 • Directors and Officers 600.00 64130 • Property Insurance 4,500.00 64140 • Gen Liability, Auto 5,750.00 64150 • Accident Insurance 600.00 64170 • Risk Management 250.00 Total 64100 • Insurance 11,700.00 64200 • Membership 64201 • Newsletter 64202 • Postage Newsletter 100.00 64203 • Newsletter Design & Printing 500.00 Total 64201 • Newsletter 600.00 64210 • National Organization Dues 6,100.00 64220 • Roster 600.00 64230 • Membership Development 2,000.00 64235 • Member Recognition 2,000.00 64240 • Pins & Badges 100.00 64250 • Hospitality 64251 • Hospitality - Meetings, Etc 2,250.00 64252 • Hospitality Supplies 500.00 Total 64250 • Hospitality 2,750.00 Page 3 11:37 AM 02/14/13 Accrual Basis Assistance League of Temecula Valley Budget Overview 2013 - 2014 June 2013 through May 2014 64260 • Historian 64270 • Miss Sunshine 64281 • December Luncheon 64282 • Christmas Party Expense 64283 • May Luncheon 64284 • Parties/Luncheons/Events Jun'13 - May 14 150.00 400.00 1,500.00 1,500.00 3,500.00 2,800.00 Total 64200 • Membership 24,000.00 64500 • Community Relations 64510 • Public Relations 8,000.00 64515 • Presidents Expenses 2,000.00 64520 • Community Ambassadors Committee 3,000.00 Total 64500 • Community Relations 13,000.00 65200 • Fundraising Expenses 65210 • Thrift Shop Labor Expense 2,500.00 65220 • Thrift Shop Supplies 8,000.00 65240 • Bank Card Fees 5,200.00 65250 • TS - Conference Expense 1,500.00 Total 65200 • Fundraising Expenses 17;200.00 65300 • Resource Development Expenses 65350 - Fundraising Events Expenses 10,000.00 65410 • Grant Writing 20,000.00 65450 • RD - Conference Expense 1,500.00 Total 65300 - Resource Development Expenses 31,500.00 66100 • PROGRAM SERVICE EXPENSE 66105 • Operation School Bell 66110 • OSB Clothing 205,500.00 66111 • OSB - Chapters for Children 7,500.00 66112 • OSB - SOS Kits 500.00 66113 • OSB Supplies 1,000.00 66120 • OSB Conference Expense 1,500.00 Total 66105 • Operation School Bell 216,000.00 66140 • Scholarships 35,000.00 66175 • Operation Bear Hug 15,000.00 66180 • Operation Foster Youth 7,000.00 66161 • Operation Community Outreach 66178 • Gifts in Kind 2,500.00 66161 • Operation Community Outreach - Other 20,000.00 Total 66161 • Operation Community Outreach 22,500.00 Page 4 11:37 AM 02/14/13 Accrual Basis Assistance League of Temecula Valley Budget Overview 2013 - 2014 June 2013 through May 2014 66170 • Operation NonProfit Partnership 66173 • Gift In Kind - Meeting Room 66174 • Gift In Kind - Miscellaneous 66176 • Gift In Kind - Thrift Shop Total 66170 • Operation NonProfit Partnership 66190 • Phil Chair - Conference Expense Total 66100 • PROGRAM SERVICE EXPENSE 66200 • Auxiliaries/Standing Committees 66220 • Assisteens Auxiliary 66221 • Administration Expenses 66222 • Special Events Expenses 66224 • Membership Expenses 66225 • National Workshops 66230 • Assisteens Program Service Exp 66231 • Operation Book Worm 66232 • Harvest Festival 66234 • Peter Rabbit 66235 • Chairman's Project 66239 • Rancho Damacitas 66244 • OSB Support Jun '13 - May 14 36,000.00 1,000.00 1,000.00 38,000.00 1,500.00 335,000.00 150.00 200.00 1,950.00 2,000.00 1,500.00 1,000.00 2,800.00 1,000.00 1,500.00 8,000.00 Total 66230 • Assisteens Program Service Exp 15,800.00 Total 66220 • Assisteens Auxiliary 20,100.00 Total 66200 • Auxiliaries/Standing Committees 20,100.00 68300 • Travel and Meetings 68310 • Conference - Executive Board 3,000.00 68311 • Conference-Mbrshp Registration 1,500.00 68320 • National Workshops 2,000.00 68330 • Chapter Circle Donation 200.00 Total 68300 • Travel and Meetings 6,700.00 69800 • Reserve Replenishment 40,272.00 Total Expense 614,712.00 Net Ordinary Income _ 0.00 Net Income 0.00 Page 5 2:21 PM 07/24/13 Accrual Basis \ssistance League of Temecula V 'ley Balance Sheet As of May 31, 2013 ASSETS Current Assets Checking/Savings 10100 • Cash On Hand 10110 • CA Bank & Trust Checking Acct 10120 • Wells Fargo Reserve Account 10121 • Wells Fargo Checking Account 10122 • Wells Fargo Savings Account Total Checking/Savings Accounts Receivable 11000 • Accounts Receivable 11100 • Contributions Receivable 11200 • Grants Receivable Total 11000 • Accounts Receivable May 31, 13 400.00 5,977.57 39, 005.97 14,096.64 138,198.29 197,578.47 1,000.00 20,400.00 21,400.00 Total Accounts Receivable 21,400.00 Other Current Assets 12000 • Inventory 12100 • Inventory - Thrift Store 12200 • Inventory -Operation School Bell Total 12000 • Inventory 12101 • Inventory Asset 13000 • Prepaid Expenses 13700- • prepaid chamber dues Total 13000 • Prepaid Expenses Total Other Current Assets Total Current Assets Fixed Assets 16600 • Banners & Signage 16700 • Security System 15000 • Property and Equipment 15001 • Accumulated Depreciation 15100 • Land 15200 • Building 15201 • Building Improvements 15300 • Furniture & Equipment 15600 • Truck - Ford 2001 Total 15000 • Property and Equipment Total Fixed Assets TOTAL ASSETS LIABILITIES & EQUITY 27,771.90 2,444.87 30,216.77 9,265.80 395.00 395.00 39,877.57 258,956.04 4,904.20 4,732.76 -651,930.00 140,196.46 560,786.34 293,279.68 67,897.56 14,340.00 424,570.04 434,207.00 693,163.04 Page 1 of 2 2:21 PM 07/24113 Accrual Basis Assistance League of Temecula %/- 1Iey Balance Sheet As of May 31, 2013 Liabilities Current Liabilities Accounts Payable 16000 • Accounts Payable Total Accounts Payable Credit Cards 16002 • Chase Credit Card Total Credit Cards Other Current Liabilities 16001 • Accrued Expenses 17000 • Deferred Revenue 17200 • Deferred Membership Dues Total 17000 • Deferred Revenue Total Other Current Liabilities Total Current Liabilities Total Liabilities Equity 32000 • Unrestricted Net Assets Net Income Total Equity May 31, 13 -3,810.11 -3,810.11 14,546.53 14,546.53 -300.00 14,185.50 14,185.50 13,885.50 24,621 92 24,621.92 639,849.20 28,691.92 668,541.12 TOTAL LIABILITIES & EQUITY 693,163,04 Page 2 of 2 2:09 PM 07/24/13 Accrual Basis 9ssistance League of Temecula V 'ley Profit & Loss June 2012 through May 2013 Ordinary Income/Expense Income 40000 • Income 40100 • Refunds, Awards, Credits 40200 • Snack Jar Income 40300 • Donation Jar Income Total 40000 • Income 41000 • Fundraising Revenue 41100 • Fundraising Events 41101 • Car Donation 41102 • Benefit Concert 41103 • Treasure Chest 41104 • Winter Wonderland of Trees 41105 • Wonderland Reservations 41106 • Wonderland Donations 41107 • Wonderland Sales 41108 • Wonderland Bar Total 41104 • Winter Wonderland of Trees 41110 • Hine Mazda Fundraiser 41111 • Other Event Fundraising Total 41100 • Fundraising Events Jun '12 • May 13 1,591.68 110.85 804.57 2,507.10 3,541.70 9,012.81 7,470.00 3,150.00 1,600.00 8,990.58 905.00 14,645.58 0,361 00 2,240.00 43,261.09 Total 41000 • Fundraising Revenue 43,261.09 46400 • Thrift Shop Income 46410 • Thrift Shop Sales 46412 • Thrift Shop Sales - Assisteens 46415 • Cash 4 Shoes 46416 • Temecula Recycling 46425 • EBay Sales 46430 • Thrift Shop Misc Revenue Total 46400 • Thrift Shop Income 43000 • Direct Public Support 43410 • Corporate Contributions 43450 • Individual Contributions 43470 • Donations - Restricted 43480 • Grants Total 43000 • Direct Public Support 43491 • Gifts in Kind - Goods 43493 • Gifts in Kind - Comm Outreach 43495 • Gifts In Kind - Miscellaneous 43496 • Gifts in Kind - OSB 43497 • Gifts in kind • Salvation Army 43498 • Gifts In Kind - Meeting Room 43499 • Gifts In Kind - Thrift Store Total 43491 • Gifts in Kind - Goods 360,974.26 27,045.25 3,866.01 140.48 3,348.18 1,421.70 396,795.88 11, 705.84 4,641.59 2,000.00 90, 362.00 108,709.43 326.51 1,376.00 65.06 4,905.00 43,218.75 1,152.49 51, 043.81 Page 1 of 6 2:09 PM 07/24/13 Accrual Basis Usistance League of Temecula v 'ley Profit & Loss June 2012 through May 2013 45000 • Investments 45030 • Interest -Savings, Short-term CD Total 45000 • Investments 47200 • Membership Income 47230 • Membership Dues 47235 • Active Member 47241 • Community Member 47250 • Sustaining Member 47255 • Active On Limited Service 47260 • PALS Member 47265 • Assisteens Member Total 47230 • Membership Dues 47300 • December Luncheon 47310 • Xmas Party 47320 • May Luncheon 47330 • Luncheons/Parties/Outside Event Total 47200 • Membership Income Jun'12 - May 13 141.84 141.84 7,058.00 900.00 4,050.00 1,955.00 1,090.00 2,355.00 17,408.00 228.00 1,005.00 2,987.46 2,780.00 24,408.46 Total Income 626,867.61 Cost of Goods Sold 46500 • Cost of Goods Sold 46510 • Thrift Shop Sales Tax 46520 • Cost of Sales - Inventory Sales Total 46500 • Cost of Goods Sold Total COGS Gross Profit Expense 60900 • Business Expenses 60915 • Bank Service Charge 60920 • Business Registration Fees 60930 • Safe Deposit Box 60940 • Fees & Permits Total 60900 • Business Expenses 61000 • Contract Services 61110 • Accounting Fees Total 61000 • Contract Services 62000 • Facilities and Equipment 62200 • Building Repairs & Maintenance 62205 • Chapter House Improvements 62210 • Snacks 62220 • Supplies 27,297.64 56,358.80 83, 656.44 83,656.44 543,211.17 170.00 10.00 90.00 89.00 359.00 12, 719.00 12,719.00 15,895.65 8,737.28 182.63 26.59 Page 2 of 6 2:09 PM 07/24/13 Accrual Basis 4ssistance League of Temecula \'-'ley Profit & Loss June 2012 through May 2013 62240 • Janitorial Services 62250 • Thrift Shop Equipment 62500 • Real Estate, Personal Prop Tax 62550 • Landscape Maintenance 62555 • Landscape Improvement 62560 • Trash 62570 • Alarm System - Security 62580 • HOA Dues 62590 • Truck 62600 • Utilities 62610 • Electricity 62620 • Gas 62630 • Water Total 62600 • Utilities Jun '12 • May 13 10,577.36 3,786.91 12,293.38 3,117.50 3,580.00 3,870.40 1,888.00 1,789.22 3,838.21 24, 309.01 243.87 3,179.16 27,732.04 Total 62000 • Facilities and Equipment 97,315.17 63000 • Administration 63100 • Postage, Mailing Service 63200 • Printing 63201 • Brochure Printing 63202 • Printing and Copying Total 63200 • Printing 63300 • Supplies 63400 • Telephone, Telecommunications 63500 • Web Site Maintenance 63600 • Copier Rental and Maintenance 63655 • Petty Cash Loss 63700 • Outside Volunteers Total 63000 • Administration 64100 • Insurance 64120 • Directors and Officers 64130 • Property Insurance 64140 • Gen Liability, Auto 64150 • Accident Insurance 64160 • Insurance Interest 64170 • Risk Management Total 64100 • Insurance 64200 • Membership 64201 • Newsletter 64202 • Postage Newsletter 64203 • Newsletter Design & Printing Total 64201 • Newsletter 64210 • National Organization Dues 64215 • Education/Orientation 64220 • Roster 443.62 900.37 2,034.83 2,935.20 3,596.70 4,504.57 990.00 3,686.62 300.12 26.99 16,483.82 600.00 4,218.00 5,573.00 520.00 -52.12 39.80 10,898.68 145.71 385.50 531.21 6,132.50 2,211.42 525.80 Page 3 of 6 2:09 PM 07/24/13 Accrual Basis 'assistance League of Temecula " 'ley Profit & Loss June 2012 through May 2013 64230 • Membership Development 64235 • Member Recognition 64240 • Pins & Badges 64250 • Hospitality 64251 • Hospitality - Meetings, Etc 64252 • Hospitality Supplies Total 64250 • Hospitality 64260 • Historian 64270 • Miss Sunshine 64281 • December Luncheon 64282 • Christmas Party Expense 64283 • May Luncheon 64284 • Parties/Luncheons/Events 66285 • Luncheon Complimentary Tickets Total 64200 • Membership 64500 • Community Relations 64510 • Public Relations 64515 • Presidents Expenses 64520 • Community Ambassadors Committee Total 64500 • Community Relations 65200 • Fundraising Expenses 65210 • Thrift Shop Labor Expense 65220 • Thrift Shop Supplies 65225 • EBay Sales Expense 65240 • Bank Card Fees 65250 • TS - Conference Expense Total 65200 • Fundraising Expenses 65300 • Resource Development Expenses 65350 • Fundraising Events Expenses 65352 • Printing Cost 65401 • Benefit Concert Expenses 65403 • Winter Wonderland of Trees 65404 • Space Event Total 65350 • Fundraising Events Expenses 65410 • Grant Writing 65450 • RD - Conference Expense Total 65300 • Resource Development Expenses 66100 • PROGRAM SERVICE EXPENSE 66101 • Philanthropic Expenses 66105 • Operation School Bell 66110 • OSB Clothing 66111 • OSB - Chapters for Children 66112 • OSB - SOS Kits 66113 • OSB Supplies Jun '12-May 13 677.92 2,757.09 105.66 1,166.02 804.78 1,970.80 320.01 605.54 676.02 1,438.94 3,176.27 2,298.13 280.00 23,707.31 7,088.38 1,279.48 2,897.22 11,265.08 1,764.35 10,269.98 1,660.90 5,698.57 1,276.05 20,669.85 41.02 4,484.80 1,548.09 150.00 6,223.91 10,596.22 820.14 17, 640.27 820.39 146,371.17 6,799.14 501.12 964.93 Page 4 of 6 2:09 PM 07/24113 Accrual Basis Assistance League of Temecula "-'ley Profit & Loss June 2012 through May 2013 66117 • Emergency OSB Clothing 66120 • OSB Conference Expense Total 66105 • Operation School Bell 66140 • Operation Scholarships 66175 • Operation Bear Hug 66180 • Operation Foster Youth 66161 • Operation Community Outreach 66170 • Operation NonProfit Partnership 66172 • Gift In Kind - Salvation Army 66173 • Gift In Kind - Meeting Room 66174 • Gift In Kind - Miscellaneous 66176 • Gift In Kind - Thrift Shop 66178 • Gifts in Kind -Community Outreac Total 66170 • Operation NonProfit Partnership Jun '12-May 13 65.06 71.38 154,772.80 29,905.72 15,920.30 6,811.83 18,129.20 4,905.00 43,218.75 1,376.00 1,152.49 325.71 50,977.95 66190 • Phil Chair - Conference Expense 1,275.66 Total 66100 • PROGRAM SERVICE EXPENSE 278,613.85 66200 • Auxiliaries/Standing Committees 66220 • Assisteens Auxiliary 66221 • Administration Expenses 66222 • Special Events Expenses 66224 • Membership Expenses 66225 • National Workshops 66230 • Assisteens Program Service Exp 66231 • Operation Book Worm 66232 • Harvest Festival 66234 • Peter Rabbit 66235 • Chairman's Project 66239 • Rancho Damacitas 66244 • OSB Support Total 66230 • Assisteens Program Service Exp 151.60 30.24 2,097.99 378.93 1,507.17 704.43 2,007.08 980.90 1,567.20 8,000.00 14,766.78 Total 66220 • Assisteens Auxiliary 17,425.54 Total 66200 • Auxiliaries/Standing Committees 17,425.54 66900 • Reconciliation Discrepancies 68300 • Travel and Meetings 68310 • Conference - Executive Board 68311 • Conference-Mbrshp Registration 68320 • National Workshops 68330 • Chapter Circle Donation 68335 • Circle Program 68330 • Chapter Circle Donation - Other Total 68330 • Chapter Circle Donation -0.17 2,153.78 2,250.00 2,793.07 200.00 25.00 225.00 Total 68300 • Travel and Meetings 7,421.85 Page 5 of 6 2:09 PM 07/24/13 Accrual Basis Assistance League of Temecula 'ley Profit & Loss June 2012 through May 2013 Jun '12 - May 13 69800 • Reserve Replenishment 0.00 Total Expense 514,519.25 Net Ordinary Income 28,691.92 Net Income 28,691.92 Note to statement: This statement Is unaudited. Audit Is currently in process and will be complete in October 2013. Page 6 of 6 Assistance League of Temecula Valley ALTV Building and Grounds improvements and Maintenance PROJECT BUDGET PROJECT INCOME INCOME City of Temecula Community Service Funding ALTV Funding - from Thrift Store sales $ $ COMMITTED - $ 924.36 $ PENDING - $ PROPOSED 5,000.00 TOTAL INCOME TOTAL INCOME $ 924.36 $ $ 5,000.00 $ 5,924.36 PROJECT COSTS COSTS Removal of Obsolete Signage from Building Completed by two (2) volunteers Exterior Building Signage (contractor: Sign -A -Rama) $ One 8" set of flat -cut acrylic lettering to read "Meeting Room", one set of 12" foam digits with acrylic faces to read "28720", installation of letters/digits; customer removes old signage, cleans surface Building Canopy Painting (contractor: Axis Painting) Sherwin-Williams paint and labor to re -paint full building canopy Tree Removal and Tree Trimming (contractor: D's R. Trees, Inc.) Remove two (2) eucalyptus trees ans stumps (at furniture doors) $ Trim trees on west side of building (trim away from building wall) $ $ $ PROJECTED 774.36 3,900.00 950.00 300.00 TOTAL COSTS TOTAL COSTS $ 5,924.36 $ 5,924.36 Revised: 25-AUGUST-2013 Assistance League of Temecula Valley ALTV Building and Grounds Improvements and Maintenance SCHEDULE OF EVENTS DAY ACTIVITY 1 Volunteers remove existing, obsolete signage from ALTV HQ building Tree removal and tree trimming commence 2 Tree removal and tree trimming continue and are completed Installation of new signage on ALTV HQ building 3 Canopy painting begins 4 Canopy painting continues and is completed 5 This day reserved for any additional or delayed efforts specified for this project*. * Project dates are subject to change due to inclement (November) weather. Any necessary rescheduling will be dependent upon weather and contractor availability. Revised: 25-AUGUST-2013 assistance league' Temecula Valley 8l st Chapter of National Assistance League' Governing Board 2013-2014 Dorcas Shaktman President Ginny Wetzel Vice President Membership Debbie Valenzuela Vice President Philanthropic Programs Terry Blanton Vice President Resource Development Kathy Laurin Treasurer Ann Reese Secrete y Elective Standing Committees Leticia Plummer Assisteens ° Liaison Electra Demos Bylaws Amy Garrett Chapter House Manager Diana Elizondo Education Charlene Lent Public Relations Sue Sampson Strategic Planning 28720 Via Montezuma Temecula, CA 92590-2510 Tel. (951) 694.8018 Fax (951) 694.8298 E-mail: altemecula@yahoo.com June 13, 2013 City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office Post Office Box 9033 Temecula, California 92589-9033 Dear Ms. Pharis: Assistance League' of Temecula Valley (ALTV) would like to thank the City of Temecula for the Community Service Funding Program grant of $5,000 for the 2012-2013 fiscal year. I. have attached are copy of the invoice for this building improvement project along with a copy of the cancelled check to the Dave DeCarl, the contractor that completed the job. This improvement was completed in November 2012. I have also included a brief project benefit statement. If you have any questions or require any additional information, please contact me directly. Sincerely, Dorcas Shaktman, President Assistance League of Temecula Valley wwww.ternef ulavafley.assistanceleague.org Coring and Commitment in Action JAW assistance league' Temecula Valley 81 st Chapter of National Assistance League' City of Temecula Fiscal Year 2012/2013 Community Service Funding Program Assistance League of Temecula Valley (ALTV) The awarded amount of $5,000 was used in full to complete improvements at Assistance League of Temecula Valley's headquarters and public thrift store location at 28720 Via Montezuma, Temecula. The improvement included the resurfacing of the 4,000 sq. ft. "furniture display room" Included in the project was the proper patching and evening of the concrete floor and the application of a colored epoxy finish that is both protective and well suited for high - traffic use. The project was carried out in approximately two weeks in the month of November 2012. The resurfacing of this area enhanced both the safety for customers and volunteers and created an area that is more esthetically comparable to the rest of our retail space. This itnprovement has helped with our efforts to increase our Thrift Shop sales and is now an area that the customers enjoy spending more time shopping. The ('oramunioy Service Program funds ensure that ALTV can continue to utilize this retail space to generate necessary income fbr the benefit of our philanthropic programs and to disadvantaged individuals throughout Temecula and surrounding areas. Dave DeCarl 31433 Chemin Chavalier Temecula, CA 92591 Phone 951-265-5852 TO Assistance League of Temecula Valley 28720 Via Montezuma Temecula, CA 92590 Attn: Kathy Laurin/Dorcas Shaktman 951.694.8018 IN'' DICE INVOICE # 111512 DATE: DECEMBER 6, 2012 SALESPERSON JOB PAYMENT TERMS DUE DATE Dave DeCarl Floor refinish Due on receipt Q•ry DESCRIPTION UNIT PRICE LINE TOTAL Prep and patch concrete floor and resurface with epoxy coat. Approximately 4,000 square feet in area known as the Furniture Room Department. 8 Gallons acid strip 19.37 154.96 1 Cement epoxy patch 14.00 14.00 18 Gallons epoxy floor finish 31.95 575.10 9 Gallons floor sealer 27.00 243.00 Labor: 14.00 4,480.00 320 4 Men ® 80 hours each 320 hours Note: Dave DeCarl to volunteer 80 hours to help supervise and direct improvement activities. TO BE COMPLETED NO LATER THAT 11.16.2012 SUBTOTAL 5,46/.06 SALES TAX 0 TOTAL 5,467.06 Eva Pharis From: Dorcas Shaktman <dshaktman@verizon.net> Sent: Tuesday, September 10, 2013 3:36 PM To: Eva Pharis Subject: Copy of check for CID disbursement Attachments: Copy of Check -Dave DeCari.pdf Eva, I have attached a copy of the check to Dave DeCarl for payment of the floor refinishing project for which the 2012 City of Temecula CID grant funding of $5,000 was used. The check amount is for $6,860 which includes payment for the floor refinishing and for an additional project that was done by this vendor. Please let me know if you have any questions. Thank you. Avrcao Snadimaa, .i7ea<de rt llZadtaace.l.'eague al Yettrecala Vak# (951) 3012605 1 REX Previewer Page 1 of 1 0 AffattStEAffiv PH. psi etwaore 28770 TE ECULULA CAA IMOLA MICE MECUM CA92390 90.3210.1222 5189 11/8/2012 mo o E Dive DeCpd $ "e,eeo.Op. Six Thousand Eight Hundred Sixty end 00/100""" Dave Deeert 31433 Chemin Chevtaler Temecula, CA 92521.5910 • I/!3/12 Seq #:94334263 Account:2270138501 Serial #:5189 Amount:$6,860.00 Dep Seq #:- https://rex.cs.zionsbank.com/TreXWorkspaceWeb/previewerjsp 9/10/2013 City of Temecula 2013-14 CS Funding Program APPLICATION NO. 7 RECEIVE! CITY OF TEMECILA FISCAL YEAR 20 I as 14 COMMUNITY SERVICE FUNDING PROGRAM APPLICATION IPI ca Drinf nr Ti,rtal 2013-14 Program Submission Deadline: Friday, August 30, 2013 (original, plus one) PROJECT INFORMATION CITibiEgig: 4 0 I ?I OFFICE Amount Requested: $ 5,000 (Maximum allowable $5,000) Project Name: Birth Choice of Temecula Pregnancy Resource Services for -Community Project Start Date: November 1, 2013 Project End Date: June 30, 2014 Application has been authorized by the organizations: Executive Committee Board -of Directors X Members-attzrge [ ORGANIZATION INFORMATION Name of Organization: BIRTH CHOICE OF T EMECULA_ Contact -Name: Jennifer Cartel) TitlelPasition: Executive Director Mailing Address: 27488 Enterprise Circle West, .#4, Temecula, CA 92590 Telephone: 951-899-9808 Ext. 105 or cellular 951-551-S428 Year Organization founded: 1989 Number of Paid Staff: (4) 2.75 FTE Number of Volunteers: -1 0) participants]_ + with board; (1000 with event eographic Area(s) Served: All Temecula area residents Is this organization incorporated in California as a non-profit organization? Yes X No Effective Date: 1990 If 'yes": Date of incorporation as a non-profit 1990 Federal identification number •*'� Include a .copy=of yourstatementof non-profit status/rim-the State of California. If "no": Name of sponsoring organization N/A Federal identification number FINANCIAL STATEMENTS 1 PLEASE ATTACH COPIES OF THE CURRENT BUDGET OF THE ORGANIZATION AND FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT). It does not require a CPA's audit, but please submit if available. Please see attached for end year 2012. Please also see budget for 2013. MISSION STATEMENT Briefly describe the goals and objectives of your organization and community services it provides. Describe the ways your organization meets the criteria listed on page 2 of the CS Funding Policy. Briefly describe the goals and objectives of your organization and community services it provides. Describe the ways your organization meets the criteria listed on page 2 of the CS Funding Policy. Birth Choice of Temecula is a Pregnancy Resource Center that serves the community with life-saving alternatives including adoption referrals and pregnancy counseling and resources. We also provide extensive material support, as well as referrals to other organizations such as food pantries, homeless shelters, host homes and transitional facilities, drug and alcohol rehab, Safe Domestic Violence and legal support sources. We have an on -site Mommy and Baby Boutique that has provided maternity, nursery layette and small baby items for Moms, Dads and Grandparents in need at no cost to them. Our goal is to offer education, options counseling, material and practical support and support of pregnancy and post pregnancy to 2 years of age. We also help the entire family including small children with clothing, gas and food cards, charity car referrals, baby food and formula, baby clothing, baby nursery furnishings and other baby items that are useful to them. Our counseling allows families to keep and support their babies if they desire to. Our Mommy and Baby Boutique has been used by Moms, Dads, grandparents, custodial parents, especially families living at or near poverty level. Items such as maternity and baby clothing, nursery items, food and formula, diapers, breast feeding supplies, wipes and bottles, gas and food cards and hygiene items for Moms and babies are not always available from other organizations in a timely manner. A. Is the organization currently non-profd? Yes, Birth Choice of Temecula is currently a non-profit organization ID # 33-0302353 B. Does the organization provide a service to the overall community? Yes, Birth Choice of Temecula provides no -cost pregnancy counseling, material goods for Pregnant Moms and Dads and for ti►eir babies and small children. Also, referrals for all members of our community who need help. Is, the size and make-up of the organization equipped to provide the` program/service to the overall community? Yes, Birth Choice of Temecula is currently staffed by an Executive Director, Asst. Director and greater than (100) volunteers that provide no cost services to our clients. We are managed by a Board of Directors comprised of (12) Board Members from various backgrounds and educational levels. D. What is the public reaction to the group? The community has been very supportive of this ministry, having provided most of our support. Numerous individuals, churches and business supporters have been involved in this organization for greater than 24 years. As seen in our newsletters, our clients are very happy that they received timely assistance that allowed them to support their baby and the other • e.. • nn rhildrnn in fhnir tAln ha,,n n►ns,anf,a hnrnnlnc c nncnrrneinnc in fhn noe+ four years. E. Does the organization have a high quality level of fiscal management? Yes, Birth Choice employs a retired Naval Officer who holds a Master's Degree in Healthcare Administration as their Executive Director. Additionally, the Board of Directors provides monthly oversight with a Treasurer who has expertise in corporate accounting. Our part-time Accounting Secretary provides weekly oversight of the budget, tax receipts and preparation of financial documents for monthly Board Meetings. F. Is the group well organized to ensure longevity in the City of Temecula? Yes, Birth Choice of Temecula has been existence in Temecula for greater than 24 years and advanced the center to include increased services with an expanded volunteer staff of receptionists, counselors, volunteer mentors, RN's, and MD OB/Gyn and community outreach volunteers. G. Is there evidence of satisfactory service provided to the City's citizens? Yes, Birth Choice of Temecula served greater than 2000 client families in 2012 and continues to see between 150- 200 clients per month for counseling and material support and referrals. Numerous client testimonials attest to our outstanding and caring support to them. In 2012, we helped numerous families to find resources for their babies and young children and to prevent homelessness. They were provided gas and food cards, maternity and baby clothing, diapers and formula and hygiene items for their family when unemployment or their salaries were not enough to sustain them. This was done when all other agencies contacted had no available funds or services. Our networking with 143 area churches, allowed us to collaborate to provide via generous donations of time, materials and monies from our community. H. Is the organization free from discrimination based on race, color, creed, nationality, sex, marital status, disability, religion, or political affiliation? Yes, Birth Choice of Temecula is nondenominational and provides equal access to services regardless of race, religion, creed, nationality, sex, marital status or political affiliation. Does the organization require attendance or participation in any political, religious or social activity`? No, Birth Choice is nondenominational. J. Can the organization provide financial statements (prepared using an appropriate method of accounting) to demonstrate sound financial management? Yes, Birth Choice maintains monthly financial reports by an Accounting Secretary for review by the Executive Director and Board of Directors. Also, end year statements using Quick Books for Non -profits. Our 990 is filed yearly. K. Can the organization provide a budget for the fiscal year of request demonstrating cost-effectiveness? Yes, the center has established a budget for 2013 and cost controls. We have been continually improving our financial standing through fundraisers, grants, church missions support and community outreach. L. Does the organization make its services available to all? Yes, services are provided to all who seek our help at no cost to them. M.Does the organization possess ongoing program evaluation tools? Yes, Birth Choice of Temecula has established Strategic Goals and Measures of Effectiveness and the Executive Director reports on the achievement of those goals each month with a written report and an Annual Report PROJECT DESCRIPTION How will your organization use the funding awarded? Describe the project, project objectives, those served, area serviced, and number of volunteers involved. Be specific. Include equipment or services that would be purchased and why. Include a detailed budget and a schedule of significant activities related to this project. You may attach a maximum of one double-spaced typewritten page of information. (Please type or How will your organization use the funding awarded? Describe the project, project objectives, those served, area serviced, and number of volunteers involved. Be specific. Include equipment or services that would be purchased and why. Include a detailed budget and a schedule of significant activities related to this project. You may attach a maximum of one double-spaced typewritten page of information. (Please type or print legibly.) if awarded this city grant funding, Birth Choice of Temecula will use the funding to purchase pregnancy support and educational supplies for community teens, women, men and families facing unplanned or financially difficult pregnancies. We will provide pregnancy tests and counseling, brochures. material goods and referrals in support of pregnancy, maternity and baby clothing and newborn layettes. We will also provide post -delivery nursery supplies and educational materials such as books, DVD's, pamphlets related to pregnancy and caring for new babies. All consumable supplies will help our pregnant clients with their pregnancy and post -pregnancy period, as well as help them to care for their child. Client families will benefit from our services on a daily basis. We will expand our operating hours by 10%. Objective One: To be available for all teens, women, men and families with pregnancy resource supportthrough a 10% increase in center operating hours and days, an after-hours hotline, mobile app and website and an increased community awareness and outreach program. Objective Two: To increase our clients and outreach contacts by 25% in 2013-2014 Objective Three: To ensure every baby born in this community and their mother has a safe bed, food and formula (preferably breast feeding for health) and proper clothing. (Collaboration with other organizations) Objective Four. To ensure all teens and women in this community are given educational resources regarding their options so they are not forced to give up their babies unless that is their choice. Objective Five: To reduce the number of unplanned pregnancies and STD's in our community through an Abstinence Education Program, RN counseling and MD referrals for healthy babies and Moms. This is part of the Riverside County Healthy Families goals. See budget for project: BUDGET PROPOSAL FOR CITY OF TEMECULA COMMUNITY SERVICE FUNDING FOR BIRTH CHOICE OF TEMECULA PREGNANCY RESOURCE CENTER Consumable Supplies: Quantity Cost Subtotal Total Cost Pregnancy brochures 25,000 .50 5000.00 12,500.00 Pregnancy 20 18.00 360.00 360.00 Educational videos/lending Material goods pregnancy and Baby (maternity, baby, food) 1,800 20.00 36000.00 36000.00 Newborn bassinets 60 100.00 6000.00 6000.00 Supplies to support client visits 2800 1.00 1800.00 2800.00 Prenatal Care educational mils 1800 1.00 1800.00 1800.00 Grand Total Cost: $59, 460 1. Requested Amount: $5,000 2. Expected Program Expenses: $59,460 3. Other financial resources $30,000 estimated from fundraising events; $25,000 estimated from donors For more details on our services, please visit our website at www.birthchoicetemecula.com. Our Services PAST PROJECT BENEFITS If your organization received City of Temecula funding in the previous year, please explain and show how Temecula residents benefited. PAST PROJECT BENEFITS Application Page 5 If your organization received City of Temecula funding in the previous year, please explain and show how Temecula residents benefited. Birth Choice of Temecula received a $5K grant from the City last year. With the addition of these monies, Birth Choice of Temecula was able to provide expanded pregnancy support services and hours to greater than 2000 client families in 2012 and between 150-200 clients per month in 2012/13. Eighty Five (85) babies have been saved in the past 4 years through counseling and material support for those who wished to keep their babies or place them for adoption with a loving family, but needed help to do so. We have expanded our center days to include Monday -Thursday, open during lunch and Friday/Saturday by appointment per our goal. We have further added more volunteers such as receptionists, counselors and boutique workers to ensure that our expanded (4) phone lines are answered timely to support between 150-200 client visits per month and numerous phone calls each day. Our new mobile app has text, email and phone capability to quick contacts. We have a volunteer Nurse Manager, (4) volunteer RN's, (3) RDMS uttrasonographers, (1) doula and a volunteer MD OB/GYN provider to provide medical counseling and referrals for earlier prenatal care and healthier pregnancies, including healthy babies and Moms. We will continue to help all families until their babies are two years of age, while also helping them to make good choices for their lives and helping them to become self-sufficient. Referrals to complete high school diplomas, college courses, job training referrals are included where needed in counseling sessions. Additionally, parents are being given abstinence counseling for their teens to prevent unplanned pregnancy and life -threatening disease such as HIV/AIDS, Hepatitis and others. Greater than 4,000 people participated in Birth Choice events providing much needed community service and volunteer support to members of our community including the Walk for Life, Respect Life Banquet, Baby Bottle Boomerang, Community Health Fairs, Community Expo's, Temecula Chamber events, Middle School, High School and correctional Community Service Programs, numerous church health and Missions Fairs, abstinence education to students from numerous schools, Educational Work and internship experience for students and adults from Mount San Jacinto, University of California San Marcos, Azusa Pacific, UC Riverside, Calvary Bible College Murrieta and Adult Work Programs for the Disabled including Care Right and Toward Maximum Independence (TMI). Local area high schools, Riverside Courts and Job Corps call us for Community Service referrals, Study programs and as guest presenters for the schools. We have a mutually beneficial relationship with Neighborhood Health Clinics, WIC, the Social Service offices and many area doctors office, clinics and hospitals. Birth Choice has presented a loving approach to pregnancy resource support and we remain a source of help and hope for many who have none. Our clients say they didn't know where to start. With your support, we can help even more. Thank you for your support. SIGNATURE PAGE We hereby certify the information contained in this application is true to the best of our knowledge and belief. Prepared By:_ Signature: President or Authorized Officer: Jennifer Cartel!, Executive Director_ NAME AND TITLE (Please Print or Type) Signature: Jennifer Cartel!, Executive Director NAME AND TITLE (Please Print or Type) n Organization Name: BIRTH CHOICE OF TEMECULA Mailing Address of Organization: Telephone: 27488 Enterprise Circle West, #4, Temecula, CA 92590 Center: 951-699-9808 Ext 105; Cellular: 951-551-5428 DATED THIS 23rd_day_ of _August, 2013. (Date) (Month) BE SURE TO INCLUDE THE ORIGINAL PLUS ONE COPY AND SUBMIT TO: Mail Completed Applications to: City of Temecula Community Service Funding City Manager's Office Attn: Eva Pharis P.O. Box 9033 Temecula, CA 92589-9033 City of Temecula City Manager's Office Community Service Funding Attn; Eva Pharis 41000 Main Street Temecula, CA 92590 4:05 PM 06/14/13 Cash Basis firth hoice of Temecula 2013 BUDGET January -through December 2013 Jan -Dec 13 Ordinary lncornelExpense Income Donations Baby Bottle Boomerang 20,000.00 Banquet 28,1)00.0D Christmas Card Mews 8,000.00 Church -Periodic 17,000.00 Coffee Cups 50.00 Indiv/Corp 42,000.130 Online Income 13,000.00 Walk For Life 13,090_00 Wash for Life 1,500.00 142,550.00 Total Donations Grants Income City of Temecula Grant Discretionary Grant God's Gift Lutheran -Missionary Grant Matching Grant San Bernardo Diocese Grant Total Grants Income Total -none Gross Profit Expense &payroll FYpPDSPS Gross Payroll - Salaries Payroll Service Fees Payroll Taxes Total A.Payroll Expenses 8.Other personnel expenses Misc Fees Staff Christmas Gifts Staff development Travel &meetingsEzpenses Volunteer/Staff Appreciation Workman's Comp Total S.olherpersonnel expenses C.Nom1,ersormel -expenses Bank Service fee Monthly Maintenance 180.00 BankService Fee - Other 680.= 5 000.00 1,000.00 20,000.00 113,000.00 500.00 _5,D00.D0 41,500.00 164,050.00 184,050 00 65,000.00 1,200_09 5,800.00 72,000.00 645 00 300.00 400.00 100.00 750.00 780.00 2,975.00 Total Bank Service Fee 860.00 Client Education Material 600.00 Client Supplies 750_00 Computer 800.00 Equip rental & maintenance 3,600.00 Mailing services 100.00 Office Supplies 1,500.00 Postage, shipping, delivery 1,200.00 Printing & copying 2,500.00 Total C.Non-personnel expenses 11,910.00 Church Outreach 4,030.00 4:05 PM Birth Choice of Temecula 06/14/13 2013 BUDGET Cash Basis .January through December 2043 .tan - Dec 13 DOccupancy -expenses Building/Maintenance 2,000.00 Electricity 1,E00.00 Gas 360.00 Rent 16,740.00 Telephone & telecommunicati... 4,200.00 Total D.Occupancy expenses 24,900.00 E. Advertising 8,000.00 End Yr. Giving Campaign 300.00 ..Community Outreach 4,500.1X0 G. Insurance 2,600.00 H. Fund Raiser Expense Babyi3ottleBoomerang 4,000.00 Baby Battle ttaurch Outreach 2,000.00 Banquet 14,000.00 Christmas Card News 3,000.00 Newsletter 2,000.00 Walk for Lille 5,000-00 Total H. fund Raiser _Expense 30,000.00 I. Miscellaneous Center improvements 100.00 -Interest expense -general 30.00 Membersbip.dues -organization 400.00 Misc. -Other 0.00 Online Expense 1,500.013 Total i. Miscellaneous 2,030.00 Medical ExarfRoam Supplies 1,000_00 Insurance/licenses 500.00 M.mile21-O tler ➢ 00 Medical Travel & Training RN 3,000.00 Total Medical 4,500.00 Total Expense 167,715.00 Net Ordinary income 16(335.00 Net Income 1E,335.40 11-:22 AM ©7/29/13 Cash Basis Birth Choice of Temecula Balance Sheet As of December 31, 2012 Dec 31, 12 ASSETS ti„wit Assets r.hecktng/Savings first Citizens Bank 43,617.11 P.aclrust Bank 1$,287 U1 PactrurstBank Sayings 596.40 -PettyCash 392 73 S-.B.GrantPetty Cash 300.00 Total -Checking/Savings -63,19325 Other.Curzent Assets -Undeposited Funds 1,100.00 Total -Other -Current ,Assets 1,11313XI0 Total Current Assets 64,293.25 TOTAL ASSETS 44,223,25 LIABILITIES & EQUITY Equity Opening Bal Equity 41,375.33 Unrestrict (retained earnin... 26;877.07 Net Income -3,959.15 Total Equity 64,29-3.25 TOTAL LIABILITIES & EQUITY 24,22125 11 t04 AM 01/11/13 Cash Basis Birth Choice of Temecula Profit-& Loss January through December 21312 Jan --Dec-12 -Ordinary hn, ne/Expense Income Donations Baby Bottle-BaO neraug Btesea1 Teresa.Church 1,74 Calvary Chapel of Temecula -407.42 Care Rite-149_53 CommunItyCChurch ofThe-valley 34.12 Community Service 716,03 Grace Evangelical 36.40 Grace Presbyterian 1.08.11 LinfieId School 851..85 Living -Hope Faith Center 151.93 Mountain View-CommunityChurch 133.64 •Oakstone CommunityChurch _50 59 Rancho Community Church 228.06 Religious Freedom Rally 20.D0 Revival 361.30 Service Project _100_32 Southwestchristian Church -496.90 St. .Catherine.Cathelic Church 916.98 St. Jeanne de -Lestonnac 1,351.39 St. Martha Catholic•Church 7,13416 Steinbeck 5.31 Stone Creek Church 119.41 TEAM Murrieta 165.67 Team Temecula 11.89 Temecula -Hills Christian -lurch 957.15 Baby Bottle Boomerang - Other 590_10 Total Baby Bottle Boomerang 16,914.00 Banquet 28,112.10 Christmas Card News .8,258.00 Church Periodic Canyon Lake ComnwnityChuicch .300.00 Canyon Lake -Community Church 3;-300.00 Crossroads -Church _157.03 Lighthouse Christian Center 900.00 Oakstone Caurmuntiy Church 1,450.00 Rancho Community Clwrch 5,200:00 Roman Catholic Bishop of S Bern 1,159.40 St. Martha Catholic Church 291.75 _Stone CreekBible Church 1,200 00 Temecula Hills -Christian Church 2,450.00 Temecula Unitedi8ethodist.Chrch 200:00 The -Springs Community Church 144.48 Total Church Periodic 16,945.66 Indiv1Corp 42,692.20 Online Income 12,786.11 Walk For Life 11,954 92 Donations --Other 307.00 Total Donations 137,99.99 .Grants Income City of Temecula Grant 5,000.00 Discretionary Grant 1, 750.00 Fidelity Charitable Gift 2,500.00 _G.od's Gift 20,000 00 Lutheran Missionary Grant 10,000.00 San.Sernardo_Diocese Grant 3,000.00 Total orantsincome Interest Income Miscellaneous income 42,250;00 - 115.23 .99454 11:04 AM 01/11/13 Cash Basis Birth Choice of Temecula Profit & Loss January through December 2012 .Jan -flee 12 Special events Special events - gift revenue 400.00 Total Special events Ammo Total income 181,729.76 Gross Profit 181,729.76 Expense A.Payrofl Expenses Gross Payroll -Salaries 63,71350 Payroll Service Fees 1,233.00 Payroll Taxes 5,975.28 A.Payrol l -Expenses -Other 164.56 Total-A.Payroll Expenses 71,086.34 B.Other personnel expenses Misc F-ees 645.67 Staff Christmas Gifts 624.85 Staff development 560.44 Volunteer/Staff Appreciation 1,492.29 Workman's Comp 553.68 Total B.Other personnel expenses 3,876.93 C.Non-personnel expenses Bank Service Fee Monthly Maintenance 1.02.96 Bank Service Fee - Other 614.58 Total Bank Service Fee /7/.54 Client Education Material - 675.37 Client Supplies 2,007.44 Computer - 77269 Equip rental & maintenance 3,57-0.98 Office Supplies 1,91451 Postage, shipping, delivery 1,047.92 Printing S.copying 2 _26729 Total C_Non personnel expenses 13,033.74 Church Outreach 3,732.11 D.Occupancyexpenses Building/Maintenance 5,423.66 Electricity 1.642.39 Gas 342 •-96 Rent 16,740.00 Telephone & telecommunications 4,132.94 D.Occupancy expenses -.Other _ .9a02 Total D.Occupancyexpenses 28;371.97 - E. Advertising Advertising .Expense .21.00 E. Advertising - Other 10,214,99 - Total E. Advertising 10,2i5.99 -F_Conmunity Outreach 5,550.80 G. Insurance 2,638.40 1 T04 AM 01/11113 Cash Basis Birth Choice of Temecula Profit & Loss January through December 2012 Jan -Dec 12 H. Fund Raiser Expense Baby Bottle Boomerang 3,741.52 Baby Bottle Church Outreach 498-50 Banquet 14,721.44 Christmas lard News 3,632.78 Comedy Nite Benefit 147.83 Newsletter 280.00 Walk for Life 7,484.33 H. Fund Raiser Expense -Other 1,640.00 Total H. Fund Raiser Expense 32,146-40 1. Miscellaneous Center Improvements 123110 Membership dues -organization 399.95 Online Expense 1,44829 1. Miscellaneous -Other 100.00 'Total I. Miscellaneous 2;072.16 Medical Exam Roorn Supplies Insurance/1 irenses Medical Travel8 Training RN Medical Equipment Medical Travel & Training RN - 0... 1,211.32 474.75 /9724 2,505.74 Total -Medical Travel li Training RN 2,702.98 Total Medical 4,389.05 Medical -Other 96_94 Misc. Other 282.95 Travel & meetings expenses Travel 89.10 Total Travel-8 meetings expenses 89.10 VOID 0.00 Total -Expense 177,602.88 Net Ordinary income 4,126.88 Net Income 4,128-813 ' r\ Internal Revenue F 'ice P 0 BOX 2350 ROOM 5127 ATTN: E.O. LOS ANGELES, CA 900532350 Department of the Treasury Date: In reply rota to: Employer Identification Number: Date: MAR. 20, 1989 Case Number: 959030023 BIRTHRIGHT OF TEMECULA Contact Person: D _4. e-AGENA-ST-1 EEi- 28677 Front St. THORNTON, B. TEMECULA, CA 92390 P.O. Box 2129 Contact Telephone Number: Temecula, CA. (213) 894-4170 92390 Dear Applicant: Accounting Period Ending: December 31 Foundation Status Classification: see attached Advance Ruling Period Ends: Dec. 31, 1992 Caveat Applies: no Based on information supplied, and assuming 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(c)(3) of the Internal Revenue Code. Because you are a newly created organization, He are not now making a final determination of your foundation status under section 509(a) of the Code. However, He have determined that you can reasonably be expected to be a publicly supported organization described in sections 509(a)(1) and 170 (b) (1)(A) (vi). Accordingly, you Hill be treated as a publicly supported organization, and not as a private' foundation, during an advance ruling period. This advance ruling period begins on the date of your inception and ends on the date shown above. Within 90 days after the end of your advance ruling period, you must submit to us information needed to determine Hhether you have met the requirements of the applicable support test during the advance ruling period. If you establish that you have been a publicly supported organization, you till be classified as a section 509(a)(1) or 509(a)(2) organization as long as you continue to meet the requirements of the applicable support test. If you do not meet the public support requirements during the advance ruling period, you Hill be classified as a private foundation for future periods. Also, if you are classified as a private foundation, you will be treated as a private foundation from the date of your inception for purposes of sections 507(d) and 4940. Grantors and donors may rely on the determination that you are not a private foundation until 90 days after the end of your advance ruling period. if you submit the required information within the 90 days, grantors and donors Letter 1045(CG) -3- BIRTHRIGHT OF TEMECULA Because this letter could help resolve any questions about your exempt status and foundation status, you should keep it in your permanent records. If the heading of this letter indicates that a caveat applies, the caveat below or on the enclosure is an integral part of this letter. If you have any questions, please contact the person whose name and telephone number are shown in the heading of this letter. Sincerely yours, Ffut,021C, C , A-) Frederick C. Nielsen District Director Letter 1045(CG) Exempt Organizations Select Check Page 1 of 1 IRS Exempt Organizations Select Check gxemol Oroanizeitions Select Check Home Organizations Eligible to Reeelve Tex•Deductbie Conbibueons (Pub. 78 date) - Search Results The following list includes lax -exempt organizations that are enable to receive tax-deductible contribution!). Click on the "Deductibility Status' column for an explanation of ■rd(atIone on the deductibility of contribution made to different types of tax•exenipl organizations. Results are sorted by EIN. To son results by another category, dick on the icon next to the column heading for that category. Clicking on that Icon a second lime will reverse the sort order. Click on a column heading for an explanation of Information In that column. 1-1 of 1 results Birth Choice of Temecula Inc. Legel Name (Doing Business As). Return to Search Results Per Page 25 OK CitK. Temecula 3tale.Coun C CA United Slates « Prev l 1-1 l Next . Deduc1014 ty Status. PC « Prev 11-1 I Nerd s http://apps. irs.gov/app/eos/pub78 Search.do?ein 1=3303023 53&names=&city=&state=CA&c... 9/5/2013 November 27, 2012 Jennifer CartelI BIRTH CHOICE OF TEMECULA 27488 Enterprise Circle West, Suite 4 Temecula, CA 92590 Dear Ms. CartelI: Congratulations on being selected for funding under the Fiscal Year 2012-2013 Temecula Community Service Funding Program. Your organization has been awarded $6,000 to be used to purchase pregnancy brochures, educational videos and materials, supplies to support client visits pregnancy and post pregnancy to 2 years of age, provide families children with clothing, gas and food cards, baby food and formula, baby clothing, baby nursery furnishings, etc. Your organization must confirm that these funds are expended in accordance with the above -stated purpose by June 30, 2013. Receipts verifying the expenditures of this year's award must be submitted to the City by September 1, 2013. The City may require access to your accounting records in accordance with this policy. If City funds are not expended as stipulated, the funds must be returned to the City. In order to disburse your fiscal year 2012-13 Community Service Funding Program Award, the City requires back-up documentation (specifically copies of invoices, receipts and cancelled checks) to support last year's 2011-12 grant of $5,000. Please submit your back-up documentation to the address below Mail or hand deliver to: City of Temecula City Manager's Office Attn: Betsy Lowrey 41000 Main Street Temecula, CA 92590 In order for these funds to be released, you must sign below acknowledging the following statement: 'We do not discriminate based on race, color, nationality, sex, marital status, disability, religion, or political affiliation." The City fully supports the efforts of your organization and its services to the citizens of Temecula. Sincerely, Betsy Lowrey Sr. Management Analyst ACKNOWLEDGMENT OF FUNDING CONDITIONS (please sign and return this letter as soon as possible): Print Name/Title Authorized SignaturelTitle Date ARROWHEA direct a ervice.arrowheadwater.com # 215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED 1111111111111111111111111111111111 \ph BIRTH CHOICE `1 v Vv / (,/ MAURA FRY / ll 27488 ENTERPRISE CIR W STE 4 TEMECULA CA 92590-4827 'illllllllllliill,lllllll'lilllillllll'lllll'illllllllllllJlllul 1 L'II.I.ING PERIOD 06/23/12 - 07/22/12 1 INVUIr. r NJUMPER 02G0027935642 UPCOMING DELIVERIES ACCOUNT NUMBER MON- AUG 27 WED- SEP 26 WED- OCT 24 MON- NOV 26 0027935842 Customer Service: 1-800-950-9393 Pay your bill online at: servlce.arrowheadwater.com or by phone at: 1-800-950-9393. It's free! Refreshing Drinks. Refreshing Savings. For a limited time, enjoy $1 off select cases of TRADEWINDS & SWEET LEAF Beverages. With prices this cool, bring on the heat! Log onto service.arrowheadwater.com or call 1-800-950-9393 to add to your next order! Offer expires 8/31/12. ACCOUNT ACTIVITY For questions or a report on water quality and information, call 1-800-950.9393 or visit service.arrowheadwater.com. DATE . REFERENCE ;i Qa.Y._. ,DESCRIPTION 6-11 a.. ress: • ' ' ' • 7/22 311710 6/27 7277715962 7/12 7281371802 7/22 7284280364 G0924131 3 2 1 PREVIOUS BALANCE PAYMENT -THANK YOU 5 GAL AH MTN SPRING WATER 9 OZ PLASTIC CUP 50 CT/SLEEVE BOTTLE DEPOSIT: 1 CHARGED, 1 CREDITED 5 GAL AH MTN SPRING WATER 9 OZ PLASTIC CUP 50 CT/SLEEVE .5 LITER AH MTN SPRING WTR 24/CS CALIFORNIA REDEMPTION CHARGE BOTTLE DEPOSIT: 3 CHARGED, 3 CREDITED OIUFUELSURCHARGE RENT SALES TAX TOTAL fi IV :4 AMOUNT 29.21 -29.21 6.79 2.59 .00 20.37 5.18 6.49 1.20 .00 2.88 3.99 .91 50.40 ACCOUNT SUMMARY Subject to terms on reverse side. PREVIOUS BALANCE PAYMENT / ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT 29.21 _ 29.21 + 50.40 = 50.40 service.arrowheadwater.com # 215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED 1111111111111111111111111111111111 BIRTH CHOICE MAURA FRY 27488 ENTERPRISE CIR W STE 4 TEMECULA CA 92590-4827 i,1111,Im4ill.1.1PIi1Ili,II11I1I'1II1di"r�ll�rll�ll�llll�lin BILLING -PERIOD INVOICE NUMBER r 07/23/12 - 08/22/12 02H0027935642 UPCOMING DELIVERIES ACCOUNTNUMBER MON- AUG 27 WED- SEP 26 WED- OCT 24 MON- NOV 26 0027935642 Customer Service: 1-800-950-9393 Pa our bill online at: service.arrowheadwater.com or by one at:1-800-950-9393. It's free! Save now through 10/31/12 on cases of TRADEWINDS Cans. At just 2 cases for $13, you can mix and match from a variety of refreshing flavors. Offer includes cases of ARIZONA Arnold Palmer. CaII 1-800-950-9393 or log onto service.arrowheadwater.com to add to your next delivery! ACCOUNT ACTIVITY For questions or a report on water quality and information, call 1.800-950-9393 or visit service.arrowheadwater.com. DATE .-REFERENCE DESCRIPTIO! E 8/19 8/22 513790 H1139218 Delivery address: BIRTH CHOICE. 27488 ENTERPRISE CIR W STE 4, TEMECULA CA 92590 PREVIOUS BALANCE PAYMENT -THANK YOU RENT SALES TAX TOTAL NfOUNT 50.40 -50.40 3.99 .31 4.30 ACCOUNT SUMMARY I PREVIOUS BALANCE PAYMENT / ADJUSTMENT CURRENT ACTIVITY P Y THIS AMOUNT c Subject to terms on reverse side. 50.40 50.40 -}- 4.30 = 4.30 service.arrowheadwater.com # 215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED 1111111111111111111111111111111111 BIRTH CHOICE MAURA FRY 27488 ENTERPRISE CIR W STE 4 TEMECULA CA 92590-4827 liullliulliillll'llllIllllllillliliilullllluiilluiillll'lllliliul I6S £LIN PL, IcD 08/23/12 - 09/22/12 INVOICE NIJNIBLR 0210027935642 UPC(► INC DELIVERIES ACCOUNT NUMBER WED- MON- WED- TUE- OCT NOV DEC JAN 24 26 26 29 0027935642 Customer Service: 1-800-950-9393 Pay your bill online at: service.arrowheadwater.com or by phone at: 1-800-950-9393. It's free! Save now through 10/31/12 on cases of TRADEWINDS Cans. At Just 2 cases for $13, you can mix and match' from a variety of refreshing flavors. Offer includes cases of ARIZONA Arnold Palmer. Call 1-800-950-9393 or loa onto service.arrowheadwater.com to add to your next delivery! ACCOUNT ACTIVITY For questions or a report on water quality and information, call 1.800-950.9393 or visit service.arrowheadwater.com. DATE REFERENCE r QTY DESCRIPTION 9/05 8/27 9/19 9/22 629698 7289440153 7295273416 7296460368 11357546 1416562 Delivery address: BIRTH CHOICE, 27488 ENTERPRISE CIR W STE 4, TEMECULA CA 92590 PREVIOUS BALANCE PAYMENT -THANK YOU 2 2 ACCOUNT SUMMARY Subject to terms on reverse side. 5 GAL AH MTN SPRING WATER 9 OZ PLASTIC CUP 50 CT/SLEEVE .5 LITER AH MTN SPRING WTR 24/CS CALIFORNIA REDEMPTION CHARGE BOTTLE DEPOSIT: 2 CHARGED, 2 CREDITED 5 GAL AH MTN SPRING WATER BOTTLE DEPOSIT: 1 CHARGED, 0 CREDITED OIL/FUEL SURCHARGE RENT RENT SALES TAX TOTAL id(gitiLy „ f.ticl' • i3iGtC UN f 4.30 -4.30 13.58 5.18 6.4C 1.20 .00 6.79 .00 2.80 3.99 FREE .71 40.74 PREVIOUS BALANCE PAYMENT / ADJUSTMENT CURRENT ACTIVITY PAY THIS AMOUNT 4.30 — 4.30 �- 40.74 40.74 ARROWHFJ\ direct servic e.a rrowheadwater.com # 215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED 1111111111111111111111111111111111 BIRTH CHOICE MAURA FRY v L 27488 ENTERPRISE CIR W STE 4 r'1 TEMECULA CA 92590-4827 1^^S LnI,,n1II�1�Ih1nP�l"11,1iI�Inu11,11111d11111111'1'1h111 I}i\t BILLING PERIOD INVOICE NUMBER 09/23/12- 10/22/12 02J0027935642 UPCOMING DELIVERIES ACCOUNT NUMBER MON- WED- TUE- THU- NOV DEC JAN FEB 26 26 29 28 0027935642 Customer Service: 1-800-950-9393 Pay your bill online at: service.arrowheadwater.com or by phone at: 1-800-950-9393. It's freel ,:. Be ready for all this year's celebrations. Now through f2131/12, enjoy savings on cases of ACCUA PANNA, S.PELLEGRINO, SAN PELLEGRINO SPARKLING FRUIT BEVERAGES & PERRIER. Call 1-800-950-9393 or log onto service.arrowheadwater.com to order today' ACCOUNT ACTIVITY For questions or a report on water quality and information, call 1-800-950-9393 or visit service.arrowheadwater.com 10/18 9/26 10/22 945581 7295462886 7302537241 J1573660 Delivery address: BIRTH CHOICE, 27488 ENTERPRISE CIR W STE 4, TEMECULA CA 92590 PREVIOUS BALANCE PAYMENT -THANK YOU 1 5 GAL AH MTN SPRING WATER 2 9 CZ PLASTIC CUP 50 CT/SLEEVE 1 5 LITER AH MTN SPRING WTR 24/CS 1 CALIFORNIA REDEMPTION CHARGE BOTTLE DEPOSIT: 1 CHARGED, 1 CREDfTED 1 OIL/FUEL SURCHARGE RENT SALES TAX TOTAL fl'ar �!1z 1! alb 40.74 -40.71 6.79 5.18 6.49 1.20 .00 2.88 3.99 71 27.27 ARROWHEAD direct / se rvl cearrowh eadwate r.co m a 215 6661 DIXIE HWY, SUITE 4 LOUISVILLE KY 40258 ADDRESS SERVICE REQUESTED 111111111111111111 1111111111111 III BIRTH CHOICE MAURA FRY 27488 ENTERPRISE CIR W STE 4 TEMECULA CA 92590-4827 iIuilliil'Illliliilluullhill'lliiilillil'l'llllluluulullllllllll BILLING PEIUC)D I`N!YO(CE NUivMBER 10/23/12 -11/22/12 02K0027935642 UPCOMING DELIVERIES ACCOUNT NUMBER WED- DEC 26 TUE- JAN 29 THU- FEB 28 MON- APR 01 0027935642 Customer Service: 1-800-950-9393 Pay your bill online at: service.arrowheadwater.com or by phone at: 1-800-950-9393. It's free! Be ready for all this year's celebrations. Now through 12/31/12, enjoy savings on cases of ACQUA PANNA, S.PELLEGRINO, SAN PELLEGRINO SPARKLING FRUIT BEVERAGES & PERRIER. Call 1-800-950-9393 or log onto service.arrowheadwater.com to order todayl ACCOUNT ACTIVITY For questions or a report on water quality and information, call 1.600-950-9393 or visit service.arrowheadwater.com. DATE REFERENCE QTY DESCRIP NON 11/11 112245 10/24 7301220237 11/22 7308582985 K1790673 Delivery address: BIRTH CHOICE, 27488 ENTERPRISE CIR W STE 4, TEMECULA CA 92590 PREVIOUS BALANCE PAYMENT -THANK YOU 9 OZ PLASTIC CUP 50 CT/SLEEVE 5 LITER AH MTN SPRING WTR 24/CS CALIFORNIA REDEMPTION CHARGE OIL/FUEL SURCHARGE RENT SALES TAX TOTAL 4 al‘0lia 1-37-27 RECEIVED BY AMOU 27.27 -27.27 2.59 6.49 1.20 2.96 3.99 .51 17.74 GLENNIE'S OFFICE PRODUCTS INC. 1 Escondido 410 West 5th Avenue 760-747-0701 Fax 760-745-0776 Temecula 41695 Enterprise Circle South 951-296-3627 Fax 951-296-3848 Customer Care 800-499-CLIP (2547) Fax 800-505-CLIP (2547) custservice@glenniesop.com www.glenniesop.com Bill To: BIRTH CHOICE OF TEMECULA 27488 ENTERPRISE CIRCLE EAW92590 TEMECULA Page CHARGE (VOICE # 1219008-0 1 P Customer Purchase Order Delivery Route Invoice Date MAURA 5 ' 07/10/12 06:34 Special Instructions Account Dept Who Called 5492 Ship To: BIRTH CHOICE OF TEMECULA 27488 ENTERPRISE CIRCLE 92590 W TEMECULA Account Executive 500/T-HOUSE Order Taker 160 Order Date: 07/09/12 Invoice Date 07/10/12 Terms Gt./Inv Net 30 55/ 1 BIO'd Ordered UM Shipped /,4, PK 1 EA 1 BX BX DZ 1 DZ 1 V12 RL 12 \%1 CT 1 rI t\1 "1, ki P Mfg Item Number AVE ACM COX UNV ACC ACC BSN UNI 05790 41218 78374 12113 72020 72010 32952 50000 Item Description LABEL,C/C.PERM,.25"DIA,RED SHEARS,8",STRT.SS,BLU BAG ,TRASH FOLDER,MAN,1/3CT,LTR VPO 813000EVT 00128 CLIP,BINDER,SML UNV 10200 CLIP.BINDER,MINI,BLK BSN 65364 TAPE,INVISIBLE,3/4 X1296" MMM 6200341296 PAPER. MULTI-PURP.COPY,LTR,ECON THANK YOU FOR YOUR ORDER 951-699-9808 Packed By Total Ctn(s) Price per Unit xtended 2.490 2.49 9.490 9.49 15.990 15.99 6.'90 6.49 1.390 1.39 1.390 1.39 .990 11.88 36.990 36.99 A locally owned business supporting our local economy [Subtotal Returns must be unused in original packaging and returned within 30 days. Other returns are subject to approval and may be subject to restocking fees. Special orders, fumiture, machines and ingestible products may not be returnable. please check with Customer Care. 86.11 Sales Tax 6.67 Invoice Total 92.78 Please Remit To: Glennie's Office Products, Inc. 410 West Fifth Avenue Escondido. CA 92025 GLENNIE'S OFFICE PRODUCTS „INC. Escondido 410 West 5th Avenue 760-747-0701 Fax 760-745-0776 Temecula 41695 Enterprise Circle South 951-296-3627 Fax 951-296-3848 Customer Care 800-499-CLIP (2547) Fax 800-505-CLIP (2547) custservice@glenniesop.com www.glenniesop.com Bin To: BIRTH CHOICE OF TEMECULA 27488 ENTERPRISE CIRCLE W TEMECULA CA 92590 J CHARGE Page JVOICE # 1220414-0 1 Customer Purchase Order Delivery Route MAURA 5 Invoice Date 25 06:34 Special Instructions Account Dept Who Called 5492 951-699-9808 Ship To: BIRTH CHOICE OF TEMECULA 27488 ENTERPRISE CIRCLE W TEMECULA CA 92590 Account Executive 500/T-!IOUSE Order Taker 160 Order Date: 07/24/12 Invoice Date 07/25/12 Terms Net 30 GUInv 55/ i B/O'd Ordered UM EA EA 1 FA Shipped 1 1 Mfg Item Number DYM 12966 AVE 17331 AVE 17334 tl ‘fiy,\(})\ Item Description IABELER,HH,EMB,3/8",XPRESS PRO BINDER,VIEW,3RG,1",LH,LBL BINDER,VIEIW,3RG,1.5",LBL V' Packed By Price per Unit 14.990 9.990 10.990 Total Ctn(s)1 Extended 14.99 9.99 10.99 1HANK YO'J FOR YOUR ORDER A locally owned business supporting our local economy 38.76Invoice Total [Subtotal 35.97 Sales Tax 2.79 Returns must be unused in original packaging and returned within 30 days. Other returns are subject to approval and may be subject to restocking fees. Special orders, furniture, machines and ingestible products may not be returnable, please check with Customer Care. Please Remit To: Glennie's Office Products, Inc. 410 West Fifth Avenue Escondido. CA 92025 n .r1NIE'S OFFICE PRODUCTS •.INC. Escondido 410 West 5th Avenue 760-747-0701 Fax 760-745-0776 Temecula 41695 Enterprise Circle South 951-296-3627 Fax 951-296-3848 Customer Care 800-499-CLIP (2547) Fax 800-505-CLIP (2547) custservice@glenniesop.com www.glenniesop.com Bill To: BIRTH CHOICE OF TEMECULA 27488 ENTERPRISE CIRCLE W TEMECULA CA 92590 Page CHARGE INVOICE # 1221113-0 1 Customer Purchase Order Delivery Route Invoice Date 5 08/01/12 06:22 Special Instructions Account Dept Who Called 5492 951-699-9808 Ship To: BIRTH CHOICE OF TEMECULA 27488 ENTERPRISE CIRCLE W TEMECULA CA 92590 J Account Executive 500/T-HOUSE 6/O'd Ordered UM 1 EA Order Taker 501 Order Date: 07/31/12 Invoice Date 08/01/12 Terms Net 30 GL/Inv 55/ 1 Shipped 1 Mfg Item Number HEW C6656AN Item Description INK CRG,IJ.#56.BLK, L)Y Packed By Price per Unit 23.990 r{ 0) 9 Lk Total Ctn(s)1 Extended • 23.99 J -THANK YOU FOR YOUR ORDER A locally owned business supporting our local economy Subtotal Sales Tax Invoice Total 23.99 1.86 25.85 Returns must be unused in original packaging and returned within 30 days. Other returns are subject to approval and may be subject to restocking fees. Special orders, furniture, Please Remit To: Glennie's Office Products, Inc. 410 West Fifth Avenue Fcrnr{dirin CA 92025 JFFICE ?RODUCTS INC. 4scondido 410 West 5th Avenue 760-747-0701 Fax 760-745-0776 Temecula 41695 Enterprise Circle South 951-296-3627 Fax 951-296-3848 Customer Care 800-499-CLIP (2547) Fax 800-505-CLIP (2547) custservice@glenniesop.com www.glenniesop.com Bill To: BIRTH CHOICE OF TEMECULA 27488 ENTERPRISE CIRCLE W TEMECULA CA 92590 CHARGE Page INVOICE # 1224171-0 1 P Customer Purchase Order Delivery Route Invoice Date 5 08/29/12 06:29 Special Instructions Account Dept Who Called 5492 951-699-9808 Ship To: BIRTH CHOICE OF TEMECULA 27488 ENTERPRISE CIRCLE W TEMECULA CA 92590 Account Executive 500/T-HOUSE Order Taker 501 Order Date: 08/28/12 Invoice Date 08/29/12 Terms Net30 GUInv 55/ 1 Packed By Total Ctn(s) B/O'd Ordered UM PK BX 1 BX 1 CT Shipped 1 1 1 1 Mfg Item Number MMM 660-3AN WBI HAB6K100 UNV 12113 UNI 50000 Item Description PAPER,POST-IT,RLC,AST NE LINER,13GAL.WH1 FOLDLR,MAN,1/3CT,LTR UPC 813000EUT 00128 PAPER,MULTI-PURP,COPY,LTR,ECON Price per Unit 10.490 12.990 6.490 36.990 Fl \\I t. /��L1J Extended. 10.49 12.99 6.49'; 36.99 iik LANK YOU FOR YOUR ORDER A locally owned business supporting our local economy Subtotal Sales Tax Invoice Total 66.96 5.19 72.15 aturns must be unused in original packaging and returned within 30 days. Other returns e subject to approval and may be subject to restocking fees. Special orders, furniture, Please Remit To: Glennie's Office Products, Inc. 410 West .Fifth Avenue ANIE'S JFFICE /RODUCTS ..INC. , scondido 410 West 5th Avenue 760-747-0701 Fax 760-745-0776 Temecula 41695 Enterprise Circle South 951-296-3627 Fax 951-296-3848 Customer Care 800-499-CLIP (2547) Fax 800-505-CLIP (2547) custservice@glenniesop.com www.glenniesop.com Bill To: BIRTH CHOICE OF TEMECULA 27488 ENTERPRISE CIRCLE W TEMECULA CA 92590 MORA CHARGE . VOICE # 1226150-0 Page 1 Customer Purchase Order Delivery Route Invoice Date 5 09/18/12 06:28 Special Instructions Account Dept Who Called 5492 MORA 951-699-9808 Ship To: BIRTH CHOICE OF TEMECULA 27488 ENTERPRISE CIRCLE W TEMECULA CA 92590 Account Executive 500/1-HOUSE Order Taker 1'l1 Order Date: 09/17/12 Invoice Date 09/18/12 Terms Net 30 GUInv 1/ 1 B/O'd Ordered UM 1 EA 1 BX 1 BX 1 BX Shipped 1 1 1 1 Mfg Item Number SLT 26166 SMD 87865 SMD 87859 SMD 87855 Item Description BULB, FLUOR, SPIRAL,151W,WHT PORTFOLI0,2PKT,L1R,LAV SMD 486LV PORTFOLI0,2PK1,LTR,RED SMD 486R PORTFOLIO , 2PKT , LIR , GRN SMD 486GN Packed By Price per Unit 8.790 20.490 20.490 20.490 -fd J Total Ctn(s)1 Extended ;, 1'1 8.79 20.49 20.49 ' 20.49 THANK YOU FOR YOUR ORDER A locally owned business supporting our local economy "Subtotal 70.26 Sales Tax 5.45 Invoice Total 75.71, Returns must be unused in original packaging and returned within 30 days. Other returns are subject to approval and may be subject to restocking fees. Special orders, furniture, machines and ingestible products may not be returnable. please check with Customer Care. Please Remit To: Glennie's Office Products, Inc. 410 West Fifth Avenue Escondido, CA 92025 _NNIE'S OFFICE PRODUCTS Oft INC. Escondido 410 West 5th Avenue 760-747-0701 Fax 760-745-0776 Temecula 41695 Enterprise Circle South 951-296-3627 Fax 951-296-3848 Customer Care 800-499-CLIP (2547) Fax 800-505-CLIP (2547) custservice@glenniesop.com www.glenniesop.com Bill To: BIRTH CHOICE OF TEMECULA 27488 ENTERPRISE CIRCLE W TEMECULA CA 92590 J l Page CHARGE INVOICE # 1226931-0 1 Customer Purchase Order Delivery Route Invoice Date 5 09/26/12 06:23 Special Instructions Account Dept Who Called 5492 951-699-9808 Ship To: BIRTH CHOICE OF TEMECULA 27488 ENTERPRISE CIRCLE W TEMECULA CA 92590 Account Executive 500/T-HOUSE Order Taker 501 Order Date: 09/25/12 Invoice Date 09/26/12 Terms Net30 GUInv 55/ 1 Packed By Total Cln(s) B/O'd Ordered UM 1 EA BX Shipped 10 1 Mfg Item Number WLJ 368-13NBL COX 78374 Item Description BINDER.R-RG,.5",VNL,DBL BAG,TRASH l lWf. �� 1( .e j),;oU; l' r Q. Price per Unit 2.790 15.990 j/r,S W Extended 27.90 15.99 A locally owned business supporting our local economy Subtotal Invoice Total 47.29 THANK YOU FOR YOUR ORDER 43.89 Sales Tax 3.40 Returns must be unused in original packaging and returned within 30 days. Other returns are subject to approval and may be subject to restocking fees. Special orders, furniture, rherL meth R, igfrr- r (' ro Please Remit To: Glennie's Office Products, Inc. 410 West Fifth Avenue Escondido. CA 92025 I'1 ^NNIE'S OFFICE PRODUCTS INC. Escondido 410 West 5th Avenue 760-747-0701 Fax 760-745-0776 Temecula 41695 Enterprise Circle South 951-296-3627 Fax 951-296-3848 Customer Care 800-499-CLIP (2547) Fax 800-505-CLIP (2547) custservice@glenniesop.com www.glenniesop.com Bill To: BIRTH CHOICE OF TEMECULA 27488 ENTERPRISE CIRCLE W TEMECULA CA 92590 Page CHARGE INVOICE # 1226892-0 1 Customer Purchase Order MAURA Delivery Route Invoice Date 5 09/26/12 06:25 Special Instructigns Account Dept Who Called 5492 MAURA 951-699-9808 Ship To: BIRTH CHOICE OF TEMECULA 27488 ENTERPRISE CIRCLE W TEMECULA CA 92590 Account Executive 500/T-HOUSE Order Taker 169 Order Date: 09/25/12 Invoice Date 09/26/12 Terms Net30 GUInv 55/ 1 Packed By Total Ctn(s) '.BJO'd Ordered UM /PK ✓1 BX v).(DZ BX Shipped 1 1 1 1 Mfg Item Number MMM 655-5PK UNV 21124 BIC GSF11-BK MAC MLFF31 Item Description NOFE.POST-IT,3X5,NE AST PROIECTOR,SHEET,LTR,TPLD,CLR CLI 62037 PEN,BP,STK,RND STIC,FN,BLK LABEL,FF,LSR,2/3X3-7/16,WHT BSN 26102 riv.> c�� j ' ,L4' Price per Unit 11.490 7.990 1.790 19.950 ti- l'el (1 . ,k Extended 11.49 7.99 1.79 19.95 ') THANK YOU FOR YOUR ORDER A locally owned business supporting our local economy Subtotal Sales Tax Invoice Total 41.22 3.19 44.41 Returns must be unused in original packaging and returned within 30 days. Other returns Please Remit To: Glennie's Office Products, Inc. r—• MIE'S ir=FICE ,SODUCTS •.INC. Oft ,ondido ,0 West 5th Avenue /60-747-0701 Fax 760-745-0776 Temecula 41695 Enterprise Circle South 951-296-3627 Fax 951-296-3848 Customer Care 800-499-CLIP (2547) Fax 800-505-CLIP (2547) custservice@glenniesop.com www.glenniesop.com Bill To: BIRTH CHOICE OF TEMECULA 27488 ENTERPRISE CIRCLE EAW92590 TEMECULA J CHARGE ' INVOICE # 1229505-0 Customer Pu se Or* MAURA Special I Account 5492 pt ailed Page 1 P Delivery Route Invoice Date 5 10/24/12 06:33 Ship To: BIRTH CHOICE OF TEMECULA 27488 ENTERPRISE CIRCLE ER 92590 W TEMECULA 951-699.9808 Account Executive 500/T-HOUSE B/O'd Ordered UM EA 1 PK 2� BX 1 CT Shipped Order Taker 160 Order Date: 10/23/12 Mfg Item Number 1 SAF 4330MH PAG 50916 1 GFM CPAL4 1 UNI 50000 THANK YOU FOR YOUR ORDER Invoice Date 10/24/12 Terms GL/Inv Net 30 55/ 1 Packed By Item Description RACK,LITERATURE,5-PKT,MAH TISSUE,TLET,4X4.4,STD,CHARMIN PUSHPIN,ALUM,1/2" PAPER, MULTI-PURP,COPY,LTR,ECON Price per Unit 58.990 17.990 4.990 36.990 Total Ctn(s)Ns xtended ti 58.99 17.99 4,99 36.99 J A locally owned business supporting our local economy Invoice Total Subtotal Sales Tax 9 22 128.18 118.96 n,„et ho „n„tAri in nrininal oackaaina and returned within 30 days. Other returns Please Remit To: Gler?nie's Office Products, Inc. •� n ui,....a C:41.1. CIT ATTN: CUSTOMER SERVICE P.O. BOX 550599 JACKSONVILLE, FL 32255-0599 View your account online at cans www.QDSontheweb.com PAGE 1 of 1 INVOICE NO. 21764293 INVOICE DATE 07/18/2012 CONTRACT NO. 900-0120510-000 DUE DATE ( 08/07/2012 Contract Number Asset Description Description of charge(s) Amount Due Sales Tax Total Due 900-0120510-000 CANON COPIER PAYMENT DUE 08/07/12 INSURANCE 08/07/12 168.00 12.98 13.02 0.00 194.00 INVOICE TOTAL 180.98 13.02 194.00 Mfj (e M14 ..AQUIRIES www.QOSorkheweb corn For Customer Servos Inquiries, Please call 1.888-204.0799 Far Insurance Inquiries pee p0 / SIG at 898-873-1917 Note, Your lease Is near the end of its inidal tens. Please refer to your lease terms & conditions for your end of Iaase notificalfon oblaslions. Nance of Bankruptcy tiring should be mailed to One Oeerwood.10201 Centurion Pkwy N, Suite 100, Jacksonville, FL 32256 (r Keep upper portion for your records err CIT ATTN: CUSTOMER IVICE P.O. BOX 550599 JACKSONVILLE, FL 32255-0599 View your account online at www,QDSontheweb.coni PArlE 1of1 II. 10E NO. / 21928169 INVOICE DATE t/ 08/18/2012 CONTRACT NO. 900-0120510-000 DUE DATE 09/07/2012 Contract N Asset Desc ription um 900.0120510-000 CANON COPIER Description of charge(s) Amount Due Sales Tax Total Due PAYMENT DUE 09/07/12 INSURANCE 09/07/12 168.00 12.98 13.02 0.00 194.00 INVOICE TOTAL 180.98 13.02 194.00 INQUIRIES wwnv.ODSontheweb.eorn For Customer Service Inquiries, please call 1-068-204.0799 For Insurance inquiries please cell ABIG at 866-873-1917 Notice of Bankruptcy filing should be filed to One Deerwood, 10201 Centurion Pkwy N, Suite 100, Jacksonville, FL 32256 Keep upper portion for your records eirr CIT ATTN: CUSTOMER SERVICE P.O. BOX 550599 JACKSONVILLE, FL 32255-0599 View your account online at QDS www.QDSontheweb.com PAGE 1 of 1 INVOICE NO. 22088229 INVOICE DATE 09/17/2012 CONTRACT NO. 900-0120510-000 DUE DATE 10/07/2012 Contract Number Asset Description Description of charge(s) Amount Due Sales Tax Total Due 900-0120510-000 CANON COPIER PAYMENT DUE 10/07/12 INSURANCE 10/07/12 168.00 12.98 13.02 0.00 194.00 INVOICE TOTAL 180.98 13.02 19k.v0 t� i ,mil /�y sr % 20".... 1114‘ u • V.An� 1 ��11111 r ig'. i I \All INQUIRIES www.QOSonthewab.com For Customer Service inquiries, please cell 1.888-2044790 For Insurance inquiries please call ABIG at 088-073-1917 Notice of Bankruptcyfiling should be mailed to One Deetuood, 10201 Centurion Ploy N. Suds 100, Jacksotwille, FL 32258 a li Keep upper portion for your records jt: (W‘ c h t 11 INNOV�T�E DOCUMEIR U110NS 26855 Jefferson Ave #F Murrieta, CA 92562 P: 951 676-8885 F: 951 296-2675 Bill To: Birth Choice Of Temecula Inc. Maura 27488 Enterprise Circle West Temecula, CA 92593 CONTRACT INVOICE Invoice Number: 118699 Invoice Date: 1/ 08/01/2012 Customer: Birth Choice Of Temecula Inc. 27488 Enterprise Circle West Temecula, CA 92593 Account: No 1_ Payment Terms Due Date. Invoice Total Balance Due BirthChoice Net 30 08/31/2012 $ 121.12 $ 121.12 Contrail Number -._____ Contact 0.0.'Nutnber Start Date _* Exp. Date CoidrbctAmount [ 3485 01 Maura Fry 951-699-9808 No 12/01/2007 12/07/2012 $ 116.60 __ Remarks Summary: Contract base rate charge for the 07/01/2012 to 07/31/2012 billing period Contract charge for the 07/01/2012 to 07/31/2012 period **See charge details below Detail: Equipment included under this contract Canon/imageRUNNER C 2880 Number Serial Number 3485 MNP01S76 Base Adj. Location $0.00 $116.60** $116.60 $0.00 Birth Choice Of Temecula Inc. 27488 Enterprise Circle West Temecula, CA 92593 Meter Type Meter Group Begin Meter End Meter Total Covered Billable Rate Overacge Total 101 3485 - Total 1( 215,361 218,320 2,959 0 2,959 $0.000000 $0.00 Total 108 3485 -Total 1( 172,290 174,475 2,185 0 2,185 $0.019000 $41.52 Color Copies 3485 - Color G 43,071 43,845 774 0 774 $0.097000 $75.08 $116.60 Paying too much for HP cartridges ? Call IDS for a Printwise evaluation to save you money Invoice SubTotal $116.60 Tax: $4.52 Invoice Total $121.12 Balance Due: $121.12 Page I of 1 26855 Jefferson Ave #F Murrieta, CA 92562 P: 951 676-8885 F: 951 296-2675 Bill To: Birth Choice Of Temecula Inc. Maura 27488 Enterprise Circle West Temecula, CA 92593 US Account No BirthChoice Customer: CONTRACT INVOICE Invoice Number: Invoice Date: Birth Choice Of Temecula Inc. 27488 Enterprise Circle West Temecula, CA 92593 Payment Terms Net 30 Due Date 10/01/2012 Invo[ Total $ 94.75 ;.;. ContractNumber 3485-01 Contact, 1�' Maura Fry 951-699-9808 P.O. Number No Start Date 12/01/2007 119725 09/01/2012 Balance Due it, , •Facp,pi._ 12/07/2012 $ 94.75 Contract Amount $ 91.22 • • em k 0? Nt.Z a/ ( ._ Summary: Contract base rate charge for the 08/01/2012 to 08/31/2012 billing Contract charge for the 08/01/2012 to 08/31/2012 period **See charge details below Detail: Equipment included under this contract Canon/imageRUNNER C 2880 Number Serial Number 3485 MNP01576 period Base Adj. Meter Type Meter Group Begin Meter End Meter Total 101 Total 108 Color Copies 3485 - Total 1( 3485 - Total 1( 3485 - Color 0 218,320 174,475 43,845 Charge period from 8/1/2012 to 8/29/2012 220,892 176,504 44,388 $0.00 $0.00 $91.22 ** Location Birth Choice Of Temecula Inc. 27488 Enterprise Circle West Temecula, CA 92593 Total 2,572 2,029 543 Paying too much for HP cartridges ? Call IDS for a Printwise evaluation to save you money $91.22 Covered Billable Rate Overage 0 2,572 $0.000000 $0.00 0 2,029 $0.019000 $38.55 0 543 $0.097000 $52.67 $91.22 (v Invoice SubTotaf Tax: Invoice Total Balance Due: $91.22 $3.53 $94.75 $94.75 Page 1 of 1 INNOVAliVE DOCUMENT SOLUT10N5 2kriamiBmsesFr6ms 26855 Jefferson Ave #F Murrieta, CA 92562 P: 951 676-8885 F: 951 296-2675 Bill To: Birth Choice Of Temecula Inc. Maura 27488 Enterprise Circle West Temecula, CA 92593 US Account No Payment Terms CONTRACT INVOICE Invoice Number: 121417 Invoice Date: 10/01/2012 Customer: Birth Choice Of Temecula Inc. 27488 Enterprise Circle West Temecula, CA 92593 Due Date 10/31/2012 P.O. !NUnlber Invoice Total IBalanoe.Rue $ 185.14 $ 185.14 star ; :_ :, ' Exp. Date Contract Attiouil$' No 08/28/2012 08/29/2017 Remarks Summary: y Contract base rate charge for the 09/01/2012 to 09/30/2012 billing period Contract charge for the 09/01/2012 to 09/30/2012 period **See charge details below $ 178.23 $0.00 $178.23 ** $178.23 Detail: Equipment induded.under tt0s contract Canon/imageRUNNER C5035 Number Serial Number Base Adj. Location 4929 GNG65896 $0.00 Birth Choice Of Temecula Inc. 27488 Enterprise Circle West Temecula, CA 92593 Meter Type Meter Group Begin Meter End Meter Total Covered Billable Rate Overage Total 109 4929 - Total 1( 25 3,394 3,369 0 3,369 $0.013100 $44.13 Color Copies 4929 - Color D 12 1,800 1,788 0 1,788 $0.075000 $134.10 $178.23 RECEIVED i\i/ BY l�l\ Paying too much for HP toners & supplies ??? Ask a IDS sales representtve for infomation on our PrintWise Program to save you money !! S l Ceti I. Invoice SubTotal $178.23 Tax: $6.91 Invoice Total $185.14 Balance Due: $185.14 Page 1 of 1 INNOVAI1VE DOCUMENT 50LUT10N5 7favlmdBmmisIbrif r 26855 Jefferson Ave #F Murrieta, CA 92562 P: 951676-8885 F: 951 296-2675 Bill To: Birth Choice Of Temecula Inc. Maura 27488 Enterprise Circle West Temecula, CA 92593 US CONTRACT INVOICE Invoice Number: Invoice Date: Customer: Birth Choice Of Temecula Inc. 27488 Enterprise Circle West Temecula, CA 92593 n�. BirthChoice 4929-01 Net30 12/01/2012 Invoke Total 122027 11/01/2012 8allI Due $ 24.07 08/29/2017 $ 23.17 Summary: i� Contract base rate charge for the 10/01/2012 to 10/31/2012 billing period Contract charge for the 10/01/2012 to 10/31/2012 period **See charge details below Detail: Equipment included under this contact Canon/imageRUNNER C5035 Number Serial Number 4929 GNG65896 Base Adj. Location Meter Type Meter Group Begin Meter End Meter Total 109 4929 - Total 1( 3,394 4,424 Color Copies 4929 - Color 0 1,800 1,929 $0.00 $23.17 ** • $23.17 $0.00 Birth Choice Of Temecula Inc. 27488 Enterprise Circle West Temecula, CA 92593 Total Covered Billable Rate Overage 1,030 0 1,030 $0.013100 129 0 129 $0.075000 Paying too much for HP toners & supplies ??? Ask a IDS sales representive for infomation on our PrintWise Program to save you money !! $13.49 $9.68 $23.17 Invoice SubTotal Tax: Invoice Total Balance Due: $23.17 $0.90 $24.07 $24.07 Page 1 of i INNOVATIVE DONMEM SOLUTIONS Sir Lan lBann Rots 26855 Jefferson Ave #F Murrieta, CA 92562 P: 951676-8885 F: 951 296-2675 Bill To: Birth Choice Of Temecula Inc. Maura 27488 Enterprise Circle West Temecula, CA 92593 US Account No I Payment Terms BirthChoice i Net 30 Contract Number. T Contacts 4929-01 I Maura Fry Summary: Contract base rate charge for the 11/01/2012 to 11/30/2012 billing period Contract charge for the 11/01/2012 to 11/30/2012 period **See charge details below Detail: Equipment included under tfiiS contract CanonjimageRUNNER C5035 Number Serial Number CONTRACT INVOICE Invoice Number: Invoice Date: Customer: Birth Choice Of Temecula Inc. 27488 Enterprise Circle West Temecula, CA 92593 pus Date ({( Invoice Total 12/31/2012 f $ 74.37 P.O. Number I Start Date No i_- 08/28/2012 L 08/29/2017 Remarks 4929 GNG65896 123069 12/01/2012 $0,00 $71.60 ** $71.60 Base Adj. Location Meter Type Meter Group Begin Meter End Meter Total 109 4929 - Total it 4,424 6,638 Color Copies 4929 - Color G 1,929 2,497 $0.00 Birth Choice Of Temecula Inc. 27488 Enterprise Cirde West Temecula, CA 92593 Total Covered Billable Rate Overage 2,214 0 2,214 $0.013100 568 0 568 $0.075000 Paying too much for HP toners & supplies ??? Ask a IDS sales representive for infomation on our PrintWise Program to save you money !! $29.00 $42.60 $71.60 V.. \ ilia F 3-)8b it(4 vs'' V t . Invoice SubTotal Tax: Invoice Total Balance Due: $71.60 $2.77 $74.37 $74.37 Page 1 of I Walmart 14www7.l1w Mu.. Shi s ment Summar THANK YOU FOR YOUR ORDER! DIDN'T GET YOUR ENTIRE ORDER? YOU MAY RECEIVE YOUR ORDER IN SEPARATE SHIPMENTS. TO TRACK YOUR ORDER STATUS, PLEASE GO ONLINE TO: WWW . WALMART . COM/ORDERTRACK 05/23/2013 f FEDEX GROUND 2677148063220 367885532 Jennifer Cartel) 27488 Enterprise Clr V Temecula CA t JENNIFER CARTELL 27488 ENTERPRISE TEL:8587229027 TEMECULA CA 9259, Order 1 ty Ship 1 Trk Nbrs: 406373384118891 Description 35 GALLON LATCH TOTE ACCS CPU: IM-FEE UPC: 0073149089045 MFG PART: 0007314908904 CARTON #s: 00001 ALT SKU: LR7754 Pnit rice 4E Want to Return or Exhange an Item? If you're not satisfied with your order for any reason please go online to: www.walmart.com/returns IIIIIIIIIIIII IIIIII1IIl11II1111111111111I1Ill)1111111111111111111II1IIIIII1111UI I111I I I1111111111111 TC Number: 013380359096831896147 Total Quantity Shipped: 1 l Questions About Your Order? Please go online to: www.walmart.com/ordertrack or contact us at: www.walmart.com/contact RECEIVED BY k Sub Total: Shipping F Tax Arnow TOTAL: Page: 1 Dest: USMRWMORO3L SID: 50-P1QV3-11 PC: 1 Watmart Shipment Summary I THANK YOU FOR YOUR ORDER! DIDN'T GET YOUR ENTIRE ORDER? YOU MAY RECEIVE YOUR ORDER IN SEPARATE SHIPMENTS. TO TRACK YOUR ORDER STATUS, PLEASE GO ONLINE TO: WWW.WALMART.COM/ORDERTRACK 11/08/2012 FEDEX GROUND 2677198159270 322594682 Jennifer Cartel) 27488 Enterprise Cir W Ste 4 Temecula CA 925904827 CARMEN HALL 27488 ENTERPRISE CIR W STE 4 TEL:8587229027 TEMECULA CA 92590-4827 Order Ship Trk Nbrs: 005794590335820 Description 66 QT LATCH BOX ACCS CPU: IM-FEE UPC: 0073149088987 MFG PART: 0007314908898 CARTON its: 00002 ALT SKU: LR7782 Unit Price Amount 53.82 53.82 Want to Return or Exhange an Item? If you're not satisfied with your order for any reason please go online to: www.walmart.comireturns 11111111111 III IIIII IIMI I1F1>IhI1II111111111111111101 I1111 II111II III1I IIIII IIIII IIIII I1hi1I1n1 II11I11 TC Number: 420124745013922988205 Total Quantity Shipped: 1 Questions About Your Order? Please go online to: www.walmart.com/ordertrack or contact us at: www.walmart.com!contact Sub Total: Shipping Fee: Tax Amount: TOTAL: 53.82 3.97 4.17 61.96 Page: 1 Dest: USMRHMOR103L SID: 50-F9TNO-11 PC: 1 JTh ACCT.NO: P9516999808 SOLD TO: PHONE: 1 Victory Won Jennifer Cartel! BirthChoice - Temecula 27488 ENTERPRISE CIR W STE 4 TEMECULA, CA 92590-4827 (951) 699-9808 919 S. MAIN STREET SNOWFLAKE, AZ 8593; (928) 536-7705 PHONE (928) 536-7785 FAX www,hh76.com www.victorywon.com SHIP TO: INVOICE NO. 00003034631 INVOICE Jennifer Cartel' BirthChoice -Temecula 27488 ENTERPRISE CIR W STE 4 TEMECULA, CA 92590-4827 CODF NO. PURCI LASE ORDER NO. 5901 SI-HP VIA UPSG DATE SHIPPED 09/18/2012 TERMS Credit Card INVOICE DATE 09/17/2012 03Y. QIY 13AC_K UfiDEREO }IiUPYEI) URI)liliU) 5 50 1 ITEM NO. DESCRIPTION UNIT PRICE EXTENDED PRICE ZL3600 ZL4110 AD1 The largest selection of Pro -fife Checks!" www.prolifechecks.com 1-877-472-0907 T I3ET Web sites: www.hh76.com (catalog) www.abortionfacts.com (pro -life information) Pregnancy Test, Quick and Clear Specimen Cups, 4.5 Oz. Main Ad Pack birthchoice@temvailey.corn Invoice Paid with Credit Card / 6 / h/' ✓O-/ -V 995.1 0.1.1066.3 1 2754.995. WS9 N ui i 111111111111111 i Thank You! $32.25 $0.29 $0.00 C\ $161.25 $14.50 $0.00 i "Thank you for your order!" "My name is Beth and 1 put in your order today. If you have any questions please call 1-800-858-3040" SALE AMOUNT TAXABLE AMOUNT SALES TAX FREIGHT TOTAL 5175.75 $0.00 $0.00 $11.95 $187.70 Heritage House76 imimnarirmircrislisfia ACCT. NO: P9516999808 SOLD TO: PHONE: CODE NO. lY Won Victory Jennifer Cartell BirthChoice -Temecula 27488 ENTERPRISE CIR W STE 4 TEMECULA, CA 92590-4827 (951) 699-9808 PURCHASE ORDER NO. 16337 SHIP VIA U PSG 919 S. MAIN STREET SNOWFLAKE, AZ 85937 (928) 536-7705 PHONE (928) 536-7785 FAX www.hh76.com www.victorywon.com SHIP TO: 00003047428 INVOICE Jennifer Cartell BirthChoice - Temecula 27488 ENTERPRISE CIR W STE 4 TEMECULA, CA 92590-4827 DATE SHIPPED 04/10/2013 QTY. QIY. BACK ORDERED SHIPPED ORDERED ITEM NO. 2 50 1 ZL3600 ZL4110 AD1 The largest selection of Pro -Life Checks! www.prolifechecks.com 1-877-472-0907 1 I._ Web sites: www.hh76.com (catalog) www.abortionfacts.com (pro -life information) Thank You! DESCRIPTION Pregnancy Test, Quick and Clear Specimen Cups, 4.5 Oz. Main Ad Pack birthchoicead@ternvalley.com Invoice Paid with Credit Card RED: t J VED ' GIi5J.0.20.3.1 150.4. 10SS.W.3.: II 11111 TERMS Credit Card INVOICE DATE 04/09/2013 UNIT PRICE EXTENDED PRICE $ 32.25 $ 0.29 $ 0.00 SALE AMOUNT TAXABLE AMOUNT SALES TAX FREIGHT TOTAL $64.50 $14.50 $0.00 $ 79.00 $ 0.00 $ 0.00 $9.95 $88.95 r" i GreatAmerica r�LLEASING CORPORATION HARD WORK • INTEGRITY • EXCELLENCE neap rower puniun wr yuut racuruN - rmaae sawn; Uppm !Jul 0.1 wm, yvu, r,aymo, Agreement Number: roice Number. /oice Print Date: Invoice Due Date: Total Due: 'America Leasing Corp. ,ox 660831 Dallas, TX 75266-0831 003-0812565-000 12688902 08/31/2012 09Ai8t2012 S276.38 Important Messages We appreciate your business, We are glad you chose GreatAmerica Leasing Corporation. Please remove the remittance portion of this invoice and include it with your payment. Dishonored Checks, Drafts Or Orders Shall Be Subject To A Surcharge Of $30 For questions about these charges. Agreement Number p lease call 877-311-4422 or visit www.AccountServicesFAO.com. (Para Espanol. Description Due Date Charge Description 003.0812565.000 Canon ImageRUNNER ADVANCE C5030 Copier System 09/25/2012 One -Time Documentation Fee 09/25/2012 Standard Payment page 1 of 2 p ida la extension 2344.) Amount Tax 69.50 192.00 14.88 Subtotal Total Due nid) Total 69.50 206.88 276.38 S276.38 Keep lower portion for your records - Please return upper portion with your payment ireement Number: u rn ✓ -� GreatAmerica° )ice Number: ...voice Print Date: LEASING CORPORATION ...voice Due Date: Total Due: HARD WORK • INTEGRITY • EXCELLENCE 4merica Leasing Corp. P� dox 660831 Dallas, TX 75266-0831 008-0812565-000 12811102 10/01/2012 / 10/25/2012 $214.19 Important Messages We appreciate your business! We are glad you chose GreatAmerica Leasing Corporation. Please remove the remittance portion of this invoice and include it with your payment. Dishonored Checks, Drafts Or Orders Shall Be Subject To A Surcharge Of $30 Fo' questions about these charges. please call 877 -31 1-4422 or visit www AccountSe v.casFA(Q corn (Pan Espanol, prda 'rr i3):1771iri 2344 i Due Date Agreement Number 008.0812565.000 2 3 page 1 of 2 Description Charge Description Canon ImageRUNNER ADVANCE C5030 Copier System 0/25/2012 Insurance Charge 10/25/2012 Standard Payment Amount Tax 7.31 192.00 14.88 Subtotal Total Due Total 7.31 206.88 214.19 S214.19 Keep lower portion for your records - Please return upper portion with your payment Agreement Number: c �; G re a to m e ri c a 'America Leasing Corp. voice Number: �� L E A S I N O CORPORATION f voice Print Date: 3ox 660831 Invoice Due Date: Dallas, TX 75266-0831 Total Due: HARD WORK • INTEGRITY • EXCELLENCE 008-0812565-000 12928994 10/31/2012 tAi/25/2012 $214.19 Important Messages We appreciate your business! We are glad you chose GreatAmerica Leasing Corporation. Please remove the remittance portion of this invoice and include it with your payment. Dishonored Checks, Drafts Or Orders Shall Be Subject To A Surcharge Of $30 For questions aoout these charges. please call 3 t t ->' i ',i.; l c,5=A0.[:01-fi pida xl) Amount Tax Agreement Number Due ,Description l Date Charge Description / 008.0812565.000 Canon ImagoRUNNER ADVANCE C6030 Copior astern 1/25/2012 Insurance Charge 11/2512012 Standard Payment Total 7.31 192.00 14.88 Subtotal Total Due 7.31 206.88 214.19 8214.19 page 1 of 2 0 GreatAmerica' (America Financial Svcs. FINANCIAL SERVICES F'uBox660831 HARD WORK • INTEGRITY • EXCELLENCE Dallas. TX 75266-0831 Keep lower portion for your records - Please return upper portion with your payment greement Number: mice Number: invoice Print Date: Invoice Due Date: Total Due: 008-0812565-000 13049970 11/30/2012 12/25/2012 $214.19 Important Messages We appreciate your business! We are glad you chose GreatAmerica Financial Services Corporation. Please remove the remittance portion of this invoice and include it with your payment. Dishonored Checks, Drafts Or Orders Shall Be Subject To A Surcharge Of $30 For questions about these charges. please call 877-311-4422 or visit www.AccountServicesFAQ.com (Para Espanol. pida la extension 2344.) Agreement Number 008-0812565-000 2 Description Due Date Charge Description Canon ImageRUNNER ADVANCE C6J30 Copier System 2/25/2012 IRsuranco Charge 12/25/201•2tandard Payment Vtz.)0\it 377- Amount Tax 7.31 192.00 14.88 Subtotal Total Due Total 7.31 206.88 214.19 $214.19 page lof2 FIRST cI1 MS BANK BIRTH CHOICE OF TEMECULA, INC. 27488 ENTERPRISE CIR W #4 TEMECULA, CA 92590 951-699-9808 3662 8/1112012 16-3775/1220 727 PAY TO THE St. Martha Catholic Church $ *•600.00 ORDER OF Six Hundred and 00/100 MEMO St. Martha Catholic Church 37200 Whitewood Rd. Murrieta, CA 92563 Gas & Food Cards n'00366 2'11' RUTORIZEB S,GNA DOLLARS 71k441 -ST CRWN8 BANK 3736 16-3776/1220 BIRTH CHOICE OF TEME.ULA, INC. 27488 ENTERPRISE CIR W #4 TEMECULA, CA 92590 951-699-9808 PAY TO THE ORDER OF by MEMO ‘/;S� DO'e a-'14e $ 0003736f1' 1:L220377601:00L0640L420311• 727 DOLLARS BIRTH CHOICE OF TEMECULA, INC. BIRTH CHOICE OF TEMECULA, INC. ta;.) ''"1--`4/1'.‘A.t, 3736 7 7 t');) l O 3736 1 � • . O-1m c u) cD u- 'CON t`- _ad ,8..0/ O h• U 0) O CV FR EA 4 X (- N �• Lc) X "O 0 CVX N O 8K — a--c U C') X S- N O > U •O 40 S 0 N_ O R O• O • F- 0)) +O+ 0 .-- O T K O 0 000 O N O CCr) N (/) M O✓ CV O CO O CO CA Ef3 N >- ▪ _ CC) 4) CO U CT) p - •• u'7 �t O O CO u) CL N O — CT) - O O CC *t N O L0 O a CV C)7 O c0 E U CV 4) CL N -V Q O N -• CO 0 W eg• N C-> "' d = • - 10 CC LC)4) C) 'CI CD ti a)1- 0) r- �II O (0 E 0- CV L. i Is- T•• 0) J - CL E—C7)C7) U 07 0 O ••O 0 0 as: 4¢ C) W N (0 Z CI to t- CO.-f U fit O U CO 1-1(.0 U0) •• .ZN 4) f- - `•--.•• CU W O 0 LC) 4) 0) 4) 4R • L .O cf) 0- -4- - • • CZ C. 0 0 O LJ-c F- <t�l--U1-C.0 Q• UC) — 0_-CC QCC Cr. �/- ?C.41 C/)U Receipt for Petty Cash Expenses Date: Amount: ' r co Reason: 1 inouadb -v ba,J W j'Ui rur e 1 .i Mu) ® R WAXIE SANITARY SUPPLY AIIMI W`I•. E P.O. Box 81006 � ;. � � San Diego, CA 92138-1006 T (858) 292-8111 SAN-I---� RY SUPPLY T 0 s BIRTH CHOICE OF TEMECULA JENNIFER CARTELL p 27488 ENTERPRISE CIR W STE 4 EXECUTIVE DIRECTOR T TEMECULA, CA 92590-4827 s BIRTH CHOICE OF TEMECULA H 27488 ENTERPRISE CIR W STE 4 I p TEMECULA. CA 92590-4827 T 0 f INVOICE NUMBER 73899/05 INVOICE CUSTOMER NUMBER SHIP TO 16960 1 INVOICE DATE 04/24/13 PURCHASE ORDER NO. MAURA ORDER NO 4B2YG/00 Page: 1 ITEM NUMBER DESCRIPTION QUANTITY UNIT PRICE EXTENDED AMOUNT ORDERED SHIPPED U1M BACKORDER 170016 WX GERMICIDAL ULTRA BLEACH 4/GL 1 1 CS 10.250 10.25 170280 WAXIE MEDICAL DISINFECTANT 2 2 TB 9.210 18.42 CLOSED ON FRIDAYS OC MAURA Transportation Surcharge 9.75 PRE PAY VISA ** Payment Terms: Credit Card Payment ,,, 1,\(t 1) sf ivrt. 1 Gr 4,I 1 \!1');Ii , \AL'Eri\ Vi\i,„ V 'IA, r T DUE AND PAYABLE IN 20 DAYS. 1 UZ%PER MONTH (1B%A.P.R.) SWAM CHARGE MAY BE APPLIED ON ALL SUB TOTAL 38.42 4.27 SALES TAX PAST DUE BALANCBS. IF PAYMENT IB NOT MADE ON THE DUB DATE, RUM AGREE! BY IR O TH 8 E INVOICE OR TAKING DEUVERY OP THE MERCHANDISE DESCRIBED ABOVE TO PAY SERVICE CHARGES. SHIPPING DATE DUE 4/25/13 R ATTORNEYS•MEEBANOALLOTHMACOSTSINCURREDBYWANEWTHEOOILSOTIONORENFORCEMENTOF M THE AMOUNT DUE. CUSTOM ORDERS CANNOT BE ACCEPTED FOR RETURN WITHOUT AUTHORIZATION. wumNOtgTRcEE 16.6cS TOTAL INVOICE �57' 69 $ RETURNS MUST BE RETURNED IN ORIGINAL CONTAINER AND IN RESALABLE CONDITION. AU. ORDERS MAY BE SUBJECT TO A RESTOCKING CHARGE, PLUS ANY FREIGHT CHARGES INCURRED. AMOUNT TENDERED / 57.69 CUSTOMER NUMBER 16960 INVOICE DATE 04/24/13 DETACH HERE INVOICE NUMBER 73899705 BIRTH CHOICE OF TEMECULA JENNIFER CARTELL 27488 ENTERPRISE CIR W STE 4 EXECUTIVE DIRECTOR TEMECULA, CA 92590-4827 TOTAL DUE BY 4/25/13 .00 TOTAL DUE AFTER 5/24/13 .00 REMIT TO ADDRESS BELOW WAXIE SANITARY SUPPLY P.O. Box 81006 San Diego, CA 92138-1006 (858) 292-8111 ,itizens ,ltral Bank Operations - DACO2 O. Box 27131 Raleigh, NC 27611-7131 13379 BIRTH CHOICE OF TEMECULA INC 27488 ENTERPRISE CIR W STE 4 TEMECULA CA 92590-4827 gent Period: January 1 , 2013 Thru January 31, 2013 cry/5� C�a� WITH CHOICE OF TINEtUt ti NC - rum ten,nnnt CA 04 %14tl.atq 3814 1f11Q013 arrr Tonr Hrdag. HOes-1■ rm. I $ a10.38 WIOVIOI Four Knead TMfety old 36rt0u .40 w �� 30ifOS�t/ ✓Kerr) SrsdaeEie. AC 85937 U> 9ItiLf s.o7 Fc_. 3• GS ♦003811.P Ki220377601:DOI0640it.203r 00u.11e7 1 Chk* 3814 $420.38 o01fe."71 tVT 001. nT/Ta/'oil 2101)T oak tee WITH 0rr1CLOF TR l , re. To./al P irlufee£ fSt wW Oa RRCIeAd were 911,01.41,01. 3810 ' 111172013 Ner To TIC crank WrEcon -306.E6 Threw Hundred fir wed ■ M V riot Caldna P.O. f!a 220341 Damao, Tx 753P2-0011 cdP0123771131007w103 i 000311 iIr` F;122037760e:0010E1.0 It. 20ie w*,-,v 63 Chk# 3816 $306.86 t171[171 CMOIC■ oC TDUCtRA. ■IG DV nfrp.eY6C We II N Tix'0A .0X01' ara6feW aloerd Goad Ideas Put:listens. 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Pendants. be. $ -Mini ens Fixated ReyFlr. and■000 1 oaua: MY] Cteenle-3Ortre Products 410 Waal Fib Avernus eacerditl, CA 11 025 0leerrberEtt2 POO la iqP a 177f13Tvernenn tneen it-ina. .40 114:,1 I,1r L• �1� �. r% rll1 1 ei ttb ik if'1,tpL/ riePi i)rr" ;.4 Li �,'c* &'`�- 7• Ii st Citizens iank Central Bank Operations - DACO2 P.O. Box 27131 Raleigh, NC 27611-7131 12858 BIRTH CHOICE OF TEMECULA INC STE 4 TEMECULA CA 92590-4827 ,cement Period: May 1 , 2013 Thru May 31, 2013 39os gime OgICl Of TIMIEDIRA, ass Denrrimie co w wawa mp closes C122o37760Cq{7106401 203 OnFON 9.1-83tt__4n Mx •70 G9253)3 P0031113 CL2203?7601:00t0640142030 $200.00 • Account Number : 001064014203 ains Mama ha. �!r F GO• EOM WOGS,12 to03408es C12203,7600001064014203r Chk* 3908 $103. 67' rrivis MarchOfDimes - Order confirmation THANKS FOR ORDERING! PRODUCT 1 Embryonic and Fetal Evaluation +,x During Pregnancy (2002) 114 Abuse During Pregnancy Eating Healthy (Bilingual) From Hurt to Healing Just for Dads: Helping Out During Pregnancy https://www.marchn`4imes.com/catalog/confirm.aspx?order gid=2Oa... ( T e'r/-- (j,( OP) ITEM # 33-1520-01 33-2118-06 09-2482-10 09-2224-08 QTY PRICE TOTAL 1 $30.00 /1 each $30.00 1 $30.00 /each $30.00 1 $10.00 /pkg 25 $10.00 1 $25.00 /pkg 25 $25.00 PD-09-2514-10 1 $4.00 /50 $4.00 viv4i • Subtotal: Tax: UPS Commercial Ground: An order confirmation # will be sent to esthernme@hotmail.com with the details of this transaction. Your credit card will be charged when your items have shipped. $ 99.00 $8.63 $16.1.5 T0T*L: $123.78 I3'2012 4:44 PM City of Temecula 2013-14 CS Funding Program APPLICATION NO. 8 CITY OF TEMECULA FISCAL YEAR 2013-14 COMMUNITY SERVICE FUNDING PROGRAM APPLICATION BOYS & GIRLS CLUBS OF SOUTHWEST COUNTY 2013-14 Program Submission Deadline: Friday, August 30, 2013 (original, plus one copy) PROJECT INFORMATION Amount Requested: $ 5,000 (matching funds) (Maximum allowable $5,000) Project Name: AM/PM TRANSPORTATION and ENRICHMENT PROGRAM for LOW INCOME YOUTH Project Start Date: January 7, 2014 Project End Date: June 1, 2014 ORGANIZATION INFORMATION Name of Organization: Boys & Girls Clubs of Southwest County Contact Name: John Whann Title/Position: Director of Operations Mailing Address: P.O. Box 892349, Temecula, CA 92589-2349 Telephone: 951-699-1526 xt 105 Year Organization Founded: 1991 Number of Paid Staff: 15FTE, 5OPTE Number of Volunteers: 250 Geographic Area(s) Served: Temecula, Murrietar Wildomar, Lake Elsinore, Canyon Lake, Corona, French Valley, and Menifee Is this organization incorporated in Califomia as a non-profit organization? If "no": Yes X No Effective Date: 1991 (amended 1996) If "yes" (Must provide a copy of your statement of non- profit status from the State of California): Date of incorporation as a non-profit: 1991 (amended 1996) Federal identification number: State identification number: 913- t75756 5 , Name of sponsoring organization: Federal identification number: State identification number: This application has been authorized by the organization's: Executive Committee Board of Directors X Members -at -Large FY 2012-13 COMPLIANCE REQUIREMENT — ATTACHMENT A IF YOUR ORGANIZATION WAS A RECIPIENT OF FUNDING FOR FY 2012-13, PLEASE ATTACH COPIES OF INVOICES, RECEIPTS AND CANCELLED CHECKS TO SUBSTANTIATE THOSE FUNDS RECEIVED AND EXPENDED BY YOUR ORGANIZATION. FINANCIAL STATEMENTS — ATTACHMENT B PLEASE ATTACH COPIES OF THE CURRENT BUDGET OF THE ORGANIZATION AND FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT). It does not require a CPA's audit, but please submit if available. GRANT CRITERIA - ATTACHMENT C PROJECT DESCRIPTION — ATTACHMENT D How will your organization use the funding awarded? Describe the project, project objectives, those served, area serviced, and number of involved. Be specific. Include equipment or services that would be purchased and why. volunteers Include a detailed budget and a schedule of significant activities related to this project. You may attach a maximum of one double-spaced typewritten page of information. (Please type or print legibly.) 05/22/2012 10:16 7602949184 RM-MECH RICK MUIR MECHANICAL 1248 North Ave Escondido, Ca. 92026 760-294-9183 760-294-9184Fax LICENSE 0609656 BID PROPOSAL DATE: May 22, 2012 JOB NAME: Boys and Girls Club LOCATION: Temecula, Ca. ESTIMATOR: Rick Muir SCOPE: Replace existing R22 5 ton Split System Heat Pump With new 5 ton York R410a Split System Heat Pump TOTAL PRICE: S6,175.00 (Tax Included) INCLUSIONS: 1. Removal & disposal of existing units 2. New York 5 ton Fan Coil P 3. New York 5 ton Condenser Heat Pumand thermostat 4. Re -connect electrical, condensate 5. Secondary pan 6. Start-up and 1 year warranty EXCLUSIONS: 1. permits and fees Date: Accepted By: V Note 1% interest per mo th on overdue Terms: 100% upon completi net 15 days ( N balance) 2/002 Jan 13 Boys & Girls Clubs of Southwest County Profit & Loss Budget January through December 2013 Feb 13 Mar 13 Apr 13 May 13 Jun 13 Jul 13 Aug 13 Sep 13 TOTAL Oct 13 Nov 13 Dec 13 Jan - Dec 13 Income Contributions Income Community Contributions One Campaign 0 00 0 00 1,800 00 1,800 00 1,800 00 1.800.00 1.800 00 1,800 00 1,800.00 1,800 00 1,800 00 1,800.00 18,000 00 Board Duos 0.00 800 00 600.00 300.00 0 00 0 00 9.00 0.00 0 00 0 00 0 00 0 00 1,700.00 Community Contributions • Other 16.350 00 5,000.00 5.000.00 10.000.00 11,000.00 12,000.00 14.000.00 14.000,00 14,000.00 14.000.00 14,000.00 16.000.00 145.350 00 Total Community Contributions 16,350 00 5 800 00 7,400 00 12,100.00 12,800 00 13.800 00 15.800 00 15,800.00 15,800 00 15.800 00 15,800.00 17.800.00 165.050 00 Fundraising Auction OKR 0.00 0 00 0-00 0 00 0.00 0 00 0.00 2,000.00 30,000 00 145,000 00 30,000 00 7.000 00 214,000 00 CTL 0 00 500.00 500 00 0.00 1,000 00 0.00 0.00 0 00 0.00 0 00 2,900 00 15,000 00 19,900.00 Field of Dreams 0 00 0 00 0 00 1,000 00 13,000.00 15,500.00 1,000 00 0.00 0 00 0,00 0.00 0 00 30,500 00 Golf Tournament 0.00 8,000 00 13,000 00 17,200.00 3,000.00 3,000 00 0.00 0 00 0 00 0.00 0.00 0.00 44,200 06 Idols Rocks 000 0.00 0.00 0 00 0.00 0_00 0.00 0.00 0.00 6.600.00 0.00 0.00 6,600.00 Total Fundraising 0 00 8,500.00 13,500.00 18,200 00 17,000 00 18,500 00 1,000.00 2,000.00 30,000 30 151,600 00 32,900.00 22,030 CC 315.200 00 Grants Bank of America 0.00 0.00 0.00 0.00 0 00 0.00 0.00 0.00 0.00 0 00 0 00 10,000.00 10,000 00 Bob Buster 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0 00 0.00 0.00 CDBG 0.00 0.00 9.400,00 7,075.00 6,509 00 6,508 00 6,508 00 0.00 0.00 0 OD 0.00 0.00 36,000 00 CSF Funds 0.00 0.00 5,000 00 0.00 0 00 0.00 0.00 0 00 0 00 0 00 0.00 0.00 5,000.00 OJP 0.00 0.00 0,00 7,000.00 7,000.00 7,000,00 7,000,00 7,000 00 7,000,00 7.000 00 0.00 0.00 49,000.00 Other Grants Best Buy 0.00 0.00 0.00 0 00 0.00 0 00 0 00 0.00 5.000 CO 0 00 0 00 0 00 5,000.00 BGCA Mission Youth Outreach 0.00 3,650.00 1,085.00 1,08500 1.085.00 1,065,00 1,085.00 1,085.00 1,085.00 1,085.00 1,08500 1,055.00 14,500:00 BGCA - Other 0.00 0.00 0.00 0 00 0.00 750,00 0.00 0 00 1,250.00 0 00 0.00 0.00 2,000.00 TotaIBGCA 0.00 3,650.00 1,085.00 1,08500 1,08503 1,83500 1,085.00 1,085.00 2,335.00 1,085.00 1,085.00 1.085-00 16.500.00 Macy's 0.00 0.00 0.00 10,570 00 C 00 0 00 0 00 0 CO 0.00 0 00 0 00 0 00 1C,570.00 Planet Youth 1,185.00 1,617.00 1,617 00 1 617 00 1,617.00 1,617 00 1,617.00 0.00 0.00 0.00 0 00 0.00 10.887 00 Professional Hospital Supply 20,000.00 0.00 0.00 0.00 0 00 0 00 0 00 0 00 0.00 0 00 0.00 0 G0 20.000.00 Other Grants - Other 1,000.00 1,000.00 1,00000 1,000.00 1,000.00 15,000.00 1,000.00 1.030.00 1.000.00 1,00000 15.000.00 1.000,00 40,000.00 Total Other Grants 22,185.00 6,267 00 3,702 00 14,272 00 3,702.00 18,452.00 3.702,00 2,085 00 8,335.00 2,085 00 16,085.00 2,085.00 102,957.00 RCTC 16,038.00 16,650.00 16,650.00 16,650.00 18,100.00 18,500.00 14,500.00 26,390 00 26,390.00 26,390,00 26,390.00 26,390.00 249,038.00 United Way 2,654.00 2,654.00 2,654.00 2.654,00 2.654,00 2,654.00 2.654.00 2.654.00 2,654.00 2,65400 2,65400 2,65400 31,848.00 US Bank 0.00 0.00 0.00 0.00 0 00 0 00 0 00 0 00 0 00 4.900 00 0.00 0 00 4,900.00 Total Grants 40,877 00 25,571.00 37,406.00 47,65100 37,965 00 53,114, 00 34,364 00 38,129 00 44,379 CO 43,029 00 45,129.00 41.129 00 488.743 00 Membership Dues Membership Dues - Great Oak 2,966.00 2,527 00 2,165 00 562 00 986.00 3,428.00 1,247 00 1.710 00 682.00 772.00 455.00 350 00 17,850.00 Membership Dues • Lake Elsinore 2,300.00 1,785.00 1,245 00 433.00 950 00 1,575.00 675 00 800 00 300 00 525 00 300.00 425 00 11,313.00 Membership Dues - Murrleta 2.960-00 835.00 685 00 1,170 00 1,615 00 2.625 00 1,175.00 1,012.00 350 00 300.00 758 00 275.00 13,760 00 Membership Dues - Sports 1,950.00 1,410 00 5.494 00 1,975 00 1.605 00 2.695.00 5.00 1.245 00 4.375 00 950 00 425 00 2,676.00 24.804 CO Total Membership Dues 10,176.00 6,55700 9.58900 4,14000 5,15600 10,32300 3,10200 4,76700 5,70700 2.54700 1.93600 3.72500 67,72700 Miscellaneous Income 500 00 500 00 500 00 500 00 500 00 500 00 500 00 500 00 500 00 500 00 500 00 6,000 00 Program Fees 500 00 AM/PM Great Oak AM/PM 24.777 00 30,023 00 24,920 00 22 283 00 21,825 00 7,068 00 2.366 00 25 429 00 25,084 00 25.110 00 22.735 00 19,470 00 251.092 00 Lake Elsinore AM/PM 9.189 00 11.803 00 10.923 00 11.054 00 10.764 00 2,793 00 736 00 10.557.00 9.664 00 8.951 00 10.208 00 8,410 00 105,052 00 Murrleta AM/PM 16.000 00 16.174 00 18.379 00 11.485 00 14.848 00 698.00 319 00 11,429 00 14.272 00 17.347 00 15.678 00 10.623.00 147,252 00 Total AM/PM 49,966 00 58,000.00 54.222 00 44.822 00 47,437 00 10.559 00 3.423 00 47 415 00 49.020 00 51,408.00 46,621 00 38,503 00 503,396 03 Boys & Girls Clubs of Southwest County Profit & Loss Budget January through December 2013 TOTAL Jan 13 Feb 13 Mar 13 Apr 13 May 13 Jun 13 Jul 13 Aug 13 Sep 13 Oct 13 Nov 13 Dec 13 Jan - Dec 13 Camp Great Oak Camp 4,639 00 1.506 00 8.519 00 5.635 00 4,748 00 42.820 00 42,754 00 14,193 00 1.778 00 0 00 2.163 00 1.061 00 129,814.00 Lake Elsinore Camp 1,275 00 575 00 1.584 00 127 00 2,928.00 14.598 00 12.977 00 4,069.00 0 00 0 00 1.837 00 1 859.00 41,829 00 Murrieta Camp 1.217 00 462 00 2,048 00 4,600 30 3,231 0.0 24.582 CC 19.195 00 10.215.00 0 00 121 00 2.010.00 2 123 00 69,804 00 Total Camp 7,131-00 2,543 00 12,151 00 10,362.00 10,907 00 82,000 00 74,926.00 28,477 00 1,776 00 121.00 6,010 00 5.043 00 241,447 00 League Fees Basketball 1,056.00 65 00 6,217 00 872 00 1,942.00 5,972 00 501.00 4,102.00 2,717 00 0 00 374 00 760.00 24,578 00 Flag Football 2,756.00 825 00 4,193 00 1,468.00 0 00 0 00 0 00 605.00 7,077 00 1.632 00 162.00 2,120 00 20,838 00 Jr. Golf 300.00 0.00 628.00 3.556 00 850.00 300.00 130.00 280 00 855.00 1.050 00 0 00 0 00 7,949 00 Soccer 1,806 00 500.00 9,571.00 1,968.00 1,849 00 2,687.00 0 00 2.582 00 7,432.00 565 00 226 00 2,520.00 31,706 00 Sports Camp 60.00 0.00 105 00 0.00 40 00 0 00 0 00 0 00 0 00 0.00 0 00 230 00 435 00 T-Ball 486 00 150.00 1.893 00 590 00 428.00 1,832.00 266 00 155 00 1,155.00 125 00 88.00 170.00 7,338.00 Volleyball 1,026.00 65.00 577.00 1,625.00 805.00 375.00 65.00 0.00 2,052.00 752 00 0.00 840.00 8.382.0t Total League Fees 7.490.00 1,605.00 23,184 00 10,279.00 5,914.00 11,166.00 962.00 7,724.00 21,288 00 4,124.00 850.00 6,640.00 101,226.00 Sessions Archery - GO 538.00 0.00 0 00 583.00 706.00 1,376 00 634 D0 524.00 796 00 312.00 756.00 0.00 6,225.00 Archery - LE 656.00 403.00 794.00 414.00 127.00 437.00 276.00 311.00 311 00 598 00 0.00 0.00 4,327-00 Archery - MURR 0.00 0-00 0.00 0.00 793.00 460.00 552.00 0 00 0.00 0 00 0 00 C 00 1,805.00 Camp Shirt - LE 0.00 0.00 24.00 0.00 0 00 66.00 78.00 18 00 0.00 0 00 0.00 0 00 186.00 Camp Shirt - MURR D.00 0 00 0 00 6 00 0.00 36,00 18 00 0 00 0 00 0 00 0 00 0 00 60.00 Field Trip -GO 26200 113.00 2,27200 700.00 1,815.00 7,76100 5,401.00 664.00 1.29000 000 840.00 50000 21,638.00 Field Trip - LE 69.00 0.00 948.00 12.00 613 OD 3,248.0.0 3,189.00 833.00 1.00 0.00 398.00 454.00 9,765 00 Field Trip - MURR 0.00 13.00 527 00 1,069.00 944.00 5,536.00 4,632.00 1,358.00 0 00 51 00 2,064 00 684.00 16.878 00 Fundamental Ballet - GO 155.00 0 00 0 00 125.00 34.00 0.00 0.00 0.00 0.00 0.00 0.00 0 00 314.00 Fundamental Ballet - MURR 207 00 0 00 0 00 0 00 0.00 0 00 0.00 0.00 23 00 80 00 0.00 0.00 310 00 Guitar Lessons - GO 282.00 0 00 242 00 135 00 0.00 471,00 0 00 181.00 96 00 90.00 0 00 0.00 1,497,00 Guitar Lessons - LE 138 00 299.00 219 00 276.00 46.00 161.00 0 00 92 00 0 00 0 00 0.00 93.00 1,324.00 Guitar Lessons - MURR 207.00 46 00 0.00 103.00 23.00 161.00 46.00 103 00 0 00 179 00 0.00 0 00 868.00 Jazz & Lyrical Dance • LE 0.00 0 00 0.00 0.00 0 00 0.00 0.00 23.00 0 00 0 00 0 00 0.00 23.00 Just Dance Class - GO 410.00 0 00 265 00 0.00 106 00 704.00 0 00 90 00 318 00 0 00 93.00 0.00 1,986.00 Just Dance Class - LE 573.00 112 00 23.00 0.00 0 00 185.00 0 00 40 00 46 00 23 00 89 00 0.00 1,091.00 Just Dance Class - MURR 224 00 242.00 173 00 235.00 253.00 570.00 0.00 80 00 103 00 69 00 113.00 0 00 2,062.00 Karate Lessons - GO 501 00 0.00 69 00 125.00 433.00 461 00 0 00 97.00 0 00 138 00 75 00 0 00 1,899 00 Karate Lessons - LE 414 00 391 00 173.00 276 00 0.00 161.00 61 00 184.00 52 00 52.00 328.00 0 00 2,092 00 Special Events - GO 0.00 0 00 0.00 35 00 24 00 0 00 0 00 76 00 566 00 0 00 53.00 0.00 754.00 Special Events - LE 0.00 0 00 0.00 0 00 0.00 0.00 0 00 7 00 0.00 545.00 0 00 0.00 552 00 Special Events - MURR 0 00 0 00 0.00 126.00 0.00 0 00 0 00 465 00 0 00 120 00 0.00 0 00 711.00 Total Sessions 4.636.00 1,619 00 5,729.00 4.220 00 5.917.00 21,794 03 14,887 00 5,166.00 3,302 00 2,257 00 4.809.00 1.731.00 76.367 00 Sports Sponsorships 1.253 00 0 00 667 00 5.000 00 0 00 625 00 238-00 0.00 0.00 625 00 200.00 1,910 CO 10.518 00 Total Program Fees 70.476 00 63.767 CO 95.953 00 74,683 CO 70.175 00 126.144 00 94.436 00 88,782.30 75.685 00 58,535.00 60.490 00 53.827 00 932 954 00 Rental Income 200 00 0 GO 0 00 2.000 00 2000 00 2 000 00 2.000 00 2,000 CO 2.000 00 2.000 00 2,000 00 2.000 CO 18.200 00 Gross Profit 138.579 00 110.695 00 164.348 00 159.274.00 145.596 00 224,381 00 151.202 00 151.978 CO 174.072 00 274,011 00 158 757 00 140.961 00 1,993.874.00 Expense 401K Administration 150 00 150 00 150 00 150 00 150 00 150 00 150 00 150 00 150 00 150 00 150 00 150 00 1,800 00 401K Employee Match 500 00 500 00 500 00 500 00 500 00 500 00 • 500 00 500 00 500.00 500 00 500 00 500 00 6.000 00 Automobile Expense Gas 5.356 00 6.167 00 8.607 00 6.389 00 7,122 00 2 479 OC 1,956 00 4,563.00 7,423 00 7.668 00 6.431 00 4,600 00 68.763 00 Registration 338 00 135 00 0 00 559 00 0 00 277 00 0 00 241 00 0 00 460 00 99 00 100 00 2,209 00 Repair & Maintenance 4.470 00 7.079 00 4.331 00 6 038 00 7.065 00 3.142 00 2.730 00 11.072 00 7 582 00 5,904 00 3 776 00 2.632 00 65.821 CO Boys & Girls Clubs of Southwest County Profit & Loss Budget January through December 2013 TOTAL Jan 13 Feb 13 Mar 13 Apr 13 May 13 Jun 13 Jul 13 Aug 13 Sep 13 Oct 13 Nov 13 Dec 13 Jan - Dec 13 Transportation 25 00 25.00 25 00 25 00 25 30 25 00 25 00 25 00 25 00 25 00 25 00 25 00 300 00 Total Automobile Expense 10.18900 13,40600 12,96300 13.011 00 14.21200 5.92300 4.71300 15.90120 '.503000 14ii5700 -0.33100 1.35i,,0 2r.o93C- Awards 8 Recognition Employee Recognition 100 00 100 00 100 00 100 00 100 00 100 00 100 00 100 00 100 00 100 00 100 00 100 00 1 200 00 Meetings 200 00 200.00 200 00 200.00 200 00 200 00 200 00 200 00 200 00 200 00 200.00 200 00 2.400 00 Total Awards & Recognition 300 03 30C 00 300,00 300 00 300 00 300 00 300 00 300 00 300.00 300 00 300 00 300.00 3.600.00 Background Check 300 00 300 00 300 00 300 00 300 00 300 00 300 00 300 00 300 00 300 00 300 00 300 00 3.600 OC Bank Service Charges 25 00 25 00 25 00 25.00 25 Do 25 00 25 00 25 00 25 00 25 00 25 00 25 00 300 00 Community Contributions 100 00 100.00 100 00 100.00 100.00 100.00 100 00 100 00 100.00 100 00 100 00 100 00 1.200 00 Credit Card Fees 750 00 750.00 750.00 750 00 750.00 900 00 1.000 00 1.000 00 750 00 4.800 00 1.000 00 750 00 13.950 00 Depreciation Expense 9.850 00 9,850 00 9.850 00 9,850,00 9,850 00 9,850 00 9,850 00 9,850.00 9,850,00 9,850 00 9.850.00 9.850 00 118,200 00 Drug Testing 150.00 150.00 150 00 150 00 150 00 150.00 150 00 150.00 150.00 150.00 150.00 150.00 1,800,0r Dues and Subscriptions 1,700 00 500.00 500 00 500 00 500.00 500 00 500 00 9200 00 500.00 500.00 500 00 4,000 00 19.400 0.. Equipment Rental 1,700.00 1.700 00 1,700.00 1,700.00 1,700 00 1,700.00 1,700 00 1,700 00 1,700.00 1,700 00 1.700 00 1,700.00 20.400 00 Fund Raising Expenses Auction 0.00 100 00 50.00 75.00 20,000.00 300 00 150 00 800.00 6,000 00 50.000 00 4,000 00 0 00 81,475.00 CTL 300 00 500 00 400.00 100.00 500 00 0 00 0 00 0.00 0.00 0,00 1,000 00 8,700.00 11,500 00 Field of Dreams 40 00 250 00 40.00 2,000 00 260 00 2,200.00 5.100.00 0 00 0 00 0 00 0 00 0 00 9,890,00 Golf 20 00 50.00 330 00 3,300 00 3,600.00 0 00 0 00 0.00 0.00 0 00 0 00 0.00 7,300.00 Idols event 0 00 0.00 0.00 0,00 370,00 0.00 0 00 20,00 20.00 0.00 0.00 0,00 410.00 Total Fund Raising Expenses 360 00 900 00 820 00 5.475 00 24,730.00 2,500 00 5,250 00 820 00 6,020 00 50,000.00 5,000 00 8,700 00 110,575.00 Insurance Auto Insurance 1,991 25 1.991.25 1,991 25 1,991.25 1,991 25 1,991 25 1,991 25 1.991 25 1,991.25 1,991 25 1,991.25 1,991 25 23,895.00 Director's Liability 283.33 283 33 283.33 283.33 283.33 283.33 283.33 283 33 283 33 283 33 283.33 283 33 3,399.96 Dishonesty Bond 0.00 199.00 0 00 0,00 0.00 0.00 0 00 0.00 0 00 0 00 0 OD 0 00 199 00 Health Insurance 2,583.33 2,583.33 2,58333 2,56333 2,583.33 2,583.33 2,58333 2,583.33 2,583.33 2.583,33 2,583.33 2,583,33 30,99996 Liability Insurance 1,320 00 1,320.00 1,320.00 1.320.00 1,320.00 1.320.00 1,320 00 1,320 00 1,320.00 1,320.00 1,320 00 1,320.00 15,840,00 Life 8 Dental 1,01600 1,016.00 1,01600 1,01600 1,01600 1,016.00 1,01600 1,016.00 1,016-00 1,016.00 1,01600 1,016.00 12.192.00 Property Insurance 672.00 672,00 672 00 672.00 672.00 67200 672 00 672 00 672.00 67200 672 00 672.00 8.064,00 Unemployment 0 00 0.00 0.00 0 00 0 00 0 00 0.00 0.00 0,00 0.00 0.00 0 00 0.00 Workers Comp 4,288 00 4,288.00 4,288.00 4,288.00 4,288 00 4,288.00 4,288.00 4.288.00 4,288 00 4,288.00 4,288 00 4,288 00 51,456,00 Total insurance 12,153.91 12,352 91 12.153.91 12.153 91 12,153 91 12,153.91 12,153.91 12,153.51 12,153.91 12.153.91 12,153 91 12,153 91 146,045 92 InterestLOC 1,27500 1,275.00 1,27500 1,27500 000 0,00 000 000 000 000 000 0.00 5,100.00 Internet Service 285 00 285 00 265.00 285 00 285 00 285 00 285 00 285 00 285 00 285 00 285 00 285 00 3,420 00 Licenses and Permits 283 00 0 00 0.00 0.00 0.00 0.00 0.00 0 00 116.00 130.00 620 00 0 00 1,149.00 Office Supplies 1.865,00 2,06900 1,63100 2,130.00 3,755.00 57900 1.32700 1.975.00 1,12700 99700 1,38800 1,01600 19.85900 Payroll Expenses Merit increase 0.00 0 00 0 00 0 00 0 00 809.00 809 00 809.00 809 00 809 00 809 00 809.00 5,663 00 Payroll Administration 31,800 00 29.000 00 33,250.00 33.250 00 33,250.00 33,250,00 36,750 00 36.750 00 37,750 00 38.750 00 36.750 00 36 750 00 417,300 00 Payroll Great Oak 13,425 00 18,300 00 18,296.00 18,296 00 19,956 00 19.123 00 18.275 00 18,945 00 18,296 00 19.708 00 18.296 00 16.078 00 216,994 00 Payroll Lake Elsinore 9,400 00 13.675,00 12,127 00 12,471 00 12,855 00 9.685.00 7,373 00 10,252.00 11,562 00 12,798 00 11.862 00 12.656 00 138,716 00 Payroll Murrieta 11,525 00 16,415 00 13.683 00 12,778 00 14,489 00 13.507 00 11,916 00 10,992.00 14,292.00 15,233 00 13,452 00 14.969 00 163,251 00 Payroll Sports 2,325,00 4,067.00 4,605.00 4,665 00 6,687 00 5.915 00 5.320.00 4,815 00 3.338 00 5.513 00 6,690 00 8,081 00 60,001 00 Total Payroll Expenses 68,475 00 81.457.00 81.961 00 81,460 00 87,237.00 82,289 00 80,443 00 82,563 00 86 047 00 92.811 CO 87.859 00 87.323 00 999,925 00 Payroll Taxes Merit increase 0 00 0 00 0 00 0 DO 0 00 50 00 50 00 50 00 50 00 50 00 50 00 50 00 350 00 Payroll Taxes Admin 3.475 00 2.780 00 3.375 00 3.375 00 3,375.00 3 375 00 3225 00 3.225 00 3.225 00 3.225 00 3 225 00 3, 225 00 39 105 00 Payroll Taxes Great Oak 1.483 00 2.060 00 2.060 00 2.060 00 2,090 00 2.090 00 2.050 00 2.050 00 2.050 00 2.075 00 2.050 00 1.950 00 24.068 00 Payroll Taxes Lake Elsinore 1.005 00 1.490 00 1 375 00 1375 00 1,375 00 875 00 925 00 925 00 940 00 1.275 00 92500 875 00 13 360 00 Boys & Girls Clubs of Southwest County Profit & Loss Budget January through December 2013 Payroll Taxes Murrieta Payroll Taxes Sports 2tC. CO 1.O4O CC 550 CO 1 350 00 1 550 30 1 550 00 1.270 00 1„270 00 1.550 CO 1 550 00 1.475 00 1.550 00 17,875 00 Total Payroll Taxes 260 00 550 C; 515 00 515 00 575 00 515 00 515 00 510,00 325 00 515 00 515.00 515 00 5.825.00 7.493 00 8 720 00 8.875 00 8 675 00 9.065 00 8.455 00 8.035 00 5.030 00 8 140 00 8.690 00 8.240 00 8.165 00 100.583 00 Postage and Delivery 20 00 20 00 20 00 500 00 20 00 20 00 20 00 500 00 100 00 20 00 20 00 500 00 1,760.00 Printing and Reproduction Professional Fees 1,10000 1,100 00 1,100 00 1,100 00 1,100 00 1,100.00 1.10000 1.100,00 1.10000 1,100 00 1.10000 1,100 00 13,200 00 AccountingAud 600 00 600.00 600 00 600 00 600 00 600 00 600 00 600 00 600 00 600 00 600 00 600 00 7.200 00 Consulting 0 00 0 00 0 00 0 00 0 00 5,000 00 0.00 2,000.00 0 00 0 00 Consulting 57 00 57.00 57.00 57.00 57 00 57.00 57 00 57.00 57 00 7 00 0 00 7,680 00 Total Professional Fees 57.00 57 00 57.00 684.00 657 00 657 00 857 00 657 00 657 00 5,657 00 657 00 2.657 00 657 00 657 00 657 00 657 00 14.884 00 Program Supply Expenses GO Archery 243.00 0 00 477 00 0.00 288 00 549 00 378 00 216 00 90 00 252.00 280 00 180 00 2,953 00 GO Camp Shirts GO Dance Class 0.00 0 00 0 00 0.00 20 D0 0 00 743 00 0 00 0 00 0.00 117 00 0.00 880 00 GO Field Trip 50 00 260 00 144.00 50 00 28 00 368 00 85 00 0 00 0.00 40.00 0 00 60.00 1,085.00 GO Fundamental Ballet 463 00 17700 750 00 750 00 336.00 1,750 00 3.434 00 750.00 0 00 225 00 650.00 400 00 9,685.00 GO Guitar 15 00 0 00 35 00 0 00 28.00 0.00 0.00 0 00 0 00 80 00 0 00 0 00 158.00 GO Karate 144.00 50.00 75.00 0 00 45 00 0.00 211.00 0.00 0 00 45 00 25 00 100.00 695 00 GO Special Events 165.00 40.00 75.00 0 00 104.00 0 00 316 00 0.00 0 00 100 00 0 00 0.00 800 00 0.00 50.00 0.00 0 00 0.00 50.00 50.00 100.00 0 00 0 00 0 00 0.00 250.00 GO Supplies LE Supplies 476.00 241 00 363.00 317 00 423 00 494.00 366 00 900.00 700 00 300 00 392 00 192.00 5,164 00 302.00 1900 193.00 47.00 181.00 LE Archery 36 00 734 00 931.00 166 00 604 00 242 00 252 00 3,707 00 LE Camp Shirts 288.00 0 00 576 00 0 00 180 00 162.00 234 00 162.00 0 00 378.00 0.00 0 00 1,980.00 LE Cheer 180.00 0.00 0 00 0.00 0.00 0 00 743.00 0.00 0.00 0 00 0 00 0 00 923.00 LE Dance Class 105 00 0 00 0 00 0 00 10.0D 0 00 0.00 0.00 0 00 0 00 0 00 0.00 115.00 220 00 0 00 0.00 114.00 105 00 168 00 0 00 0 00 0 00 98 00 0 00 0 00 705 00 LE Field Trips 67 00 0.00 706.00 0 00 321 00 1,839 00 2,255.00 425.00 202 00 15.00 506 00 64.00 6.400.00 LE Guitar LE Karate 66.00 1500 165 00 0 00 189 00 0.00 162.00 0.00 49 00 0.00 0.00 81.00 727.00 LE Keyboard 132.00 0 00 150.00 0 00 110:00 0 00 110.00 0 00 115.00 0 00 0.00 466.00 1,083.00 0 00 500.00 0 00 0 00 90.00 0 00 0.00 0 00 0.00 0 00 0.00 0 00 590 00 MURR Archery 0.00 0.00 0.00 0 00 0:00 306.00 306.00 0 00 0 00 0 00 0.00 0 00 612.00 MURR Camp Shirts MURR Dance Class 97 00 0 00 0 00 - •-' 0 00 0.00 173.00 743.00 0.00 0 00 0.00 0 00 0.00 1,013.00 100.00 0.00 98 00 72 00 147.00 408.00 105.00 0.00 0 00 180 00 0 00 70.00 1,180.00 MURR Field Trips 66.00 0 00 0.00 924.00 85.00 1,210 00 2,317 00 824 00 50 00 262 00 726 00 314-00 6.779.00 MURR Fundamental Ballet MURR Guitar 130 00 0 00 0.00 0.00 0.00 0 00 0 00 0 00 0.00 0 00 0 00 28 00 158 00 88 00 20 00 40 00 0 00 0 00 0.00 108.00 0.00 135 00 81 00 0 00 13500 607.00 MURR Supplies 89.00 15 00 349 00 418 00 372 00 510 00 299.00 185.00 126 00 216 00 73 00 32 00 2.68400 SPORTS League Expenses Basketball Football 30 00 136 00 439 00 846 00 795 00 363 00 21 00 384 00 9 00 511 00 619 00 30 00 4,183.00 Get Fit 15 00 127 00 435 00 17 DO 1.330 00 131.00 0 00 366.00 33 00 980 00 1,552.00 63 00 5.049 00 Jr. Golf 0 00 0 00 0 00 80 00 157 00 147 00 0 00 0 00 0 00 0 00 0 00 0 00 384 00 Soccer 297 00 390 00 1,102 00 648 00 119 00 1,220 00 390 00 636.00 720 00 850 00 22 00 156.00 6.550 00 T•Ball 2.324 00 36 00 446 00 105 00 2.685 00 115 00 61 00 408 00 46 00 622 00 2.090 00 84 00 9,022 00 f 80 0 Volleyball 14 00 00 19526 CC0 433 00 6 00 736 00 350 00 22 00 375 00 0 00 875 00 569 00 28 00 3,606_00 461 00 1,008 00 504 00 94 00 43 00 413 00 32 00 545 00 379 00 0 00 3.685 00 Total SPORTS League Expenses 2.860.00 913.00 3.316 00 2 710.00 6.326 00 2.420.00 537 00 2.582.00 840 00 4,383.00 5,231.00 36100 32.479 00 Total Program Supply Expenses 6.346.00 2.303 00 7.512 00 5 402 OO 9.389 00 Rent 10.443 00 14.236 00 7 075 OC 2 473 GO 7,259 00 8.242 00 2.735 00 83.412 00 TOTAL Jan 13 Feb 13 Mar 13 Apr 13 May 13 Jun 13 Jul 13 Aug 13 Sep 13 Oct 13 Nov 13 Dec 13 Jan- Dec 13 U Store it 497 00 497 00 497 00 497 00 Rent - Other 36100 36100 36100 36100 36100 497 00 497 00 497 00 497 00 497 00 497 00 497 CO 497 00 5,964 00 361 00 361 00 361 00 361 00 361 00 4.332 00 36100 33100 1,785 00 400 00 1,062.00 3.247.00 1,785 00 400.00 1.106.00 3,291.00 1,785 00 400 00 1,120.00 3.305.00 1,785 00 400.00 1,025 00 3,210 00 Boys & Girls Clubs of Southwest County Profit & Loss Budget January through December 2013 Jan 13 Feb 13 Mar 13 Apr 13 May 13 Jun 13 Jul 13TTAL Total Rent Aug 13 Sep 13 Oct 13 Nov13 Dec 13 Jan -Dec 13 Repairs and Maintenance 858 DO 858.00 858 00 858 00 858 00 858 00 858 00 858 00 858 00 858 D0 858 00 858 OG 10.296 00 Building Repairs 40000 40000 40000 40000 40000 40000 40000 40000 40000 40000 40000 40000 4,80000 Cleaning/Janitorial Services Cleaning/Janitorial Supplies 1.12000 1.12000 1,12000 1,12000 1,12000 1,12000 1 120 00 1 12000 1.12000 1.12000 1,120.00 1,12000 13.44000 74900 54800 965.00 70200 648.00 1 274 00 54900 93800 70900 67000 73500 73500 9.22200 Exterminator 180 00 180 00 180 00 180 00 180 00 180 00 180.00 180 00 180 00 180 00 180 00 180.00 2,160 00 Total Repairrss and Maintenance Landscape nt. 440.00 440 00 440 00 440 00 440 00 440 CO 440 00 440 00 440.00 440 00 440 00 440 00 5.280 00 Security nd 2.88900 2.688.00 3.10500 2,842.00 2.782,8 800 3.414G0 2.68900 3.07800 4900 2,81000 2,87500 2.87500 34.90200 105 00 105 00 Snack Program Expense 9400 13300 105.00 105 00 105 00 105,00 105 00 105 00 105 00 105 00 105.00 105.00 1,260 00 16300 8300 1 Staff Training 5600 000 000 36500 27400 27600 25000 25000 2.04400 Driver Trairing 60000 60000 600.00 600.00 60000 10000 10000 60000 600.00 60000 Property Taxes 600 00 600 00 6,200 00 800 00 Telephone 000 000 000 000 000 000 000 000 400.00 000 40000 1,60000 Cell Phones Long Distance Telephone Service Total Telephone Utilities Gas and Electric SeweriWater 2.899,00 2.866.00 2,759.00 2.92500 2,926.00 3.454,00 4.82600 6.524,00 5.250.00 3.41400 2.95000 2,675.00 43,468.00 1,116.00 964.00 Total Utilities 992.00 1,011.00 1,148.00 97800 1,03100 97200 97200 1,067.00 96500 965.00 12,181,00 Workl 4,015.00 3,830.00 3,751.00 3,936.00 4.074.00 4,432.00 5.85700 7,49600 6,22200 4,48100 3.91500 3,640.00 55,64900 1,067.00 1,311.00 1,169.00 874.00 1,589,00 Total Expense 976.00 1,079.00 1,24300 1,310.00 1,753.00 1,125.00 1,025.00 14.521,00 NET INCOME138;901.91 151,682.91 157,43391 158.95691 190.885.91 157,061.91 156,785.91 173,394.91 163,098.91 221,100.91 163,428.91 160,79991 1,993.530.92 -322.91 -40.987.91 6,914.09 317.09 -45.289.91 67,319.09 .5.583.91 -21.416.91 10.975.09 52,910.09-4.671.91-19,818. 1,785 00 400 00 1,602 00 3,787.00 1,785 00 400 00 1,112.00 3,297 00 1,785 00 400.00 1,118.00 3,303.00 1,785 00 400.00 1,130.00 3.315 00 1,785 00 400.00 1,120,00 3,305.00 1,785 00 400 00 1,09800 3,283,00 1,785 00 400 00 1.045 00 3.230 00 1,78500 400.00 1.045 00 3,230.00 21,420.00 4,800.00 13.563 00 39.803 00 Boys & Girls Clubs of Southwest County Profit & Loss January through December 2011 Jan - Dec 11 Ordinary Income/Expense Income Contributions Income 185,925.33 Fundraising 296,034.13 Grants 557,645.17 Membership Dues 60,162.70 Miscellaneous Income 15,839.59 Program Fees 932,080.73 Rental Income 48,750.00 Vending 88.72 Total Income 2,096,526.37 Gross Profit 2,096,528.37 Expense 401K Administration 1,325.88 401K Employee Match 5,213.63 Automobile Expense 136,643.57 Awards & Recognition 8,821.88 Background Check 1,994.75 Bank Service Charges 283.45 Community Contributions 1,726.54 Credit Card Fees 14,362.14 Depreciation Expense 149,975.00 Drug Testing 2,948.00 Dues and Subscriptions 20 555.60 Equipment Rental 7,882.11 Fund Raising Expenses 105,279.80 Insurance 189,589.88 Interest Expense 27,091.19 Internet Service 3,542.93 Licenses and Permits 1,285.18 Marketing 186.48 Miscellaneous 0.00 Office Supplies 31,872.47 Payroll Expenses 1,093,450.21 Payroll Taxes 83,154.00 Postage and Delivery 3,702.12 Printing and Reproduction 16,435.90 Professional Fees 20,092.09 Program Supply Expenses 122,559.46 Rent 51,884.62 Repairs and Maintenance 51,670.91 Security 3,081.11 Snack Program Expense 1,206.98 Staff Recruitment 254.95 Staff Training 13,212.28 Staff Uniforms 2,078.93 Taxes 1 428.94 Telephone 45,081.85 Utilities 61,558.99 Work Travel 19,324.76 Total Expense 2,300,756.38 Net Ordinary Income -204,230.01 Other Income/Expense Other Income Other Income 22 02 Realized GainsfLosses 4,075.00 Unrealized Gains/Losses -1,595.81 Total Other Income 2,501.21 Net Other Income Net Income 2,501.21 -201,128.110 Boys & Girls Clubs of Southwest County Balance Sheet As of December 31, 2011 ASSETS Current Assets Checking/Savings Bank of America 2123 (LE) First Citizens 4221 (MURR) Merrill Lynch 4105 (Stock) Pac Western OCTL 3894 Pac Western Operation Acct 3878 Pac Western Payroll Acct 3449 Pac Western Vtea1MC 3886 Total Checking/Savings Accounts Receivable Due From Capital Campaign Due From Philadelphia Insurance Grants Receivable Total Accounts Receivable Other Current Assets Prepaid Expense Total Other Current Assets Dec 31,11 2,580.19 3,273.11 0.83 1,947.88 39 004.30 1,094.74 11, 379.30 59,280.13 4,193.11 4,075.00 102,658.44 110,928.55 37,581.39 37,581.39 Total Current Assets 207,788.07 Fixed Assets Buildings 2, 826, 047.94 French Valley Land 1,230,000.00 Furniture, Fixtures, Equipment 175,200.88 Improvements 103,898.31 Office Equipment 213,313.15 PuJol Land 235,000.00 Vehicles 309,792.35 zAccumutated Depreciation -1,141,227.00 Total Fixed Assets 3,952,023.83 TOTAL ASSETS 4,159,811.70 LIABILITIES & EQUITY Liabilities Current Liabilities Accounts Payable Accounts Payable 305,950.41 Total Accounts Payable 305.950.41 Credit Cards Credit Cards 15,400.10 Total Credit Cards 15,400.10 Other Current Liabilities Current Portion of LTD Pacific Western LOC 7019 Payroll LlablUttes Sales Tax Payable 33,213.73 422,118.92 74,734.74 2,423.00 Total Other Current Liabilities 532,488.39 Total Current Liabilities 853,838.90 Long Term Liabilities Key Equipment Finance 23,472.50 Lease Payable - De Lage 54,363.80 Less Current Portion - Vehicle -33,213.73 Mission Oaks Bank 1500 - Murr 9,389.45 Mission Oaks Bank 8300 - Pupol 8,535.83 Total Long Term Liabilities 62,527.85 Total Liabilities 916,366.75 Equity Capital Campaign Transfer Acct Retained Earnings Net Income Total Equity TOTAL LIABILITIES & EQUITY 77, 781.82 3,367,391.93 -201,728.80 3,243,444.95 4,188,811.70 Boys & Girls Clubs of Southwest County Profit & Loss January through December 2012 Jan - Dec 12 Ordinary Income/Expense Income Contributions Income 154,038.71 Fundraising 286,693.77 Grants 557, 348.33 Membership Dues 70,401.50 Miscellaneous Income 14,316.73 Program Fees 929,573.64 Rental Income 19,578.00 Vending 58.50 Total Income 2,032,009.18 Gross Profit 2,032,009.18 Expense 401K Administration 1,610.89 401K Employee Match 6,423.38 Automobile Expense 134.046.55 Awards & Recognition 6,688.01 Background Check 3,848.49 Bank Service Charges 358.70 Community Contributions 5,359.08 Credit Card Fees 14,543.76 Depreciation Expense 129,856.00 Drug Testing 4,013.00 Dues and Subscriptions 18,898.92 Equipment Rental 4,408.68 Fund Raising Expenses 108,065.75 Insurance 135,913.44 Interest Expense 25,701.32 Internet Service 3,415.30 Licenses and Penults 1,178.95 Marketing 52.68 Office Supplies 25,484.37 Payroll Expenses 1,051,899.55 Payroll Taxes 82,179.08 Postage and Delivery 2,599.11 Printing and Reproduction 19,132.12 Professional Fees 17,224.05 Program Supply Expenses 93,301.94 Rent 52,302.12 Repairs and Maintenance 41,926.74 Security 4,904.09 Snack Program Expense 1,759.12 Staff Training 20,422.15 Staff Uniforms 1,990.63 Taxes 2,275.78 Telephone 43,343.29 Utilities 58,128.83 Work Travel 20,430.75 Total Expense 2,143,464.62 Net Ordinary Income-111,455.44 Other Income/Expense Other Income Other Income 71.88 Total Other Income 71.88 Other Expense Penalties 409.29 Total Other Expense 409.29 Net Other Income-337.43 Net Income 411,792.87 Boys & Girls Clubs of Southwest County Balance Sheet As of December 31, 2012 ASSETS Current Assets Checking/Savings Bank of America 2123 (LE) First Citizens 4221 (MURR) Merrill Lynch 4105 (Stock) Pac Westem OCTL 3894 Pac Westem Operation Acct 3878 Pac Western Payroll Acct 3449 Pac Westem VisaJMC 3886 Total Checking/Savings Accounts Receivable Due From Capital Campaign Grants Receivable Total Accounts Receivable Other Current Assets Prepaid Expense Total Other Current Assets Dec 31, 12 2,351.68 3,149.47 0,83 1,114.19 28,023.48 867.53 7,987.86 43,295.04 3,710.63 53,987.13 57,697.76 41,606.01 41,606.01 Total Current Assets 142,598.81 Fixed Assets Buildings 2,826,047.94 French Valley Land 1,230,000.00 Furniture, Fixtures, Equipment 175,200.88 Improvements 103 896.31 Office Equipment 213,313.15 Pujol Land 235,000.00 Vehicles 309,792.35 zAccumulated Depreciation -1,271,083.00 Total Fixed Assets 3,822,167.63 TOTAL ASSETS 3,964,766.44 LIABILITIES 8 EQUITY Liabilities Current Liabilities Accounts Payable Accounts Payable 191,599.45 Total Accounts Payable 191,599.45 Credit Cards Credit Cards 15,214.57 Total Credit Cards 15,214.57 Other Current Liabilities Current Portion of LTD 20,940.14 Pacific Westem LOC 7019 497,116.92 Payroll Liabllttles 59,299.39 Sales Tax Payable 2,397.00 Total Other Current Liabilities 579,753.45 Total Current Liabilities 768,587.47 Long Tenn LisblltUee Key Equipment Finance Lease Payable - De Lage Less Current Portion - Vehicle 17,556.12 41,149.81 -20,940.14 Total Long Tenn Liabilities 37,765.79 Total Liabilities 824,333.26 Equity Capital Campaign Transfer Acct 87,781.62 Retained Earnings 3,164,444.23 Net Income -111,792.87 Total Equity 3,140,433.18 TOTAL LIABILITIES 8 EQUITY 3,964,768.44 BOYS AND GIRLS CLUBS OF SOUTHWEST COUNTY (A California Public Benefit Corporation) AUDIT REPORT For the Year Ended December 31, 2011 BOYS AND GIRLS CLUBS OF SOUTHWEST COUNTY For the Year Ended December 31, 2011 Table of Contents FINANCIAL SECTION Page independent Auditors' Report 1 Basic Financial Statements: Statement of Financial Position 2 Statement of Activities w M 3 Statement of Cash Flows ...............»...............».» ....»....»»....»_........»........................»... 4 Statement of Functional Expenses ... . 5 Notes to Financial Statements ... 6 Financial Section INDEPENDENT AUDITORS' REPORT Board of Directors Boys and Girls Clubs of Southwest County Temecula, California We have audited the accompanying statement of financial position of Boys and Girls Clubs of Southwest County (A California Public Benefit Corporation) as of December 31, 2011, and the related statements of activities, cash flows, and functional expenses for the year then ended. These financial statements are the responsibility of Boys and Girls Clubs of Southwest County's management. Our responsibility is to express an opinion on these financial statements based on our audit. We conducted our audit in accordance with auditing standards generally accepted in the United States of America. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatement. An audit includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements, assessing the accounting principles used and significant estimates made by management, as well as evaluating the overall financial statement presentation. We believe that our audit provides a reasonable basis for our opinion. In our opinion, the financial statements referred to above present fairly, in all material respects, the financial position of Boys and Girls Clubs of Southwest County as of December 31, 2011, and the change in its net assets and its cash flows for the year then ended in conformity with accounting principles generally accepted in the United States of America. , 2f `to, "d- October 30, 2012 BOYS AND GIRLS CLUBS OF SOUTHWEST COUNTY Statement of Financial Position December 31, 2011 ASSETS Current Assets: Cash $ 1,665,377 Investments 5,790 Pledges receivable net of uncollectible amounts 1,220,462 Grants receivable 102,658 Prepaid expenses 41,656 Total Current Assets 3,035,943 Capital assets, net of accumulated depreciation 4,989,145 Total Assets $ 8,025,088 LIABILITIES AND NET ASSETS Liabilities Current Liabilities: Accounts payable $ 282,962 Accrued expenses 77,188 Notes payable 17,905 Capital leases, current portion 20,109 Total Current Liabilities 398,164 Long -Term Liabilities: Capital leases, less current portion Line of credit Total Long -Term Liabilities 57,727 422,117 479,844 Total Liabilities 878,008 Net Assets Unrestricted 3,252,226 Temporarily restricted 3,894,854 Total net assets 7,147,080 Total liabilities and net assets $ 8,025,088 See accompanying notes to financial statements. 2 BOYS AND GIRLS CLUBS OF SOUTHWEST COUNTY Statement of Activities For the Year Ended December 31, 2011 Unrestricted REVENUES, GAINS, AND OTHER SUPPORT Temporarily Restricted Total Program service fees $ 932,081 $ $ 932,081 Grant income 557,645 557,645 Fundraiser income 296,034 296,034 Donations 133,125 133,125 Membership income 60,163 60,163 Rental income 48,750 48,750 In-kind donations 46,800 46,800 Miscellaneous income 15,929 - 15,929 Interest income 22 9,360 9,382 Gain on Disposition of Vehicle 4,075 - 4,075 Pledge income 980 980 Net assets released from restrictions: Pledge income 52,830 (52,830) Total Revenues, Gains, and Other Support 2,147,454 (42,490) 2,104,964 EXPENSES Program services Supporting services Management and general Fundraising 1,547,421 619,886 183,094 1,547,421 619,886 183,094 Total Expenses 2,350,401 2,350,401 Change in Net Assets (202,947) (42,490) (245,437) Net Assets at January 1, 2011 3,455,173 3,937.344 7,392,517 Net Assets at December 31, 2011 $ 3,252,226 $ 3,894,854 $ 7,147,080 See accompanying notes to financial statements 1 3 BOYS AND GIRLS CLUBS OF SOUTHWEST COUNTY Statement of Cash Flows For the Year Ended December 31, 2011 CASH FLOWS FROM OPERATING ACTIVITIES Change in Net Assets $ (245,437) Adjustments to reconcile increase (decrease) in net assets to net cash provided (used) by operating activities Depreciation expense 149,975 Vehicle donation to club income (4,800) Net unrealized (gain)/loss on investments 17 (Increase) decrease in operating assets: Pledges receivable 11,825 Grants receivable (44,083) Prepaid expenses (18,386) Increase (decrease) in operating liabilities: Accounts payable 124,446 Accrued expenses 13,556 NET CASH USED BY OPERATING ACTIVITIES (12,887) CASH FLOWS FROM INVESTING ACTIVITIES Payments for construction in progress (190,914) Purchase of capital assets (26,530) NET CASH USED BY INVESTING ACTIVITIES (217,444] CASH FLOWS FROM FINANCING ACTIVITIES Payments on notes payable (29,346) Payments on capital leases (16,372) Payments on vehicle loans (2,774) NET CASH USED BY FINANCING ACTIVITIES (48,492) NET INCREASE (DECREASE) IN CASH (278,823) Cash balances, January 1, 2011 1,944,200 Cash balances, December 31, 2011 $ 1,665,377 OTHER REQUIRED INFORMATION: Interest Paid $ 27,091 See accompanying notes to financial statements. 4 BOYS AND GIRLS CLUBS OF SOUTHWEST COUNTY Statement of Functional Expenses For the Year Ended December 31, 2011 Program Services Supporting Services Management Youth and Total Services General Fundraising Expenses EXPENSES Salaries $ 738,556 $ 332,057 $ 61,555 $ 1,132,168 Insurance 102,060 86,605 - 188,665 Transportation 136,644 19,325 155,969 Depreciation 136,775 13,200 149,975 Program events 124,213 124,213 Fundraising events - 105,430 105,430 Payroll taxes 53,126 26,817 6,166 86,109 Utilities 61,559 - 61,559 Rent 48,732 4,353 53,085 Repair and maintenance 51,671 - 51,671 Telephone 20,021 25,061 45,082 Office supplies 22,648 9,224 31,872 interest expense - 27,091 - 27,091 Printing 19,441 2,287 2,061 23,789 Dues and subscriptions 3,396 18,456 - 21,852 Professional fees - 19,092 - 19,092 Credit card fees 9,007 4,490 3,184 16,681 Seminars 7,054 6,408 - 13,462 Awards and recognition 6,443 2,379 8,822 Retirement plan 5,214 - 5,214 Taxes 5,368 5,368 Staff recruitment 5,196 - 5,196 Postage and delivery 803 1,383 2,319 4,505 Internet services 3,543 - - 3,543 Security 3,081 3,081 Staff uniforms 2,079 2,079 Community contribution 1,727 - 1,727 Retirement fees 1,326 1,326 Licenses and fees 1,285 - 1,285 Bank charges 473 473 Unrealized (gains)/losses 17 17 Totals $ 1,547,421 $ 619,886 $ 183,094 $ 2,350,401 See accompanying notes to financial statements. 5 BOYS AND GIRLS CLUBS OF SOUTHWEST COUNTY Notes to Financial Statements December 31, 2011 NOTE 1 -NATURE OF ACTIVITIES AND SIGNIFICANT ACCOUNTING POLICIES A. Nature of Activities The Boys and Girls Clubs of Southwest County (the "Organization") was established in August 1990. The Organization is a member of the Boys and Girls Clubs of America chartering organization and provides services to youth, the objectives of which are to foster and to promote the physical, social, and educational, vocational, and character development of boys and girls in or near Southwest Riverside County, California. Major classes of programs include after school care, day camp and youth sports programs. The Organization operates facilities in Temecula, Murrieta and Lake Elsinore. The Organization is funded through membership dues, performance of services for the City of Temecula (the "City") and sponsorships from businesses and the general public in conjunction with its fundraising efforts. B. Accounting Policies The accounting policies of the Organization conform to generally accepted accounting principles as prescribed by the Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC) and the American Institute of Certified Public Accountants (AICPA). C. Basis of Presentation The Organization's policy is to prepare its financial statements on the accrual basis of accounting. This means that revenues are recorded when earned, rather than when received, and expenses are recorded when incurred, not when they are paid. The Organization follows FASB ASC 958-210-45. (ander paragraphs 9-11, the Organization is required to report information regarding its financial position and activities according to three classes of net assets: unrestricted net assets, temporarily restricted net assets, and permanently restricted net assets. As permitted by the statement, the Organization does not use fund accounting in its financial statement presentation. Unrestricted: These generally result from revenues generated by receiving unrestricted contributions, providing services, and receiving interest from investments less expenses incurred in providing program related services, and performing administrative functions. Temporarily Restricted: The Organization reports gifts of cash and other assets as temporarily restricted support when they are received with donor stipulations that limit the use of the donated assets. When the donor restriction expires, i.e. the stipulated time restriction ends or the purpose of the restriction is accomplished, temporarily restricted net assets are reclassified to unrestricted net assets and reported in the Statement of Activities as net assets released from restrictions. D. Recognition of Revenue The Organization has also adopted FASB ASC 958-605. The "Contributions Received" subsections of that standard provides guidance for contributions of cash and other assets received, including promises to give. Contributions received are recorded as unrestricted, temporarily restricted, or permanently restricted support depending on the existence and/or nature of any donor restrictions. The Organization has not received any contributions with donor -imposed restrictions that would result in permanently restricted net assets. 6 BOYS AND GIRLS CLUBS OF SOUTHWEST COUNTY Notes to Financial Statements December 31, 2011 NOTE 1- NATURE OF ACTIVITIES AND SIGNIFICANT ACCOUNTING POLICIES (continued) D. Recognition of Revenue (continued) Revenues are received primarily from pledge income, fundraising, before direct expenses, and program service fees. Membership dues are recorded as revenue in the year received. Management believes that recognizing membership dues pro -rata on a monthly basis would have an immaterial effect on the Organization's financial statements. Program fees represent fees related to member participation in specific day camp, youth sports, before and after school and transportation programs are recorded as revenue in the year received. Fund raising revenues, which consist of the "Our Kids Rock" dinner, golf tournament and annual giving campaign are recorded when the event occurs. Contributions received are recorded as unrestricted, temporarily restricted, or permanently restricted support depending on the existence and/or nature of any donor restrictions. The Organization has not received any contributions with donor -imposed restrictions that would result in permanently restricted net assets. E. Donated Services The Organization's accounting policy for donated materials and equipment is to record these items as contributions at the estimated fair market value as stated by the donor at the date they are received. Contributions of donated services that create or enhance non financial assets or that require specialized skills, are provided by individuals possessing those skills, and would typically need to be purchased if not provided by donation, are recorded at the fair values in the period received. Numerous hours of volunteer services were performed on behalf of the Organization during the year ended December 31, 2011 in support of its programs. Since these services do not meet the criteria specified in Statement of Financial Accounting Standards No. 116, Accounting for Contributions Received and Contributions Made, for recognizing a monetary value of these services, no such value has been assigned to these services in the Organization's financial statements. F. Property and Equipment Property with a cost of $1,000 or greater is capitalized and recorded as additions to property and equipment. Donated property is recorded at the estimated fair value at the date of the gift. Buildings and equipment are depreciated using the straight-line method over and estimated useful life of forty years and ten years, respectively. Maintenance and repair costs are charged to expense as incurred. G. Cash and Cash Equivalents The Organization considers cash on hand and certificates of deposit with maturity dates of three months or less at the date of investment to be cash and cash equivalents. H. Investments investments are recorded at fair value. Unrealized gains and losses are recorded as increases or decreases on the statement of activities. 7 BOYS AND GIRLS CLUBS OF SOUTHWEST COUNTY Notes to Financia( Statements December 31, 2011 NOTE 1— NATURE OF ACTIVITIES AND SIGNIFICANT ACCOUNTING POLICIES (continued) I. Concentration of Risk The Organization maintains its cash in various accounts at several financial institutions. At various times during the year, the amount on deposit with a single financial institution may exceed federal depository insurance limits. At December 31, 2011, the Organization had balances on deposit approximating $1,078,868 in excess of such limits. I. Estimates The preparation of financial statements in conformity with generally accepted accounting principles requires management to make estimates and assumptions that affect certain reported amounts and disclosures. Accordingly, actual results could differ from those estimates. K. Income Taxes The Organization is a non-profit public -benefit corporation and has been recognized as tax-exempt pursuant to Section 501(c)(3) of the Internal Revenue Code and Section 23701d of the California Revenue and Taxation Code. Accordingly, no provision has been made for income taxes. Management has evaluated its tax positions and the certainty as to whether those positions will be sustained in the event of an audit by taxing authorities at the federal and state levels. The primary tax positions evaluated are related to the Organization's continued qualification as a tax-exempt organization and whether there are unrelated business income activities conducted that would be taxable. Management has determined that all income tax positions are more likely than not of being sustained upon potential audit or examination; therefore, no disclosures of uncertain income tax positions are required. The Organization files informational returns in the U.S. federal jurisdiction and the state of California. L. Fair Value of Financial Instruments The following methods and assumptions were used by the Organization in estimating its fair value disclosures for financial instruments: Cash and accounts payable as reported in the balance sheet approximate fair value because of the short maturities of those instruments. M. Functional Expenses The costs of providing the various programs and other activities have been summarized on a functional basis in the combining statement of activities. Accordingly, certain costs have been allocated among the programs and supporting services based on the benefits derived. 1 8 BOYS AND GIRLS CLUBS OF SOUTHWEST COUNTY Notes to Financial Statements December 31, 2011 NOTE 2 - INVESTMENTS Investments consist of stock donated to the Organization. The following discloses the aggregate carrying amount of investments by major types at December 31, 2011. Estimated Market Price Fair Value Shares Per Share December 31, 2011 Stock - Biogold Fuels Corporation 1,052,632 0.0055 $ 5,789 Merrill Lynch Cash & Money Funds 1 Total investments at fair value $ 5,790 Investment Return: Net unrealized loss NOTE 3 - CAPITAL ASSETS $ (17) Land, building and equipment as of December 31, 2011 consisted of the following: Balance, Balance, January 1, 2011 Additions Decreases December 31, 2011 Capital assets not being depreciated: Land $ 1,465,000 $ $ $ 1,465,000 Construction in progress 846,207 190,914 1,037,121 Total capital assets not being depreciated 2,311,207 190,914 2,502,121 Capital assets being depreciated: Buildings 2,826,048 2,826,048 Furniture, equipment & improvements 465,880 26,530 492,410 Vehicles 323,057 4,800 (18,064) 309,793 Total capital assets being depreciated 3,614,985 31,330 (18,064) 3,628,251 Total accumulated depreciation (1,009,316) (149,975) 18,064 (1,141,227) Total capital assets being depreciated, net 2 605,669 (118,645) 2,487,024 Total capital assets, net $ 4,916,876 $ 72,269 $ . $ 4,989,145 1 9 BOYS AND GIRLS CLUBS OF SOUTHWEST COUNTY Notes to Financial Statements December 31, 2011 NOTE 4 -LINE OF CREDIT The Organization has a tine of credit from Pacific Western Bank available for its use. The line of credit is as follows: Pacific Western Bank December 31, 2011 Interest rate: 2.95% Credit limit: $ 500,000 Loan date: April 17, 2011 Maturity date: April 17, 2013 Balance at December 31, 2011 $ 422,117 NOTE 5 - NOTES PAYABLE Murrieta Building During 2002 the Organization borrowed $127,780 to purchase a building. Monthly payments are $1,381, with a variable interest rate through September 2012. The note is secured by the purchased building. The total loan balance at December 31, 2011 was $9,369. Pujol Land During 2007 the Organization borrowed $50,258 to purchase land on Pujol Street in Temecula. Monthly payments are $1,016, including interest at a rate of 7.75 percent through September 2012. The total Loan balance at December 31, 2011 was $8,536. NOTE 6 - LEASES The Organization began leasing the land for Its Great Oak Facility under a 40 -year lease from the City of Temecula. The term of this lease agreement extends through June 30, 2046 with an annual lease payment of $1. Accounting standards require recognition at fair value of such discounted lease costs. Management estimated that the fair value of such discounted lease costs is approximately $42,000 per year. This amount is included in both revenues and expenses on the statement of activities. The Organization leases certain equipment under agreements that provide for title to pass upon expiration of the lease period. Future minimum lease payments are as follows: Capital Leases: December 31, 2011 Total loan balance $ 77,836 Less current portion (20,109) Long-term portion $ 57,727 10 BOYS AND GIRLS CLUBS OF SOUTHWEST COUNTY Notes to Financial Statements December 31, 2011 NOTE 6 - LEASES (continued) Future lease payments: Year ending December 31, Payment 2012 $ 28,116 2013 26,136 2014 26,135 2015 13,926 Total Less Amount Representing Interest 94,313 (16,477) Present Value of Net Minimum Lease Payments $ 77,836 NOTE 7 - EMPLOYEE RETIREMENT PLAN The Organization maintains a defined contribution retirement plan conforming to the provisions of Section 401(k) of the Internal Revenue Code for its salaried employees. Such employees become eligible to participate in the Plan after reaching age 21 and accumulating 1,000 hours of service during the year with the Organization. The Organization matches employee contributions to a maximum of five percent of each employee's eligible compensation, as defined in the Plan, and may also make discretionary contributions. Employee contributions are fully vested at all times. Employer matching and discretionary contributions vest ratably over a five-year period. If an employee terminates employment prior to age 65, the distribution from employer matching and discretionary accounts is limited to the vested portion based upon years of eligible service. The Organization's matching contributions was $5,214 for the year ended December 31, 2011. NOTE 8 - PLEDGE INCOME Contributions are recognized when the donor makes a promise to give to the Organization that is, in substance, unconditional. In 2005, the Organization established a "Capital Campaign" which was created to fund a new facility in the City of Temecula. No pledges to the Capital Campaign were collected for the year ended December 31, 2011. In 2009, the Organization established a "Sustainability Campaign" which was created to fund another new facility in the City of Temecula. The pledges amounted to $980 for the year ended December 31, 2011. NOTE 9 - PLEDGES RECEIVABLE Pledges receivable are recorded when the donor makes a promise to give to the organization. The amount of the pledges receivable at December 31, 2011 amounted to $1,270,462. The Organization estimates an allowance for uncollectible pledges based on management's consideration of donors, historical activity and economic conditions. The allowance for uncollectible pledges amounted to $50,000 at December 31, 2011, bringing the net pledge receivable to $1,220,462. 1 11 BOYS AND GIRLS CLUBS OF SOUTHWEST COUNTY Notes to Financial Statements December 31, 2011 NOTE 10 - CONTINGENCIES Grant activities are subject to monitoring and review by the respective grantor. As a result of such review, costs may be questioned and subsequently disallowed. Management has not been notified of any such disallowance. NOTE 11- TEMPORARILY RESTRICTED NET ASSETS Temporarily restricted net assets as of December 31, 2011 were comprised of the following: December 31, 2011 Capital campaign - use restriction $ 3,883,813 Sustainability 11,041 Total $ 3,894,854 NOTE 12 -FUNDRAISING EVENTS During the year ended December 31, 2011, the Organization conducted the following fundraising events: December 31, 2011 Revenues Expenses Net Auction $ 186,371 $ 80,227 $ 106,144 Golf Tournament 44,420 8,032 36,388 Field of Dreams 45,383 4,922 40,461 Other 19,860 12,249 7,611 $ 296,034 $ 105,430 $ 190,604s NOTE 13 - NONCASH CONTRIBUTIONS During the year ended December 31, 2011, Boys and Girls Clubs of Southwest County received noncash contributions as follows: Use of Facilities $ 42,000 Vehicle (Van) 4,800 Total $ 46,800 NOTE 14 -SUBSEQUENT EVENTS Events subsequent to December 31, 2011 have been evaluated through October 30, 2012, the date at which the Organization's audited financial statements were available to be issued. No other events requiring disclosures have occurred through this date. If events requiring disclosures have occurred between the balance sheet date and the date of the financial statements were available to be issued they would be disclosed here. 12 CITY OF TEMECULA COMMUNITY SERVICE FUNDING APPLICATION 2013-14 CRITERIA BOYS & GIRLS CLUB of Southwest County BEFORE- AND AFTER-SCHOOL TRANSPORTATION and YOUTH DEVELOPMENT PROGRAMS for LOW INCOME TEMECULA YOUTH A. Is the organization currently non-profit? Yes. The Boys & Girls Clubs of Southwest County (BGCSWC) is a 501c(3) California non-profit corporation. B. Does the organization provide a service to the overall community? Yes. BGCSWC serves ALL Temecula residents, ages 6-18 and their families. C. Is the size and make-up of the organization equipped to provide the program/service to the overall community? Yes. Over the past 22 years, BGCSWC has served tens of thousands of Temecula's children at the two Temecula clubhouses. Operating with a balanced budget of $1.9 million annually, the staff of 77 trained professionals utilizes well-established programs provided by the Boys & Girls Clubs of America, the nation's oldest and largest youth development organization with more than 130 years of history. D. What is the public reaction to the group? Positive. BGSCSW is honored to receive acknowledgement and support from all segments of the community. Recognized by the Temecula Valley Chamber of Commerce as Non -Profit of the Year on numerous occasions, the Organization also receives support in the form of donations, grants, volunteers, and in-kind goods and services from hundreds of sources in the business community and from individuals. BGCSWC also has strong working partnerships with key service providers and businesses including Southwest Healthcare, Temecula/Murrieta Rescue Mission, United Way, Temecula Auto Dealers, Safe Alternatives, Abbot Labs, Oak Grove Institute, PHS, City of Temecula, Operation School Bell, Old Town Temecula Merchants Association, Paulson Manufacturing, PTA, Promenade Mall, etc, E. Does the organization have a high quality level of fiscal management? Yes. The organization is governed by a 19 -member volunteer Board of Directors comprised of local community leaders, business owners, and professionals that meets monthly to review fiscal matters. The Board of Directors is responsible for all fiscal aspects of the organization including creating and monitoring of the annual budget. The entire Board meets monthly to review financials and P&Ls. A licensed local CPA serves as the corporate treasurer and reviews all Club financials three times each month working with the Finance committee, Executive Committee, and Board. Is the group well organized to ensure Longevity in the City of Temecula? Over the past 22 years, BGCSWC has built a strong network of community partners, hundreds of volunteers, alumnus and friends. Temecula residents have come to rely on The Clubs' programs, services, transportation, camps, field trips, and Saturday sports leagues. Thousands of BGCSWC members have grown up at The Clubs, graduated from high school, attended college or started careers, and continue to come back to visit or to work. As long as Temecula has youth, ages 5-18, BGCSWC will continue work with strong community partners to provide quality youth development programs and services. G. Is there evidence of satisfactory service provided to the City's citizens? Yes. Data collected and tracked on each Club member clearly indicates Club kids do better in school, have greater attendance, graduate in higher numbers, avoid drugs and alcohol in greater numbers, and are involved in less crime than non -Club kids. Keeping children off the streets, occupied in enriching activities, and out of trouble contributes to Temecula's outstanding quality of life. Increased daily attendance, increased ridership in the Before- and After -School Daily Transportation Program, increased numbers in summer camp enrollment, indicate parents are satisfied with Club services. Is the organization free from discrimination based on race, color, creed, nationality, sex, marital status, disability, religion, or political affiliation? Yes. BGCSWC serves ALL Temecula children, ages 6-18, and their families. Does the organization require attendance or participation in any political, religious or social activity? No Can the organization provide financial statements (prepared using an appropriate method of accounting) to demonstrate sound financial management? Yes. BGCSWC operates with a professional finance department using Quickbooks Pro software. The annual financial audit consistently demonstrates sound financial management. K. Can the organization provide a budget for the fiscal year of request demonstrating cost-effectiveness? Yes. The Clubs operate with a balanced budget which is monitored on a regular basis by the Executive Committee, Finance Committee, Board of Directors, and the auditing firm of Nigro and Nigro. L. Does the organization make its services available to ail? Services are available to ALL Temecula children, ages 6-18, and their families. Does the organization possess ongoing program evaluation tools? Yes. Using the Kid Trax data tracking system, each child is tracked daily for attendance, program participation, retention of program materials, etc. Boys & Girls Clubs of America has direct computer access to all data and uses it constantly to evaluate program impact and benefit. Report cards, parent interviews, school attendance records, behavioral activity, etc. are used as tools to measure program effectiveness. The Clubs' annual Strategic Review also provides a snapshot of program values and effectiveness. PROJECT DESCRIPTION 130Y5 & GIRLS CLUB of Southwest County AM/PM School Transportation and Enrichment Program The Boys & Girls Clubs of Southwest County is seeking $5,000 in matching funds for transportation and program scholarships for 150 low income Temecula children (ages 6-12) who participate in the Clubs' AM/PM School Transportation and Enrichment Program. BGCSWC will provide the $5,000 match from monies raised through other funding sources such as local donations, grants, and fundraising events. For only $33 per week, scholarship children may be dropped off at The Club at 6:30am and receive daily early morning care and enrichment programs before school, along with round trip transportation to and from school on private Club buses, after school tutoring, followed by fun academic, sports, arts and leadership programs that improve grades, boost self-esteem, and build character. Commuting Temecula parents love the affordability and convenience of the 6:30am Club drop-off, knowing their children travel safely to and from school, and are engaged in fun and challenging programs offered by trained professional Club staff. The community benefits because children are engaged in worthwhile activities out of harm's way, and because more than 40,000 cars were removed from streets near Temecula schools in 2012 by the BGCSWC transportation department's 13 Targe school buses and vans. To satisfy grant parameters, proof of eligibility for scholarships is required, but scholarships are unlimited, and in the Club's 22 year history, no family qualifying as low income has been denied a scholarship. To serve ALL Temecula children, it is an organizational goal to keep fees low. The organization does this by supplementing scholarship fees through local donations, grants, and fundraising events to generate revenue. This philosophy provides a broad base for funding and removes the risk of becoming dependent on one source for sustainability. A $5,000 Community Service Funding grant from the City of Temecula will be combined with matching funds provided by BGCSWC to provide Daily Transportation and Program Scholarships for 150 low income Temecula youth. The mission of the Boys and Girls Clubs of Southwest County is to inspire and empower ALL youth to reach their full potential as productive, responsible, and compassionate citizens. With help and matching funds from the City of Temecula, BGCSWC will continue to change the world, one child at a time. PAST PROJECT BENEFITS If your organization received City of Temecula funding in the previous year, please explain and show how Temecula residents benefited. In 2012-13 funding was requested to replace the main air conditioning unit at the Old Town Clubhouse. After 21 years of service, it had stopped working and needed to be replaced. (see attached invoices & bids) Work was accomplished on the air conditioning system utilizing services from several providers. The new air conditioning unit at the Old Town Clubhouse has made the environment comfortable for staff and club members. Because of the replacement, BGCSWC has been able to maximize the clubhouse use by allowing other non-profit organizations (Boy Scouts, Shakespeare in the Vines...) to use the facility free of charge. The OT Club has also been used for charter school classes, dance classes, etc., and has been a community benefit. SIGNATURE PAGE We hereby certify the information contained in this application is true to the best of our knowledge and belief. PREPARED BY: John Whann, Program Director SIGNATURE: NAME and TITLE (Please Print or Type) PRESIDENT or Steve Amante, Chairman AUTHORIZED OFFICER: SIGNATURE: NAME and TITLE P - int or Type) ORGANIZATION NAME: Boys & Girls Clubs of Southwest County MAILING ADDRESS: PO Box 892349, Temecula, CA 925892349 TELEPHONE: 951-699-1526 xt. 105 EMAIL ADDRESS: Johnw(bucswc.orq DATED THIS 29th of August (Date) (Month) , 2013 BE SURE TO INCLUDE THE ORIGINAL PLUS ONE COPY AND SUBMIT BY AUGUST 30, 2013 TO: Mail Completed Applications to: Or Deliver in Person to: City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office Post Office Box 9033 Temecula, CA 92589-9033 City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office 41000 Main Street Temecula, CA 92590 Application Page 4 internal Revenue Service Date: November 22, 2002 Eloy s & Girls Club of Southwest County % Donald K. Engdahl 25790 Niel Street Temecula., CA 92590-2828 Department of the Treasury P. 0. Box 2508 Cincinnati, OH 45201 Person to Contact: Stephanie Broach -Camp 3'1-04022 Customer Service Specialist Toll Free Telephone Number: A:OO a,m. W G:30 p.m. EST 877-829-5500 Fax Number; 513-263-3758 Federal Identification Number: Dear Sir or Madam: This is in response to the amendment to your organization's Articles of krubrporation filed with the stale on March 7, 2001. We have updated our records to reflect the name change as indicated above. Our records indicate that a determination letter issued in July 1996 granted your organization exemption from federal Income tax under section 5O1(c)(3) of the Internal Revenue Code. That letter is still in effect. Rased on information subsequently submitted, we classified your organization as one that is not a pevztte foundation within the meaning of section 509(a) of the Code because it is an organization described in suctions 500(a)( 1) and 170(b)(1)(A)(vi). This claseification was based ort.the assumption that your organization's operatierte would continue as stated in the application. If your option's sob[tces of support, or its Character, method' of operations, or purposes have :haeged, please let us know so we can consider the effect of ttie change on tate exempt status and foundation status of your organization. Your organization is required to file form 990, Return of Organization Exempt from Income Tax, only if its gross receipts each year are normally more than $25,000. if a return is required, it must be filed by the 15th day of the fifth month after the end of the organization's annual accounting period. The taw imposes e penalty of $20 a day, up to a maximum of $10,000, when a return is filed late, unless there is reasonebte cause for the delay. Ail exempt organlzations (unless specifically excluded) are liable for taxes under the Federal insurance Contributions Act (social security taxes) on remuneration of $100 or more paid to each empleyee during e calendar year. Your organization is not liable for the tax imposed under Me Federal Unentpleyment Tax Act (FUTA)_ , Organizations that are not private foundations are not subject to the excise taxes under Chapter 42 of the Code. However, these organizations are not automatically exempt from other federal excise taxes. Donors may deduct contributions to your organization as provided in section 170 of the Code, Bequests, legacies, devises, transfers, or gifts to your organization or for its use are deductible for federal estate and gift tax purposes if they meet the applicable provisions of sections 2055, 2106, and 2522 of the Cocle. toys S. Girls Club of Southwest County ,?..-a475756 YOUr organization is not required 10 f>le federal inComo tax rctums unless ft is sti ;ect to the: tax ori Li:nu:ale? csi.sfness ;ncorne under section 511 of the Code, If your organization is subject to this tax, et must filo an income tax return on the Fount •T. Exempt Org3nizetloo Business income Tax Return In this tr':I:tr'r, are not determining whether any of your organtx&lion's present of proposed activities are unrelated !rade or fres rless as defined in section 513 of the Code. Inc.. 13w requires you to make your organization's annual return available tor pub1ioinspection witi:ou; 'or th;ue years after the duo date~ of the return. You are also required to make ova-ilebfe tor ;;tulle ens r• ct;c:t a copy of your orgenlzation's exemption application. any supporting documents and me oxemptron letter ;;D any Individual who requests such documents fn person or In voting. You can charge only a reasonable. ser; for reproduction and actual postage costs for the copied materials. The taw dons not regtnre you to f;rut.det ix pier of public inspection documents that aro widely auadabto. such as by posting them on the: interr:e: t'Aroric. Wide Web). You may be liable for a penalty 01520 a day for each day you do not rnake those c:nrutslents; available for public inspection (up to amaximum! 01 S10,t )O in me case 01 on annum rntu;rt; BCCaUse this ie3ttor could fi0lp re$olve any Questions about your organization's exempt o to S-CtItla, YEW Stlr)uld keep it with the organ ation`s permanent records, li }'0t: riave any'quesstlons. please call us at the telephone number shown ;r iilo near:fa:I of tfi:i E?t:er flatter affirms your organization's exempt status. Sincerely. John E. Rtczcetts, Orcctor, TE/GE Customer Account Services Retum to Search Exempt Organizations Select Check Page 1 of 1 IRS Exempt Organizations Select Check l xempl Oruanizauons Select Check Home Organizations Eligible to Receive Tex -Deductible Conbibugons (Pub. 78 data) • Search Results The following Ilei Incudes tax-exempt organIzatone that are eligible to receive lax•dedudlble contributions. Click on the "Deductibility Status" column for an explanation of limitations on the deductibility of conldbutons made to different types of tax-exempt organizations. Results are sorted by EIN. To sort results by another category. dick on the icon next to the column heading for that category. Clicking on that Icon a second time will reverse the Bort order. Ckck on a column heading for en explanation of Information In that column, 1.1 of 1 results EIN t.cgat t"mno (Doing Business As). Boys & Girls Club of Southwest County Results Per Page 25 • OKI City, Temecula .Prev11.1lNords tale.CouMryOaQuctibNtty„Status. CA United States PC Prev 11.1 I Next http://apps.irs,gov/app/eos/pub78Search.do?ein 1=330475756&names=&city=&state=CA&c... 9/9/2013 r.1 City of Temecula City Manager's Office 41000 Main Street • Temecula. CA 92590 Mailing Address: P.O. Box 9033 • Temecula, CA 92589-9033 Phone 1951 J 506-5100 • Fax (951 ) 694-6499 • www.dtyoftemecula,org September 30, 2013 John Whann BOYS & GIRLS CLUB OF SOUTHWEST COUNTY P. 0. Box 892349 Temecula, CA 92589-2349 RE: Temecula Community Service Funding Program FY 2012-13 Dear John: This is a follow-up with regard to your organization's Community Service Funding award for fiscal year 2012-13 of $5,000 which was to be used for the installation of a new air conditioning unit and the flushing and cleaning of refrigerant lines and air filter grills to protect the new system. As stated in the Compliance section of the attached Community Services Funding Program Policy, funds received from the City should have been expended prior to June 30, 2013, and documentation to substantiate the funds received and expended should have been provided to the City by September 1, 2013. As of this date we have not received documentation to substantiate the $5,000 award your organization received on or about February 21, 2013. If the funds were not expended in accordance with the above -stated purpose, the organization is required to refund the amount of funds. Failure to provide proper documentation may jeopardize any future funding. If you have any questions or concerns, please do not hesitate to contact me at 951-693-3959. Thank you for your prompt attention to this matter. Sincerely, Betsy Lo �y Sr. Management Analyst BL:ep Enclosure: as stated City of Temecula 2013-14 CS Funding Program APPLICATION NO. 9 RECEIVED AUG 1 0 7013 CITY MANAGER'S FISCAL YEAR 2013.14 OFFICE COMMUNITY SERVICE FUNDING PROGRAM APPLICATION (Please Print or Tvoe) 2013-14 Program Submission Deadline: Friday, August 30, 2013 (original, plus one copy) CITY OF TEMECULA_ PROJECT INFORMATION Amount Requested: $ 5,000 Project Name: Service Dog Training Program Project Start Date: 12/1/2012 (Maximum allowable $5,000) Project End Date: 6/1/2014 ORGANIZATION INFORMATION Name of Organization: Canine Support Teams Contact Name: Sunny Poulson Thomas Title/Position: Operations Director Mailing Address: P.O. Box 891767, Temecula, CA 92589 Telephone: 951.301.3625 Number of Paid Staff: 6 Year Organization Founded: 1990 Number of Volunteers: 100 Geographic Area(s) Served: Southwest Riverside County and Nationally Is this organization incorporated in California as a non-profit organization? Yes X No Effective Date: 1990 If "yes" (Must provide a copy of your statement of non- profit status from the State of California): Date of incorporation as a non-profit: 7/20/1990 Federal identification number: State identification number: If "no": Name of sponsoring organization: Federal identification number: State identification number: This application has been authorized by the organization's: Executive Committee X Board of Directors X Members -at -Large Application Page 1 FY 2012-13 COMPLIANCE REQUIREMENT IF YOUR ORGANIZATION WAS A RECIPIENT OF FUNDING FOR FY 2012-13, PLEASE ATTACH COPIES OF INVOICES, RECEIPTS AND CANCELLED CHECKS TO SUBSTANTIATE THOSE FUNDS RECEIVED AND EXPENDED BY YOUR ORGANIZATION. FINANCIAL STATEMENTS PLEASE ATTACH COPIES OF THE CURRENT BUDGET OF THE ORGANIZATION AND FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT). It does not require a CPA's audit, but please submit if available. MISSION STATEMENT Briefly describe the goals and objectives of your organization and community services it provides. Describe the ways your organization meets the criteria listed on page 2 of the CS Funding Policy. The mission of Canine Support Teams (CST) is to provide service/assistance dogs to the disabled (other than the blind to support their personal, social, and occupational independence. All aspects of our agency directly serve to this end and while we may place a trained service dog nationally they are all trained locally. Our local programs include the Prison Pup Program, which is a collaborative effort among CST. the California Institute for Women (CIW) in Chino, and the Southwest Juvenile Hall in Murrieta. The Prison Pup Program places potential service dogs with inmates from CIW and with male juvenile offenders at Southwest Juvenile Hall. The inmates become talented Trainers and they learn valuable life skills. The rehabilitative nature of this program has taught the inmates teamwork, compassion, self-control, and the joy of altruism. In fact, when the juveniles and parolees from the Prison Pup program exit the system they have overwhelmingly been able to gain employment in the animal services field; indeed, to date there has not been a single parolee from CIW returned to the prison system. While this is clearly a wonderful opportunity for Canine Support Teams, the rewards of the Prison Pup Program are further reaching. Many of the service dogs that we train are placed locally through our PAWZ for Wounded Veterans program. This program is designed to provide service dogs to those who have been wounded in the service of our country and who are now seeking the enhanced mobility, independence, unconditional love, and the companionship an assistance dog offers. Not only does a service dog provide assistance with daily activities, the dog serves as a bridge...people focus on the dog, not the disability. This leads to conversation and acceptance. For some veterans, the dog gives them the motivation to continue the challenges of everyday life. Temecula, due to it's close proximity to Camp Pendleton and several VA hospitals, has a large number wounded veterans in need of a service dog. Additionally, the majority of our Puppy Raiser Volunteers also live in the Temecula area, and would love to place "their" dog with a local family. PROJECT DESCRIPTION Application Page 2 How will your organization use the funding awarded? Describe the project, project objectives, those served, area serviced, and number of volunteers involved. Be specific. Include equipment or services that would be purchased and why. Include a detailed budget and a schedule of significant activities related to this project. You may attach a maximum of one double-spaced typewritten page of information. (Please type or print legibly.) Canine Support Teams would utilize the funding provided by the City of Temecula Community Service Funding Program to offset the training costs of a service dog to be placed with a local Temecula family; likely one of the veterans on the PAWS waiting list. We are currently seeking funding for capital expenses relating to this program; in that, we need to update our facility equipment, and offset the expenses of our volunteer puppy raisers. Our facility is always in need of repairs in fencing, water lines, and other building maintenance. Anyone who has ever raised a few puppies understands what "teething" damage can do to a kennel. Additionally, our volunteer Puppy Raisers cover the majority of costs associated with raising a future service dog. These costs include food, veterinary expenses, toys and other supplies. On average our volunteers spend close to $2,000 on this dog, yet, their investment will serve someone they don't even know. The altruism of our volunteers is unmatched, yet not every volunteer can afford to be so financially generous. If awarded, we could identify a recipient and begin training of a service dog that would best fit the individual's unique needs. The entire process would consist of local volunteer Puppy Raisers, our training teams, and would potentially include participants in the Prison Pup Program. While the overall number of people involved in the process is not large, the impact is truly profound. Application Page 3 PAST PROJECT BENEFITS If your organization received City of Temecula funding in the previous year, please explain and show how Temecula residents benefited. Did not receive funding last year. Application Page 4 S1GNATURE PAGE We hereby certify the information contained in this application is true to the best of our knowledge and belief. PREPARED BY: SIGNATURE: Sunny Poulson Thomas, Operations Director /C��e ericz Y�n'b BFr7G .c. NAME and TITLE (Please PrInt'or Type) /fit/dovsdave-d PRESIDENT or AUTHORIZED OFFICER: Sunn Poulson Thomas O•erations Director NAME and TITLE (Please Print or Type) SIGNATURE: ORGANIZATION NAME: 211114/1.-4101411fr Canine Support Teams MAILING ADDRESS: P.O. Box 891767, Temecula, CA 92589 TELEPHONE: 951.301.3625 EMAIL ADDRESS: operationsdirector@canincesupportteams.org DATED THIS 22nd,pf August 2013 (Date) (Month) BE SURE TO INCLUDE THE ORIGINAL PLUS ONE COPY AND SUBMIT BY AUGUST 30, 2013 TO: Mail Completed Applications to: Or Deliver in Person to: City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office Post Office Box 9033 Temecula, CA 92589-9033 City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office 41000 Main Street Temecula, CA 92590 Application Page 5 N'ERNA.L REVENUE SERVICE DISTRICT DIRECTOR 2 CUPANIA CIRCLE MONTEREY PARK, CA 91755-7406 Data: RPO 2 6 1995 CANINE SUPPORT TEAMS INC 80 E DAWES.SP 24 PERRIS, CA 92571-3122 Dear Applicant: DE!?AR'rri1)2 NT OF HE 'TREASURY Employer Identification Number: Case Humber: 955073044 Contact Person: LEON DEHAVGN Contact Telephone Number: (714) 738-1583 Our Letter Dated: May 13, 1991 Addendum Applies: No This modifies our letter of the above date in which we stated that you would be treated as an organization that is not a private foundation until the expiration of your advance ruling period. Your exempt status under section 501(a) of the Internal Revenue Code as an organization described in section 501(c) (3) is still in effect. Based on the information you submitted, we have determined that you are not a private foundation within the meaning of section 509(a) of the Code because you are an organization of the type described in section 509 (a) (1) and 170 (b) (:.) (A) (vi) . Grantors and contributors may rely on this determination unless the Internal Revenue Service publishes notice to the contrary. However, if you lose your section 509(a)(1) status, a grantor or contributor may not rely on this determination if he or she was in part responsible for, or was aware of, the act or failure to act, or the substantial 'Orma'teri l':charige oa.the part of the organization that resulted in your loss of such status, or if he or she acquired knowledge that the Internal Revenue Service had given notice that you would no longer be classified as a section 509(a)(1) organization. 'If' we -have indicated in the heading of this letter that an addendum applies, the addendum enclosed is an integral part of this letter. Because this letter could foundation status, please keep If you have any questions, telephone number are shorn aeov .•;1• 'r '1 •I• • . help resolve any questions about your private it in your permanent records. please contact the person whose name and e. • S. • Sincerely yours, 2ichard R. Orosco District Director Letter 1050 (DO/CG) Exempt Organizations Select Check Page 1 of 1 IRS Exempt Organizations Select Check pjselnot OmanIzations Select Check Hom Organization ENgible to Receive Tax -Deductible Contributions (Pub. 78 data) - Search Results The following Ott Includes lex-exempt organizations that are eligible to receive tax•doducdble contribution. Click on the "Deductibility Status" column for an explanation of !Inflations on the deducUbi lty of contributions made to different types of lax -exempt organizations. Results are sorted by EIN. To sort results by another category, dick on the icon next to the column heading for that category. ClIcktng on that Icon a eecond time will reverse the sort order. Click on a column heading for an explanation of intonation in that column. 1-1 of 1 results Canine Support Tams Inc. Return to Search Results Per Page 25 4; n • Prev 11.1 I Next» C{lye• Stets .Co .! tral. Dedudirliik Status. Menges CA United Stales PC 4 Prev I 1-1 I Next* http://apps.irs.gov/app/eos/pub78Search.do?ein1=330434821 &names=&city=&state=CA&c... 9/9/2013 STATE OF CALIFORNIA FRANCHISE TAX BOARD PO BOX 942857 SACRAMENTO CA 94257-0540 Entity Status Letter Date: 8/20/2013 ESL ID: According to our records, the following entity information is true and accurate as of the date of this letter. Entity ID: 1484828 Entity Name: CANINE SUPPORT TEAMS, INC. 1. The entity is in good standing with the Franchise Tax Board. 111 2. The entity is not in good standing with the Franchise Tax Board. 3. The entity is currently exempt from tax under Revenue and Taxation Code (R&TC) Section 23701 d. 4. We do not have current information about the entity. The above information does not necessarily reflect: • The entity's status with any other agency of the State of California, or other government agency. • If the entity's powers, rights, and privileges were suspended or forfeited at any time in the past, or the entity did business in Califomia at a time when it was not qualified or not registered to do business in California: o The status or voidability of any contracts made in California by the entity at a time when the entity was suspended or forfeited (R&TC Sections 23304.1, 23304.5, 23305a, 23305.1). ✓ For entities revived under R&TC Section 23305b, any time limitations on the revivor or limitation of the functions that can be performed by the entity. Internet and Telephone Assistance Website: ftb.ca.gov Telephone: 800.852.5711 from within the United States 916.845.6500 from outside the United States TTY/TDD: 800.822.6268 for persons with hearing or speech impairments FTB 4263A WEB (NEW 02-2012) Canine Support Teams, Inc. Profit & Loss July 2013 Jul 13 Jan -Jul 13 % of Income Ordinary Income/Expense Income 4 • Contributed support 4010 • Indivlbusiness contribution 582,792.28 765,729.18 100,0% Total 4 • Contributed support 582,792.28 765,729.18 100.0% 5 • Eamed revenues 5310 • Interest-savings/short-term inv 140.32 343.67 0.0% Total 5 • Eamed revenues 140.32 343.67 0.0% Total Income 582,932.60 766,072.85 100.0% Expense 7200 • Salaries & related expenses 7201 • Payroll 7220 • Salaries & wages 18,606.10 72,759.82 3.2% Total7201 • Payroll 18606.10 72,759.82 3.2% 7223 • Independent Contractor 5,445.00 21,702.57 0.9% 7241 • Employee Insurance/Workers Comp 2,175.50 2,175.50 0.4% 7244 • Health Insurance 499.50 999.50 0.1% 7242 • Payroll Processing Fee 209.00 1,304.00 0.0% 7250 • Payroll taxes 1,806.28 8,566.50 0.3% 7500 • Other personnel expenses 7500 • Other personnel expenses - Other Total 7500 • Other personnel expenses Total 7200 • Salaries & related expenses 8100 • Direct Program Expenses 8101 • Team Training Expense 8110 • Dog Supplies 7221 • Dog Training Expense 8112 • Dog Food 8110 • Dog Supplies - Other Total 8110 • Dog Supplies 8117 • Grooming 8501 • Veternarian 8571 • Puppy Raisers - Other Expenses 8680 - other Total 8100 • Direct Program Expenses 8199 • Office Supply, Maint. & Admin. 8111 • Office Supplies 8140 • Postage, shipping, delivery 8140 • Postage, shipping, delivery -Other Total 8140 • Postage, shipping, delivery 8160 • Equip rental & maintenance 8170 • Printing & copying 8170 • Printing & copying - Olher Total 8170 • Printing & copying 8185 • Dues and Subscriptions 8560 • Outside computer services 8199 • Office Supply, Maint. & Admin. - Other Total 8199 • Office Supply, Maint. & Admin. 8200 - Occupancy expenses 8233 • Alarm Service 8201 • Facility Cleaning 8220 • Utilities 8130 • Telephone & telecommunications 8225 • Telephone Expense 332.83 5,733.57 0.1% 332.83 5,733.57 0.1% 29,074.21 113,241.46 5.0% 600.00 1,602.99 0.1% 0.00 500.00 0.0% 0.00 173.29 0.0°% 126.73 2,118.12 0.0% 126.73 2,791.41 0.0% 0.00 67.50 0.0% 199.50 10,715.15 0.0% 0.00 300.00 0.0% 0.00 1,861.45 0.0% 926.23 17,338.50 0.2% 4.16 1,976.77 0.0% 41.70 187.14 0.0% 41.70 187.14 0.0% 1,382.27 4,006.81 0.2% 654.76 1,210.63 0.1% 654.76 1,210.63 0.1% 239.95 657.90 0.0% 0.00 820.14 0.0% 299.05 299.05 0.1% 2,621.89 9,158.44 0.4% 134.46 268.92 0.0% 0.00 500.00 0.0% 1,303.60 4,15820 0.2% Page 1 FOR MANAGEMENT PURPOSES ONLY Canine Support Teams, Inc. Balance Sheet As of July 31, 2013 ASSETS Current Assets Checking/Savings 1010 • Cash in bank -operating 1020-11 • Robobank - general account 1020-12 • Robobank-service dog/fundraiser 1020-15 • Robobank-Marti Fund 1020-14 • Robobank-Hikene/Anaya account 1020-13 • Robobank-grant account 1010-12 • Commerce Bank - General Account 1010-20 • Commerce - Grant Acct 1010-22 • The Hilkene/Anaya Fund Total 1010 • Cash in bank -operating Jul 31, 13 200.00 200.00 200.00 200.00 200.00 535,111.63 29,079.61 86,894.77 652,086.01 Total Checking/Savings 652,086.01 Total Current Assets 652086.01 Fixed Assets 1600 • Fixed Assets 1630 • Building/Land Improvements 1631 • Drive Way 1632 • Septic Tank 1640 • Furniture, fixtures, & equip 1650 • Vehicles 1600 • Fixed Assets - Other Total 1600 • Fixed Assets 1700 • Accumulated Depreciation 1725 • Accum depr- building 1735 • Accum amort -Building Improve. 1745 • Accum deprec-fum,fix,equip 1755 • Accum deprec - vehicles 1700 • Accumulated Depreciation -Other Total 1700 • Accumulated Depreciation Total Fixed Assets Other Assets 1500 • Deposit on Fencing 202,880.42 2,500.00 3,400,00 39,469.18 90,108.67 3,720.00 342,078.27 (11,295.00) (6,596.00) (21,898.00) (46,580.00) (20,486.00) (106,855.00) 235,223.27 1,500.00 Total Other Assets 1,500.00 TOTAL ASSETS 888,809.28 LIABILITIES & EQUITY Liabilities Current Liabilities Other Current Liabilities 3135- • Clearing (9,791.10) Total Other Current Liabilities (9,791.10) Total Current Liabilities Long Term Liabilities 2730 • Mortgages payable Total Long Term Liabilities Total Liabilities Equity 3010 • Retained Earnings Net Income Total Equity TOTAL LIABILITIES & EQUITY Page 1 FOR MANAGEMENT PURPOSES ONLY (9,791.10) 160,939.14 160,939.14 151,148.04 161,642.04 576,019.20 737,661.24 888,809.28 Canine Support Teams, Inc. Profit & Loss July 2013 Jul 13 Jan -Jul 13 % of Income Total 8130 • Telephone & telecommunications 1,303.60 4,158.20 0.2% 8221 • Pedely Propane 83.16 809.08 0.0% 8222 • Garbage 0.00 64.20 0.0% 8223 • Exterminator Expense 0.00 150.00 0.0% 8224 • Electricity Expense 537.27 725.13 0.1% 8228 • Water Expense 0.00 65.47 0.0% Total 8220 • Utilities 1,924.03 5,972.08 0.3% 8232 • Facilty upkeep 79.00 9,120.73 0.0% Total 8200 • Occupancy expenses 2,137.49 15,861.73 0.4% 8300 • Travel & meetings expenses 8330 - Meals 14.95 237.68 0.0% Total 8300 • Travel & meetings expenses 14.95 237.68 0.0% 8302 • Vehicle Expense 8301 • Gas & Mileage Reimb 2,339.62 8,736.95 0.4% 8304 • Vehicle Repair and Maintenance 0.00 991.68 _ 0.0% Total 8302 • Vehicle Expense 2,339.62 9,728.63 0.4% 8350 • Professional Fees 7000 • Grant & contract expense 7000 • Grant & contract expense - Other 240.00 240.00 0.0% Total 7000 • Grant & contract expense 240.00 240.00 0.0% 7520 • Accounting fees 400.00 1,850.00 0.1% 7530 • Legal fees 1,461.66 2,436.66 0.3% 7540 • Professional fees - other 445.00 445.00 0.1% Total 8350 • Professional Fees 2,546.66 4,971.66 0.4% 8500 • Misc expenses 8500 • Misc expenses - Other (880.73) 14.11 (0.2)% Total 8500 • Misc expenses (880.73) 14.11 (0.2)% 8590 • Other expenses 0.00 5,071.85 0.0% 8600 • Taxes, Insurance & Interest 8215 • Bank Service Charges 50.00 50.00 0.0% 8592 • Credit Card Merchant Fees 24 95 419.14 0.0% 8230 • Real estate taxes 0.00 223.50 0.0°,6 8250 • Mortgage interest 836.02 6,524.17 0.1% 8520 • Insurance-non-enployee 0.00 1,891.50 0.0% Total 8600 • Taxes, Insurance & Interest 910.97 9,108.31 0.2% 8701 • Fund Raising Expense--Misc. 8704 • Fund Raising Services 0.00 1,572.11 0.0% 8105 • Graduation Expense--Misc. 0.00 3,338.97 0.0% Total 8701 • Fund Raising Expense--Misc. 0.00 4,911.08 0.0% 8570 • Advertising expenses 35.00 410.20 0.0% Total Expense 39,726.29 190,053.65 6.8% Net Ordinary Income 543,206.31 576,019.20 93.2% Net Income 543,206.31 576,019.20 93.2% Page 2 FOR MANAGEMENT PURPOSES ONLY CST 2013 ANNUAL BUDGET Revenue grants 280,000 other grants and donations 275,000 fundraising events 22,000 client fees 162,000 interest 155 Expense direct program personnel overhead personnel 88,000 192,000 direct program expense dog raising veterinarian services 13,400 supplies 5,875 pet chip registrations 450 mileage reimbursement 4,224 dog training dog food 8,400 prison pup program 1,200 urgent veterinarian services 8,700 mileage 3,100 client -dog selection & training 2,400 annual volunteer appreciation 2,800 indirect expense marketing and presentations 5,200 dues 1,200 grant writing 7,600 mileage and travel 8,200 office supplies and postage 6,420 insurance 10,270 accounting 4,800 property taxes 1,300 office equipment 8,900 utilities 21,000 mortgage 16,200 depreciation 10,200 IT consultant - contract employee 1,500 reserve account "Marti Fund" 200,000 739,155 280,000 23,949 26,600 302,790 633,339 Pa.*. •tAab+,eet Ay" r, Pu. Pus S• Canine Support Te • s Providing SER'./ 1 I )0C, 1c� ihuuy wills 1mobililu.i ILM 11“1. Canine Support Teams 2013 Operating Budget Income Contributed support Indiv/business contribution $ 275,000 Legacies & bequests $ 50,000 Foundation/trust grants $ 183,000 Earned revenues Adoption Fees $ 5,000 Special events/Fundraising $ 25,000 Interest Income $ 600 Total Income $ 538,600 Expenses Salaries & related expenses Staff and Admin Comp $ 39,000.00 Emp Ins/Work Comp $ 5,000.00 Acctg & Payroll Processing Fee $ 7,035.00 PAWS for Wounded Vets/Staff $ 67,000.00 Payroll taxes $ 28,000.00 Total • Salaries & related expenses $ 146,035.00 Direct Program Expenses Team Training Expense $ 2,500.00 Dog Supplies $ 5,900.00 Dog Food $ 8,400.00 Veternarian & Health $ 18,600.00 Puppy Raisers Pgm Kennel Staff $ 28,750.00 Mileage reimb $ 3,100.00 Graduation & Placement $ 8,538.00 Total • Direct Program Expenses $ 75,788.00 Office Supply, Maint. & Admin. Office Supplies $ 3,400.00 Postage, shipping, delivery $ 750.00 Equip rental & maintenance $ 8,900.00 Printing & copying $ 2,000.00 Dues and Subscriptions $ 950.00 Outside computer services $ 1,500.00 Total • Office Supply, Maint. & Admin. $ 17,500.00 Canine Support le • s Providing `;l RV1Ll wills I ii,c,bi'iti<^ti Avokten W.lm.uere 0•01 Canine Support Teams 2013 Operating Budget Occupancy expenses Alarm Service $ 500.00 Utilities $ 12,500.00 Exterminator Expense $ 3,480.00 ADA Bldg. retrofit, kennel additions $ 131,000.00 Facilty upkeep/maintainence $ 18,500.00 Total • Occupancy expenses $ 165,980.00 CST Vehicle Expense Gas & Mileage Reimb $ 8,900.00 Vehicle Repair and Maintenance $ 1,500.00 Vehicle purchase w/wheelchair moditifcations $ 61,000.00 Total • Vehicle Expense $ 71,400.00 Travel & meetings expenses Travel $ 750.00 Conference,convention,meeting $ 430.00 Meals $ 1,069.22 Total • Travel & meetings expenses $ 2,249.22 Professional Services/Fees Accounting fees $ 3,171.00 Professional fees - other $ 6,640.00 Total • Professional Fees $ 9,811.00 Taxes, Insurance & Interest Bank Service Charges $ 100.00 Credit Card Merchant Fees $ 850.00 Real estate taxes $ 1,250.00 Mortgage interest $ 11,184.00 Insurance $ 8,100.00 Total • Taxes, Insurance & Interest $ 21,484.00 Fund Raising Expense-Misc. Findraising personnel $ 11,780.00 Fund Raising Services $ 7,200.00 Fund Raising Expense-Misc. - Other $ 2,700.00 Advertising expenses $ 1,000.00 Total • Fund Raising Expense-Misc. $ 22,680.00 Total Expenses $ 532,927.22 Year End Net $ 5,673 City of Temecula 2013-14 CS Funding Program APPLICATION NO. 10 CITY OF TEMECULA RECEIVED FISCAL YEAR 20 13-14 AUG 12 2013 COMMUNITY SERVICE FUNDING PROGRAM APPtirtyON (Please Print or Tvoe) 2013-14 Program Submission Deadline: Friday, August 30, 2013 (original, plus one copy) L PROJECT INFORMATION Amount Requested: $ 5,000.00 or any amount Project Name: Chaparral High School Grad Night (Maximum allowable $5,000) Project Start Date: 08/01/2013 Project End Date: 06/08/2013 ORGANIZATION INFORMATION Name of Organization: Chaparral High Foundation Grad Night Contact Name: Teresa Boullain Title/Position: President Mailing Address: 40615 Chantemar Way, Temecula, CA 92591 Telephone: 951-200-9223 Number of Paid Staff: None Year Organization Founded: 1998 Number of Volunteers: 200 Geographic Area(s) Served: Greater Temecula Valley Is this organization incorporated in California as a non-profit organization? Yes X No Effective Date: 05/15/1998 If "yes" (Must provide a copy of your statement of non- profit status from the State of California): Date of incorporation as a non-profit: May 18, 1998 Federal identification number: If "no": Name of sponsoring organization: Federal identification number: State identification number: This application has been authorized by the organization's: Executive Committee X Board of Directors X Members -at -Large Application Page 1 FY 2012-13 COMPLIANCE REQUIREMENT 1 IF YOUR ORGANIZATION WAS A RECIPIENT OF FUNDING FOR FY 2012-13, PLEASE ATTACH COPIES OF INVOICES, RECEIPTS AND CANCELLED CHECKS TO SUBSTANTIATE THOSE FUNDS RECEIVED AND EXPENDED BY YOUR ORGANIZATION. FINANCIAL STATEMENTS PLEASE ATTACH COPIES OF THE CURRENT BUDGET OF THE ORGANIZATION AND FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT). It does not require a CPA's audit, but please submit if available. MISSION STATEMENT Briefly describe the goals and objectives of your organization and community services it provides. Describe the ways your organization meets the criteria listed on page 2 of the CS Funding Policy. The Chaparral High School Grad Night Committee operates under the Chaparral High School Education Foundation, a non-profit organization. The committee's goal is to provide a safe, alcohol,drug free, and memorable celebration for the 2014 Chaparral High School (CHS) graduates after commencement exercises. The Grad Night Celebration begins at 9:00 pm and continues until 5:00 am. The evening provides CHS graduated Seniors a night to celebrate and remember this milestone in their lives. The graduates enjoy, games, dancing, food, entertainment, and many exciting activities. This night is a much anticipated and climactic event for our seniors to share a fun and memorable evening. We do not discriminate based on race, color, creed, nationality, sex, marital status, disability, religion, or political affiliation. We do not require attendance or participation in any political, religious or social activity. We cater to the needs of our seniors whether it be wheelchair accessibility or allergies to latex. Donations also help us provide free tickets for those students that cannot afford to attend the event. We continue to provide an opportunity for juniors to earn a free Grad Night ticket by helping with the clean up. Over the past ten years Grad Night has received overwhelming positive feedback from both graduates and parents. Many graduates return to help with the Grad Night event after they leave Chaparral. The planning for the 2014 Grad Night Celebration has already begun. The event requires hundreds of parents, faculty/staff, and community volunteers coming together for one common goal: saving the lives of our teenagers. At this time 2014 is approximately 700 L PROJECT DESCRIPTION Application Page 2 PAST PROJECT BENEFITS If your organization received City of Temecula funding in the previous year, please explain and show how Temecula residents benefited. decorating. Each student was given a duffle bag with CHS luggage tag. and an opportunity to spin the wheel for a prize. We also gave away 15 grand prizes ranging from cameras to laptops. Last year we gave away 18 grand prizes ranging from dorm supplies to a laptop. Any help and support you can provide is greatly appreciated. Thank you for your time and consideration. Application Page 4 SIGNATURE PAGE We hereby certify the information contained in this application is true to the best of our knowledge and belief. PREPARED BY: Teresa Boullain President of CHS Grad Night NAME and TITLE (Please Print or Type) SIGNATURE: ' J,f‘L'JG,' ec�� PRESIDENT or AUTHORIZED OFFICER: Teresa Boullain President of CHS Grad Night NAME and TITLE (Please Print or Type) SIGNATURE: ` J (��t'�/ ' % i:rj�"7(: •11 ORGANIZATION NAME: Chaparral High School Foundation Grad Night MAILING ADDRESS: 40615 Chantemar Wav Temecula, CA 92591 TELEPHONE: 951-200-9223 EMAIL ADDRESS: tboullain@msn.com DATED THIS 28th of July , 2013 (Date) (Month) BE SURE TO INCLUDE THE ORIGINAL PLUS ONE COPY AND SUBMIT BY AUGUST 30, 2013 TO: Mail Completed Applications to: Or Deliver in Person to: City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office Post Office Box 9033 Temecula, CA 92589-9033 City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office 41000 Main Street Temecula, CA 92590 Application Page 5 f� .' �.� it �,t�•.. .: v-:,�., -_.. -�� r� [ _ ?•,fit+•:�j.�:[. r..firSt�.r .. � •ir'i'�i'� os: og.41 ST 4�'ono3, °` a � mD �1c4 moo. goat: sad, .�-.. 11 SECRETARY OF STATE 1, SILL JONES, Secretary of State of the State of California, hereby certify: That the attached transcript has been compared with d on file in. this office, of which it purports to the recon be a copy, and that it is full, true and correct. IN WITNESS WHEREOF, 1 execute thisofth Seal of th certificate State of California this MAY 1 S 199 — Secretary of State ARTICLES OF INCORPORATION OF MAY 15 1998 CHAPARRAL HIGH SCHOOL EDUCATION FOUNDATION BEL JONES, Secretary of Slate 2039208 fi 1DORSED • FILED Ii me oftitt of the Secretary al State et the Slate of CatIfornia The name of this corporation is CHAPARRAL HIGH SCHOOL EDUCATION FOUNDATION. This corporation is a nonprofit public benefit corporation and is not organized for the private gain of any person. It is organized under the Nonprofit Public Benefit Corporation Law for charitable purposes. - The specific purpose of this corporation is,to promote and support excellence and innovation in education for students in the Temecula Valley Unified School District_ The name and address in the State ofCalifornia of this corporation's initial agent for service of process is John K. Ruffner, 27215 Nicolas Rd., Temecula, California, 92591-7324. This corporation is organized and operated exclusively for charitable purposes within the meaning of Section 501(c) (3) of the Internal Revenue Code. Notwithstanding any other provisions of these articles, the corporation shall not carry on any other activities not permitted to be carried on (a) by a corporation exempt from federal income tax under Section 501 (c) (3) of the Internal Revenue Code or (b) by a corporation to which contributions are deductible under Section 170 (c) (2) of the Internal Revenue Code, No substantial part of the activities of this corporation shall consist of carrying on propaganda, or otherwise attempting to influence legislation, and the corporation shall not participate or intervene in my political campaign (including the publishing or distribution . ofstatements) on•behalf of any candidate.for.public office. • The property of this corporation is irrevocably dedicated to charitable purposes and no part of.rhe.notir ,rne oz- assets of this corporation shall..ever itluiie-tp the benefit.of. any director,'; oifie€r•::or•member thereof or t'b the:bencfit of any private. pers'on?.i Uptftt the..; dissolutioii'or.winding.up ofthe'tvorporation; iits.asssts remaining aterppayiiiti1 br'• • provisions for psymntt 'of all (leas: an'd`4iabilities tifthis corporation stall b distributed. to a nonprofiE': eiftfouridation'or cor}idiatit ti�wluclt i� organized. and Operata1iaiclusiveiy. for chant ila'p,itip ses ano,:whichhias established. its• tax exempt stiitu&under Section•501 (c) (3) of the ii rnal R8Qhie Code; .: • , PAi3E 1. OP. 2 September 1, 2011 Ms. Judy McNabb City of Temecula Community Service Funding P.O. Box 9033 Temecula, CA 92589-9033 Dear Ms. McNabb, Attached you will find the documentation to substantiate the funds Chaparral High School Grad Night received from the City of Temecula. Below is an itemized list of expenditures. Vendor WalMart Amount Spent Office Max So Cal Events Oriental Trading TOTAL: $ 1,512.54 $ 76.11 $10,000.00 $ 85.75 $ 11,673.82 Description of Expenditure Prizes for Students — laptop, GPS, system, Microwave Prize for Students — Digital Camera Venue, Decorations, Food, Entertainment Decorations Once again, thank you for your generous support of the 2012 Chaparral High School Grad Night. The support of the City of Temecula was instrumental to the success of the evening. Please call if you have any questions or require more information. Sin rely, ,, V isa tSolorzano 2012 Grad Night committee (951) 677-9954 cheerontorieverizon.net or lsolorzano@tvusd.k12.ca.us 9 l 1-1s f-' t'` CHAPARRAL HIGH SCHOOL GRAD NIGHT COMMITTEE 2006 40335 Winchester Rd. Ste. PMB233 ` Temecula, CA 92591 IOUCATION IOUNOAIION Exempt Organizations Select Check Page 1 of 1 IRS Exempt Organizations Select Check Demut Ornanizal ons Select Check Home Organizations Eligible to Receive Tex -Deductible Contributions (Pub. 78 dela) - Search Results The following list Includes lax -exempt organizations that are eligible to receive tax-deductible contributions. Click on the "Deductibility Statue" column for an explanation of limitations on the deductibility of contributions made to different types of lax -exempt organizations. Results ere sorted by EIN. To sort results by another category, dick on the icon next to the column heading for that category. Clicking on that Icon a second time will reverse the sort order. Click on a column heading for an explanation of Information In That column. 1-1 of 1 results EIN. legal risme (Doig Buetnes* Ae). Chaparral High School Education Foundation Results Per Page 26 OK City . Temecula I Return to Search e Prev 1 1.1 I Next State .Coun . DedudlbNk Status. CA United Statee PC r Prev I 1-1 (Next http://apps.irs.gov/app/los/pub78Search.do?ein1=330800705&names=&city=&state=All 9/9/2013 City of Temecula 2013-14 CS Funding Program APPLICATION NO. 11 RECEIVED CITY OF TEMECULA AUG 3 0 203 FISCAL YEAR 2013-14 CITY OANICER'S COMMUNITY SERVICE FUNDING PROGRAM APPLICATION 2013-14 Program Submission Deadline: Friday, August 30, 2013 (original, plus one copy) PROJECT INFORMATION Amount Requested: $5000.00 (Maximum allowable $5,000) Project Name: PERFORMERS CONNECTING WITH STUDENTS or the SHOW IN THE BOX Project Start Date: November 15, 2013 Project End Date: June 30, 2014 (and ongoing thru-out school year) Name of Organization: FINE ARTS NETWORK Contact Name: Title/Position: Shezwae Powell, Artistic Director Mailing Address: 41391 Kalmia, #200, Murrieta, CA 92562 Resident company at Old Town Temecula Community Theater, 42051 Main Street, Temecula Telephone: 951-263-2868 Year Organization Founded: 1994 Number of Paid Staff: -0- Number of Volunteers: Varies with project but generally 150-200/year Geographic Area(s) Served: Southwest Riverside County from Corona to Fallbrook. Is this organization incorporated in California as a non-profit organization? YES Yes No Effective Date: July, 1994 If "yes" (Must provide a copy of your statement of nonprofit status from the State of California): see attached. Date of incorporation as a non-profit: July 27,1994 Federal identification number: State identification number: If "no": n/a Name of sponsoring organization: Federal identification number: State identification number: This application has been authorized by the organization's: Executive Committee Board of Directors _X_ Members -at -Large Application Page 1 FY 2012-13 COMPLIANCE REQUIREMENT IF YOUR ORGANIZATION WAS A RECIPIENT OF FUNDING FOR FY 2012-13, PLEASE ATTACH COPIES OF INVOICES, RECEIPTS AND CANCELLED CHECKS TO SUBSTANTIATE THOSE FUNDS RECEIVED AND EXPENDED BY YOUR ORGANIZATION. - Not Applicable FINANCIAL STATEMENTS PLEASE ATTACH COPIES OF THE CURRENT BUDGET OF THE ORGANIZATION AND FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT). It does not require a CPA's audit, but please submit if available. —See attached MISSION STATEMENT Briefly describe the goals and objectives of your organization and community services it provides. Fine Arts Network Theater Company through creative artistic endeavors seeks to provide area residents the opportunity to both attend and participate in quality, enriching theatrical experiences. Our focus is on inclusion while fostering professionalism and increasing awareness of the capabilities and contributions of the Old Town Temecula Community Theater to the community and advancing attention to the City of Temecula as a destination to experience quality stage performances. Fine Arts Network Theater Company endeavors to maintain a synergy between all populations within the community by providing outreach and education through youth camps, acting and directing competitions, theatrical internships and support of other nonprofit organizations and charities in the accomplishment of their missions. We will generate and efficiently manage the necessary resources to support all our goals. Briefly describe the goals and objectives of your organization and community services it provides. Describe the ways your organization meets the criteria listed on page 2 of the CS Funding Policy. As referenced in our Mission Statement, Fine Arts Network, provides educational and cultural experiences for our community through performance and outreach. In the past we have spearheaded, collaborated and/or created such projects as: Arts in the Park (Children's Arts and craft event), Haunted Old Town, Caroling in Old Town, Artists -in -Resident programs on school campus', Broadway Bootcamp, House of Terrors, Mind Terrors, Summer Theater Camps and Old Town Temecula Christmas Parade. We annually provide 1000's of community service hours for high school and middle school students. We work with local schools to provide costuming and sets for their productions. We have presented, over the past 20 years, performances at different venues throughout the local communities and for the past 7 years at the Old Town Temecula Community Theater which annually draw thousands to our community and Old Town area, while offering tickets for a price equivalent to a movie tickets. As a non-profit organization we have also collaborated with other non -profits such as Theatre Foundation, Temecula Valley Players, Temecula Performing Arts Company, Shakespeare in the Vines, Penny Pickles Children's Museum, Rose Society, Southwest Women's Chorus, The Arts Council and Temecula Valley International Film and Music Festival for fundraising efforts, support, costuming and entertainment. Our organization has been in existence since 1994 and continues to reach into the community to provide support, education and presentation of the performing arts. Our 20 year existence demonstrates our longevity, resourcefulness and the community's commitment to our programs, as we have survived both the recession of the '90's and the current recession, as well, and are still here. Throughout our 20 year tenure, we have seen thousands of young people go through our programs, go on to colleges and universities and then return with degrees in hand to take up the mantle of "giving back". Currently, on our board of 13, we have 2 such individuals and our production teams are made up of choreographers, music directors, directors, stage managers, lighting designers, costume designers, actors, singers who were involved with FAN in their youth and now are returning themselves or enrolling their children in our programs. Additionally, we are currently collaborating with Mt. San Jacinto College, Menifee, to present PIPPIN, our season opener in October, 2013. This collaboration, we anticipate will be an on-going one in which it gives performers of Fine Arts Network and students from MSJC an experience that neither would be able to have without the partnership. MSJC Menifee students get the opportunity to perform in a "jewel box" of a theater in Old Town Temecula and FAN performers get an opportunity to work with the highly trained, skilled professors from MSJC of which ALL of them possess amazing professional resumes from Broadway to London to the world. This is a service FAN is able to provide that is available through no other organization in this community and extremely rare throughout the country. Fine Arts Network is a rainbow colored organization of multiple races, creeds, ethnic and religious persuasions. We do not know or care about someone's political affiliations, marital status or nationality. And, in the past 20 years we have had many participants that have had some level of disability including down - syndrome, autism, severe food allergies, psychological trauma and physical handicaps. We have never turned anyone away because of finances. Our doors are always open to all, as long as they make the commitment and effort to actively participate to the best of their abilities. We have different criteria for program evaluation and genuinely seek feedback from our participants and audience. PROJECT DESCRIPTION: PERFORMERS CONNECTING WITH STUDENTS or the SHOW IN THE BOX is designed to bring the performing arts to our local public schools. We are utilizing a program created by Missoula Children's Theater where different age appropriate productions...all musicals...are costumed, props, sets, drops....everything needed to produce and perform a show are created, packaged and brought to local public schools (generally grades 2-6) as a ONE -STOP -SHOP for providing an educational, performance experience. The program is being developed by a former Missoula Children Theater director, Lissa Supler and choreographer/director, Brittany Campbell. Both are current professional directors for several youth organizations locally and in the Orange County, Riverside County and Los Angeles County areas. As "graduates" of Fine Arts Network, they spent their years after receiving their degrees from Cal State Fullerton and UC Irvine, honing their skills, interning and working for such professional organizations as South Coast Rep and Missoula Children's Theater, amongst others. The process: SHOW IN A BOX, after being contracted by a school, goes onto a campus and meets with interested students 3 hours each afternoon for 1 week. At the end of the week, the students present their production to their family and friends. The students help to design the show poster and the program and are the performers for the show. We can provide this service free to the school and recoup any expenses through the ticket sale process, which makes this a sustainable project. Currently, the City of Temecula has a "pay -to -perform" theater arts program offered through the CRC. This is a 3 month program with a performance at its culmination. Our program is not designed to replace this program but perhaps to augment it through a reduced time restriction and cost. If we receive funding, we would organize with CRC to find dates and time that we could offer SHOW -IN -A -BOX and present it at CRC, hopefully utilizing the amphitheater. PROJECT OBJECTIVE: The objective of the program is to bring performing arts back to the schools and to continue to introduce our youth and their families to the performing arts. Performing arts incorporates and fosters the very useful skills of memorization, musical timing, harmonics, coordination of both small and large motor skills, teamwork, creativity, responsibility, independence, presentation, spatial relationship and many other skills necessary to excel in our fast -paced, multi -media culture. AREA SERVED AND THOSE SERVED: Our first year goals are to service our Temecula schools. We will focus on the elementary schools, grades 2-5. Once the SHOW -IN -THE -BOX is created, it is available to go to as many campuses as want us. Future plans include expanding our area to Murrieta, while maintaining opportunities with the Temecula school district. Each show usually has 50-75 participants. VOLUNTEERS: The volunteers are generated by the directors. Each show has 2 directors, who then recruit the additional volunteers they need, either through the school staff, parents or high school mentors. Generally, each production will have 5-15 volunteers depending on how many students participate. EQUIPMENT & SERVICES: see budget Application Page 3 BUDGET FOR SHOW -IN -A -BOX Drops (2) Costumes 70 Props Storage BOXES: Printed Materials Transportation Sound equipment Total budget: $1500.00 (2 custom-made, hand painted drops designed to fit mult-space requirements) $1600.00 (costumes designed to fit multiple sizes and easily adaptable, hand construct) $ 300.00 (Necessary small set pieces and props to adequately compliment the show) $ 200.00 (Cases for packing and preserving the above items) $ 200.00 (Postcards, brochures, forms, flyers, scripts, marketing) $ 200.00 (Truck rental/gasoling for transporting, sets, costumes, etc.) $1000.00 (rental of mics & sound board) $5000.00 Director & choreographer are paid from ticket proceeds. Once we receive notification of funding, we will solicit local schools through the district office, contact with principals at individual schools and personally with individual elementary school teachers that we have worked with in the past. The time frame for presentation on campus' would be the Spring as that allows us to "build" the production pieces necessary to present the show and the schools enough time to put it into their calendars. Once the show is "built" it can have a life span of 5-10 years with minor repairs and proper management. Each year we would expand upon this project until we have 6-10 shows and multiple teams of directors & choreographers that are doing these productions on campuses throughout our target region and further into Riverside and San Diego counties. PAST PROJECT BENEFITS N/A BUDGET 2013 -2014 INCOME: Ticket Sales: $110,000* Sponsors Advertising $ 5,000 Show Underwriting $ 5,000 Fundraising $ 10,000 Grants $ 20,000 Contributions $ 25,000 Costume Rentals $ 5,000 Set Rentals $ 5,000 Total income: $185,000 EXPENSES: Rent $ 15,408 Insurance $ 1,500 Production expenses Facility $ 40,000 All other production Expenses $ 75,000 Marketing, Advertising $ 5,000 Other expenses $ 10,000 Total expenses $146,908* *(due to closure of Old Town Theater we have 1 less show in season, so our figures for ticket sale income and production expenses are less than previous years.) See attached financials for better picture of scope of income and expenses. SIGNATURE PAGE We hereby certify the information contained in this application is true to the best of our knowledge and belief. PREPARED BY: F-QL/Z' J CS l 1 Li LC fv 1„ Dom bli&i.)C 09 ' - 2)2-00 r&y AME and TITLE (Please Print or Type) SIGNATURE: c42' -"L PRESIDENT or • AUTHORIZED OFFICER: f�� ki � hG'dl�(\�i reu�vo-� r ' Je u�(o -,mow NAME and ITLE (Please Print or Type) SIGNATURE: Q5-4_, C. U ORGANIZATION NAME: f1n'e, ArIS MAILING ADDRESS: LA 16 QOLLW'AtGL 14(D00 cAikG'2. eL TELEPHONE:g1 -314 -a )401 * q -S1 cDC.Q 3 - t,o &0e DATED THIS COof �� (Date) (Month) EMAIL ADDRESS: Foie-leS 12..3 C.. `lc. ham' WFA1--11-14.:--1,0 Tt-A2 • ice' `^ , 2013 BE SURE TO INCLUDE THE ORIGINAL PLUS ONE COPY AND SUBMIT BY AUGUST 30, 2013 TO: Mail Completed Applications to: Or Deliver in Person to: City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office Post Office Box 9033 Temecula, CA 92589-9033 City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office 41000 Main Street Temecula, CA 92590 Application Page 5 9:43 AM 08130113 Cash Basis Fine Arts Network Profit & Loss January through July 2013 Ordinary Income/Expense Income Ad Sales 4030 • Contributions Income 4040 • Fundraising Win A Trip 4040 • Fundraising - Other Total 4040 • Fundraising 4070 • Unrestricted Total 4030 • Contributions Income 4100- • Production Income Caroling Costume Income 4103 • Ticket Sales Presale Tickets Season Tickets Reg. 4103 • Ticket Sales - Other Total 4103 • Ticket Sales 4106 • Videos 4109 • School day shows Total 4100- • Production Income 4170 • Program Fees 4178 • Summer Camp Reg Total 4170 • Program Fees 4190 • Reimbursed Expenses Total Income Jan - Jul 13 5,730.00 280.68 100.00 6,010.68 11,266.00 17,276.68 50.00 25.00 6,146.00 -82.33 8,563.13 14,626.80 30.00 3,000.00 17,731.80 7,512.50 7,512.50 0.00 42,620.98 Gross Profit 42,620.98 Expense Advertising 395.00 6120 • Bank Service Charges 248.00 6121 • Credit card discount tees 245.41 6160 • Dues and Subscriptions 396.25 6170 • Equipment Rental 1,815.28 6180 • Insurance 1,099.83 6230 • Licenses and Permits 1.00 6250 • Postage and Delivery 14.26 6260 • Printing and Reproduction 198.00 6270 • Professional Fees 6660 • Accounting 1,165.00 Total 6270 • Professional Fees 1,165.00 6290 • Rent 8,988.00 6360 • Travel & Ent Gas 106.72 Total 6360 • Travel & Ent 106.72 6460 • Contract Labor -700.00 6600 • Production Concessions 191.60 Guest Artist 200.00 Lighting 250.00 Scene Shop 100.00 Script Rental 550.00 Set Construction 5,992.01 Set Rental 348.75 Shipping 178.12 Theatre Rent 1,550.00 Tickets -17,120.83 Page 1 9:43 AM 08/30113 Cash Basis Fine Arts Network Profit & Loss January through July 2013 Jan - Jul 13 6601 • Construction 506.60 8602 -Ph • Photography 500.00 6503 -Co • Costumes 437.49 6608 • Video Production 680.00 6509 • Transportation 223.21 6610 • Tech Stage Crew Load -in 840.00 Sound Tech 2,000.00 Spotlight operator 775.00 Stage Manager 1,100.00 6510 • Tech Stage Crew - Other 2,000.00 Total 6510 • Tech Stage Crew 6,715.00 6512 • Prod. Tech Supplies Batteries 2,210.73 Total 6512 • Prod. Tech Supplies 2,210.73 6614 • Facility rental 2,000.00 6515 • Props & sets 324.37 6516 • Royalties Rental Deposit -330.22 6516 • Royalties - Other 645.00 Total 6516 • Royalties 314.78 6518 • Director Assistant Director 170.00 Conductor 500.00 Music Director 350.00 Technical Director 1,200.00 65184 • Vocal Director 750.00 6518-4 • Musician Stipend 1,850.00 Total 6518 • Director 4,820.00 6600 • Production - Other 16,338.00 Total 6600 • Production 27,309.83 6670 • Program Expense 6672 • Art Supplies 8.51 Total 6670 • Program Expense 8.51 Total Expense Net Ordinary Income Net Income 41,291.09 1,329.89 1,329.89 Page 2 10:13 AM 08/30/13 Cash Basis Fine Arts Network Profit & Loss January through December 2012 Ordinary Income/Expense Income Ad Sales Donations 4030 • Contributions income 4040 • Fundraising Raffle 4040 • Fundraising - Other Total 4040 Fundraising 4070 • Unrestricted Total 4030 • Contributions Income 4100- • Production Income Caroling Costume Rental 4103 • Ticket Sales Presale Tickets Season Tickets Reg. Ticket Vouchers 4103 • Ticket Sales - Other Jan - Dec 12 2,125.00 81,188.00 215.00 960.00 1,175.00 33,185.19 34,360.19 2,600.00 2,410.00 22,598.09 3,778.52 432.66 104,997.63 Total 4103 • Ticket Sales 131,806.90 Total 4100- • Production Income 136,816.90 4170 • Program Fees 4178 • Summer Camp Reg 5,800.00 Total 4170 • Program Fees 5,800.00 4190 • Reimbursed Expenses -20.00 Total Income 260,270.09 Gross Profit 260,270.09 Expense Advertising 1,500.00 Petty Cash 280.00 Subscription Season Ticket Commission 1,842.75 Total Subscription 1,842.75 6120 • Bank Service Charges 6121 • Credit card discount fees 6160 • Dues and Subscriptions 6170 • Equipment Rental 6171 • Equip. Lease 6180 • Insurance 6230 • Licenses and Permits 6250 • Postage and Delivery 6280 • Printing and Reproduction Playbill expenses 6260 • Printing and Reproduction - Other Total 6260 • Printing and Reproduction 6270 • Professional Fees 6660 • Accounting Total 6270 • Professional Fees 6290 • Rent Late Fee 6290 • Rent - Other Total 6290 • Rent 6340 • Telephone 5,866.99 606.85 35.00 3,102.11 315.40 1,581.76 35.00 79.81 939.50 1,921.68 2,861.18 900.00 900.00 298.30 13,840.50 14,138.80 93.93 Page 1 10:13 AM 08130113 Cash Basis Fine Arts Network Profit & Loss January through December 2012 6350 • Travel & Ent Gas 6370 • Meals Total 6350 • Travel & Ent Jan - Dec 12 714.94 219.96 934.90 6460 • Contract Labor 1,950.00 6600 • Production Box Office charges 3,633.61 catering 898.50 Concessions 313.55 Dry Ice 38.00 Guest Artist 12,735.00 make-up 40.00 Musicians accompanist 850.00 Total Musicians 850.00 producer Scene Shop Script Rental late fee scripts Script Rental - Other Total Script Rental Scripts Set Construction Set Rental Drops Set Rental - Other 129.50 3,310.00 500.00 900.00 3,439.50 150.00 17,518.77 3,623.42 1,175.00 Total Set Rental 4,798.42 Shipping Theatre Rent stage equipment rental Theatre Rent - Other Total Theatre Rent 997.35 3,510.00 13,642.82 17,152.82 Tickets -65,938.52 video licensing 550.00 6603 -Co • Costumes 5,009.19 6606 • Program 1,695.99 6508 • Video Production 1,250.00 6609 • Transportation 1,247.00 6510 • Tech Stage Crew Light Design 3,500.00 Load -in 1,973.40 Prop Manager 400.00 Sound Tech Clean Mics 480.00 Sound Tech - Other 8,700.00 Total Sound Tech 9,180.00 Spotlight operator Stage Manager 6610 • Tech Stage Crew - Other Total 6610 • Tech Stage Crew 6612 • Prod. Tech Supplies Batteries 6612-2 • City Stage Labor Total 6512 • Prod. Tech Supplies 2,600.00 3,655.00 5,490.00 26,798.40 3,223.04 31,465.44 34,688.48 Page 2 10:13 AM 08/30/13 Cash Basis Fine Arts Network Profit & Loss January through December 2012 6614 • Facility rental Front of House Rehearsal Space Ticket Office charges 6614 • Facility rental -Other Total 6614 • Facility rental Jan - Dec 12 2,275.00 2,250.00 5,086.55 4,750.00 14,361.55 6616 • Props & sets 411.25 6616 • Royalties Music 1,750.00 Rental Deposit 1,400.00 6616 • Royalties - Other 24,810.70 Total 6616 • Royalties 27,960.70 6517 • Choreographer 4,000.00 6518 • Director Assistant Director 400.00 Conductor 2,000.00 Music Director 750.00 6618-1 • Cast Stipend 4,522.00 6618.3 • Vocal Director 3,050.00 6518-4 • Musician Stipend 700.00 6618 • Director - Other 4,568.25 Total 6618 • Director 15,990.25 6620 • Admin asst -production 870.00 6621 • Contest Ticket Rewards 25.00 Total 6521 • Contest 25.00 6500 • Production - Other 21,253.00 Total 6600 • Production 154,137.81 6560 •Office Supplies 162.51 6800 • Taxes 50.00 Total Expense 190,474.80 Net Ordinary Income 69,795.29 Net Income 69,795.29 2011 Return Summary FINE ARTS NETWORK FORM 990: TOTAL REVENUE TOTAL EXPENSES EXCESS <DEFICIT> BEGINNING NET ASSETS CHANGES IN NET ASSETS ENDING NET ASSETS BALANCE SHEET ANALYSIS ENDING TOTAL ASSETS ENDING TOTAL LIABILITIES ENDING TOTAL NET ASSETS OR FUND BALANCES 219,400. 249,879. —30,479. 28,568. 0. —1,911. 11,889. 13,800. —1,911. ENDING TOTAL ASSETS MINUS LIABILITIES AND NET ASSETS 0. ENDING NET ASSETS DIFFERENCE BETWEEN PAGE 1 AND PAGE 11 0. CALIFORNIA FORM 199: GROSS RECEIPTS TOTAL EXPENSES EXCESS <DEFICIT> BEGINNING NET ASSETS CHANGES IN NET ASSETS SCHEDULE M-1 ADJUSTMENTS ENDING NET ASSETS (1) BALANCE DUE BALANCE SHEET ANALYSIS ENDING TOTAL ASSETS ENDING TOTAL LIABILITIES ENDING TOTAL NET ASSETS OR FUND BALANCES (2) ENDING TOTAL ASSETS MINUS LIABILITIES AND NET ASSETS ENDING NET ASSETS DIFFERENCE BETWEEN ITEMS (1) AND (2) s U/ Gc ,e—GL 219,400. 249,626. —30,226. 28,568. 0. —253. — 1,911. 0. 11,889. 13,800. — 1,911. 0. 0. c I126310 05-01-11 Form 8868 (Rev. 1.211121 • If you are filing for an Additional (Not Automatic) 3 -Month Extension, complete only Part II and check this box ► 1 X1 Note. Only complete Part II if you have already been granted an automatic 3 -month extension on a previously filed Form 8868. Cr,!`.vou are filing for an Automatic 3 -Month Extension, complete only Part I (on page 1). t 1I 1 Additional (Not Automatic) 3 -Month Extension of Time. Only file the original (no copies needed). Enter filer's identifying number, see instructions Employer identification number (EIN) or Pace 2 Type or print File by the due date for filing your return. See instructions. Name of exempt organization or other filer, see instructions FINE ARTS NETWORK Number, street, and room or suite no. If a P.O. box, see instructions. 41391 KALMIA AVE, STE 200 City, town or post office, state, and ZIP code. For a foreign address, see instructions. MURRIETA, CA 92562 [Xi Social security number (SSN) Enter the Retum code for the retum that this application is for (file a separate application for each return) Application Is For Return Code Application Is For Return Code Form 990 01 Form 990 -BL 02 Form 1041-A 08 Form 990•EZ 01 Form 4720 09 Form 990 -PF 04 Form 5227 10 Form 990•T (sec. 401(a) or 408(a) trust) 05 Form 6069 11 Fnrm gg0-T (trust other than above) 06 Form 8870 12 STOPI Do not complete Part 1I if you were not already granted an automatic 3 -month extension on a previously filed Form 8868. BEVERLY STEPHENSON • The books are in the care of ► 41391 KALMIA AVE , SUITE 200 - MURRI ETA , CA 92562 Telephone No. ► 951-314-2401 FAX No. ► • If the organization does not have an office or place of business in the United States, check this box ► 'this is for a Group Return, enter the organization's four digit Group Exemption Number (GEN) . If this is for the whole group, check this �_.. ► I-7 .4f rt is for part of the orouo. check this box ► Fl and attach a list with the names and EINs of all members the extension is for. 4 I request an additional 3 -month extension of time until NOVEMBER 15 , 2012. 5 For calendar year 2011 , or other tax year beginning , and ending 6 If the tax year entered in line 5 is for less than 12 months, check reason: El Initial return i 1 Final retum El Change in accounting period 7 State in detail why you need the extension FINE ARTS NETWORK FINISHED ITS 2011-2012 SEASON IN JUNE AND IS STILL COMPILING DOCUMENTS TO SUPPORT ITS 2011 TAX RETURN. 8a If this application is for Form 990 -BL, 990 -PF, 990-T, 4720, or 6069, enter the tentative tax, Tess any nonrefundable credits. See instructions. 8a $ b If this application is for Form 990 -PF, 990-T, 4720, or 6069, enter any refundable credits and estimated tax payments made. Include any prior year overpayment allowed as a credit and any amount paid previously with Form 8868. 8b $ c Balance due. Subtract line 8b from line 8a. Include your payment with this form, if required, by using EFTPS (Electronic Federal Tax Payment System). See instructions. 8c S Signature and Verification must be completed for Part II only. Under penalties of perjury, I declare that I have examined this Corm, including accompanying schedules and statements. and to the best of my knowledge and belief, it is true, correct, and complete, and that I am authorized to prepare this form. Signature ► Title 10. CEO Date ► 123042 01-06-12 0. 0. 0. Form 8868 (Rev. 1-2012) Forrn 8868 (Rev. January 2012) Department of the Treasury Internal Revenue Service Appiic� ,n for Extension of Time T:1.9? Exempt Organization Return • - `' ► File a separate application for each return. r lf,o� `V7 e'No.15 5.11,09 /ou are filing for an Automatic 3 -Month Extension, complete only Part I and check this box ► LX -I • If you are filing for an Additional (Not Automatic) 3 -Month Extension, complete only Part II (on page 2 of this form). Do not complete Part 1! unless you have already been granted an automatic 3 -month extension on a previously filed Form 8868. Electronic filing (e -life). You can electronically file Form 8868 if you need a 3 -month automatic extension of time to file (6 months for a corporation required to file Form 990-1), or an additional (not automatic) 3 -month extension of time. You can electronically file Form 8868 to request an extension of time to file any of the forms listed in Part I or Part II with the exception of Form 8870, Information Return for Transfers Associated With Certain Personal Benefit Contracts, which must be sent to the IRS in paper format (see instructions). For more details on the electronic filing of this form, visit www.irs.00v/elile and click on a -life for Charities & Nont rolits. I Part I 1 Automatic 3 -Month Extension of Time. Only submit original (no copies needed). A corporation required to file Form 990•T and requesting an automatic 6 -month extension - check this box and complete Part I only ► All other corporations (including 1120-C filers), partnerships, REMICs, and trusts must use Form 7004 to request an extension of time to file income tax retums. Il Type or print File by the due date foo filing your return See instructions Name of exempt organization or other filer, see instructions. FINE ARTS NETWORK Number, street, and room or suite no. If a P.O. box, see instructions. 41391 KALMIA AVE, STE 200 City, town or post office, state, and ZIP code. For a foreign address, see instructions. MURRIETA, CA 92562 Employer identification number (EIN) or Lxi Social security number (SSN) Enter the Return code for the return that this application is for (file a separate application for each return) Application Is For Return Code Application Is For Return Code - i 090 01 Form 990-T (corporation) 07 , in990•BL 02 Form 1041.A 08 Form 990 -EZ 01 Form 4720 09 Form 990•PF 04 Form 5227 10 Form 990•T (sec. 401 tai or 40Bta1 trust) 05 Form 6069 11 Form 990.7 (trust other than above) 06 Form 8870 12 BEVERLY STEPHENSON • The books are in the care of ► 41391 KALMIA AVE , SUITE 200 - MURRIETA r CA 9256 2 Telephone No. ► 951-314-2401 FAX No. ► • If the organization does not have an office or place of business in the United States, check this box ► CI • If this is for a Group Return, enter the organization's four digit Group Exemption Number (GEN) If this is for the whole group, check this box ► El . If it is for Dart of the orouo. check this box ► n and attach a list with the names and EINs of all members the extension is for. 1 I request an automatic 3 -month (6 months for a corporation required to file Form 990-T) extension of time until AUGUST 15, 2012 , to file the exempt organization return for the organization named above. The extension is for the organization's return for: ► I X I calendar year 2011 or ► 0 tax year beginning . and ending 2 If the tax year entered in line 1 is for less than 12 months, check reason: EI Initial return 0 Final return n Change in accounting period 3a If this application is for Forrn 990 -BL, 990•PF, 990-T, 4720, or 6069, enter the tentative tax, less any nonrefundable credits. See instructions. 3a S 0 • b If this application is for Form 990 -PF, 990-T, 4720, or 6069, enter any refundable credits and estimated tax payments made. Include any prior year overoavment allowed as a credit. 3b S 0 • Balance due. Subtract line 3b from line 3a. Include your payment with this form, if required, by uslno EFTPS (Electronic Federal Tax Payment Svstentl. See instructions 3c S 0 . Caution. If you are ooinc to make an electronic fund withdrawal with this Form 8868. see Form 8453•E0 and Forrn 8879•E0 for payment instructions. LHA For Privacy Act and Paperwork Reduction Act Notice, see Instructions. Form 8868 (Rev. 1-2012) 1 1 1 1 Form 990 Department of the Treasury Internal Revenue Service Return o. rganization Exempt From 11 sme Tax Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation) ► The organization may have to use a copy of this retum to satisfy state reporting requirements. OMB No. 1545-0047 2011 Open to Public Inspection A For the 2011 calendar year, or tax year beginning and ending B Check 11 applicable: Address change Name change Oburt return nTermin- ated nAmended return ntioo nce pending C Name of organization FINE ARTS NETWORK Doing Business As D Employer identification number Number and street (or P.O. box if mail is not delivered to street address) 41391 KALMIA AVE. City or town, state or country, and ZIP + 4 MURRIETA, CA 92562 Room/suite E Telephone number 200 951-314-2401 219,400. G Gross receipts $ H(a) Is this a group return F Name and address of principal officer:BEVERLY STEPHENSON for affiliates? 1T1 Yes {XJ No 41391 KALMIA AVE . , SUITE 200 , MURRIETA , CA H(b) Are all affiliates included? El Yes 0 No Tax•exempt status: 501(c)(3) 11 501(c) )41 (insert no.) [I 4947(a)(11 or Ln 527 IJ Website: WWW. FINEARTSACTICS . COM K Form of organization: Do Corporation rn Trust 1 1 Association CI Other IP' 1 1 Part 1 Summary If "No," attach a list. (see instructions) H(c) Group exemption number ► L Year of formation: 19941 M State of kraal domicile: CA Activities & Govemance 1 Briefly describe the organization's mission or most significant activities: BRING QUALITY THEATRICAL PRODUCTIONS AND PERFORMANCE OPPORTUNITIES TO THE TEMECULA VALLEY. 2 Check this box ► r 1 If the organization discontinued its operations or disposed of more than 25% of Its net 3 Number of voting members of the governing body (Part VI, fine la) 4 Number of independent voting members of the governing body (Part VI, line 1 b) 5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) 6 Total number of volunteers (estimate if necessary) 7 a Total unrelated business revenue from Part VIII, column (C), line 12 b Net unrelated business taxable income from Form 990•T. line 34 assets. 3 13 4 13 5 0 6 350 7a 0 . 7b 0 . Revenue 1 8 Contributions and grants (Part VIII, line 1 h) 9 Program service revenue (Part VIII, line 2g) 10 Investment income (Part VIII, column (A), lines 3, 4, and 7d) 11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 12 Total revenue - add lines 8 through 11 (must equal Part VIII. column (A). line 12) Prior Year Current Year 195,561 . 0 . 137,453. 186,002. 0 . 0 . 36,516. 33,398. 369,530. 219,400. Expenses 13 Grants and similar amounts paid (Part IX, column (A), lines 1.3) 14 Benefits paid t� or for members (Part IX, column (A), line 4) 15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-10) 16a Professional fundraising fees (Part IX, column (A), line 11e) b Total fundraising expenses (Part IX, column (0), line 25) ► 0 . 0 . 0 . 0 . 0 . 0 . 0 0 . 0 . 17 Other expenses (Part IX, column (A), lines 11a -11d, 11f -24e) 18 Total expenses. Add lines 13-17 (must equal Part IX, column (A), line 25) 19 Revenue less expenses. Subtract line 18 from tine 12 231,819. 249,879. 231,819. 249,879. 137,711. -30,479. etksets or and alancesl 20 Total assets (Part X, line 16) 21 Total liabilities (Part X, line 26) 22 Net assets or fund balances. Subtract line 21 from line 20 Beginning of Current Year End of Year 32,568. 11,889. 4,000. 13,800. 28,568. -1, 911. IPart II I Signature Block Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on at information of which preparer has any knowledge. I Sign Here Signature of officer 'BEVERLY STEPHENSON, EXECUTIVE DIREC OR Type or print name and title Date Paid Preparer Use Only Print/Type preparer's name JOSEPH J. KUEBLER, CPA Preparers signature 1'rli Gar,.e Fil PTIN sear oinco Phoneno. (951)676-3013 Mav the IRS discuss this return with the preparer shown above? (see instructions) .... ... (.�n.. I t) I�S1��%. r, I� .. •.. ves �� No �f �, ��1U ln) ll I�tJ 1.1 !) i rm 990 2011 LHA For Paperwork Reduction Act Notice, see the separate Instructions. ( J 132001 01-23-12 1 1 1 1 1 1 1 1 1 1 1 1 1 1 Form 990 (2011) FINE AR NETWORK Page 2 Statement of Program Service Accomplishments Check if Schedule 0 contains a response to any question in this Part III L1 1 Briefly describe the organization's mission: TO PROVIDE THE OPPORTUNITY FOR CHILDREN TO ACHIEVE SUCCESS AND SELF-ESTEEM THROUGH BROAD-BASED EXPOSURE TO AND EXPERIMENTATION IN THE FINE AND PERFORMING ARTS IN A HANDS-ON EDUCATIONAL ATMOSPHERE. 2 Did the organization undertake any significant program services during the year which were not listed on the prior Form 990 or 990•FZ? EJ Yes al No If "Yes," describe these new services on Schedule 0. 3 Did the organization cease conducting, or make significant changes in how it conducts, any program services'? 0 Yes ® No If "Yes," describe these changes on Schedule 0. 4 Describe the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(o)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue. if any, for each program service reported. 4a (Code: ) (Expenses $ 200. including grants of $ ) (Revenue $ 11,100.) PRODUCED PERFORMANCES AND PROVIDED WORKSHOPS FOR CHILDREN TO EXPAND THEIR KNOWLEDGE AND GIVE THEM THE OPPORTUNITY TO BE INVOLVED IN THE FINE AND PERFORMING ARTS. Part I11 4b (Code: ) (Expenses $ 214,101 . including grants of $ ) (Revenue $ 174,902.) BRING QUALITY THEATRICAL PRODUCTIONS AND PERFORMANCE OPPORTUNITIES TO THE TEMECULA VALLEY 4c (Code: ) (Expenses $ including grants of $ ) (Revenue $ 4d Other program services (Describe in Schedule 0.) including wants of $ ) (Revenue $ I(Exoensu S 4e Total program service expenses i10.214,301. 1 132002 02-09-12 ) Form 990 (2011) I 1 1 1 1 1 1 1 1 Form 990 (2011) FINE AR NETWORK Part VIII Statement of Revenue Page9 132009 01-23.12 990 Form (2011) (A) (B) (C) Revenue Total revenue Related or Unrelated excluded from exempt function business tax under revenue revenue sections 512, 513, or 514 Contributions, Gifts, Grants and Other Similar Amounts 1 a Federated campaigns b Membership dues c Fundraising events d Related organizations e Government grants (contributions) f All other contributions, gifts, grants, similar amounts not included above g Noncash contributions included In lines to h Total. Add lines la -1f and -1f: S la 1b 1c 1d 1e 1f ► Program Service 4 Revenue 2a TICKET SALES Business Code 172,292. 172,292. 711110 b SUMMER CAMP MUSIC 711110 11,100. 11,100. c CAROLING 711110 1,780. 1,780. d MISC 711110 830. 830. e f All other program service revenue q Total. Add lines 2a•2t ► 186,002. Other Revenue I 3 Investment income (including other similar amounts) 4 Income from investment of tax-exempt 5 Royalties 8 a Gross rents b Less: rental expenses c Rental income or (loss) d Net rental income or (loss) 7 a Gross amount from sales of assets other than inventory b Less: cost or other basis and sales expenses c Gain or (loss) d Net gain or (loss) 8 a Gross income from fundraising including $ dividends, interest, and ► bond proceeds P. ► (1) Real (ii) Personal ► () Securities (ii) Other events (not of a b events See a b a b ► 33,398. 33,398. 33,398. contributions reported on line lc). See Part IV, line 18 b Less: direct expenses c Net income or (loss) from fundraising 9 a Gross income from gaming activities Part IV, line 19 b Less: direct expenses c Net income or (loss) from gaming activities 10 a Gross sales of inventory, less returns and allowances b Less: cost of goods sold c Not income or (loss) from sales of inventory 0 . ► ► ► Miscellaneous Revenue Business Code 11 a b c d All other revenue e Total. Add lines 11a-1 ld 12 Total revenue. See instructions. ► ► 219,400.1 186,002. 0. 33,398. 132009 01-23.12 990 Form (2011) Form 990 (2011) FINE AFS NETWORK Part IX 1 1 1 1 1 1 1 1 i 1 1 Page10 Statement of Functional Expenses Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D). Check if Schedule 0 contains a response to any question in this Part IX ( Do not include amounts reported on lines 6b, B C Fundraising Total expenses Program service Management and Fun raising 7b, 8b, 9b, and 10b of Part VIII. expenses general expenses expenses 1 1 1 1 1 Grants and other assistance to governments and organizations in the United States. See Part IV, line 21 2 Grants and other assistance to individuals in the United States. See Part IV, line 22 3 Grants and other assistance to govemments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16 4 Benefits paid to or for members 5 Compensation of current officers, directors, trustees, and key employees 6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) 7 Other salaries and wages 8 Pension plan accruals and contributions (include section 401(0 and section 403(b) employer conbibutions) 9 Other employee benefits 10 Payroll taxes 11 Fees for services (non•empioyees): a Management b Legal c Accounting d Lobbying e Professional fundraising services. See Part IV, line 17 f Investment management fees g Other 12 Advertising and promotion 13 Office expenses 14 Information technology 15 Royalties 16 Occupancy 17 Travel 18 Payments of travel or entertainment expenses for any federal, state, or focal public officials 19 Conferences, conventions, and meetings 20 Interest 21 Payments to affdiates 22 Depreciation, depletion, and amortization 23 Insurance 24 Other expenses. Itemize expenses not covered above. (List miscellaneous expenses In line 24e. It line 24e amount exceeds 10%4 of line 25, column (A) amount, list line 24e expenses on Schedule 0.) a PRODUCTION EXPENSES b BANK CHARGES c UTILITIES d SALES TAX e All other expenses 25 Total functional expenses. Add lines 1 through 24e 26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here 134 it tollowino SOP 9e-2 (ASC 0561201 132010 01-23-12 908. 908. 1,830. 22. 1,830. 22. 22,860. 254. 22,860. 254. 1,142. 1,142. 1,839. 1,839. 214,101. 3,926. 214,101. 1,666. 439. 892. 200. 249,879. 214,301. 3,926. 1,666. 439. 692. 35,578. 0. Form 990 (2011) 1 Form 990 (2011) FINE ARS , NETWORK 1 1 1 1 1 1 1 Page11 ra, i /IL I ..sa.a.•....ser ..ow.. (A) Beginning of year (B) End of year Assets 1 Cash • non•interest•bearing 2 Savings and temporary cash investments 3 Pledges and grants receivable, net 4 Accounts receivable, net 5 Receivables from current and former officers, directors, employees, and highest compensated employees. of Schedule L 6 Receivables from other disqualified persons (as defined 4958(0(1)), persons described in section 4958(c)(3)(8), employers and sponsoring organizations of section employees' beneficiary organizations (see instructions) 7 Notes and loans receivable, net 8 Inventories for sale or use 9 Prepaid expenses and deferred charges 10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D b Less: accumulated depreciation 11 Investments • publicly traded securities 12 Investments • other securities. See Part IV, line 11 13 Investments • program -related. See Part IV, line 11 14 Intangible assets 15 Other assets. See Part Iv, line 11 16 Total assets. Add lines 1 through 15 (must equal Complete 501(c)(9) 10a 26,563. 1 6,797. 2 3 4 trustees, key Part II 5 under section and contributing voluntary 6 7 8 9 17,765. 848. 1oc 239. 10b 17,526. line 34) .. 11 12 13 14 5,157. 15 4,853. 32,568. 16 11,889. d = @ —r 17 Accounts payable and accrued expenses 18 Grants payable 19 Deferred revenue 20 Tax-exempt bond liabilities 21 Escrow or custodial account liability. Complete Part IV of Schedule D 22 Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified persons. Complete Part II of Schedule L 23 Secured mortgages and notes payable to unrelated third parties 24 Unsecured notes and loans payable to unrelated third parties 25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17.24). Complete Part X of Schedule D 26 Total liabilities. Add lines 17 through 25 . _.... _........ _... _ 17 18 19 20 21 4,000. 22 13,800. 23 24 25 4 0 0 0 . 26 13,800. Net Assets or Fund Balances ,........ Organizations that follow SFAS 117, check here 110.0 an d complete lines 27 through 29, and lines 33 and 34. 27 Unrestricted net assets 28 Temporarily restricted net assets 29 Permanently restricted net assets Organizations that do not follow SFAS 117, check here ► LXJ and complete lines 30 through 34. 30 Capital stock or trust principal, or current funds 31 Paid -in or capital surplus, or land, building, or equipment fund 32 Retained earnings, endowment, accumulated income, or other funds 33 Total net assets or fund balances , 34 Total liabilities and net assets/fund balances 27 28 29 0 . 30 0 . 0 . 31 0 • 137,711. 32 107,232. 28,568. 33 —1,911. 32,568. 34 11,889. e___ OCtA ,nnI .. 132011 01-23-12 1 Form 990 2011) FINE M. NETWORK Part XII' Reconciliation of Net Assets Check if Schedule 0 contains a response to any question in this Part XI 0 1 Total revenue (must equal Part VIII, column (A), line 12) 1 219,400. 2 Total expenses (must equal Part IX, column (A), line 25) 2 249,879. 3 Revenue less expenses. Subtract line 2 from line 1 3 -30,479. 4 Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) 4 28,568. 5 Other changes in net assets or fund balances (explain in Schedule 0) 5 0 6 Net assets or fund balances at end of year. Combine lines 3. 4, and 5 (must equal Part X, line 33. column (8)) 6 —1 , 911. Financial Statements and Reporting Check if Schedule 0 contains a response to any question in this Part XII 0 No Page 12 Part XII, 1 Accounting method used to prepare the Form 990: ® Cash [] Accrual n Other If the organization changed its method of accounting from a prior year or checked "Other," explain in Schedule 0. 2a Were the organization's financial statements compiled or reviewed by an independent accountant? b Were the organization's financial statements audited by an independent accountant? c If "Yes" to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant? If the organization changed either its oversight process or selection process during the tax year, explain in Schedule 0. d If "Yes" to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both: El Separate basis Consolidated basis n Both consolidated and separate basis 3a As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? b If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits. explain why in Schedule 0 and describe any steos taken to underoo such audits. 132012 01.23.12 ................................ Yes 2a X 2b X 2c 3a X 3b Form 990 (2011) Form 990 2011) FINE AR NETWORK Pagel Part VIII Compensation of Officers, virectors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors Check if Schedule 0 contains a response to any question in this Part VII Li Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees 1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization's tax year. • List all of the organization's current officers, directors, trustees (whether individuals or organizations), regardless of amount of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid. • List all of the organization's current key employees, if any. See instructions for definition of "key employee." • List the organization's five current highest compensated employees (other than an officer, director, trustee, or key employee) who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the organization and any related organizations. • List all of the organization's former officers, key employees, and highest compensated employees who received more than $100,000 of reportable compensation from the organization and any related organizations. • List all of the organization's former directors or trustees that received, in the capacity as a former director or trustee of the organization, more than $10,000 of reportable compensation from the organization and any related organizations. List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest compensated employees; and former such persons. r, director, or trustee. LdJ'.jFIUl:K 11115 WA 11 110111101 aro V,ya,ncauvr,..v. (A) Name and Title 0..7.v.o•v.. v.yw....................-,,...,_.__ (B) Average hours per week (C) Position(do not check more than one box unless person 's both an officer and a director/trus ee) _..i __.._-_ -.... (D) Reportable compensation from the organization (W-2/1099•MISC) (E) Reportable compensation from related organizations (W-2/1099•MISC) (F) Estimated amount of other compensation from the organization and related organizations (describe hours for related organizations in Schedule 0) i7 5 ' a - — ¢ U Key emp"oyee 5 ' ta o 4°E . (1) WINSTON EARLE PRESIDENT 3.00 X O. O. O. (2) TERRY WELBORN TREASURER 1.00 X 0. 0. 0. (3) ELAINE NELSON SECRETARY 2.00 X O. 0. O. (4) BEVERLY STEPHENSON EXECUTIVE DIRECTOR 40.00 X O. O. O. (5) PAUL JACQUES VICE PRESIDENT 1.00 X 0. 0. 0• (6) JOSEPH ARREOLA VICE PRESIDENT 1.00 X O. O. O. (7) JOE ARREOLA VICE PRESIDENT 1.00 X O. O. 0. (8) ANNE YORK VICE PRESIDENT 1.00 X 0. 0. 0 (9) BOBBIE GOES VICE PRESIDENT 2.00 X 0. 0. 0 (10) DENISE WALKER VICE PRESIDENT 1.00 X 0. 0. 0. (11) DANTE GUMICIO VICE PRESIDENT 1.00 X O. O. O. (12) LISSA SUPLER VICE PRESIDENT 1.00 X O. O. 0. (13) MARY JO RODRIGUEZ VICE PRESIDENT 1.00 X 0. O. O. — AAA ........ OM) . 132007 01.23.12 Exempt Organizations Select Check Page 1 of 1 IRS Exempt Organizations Select Check Exempt omanizations SelectCheck Home Organizations ElIgtie to Receive Tex -Deductible Con1rlbutione (Pub. 78 dete) - Sottish Results The follovAng list Includes lax -exempt organizations that ere eligible to receive tax-deductible contributions. Click on the *Deductibility Status' column for an explanation of Nmilatons on the deductibility of contributions made to different types of tax-exempt organizations. Results ere sorted by EIN. To sort results by another category. dick on the 10011 next to the column heading for that category. Clicking on that Icon a second time wit reverse the sort order. Click on a column heading for an explanation of Information In that column. 1-1 of 1 mutts Results Per Page 26 :!.f, OK 1 EIN., LegalName(Doing Business As) . City. Fine Ade Network Murrieta R _u to J Stale Country a CA United Stales ePrey il-1INext ► Dedudibili ,Stelus A PC .Prey i1-1INext s http://apps.irs.gov/app/eos/pub78Search.do?ein1=330624570&names=&city=&state=All 9/9/2013 City of Temecula 2013-14 CS Funding Program APPLICATION NO. 12 RECEIVED CITY OF TEMECULA AUG 3 G 2013 CITY MANAGER'S FISCAL YEAR 2013.1 4 OFFICE COMMUNITY SERVICE FUNDING PROGRAM APPLICATION (Please Print or Type) 2013-14 Program Submission Deadline: Friday, August 30, 2013 (original, plus one copy) PROJECT INFORMATION Amount Requested: $ 5, 000 Project Name: Transitional & Supportive Housing Project Start Date: June 2011 Project End Date: N/A (Maximum allowable $5,000) ORGANIZATION INFORMATION Name of Organization: God's Fan Club DBA Project T.O.U,C.H, Contact Name: Anne Unmacht Title/Position: President Mailing Address: 30141 Antelope Rd. #D103, Menifee CA 92584 Telephone: 951-677-9661 Year Organization Founded: 2003 Number of Paid Staff: 0 Number of Volunteers: 100+ Geographic Area(s) Served: Temecula -Southwest Riverside County Is this organization incorporated in California as a non-profit organization? Yes X No Effective Date: 9/26/03 If "no": If "yes" (Must provide a copy of your statement of non- profit status from the State of California): Date of incorporation as a non-profit: 9/26/03 Federal identification number: State identification number: Name of sponsoring organization: Federal identification number: State identification number: This application has been authorized by the organization's: Executive Committee Board of Directors X Members -at -Large Application Page 1 FY 2012-13 COMPLIANCE REQUIREMENT IF YOUR ORGANIZATION WAS A RECIPIENT OF FUNDING FOR FY 2012-13, PLEASE ATTACH COPIES OF INVOICES, RECEIPTS AND CANCELLED CHECKS TO SUBSTANTIATE THOSE FUNDS RECEIVED AND EXPENDED BY YOUR ORGANIZATION. FINANCIAL STATEMENTS PLEASE ATTACH COPIES OF THE CURRENT BUDGET OF THE ORGANIZATION AND FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT). It does not require a CPA's audit, but please submit if available. MISSION STATEMENT Briefly describe the goals and objectives of your organization and community services it provides. Describe the ways your organization meets the criteria listed on page 2 of the CS Funding Policy. Project T.O.U.C.H. (PT) provides critical shelter to single mothers with children, single fathers, with children, entire families, emancipated foster youth, U.S. Veterans, indigent hospital patients, single men. single women. and anyone in need of assistance. Since 2003 PT has been serving the community of Temecula by operating a call resource center to assist area residents with resources that are available to them in a time of need. We are listed with 211 as a resource for our community. We also assist the Temecula Police with homeless situations by operating a dedicated 24/7 phone line allowing the police to move on to other calls. We provide resources and services such as motel stays; food and clothing; bus tickets; gas; and many other emergency services we may face on a case by case basis. PT has ran the local cold weather shelter the last few years providing shelter, a warm place to sleep, food, clothing, and blankets to those homeless in our valley. We've been able to transition some of our homeless clients into our transitional housing program and we have been able to get some back to their families and/or into other programs. Our Mission: Bridging individual and collective bodies of faith within our communities together with civil and business organizations to effectively overcome homelessness and establish effective methods of homeless prevention. PT does not request or require adherence by program beneficiaries to any particular faith in order to receive program services. PROJECT DESCRIPTION Application Page 2 How will your organization use the funding awarded? Describe the project, project objectives, those served, area serviced, and number of volunteers involved. Be specific. Include equipment or services that would be purchased and why. Include a detailed budget and a schedule of significant activities related to this project. You may attach a maximum of one double-spaced typewritten page of information. (Please type or print legibly.) Funds awarded will go towards our Transitional Housing Program which serves low income, extremely low income, and no income clients in Temecula. In the last three years PT has dramatically increased its capacity to shelter homeless individuals and families with 25 apartment units and one single family residence where we house approximately 120 clients which includes approximately 40 children on any given day. There are approximately 20 volunteers that support and maintain this program. Our program objective is to safely shelter our clients in a healthy and nurturing environment creating a sense of family amongst program participants. Each client or family head will collaborate with case management volunteers, mentors, and peers to progress toward gainful employment and/or educational achievement to attain self-sufficiency. Because our clients are at the lowest income levels PT must assist with even the most basic of living necessities such as food; hygiene; clothing; cleaning products and detergents; medication and prescriptions; transportation to appointments for medical, employment, social services, and shopping; and bus passes. The funds will be used primarily to cover Specific Assist expenses (per program budget) and costs associated with running our transportation van such as gas and maintenance. Transportation is critical to our clients. The van is driven six days a week to get our clients to and from medical appointments, social services, employment interviews, grocery shopping, food resources, laundry services, and educational classes. Application Page 3 PAST PROJECT BENEFITS If your organization received City of Temecula funding in the previous year, please explain and show how Temecula residents benefited. Application Page 4 SIGNATURE PAGE We hereby certify the information contained in this application is true to the best of our knowledge and belief. PREPARED BY: Monica Femandez Accountant NAME and TITLE (PI Print or Type) SIGNATURE: PRESIDENT or AUTHORIZED OFFICER: Anne Unmacht President NAME and TITLE (Please Print or Type) SIGNATURE: ,/ %`.'m'i`l.- ORGANIZATION NAME: Protect T.O.U.C.H. MAILING ADDRESS: 30141 Antelope Rd., #D103, Menifee CA 92584 TELEPHONE: 951-677-9661 EMAIL ADDRESS: info@projecttouchonline.com DATED THIS 30th of August , 2013 (Date) (Month) BE SURE TO INCLUDE THE ORIGINAL PLUS ONE COPY AND SUBMIT BY AUGUST 30, 2013 TO: Mail Completed Applications to: Or Deliver in Person to: City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office Post Office Box 9033 Temecula, CA 92589-9033 City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office 41000 Main Street Temecula, CA 92590 Application Page 5 God's Fan Club Program Budget December 2013 through November 2014 Dec 13 Jan 14 Feb 14 Mar 14 Apr 14 May 14 Jun 14 Ordinary IncomelExpense Income 43450 • Individ, Business Contributions 3,000.00 3,000.00 3,000.00 3,000.00 3,000.00 3,000.00 3,000.00 44000 • Program Service Revenue 33,000.00 33,000.00 33,000.00 33,000.00 33,000.00 33,000.00 33,000.00 44500 • Grants 0.00 5,000.00 Total Income 36,000.00 36,000.00 41,000.00 36,000.00 36,000.00 36,000.00 36,000.00 Gross Profit 36,000.00 36,000.00 41,000.00 36,000.00 36,000.00 36,000.00 36,000.00 Expense 60300 • Specific Assist to Individuals 60320 • Food 125.00 125.00 125.00 125.00 125.00 125.00 125.00 60330 • Gas 100.00 100.00 100.00 100.00 100.00 100.00 100.00 60350 • Hygiene 50.00 50.00 50.00 50.00 50.00 50.00 50.00 60360 • Misc 100.00 100.00 100.00 100.00 100.00 100.00 100.00 60370 • Automotive Expenses & Repairs 60.00 60.00 60.00 60.00 60.00 60.00 60.00 60380 • Utilities 5,000.00 5,000.00 5,000.00 5,000.00 5,000.00 5,000.00 5,000.00 60390 • Rental Assistance 30,000.00 30,000.00 30,000.00 30,000.00 30,000.00 30,000.00 30,000.00 60400 • Bus Pass & Transportation 50.00 50.00 50.00 50.00 50.00 50.00 50.00 60410 • Medication 100.00 100.00 100.00 100.00 100.00 100.00 100.00 60430 • Gift Cards 50.00 50.00 50.00 50.00 50.00 50.00 50.00 Total 60300 • Specific Assist to Individuals 35,635.00 35,635.00 35,635.00 35,635.00 35,635.00 35,635.00 35,635.00 62100 • Contract Services 62110 • Accounting Fees Total 62100 • Contract Services 62800 • Facilities and Equipment 62805 • 2007 Toyota Sienna 62810 • Gas 62815 • Maintenance 750.00 750.00 750.00 600.00 600.00 600.00 750.00 750.00 600.00 600.00 750.00 750.00 600.00 600.00 30.00 30.00 Page 1 of 4 God's Fan Club Program Budget December 2013 through November 2014 Dec 13 Jan 14 Feb 14 Mar 14 Apr 14 May 14 Jun 14 Total 62805 • 2007 Toyota Sienna 600.00 600.00 630.00 600.00 600.00 630.00 600.00 65000 • Operations 65035 - Program Supplies 200.00 200.00 200.00 200.00 200.00 200.00 200.00 65040 • Office Supplies 50.00 50.00 50.00 50.00 50.00 50.00 50.00 65050 • Telephone, Telecommunications 120.00 120.00 120.00 120.00 120.00 120.00 120.00 Total 65000 - Operations 370.00 370.00 370.00 370.00 370.00 370.00 370.00 65100 • Other Types of Expenses 65120 • Insurance - Liability, D and 0 200.00 200.00 200.00 200.00 200.00 200.00 200.00 Total Expense 36,805.00 36,805.00 36,835.00 36,805.00 36,805.00 36,835.00 36,805.00 Net Ordinary Income -805.00 -805.00 4,165.00 -805.00 -805.00 -835.00 -805.00 Net Income -805.00 -805.00 4,165.00 -805.00 -805.00 -835.00 -805.00 Page 2 of 4 Ordinary Income/Expense Income 43450 • Individ, Business Contributions 44000 • Program Service Revenue 44500 • Grants Total Income Gross Profit God's Fan Club Program Budget December 2013 through November 2014 Jul 14 Aug 14 Sep 14 Oct 14 TOTAL Nov 14 Dec '13 - Nov 14 3,000.00 3,000.00 3,000.00 3,000.00 3,000.00 36,000.00 33,000.00 33,000.00 33,000.00 33,000.00 33,000.00 396,000.00 5,000.00 10,000.00 36,000.00 36,000.00 41,000.00 36,000.00 36,000.00 442,000.00 36,000.00 36,000.00 41,000.00 36,000.00 36,000.00 442,000.00 Expense 60300 • Specific Assist to Individuals 60320 • Food 125.00 125.00 125.00 125.00 125.00 1,500.00 60330 • Gas 100.00 100.00 100.00 100.00 100.00 1,200.00 60350 • Hygiene 50.00 50.00 50.00 50.00 50.00 600.00 60360 • Misc 100.00 100.00 100.00 100.00 100.00 1,200.00 60370 • Automotive Expenses & Repairs 60.00 60.00 60.00 60.00 60.00 720.00 60380 • Utilities 5,000.00 5,000.00 5,000.00 5,000.00 5,000.00 60,000.00 60390 • Rental Assistance 30,000.00 30,000.00 30,000.00 30,000.00 30,000.00 360,000.00 60400 • Bus Pass & Transportation 50.00 50.00 50.00 50.00 50.00 600.00 60410 • Medication 100.00 100.00 100.00 100.00 100.00 1,200.00 60430 • Gift Cards 50.00 50.00 50.00 50.00 50.00 600.00 Total 60300 • Specific Assist to Individuals 35,635.00 35,635.00 35,635.00 35,635.00 35,635.00 427,620.00 62100 • Contract Services 62110 • Accounting Fees Total 62100 • Contract Services 750.00 750.00 750.00 750.00 750.00 9,000.00 9,000.00 62800 • Facilities and Equipment 62805 • 2007 Toyota Sienna 62810 • Gas 600.00 600.00 600.00 600.00 600.00 7,200.00 62815 • Maintenance 30.00 30.00 120.00 Page 3 of 4 Total 62805 • 2007 Toyota Sienna God's Fan Club Program Budget December 2013 through November 2014 TOTAL Jul 14 Aug 14 Sep 14 Oct 14 Nov 14 Dec '13 - Nov 14 600.00 630.00 600.00 600.00 630.00 7,320.00 65000 • Operations 65035 • Program Supplies 65040 • Office Supplies 65050 • Telephone, Telecommunications Total 65000 • Operations 200.00 200.00 200.00 200.00 200.00 50.00 50.00 50.00 50.00 50.00 120.00 120.00 120.00 120.00 120.00 370.00 370.00 370.00 370.00 370.00 2,400.00 600.00 1,440.00 4,440.00 65100 • Other Types of Expenses 65120 • Insurance - Liability, D and 0 200.00 200.00 200.00 200.00 200.00 2,400.00 Total Expense 36,805.00 36,835.00 36,805.00 36,805.00 36,835.00 450,780.00 Net Ordinary Income -805.00 -835.00 4,195.00 -805.00 -835.00 220.00 Net Income -805.00 -835.00 4,195.00 -805.00 -835.00 220.00 Page 4of4 God's Fan Club Organizational Budget December 2012 through November 2013 Dec 12 Jan 13 Feb 13 Mar 13 Apr 13 May 13 Jun 13 Ordinary Income/Expense Income 43450 • Individ, Business Contributions 10,000 10,000 44000 • Program Service Revenue 33,000 33,000 44500 • Grants 49015 • Special Events 13,000 8,000 Total Income 56,000 51,000 Gross Profit 56,000 51,000 10,000 10,000 10,000 10,000 10,000 33,000 33,000 33,000 33,000 33,000 5,000 1,000 250 250 500 60,000 48,000 44,000 43,250 43,250 103,500 48,000 44,000 43,250 43,250 103,500 Expense 60300 • Specific Assist to Individuals 60310 • Motel Stays 200 200 200 200 200 200 200 60320• Food 150 150 150 150 150 150 150 60330• Gas 250 250 250 250 250 250 250 60340 • Clothing 100 100 100 100 100 100 100 60350 • Hygiene 100 100 100 100 100 100 100 60360• Misc 200 200 200 200 200 200 200 60370 • Automotive Expenses & Repairs 100 100 100 100 100 100 100 60380 • Utilities 5,000 5,000 5,000 5,000 5,000 5,000 5,000 60390 • Rental Assistance 30,000 30,000 30,000 30,000 30,000 30,000 30,000 60400 • Bus Pass & Transportation 100 100 100 100 100 100 100 60410 • Medication 50 50 50 50 50 50 50 60430•Gift Cards 100 100 100 100 100 100 100 Total 60300 • Specific Assist to Individuals 36,350 36,350 36,350 36,350 36,350 36,350 36,350 60900 • Business Expenses 60910 • Bad Debts 1,000 60920 • Business Registration Fees 100 Total 60900 • Business Expenses 1,100 1,000 1,000 1,000 1,000 1,000 194 1,194 1,000 1,000 1,000 1,000 1,000 1,000 Page 1 of 6 God's Fan Club Organizational Budget December 2012 through November 2013 Dec 12 Jan 13 Feb 13 Mar 13 Apr 13 May 13 Jun 13 62100 • Contract Services 62110 • Accounting Fees 2,000 2,000 2,800 2,000 2,000 2,000 2,000 62150 • Outside Contract Services 500 500 500 500 500 500 500 Total 62100 • Contract Services 2,500 2,500 3,300 2,500 2,500 2,500 2,500 62800 • Facilities and Equipment 62805 • 2007 Toyota Sienna 62810• Gas 600 600 600 600 600 600 600 62815 • Maintenance 30 30 Total 62805 • 2007 Toyota Sienna 600 600 630 600 600 630 600 62880 • Rent 840 1,340 1,340 1,340 1,340 1,340 1,340 Total 62800 • Facilities and Equipment 1,440 1,940 1,970 1,940 1,940 1,970 1,940 65000 • Operations 65010 • Books, Subscriptions, Reference 30 25 25 21 65020 • Postage, Mailing Service 31 4 30 18 114 18 12 65030 • Printing and Copying 19 38 18 65035 • Program Supplies 243 186 85 246 309 192 194 65040 • Office Supplies 238 152 326 331 26 727 284 65050 • Telephone, Telecommunications 412 447 417 637 334 514 456 65060 • Payment Processing Fee 172 156 99 94 115 93 101 65070 • Bank Service Fees 65 55 63 51 57 64 33 65080 • Website Hosting Total 65000 • Operations 1,161 1,047 1,045 1,376 980 1,645 1,118 65100 • Other Types of Expenses 65110 • Advertising Expenses 55 65120 • Insurance - Liability, D and 0 300 2,500 200 200 200 200 65150 • Memberships and Dues 85 100 55 65160 • Other Costs 55 572 480 422 65170 • Staff Development 200 280 Page 2of6 God's Fan Club Organizational Budget December 2012 through November 2013 Dec 12 Jan 13 Feb 13 Mar 13 Apr 13 May 13 Jun 13 65180 • Charitable Donations 100 10 104 250 67 200 65190 • Gifts & Promotions 640 50 17 10 31 Total 65100 • Other Types of Expenses 1,095 3,132 406 200 1,030 809 711 68300 • Travel and Meetings 68310 • Conference, Convention, Meeting 25 80 20 68325 • Mileage Reimburse- Volunteers 250 250 250 250 250 250 250 68330 • Business Meals 107 71 80 126 42 197 67 Total 68300 • Travel and Meetings 382 321 330 376 292 527 337 69000 • Fundraising Expenses 69010 • Banquet Expenses 5,000 69020 • Green Fees 15,000 69030 • Printing & Copying 129 69040 • Prizes 1,215 69050 • Supplies 500 3,446 69060.Other Expenses 852 69070 • Event Planning-M&E 443 Total 69000 • Fundraising Expenses 500 0 0 0 0 0 26,085 Total Expense 44,527 46,290 44,401 43,937 44.091 44,802 70,042 Net Ordinary Income 11,473 4,710 3,599 63 -841 -1,552 33,458 Net Income 11,473 4,710 3,599 63 -841 -1,552 33,458 Page 3 of 6 God's Fan Club Organizational Budget December 2012 through November 2013 Jul 13 Aug 13 Sep 13 Oct 13 TOTAL Nov 13 Dec 12 -Nov 13 Ordinary Income/Expense Income 43450 • Individ, Business Contributions 10,000 10,000 10,000 10,000 10,000 120,000 44000 • Program Service Revenue 33,000 33,000 33,000 33,000 33,000 396,000 44500 • Grants 5,000 12,000 49015 • Special Events 81,000 Total Income 43,000 43,000 48,000 43,000 43,000 609,000 Gross Profit 43,000 43,000 48,000 43,000 43,000 609,000 Expense 60300 • Specific Assist to Individuals 60310 • Motel Stays 200 200 200 200 200 2;400 60320 • Food 150 150 150 150 150 1,800 60330 • Gas 250 250 250 250 250 3,000 60340• Clothing 100 100 100 100 100 1,200 60350 • Hygiene 100 100 100 100 100 1,200 60360 • Misc 200 200 200 200 200 2,400 60370 • Automotive Expenses & Repairs 100 100 100 100 100 1,200 60380 • Utilities 5,000 5,000 5,000 5,000 5,000 60,000 60390 - Rental Assistance 30,000 30.000 30,000 30,000 30,000 360,000 60400 • Bus Pass & Transportation 100 100 100 100 100 1,200 60410 • Medication 50 50 50 50 50 600 60430 • Gift Cards 100 100 100 100 100 1,200 Total 60300 • Specific Assist to Individuals 36,350 36,350 36,350 36,350 36,350 436,200 60900 • Business Expenses 60910 • Bad Debts 1,000 60920 • Business Registration Fees 60 Total 60900 • Business Expenses 1,060 1,000 1,000 1,000 15 1,015 1,000 1,000 12,000 369 1,000 1,000 12,369 Page 4 of 6 God's Fan Club Organizational Budget December 2012 through November 2013 TOTAL Jul 13 Aug 13 Sep 13 Oct 13 Nov 13 Dec 12 -Nov 13 62100 • Contract Services 62110 • Accounting Fees 2,000 2,000 2,000 2,000 2,000 62150 • Outside Contract Services 500 500 500 500 500 Total 62100 • Contract Services 2,500 2.500 2,500 2,500 2,500 62800 • Facilities and Equipment 62805 • 2007 Toyota Sienna 62810•Gas 600 600 600 600 600 62815 • Maintenance 30 30 Total 62805 • 2007 Toyota Sienna 600 630 600 600 630 62880 • Rent 1,340 1,340 1,340 1,340 1.340 Total 62800 • Facilities and Equipment 1,940 1,970 1,940 1,940 1,970 24,800 6,000 30,800 7,200 120 7,320 15,580 22,900 65000 • Operations 65010 • Books, Subscriptions, Reference 26 81 20 38 265 65020 • Postage, Mailing Service 24 32 24 135 5 447 65030 • Printing and Copying 61 10 146 65035 • Program Supplies 233 316 199 88 232 2,522 65040 • Office Supplies 253 389 1,143 338 537 4,742 65050 • Telephone, Telecommunications 445 454 452 448 413 5,429 65060 • Payment Processing Fee 113 199 256 597 431 2,425 65070 • Bank Service Fees 39 46 10 20 5 509 65080 • Website Hosting 140 20 160 Total 65000 • Operations 1,133 1,637 2,184 1,655 1,661 16,643 65100 • Other Types of Expenses 65110 • Advertising Expenses 55 65120 • Insurance - Liability, D and 0 200 200 200 200 200 4,800 65150 • Memberships and Dues 200 720 65160 • Other Costs 38 295 58 1,919 65170 • Staff Development 100 100 Page 5 of 6 God's Fan Club Organizational Budget December 2012 through November 2013 TOTAL Jul 13 Aug 13 Sep 13 Oct 13 Nov 13 Dec 12 -Nov 13 65180 - Charitable Donations 300 1,031 65190 • Gifts & Promotions 134 102 105 1,091 Total 65100 • Other Types of Expenses 334 238 1,197 305 258 9,716 68300 • Travel and Meetings 68310 • Conference, Convention, Meeting 68325 • Mileage Reimburse- Volunteers 68330 • Business Meals Total 68300 • Travel and Meetings 20 8 85 238 250 250 250 250 250 3,000 22 178 113 102 1,106 272 448 363 360 335 4,344 69000 • Fundraising Expenses 69010 • Banquet Expenses 5,000 69020 • Green Fees 15,000 69030 • Printing & Copying 129 69040 • Prizes 1,215 69050 • Supplies 3,946 69060 • Other Expenses 852 69070 • Event Planning-M&E 443 Total 69000 • Fundraising Expenses 0 0 0 0 0 26,585 Total Expense 43,590 44,143 45,550 44,111 44,074 559,557 Net Ordinary Income -590 -1.143 2,450 -1,111 -1,074 49,443 Net Income -590 -1,143 2,450 -1,111 -1,074 49,443 Page 6 of 6 God's Fan Club Statement of Activities December 2011 through November 2012 Income 43400 • Direct Public Support 43440 • Gifts in Kind - Goods $ 3,311 43450 • Indlvid, Business Contributions 106,591 Total 43400 • Direct Public Support $ 109,901 44000 • Program Service Revenue 267,732 44500 • Grants 36,500 Total 45000 • Investments 26 49000 • Special Events Income- Fundrais 43,136 Total Income $ 457,295 Gross Profit $ 457,295 Expense 60300 • Specific Assist to Individuals 60310 • Motel Stays $ 4,103 60320 • Food 1,498 60330 • Gas 2,832 60340 • Clothing 916 60350 • Hygiene 127 60360 • Misc 1,570 60370 • Automotive Expenses & Repairs 4,061 60380 • Utilities 40,254 60390 • Rental Assistance 251,204 60400 • Bus Pass & Transportation 1,035 60410 • Medication 373 60420 • Cash Assistance 535 60430 • Gift Cards 1,680 Total 60300 • Specific Assist to Individuals $ 310,188 60900 • Business Expenses 60910 • Bad Debts 8,829 60920 • Business Registration Fees 369 Total 60900 • Business Expenses $ 9,198 Page 1 of 3 God's Fan Club Statement of Activities December 2011 through November 2012 62100 • Contract Services 62110 • Accounting Fees 18,633 62150 • Outside Contract Services 6,680 Total 62100 • Contract Services $ 25,313 62800 • Facilities and Equipment 62805 • 2007 Toyota Sienna 62810 • Gas 2,749 62815 • Maintenance 426 Total 62805 • 2007 Toyota Sienna $ 3,175 62830 • Donated Facilities 3,250 62840 • Repairs and Maintenance 88 62880 • Rent 16,730 Total 62800 • Facilities and Equipment $ 23,243 65000 • Operations 65010 • Books, Subscriptions, Reference 265 65020 • Postage, Mailing Service 447 65030 • Printing and Copying 150 65035 • Program Supplies 2,522 65040 • Office Supplies 4,742 65050 • Telephone, Telecommunications 5,429 65060 • Payment Processing Fee 2,425 65070 • Bank Service Fees 509 65080 • Website Hosting 160 Total 65000 • Operations $ 16,648 65100 • Other Types of Expenses 65110 • Advertising Expenses 55 65115 • Cash Over/Short 174 65120 • Insurance - Liability, D and 0 4,868 65150 • Memberships and Dues 620 65160 • Other Costs 1,519 65170 • Staff Development 100 65180 • Charitable Donations 1,031 65190 • Gifts & Promotions 1,091 Total 65100 • Other Types of Expenses $ 9,458 68300 • Travel and Meetings 68310 • Conference, Convention, Meeting 238 68325 • Mileage Reimburse- Volunteers 3,251 68330 • Business Meals 1,106 Total 68300 • Travel and Meetings $ 4,595 Page 2 of 3 God's Fan Club Statement of Activities December 2011 through November 2012 69000 • Fundraising Expenses 69010 • Banquet Expenses 3,200 69020 • Green Fees 10,030 69030 • Printing & Copying 129 69040 • Prizes 1,215 69050 • Supplies 3,445 69060 • Other Expenses 852 69070 • Event Planning-M&E 443 Total 69000 • Fundraising Expenses $ 19,314 Total Expense $ 417,957 Net Ordinary Income $ 39,338 Net Income $ 39,338 Page 3 of 3 God's Fan Club Statement of Financial Position As of November 30, 2012 Nov 30, 12 Nov 30, 11 $ Change ASSETS Current Assets Checking/Savings 10000 • GFC- Wells Fargo- 0681 $ $ 4 $ (3.90) 10002 • PT- Wells Fargo Checking- 0418 33,763 (33,763) 10003 • The Brook- Wells Fargo- 6007 474 (474) 10004 • US Bank - PT Checking 46,729 46,729 10005 • US Bank - PT Money Market 17,617 - 17.617 10006 • US Bank - The Brook 334 334 10103 • PT- Wells Fargo Savings- 6801 0 9,995 (9,995) 10200 • Petty Cash- Anne 39 300 (261) 10201 • Petty Cash- Office 343 500 (157) 10202 • Petty Cash- The Brook 118 119 (1) 10203 • Petty Cash -Fundraising Events 200 200 Total Checking/Savings $ 65,379 $ 45,354 $ 20,025 Accounts Receivable 11000 • Accounts Receivable 14,780 6,271 8,509 Total Accounts Receivable $ 14,780 $ 6,271 $ 8,509 Other Current Assets 12000 • Undeposited Funds $ 3,250 $ 350 $ 2,900 12810 • Loans Receivable 4,500 4,500 Total Other Current Assets $ 7,750 $ 350 $ 7,400 Total Current Assets $ 87,909 $ 51,975 $ 35,934 Fixed Assets 15000 • Furniture and Equipment $ 1,561 $ 290 $ 1,271 15001 • 2007 Toyota Sienna Van 17,623 17,623 15002 • 1991 Isuzu Box Truck 3,000 3,000 16000 • Accumulated Depreciation (989) (989) Total Fixed Assets $ 21,195 $ 16,925 $ 4,271 Other Assets 18600 • Security Deposits Receivable $ 8,810 $ 6,155 $ 2,655 Total Other Assets $ 8,810 $ 6,155 $ 2,655 TOTAL ASSETS $ 117,914 $ 75,055 $ 42,859 Page 1 of 2 God's Fan Club Statement of Financial Position As of November 30, 2012 Nov 30, 12 Nov 30, 11 $ Change LIABILITIES & EQUITY Liabilities Current Liabilities Accounts Payable 20000 • Accounts Payable $ 1,615 $ 2,057 $ (442) Total Accounts Payable $ 1,615 $ 2,057 $ (442) Credit Cards 21000 • Wells Fargo Business Card 0424 $ 5,092 $ 1,542 $ 3,550 21001 • Wells Fargo Business Card 9424 136 (136) Total Credit Cards $ 5,092 $ 1,679 $ 3,414 Other Current Liabilities 27150 • Security Deposits Payable $ 1,000 $ - $ 1,000 Total Other Current Liabilities $ 1,000 $ - $ 1,000 Total Current Liabilities $ 7,707 $ 3,735 $ 3,972 Long Term Liabilities 27200 • Other Liabilities 450 (450) Total Long Term Liabilities $ $ 450.00 $ (450.00) Total Liabilities Equity 32000 • Unrestricted Net Assets Net Income Total Equity $ 7,707 $ 4,185 $ 3,522 70,870 39,338 42,345 28,525 28,525 10,813 S 110,207 $ 70,870 $ 39,338 TOTAL LIABILITIES & EQUITY $ 117,914 $ 75,055 $ 42,859 Page 2 of 2 Exempt Organizations Select Check Page 1 of 1 IRS Exempt Organizations Select Check Exempt Organizations Select Chgdc Home Organizations Eligible to Receive Tex -Deductible Contributions (Pub. 78 data) - Search Results The following let indudes tax-exempt organizations that are eligible to receive tex-deductible contributions. Click on the "DedudlbNty Status' column for an explanation of limitations on the deductibility of contributions made to different types of tax-exempt organizations. Results are sorted by EIN. To sort results by another category, dick on the Icon next to the column heading for that category. Clicking on That loon a second Ume will reverse the sort order. CUdc on a column heading for en explanation of Information In that column. 1.1 of 1 results EIN. Legal Name (Doing Business As). 73.1681483 Clods Fan Club to - rch Results Pet Page 25 , OK City. Muniete Prep I 1-1 1 Next s State &Country. DeductiIl StaUrs. CA United States PC Prep I 1-1 I Next, http://apps.irs.gov/app/eos/pub78Search.do?ein 1=731681483&names=&city=&state=All 9/9/2013 City of Temecula 201344 CS Funding Program APPLICATION NO. 13 REcel"° CITY OF TEMECULA AUG 3 0 2OI FISCAL YEAR 2013-14 ✓►r� ria R's COMMUNITY SERVICE FUNDING PROGRAM APPLIC ►fFION (Please Print or Type) 2013-14 Program Submission Deadline: Friday, August 30, 2013 (original, plus one copy) PROJECT INFORMATION Amount Requested: $ 5,000 (Maximum allowable $5,000) Project Name: A Brush with Kindness Project Start Date: January 1, 2014 Project End Date: June 30, 2014 ORGANIZATION INFORMATION Name of Organization: Habitat for Humanity Inland Valley Contact Name: Tammy Marine Title/Position: Executive Director Mailing Address: 27475 Ynez Road, #390, Temecula, CA 92591 Telephone: 951-296-3362 Year Organization Founded: 1991 Number of Paid Staff: 6 Number of Volunteers: 375 Geographic Area(s) Served: Southwest Riverside County Is this organization incorporated in California as a non-profit organization? Yes x No Effective Date: _October 24, 2001 If "yes" (Must provide a copy of your statement of non- profit status from the State of California): Date of incorporation as a non-profit: October 21, 2001 Federal identification number: State identification number: If "no": Name of sponsoring organization: Federal identification number: State identification number: This application has been authorized by the organization's: Executive Committee Board of Directors x Members -at -Large Application Page 1 FY 2012-13 COMPLIANCE REQUIREMENT IF YOUR ORGANIZATION WAS A RECIPIENT OF FUNDING FOR FY 2012-13, PLEASE ATTACH COPIES OF INVOICES, RECEIPTS AND CANCELLED CHECKS TO SUBSTANTIATE THOSE FUNDS RECEIVED AND EXPENDED BY YOUR ORGANIZATION. FINANCIAL STATEMENTS PLEASE ATTACH COPIES OF THE CURRENT BUDGET OF THE ORGANIZATION AND FINANCIAL. STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT). It does not require a CPA's audit, but please submit if available. MISSION STATEMENT Briefly describe the goals and objectives of your organization and community services it provides. Describe the ways your organization meets the criteria listed on page 2 of the CS Funding Policy. Please see attached Application Page 2 Inland Valley • Pe Habitat for Humanity' Mission Statement The mission of Habitat for Humanity Inland Valley, in partnership with God, is to facilitate the dream of homeownership as well as improve living conditions for those in the community. Habitat gives a "hand -up, not a hand-out(" A. Habitat for Humanity Inland Valley is a non-profit organization with a Federal ID 33-0461804. B. Habitat for Humanity serves the entire community through a variety of projects. Affordable housing is a staple of Habitat affiliates, but our agency also provides low-cost exterior home repair services to low-income homeowners to help maintain the appearance of homes and neighborhoods. In addition, we operate ReStore facilities which enable surplus construction supplies, gently used appliances, furniture and home decor pieces to be repurposed, rather than be disposed of in landfills, once again, serving the community as a whole. C. Within the past two years Habitat for Humanity purchased, rehabilitated and sold 18 foreclosed homes to worthy families, restoring neighborhoods while providing affordable housing to families needing decent housing. The entire budget was roughly $3.2 million, and Habitat successfully utilized all available funding through the Neighborhood Stabilization Program. We are successfully responsible for all of our area fundraising, site location, planning and permits, construction, selection of families, and mortgage servicing. With staffing in place and a strong Board of Directors, Habitat was and is positioned to continue serving our community's home ownership, repair, and conservation needs. D. Habitat has a high number of regular volunteers, demonstrating a positive public reaction to our organization. All of Habitat's projects result in a positive impact in neighborhoods; therefore the public reaction is typically positive, supportive and encouraging. E. Our agency is debt -free as a result of our history of fiscally conservative business practices. Each Habitat home that is built, or rebuilt, is completed without debt, allowing our agency to build future sustainability for our agency and enhance our ability to continue providing affordable housing in the future. Ongoing financial oversight is provided by our Board of Directors including our co -treasurers from the banking industry. One is a Vice President of California Bank and Trust, and the other serves as Regional Director of Citibank. G. Evidence of satisfactory service provided to the City's citizens can easily be seen through the number of volunteers, individual donors, and businesses that support Habitat and the work we accomplish in the community. In addition to volunteer and financial support, our agency receives many requests for assistance from Temecula residents, once again demonstrating that our agency provides exceptional services to residents. Recipients of this program often express their wonder and gratitude at being helped to make their homes better. Many go on to learn how to do more repairs themselves. Anecdotal reports suggest that getting started with simple maintenance projects encourages neighbors to keep on pooling their talents and helping each other. H. & I. Habitat does not discriminate based on race, color, creed, nationality, sex, marital status, disability, religion, or political affiliation. Habitat does not require attendance or participation in any political, religious or social activity. J. Habitat recently completed the first agency audit, resulting in no findings. A copy has been provided. K. An operating budget for 2013 has been provided. L. Habitat serves the entire community by providing affordable housing, neighborhood beautification, exterior home repair, and significantly discounted construction and home ddcor items through ReStore. M. Habitat has successfully implemented and maintained ongoing programming for many years with program evaluation tools already in place. PROJECT DESCRIPTION 1 How will your organization use the funding awarded? Describe the project, project objectives, those served, area serviced, and number of volunteers involved. Be specific. Include equipment or services that would be purchased and why. Include a detailed budget and a schedule of significant activities related to this project. You may attach a maximum of one double-spaced typewritten page of information. (Please type or print legibly.) Please see attached Application Page 3 Prosect Description Habitat for Humanity Inland Valley will use funding to directly benefit low-income homeowners in Temecula. Specifically, funding will be used to offset the cost of home repair materials to homeowners. Through our A Brush with Kindness Program, we assist seniors, the physically disabled, and low-income homeowners by performing small home repair and improvement projects. In 2011, our agency began the A Brush with Kindness program in an effort to increase the number of families living in safe, decent and affordable homes, and the response has been overwhelming. We have many requests for assistance. Typically our programs focus solely on providing affordable housing to one family, but recent economic circumstances have resulted in many families struggling to keep up with mortgage payments, let alone home repairs. Even those that are seriously needed and affect family safety, often have to become a low priority. By helping families in need to fund and perform small repairs around their properties, Temecula can help to make their homes safer and more beautiful. A Brush with Kindness helps these families by providing exterior home repair services such as painting, minor exterior repairs, landscaping, exterior clean-up and weatherization. Groups of 10-20 volunteers work alongside the homeowner to revitalize a home's exterior. The program utilizes volunteers and donated materials, when available, and no interest loans to make repairs affordable, helping low-income homeowners continue to live independently and securely in their homes while simultaneously improving the visual beauty of neighborhoods. Traditionally supplies are provided by homeowners, but funding from the City of Temecula would allow our agency to extend our reach by providing $5,000 worth of construction and repair expenses. By providing the funding necessary to complete repairs, we will be able to serve more families than we are currently able to serve. For the purposes of this funding, the Brush with Kindness program will serve any low-income homeowner within the City of Temecula with minor exterior home repair services. In addition to completing individual home repairs, we now apply a "Neighborhood Revitalization Approach" that works to assist an individual homeowner while also remediating blight in aging neighborhoods. With this approach, we multiple homes in a concentrated work area. We are now working with homeowner associations to identify need and to work together to market the program to struggling homeowners. With this efficient approach, we plan to serve at least 100 Temecula residents between January 1, 2014 and June 30, 2014. Habitat has a loyal dedicated team of volunteers, and the A Brush with Kindness program is an excellent way for volunteers to utilize their skills between traditional construction builds. We estimate that 100-200 volunteers will be volunteering 500-1,000 hours to improve the neighborhood appearances of housing tracts within the City of Temecula. Habitat for Humanity Inlano Valley believes that our program is unique in providing both materials and experienced assistance to maintain family homes. Our program is also the only one that brings experts and area residents together to work on a single neighborhood as a cooperative team, thus transferring applicable skills and experience to the people continuing to reside in each area. If your organization received City of Temecula funding in the previous year, please explain and show how Temecula residents benefited. Last year, Habitat was pleased to receive $5,000 from City of Temecula. The money purchased materials, supplies and program related expenses and impacted multiple homes and neighborhoods within the city limits. Although many residents were impacted by the funding and, due to the success of the program and high demand, one additional large scale project is schedule for later this year. In addition, More than 250 volunteers, due to the many teens and youth, helped Temecula homeowners and residents to improve and beautify their homes and their neighborhoods. Most important is the positive impact on the community when homes are repaired. A typical homeowner was elated and grateful: "The fact that they are making this place look nicer is great," she said. "I am glad I can be a part of it". Resident Jule Cooley stated to one of our staff, "Let me give you a hug! You have just made a huge difference in my life — thank you, thank you , thank you!" PAST PROJECT BENEFITS If your organization received City of Temecula funding in the previous year, please explain and show how Temecula residents benefited. Please see attached Application Page 4 r SIGNATURE PAGE We hereby certify the information contained in this application is true to the best of our knowledge and belief. PREPARED BY: Tammy Marine, Executive Director NAME and TITLE (Please Print or Type) SIGNATURE: PRESIDENT or k776-- Cliq •€----)AUTHORIZED OFFICER: Estella Cline Treasurer (� NAME and TITLE (Please Print or Type) SIGNATURE: CS ORGANIZATION NAME: Habitat for Humanity Inland Valley MAILING ADDRESS: 27475 Ynez Road, #390, Temecula, CA 92591 TELEPHONE: 951-296-3362 EMAIL: tammy(a�habitat4inlandvalley.orq ADDRESS: 41615 Winchester Road, Suite 214, Temecula, CA 92591 DATED THIS 28th of August (Date) (Month) , 2013 BE SURE TO INCLUDE THE ORIGINAL PLUS ONE COPY AND SUBMIT BY AUGUST 30, 2013 TO: Mail Completed Applications to: Or Deliver In Person to: City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office Post Office Box 9033 Temecula, CA 92589-9033 City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office 41000 Main Street Temecula, CA 92590 Application Page 5 HABITAT FOR HUMANITY INLAND VALLEY, INC. AUDIT REPORT JUNE 30, 2012 Habitat for Humanity Inland Valley, Inc. Table of Contents June 30, 2012 Page(s) Independent Audit Report 1 Financial Statements: Statement of Financial Condition 2 Statement of Activities 3, 4 Statement of Cash Flows 5 Notes to Financial Statements 6, 7 Thomas A. Ralston Certified Public Accountant October 12, 2012 41674 Sixth Street Temecula, California 92590 The Board of Directors Habitat for Humanity Inland Valley, Inc. 27475 Ynez Road #390 Temecula. California 92591 Phone: 95 t -296-9030 Fax: 951.296-9033 Email: tomralstoncpa@yahoo.com INDEPENDENT AUDITOR'S REPORT We have audited the accompanying statement of financial position of Habitat for Humanity Inland Valley, Inc. (a nonprofit organization) as of June 30, 2012 and the related statements of activities, functional expense, and cash flows for the year then ended. These financial statements are the responsibility of the management of Habitat for Humanity Inland Valley, Inc. Our responsibility is to express an opinion on these financial statements based on our audit. We conducted our audit in accordance with auditing standards generally accepted in the United States of America. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatements. An audit includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements, An audit also includes assessing the accounting principles used and significant estimates made by management, as well as evaluating the overall financial statements presentation. We believe that our audit provides a reasonable basis for our opinion. In our opinion, the financial statements referred to above present fairly, in all material respects. The financial position of Habitat for Humanity Inland Valley, Inc., as of June 30, 2012 and the changes in its net assets and its cash flows for the year then ended in conformity with accounting principles generally accepted in the United States of America. Our audit was made for the purpose of forming an opinion on the basic financial statements of Habitat for Humanity Inland Valley, Inc. taken as whole. The accompanying schedule of direct agency support allocations is presented for the purpose of additional analysis and is not a required part of the financial statements. Such information has been subjected to the auditing procedures applied in the audit of the financial statements and, in our opinion, is fairly stated in all material respects in relation to the basic financial statements taken as whole. Sincerely, Thomas A. Ralston Certified Public Accountant 1 INLAND VALLEY HABITAT FOR HUMANITY STATEMENT OF FINANCIAL POSITION JUNE 30, 2012 ASSETS Current Assets Cash and Cash Equivalents $ 158,974 Accounts Receivable 36,339 Total Current Assets $ 195,313 Fixed Assets Property and Equipment (Note 2) Less Accumulated Depreciation (Note 2) 28,314 (16,099) Total Fixed Assets 12,215 Other Assets Loans to Homeowners 600 Inventory 2,622 Undeposited Funds 7,843 Security Deposit -Restore (Note 1) 11,600 Security Deposit -Interim Maintenance 470 Security Deposit -City of Temecula 150 First Trust Deeds (Note 3) 2,035,742 Second Trust Deeds (Note 3) 848,030 Total Other Assets 2,907,057 Total Assets $ 3,114,585 LIABILITIES AND NET ASSETS LIABILITIES Current Liabilitles Eserow Funds $ 6,708 Section 125 Plan 3,202 Accounts Payable 28,171 Sales Tax Payable 4,818 Total Current Liabilities $ 42,899 Long -Term Liabilities - Habitat Way Street Maintenance 2,290 Total Liabilities 45,189 NET ASSETS Net Assets Unrestricted 3,069,396 Total Liabilities and Net Assets $3,114 585 SEE ACCOUNTANTS AUDIT REPORT 2 INLAND VALLEY HABITAT FOR HUMANITY STATEMENT OF ACTIVITIES FOR THE YEAR ENDED JUNE 30, 2012 HABITAT RESTORE COMBINED INCOME Donations $ 113,881 $ 127 $ 114,008 A Brush With Kindness 8,613 8,613 Grant - Community Action Partners Grant- NSP - Grants - Other 16,524 16,524 Fundraising 89,192 - 89,192 Earned Revenues - 778,816 778,816 Home Sales Revenues 375,000 375,000 Refunds - - TOTAL INCOME 603,210 778,943 1,382,153 RESTORE OPERATING EXPENSES Advertising 24,630 24,630 Depreciation Expense E -Bay Expenses 4,893 4,893 Employee Expenses 248,326 248,326 Equipment Rental 2,648 2,648 Freight 47,111 47,111 Insurance 2,669 2,669 Landscape Expenses 2,250 2,250 Membership/Dues 10 10 Merchant Account Fees 10,857 10,857 Office Expense 2,522 2,522 Recognition 1,282 1,282 Rents 172,895 172,895 Repairs & Maintenance 837 837 Resale Purchases 78,123 78,123 Store Supplies 4,896 4,896 Telephone / Internet - 10,703 10,703 Truck Expense 8,297 8,297 Utilities 21,357 21,357 3 INLAND VALLEY HABITAT FOR HUMANITY STATEMENT OF ACTIVITIES FOR THE YEAR ENDED JUNE 30, 2012 HABITAT RESTORE COMBINED HABITAT EXPENSES Employee Expenses 181,942 181,942 Escrow Closing Costs 3,896 3,896 Grant Expenses -NSP 45,643 45,643 Public Relations 20,907 20,907 Fundraising Expenses 41,843 41,843 Brush with Kindness 66,803 66,803 Outside Services 33,259 33,259 Other Direct Expenses 33,494 33,494 Debt Forgiveness 26,419 26,419 Office Expenses 17,141 17,141 Insurance Expense 43,191 43,191 TOTAL EXPENSES 514,538 644,306 1,158,844 NET INCREASE (DECREASE) IN NET ASSETS BEFORE OTHER INCOME 88,672 134,637 223,309 OTHER INCOME Interest Income 63 63 NET INCREASE (DECREASE) IN NET 88,672 134,700 223,372 ASSETS NET ASSETS BEGINNING OF YEAR 2,583,347 262,677 2,846,024 NET ASSETS END OF YEAR. $ 2,672,019 $ 397,377 $ 3,069,396 SEE ACCOUNTANTS AUDIT REPORT 4 INLAND VALLEY HABITAT FOR HUMANITY STATEMENT OF CASH FLOWS FOR THE YEAR ENDED JUNE 30, 2012 CASH FLOWS FROM OPERATING ACTIVITIES Increase in Net Assets $ 223,373 Net Increase in Accounts Receivable (36,339) Net Increase in Fixed Assets Net Increase in Acctunulated Depreciation Net Decrease in Prepaid Workers Comp 8,041 Net Increase in Note Receivable (1st Deeds) (269,103) Net Increase in Note Receivable (2nd Silent Deeds) (12,821) Net Increase in Security Deposits (620) Net Increase in Other Assets (11,065) Net Decrease in Insurance Payable (22,752) Net Increase in Escrow Account 529 Net Increase in Accounts Payable 24,329 Net Decrease in Sales Tax Payable (3,170) Net Increase in Long Term Liabilities 580 Decrease in Cash and Cash Equivalents Cash and Cash Equivalents, Beginning of the Year Cash and Cash Equivalents, End of the Year SEE ACCOUNTANTS AUDIT REPORT 5 (99,018) 257,992 $ 158,974 1-labitat for Humanity Inland Valley, Inc. Notes to Financial Statements June 30, 2012 Habitat for Humanity Inland Valley is dedicated to serving families within southwest Riverside County. One of the many ways that the agency accomplishes that is through the building of affordable homes for worthy families. While that is the main focus, they also serve the entire community by participating in neighborhood revitalization and beautification projects, senior minor home repair and most recently rehabilitation of foreclosed homes creating affordable housing for families. In addition, the agency has opened two ReStore locations, one in Temecula and one in Lake Elsinore. Habitat ReStore is a unique retail facility, operated by Habitat for Humanity Inland Valley, which offers the community the opportunity to purchase new and used building materials, appliances and household items at greatly reduced prices. The materials and appliances sold are donated by local vendors, construction companies and individuals which are then resold to the public rather than being thrown away and filling up landfills. Families that Habitat for Humanity Inland Valley serves are considered low-income by HUD standards. For families to be selected for a Habitat house, they must have income that cannot exceed 80% of the Riverside County median income and they cannot qualify for conventional financing. Additionally, families are selected on need, ability to pay and willingness to partner with Habitat for Humanity. Each family must contribute 300-500 "sweat -equity" hours in the construction of their home, or other Habitat projects. Habitat does not discriminate, nor are families chosen based on race, ethnicity or age. The agency chooses families who meet the criteria set in our selection process and who demonstrate the biggest need for assistance. Habitat for Humanity is dedicated to making affordable housing readily available within southwest Riverside County. The Habitat for Humanity Inland Valley, Inc. is a 501 (c)(3) nonprofit organization. The organization maintains its books on the accrual basis of accounting. NOTE 1: DEPOSITS Rental Deposits on two retail stores located at 27479 Enterprise Circle West, Temecula, California and 570-I Central Avenue, Lake Elsinore, California. NOTE 2: FIXED ASSETS Fixed Assets are recorded at cost. Depreciation is calculated using MACR's method of depreciation, which is consistant with Internal Revenue Service calculations. Fixed Assets Consist of: Restore Truck $ 23,942 Tenant Improvements 4.372 Total Fixed Assets 28,314 Less Accumulated Depreciation ( 16,099) Net Fixed Assets $ 12,215 6 Habitat for Humanity Inland Valley, Inc. Notes to Financial Statements (cont.) June 30, 2012 NOTE 3: NON-INTEREST BEARING NOTES Non -Interest bearing notes are secured by real property held by Habitat for Humanity. There are certain restrictions that apply to the notes with incentives for the homeowners to stay in the house for a minimum of 5 years. 7 Prop 1 Operations Budget - Habitat for Humanity Ir ' Valley Page 1 of 3 FY 2011 (July 1, 2012 through June 30, 2013, Category/Description Budget FY 2012/2013 Actual FY 201210 months Budget FY 2012 INFLOWS g-,112Mapari2M1 pon9lions General Donations 10,000 107,952 6,500 Covenant Church Donations 5,000 1,101 6,000 International Donations Onc cars for homes) 4,500 2,372 4,600 Corporate Sponsors 5,000 0 12,000 Grants 130,000 17,800 126,000 129,225 153,000 Total Donations 154,500 FVJOrplsIP9 Direct Mall Campaigns 7,000 2.561 6,000 Golf 2008 (also 2007 3200) 42,000 27,637 30,000 Other - inc Marg event 13,000 16,119 12,000 __ _ Script 13,000 6,964 Christmas Event 18.000 14,884 25,000 MlcrobrewlWine Fest 38,000 17,493 20,000 86,258 93000 Total Fundraising 131.000 Other Income Bank Interest 30 32 50 1,113 10,000 A Brush with Kindness 5,000 26 1,170 215,663 10,050 256,050 Mortgage Late Fees Total Other income 5,030 Total Operetlons income 290,530 "Total Falr Build Income 280,000 200,000 "Total NSP 1 Income 120,000 193,000 0 643,503 859,156 193,000 725,000 1,454,050 "Income Designated for Construction 1,000 "Income for ReStore 840,000 TOTAL INCOME 1,251,530 Homeowner 1st Trust Deeds Cochran 1,186 3,200 Gonzalez 1,988 3,200 Van Worth 534 3,200 Muro 1,925 3,200 Pleasant 1,925 3,200 Cabulagan 2,487 3,200 Alcantar 1,925 3,200 Castaneda 1,925 3.200 Thomas 2,191 3,200 Morales 2,849 3,200 Buono ' 1,416 3,200 Hourtal 2,709 3,200 Provido 2,716 3,200 Steward 2,611 3,200 Franco 2,492 3,200 Lobado 2,352 3,200 Rahe 2,429 3,200 Vasquez 3,200 3,200 09,500 Arais plus new mortgages Total tat Trust Deeds 59,000 37,703 @ 39000 ttl 2,462,074 67,100 1,521,150 NOTE: 3 mortgages to be set aside tor Fund tor` Humanity TOTAL INFLOWS (Income + 1st Trust Deeds +Total Income 1,320,530 Pror 1 Operations Budget - Habitat for Humanity Ir Valley Page 2 of 3 FY 2011 (July 1, 2012 through June 30, 2013, Category/Description Budget FY 2012/2013 Actual FY 201210 months Budget FY 2012 6,000 EXPENSES Bank Charges and Payroll Feeg Benefits Fee - service fees only 6.000 272 Checks Total Bank Charges 200 121 393 200 6,200 6,200 Employee Expense Executive Director (salaried plus taxes) 64,500 49,042 Admin Support (salaried and hourly plus taxes) 55.000 55,243 223.000 AmertCorp (salaried plus taxes) 32.000 Helping Hands Coordinator 44,575 Bookkeeping (hourly plus taxes) 35,000 17,780 Res Develop (salaried plus taxes) 46,000 10,919 Federal Payroll Taxes (see above) 3,169 26,000 State Payroll Taxes (see above) 350 8.000 Worker's Comp 45.000 2,960 22,000 Mileage 3.000 2,092 3,000 Miscellaneous Expense (inc benefits and xmas bon Total Employee Expense 25.000 16,744 202,884 30,000 310,000 305.500 Fundraislno Expense Direct Mall Campaign 4,500 2,956 2,000 Golf 15.000 14.791 15,000 Christmas 8,000 7,239 10,000 Microbrew/Wine Fest 14,000 13,980 8,000 Other Total Fundraising Expense 3,000 -91 38,784 35,000 44.500 Con$trucfion/ABWK Materials/Equip Rental - ABWK 18,000 6,118 6,000 Labor-ABWK 2.000 0 Equip 2,500 412 5,000 Salaries (salaried plus taxes) Total A Brush with Kindness 90.300 0 6,530 10,000 112,800 Insurance 7,000 6,043 6.000 Builders' Program/General Liability Officers & Directors Total Insurance 800 340 6,383 600 0,500 7,800 Mg P.O. Box Rental 300 253 200 Misc. Expense 1.500 3,033 2,000 Postage 2,000 1,720 2,000 Printing and Copying 2,000 762 3,800 Supplies 7,000 4,631 8,000 Telephone Total Office 9,000 4,703 7,600 23,400 21,800 15,102 Prof d Operations Budget - Habitat for Humanity Ir I Valley Page 3 of 3 FY 2011 (July 1, 2012 through June 30, 2013, Category/Description Budget FY 2012/2013 Actual FY 201210 months Budget FY 2012 EXPENSES (Continued) 5,800 gihK Conferences & Seminars 8,800 11,036 Credit Card Processing Fees 517 international Trip 2,500 7,599 5,000 Manuals 500 833 500 Memberships 1,000 492 800 mist Advocacy Expense 2,000 1,000 2,500 Staff Development 0 3,454 3,000 Tithe to HFH International 25,000 0 15,000 Taxes - State Nonprofit 400 395 100 Website Total Other 500 0 26,942 0 32,700 40,700 Outside Servloes _ HR (was Bookkeeper) 2,000 1,450 18,000 Tax Preparation Fee 500 0 500 Grant Support 9,500 9,075 8,000 Legal 20,000 Exec Coaching 5,000 6,115 Marketing Support 13,000 2,522 8,500 Audit Support Total Outside Services 4,500 0 21,252 4,500 39,500 54,500 Public Relations Community Relations 1,500 1,220 3,000 Supplies 1,000 183 2,000 Marketing 1,941 1,000 Misc. Expense 500 2,084 500 Recognitions (plaques, annual recog event) Total PubIIC Relations 3,000 3,198 19,624 2,000 8,500 6.000 Technology Webhosting 600 0 600 IT Support 2.000 1,547 2,000 Software and Hardware 2,000 1,597 1,200 Constant Contact/GEworks Total Technology 700 0 600 4,300 5.300 3,144 Total Operations Expenses 605,100 338,109 476,100 CAP Expenses (Inc under grants) 0 NSP Expenses 73,894 200,000 Fair Build Ex ' nses 198 180,000 Construction -Related Expenses (1) (see above) 0 ReSale Store Expenses 715,000 532,297 665,000 TOTAL EXPENSES 1,320,100 944,496 1,521,100 Net Profit/Loss 430 -85,340 50 Initlrildl rwvcluuo .w, e ti Date: OCT 2 4 2001 Habitat for Humanity International, Inc. Inland Valley c/o Deborah Hollingsworth 27475 Ynez Road, 4190 Temecula, CA 92591 4612 P, 0, Box 2508 Cincinnati, OH 45201 Person to Contact Brett Siereveld 31-02633 Customer Service Specialist Toll Free Telephone Number: 8:00 A.M. to 8,30 P.M, EST 877-829-5500 Fax Number: -13-263-3756., Federal Identification Number: ' Group Exemption Number: 8545 Dear Madam: We have received your request for affirmation of your organization's tax exempt status. Please note that the Federal Idontification Number you provided In your letter is not the correct one for your organization. Tho number shown in the heading of this letter is the one assigned to you and is the only one you should use. Your organization Is exempt under section 501(c)(3) of the Code because it is Included In a group ruling Issued to Habitat for Humanity Intemationei, Inc., located In Americus, Georgia. Individual exemption letters are not avaiteblc to organizations includod in group rulings. The group exemption letter applies to all of the subordinate organizations on whose behalf Habitat for Humanity International, Inc. has applied for recognition of exemption. if you want a copy of the group exemption letter, please contact your parent orpanizatlon. Your organization is required to filo Form 990, Return of Organization Exempt from Income Tax, only If Its gross receipts each year are normally more than $25,000. If a return is required, it must be filed by the 15th day of the fifth month after the end of the organization's annual accounting period. Tho low Imposes a penalty of $20 a day, up to a maximum of 010,000, when a return is filed late, unless there is reasonable cause for the delay. Donors may deduct contributions to your organization as provided in section 170 of the Code. Bequests, legacies, devises, transfers, or gifts to your organization or for its use are deductible for federal estate and gift tax purposes if they meet the applicable provisions of sections 2055, 2108, and 2522 of the Coda. The law requires you to make your organization's annual return available for public inspection without charge for three years after the due date of the retum. You can charge only a reasonable fee for reproduction and actual postage costs for the copied materials. The law does not require you to provide copies of public inspection documents that are widely available, such as by posting them on the Internet (World Wide Web). You may be liable for a penalty of 020 a day for each day you do not make these documents available for public inspection (up to a maximum of $10,000 in the case of an annual return). Exempt Organizations Select Check Page 1 of 1 I RS Exempt Organizations Select Check Exe npl Organizations Select Check liome Organizations Eligible to Receive Tax -Deductible Contnbutions (Pub. 78 date). Search Results The following list Includes lax -exempt organizations that ere eligible to receive lax -deductible contributions. Click on the "Deductibility Status" column for an explanation of limitations on the deductibility of conbibulons made to different types of tax-exempt organizations. Results are sorted by EIN. To sort results by another category. click on the Icon next to the column heading for that category. Clicking on that icon a second time will reverse the son order. Click on a column heading for an explanation of Information in that column. 1.1 of 1 results EIN . Legal Name (Doing Business As) . Habitat for Humanity- Riverside Inc Return to Search Results Per Page 25 l OK « Prev 1 1-1 1 Next o City. Stale.Counlry. Dcductihtlily, Status. Riverside CA United Stales PC « Prev 1 1.1 1 Next http://apps.irs.gov/app/eos/pub78Search.do?ein 1=330288930&names=&city=&state=A11 9/10/2013 November 20, 2012 Tammy Marine, Executive Director HABITAT FOR HUMANITY INLAND VALLEY 27475 Ynez Road, Suite 390 Temecula, CA 92591 Dear Ms. Marine: Congratulations on being selected for funding under the fiscal year 2012-2013 Temecula Community Service Funding Program. Your organization has been awarded $5,000 to be used to offset costs of home repair materials to low-income homeowners in Temecula Your organization must confirm that these funds are expended in accordance with the above -stated purpose by June 30, 2013. Receipts verifying the expenditures of this year's award must be submitted to the City by September 1, 2013. The City may require access to your accounting records in accordance with this policy. If City funds are not expended as stipulated, the funds must be returned to the City. Mail or hand deliver to: City of Temecula City Manager's Office Attn: Betsy Lowrey 41000 Main Street Temecula, CA 92590 In order for these funds to be released, you must sign below acknowledging the following statement: "We do not discriminate based on race, color, nationality, sex, marital status, disability, religion, or political affiliation." The City fully supports the efforts of your organization and its services to the citizens of Temecula. Sincerely, Betsy Lowrey Sr. Management Analyst ACKNOWLEDGMENT OF FUNDING CONDITIONS (please sign and return this letter as soon as possible): Print Name/Title Authorized Signature/Title Date Habitat for Humanity Inland Valley Grant Back-up City of Temecula - 2012-2013 Construction Small Tools and Supplies Workday (day of) Supplies - including signage Mileage Associated with ABWK-Temecula 946.60 miles @ .52 per mile (attached expense reports) Marketing - Trifold Brochure, Neighborhood Flyers, Public Relations $ 2,754.60 $ 918.98 $ 492.23 $ 953.12 $ 5,118.93 MAR 0668 CASHIER 07329133000 4X4-8FT *12 0000-999-735 CA 092097L011 R SLEEVE 601.41 XKXXKX AUTH saving. re doing; AVE JE (95I)698-1555 Ftrh 06/28/13 10:05 AM -8 GOF %A. 8.62 R PREMIUM DOUG FIR L8R FEE KAII' 0.08 ANC1iA �Ay -1/4 HEX, STS CT 8.46 SALES X44.'X3R�gg172o TOTAL 17.16 $18.54 18.54 More saving, More doing,' 18262 COLLIER AVFMIF LAKE ELSINORE. CA 925J0 (9511245 9055 8988 00057 16766 06/17!13 10:26 AM CASHIER SELF CHtCX OUT - SC0157 636693402067 29 HUSE -A= 25' PW HOST. MAX 2000PSI SUBTOTAL SALES TAX 'TOTAL XXxxxx000064E2 DEBIT AIITH COUF B30796 111 28.77 28.71 2.30 $31.07 31.01 1 1111111111111 8968 h/ 16/66 06/17/2013 3044 BIOS.STATER Where You "Always" "GET MORE...FOR LESS„ So. Sun City (951y) �6y7�2-6780 Rr R.ARR MANAGER Rill Landgrst Store N 111 Cass I er : Debra 11. (-)6/'12/1.:3 07:01:.1-1 TCC CBS OLACLER20N 5.49 TF ICC CBS GiLACIE i20Y 5,49 TF 5llaTOTAI 10.98 TOTAL TAX .88 -/ TOTAL DUE 11.86 CASH TENDER 20.00 (;ASH CHANOF 8.14 Manor OF INS 2 wwwwwwRR RR'71RR1RR RRRRR.tRR RRRtR I7.VS W..• 06/22/13 mer M 82 Trx N 93 07:01:50 Tern N 2 Store N111 tt11..Y.itWM PLEASE RETAIN REt3.IPT FOR AIL REFUf90S LOWE'S4 WW1 ]AXE El LIYH'i KIY, INC. 29335 CHITRAL /NE RE. CA 92532 SALES,: SIi871CS 9 194594 ORBT FILL 442150 15 FT 1/ • s1 Ex C 3 SALE 4 1 ITE 0 1) 2534000 : 12179540 06-25-13 STREAM 6 2.97 0.99 EKRLE 1.67 SUBTOTAL: TAX: 1(1 12957 TOTAL: CASH 4.64 0.37 5.01 5.01 : (A7 TERKTXAL: 12 if125/13 69: ITEMS PURCHASED: 4 1 E5 FIER HEAYNES N10 MUM. $00€1 ITEMS I11IIIIHhIIIIHIIIkII --1127P/i TY Price 1 1 12" Turkey Breast 12" Turkey Breast S6.5i $6.50 1 1 1 12" turkey Breast__ $6.50_ r $5.00 12" Turkey Breast$6.50 12" Black Forest Hem _ 12" Black Forest Han $5.00 'options Roast Beef 57.00 otlons Roast Beef 57.00 os s1.o0 $1.00 $1.00 $1.00 .,.,Ps $1.00 1 Chips 51.00 1 Chips $1.00 1 Chips $1.00 1 Chips $1.00 1 Chips $1.00 1 Chips $1.00 1 Chips $1.00 1 Chips S1.00 1 Chips 51.00 SUBTOTAL Sales Tx TAKE-OUT **TOTAL CredCardAMT TEND CHANGE DUE Id: 683-72-266226 $64.00 $0.00 $64.00 $64.00 $0.00 -o Geta FREE Cookie and recelve your rawer Take our 1 minute surve at www.tel subway -cam Store 035837 ](951) 587-6274 31891 Rancho CA 05/25/13 09:52:29 Trans #13 Clerk: AMBER Clerk #32 Call your local area SUBWAY° restaurant today! 1 11t11A1C ADVANCE HO=E 4PPH[014110• �, I....... w...anIra....",.. •...........,...., PowerPowertl 5martReceipt Receipt.c(:.0 P. c�.. Mole iat,frug. Yr , Morns doing;. •32020 PARKWAY TE:ME(IJ_,1 ':A 92'5i?2 ::`51 ;103 6760 1028 00( a /25/ 13 09 15 AM CASHIE:R ; I: _i CHE (II )..11' SCO'[917 73191905(330 I:;LC''I:S «.1 LATEX 111:(I,f)!: ' IOC ' ')VE -LARGE' 51/3.9E 19.90 731919072'57:3 D 7'.. '31 1.'v CA> DIGZ NEI 00111:1) W.' LOVE:5 31112.47 7.41 A.:: "AX fOfAI. XXXXXXXXKI X:?x)1.3 :1.M•; u AUTH CODE 513071)i°67::6:: 111 27.31 2.18 $29.49 29.49 ;^Y TA 111111111111111111 102E 501 415'1 A) ):°i2:./20:3 2871 RE f iI J 1:,('t IC( 01::: (NI `(0143 POLI( 1 ;I) to? ; •SLI :'I EXP]ITES ON A 1 ! .'. 01.! X3/2013 THE HON: I)13•?1 T RIGHT' TO LIMIT )FTA T E r U:'d; PLE 131: SEE: THE RE:TUFN Ih:)l fl 1 >f S 'ORES F'OR BUY MUNE 1:1.:44.1:: IN S -ORE AVAll,t 3I.F WOW OA H0"EDEPO" .COM. CONVENIENT, EAS/ AN: MOST ORDERS READI IN 1 E S5 " HA`• 2 HOURS? *****Y•*1Y t 4x::11IST A t %rtkA n***V••tn***Yx**** ENTU:FI =C IFI A C:IF•IANCE 'I' O '0:1: ref A F.45 . 000 l»tOry1I9 DIE F::'ta-'r I::t F" r' C Ai•:t0'I Share Y')Jr Dpirr1o'r 'n'I;:li Us,1 Complete the br•ie1 sur•a,y zsb),.It your s-:orrj visit and er ter 1.>r a :.••ran:•e to win wmlx:ro'a(Itt)ot .Co7 Hopi n on COMPAR FA 511 (H>:(::Ow EN UNNA I3REVE .NCUE:STA 3AOA 11'. 0'>: i 1..NIDId) DE (iANAR. IJ sew. i:C] 1 9 1 ;:l1 7 1 90:2145 :7!'.1 :1.90 2E19 Entr i es in.e> I• Imo• ant }.••e:: by 01i,4 2013. Entrant: nu ~ I.'n1dEu^ to/2einter. See ow)! U )r. THE SHERWIN WILLIAMS CO. 26910 NEWPORT RD MENIFEE CA 92584 9081 ACCOUNT: 4234-4539-4 HABITAT FOR HUMANITY INLAND VA 41615 WINCHESTER RD # 214 TEMECULA CA 92590 4882 (951) 296-3362 SHERWIN-WILLIAMS. Visit www.sherwin-willams.com CHARGE Store 8693 INVOICE (951) 301-7360 NO. 2531-1 JOB 01 HABITAT FOR HUMANITY INLAND VA PAGE 1 OF 1 PO# COOLEYS HOUSE ORDER: 0E000157808693 DATE: 04/11/2013 TIME: 08:15 AM 2-0100 E30/18425 TERMS: NET PAYMENT DUE ON MAY 20TH SALES NUMBER SIZE PRODUCT DESCRIPTION QTY PRICE VALUE 6503-77807 GALLON C1 T254 DURACRAFT FL ULTRA 1 16.99 16.99 COLOR: SW6055 FIERY BROWN CCE COLOR CAST OZ 32 64 128 W1 WHITE - 34 1 1 B1 BLACK 4 40 - 1 R2 MAROON 4 7 - - SHER-COLOR FORMULA 000.010 EACH ECO FEE 1 .75 .75 6503-52123 GALLON C1W253 DURACRAFT FL DEEP 1 16.99 16.99 COLOR: SW6235 FOGGY DAY CCE COLOR CAST OZ Z 32. 64 128 W1 WHITE - 19 1 - B1 BLACK 2 18 1 • G2 NEW GREEN - 8 1 - N1 RAW UMBER - 17 1 SHER-COLOR FORMULA 000-010 EACH ECO FEE 6503-52107 GALLON C1W251 DURACRAFT FL EXTRA COLOR: SW6052 SANDBANK CCE COLOR CAST OZ 32 64. 128 B1 BLACK - 11 1 R2 MAROON - 13 - 1 Y3 DEEP GOLD - 22 1 1 SHER-COLOR FORMULA 000-010 EACH ECO FEE 1 .75 .75 1 .75 .75 1 16.99 16.99 Thank You _ receipt required for refund MERCHANDISE RECEIVED IN GOOD ORDER BY: MALCOM SUBTOTAL 8.000% SALES TAX:1-059258402 CHARGE • 53.22 4.26 $57.48 OFFICE DEPOT STORE 609 40144 Winchester RD Temecula, CA 92591 (951) 296-5325 04/22/2013 13.1 10:56 AM SIR 609 RE64 IRN 1596 EMP 628062 SALE Producl ID Descrii'trun Total 624900 PRTCT,SHT,HW,1 15 79 SS 985805 BINDER,WJ,BSC, 21 99 SS Subiuial: 37 78 Sales Tax: 3 02 Total: 40 80 Debit Card 9712. 10 80 ****N*N*******N** M( XNNNNNNNXN****N*X**N*N HABITAT FOR HUMANITY 1NL 1700887506 Ready to yet Rewarded faster? t` To receive Rewards electronically update your member prufile online al www.myworkliferewards.com Shop online ai www offic:edep;il cum RN*JEKAWAXXXNNNNXXXVAXXYXXNXNXXx Nif#NX1**X WE WANT TO HEAR FROM YOU! 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Visit www.officedepot.com/feedback and enter the survey code below Survey Code 13Q8 3,116 ?WO NNN****NNX*N****XNNN********NN**X*NN*****X u 11 111110141ueiau1 AlthAlbertsoos You're in for something fresh' 30530 RANCHO CALIFORNIA TEMECULA, CA 92390 Phone # (951) 694-0244 Store Director - John Hurst Cashier:MONICA S 06/26/13 18:22:14 DAIRY *SHOP VAL 2% GAL 4113030747 2.99 F You Save .50 *SHOP VAL 2% GAL 4113030747 You Save .50 HOME HEALTH BEAUTY 1 ® 2/ 5.00 *CARRYCOOL RSBL BG 89366900102 2.50 T You Save 1.49 FROZEN 1 ® 2/ 5.00 ICE 10LB 37912 2.50 FT SUBTOTAL 10.98 Tax 1 8% .40 TOTAL 11.38 Cash TENDER X2.00 Cash CHANGE St: 127 Murietta Madison & Nuriette Hot Springs 25270 Madison Murietta CA 92562 2.99 F AXXION-ClearCups/35ct/8ozq(00 1 .3 .9999 0.9999 AXXION-ClearCups/35ct/8ozar00 1 2 .9999 0.9999 1 NUMBER OF ITEMS ***x******* SAVINGS SUMMARY x*x*** YOU SAVE 3 f 2.49 x*x***xxx******x)Cxx**********RV, R*xx*** TODAY'S TOTAL SAVINGS 1 2.49 THAT IS A SAVINGS OF \` 18% *xxx**********xxx**xxx*x**xx***x**#xx*xx t Trx:279 Oper 121 Term: 1 Store: 6706 06/26/13 18:23:04 Thank You For Shopping At ALBERTSONS Pharmacy Phone # (951) 694-0055 ***xxx***x*x*xxx***x*x Your Opinion Matters We invite you to complete our CUSTOMER SATISFACTION SURVEY Enter for a chance to be a weekly winner of a $100 gift card? SUBTOTAL 32.90 TAX SO 16 TOTAL 32.16 W t CASH 320 16 CHANGE 516 00 1]9111,111, 7�IIlII IN 11 ITEMS SOLD 2 06-25-2013 01:31PM 0127 05 7016 Arnida Need These Iteas In 5_1k? Visit 99only.con/C1ub99 FREE Shipping 8 Handling To A Store of Your Choice! FedkzOffice.. �3 FedEx Office is your destination for printing and shipping. 32389 Temecula Pkwy Temecula, CA 92592 Tel: (951) 302-1401 6/24/2013 5:56:06 PM PST Team Member: Aaron L. SALE 8.5x11 Lamination 7 000337 Reg. Price 2.49 Regular Total 17.43 Discounts 0.00 Total 17.43 2.4900 T Sub -Total 17.43 Tax 1.39 Deposit 0.00 Total 18.82 Cash 19.00 19.00 (0.18) Total Tender Change Due Total Discounts 0.00 1111liliJ!!ii 111 iiiip. 11 Tell us how we're doing and receive $5 off your next $25 print project fedex.com/welisten or 1-800-398-0242 :Offer Code:.__ Offer expires in 30 days Thank you for visiting FedEx Office Make It. Print It. Pack It. Ship It. fedex.com/office BIG 6 SPORTING GOODS - 8364 33385 Highwaw i9 South Temecula, CA 92592 1-951-302-9428 1871035 0809 364 001 3734662 12 -UP SPRINT 10X10 59.99 1 59.997 Original Price: 119.99 3734662 Iii: -UP SPRINY 10X10 F.0 99 1 59.997 Original Price: 119.99 0601005 SYNSPI:T TNTSTAI;E 1.49 4 5 96T Subtotal125 5y Sale. Tax 410 CS TOTAL. $136.02 Cash 140.0 CHA11i iE: _ - _) 3.98 l fix 100364 11.0000% 10.08 6/[4/13 5:31'11 THANK YUU FOR SHOPPING At BIG 6! •SSuS•awaosbno 0,6011.431t4 tiros,. JOIN OUR E -TEAM TODAY ll SAVE 1011 off your next Purchase! www,b1a5sprirt1nnmoods,com/steam Join un on: www.Fiecebook•con/bin5spurtlnseoods www.Twl1ter,cum/his5nlnce65 00.1 Walmart ' Save money. Live better. ( 951 ) 696 - 7135 MANAGER SHAURA OLSEN 41200 HURRIETA HOT SPRINGS RD HURRIETA CA 92562 STU 2952 OPt 00006307 TE11 10 TR11 09900 NPL 35PK 006827166931 F 4.81 N CRV FEE 068113116021 F 1.75 0 NPL 35PK 006827466931 F 4.84 N CRV FEE 068113116021 F 1.75 0 8 MILANO CT 003116262452 2.12 X 8 MILANO CT 003146262452 2.12 X 81N PLANTER 003116252358 1.97 X 8IN PLANTER 003146252358 1.97 X 8IN PLANTER 003146252358 1.97 X 8IN PLANTER 003146262368 1.97 X 8IN PLANTER 003116252358 1.97 X 8IN PLANTER 003146252368 1.97 X BIN PLANTER 003146252358 1.97 X BIN PLANTER 003146252358 1.97 X 3PK GLOVES 073191977330 2.97 X 3PK GLOVES 073191977330 2.97 X GV SAND 200 007871208017 3.97 X WASTEBAGS 007874201849 6,97 X JELLO PUD 004300020471 F 1.18 0 JELLO PUD 001300020171 F 1.18 0 JELLO PUD 004300020471 F 1.18 0 JELLO PUD 001300020471 F 1.18 0 JELLO PUD 004300020471 F 1.1B 0 JELLO PUD 004300020471 F 1.18 0 JELLO PUD 004300020471 F 1.18 0 JELLO PUD 004300020471 F 1.18 0 GV PUDDING 007871209350 F 0.68 0 GV PUDDING 007874209350 F 0.68 0 GV COOKIE 007874208195 F 1.98 N GV COOKIE 007871208195 F 1.98 N GV COOKIE 007871208195 F 1.98 N GV COOKIE 007871208195 F 1.98 N DROP CLOTH 007325700958 3.27 X WET ONES AB 007682804869 1.96 X WET ONES AB 007682804869 1.98 X TC ELEC BLUE 001117960217 0.97 X TC ELEC BLUE 001117950217 0.97 X CANDY 002070921231 F 2.62 N CANDY 002070921231 F 2.62 N TROWEL 004656117978 0,84 X TROWEL 004666117978 0.81 X TROWEL 004656117978 0.84 X TROWEL 004666117978 0.84 X TROWEL 004656117978 0,84 X TROWEL 004656117978 0.84 X TROWEL 004666117978 0.84 X TROWEL 004656117978 0.84 X TROWEL 004656117978 0.84 X TROWEL 004666117978 0.84 X TROWEL 004666117978 0.84 X TROWEL 004656117978 0.84 X SUBTOTAL 93.27 TAX 1 8.000 X 4,49 TOTAL 97.76 CASH TEND 100.00 CHANGE DUE 2.24 # ITEMS SOLD 51 TC* 7403 2810 4013 7982 184 If'II ' JI 11111 1 11111 1 111 1 I '11111.1111 i 11 Ask a Pharmacy Sales Associate how you can save money on pet medications! 06/25/13 12:46:17 illipiPki'r ?'''1:1;; %-: kc MI savirIg. ilh,41ll1IC4II . I !Moire d ci I Ili] 2"100 M'1DISOV AVENUE MIJRRIIE1 A,(•A 92!9':12 (951)698.1555 066( 00029 8750 05/25/13 01:15 PM CASHIER KALI - KBI :3644 (17254)10150re SUPER3011 <A' 6.97 2 (:U FT f.UPERS':'Il. PATTING SOIL. 0928520670K .3PK RJN.JA_ <A. ANNUAL 8 PACK 602.69 :'JIITC'TAL hL TAX )TAL :;HANGE DUE 15.14 23.11 1 85 .r ' $24.96 2'5.00 0.04 (1,111j,111,17f111 1)111111914'.1,,j411111 RETUPN POL CV D=FINITIONS POL [CY 10 DIM POLICY EXPIRES ON P, 1 9'' 09/23/2013 THE • i JME I'EPOT Ri:::i k VES THE RLGHT TO L:(MJ 1 / D1 NY REAM.. PLEASE SEE THE RETURN 1.OLICY 3:I3N IN STORES FOR DICAILS. 7**xXl.K4NK*I11CKX**.:rtXK*KxX****1**k*xKx** ENTER FOR A CHANCE 1-C) WIN A $5, COC) HOME DEF'C)11 GIFT CARE)11 Share Your Opin on With Usl Comp1.3te the brie si.irvey • 1)o.Jt your story visit and enter for •i clave to win at: www.homedelxrt cm/opinion COMPARTA SU OI'rNIOV EN UNA BREVE ENC(JE S rA PARA LA WJP.[IINIDAD DE GANAR. UsE°'r• ID : 1 7'5959 :I. 75320) has•sonor-d = 1132wi 175291 Entries mu .t be • accred by 07/25/2013: Entrants nList be 18 c.- older to loiter. 6ae complete rides on website. No ourchas.• necessary. I l%J T R .:)1-)l 10:;1 NG WWW . J2EDI !.EACC)N .C10144 CueO i t,i Jo!: Regu• > i >, for Trusted Pros 7. -€15E5-• 7:2a-•2265 -1355 RUEACON More saving. More doing" 3150 CASE ROAD - BLOG P PERRIS, CA 92570 (951)928-0252 6875 00058 87757 10/31/12 02:35 PM CASHIER SELF CHECK OUT - SCOT58 636893402067 25' HOSE <A> 28.77 0463965549255E 3000MAX PSI2800PPW 'BI 3100 PSI HOMELITE HONDA PW 09 /12 399.00 SUBTOTAL 427.77 33.15 XXXXXXXX5132 ( GIFTAL CARD $460.92 CARD BALANCE 528 34 460.92 TA 11111111111111111111111 6875 58 87757 10/31/2012 3284 RETURN POLICY DEFINITIONS POLICY ID DAY', POLICY EXPIRES ON A 1 90 01/29/2013 B 7 30 11/30/2012 THE HOME DEPOT RESERVES THE RIGHT TO LIMIT / DENY RETURNS. PLEASE SEE THE RETURN POLICY SIGN IN STORES FOR DETAILS. BUY ONLINE PICK-UP IN STORE AVAILABLE NOW ON HOMEDEPOT.COM. CONVENIENT. EASY AND MOST ORDERS READY IN LESS THAN 2 HOURS! xxxxxa.xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx �NT�Q P-nQ A r=HANf`_r- Sun Ia ty Hardware 21+250 81 adley Rd. Sun City. CA 9258E 1-9's1-1:119.38bb lransactioo : t449h41 Associate: Employee Date: 04/21/2013 lime: M:50:4:1 AM •H SALE ••• 391AL LAWN & Lf_Af DAG 3.00 BOX l $16.99 1 $50.97 Subtotal: $!)0.97 u% I:alitnroia: $4.08 l I I I AI : $Sb.05 VIA: $'15.05 ir:Iait . $0.00 BUYER AWLS 1u PAY 101A1 AMOUNT ABOVE AC'I:IIRU1rNi 111 i:ARIIHUI UI.ft'S AGREEMENT WITH ISSUER App'eval:002476 CNUM:VISA-DB 2099 EXP:++/*• NAME:CHARLES A SIEEIE AMT:55.05 Thank You! "Give ns a gall. We have it all" 111 STATER BROS. Where You "Always" "GET MORE...FOR'LESS" Sun City (951) 679-6655 ******* MANAGER ******* Carlos Gomez S -tor e # 83 Cashier: Stacy E 03/15/13 AOUAFINA WATER 3 D 3.99 +CA REDEMP VA 3 9 1.20 (07:37:32 11.97 F 3.60 F E; '- ICE BREAKERS (il1M 3.99 F 5UL I;)TAl 19.56 MOTAI. TAX .00 'MAL DUE Debit Card TENDER GASH CI IAN(aL: 19.56 59.56 40.00 Number OF ITEMS 7 **XX*X*xXX****K**X*x*xXX**XXXXXXX**X** Stater Bros. Market Store # 83 R**** Electronic Payment Activity **xx Purchase $ 19.56 Cashback $ 40.00 Total $ ;9_56 Debit Card Auth # 699949 Lane # 02 03/15/13 07:38 EPS Sequence PIN Used #SXXXXXXXXXXXX2099 Payment from primary Cashier # 81 Ref'Seq # 021498 # .).4 498 *********xX*x*****e'..K*X************XX* 03/15/13 Oper # 81 Trx # 114 07:38:02 Term # 2 Store #83 *X*xXXXx***xx**x**xx****X*xXX***x*x*XXX STATER TER : Where You "Always" "GET MORE...FOR LESS" Sun City (951) 679-6655 *W"*" MANAGER **X**** Carlos Gomez Store # 83 Cashier: PattvM 03%11/13 AOUAFINA WATER 1 -CA REDEMP VA SUBTOTAL TOTAL TAX 07:10:42 3.99 F 1.20 F 5.19 14.412 TOTAL DUE 5.19 Debit Card TENDER 5.19 CASH CHANGE .00 Number OF ITEMS 2 xXWXXXXXXXX*XXXx'**x*XZXxX*XX********X Stater Bros. Market Store # 83 xx*x* Electronic Payment Activity **** Purchase $ 5.19 PIN Used Debit Card #SXkr(XXXXXXXXX2099 Auth # 242731 Pa"rni t from primary Lane # 02 Cashier # 85 03/11/13 07:11 Ref/Seq # 020666 EPS Sequence # 020666 **X*XxXX******XXXXXX****Xx**X*******x** 03/11/13 Oper # 85 Trx # 58 07:11:10 Term # 2 Store #83 X*****X*XX*XXXA M*****X*XX**xX***X*** PLEASE RETAIN RECEIPT FOR ALL REFUNDS (HANK YOU FOR SHOPPING AT STATER BROS INVOICE FROM. George Solis Painting Co. 27222 Park Ave Menifee Ca. 92586 (951) 301-6107 Licit 762711 Email : itcorgcsolispaintinl;@yahoo.corn TO: Habitat For Humanity NO. 2009 WORK PERFORMED AT Jewel cool 44458 KnightHawk Pass Temecula Ca . 4/16/2013 1 YOUR WORK ORDER NO OUR BID NO DESCRIPTION OF WORK PERFORMED Painted Exterior Front of house #1 Paint front Facia Board #2 Paint window suffers #3 Paint window pop out #4 Paint Garage wood trim ti All material is guaranteed to be as specified, and the above work was performed in accordance with the drawings and specifications provided for the above work and was completed in a substantial workmanlike manner for the agreed sum of Two Hundred Dollars ($200.00). This is a 0 Partial ❑ Full invoice due and payable by: In accordance with our 0 Agreement 0 Proposal No. Dated 4 /16/2013 m 0 FLANK'S C. 41740 ENTERRLSEIRC SOUTH TEMECULA, CA. 92590 PHONE: (951) 676-4265 PLEASE KEEP YOUR RECEIPT FOR RETURNS HABITAT FOR HUMANITY IN. VAL. 27475 YNEZ ROAD, #390 TEMECULA CA 92591 z QUANTITY H 9512969968 Cr; 48 48 14 26 2 5 16 8 23 4 1 1 8 1 9 1 1 6 5 (7M EA EA EA EA EA EA EA EA EA EA EA EA EA EA EA EA EA EA EA EA 640 640458 640466 RC1386 13972 11899 1707463 PREMIERE258 62/4910 RM410 73406 70877 5 12705 2195477 6102727 5002175 1 1092675 140.1412 COST # 3843 TERMS: IF PAID BY THE 10TH PAGE NO 1 INV # 839243 DATE : 4/26/13 CLERK: JH TERM # 566 TIME : 8:36 *************** * INVOICE * *************** ITEM DESCRIPTION SUG.PRICE PRICE/PER EXTENSION ckf"-aix Receive4 By PR• PROPJT 2 1/2" PROPJT 3" GEN CONT 6WAK 3-/.8- ROLLk'P - CALI BRATEW:ONTAI NER : a SPRYPAINT 1T4,SS. VAT PLASTIC PAINT TRAY - GgEER 9" PAINT TRAY ACE 33GAL DRWST BAG 20CT 9" White Tray Liner LINE TRMR.065 40' LOOP LINE TRIMR.095 40' LOOP ROPE MASKING TAPE1.41X60YD GP BOLT CUTTER ACE 24" PAPER TOWEL BNTY SGL WHT PADLOCK LAMI-1/2TWIN ACE SPONGE PAIL 4 DUTY 2GAL PVC WHT CLEANR GLAS190Z SPRAYWAY 2.29 /EA 109.92 3.19' /EA 153.12 6.99 /EA 97.86 4.29 .58 1.49 /EA EA 27.45 2.24 /EA 36.64 8.19 /EA 65.52 .79 /EA 18.17 1.29 /EA 5.16 1.79 /EA 1.79 2.99 /EA 2.99 1.99 /EA 15.92 19.99 /EA 19.99 2.49 /EA 22.41 7.99 /EA 7.99 2.99 /EA 2.99 3.45 /EA 20.70 3.79 /EA 18-95 CONT'D 0 2 9512969960 c+ CD HANK'S HARDWARE AND LUMBER,INC. 41740 ENTERPRISE CIRCLE SOUTH TEMECULA, CA. 92590 PHONE: (951) 676-4265 PLEASE KEEP YOUR RECEIPT FOR RETURNS HABITAT FOR HUMANITY IN. VAL. 27475 YNEZ ROAD, #390 TEMECULA' CA 92591 CUST # 3843 TERMS: IF PAID BY THE 10TH PAGE NO 2 INV # 839243 DATE : 4/26/13 CLERK: JH TERM # 566 TIME : 8:36 * INVOICE *************** QUANTITY 1 OM EA 6214910 DESCRIPTION ACE 33GAL DRWST BAG 2DCT ,n••i- SUG.PRICE • PRICE/PER 8.19 TEA EXTENSION 8.19 6983 ** AMOUNT m CL 7 m m xm RE, cv)ved E3y HARGED TO ACCOUNT ** (CHARLES (CHUCK) H) 841.54 TAXABLE NON-TAXABLE SUB -TOTAL TAX AMOUNT TOTAL INVOICE 779.20 0.00 779.20 62.34 841.54 (TARGET LAKE ELSINORE - 951-674-2620 11/13/2012 09 21 AM EXPIRES 02/11/13 11111111111111111111111111111111111 031O5033Y OTllE PANG FILE 1 $6.19 SUBTOTAL T = CA TAX 7.7500% on $6.19 83701 DEBIT TOTAL PAYMENT aA 19 U . a,f 6.67 $6.67 REC#2-2318-2195.0080-1200-7 VC00757-288-455 P.0 Box 8076/Golesburg, Illinois 61402.8076 / 309 343.0704 Ms. Tammy Marine Executive Director HABITAT FOR HUMANITY INLAND VALLEY INC 27475 Ynez Rd Temecula, CA 92591-4612 Date February 7, 2013 Member Number 80529 3001 Invoice No. H500868 Date February 7, 2013 Member No. 80529 3001 Order No. S001-171520 Terms UPON RECEIPT Order Number SO01-171520 Return This Portion With Your Remittance INVOICE $ 78.50 Invoice Number H500868 Keep This Portion For Your Records NAEIR Basic "Special Offer" Order Number # (171520) Retractable Dry Erase Marker Assortment(2) uni ball Vision RT Pens(1) Work Gloves(5) Post it Adhesive Name Badges(3) - Handling Charges - Handling Charges -Handling Charges - Handling Charges - Shipping Charges * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Value of Merchandise Received: 251.0051.00 * Cost to your Organization: ONLY * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Now Accepting MASTERCARD, VISA, DISCOVER and AMERICAN EXPRESS. ' Please Contact One Of Our Membership Advocates For Details. Payment 01 this invoice acknowledges that your orginlzanGn will use tlw merchandise received through NAEIR m accordance with the prow>10nMoI IRS Cod 170 1Q1131. The merchandise will riot be bartered. tror aded or sold. Iand in t is atso underbtwith OOdthe 111 nl 50 , 0 San zation�willllEeep a rotate owill bo f this tsed ronaec tort torr the care r the IRS needy e eventMSlminael. they wrs11 10 verily the IransaCI On. - -!-sataa•s0► D n Rnv R076 / Galesburg, Illinois 61402.8076 / 309 343 0704 $ 5.00 $ 19.00 $ 27.50 $ 27.00 0.00 if Remittance Amount $ 78.50 1^1 4 TEMECULAGLASS, uc. # 766481 COMMURC)AL & RESIO -..4 Ali, t. 41755 Rider Way #2, Temecula A 92590 Bill To g) II o iC30 WWW.TEMECULAGLA Habitat For Humanity Frank -951-805-8272 P.0 Requested by Frank Description Dual Glazed Unit 34" X 68-3/4" C/C/C 11/16" O/A annealed Installation Riverside county Sales Tax 5. W illictrns 4,46 We Appreciate The Opportunity To Serve You. Invoke Date Installed Date 8/6/2013 8/6/2013 I Installed by '.-- Terms Due Date Due on Rece... 8/6/2013 Telephone # Web Site 951.695-5572 www.TemeculaGlass.com I/We are 100% satisfied with all work performed by Temecula Glass, inc. to my/our full satisfaction. Upon cornpleilon no refunds will be given. X Ocertsi* 766481 FAx: 9.516-33G3-poptia Qty I Rate 1 ; 198.33 85.00 8.00% Total Payments $-299.20 ! Balance Due so.00; Amount 198.331' 85.001 15.87 ; $299.20 THANK YOU FOR CHOOSING TEMECULA GLASS, INC. "WHERE QUALITY AND SERVICE COUNT" L7:te7 13 k tPi y'Itr:rt •Sr4oat2taw. www.trilakessportswcar.com Ph one:951-301-8884 Fax: 951-301-8885 E- Mail: peterg@trilakesca.com 32100 Menlee Roed,Menrfee. C4, 92584 Bill To: Habitat For Humanity Mary Stein 27475 Ynez Road #39D Temecula, CA 92591 Phone 951.699-5799 E -Mal Mary(alhabta14intaMyatt y.org Celt Fax ( -) Terms Sales Rep INVOICE Date Invoice Number 3/1212013 S 24140 Volunteer Shirts Page 1 of 1 Ship To: 27475 Ynez Road #390 Temectla, CA 92591 Stip Method: Deliver Cusbmer PC Due on receipt Rhonda Giummo r Descrition titc hes Size Qty Rate Amount otyie p - --- - 2000 2000 Gildan Adult 100% Cot Tee 11 L 30 46 4 90 4 90 147 00 220 50 X 20 4 90 9800 2XL 6 490 2450 Screen Preit With Flash i Col.Chest- Left 100 Screen and Setup Charge 1 Additional Location 1 Col Center• Back 100 Screen Fees Additional Location 1 /cr\i 1) V'� \cC) \ /1 0 7),..\ ,/ \ () J Payments Made: Thank you forchoosing ou company. Copr4gh12008JC1V Soto are LLC Ninghls,eserved-xa•nwfaaGr!aneget co" Total Tax Amount Net Total Payments Balance Due 490.00 39.20 529.20 0.00 52 b0 \' \ Seq# 20487 HANK'S HARDWARE AND LUMBER INC. 41740 ENTERPRISE CIRCLE SOUTH TEMECULA, CA. 92590 PHONE: (951) 676-4265 PLEASE KEEP YOUR RECEIPT FOR RETURNS HABITAT FOR HUMANITY IN. VAL. CUST # 3843 27475 YNEZ ROAD, #390 TEMECULA CA 92591 TERMS: IF PAID BY THE 10TH NO INV # 830559 DATE : 2/01/13 CLERK: JH TERM # 561 TIME : 9:11 *************** * INVOICE *************** 4731 (CHARLES (CHUCK) H) NON - TA_XABLE SUB -TOTAL TAX AMOUNT TOTAL INVOICE 0.00 274.87 21.99 296.86 / .. UM l ITEM DESCRIPTION SUG.PRICE PRICE/PER EXTENSION QUANTITY 12 2 EAII1 EA 4X15CANVAS PAINT ROLLER 4 X 15 CANVAS DROPCLOTH 2.49 [EA 14.99 /EA 29.888 2, 98 9.90 10 EA 13972 CALIBRATED CONTAINER QT .99 /EA 23.98 2 EA TRYTOWELS TERRY TOWELS BUFFALO 24PAK 11.99 /EA 2.36 4 EA 5 NUMBERS :59 /EA 6 EA 12706 MASKING TAPE1.88X60YD GP 2.79 /EA 16.74 32.28 12 EA 640532 PROPJT ANG 2 1/2" 2.69 /EA 6 EA 640466 PROPJT 3" 3.19 /EA 19.14 17 EA 640458 PROPJT 2 1/2" 2.29 /EA 38.93 17.88 12 EA L707463 PLASTIC PAINT TRAY - GREEN 1.49 /EA 11.85 15 EA RM410 9" White Tray Liner .79 /EA 41.95 5 EA L559088 ONE COAT COVER 6/PK 559088 8.39 /EA ')OG 4a TZ1MRT.P ',74 R7 4731 (CHARLES (CHUCK) H) NON - TA_XABLE SUB -TOTAL TAX AMOUNT TOTAL INVOICE 0.00 274.87 21.99 296.86 / .. • • titclIti • Ste!: Yysc 1itQd4:'• sw,s •Sckol utcros- www.trilakessp ortswear.com Ph one:951-301-8884 Fax: 951-301-8885 E -Mail: pe to rg@trila kesca.com 32100 Men fee Road.A,nifee CA.92584 Bill To: Habitat For Humanity Dawn Madera 27475 Ynez Road #390 Temecula CA 92591 Terms Sales Rep INVOICE Date Invoice Number 12'27/2012 ES 23131 polos for Star Page 1 of 3 Ship To: 27475 Ynez Road #390 Temecula. CA 92591 Shp Methoo: Deliver Customer PO Cite on receipt Rhonda Giummo Style Description Colors /Stitches Size Qty Rale Amount ` Joh Site K510 NEW Port Authority - Stan -Resistant t 2 17 50 :5 C C Sport Shi K510 NEW Port Authority • Stah-Resistant -;to', L 1 17 50 1? 5 C Sport Shi ;-!_ 5 11 50 67 EC K510 NEW PortAuthority - Stah-Resistant 2 17 53 °5 CC Sport Shi L510 NEW PortAuthority - Ladies Stain -Resistant Sp Stone ., 1 17 50 17 5 0 L510 NEW Port Authority - Ladies tavy 1 17 50 17 _=u Stain -Resistant Sp Embroidery :suo suu•:e . ::rr:st•LeF.. 12 Admin L500 Port Authority • iaoies Sik Touch ',e ••Y 1 13 53 15 5 G Sport Shirt L500 Port Authority - Ladies Sik Touch •`.,.t. ; 1 1350 13 56 Sport Shirt L510 NEW PortAuthority - Ladles Sone 1 17 50 17 E. 0 Stain -Resistant Sp L612 Port Authority - Ladies 3'4 -Sleeve •`,'1 to i 1 19 50 % 5 c Easy Care L523 NEW Port Authority reg - Ladies Silk ',3?'; 1 19 50 19 6C Touch153 Int Payments Made: Thaik you forchcosing oz: company. X11' 5Cr 3'6 LLL - ,1 •;s—eaN'.ac !8':r:a a68' Total Tax Amount Net Total Payments Balance Due 927.35 71.87 999.22 0.00 999.22 Seq# 20143 1 Habitat for Humanity Inland Valley Attn: Tammy Marine 27475 Ynez Road, #390 Temecula, CA 92591 Date: 11/5/2012 Invoice: H4H153 Payable Upon Request Item Public Relations Description November Public Relations Retainer • Manage Advertising Programs • Social Media Management • Create and submit VB1 article • Assist in creation of branding materials including Habitat brochure, marketing kit, Sun City project signage • Create and distribute press releases for gift card program and Healthy Home Series Products/Services purchased on behalf of Habitat for Humanity Inland Valley Advertising: Penny Saver Ad — week of 10/7 Penny Saver Ad — week of 10/14 Penny Saver Ad — week of 9/16 Penny Saver Ad — week of 10/21 Friday Flyer Ad — November Valley Business Journal Ad — October Patch.com ads — October (last month) Facebook ads —10/30-11/3 SWRNN.com online ads — November Neighbors Newspaper ad — November Printing: ReStore rack cards — Real Estate (Qty. 500) public relations Total $750 Press Release: Additional press release in October for Healthy Home Series (Xmas Tree Lane press release is included in retainer) Signage: 20 (22)(28) signs/stakes and 2 large banners ford ird Tract -$ 8 small house signs a akes -.5€* 2 Banners for 951.704.6395 2 Large banners for Sun City a er roject 28465 Old Town 590 580 5184 590 5336 5695 5208 530 5295 5252 599 5125 \N^-. L"/ Subtotal Tax Shipping Balance Due 5238 $4,624 n/a n/a $4,624 r 1lc'ky1ie OL l_G6 512(5 iIry Whi . e6f.vie �75o 09,50/11'79.! t % 3 ZS - Front Street, #315, Temecula CA 92590 J www. ealr. n. P004—\10-3 c9S 7.i1V IOJOYJ Habitatint y Reimbursement Request Pay to: /2'A'.� /e -l eld Purchase Rdnibirseaseat (Receipts least be attached) Location of Purchase -We) Itcm(s) Purchascxl Purpose/Project Amount A04--- U17.1)o r /11' 5svRC N is w9. /yos� pettA) s ftio ./.10.c" . ...-Y/, o SPWreIZ �� A4 V o' ,rQe ":„d- x -¢e .p(dArt#f—co/. 54 rrs'w ys veivai tea acS $l f 1-4 he icJ S . • Ln,C, ,r_ F 57'4w# l e/t /y1/ P: .0,- i', /'1 e /C yC.sw_rrt,p t/5 AA(*) //So. ts a /015 A //'u. 14. s� 5, d / , 116,4e e S1)E7,00 r- AOuxit/•crAt ijx4 f'asr "Lecve $R/QJtiA.S /8-,..3"1 Mileage Rehm baritone's Driving toil /Z' creci/ 4 Slo,c/J jc /r 1 '°`u: e-/1 Xthe'$ rna J O ,vSfr HP.v 5ro.e.Aj e�Sv�� /-.Gv S4 Alp //d.4LA1S /' Js °. .4I.$ Is2 A eo ML's/ y 1b�Q A e sOi !.� tY -, l A? off / o - Too 4.5 r[,N�,a �41,� MFiv,�'/SdivD,f/4DOe ,b'et,Si� .1/17-1 /C/1/0Nes� srn.:�dr .1/4-‘44 7.2- .es i1,d_;t.. rF : IA(/5 psr4t. M ',v, yd M(TA Oak()S .RAe.t Dn1 W4,0,47 %'10M e J)P rwp Alce iii .9mi Q./Ty He dtJ.9'////IAAG•'," A* 72CA4,C r, LA otreP /MOr,a' I /9n /eo Tout! miles !7iI ,Li.c.,/. �oK MA/4. lgox Nd.✓ hit›,',1 /$ /.56 E //t S4L /c,/ v/' l,V dijs Sort e 4- A.r�� t o /2" 1/6 Amami Owed (miles L,52) 2 6. 3 Ns P a 9, 9 2 2,4,0 / 3, Sa . /.1 o far 3, ,10 Date: ul23 /2 • ro,. • fc' Reimbursement Request Pay to: OW (-0( yr azy-) alu,rrioc,K- Total Amount: Purchase Reimbursement (Receipts must be attached) Location of Purchase Items) Purchased Purpose/Project Amount }low+ tw 04 cc.l G`1`•✓('•Dm. etr S fl b 00......4.,...4..c v,„.„ezlA i 4- I. 1,,,.(-c- 14 . c -) 10-'1\ 9- / I , Nm - “bet --5t r -o vv„ve.ef., t`o iN,-ekt*A..4 yf; - ' .ov...t c u { - u'+1 vt ex, Ig -•r' 0, t/- a til,, 6.r� tr•,c4- - IZ- y fq- sre 1'c -4O °%(. c#- - 'L'L ry,•K.w(k °Act ;t,,,,cc - 3O / / c�� V' �'�� V/1i-rv,Ln�e b 1-4...„„.. erevic. v Os Mileage Reimbursement \s Driving to/from Reason/Project Toth. e - Amount owed i.•s ?} 3/27 -Tt.v e_c-ut c� tv gird 1rc..c.t- _ 3/•t3 - T �0k �Aw►c ..o R.•-,cth.ct, ijz�- 13$e-6( Tract -4o ty3-8;d Gip .i.1.. ��r ..c L.4172. (.1 BacicLp Included?` s 1 1 Nm - “bet --5t r -o vv„ve.ef., t`o iN,-ekt*A..4 yf; - ' .ov...t c u { - u'+1 vt ex, Ig -•r' 0, t/- a til,, 6.r� tr•,c4- - IZ- y fq- sre 1'c -4O °%(. c#- - 'L'L ry,•K.w(k °Act ;t,,,,cc - 3O / 4- -Z c�� V' �'�� V/1i-rv,Ln�e b 1-4...„„.. erevic. •Z,• ''OI • 76 Q 35 g *, W/17-- wi1aoe„n,e 1-► Sh+..�5e iv cat 9 II? — Fee,. S hi n,._,,,•,c . t. . Qix c. s - a w rc•s l+.•..er,bfee"4Y -y fig - ;Mr a, rb-et tci 14 - c .�,�._� • c -u. Ito Qc..rr, — e> +0/2 t -.is -Zb -32 Check Request 7 / 3 01 50 " r4(006tvict5a-r) Pay to Reason/Project Amount Req sted 250•OC BacicLp Included?` s 1 1 Tykd c (Y••rr,s0r, R e -ht L1 A 01 50 " r4(006tvict5a-r) .5 /Zq / r3 1 f;17 Reimbursement Request Purchase Reimbursement (Receipts must be attached) Location of Purchase Item(s) Purchased 15'n/Project ` Purpose/Projec--�mount Total les f Amount owed (miles x.52) r^ -3123_'x.--e C'v%v. ' i`k.-e. -ref c.,5t� yvta. • -yr'.- ',� ,e,t.h;ke. y...sok saz•& - -2,.4p 'lras - "7 ^amu j. wstKIL ,P S Tb� k i -O N.Q.(i`4 t..i� y �2 11/44 Backup Included? sit cep - ��{ P411 .1a fc j , ,/ n ilc1-,/---r h +�� w 4•�+ 2-84-kox l—Ort'oar‘o pfort e� k 4a5 h(3%'v`""..yt2h„ ,,f_ _—��_ �lV ~ , - 6 A • .0 >l _. Vit►Z<'1 A I1' 1.4.4,• r,.r I,., 404 i1 i. a . , tx‘,.. View 4 ,r LE 30 6 3. 00 li /` 1 ~ 1 .► 1 i, Mileage Reimbursement Driving to/from - • +\ 15'n/Project ` Total les f Amount owed (miles x.52) r^ -3123_'x.--e C'v%v. ' i`k.-e. -ref c.,5t� yvta. • -yr'.- ',� ,e,t.h;ke. y...sok saz•& - -2,.4p 'lras - "7 ^amu j. wstKIL ,P S Tb� k i -O N.Q.(i`4 t..i� y �2 Amount Requested Backup Included? sit cep - ��{ P411 .1a fc j , ,/ n ilc1-,/---r h +�� w 4•�+ 2-84-kox �Il ��w I h(3%'v`""..yt2h„ ,,f_ _—��_ �lV ~ , - 6 A • .0 >l _. Vit►Z<'1 /l6 •- {Gwo. (.1/1 a C' t4 I ' n i- o � - %e wtC. uu, 6 %fj' ut. ro (466."6,4 1 CO , rx) ) - - •c ► f i. a . , tx‘,.. View 4 ,r LE 30 Check Request o Pay to Reason/Project Amount Requested Backup Included? ✓ - • - • h ► . - •c ► M'4 181 ~ l•--2 s -V M Ilif 3 r Reimbursement Request Date: 3) 2 C' / Pay to: (1'IG (w 1w. V -"vv -p • 61.,v-dt-cc-k /7-`)/eY s o ,� /by. 32 - Total Amount: Purchase Reimbursement (Receipts must be attached) Location of Purchase Item(s) Purchased Purpose/Proj - ct CI ' \ Amqun, ? li 2.00. Ov 3/11 - etric HA)" -e • 8 3r It Ty Ica A� c iv .ter t�( t„ sI. 3/(W•(7en•St{pdce }q r.,..("9.;.- ••s e,�tittis4 . Ptgv4 ccs e' -Z4 _ ,:s -c 4.. \ .,..) ...),\1/4-. \ \ \ c -c), V A.SZ =11,t1.32_ 'VW -itwc„alko:$ 4 kgw1','Rn.-twlr e,rif -Att<-twQG4,r-z oitli•S tiPir, Shi - et"-r.r -8 3/-1a •- c.4..r-rte nom, n z Mileage Reimbursement Driving to/from Reason/Project Total miles Amount owed (miles x.52) 1 b - 7vstc4 d o.ASce - �.Siv L - rZrtr. g • ea( 0.' -A d2( rol Iv At✓rraC9 t Rg rt, f•}presCrA(4Ma AO % f- Z(ft ? li 2.00. Ov 3/11 - etric HA)" -e • 8 3r It Ty Ica A� c iv .ter t�( t„ sI. 3/(W•(7en•St{pdce }q r.,..("9.;.- ••s e,�tittis4 . Ptgv4 ccs e' -Z4 _ ,:s -c 4.. S m $$wK-2'z- 4/36.k -l6 `, 1 1b V A.SZ =11,t1.32_ 'VW -itwc„alko:$ 4 kgw1','Rn.-twlr e,rif -Att<-twQG4,r-z oitli•S tiPir, Shi - et"-r.r -8 3/-1a •- c.4..r-rte nom, Check Request Pay to Reason/Project Amount Requested Backup Included? -Tikc (70.4-fiior Q.e.-v. t- C --ti li 2.00. Ov t-3 - Ito 4.64-3u -7Li , qfrA 7 41 :h +- &Li 7 3)t; .. ,itat for Humanity' Date: l (IA Reimbursement Request Pay to: M�A°k,-^ (?-comer - rn�rc�c� Total Amount: 112. 81i I' Purchase Reimbursement Location of Purchase Purpose/Project Total e Reimbursement Driving to/from Purpose/Project Total miles we Amount owed (miles x.52) 12- prQ J\t..1 .recutatkov Se(el itrs Is. b - 149'WV tti+vSeS Mvcite-c. f..1r,..1sIS i 1 AgWIC V.6%,;e "s• 'RV.a.CVILA An -lc M,Kr .tet coAce iew.,1.ef 6,,...,l4 S 1 It t +vwlh04 t+cA V•st'ts -k2 w. 1(4 : Mvrr:CkC. VIt-8O%-.'* TN.., h...t(VIA /S= prgwt IN_DV 'S I•. lCs..ere - ih , 764,-e Lvtc• 00-, t -e : I'Ln ..,Ur - 4 • "rtwt A. OMee - pie -a '%eAer - u� w.% '3Ej „sits thwt CJl t 0 ►4S Lt J[lel "DM .. vn L. 1.7 3 n ,,,..1te c %h till = Ser... -5 ,cy,..11f 4�.�,.Ier Os � s Tcwecartk ocA(..e. OS re i'w^ 6i)(wee.,ft�t •" 2.3., ~ter l . Far.0 lc, 04Aza les (I) 2.I i-7 n 52 t� '1112 .8 1 t,.�r-cs tv- I lL S ..a•n Lit) >rb-csh� -- 1JI5 rat W� �� r ( L'- ) c% ` Lsr' •r• CP",") k.vtalt.S veI. c1 55. c.. n , we 6.- \re lvrwr.S V\o s CEA tow ve Pr3 J K &vv.-0 d fro *' N c e e t -t �^'� h a c 6-4 1 S- kct 9yl 7'j 9 . ..te1rr ••y7•' ..I ,+�� r j.�• i Reimbursement Request Date: 2 fLiJ/i3 Pay to: Mai(ha,--cam c Total Amount: 35b. Purchase Reimbursement (Receipts must be attached) Location of Purchase Item(s) Purchased Purpose/Project Amount Driving to/from L.ti Reason/Project Total miles Amount owed (miles x.52) th.(1• Orbic - Is,..,...iooft timet - s')y. 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Piety �.{o 32A •� �} 91Pti%V YFllo g5 Pay to Check Request Reason/Project Amount Requested Backup included? - t•>\ . . O 27625 Jefferson Ave., Suite 107 Temecula, CA 92590 (951) 693-2136 • FAX (951) 693-2143 Info@potamuspress.com ARTWORK PROVIDED O INVOICE# 69 1 4 i DATE 0 'C6 ' -a- DUE DATE P O. # CSR NEW CUSTOMER 0 REFFERED BY Final Count Final Count Final Count I have received my order and have checked it carefully. I understand that after 30 days �• there will be no refunds or credit given. Received By THANK YOU! Date DATE PAID 0 CASH O CHECK# 74:CUSTOMER ACCOUNT O CREDIT CARD VISA MC AMX DISCVR NAME:.Vt.k t.kc`�" 1.•Y:'\ \IIL1,)1 ilt(( Seetog�oO PROOF NEEDED BY: 1 - ARTWORK SIGNED OFF DATE s PROOF REQUEST: RIP) POLY 0 METAL 0 HMCP O I r , CC 0 CELL NUMBER: BOOKLET MAKER L FOLDING LETTER 1/2 D O PHONE: COLLATING T t _ O FAX #: '/ '. �i PADS IN 25's 50's 100's Top Side Bottom / - CUTTING Finish Size 0 0 Email: BINDERY Staple Drill Tabbing `•- CONTACT PERSON: 2 ff G 0 Spiral 0 Comb 0 Clear Cover/ Black Back Other STOCK ORDERED NEW ARTWORK 0 NUMBERING Start # End # RE -RUN WITH CHANGES 0 EXACT RE -RUN O SCORING PERFORATING FINISHED QUANTITY DESCRIPTION ORIG. SIDES SIZE SHEET INK WGT. STOCK 2rl .0 t (....0-k...L) k 4.4 ,--er% 'IL' 0' '1(41 7. ,c o , APPROVEDU ow MA, DM G N ,'N / 31 Special Instructions: SUB -TOT '70 13`') SALES TAX / RESALE (, .- (, •Graphics based on $85.00/hr. Minimum graphic charge 520.00 Graphic Time: hour minutes. Graphic estimate 1145.00. TOTAL �'7SS ' 1 ` \i Initials: DEPOSIT .7 Pre -press Press Bindery QC S IA Name & Date Final Count Final Count BALANCE DUE Final Count Final Count Final Count I have received my order and have checked it carefully. I understand that after 30 days �• there will be no refunds or credit given. Received By THANK YOU! Date DATE PAID 0 CASH O CHECK# 74:CUSTOMER ACCOUNT O CREDIT CARD VISA MC AMX DISCVR S O L D T O rmann PRINT 41669 Winchester Rd. • Ste 103 Temecula, California 92590 (951) 296-6595 / 296-6597 )NVO C No. 118113 Habitat For Humanity Company 41615 Winchester Rd. acktiess Temecula Gutle CA 92590 City Siete Zip ATTN: Customer Phone number 951-296-3362 Invoice Date: 1/7/2013 Customer P.O. No. If you have any questions please call (951) 296-6595 Non -Taxable Taxabl Service/Material Description Quantity Rate Extended Amount Unit Cost Extended Amount 2,000 Nelgborhood Enhancement Project 2000.00 $0.03 $60.00 0.00 *---)--- \ 9 \ t_i\ ‘.)\\--/jr/ .) J \0 ,-\/ U \---V,, ,-)\\.._/ /41 Please make all checks payable to OMEGA PRINT Date Paid: Received by Non taxable subtotal Taxable subtotal Tax rate $60.00 $0.00 $0.0775 Subtotal Sales tax $60.00 0 Total Previous Balance $60.00 Amount paid Balance due $60.00 ALL ACCOUNTS DUE AND PAYABLE By 2-20-13 Past Due Accounts Will Be Charged 1-1/2% Service Charge Habitat for Humanity Inland Valley Attn: Tammy Marine 27475 Ynez Road, #390 Temecula, CA 92591 Date: 3/1/2013 Invoice: H4H157 Payable Upon Request Y') public relations Item Public Relations Description Total March Public Relations Retainer • Manage Advertising Programs • Media Relations for Healthy Home Series, Perris build, Earth Day and LE Bird Tract ceremony • Social Media Management —AZV✓)L • Create and submit VBJ article • Assist in creation of branding materials in uding-Case-Study-ancl Tract signage •� Finalize weekly eblast template Create bi-monthlyn wslett • Revie anz update website $1,650 Products/Services purchased on behalf of Habitat for Humanity Inland Valley Advertising' Penny Saver Ad — week of 2/3 Penny Saver Ad — week of 2/10 Penny Saver Ad — week of 2/17 Penny Saver Ad — week of 2/24 Friday Flyer Ad — February Valley Business Journal Ad — February Printing: Tri -fold brochure (qty. 2,500) b i(4250 (05- 0 L -(a.50 ( Jo Subtotal Tax Shipping Balance Due $110 $80 $110 $110 $675 6D 1 '1:;;;* -*- $265` $3,085 n/a n/a $3,085 cd\ 0,c_s ( utA5sh-ie - Le EPr s 28465 01r1 loavri I o t Stree #31 5, Tela CA 92590 1 0 0/10 www.PearP;3.c rn Eva Pharis From: Tammy Marine<tammy@habitat4inlandvalley.org> Sent: Friday, August 30, 2013 12:23 PM To: Eva Pharis Subject: RE: Community Service Funding 2013-14 Thanks for the reminder. Our application will be there before 5pm. Thanks again':! Tammy Marine Executive Director Habitat for Humanity Inland Valley 41615 Winchester Road, Suite 214 Temecula, CA 92591 Mailing address: 27475 Ynez Road, #390 Temecula, CA 92591 (951) 296-3362 (951) 296-3363 (fax) (951) 551-6244 (cell) tammyCa,habitat4inlandvalley.org www.habitat4inlandvalley.org "We must accept finite disappointment, but never lose infinite hope!" Martin Luther King Jr. From: Eva Pharis[mailto:Eva.Pharis@cityoftemecula,org] Sent: Thursday, August 29, 2013 5:04 PM To: Undisclosed recipients: Subject: Community Service Funding 2013-14 Temecula Community Service Funding Program for fiscal year 2013-14 will be accepting applications through Friday August 30, 2013. If you would like to submit an application please visit the City of Temecula website at: www.citvoftemecula.orq where you may download an application and deliver to the Temecula Civic Center. We will be open until 5:00 pm on Friday August 30th. Should you have any questions or if you require assistance please do not hesitate to give me a call. Thank you. Eva Pharis Office Aid III City of Temecula 951-694-6413 eva.pharisa.cityoftemecula.orq Connect with the City of Temecula 1 November 20, 2012 Tammy Marine, Executive Director HABITAT FOR HUMANITY INLAND VALLEY 27475 Ynez Road, Suite 390 Temecula, CA 92591 Dear Ms. Marine: f �A.•,n,. hab,'�r�i ;;�!�.n v&..1 fe•f, off q 5/- �-�3�� --� Congratulations on being selected for funding under the fiscal year 2012-2013 Temecula Community Service Funding Program. Your organization has been awarded $5,000 to be used to offset costs of home repair materials to low-income homeowners in Temecula Your organization must confirm that these funds are expended in accordance with the above -stated purpose by June 30, 2013. Receipts verifying the expenditures of this year's award must be submitted to the City by September 1, 2013. The City may require access to your accounting records in accordance with this policy. If City funds are not expended as stipulated, the funds must be returned to the City. Mail or hand deliver to: City of Temecula City Manager's Office Attn: Betsy Lowrey 41000 Main Street Temecula, CA 92590 In order for these funds to be released, you must sign below acknowledging the following statement: "We do not discriminate based on race, color, nationality, sex, marital status, disability, religion, or political affiliation." The City fully supports the efforts of your organization and its services to the citizens of Temecula. Sincerely, Betsy Lowrey Sr. Management Analyst ACKNOWLEDGMENT OF FUNDING CONDITIONS (please sign and return this letter as soon as possible): Print Name/Title Authorized SignaturelTitle Date City of Temecula 2013-14 CS Funding Program APPLICATION NO. 14 J RECEIVED iJi CITY OF TEMECULACITY MANAGER'S OFFICE FISCAL YEAR 2013-14 COMMUNITY SERVICE FUNDING PROGRAM APPLICATION (Please Print or Type) PROJECT INFORMATION Amount Requested: $ 5,000.00 Project Name: Hospice of the Valleys Senior Assistance Program Project End Date: N/A Project Start Date: N/A (Maximum allowable $5,000) ORGANIZATION INFORMATION Name of Organization: Hospice of the Valleys Contact Name: Gina O'Brvant Title/Position: Director of Development Mailing Address: 25240 Hancock Avenue, Suite 120. Murrieta, CA 92562 Telephone: 951-200-7800 Year Organization Founded: 1982 Number of Paid Staff: 75 Number of Volunteers: 215 Geographic Area(s) Served: Southwest Riverside County Is this organization incorporated in California as a non-profit organization? If "no": Yes X No Effective Date: 1983 If "yes" (Must provide a copy of your statement of non- profit status from the State of California): (Please See Attachment I) Date of incorporation as a non-profit: June 29, 1983. Federal identification number: State identification number: Name of sponsoring organization: N/A Federal identification number: N/A State identification number: N/A This application has been authorized by the organization's: Executive Committee Board of Directors X Members -at -Large Apptication Page 1 FY 2012-13 COMPLIANCE REQUIREMENT 1 IF YOUR ORGANIZATION WAS A RECIPIENT OF FUNDING FOR FY 2012-13, PLEASE ATTACH COPIES OF INVOICES, RECEIPTS AND CANCELLED CHECKS TO SUBSTANTIATE THOSE FUNDS RECEIVED AND EXPENDED BY YOUR ORGANIZATION. FINANCIAL STATEMENTS 1 PLEASE ATTACH COPIES OF THE CURRENT BUDGET OF THE ORGANIZATION AND FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT). It does not require a CPA's audit, but please submit if available. (Please See Attachment II.A — II.B) MISSION STATEMENT Briefly describe the goals and objectives of your organization and community services it provides. Describe the ways your organization meets the criteria listed on page 2 of the CS Funding Policy. (Please See Attachment IIIA — 111.13) Application Page 2 /41x/1m-we 1 jl , Q-, Hospice of the Valleys Mission Statement Hospice of the Valleys has been offering loving care to people with Ilfe-threatening illnesses, support to their families and service to the community in a spirit of enriching lives since 1982. As the only non-profit hospice headquartered in Temecula Valley, we understand that coping with terminal illness presents many challenges - physical, emotional and spiritual - to the patient and family. Our caring, experienced team of professionals and volunteers is prepared to meet those challenges and we believe that no one, regardless of illness, age or ability to pay, should die alone or In pain. We believe that everyone has the right to be surrounded by love as they complete their life. At Hospice of the Valleys, we are committed to providing the highest quality hospice care available. We have a company -wide integrated and comprehensive quality assessment/ performance improvement, (QAPI) program and we use nationally recognized, industry specific evaluation tools to measure our family satisfaction. These standardized tools were created by the National Hospice and Palliative Care Organization and are used by hospices all over the country to measure family satisfaction. Hospice of the Valleys scores are compared to other hospices in CA as well as other hospices around the country. Hospice of the Valleys consistently scores above state and national averages for providing "medicine to relieve the patient's pain", "patient treated with respect", "helped with patient's feelings of anxiety/sadness" and "help with patient's breathing." Each quarter, we consistently achieve the score of 100% of the families we serve would recommend our hospice organization to others. We take pride In offering the highest standards of excellence in the provision of hospice care and count it a privilege to serve our community in such a vital and meaningful way. 25240 Hancock Ave., Suite 120, Murrieta, CA 92562 • 951-200-7800 • www.hospIceofthevalieys.org ,q 01 wr.ei-t7f-11/-6 Hospice of the Valleys MISSION We foster reverence for life, relief of suffering, and compassion in Toss for the terminally ill residents and their families of Southwest Riverside communities. VISION Recognized leader of excellence in comprehensive end -of -life care. VALUES We seek to embody the hospice philosophy in all we do, Including: the affirmation of life, promotion of self-determination, education, understanding, and acceptance. We dedicate ourselves to the values of compassionate care, loving presence, and the sustenance of hope for those dealing with the many difficult challenges at the end of life. We believe that transformation and healing are a part of the dying process and change all who participate in this sacred experience. We advocate sensitivity, attentiveness, and respect of all persons as we honor each life entrusted to our care. We support a culture of teamwork and professional collaboration. We embrace the calling to work diligently to provide leadership as educators and advocates for the suffering and dying in our community. We hold ourselves accountable for the valuable resources which we have been given and vow to use them responsibly. We are committed to the highest standards of personal and professional ethics and integrity and maintain the highest standards of excellence in the provision of care. We continue our professional growth through advanced training and educational certification. Hospice of the Valleys 25240 Hancock Avenue, Sulte 120 • Murrieta, CA 92562 951-200-7800 • www.hosplceofthevalleys.org PROJECT DESCRIPTION How will your organization use the funding awarded? Describe the project, project objectives, those served, area serviced, and number of volunteers involved. Be specific. Include equipment or services that would be purchased and why. Include a detailed budget and a schedule of significant activities related to this project. You may attach a maximum of one double-spaced typewritten page of information. (Please type or print legibly.) (Please See Attachment IV) Application Page 3 }ffichk1tt IV . Hospice of the Valleys Senior Assistance Program Project Description Hospice of the Valleys (HOV) provides care for terminally ill patients and their families, addressing their personal experiences affecting the body, mind and spirit. This is accomplished through work of the corresponding members of the interdisciplinary team (Physician/ Nurse/Hospice Aide, Social Worker, and Spiritual Care Provider) who make house calls on a regular basis throughout the course of care. Many life -enriching, supportive activities are offered by HOV's 219 active volunteers, such as companionship, emotional support, reading, singing, holding a hand, caregiver relief, running errands, shopping, meal preparation, housekeeping, and legacy DVD interviews and recordings. HOV helps people fulfill their dying wishes by helping them find closure, validating the deep meaning of their life's purpose, helping them to accomplish all they wish before they die, and assisting in preserving their dignity. The number of people over the age of 65 makes up approximately 8% of Temecula's population. The poverty rate in Temecula is estimated at 9.5%, having increased significantly since 2005. Even those in our community that do not live in poverty are struggling to make ends meet. In 2012, approximately 50% of all Americans are underinsured or uninsured, showing an 80% increase over the past 5 years. For those with health insurance, all are finding their insurance no longer covers all the costs related to medical treatment. Many families are over -burdened with huge bills on top of having to face a terminal illness. Annually, HOV serves over 450 adults with terminal illness and a life expectancy of 6 months or less. 92% of the patients served are age 61 and over. Many come with no insurance, limited insurance coverage, or lack the resources to pay for the full cost of hospice care. HOV's goal is to ensure no one is turned away or provided limited hospice care due to inability to pay. In 2012 alone, through the generous support of donors and community partners, HOV was able to provide $55,000 in charity care — a significant feat considering the drastic reduction in non-profit organizations' ability to raise funds due to the ailing economy. HOV is requesting grant monies to benefit the citizens of Southwest Riverside County, and surrounding areas, who are near the end of their lives through their Senior Assistance Program. The project objectives are to 1) increase access to hospice care for those with limited or no funding source; 2) enhance the experience of patients and families at end -of - life by providing tangible support and assistance in meeting their unique needs; and 3) further HOV's mission to "foster reverence for life, relief of suffering and compassion in loss." The monies provided by the Temecula Community Service Funding Program will be used to extend our ability to pay for more patients to receive unreimbursed medications, durable medical equipment and medical supplies essential to provide the highest quality comfort care. The Senior Assistance program exemplifies our long-term commitment to meeting the needs of our community. As a responsible steward of public funds, we continue ongoing efforts to strategically fundraise, work to grow and nurture our donor base, build new funding relationships and raise awareness for meeting the vital needs of patients and families at end -of - life in Southwest Riverside County. Budget - Hospice of the Valleys' spends an average of $22 per day for each patient to receive the following homemaker services: running errands, laundry, shopping, meal preparation and planning, Tight housekeeping, etc... Full funding from the 2013-2014 Community Service Funding Program will pay for direct costs only, enabling us to provide these vital services for those who are underinsured or non-insured and live alone in their home and do not have local family/friend support. Our funding request would help support approximately 5% of our patients that need the additional support mentioned above. Although this is a small percentage, this grant would make a significant impact in the lives of our community members facing life's end. Thank you for your kind consideration of this proposal. 25240 Hancock Ave., Suite 120, Murrieta, CA 92562 • 951-200-7800 • www.hosplceofthevalleys.org PAST PROJECT BENEFITS If your organization received City of Temecula funding in the previous year, please explain and show how Temecula residents benefited. (Please See Attachment V) Application Page 4 tctiwreq- V. Ph: (951) 200-7800 25240 Hancock Avenue, Suite 120 • Murrleta, CA 92562-5991 Fx: (951) 973-7760 Past Project Benefits Hospice of the Valleys did receive funding from the Temecula Community Service Funding Program for 2012-2013. This generous contribution helped substantially with our process of providing compassionate end -of -life care to patients and their families. In addition to the routine care Hospice of the Valleys (HOV) provides, we were able to expand our services into the Homemaker Services. Although the grant only helped a small fraction of our patients we serve, every bit counts toward making an impact in their lives. Temecula residents benefited tremendously as the majority of our patients reside in the Temecula/Murrieta area. We are honored to have received your funding and be given the opportunity to provide care, as we are the only locally headquartered non-profit Hospice organization! www.hospiceofthevalleys.org 12:30 PM 04404/13 Accrual Basis ASSETS Hospice of the Valleys Balance Sheet As of December 31, 2012 Dec 31,12 Total CheckinglSavingsllnvestments 1,080,081 Other Current Assets 1303 • Bequests & Donations Receivable 1300 • AR Patient Accounts 1302 • AR Room & Board 1330 Other Receivable 1560 Deposits 1501 • Prepaid Insurance 1600 • Prepaid Expenses Total Other Current Assets Fixed Assets 1900-1 • Fixed Assets, Net Accum. Deprec Total Fixed Assets 1,750 538,051 20,634 1,728 11,390 9,064 50,064 632,68D 215,411 215,411 TOTAL ASSETS 1,928.172 LIABILITIES & EQUITY Liabilities 2000 • Accounts Payable 2009 • Accounts Payable --Accrued 2110 • Accrued Payroll 2200 • Accrued Payroll Ben Liabilities 2400 . Deferred Rent 90,126 35,649 90,947 78,999 13,038 Total Liabilities 308,758 Equity 2920 • Temporarily Restricted 11,275 2901 • Retained Earnings—Undesignated 2,069,773 Net Income -461,635 Total Equity 1,619,414 TOTAL LIABILITIES & EQUITY 1,928,172 Page 1 of 2 10:53 AM 04104/13 Accrual Basis Hospice of the Valleys Profit & Loss January through December 2012 Jan - Dec 12 Income 3750 • Medical Records 22 3610 • Physician Visit Revenue 94,086 3000 • Medicare -Ben Routine 5,267,658 3010 • MCD -Ben Routine 175,684 3020 • Commercial Benefit 107,074 Total income 5,644,506 Expense 4000-1 Salaries, Benefits & Related Ex 4,259.887 5000-1 • Patient -Related Expenses 1,368,321 8000-1 • Faculty -Related Expenses 139,068 6500-1 • Admin. Expenses 404.832 6960 • Depreciation Expense 118,443 6999 • Loss on Disposal of Fixed Asset -2.227 Total Expense 6288,325 Not Ordinary Income -643.819 Other Income 7040 • Bequests 209 7000-2 • Support 44,451 7200-1 • Fundraising 104,359 7700-1 • Interest & investment Income 33,165 Total Other Income 182,184 Net Income -461,635 Page 2 of 2 SIGNATURE PAGE We hereby certify the information contained in this application is true to the best of our knowledge and belief. PREPARED BY: Sarah Gerow, Development Coordinator SIGNATURE: PRESIDENT or AUTHORIZED OFFICER: Lynette Cvar, Finance Director NAME and TITLE (Please Print or Type) ME and TITLE (Please Print or Type) SIGNATURE: ORGANIZATION NAME: Hospice of the Valleys MAILING ADDRESS: 25240 Hancock Avenue, Suite 120. Murrieta, CA 92562 TELEPHONE: 951-200-7800 EMAIL ADDRESS: info( hovsc.or0 DATED THIS 28th of August , 2013 (Date) (Month) BE SURE TO INCLUDE THE ORIGINAL PLUS E COPY AND SUBMIT BY AUGUST 30, 2013 TO: Mail Completed Applications to: Or Deliver in Person to: City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office Post Office Box 9033 Temecula, CA 92589-9033 City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office 41000 Main Street Temecula, CA 92590 Application Page 5 ON Exempt Organizations Select Check Page 1 of 1 IRS Exempt Organisations Select Check Exer of Oruenizations Select Chess glome Organizations Eligible to Receive Tax -Deductible Contributions (Pub. 78 data) - Search Results The following Ilet Includes tax-exempt organizations that are eligible to receive tax•deducfble contributions. Click on the "Deductibility Statue" column for en explanation of limitations on the deductibility of contributions made to different types of tax-exempt organizations. Results are sorted by EIN. To sort results by another category, click on Use icon next to the column heading for that category. Clidting on that icon a second Ume MI reverse the son order. Click on a column heading for an explanation of information in that column. 1-1 of 1 results Results Per Page 25 OK a Prev 11-11 Next v Hospice of the Valleys Se Retum to Search City. Munlete Stnte.Country. Oaduclibiltty Status. CA United States PC a Prov l 1-1 l Next v http://apps.irs.gov/app/eos/pub78Search.do?ein1=953846314&names=&city=&state=CA&c... 9/9/2013 .•., .. . • • (INsiiidt,birector to5 .51.0 9.1883: • Ropy4s-dt Sun City Thom:polo:1 , • ,1/851.4ite4ley Rdw • SunCity 4 9.1301- - . Department of the Treasilry um n. . OcaounUng. arted December .31 raninfatfon Statue communion: 509(4(t) and 170(b)(1)0).,(vd,) Advance inning rood elitist Decesiber 31, 1934 Paean tefeAdoott • •...4bliet4e.phone.Numben• (113) 608•441389 _'.'. ,..7.:,, .. :.:•,•:177. Dear Applioant: • .. . 16.'•'' • Based on information:supplied; and asinningViir operationwill be as stated in your application forreoognition we have determined you are exempt r..•-,.... Ivafederal Anotntie tak under te on .301(?)(3) o the.Internal Rev•pnue 0ode. . .1:. •, ....;e;•..1:.:.. 3Soause• yotj., are a newly Mate . dtganizatioxi, we are not n w m g Mal. fll: - • • detereination or your fOuodatiOn statue onder:,seetion 609(a) ot the Code.* Howeier, e have determined that You. Oan teadonablY be eipeoted to be'apublloly euPPorted .;7., organization described in motion .509(a)(1).aodlletb).(1XAMi). ,.,•:: Apoordingly, you will be treated.as a publioliy'supportedorgasimation, andcno't ....1..:. , .. . . - .. aa a private foundation, digingan adVithoeruling. petiod, Tato advanoe•ruling,period , --...- begins onthe dateotyour indeptiowand•e)1da Os the 44ohoil. above. Within 90 days atter 4hP.onit of:your.advast4 r4440 Period. YOU mnot eubmlt te ,. • , usinforMation needed todetorMine whether you have et the requiremeats of the :. :applioable support toot duririgths•adVanoe rUlidg period, If yon.eStablish that yen ' • have beeh cpublioiy Opperted organikOtiOh,.'yoli will bp-olaeSified ne a seotion • '. - • 00900(1),or150940(9) organiiatiOn as lortg.aS you oontintte to meet the regnirements of the Opplidable sOpptirt teat. If you do not meet the public) support- requirements.. WA during the advance- ruling period, • you will. tie Olassified as a Private foundation for future .periodo. Also, if you are classified aa ' -a private: foupdation, you will be treated se a private foUndation ficini the date of yourinoeptibil for ptirposee of agotionS 307(d) and 49.40. • . ' - Grantors and dfiners may rely on the .deterfaination that you are not a priVate • , . toundation•until 90 days after the. etta of your advance. ruling. period, If yen submit the .reqUired infOrmiti:on within the 90 day0, grantore. and 'donors hay *contnue to . rely on the advanoe determination until 'the $ervioe a4100. a t3na1 determination ot your foundation otAtus. However, if notioe• that you Will 00 longer be treated ao a section 509(a)(1)**organiOtion ie published in the Internal ReVenue Isnitetin, grantors and donors may not raly on thio determination atter the date of suit Pnblicatien, Also.„. a grantor or donor may not rely onthis determination if he or oho w.ea i4 Part responeible for, or woo, aware o.f, the act or failure to ad- that restated in your loes. of deation .509(0'(1)** gtatua,.. or aoquired knowledge that the'reterhal Revenue SerVige had given notiOe that. yqu WoUld be removed, from olass1fioation as a.seotiOn ••• 509( a) ( I )10e prganiziltli. • , Le00.1.048.(0),(6.47) P.O. Box gun, Los Angelo, Ge4 90053 004. , . , . , HOSPICE OF THE VALLEYS City of Temecula Grant 7/1/12 - 6/30/13 Costs Incurred Worksheet Senior Assistance Program: Temecula Homemaker Services $ 2,291.07 B1.3 Temecula Bereavement Services $ 568.21 C1 Temecula Homemaker Services Medical Supplies $ 3,055.20 D1.1 Total services to Temecula hospice residents $ 5,914.48 A HOSPICE OF THE VALLEYS Temecula Homemaker Services 7/1/12 - 6/30/13 A B=A+20% Page 1 C D=B*C E Provided by Provided Cotton, Cheryl L. Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L 02-08-2013 P8384 09-27-2012 P8382 10-04-2012 P8382 10-10-2012 P8382 10-15-2012 P8382 10-22-2012 P8382 10-29-2012 P8382 11-05-2012 P8382 11-12-2012 P8382 11-19-2012 P8382 11-28-2012 P8382 12-03-2012 P8382 12-10-2012 P8382 12-31-2012 P8382 01-23-2013 P8382 02-04-2013 P8382 02-11-2013 P8382 02-20-2013 P8382 02-25-2013 P8382 03-04-2013 P8382 03-11-2013 P8382 03-18-2013 P8382 03-25-2013 P8382 04-01-2013 P8382 04-08-2013 04-15-2013 04-22-2013 05-20-2013 05-29-2013 06-03-2013 06-10-2013 06-17-2013 06-24-2013 10-11-2012 10-18-2012 10-25-2012 11-08-2012 11-30-2012 12-07-2012 12-12-2012 P8382 P8382 P8382 P8382 P8382 P8382 P8382 P8382 P8382 P8384 P8384 P8384 P8384 P8384 P8384 P8384 Hourly Hate + 20% benefits/ Hours IC Hourly Rate taxes Worked Payroll Cost Mileage $ P007 $t to ( 16.04 $ 19.25 0.75 14.44 0.00 P007 $0i; )-16.16 $ 19.39 1.00 19.39 0.00 P007 $ 16.16 $ 19.39 1.00 19.39 0.00 P007 $ 16.16 $ 19.39 1.00 19.39 0.00 P007 $ 16.16 $ 19.39 1.00 19.39 5.00 P007 $ 16.16 $ 19.39 1.00 19.39 0.00 P007 $ 16.16 $ 19.39 1.00 19.39 0.00 P007 $ 16.16 $ 19.39 1.00 19.39 0.00 P007 $ 16.16 $ 19.39 1.00 19.39 0.00 P007 $ 16.16 $ 19.39 1.00 19.39 0.00 P007 $ 16.16 $ 19.39 1.00 19.39 0.00 P007 $ 16.16 $ 19.39 1.00 19.39 0.00 P007 $ 16.16 $ 19.39 1.00 19.39 0.00 P007 $ 16.16 $ 19.39 1.00 19.39 0.00 P007 $ 16.16 $ 19.39 1.00 19.39 0.00 P007 $ 16.16 $ 19.39 1.00 19.39 0.00 P007 $ 16.16 $ 19.39 1.00 19.39 0.00 P007 $ 16.16 $ 19.39 1.00 19.39 0.00 P007 $ 16.16 $ 19.39 1.00 19.39 0.00 P007 $ 16.16 $ 19.39 1.00 19.39 0.00 P007 $ 16.16 $ 19.39 1.00 19.39 0.00 P007 $ 16.16 $ 19.39 2.00 38.78 0.00 P007 $ 16.16 $ 19.39 1.00 19.39 0.00 P007 $ 16.16 $ 19.39 1.00 19.39 0.00 P007 $ 16.16 $ 19.39 1.00 19.39 0.00 P007 $ 16.16 $ 19.39 1.00 19.39 0.00 P007 $ 16.16 $ 19.39 1.00 19.39 0.00 P007 $ 16.16 $ 19.39 1.00 19.39 0.00 P007 $ 16.16 $ 19.39 1.00 19.39 0.00 P007 $ 16.16 $ 19.39 1.00 19.39 0.00 P007 $ 16.16 $ 19.39 1.00 19.39 0.00 P007 $ 16.16 $ 19.39 1.00 19.39 0.00 P007 $ 16.16 $ 19.39 1.00 19.39 0.00 P007 $ 16.16 $ 19.39 1.00 19.39 0.00 P007 $ 16.16 $ 19.39 1.00 19.39 0.00 P007 $ 16.16 $ 19.39 1.00 19.39 0.00 P007 $ 16.16 $ 19.39 1.00 19.39 0.00 P007 $ 16.16 $ 19.39 1.00 19.39 5.55 P007 $ 16.16 $ 19.39 1.00 19.39 0.00 P007 $ 16.16 $ 19.39 1.00 19.39 0.00 HOSPICE OF THE VALLEYS Temecula Homemaker Services 7/1/12 - 6/30/13 Provided by Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Escolano, Leni L Garcia, Dora Garcia, Dora Garcia, Dora Garcia, Dora Garcia, Dora Garcia, Dora Garcia, Dora Garcia, Dora Garcia, Dora Provided 12-14-2012 12-19-2012 12-21-2012 12-26-2012 12-28-2012 01-02-2013 01-04-2013 01-09-2013 01-11-2013 01-16-2013 01-18-2013 01-25-2013 01-30-2013 02-01-2013 02-22-2013 02-27-2013 03-06-2013 03-13-2013 03-20-2013 03-27-2013 04-03-2013 04-10-2013 04-17-2013 04-24-2013 04-26-2013 05-22-2013 06-05-2013 06-12-2013 06-19-2013 06-26-2013 07-05-2012 07-11-2012 07-25-2012 08-16-2012 08-30-2012 09-20-2012 10-17-2012 10-25-2012 11-08-2012 11-29-2012 12-13-2012 P8384 P8384 P8384 P8384 P8384 P8384 P8384 P8384 P8384 P8384 P8384 P8384 P8384 P8384 P8384 P8384 P8384 P8384 P8384 P8384 P8384 P8384 P8384 P8384 P8384 P8384 P8384 P8384 P8384 P8384 P8875 P8875 P8202 P8202 P8202 P8202 P8202 P8202 P8202 P8202 P8202 IC P007 P007 P007 P007 P007 P007 P007 P007 P007 P007 P007 P007 P007 P007 P007 P007 P007 P007 P007 P007 P007 P007 P007 P007 P007 P007 P007 P007 P007 P007 P007 P007 P007 P007 P007 P007 P007 P007 P007 P007 P007 A B=A+20% Hourly Hate + 20% benefits/ Hourly Rate taxes $[,,,.}-16.16 $ 19.39 $ 16.16 $ 19.39 $ 16.16 $ 19.39 $ 16.16 $ 19.39 $ ' 16.16 $ 19.39 $ 16.16 $ 19.39 $ 16.16 $ 19.39 $ 16.16 $ 19.39 $ 16.16 $ 19.39 $ 16.16 $ 19.39 $ 16.16 $ 19.39 $ 16.16 $ 19.39 $ 16.16 $ 19.39 $ 16.16 $ 19.39 $ 16.16 $ 19.39 $ 16.16 $ 19.39 $ 16.16 $ 19.39 $ 16.16 $ 19.39 $ 16.16 $ 19.39 $ 16.16 $ 19.39 $ 16.16 $ 19.39 $ 16.16 $ 19.39 $ 16.16 $ 19.39 $ 16.16 $ 19.39 $ r 16.16 $ 19.39 $ . 16.16 $ 19.39 $ 16.16 $ 19.39 $ 16.16 $ 19.39 $ 16.16 $ 19.39 $ 16.16 $ 19.39 $ 16.16 $ 19.39 16.16 $ 19.39 04,3 16.12 $ 19.34 $ I 16.12 $ 19.34 $ 16.12 $ 19.34 $ 16.12 $ 19.34 $ 16.12 $ 19.34 $ 16.12 $ 19.34 $ 16.12 $ 19.34 $ 16.12 $ 19.34 $ 16.12 $ 19.34 Page 1 C D=B*C E Hours Worked 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.50 1.50 2.50 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 Payroll Cost 19.39 19.39 19.39 19.39 19.39 19.39 19.39 19.39 19.39 19.39 19.39 19.39 19.39 19.39 19.39 19.39 19.39 19.39 19.39 19.39 19.39 19.39 19.39 19.39 19.39 19.39 19.39 19.39 19.39 19.39 29.09 29.09 48.36 19.34 19.34 19.34 19.34 19.34 19.34 19.34 19.34 Mileage $ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 5.08 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 2.78 4.44 0.00 0.00 0.00 0.00 36.08 0.00 38.85 13.88 17.76 HOSPICE OF THE VALLEYS Temecula Homemaker Services 7/1/12 - 6/30/13 Page 1 A 8=A+20% C D=B*C E Hourly Hate + 20% benefits/ Hours Provided by Provided IC Hourly Rate taxes Worked Payroll Cost Mileage $ Garcia, Dora 12-27-2012 P8202 P007 $t?.'16.12 $ 19.34 1.00 19.34 17.76 Garcia, Dora 01-03-2013 P8202 P007 $ ' 16.12 $ 19.34 1.00 19.34 27.20 Garcia, Dora 01-31-2013 P8202 P007 $ 16.12 $ 19.34 1.00 19.34 29.38 Garcia, Dora 02-28-2013 P8202 P007 $ 16.12 $ 19.34 1.00 19,34 45.20 Garcia, Dora 03-14-2013 P8202 P007 $ 16.12 $ 19.34 1.00 19.34 23.73 Garcia, Dora 03-28-2013 P8202 P007 $ 16.12 $ 19.34 1.00 19.34 37.29 Garcia, Dora 11-15-2012 P8384 P007 $ ., 16.12 $ 19.34 1.00 19.34 0.00 Morales, Mirna 05-30-2013 P9473 P007 $ it 4 , Y16.10 $ 19.32 1.00 19.32 0.00 Morales, Mirna 06-03-2013 P9473 P007 $ 16,10 $ 19.32 1.00 19.32 0.00 Morales, Mirna 06-12-2013 P9473 P007 $ 16.10 $ 19.32 1.00 19.32 0.00 Morales, Mirna 06-19-2013 P9473 P007 $ 16.10 $ 19.32 1.00 19.32 0.00 Morales, Mirna 06-26-2013 P9473 P007 $ 16.10 $ 19.32 1.00 19.32 0.00 Morales, Mirna 05-01-2013 P8382 P007 $ 16.10 $ 19.32 1.00 19.32 0.00 Morales, Mirna 05-06-2013 P8382 P007 $ 16.10 $ 19.32 1.00 19.32 0.00 Morales, Mirna 04-29-2013 P8384 P007 $ 16.10 $ 19.32 1.00 19.32 0.00 Morales, Mirna 05-08-2013 P8384 P007 $ 16.10 $ 19.32 1.00 19.32 0.00 Morales, Mirna 05-13-2013 P8384 P007 $ 16.10 $ 19.32 1.00 19.32 0.00 Morales, Mirna 05-15-2013 P8384 P007 $ - 16.10 $ 19.32 1.00 19.32 0.00 102.25 1981.09 309.98 2291.07 4. 6>>3 .try Address' '24". Wi:.rrark V:sco Federal/ScatTax Code Filing Status Exempt/06P. 17Fn KAR Current MTV Rate Hours Amount Hours An :------, _, . .. .. . .. . • ' 6 Diaz•e, Address' Telephones 71,'1 ()on) uo.0-0oos Ext. 004 Federal/state Tax Direct Code Filing status Exempt/Dep. Bank current MTD . Rate Hours Amount Hours Amount 1195.84 "14.0,1 1195.64 11,STL • .4- Addreso: 6657 W. Stetson Ave. Toi•phono: CA OCC. 3C:0 Federal/Stace Tax Direct Code Filing Status Rxempt/Dep. Bank Current MTD Rate Hours Amount Hours Amount • • Name l Addresel Telphone: • ►toralee,Mirna 25840 Via Hamaca Avenue torero • alIey CA »S5] 1 g51 } 007-518‘5 ::xt . !)CSC Federal/State Tax Direct Code Filing Status Sxempt/Dep. Bank ma CA .:.., ... Current MTh Rate Hours Amount Hours Amount ' J 1034.80 68.00 , • • 0 HOSPICE OF THE VALLEYS Temecula Bereavement Services 7/1/12-6/30/13 Page 1 A B=A+20% C D=B' C E Hourly Rate + 20% benefits/ Hours Payroll Mileage Provided by Provided IC Hourly Rate taxes Worked Cost $ Euzenas, Lynn 04-1 1-2013 p7332 B042 $%. ,.. 1 36.62 $43.94 0.50 $ 21.97 $ Euzenas, Lynn 07-12-2012 p8202 B044 $ 1 36.62 $ 43.94 1.00 $ 43.94 $ 33.86 Goldstein, Helaine 04-15-2013 p7332 13042 $1' ,, 28.00 $ 33.60 0.08 $ 2.69 $ Goldstein, Helaine 04-23-2013 p7332B042 $ 28.00 $ 33.60 0.33 $ 11.09 $ Goldstein, Helaine 10-30-2012 p8203 B042 $ 28.00 $ 33.60 0.25 $ 8.40 $ Goldstein, Helaine 11-16-2012 p8203B042 $ 28.00 $ 33.60 0.08 $ 2.69 $ Goldstein, Helaine 12-04-2012 p8203 B042 $ 28,00 $ 33.60 0.08 $ 2.69 $ Goldstein, Helaine 12-04-2012 p8203 13043 $ 28.00 $ 33.60 0.92 $ 30.91 $ Goldstein, Helaine 05-21-2013 p8384 B042 $ 28.00 $ 33.60 0.50 $ 16.60 $ 9.04 Goldstein, Helaine 07-12-2012 p8585 B042 $ 28.00 $ 33.60 0.25 $ 8.40 $ Goldstein, Helaine 07-27-2012 p8585 B043 $ 28.00 $ 33.60 0.510 $ 16.80 $ Goldstein, Helaine 07-30-2012 p8696 8042 $ 28.00 $ 33.60 0.17 $ 5.71 $ Goldstein, Helaine 01-11-2013 p8887 B042 $28.00 $ 33.60 0.08 $ 2.69 $ Goldstein, Helaine 01-22-2013 p8887 B043 $ 28.00 $ 33.60 0.75 $ 25.20 $ Goldstein, Helaine 07-16-2012 p8937 B042 $ 28.00 $ 33.60 0.17 $ 5.71 $ Goldstein, Helaine 09-13-2012 p8937 B042 $ 28.00 $ 33.60 0.50 $ 16.80 $ Goldstein, t-lelaine 08-31-2012 p8950 8043 $ 28.00 $ 33.60 0.50 $ 16.80 $ Goldstein, Helaine 09-20-2012 p8989 B042 $ 26.00 $ 33.600.08 $ 2.69 $• Goldstein, Helaine 09-25-2012 p8989 0043 $ 28.00 $ 33.60 0.17 $ 5.71 $ 4.44 Goldstein, Helaine 02-19-2013 p8989 B043 $ 28.00 $ 33.60 0.50 $ 16.80 $ 2.26 Goldstein, Helaine 10-10-2012 p9112 B043 $ 28.00 $ 33.60 0.67 $ 22.51 $ • Goldstein, Helaine 10-10-2012 p9112 B042 $ 28.00 $ 33.60 0.08 $ 2.69 $ • Goldstein, Helaine 01-29-2013 p9246 13042 $ 28.00 $ 33.60 0.50 $ 16.80 $ Goldstein, Helaine 02-19-2013 p9317 8043 $ 28.00 $ 33.60 0.33 $ 11.09 $ Goldstein, Helaine 02-21-2013 p93178043 $ 28.00 $ 33.60 0.25 $ 8.40 $ Kaffka, Mariah 02-16-2013 p9317 13042 $ C,t.. b 28.00 $ 33.60 0.08 $ 2.69 $ Koster, William G. 08-15-2012 p8989 B040 $ C2. L/ 27.50 $33.00 1.25 $ 411,25 $ 7.22 Lebowitz, Dorothy 05-22-2013 p8202 13042 $ 5 28.00 $ 33.60 0.33 $ 11.09 $ Lubbers, Theresa 11-26-2012 p8989 6043 $C•"it 27.50 $ 33.00 0.50 $ 16.50 $ Lubbers, Theresa 03-11-2013 p9246 13042 $ 27.50 $ 33.00 0.08 $ 2.64 $ Lunday, Don 07-12-2012 p8696 B042 $- 4.1 25.50 $ 30.60 0.17 $ 5.20 $• Lunday, Don 07-13-2012 p8696 B044 $ 25.50 $ 30.60 1.00 $ 30.60 $ 3.89 Matson, Pamela L. 09-19-2012 p9066 B043 $ C -L, J 29.93 $35.92 1.00 $ 35.92 $ Matson, Pamela L. 09-20-2012 p9066 13043 $ L 29.93 $ 35.92 0.75 $ 26.94 $ Ramirez, Joseph 08-26-2012 p8950 6042 $c:.1, J 29.00 $ 34.80 0.25 $ 8.70 $ 14.65 $ 507.50 $ 60.71 $ 568.21 G.1 MILIJIMS 1 Addrrsel Tel...1.01one ; Federal/State Tax code FilIng Status EX er.lp I. ! De p . Current Y.TD Rate MOUra A.MoUl.t I:o It r 3 A.MC : ...; • • ' , 75)), • 07(36'.6.2/A0a(: Natles Addrease Telephones 7cmccuta CA 12102 Pnll 014-1303 OC30 Federal/State Tax Direct Code Fil!ng Statue Sxempt/Dep. Sank , Current gTn Rate Hours Amount Hours Amount yetem Bare: 9/5/2013 or Dat: 1/5/2013 Sao: 4210:46 PM an7cs: za: fca :nwAcc No. :42 • I Y DI. X - DUI( X ( . 2074.24 74.70 2074.24 - 0\ • I amo ; Kfk2,Marlah Address; ;373 iThado Li11OrAvy Telephone§ 3:versIdc GOG 1:zt. 00O3 Federal/State Tax Code F111ng Gtatus Zxerept/Dep. Dlreot Bank 1.72 C :11 Currant XTD. • Kato floure amount Hours Amount 6.,.16 2.17 • 17.30 ) .) Address, Telephone: Eoster,W11: 2CY. 0,51) 545-3DC Ext. CCOD Federal/State Tax Direct Code Fillng Status Exempt/Dep. Sank :-•:'..._' mr, MAR MAR2 4 4 1220 Current MTD Pate Hours Amount Hours Amount • 2041.8B 74.25 2041.08 • Address: Telephone: Lcb•oNttn,2 rothy 3ssas sugar Cine Way Murrlota CA 92562 i000 000-0000 Ext:. 0000 rederal/Ctate Tax Dlrec Code P111ng statue Exempt/Dep. Bank - ,. . .. gINC LE 10 12104 ■ Current MTD Rate EouTs Amount Hours Amount :•'d �. - i\ 4,J: ,,SO • Name: Lubbars,Theresa Addresa) 27150 Shadel Rd 429 Sun City CA 92506 (951) S06-6195 Ext. 0000 -.71ophone! Federal/State Tax Direct Code Filing Statup Exempt/Dep. Bank CA f7::::. 1 1 11190( Current MTD Rate ROUTS AMOUllt Hours Amount 1067.53 67.01 3867..53 • • • hese, Lunday,Donald Address, 42936 Avenida Viet& i.adera TemeCUla CA 92s91 Telephone, i.9! L) 723-2640 ext. 0000 ,':s :.adoral/state Tax D1rict Code Piling Statue xeapt/Dap. Bank PBD MAR CA. MAR1. Currant NTD Rate ::ours Amount Houra Amount 324.M7 • • Narne• addreas3 Telephones Matean,Pamela 30121 Lauda End P1 Canyon Lake CA 92597 (000) Cho -G000 Ext. 0660 Fiideral/_tato Tax D17ic Code riling Status Excspt/Dep. sank. FE[) Cly. t, ".:< MAi>.I 1 1 =,3.-... Current ETD Y Hata Hours Amount Hours' Amount FL'L14 -X 2.'...0.; • Masse' Ramiroz,Josept Address' 31189 Corte Sonora Telephone' 19515 1F4I-9154 Ext. :law Federal/State; Ta.X Code Filing status Exempt/Dep. Direct Bank MAR MA2f 2 Current !!TD Rata /tours Amount Hours Amount • HOSPICE OF THE VALLEYS Temecula Patients on Service 7/1/12 - 6/30/13 MRN Days on Service Start of Care or 7/1/12 Date of Death or 6/30/13 City Zip P8202 P8382 P8384 P8875 P9473 P5213 P7163 P7332 P7348 P7430 P7640 P7750 P7791 P6020 P8020 P8158 P8203 P8294 P8305 P8321 P8517 P8558 P8585 P8605 P8655 P8678 P8696 P8737 P8835 P8841 P8867 P8876 P8887 P8904 P8937 P8944 P8950 P8961 P8974 P8989 Homemaker Homemaker Homemaker Homemaker Homemaker IJ l �L 304 7/1/2012 331 08-03-2012 331 08-03-2012 601 73 7/1/2012 33 05-28-2013 135 7/1/12 135 09-06-2012 284 7/1/12 260 10-13-2012 2 10-13-2012 364 7/1/2012 57 05-03-2013 288 7/1/2012 111 09-22-2012 3 01-16-2013 35 7/1/2012 121 7/1/2012 364 7/1/2012 233 7/1/2012 24 10-02-2012 277 7/1/2012 364 7/1/2012 11 7/1/2012 124 7/1/2012 98 7/1/2012 96 7/1/2012 12 7/1/2012 146 7/1/2012 157 01-24-2013 147 7/1/2012 364 7/1/2012 65 7/1/2012 194 7/1/2012 73 7/1/2012 7 07-09-2012 11 07-13-2012 41 07-16-2012 37 07-23-2012 34 07-30-2012 12 08-06-2012 bo 7� �LIS 05-01-2013 Temecula 6/30/2013 Temecula 6/30/2013 Temecula 9/12/2012 Temecula 6/30/2013 Temecula 11-13-2012 Temecula 01-19-2013 Temecula 04-11-2013 Temecula 6/30/2013 Temecula 10-15-2012 Temecula 6/30/2013 Temecula 06-29-2013 Temecula 04-15-2013 Temecula 01-11-2013 Temecula 01-19-2013 Temecula 08-05-2012 Temecula 10-30-2012 Temecula 6/30/2013 Temecula 02-19-2013 Temecula 10-26-2012 Temecula 04-04-2013 Temecula 6/30/2013 Temecula 07-12-2012 Temecula 11-02-2012 Temecula 10-07-2012 Temecula 10-05-2012 Temecula 07-13-2012 Temecula 11-24-2012 Temecula 6/30/2013 Temecula 11-25-2012 Temecula 6/30/2013 Temecula 09-04-2012 Temecula 01-11-2013 Temecula 09-12-2012 Temecula 07-16-2012 Temecula 07-24-2012 Temecula 08-26-2012 Temecula 08-29-2012 Temecula 09-02-2012 Temecula 08-18-2012 Temecula u•a,) 1)s ;; f) 1.))- 92591 92592 92592 92592 92592 92592 92591 92592 92592 92592 92592 92591 92592 92591 92591 92592 92592 92592 92591 92592 92592 92592 92592 92591 92592 92591 92592 92592 92591 92591 92592 92591 92592 92591 92591 92591 92592 92592 92592 92592 6 5/ N 0 r,:., .J.1:( `,9.1/'4 � �� ) U. �..1 , i n 1 c: '�� ,,,,,,,\0\./(.4k1' t.'j � I,i 1` D1►) HOSPICE OF THE VALLEYS Temecula Patients on Service 7/1/12 - 6/30/13 Start of Date of Days on Care or Death or MRN Service 7/1/12 6/30/13 City Zip P8991 8 08-08-2012 08-16-2012 Temecula 92591 P900966 08-16-2012 10-21-2012 Temecula 92592 P9013 6 08-19-2012 08-25-2012 Temecula 92592 P9016 4 08-21-2012 08-25-2012 Temecula 92592 P9018 76 08-22-2012 11-06-2012 Temecula 92592 P9036 9 08-29-2012 09-07-2012 Temecula 92592 P9044 2 09-27-2012 09-29-2012 Temecula 92592 P9051 5 09-02-2012 09-07-2012 Temecula 92592 P9053 21 09-05-2012 09-26-2012 Temecula 92592 P9055 218 09-05-2012 04-11-2013 Temecula 92592 P9060 41 09-06-2012 10-17-2012 Temecula 92592 P9060 -readmit 14910-18-2012 03-16-2013 Temecula 92592 P9060 -readmit 63 03-21-2013 05-23-2013 Temecula 92592 P9066 9 09-10-2012 09-19-2012 Temecula 92592 P9072 8 09-12-2012 09-20-2012 Temecula 92592 P9085 9 09-18-2012 09-27-2012 Temecula 92592 P9086 179 09-18-2012 03-16-2013 Temecula 92592 P9087 5 09-23-2012 09-28-2012 Temecula 92592 P9091 13710-02-2012 02-16-2013 Temecula 92592 P9097 9 09-23-2012 10-02-2012 Temecula 92592 P9112 10 09-30-2012 10-10-2012 Temecula 92592 P9115 28 10-01-2012 10-29-2012 Temecula 92592 P9128 210-10-2012 10-12-2012 Temecula 92591 P9141 3810-19-2012 11-26-2012 Temecula 92592 P9160 0 11-01-2012 11-01-2012 Temecula 92591 P9162 225 11-16-2012 06-29-2013 Temecula 92592 P9182 97 11-18-2012 02-23-2013 Temecula 92592 P9184 1711-19-2012 12-06-2012 Temecula 92592 P9186 15 11-23-2012 12-08-2012 Temecula 92592 P9197 411-26-2012 11-30-2012 Temecula 92592 P9202 1 11-30-2012 12-01-2012 Temecula 92591 P9207 212-02-2012 12-04-2012 Temecula 92592 P9215 17912-06-2012 06-03-2013 Temecula 92591 P9230 185 12-27-2012 6/30/2013 Temecula 92591 P9231 6612-20-2012 02-24-2013 Temecula 92592 P9246 21 01-08-2013 01-29-2013 Temecula 92592 P9251 88 03-25-2013 06-21-2013 Temecula 92591 P9252 60 01-28-2013 03-29-2013 Temecula 92591 P9254 145 01-04-2013 05-29-2013 Temecula 92591 P9267 13 01-11-2013 01-24-2013 Temecula 92592 P9280 2 01-24-2013 01-26-2013 Temecula 92590 P9288 3 01-27-2013 01-30-2013 Temecula 92592 P9294 1 01-30-2013 01-31-2013 Temecula 92592 HOSPICE OF THE VALLEYS Temecula Patients on Service 7/1/12-6/30/13 Start of Date of Days on Care or Death or MRN Service 7/1/12 6/30/13 City Zip P9317 3 02-13-2013 02-16-2013 Temecula 92592 P9325 50 02-20-2013 04-11-2013 Temecula 92592 P9328 7 02-21-2013 02-28-2013 Temecula 92591 P9350 61 03-02-2013 05-02-2013 Temecula 92591 P9358 116 03-06-2013 6/30/2013 Temecula 92592 P9361 43 03-11-2013 04-23-2013 Temecula 92592 P9394 28 04-05-2013 05-03-2013 Temecula 92590 P9400 9 04-11-2013 04-20-2013 Temecula 92592 P9410 75 04-16-2013 6/30/2013 Temecula 92592 P9414 32 04-18-2013 05-20-2013 Temecula 92592 P9417 6 04-22-2013 04-28-2013 Temecula 92.592 P9450 48 05-13-2013 6/30/2013 Temecula 92591 P9457 12 05-17-2013 05-29-2013 Temecula 92592 P9467 32 05-23-2013 06.24.2013 Temecula 92592 P9496 22 06-08-2013 6/30/2013 Temecula 92591 P9507 18 06-12-2013 6/30/2013 Temecula 92592 P9516 15 06-15-2013 06-30-2013 Temecula 92591 Total Patient Days - Temecula Patients 7595 22.95% Total Patient Days - All Patients 33095 HOSPICE OF VALLEYS SC Medline industries, Inc. uaie Type Reference 8/6/2012 Bill 90627834 Wells Fargo Operatin 1293406 • 1MPIOO M/P CHECK BY: _IV %-1 3069 8/9/2012 Original Amt. Balance Due 7,803.10 Discount Payment 7,803.10 7,803.10 Check Amount 7,803.10 NAME "'ROVED BY Payment Details ❑ Cash O Check ❑ Credit Card Name: CC/ _ EXPIRES: Payment terms are Net 30 Sub Total Total Tax TOTAL 7,803 10 -_` — --- _ $7,241 85 $561.25 _ 57,80310 Page I / 1 MEDL/NE Medline Industries, Inc. Dept LA 21558 Pasadena, CA 91185-1558 847-949.5500 B'ling Inquiries 1.800.388-2147, Jennifer Snyder x4214 Invoice No: 90627834 Invoice (Customer: I HOSPICE OF THE VALLEYS (PPD) 25240 HANCOCK AVE 120 MURRIETA, CA 92562-5991 Quantity Description 2,541 JULY PPD PURCHASES BY: h -c-- --__ Payment Details ❑ Cash ❑ Check ❑ Credit Card Name: CC 4 — — EXPIRES. Payment terms are Net 30 Dote: Cust.No: Sales Rep • Order No: 08/06/2012 1297803 MICHAEL MONTOYA # 842 70796582 Rate 82.85 SLID Total Total Tax TOTAL Total $7,241.85 87,241.85 8561.25 $7,803.10 Page 1 ! 1 1 • Medline Industries, Inc. Date Type Reference 12/18/2012 Bill 1060008098 12/19/2012 Bill 1060041315 12/20/2012 Bill 1060080092 1/4/2013 Bill 70815016 Wells Fargo Operatin 1293406 LMP100 M/PCHECK Ric Original Amt. Balance Due 76.62 76.62 332.73 332.73 41.14 41.14 8,507.59 8,507.59 '.AME ._--..OVEDBY`1� C GROSS TAX AMOUNT 30.95 2.40 v� I 1/9/2013 Discount Payment /. 76 62'� 332.73 41.14 / / 8,507.59 Check Amount 8,958.08 FREIGHT 7.79 8.958 08 51N:112/39290 TOTAL 41.14 • wMI Code TE Tax Exempt C Customer Freight CUsTOr.1Fx SIIALL PAY 11 it: rRCIGI IT CI iARGES INDICATED ON TI us 1NLow:r AI 1 CIAIIAS OF SHORT SHIPMENTS. MIS -SHIPMENTS AND OTHER ERRORS IN DELIVERY SHALL BE r:OLIMUIIIC.ATEr TO MEDLINE IN WR11 ING 4VI11RN *MO BUSINESS DAYS or NIT INVOICE DATE, OR THEY ARE DEEMED WAIVED. ALL CLAIMS FOR PRICING AND BILLING ERRORS SNALI DE COMMUNICATED TO MEDI INF 1N WRITING WNHIN 100 DAYS or INVOICE DATE. OR THEY ARE DEEMED WAIVED. rxPORT PROIIIBITED CONTRARY TO u.S. FEDERAL (AWS. IIS RE111RNS WILL OF AI.LOWEDWIT1IOUT WRITTEN MEMORIZATION. Int B00.307•03BG) INTEREST WIN L Be CHARGEE° AT 111E RA1 E OF 1 5% PER MONTH ON PAST DUE DALANCE Billing Inquiries: 1-800-388-2147, A/R Svcs Rep: Jennifer Snyder x4274 Payment Details ❑ Cash ❑ Check ❑ Credit Card Name: Cc a __ _. EXPIRES: Payment terms are Net 30 Sub Total Total Tax TOTAL 004832P /3si/.4u $630.19 jl $8,507.59 j.i l ..1\) ; , Page 1 1 1 3l 1 MFS/NE r Medline Industries, Inc. Dept LA 21558 Pasadena, CA 91185-1558 847-949.5500 Billing Inquiries 1-800.388.2147, Jennifer Snyder x4274 Invoice No: 90636192 Customer: HOSPICE OF THE VALLEYS (PPD) 25240 HANCOCK AVE STE 120 MURRIETA, CA 92562-5991 ( Quantity Description 2,764 DECEMBER PPD PURCAHSES Payment Details 0 Cash O Check D Credit Card Name: CC # _ EXPIRES Payment terms are Net 30 FOE .0 VED BY Invoice , Date: 01/04/2013 Cust.No: 1297803 Sales Rep: MICHAEL MONTOYA # 842 Order No: 70815016 Total Sub Total Total Tax TOTAL $7,877.40 $7,877.40 8630.19 -$8,5507.59. Page 1 1 1 D3.3- Meciiir e Industries, Inc. Date Typ : Reference Original Amt. 6/14/2013 Bill 1064607377 115.80 6/22/2013 Bill 1064816813 181.75 7/2/2013 Bill 90645970 7,498.01 7/9/2013 Bii 77.21 Wells Fargo Operatin 1293406 • LMP700 l MIP CHECK Payment Details ❑ Cash ❑ Check ❑ Credit Card Name CC # EXPIRES: APPROVED BY V-- 443 Payment terms are Net 30 3755 7/15/2013 Balance Due Discount Payment 115.80 115 80 181.75 181 7V/ 7,498.01 7.498 01 / ' 77.21 77.21 Check Amount 7.872 77 Sub Total Total Tax TOTAL 7,872.77 S6.942.60 ----_S555 41 $ 7,498-01 Page 1 / 1 MEDL/NE r Medline Industries, Inc. Dept LA 21558 Pasadena, CA 91185-1558 847-949-5500 Billing Inquiries 1.800.388.2147, Jennifer Snyder x4274 invoice No: 90645970 Invoice Customer: HOSPICE OF THE VALLEYS (PPD) 25240 HANCOCK AVE STE 120 MURRIETA, CA 92562-5991 Quantity — i 7.43(5 Description JUNE PPD PURCHASES Payment Details ❑ Cash ❑ Check ❑ Credit Card Name: CCN_ EXPIRES: APPROVED BY Date: Cust.No: Sales Rep: Order No: T(4 -r /-) 07/02/2013 1297803 MICHAEL. MONTOYA /1 842 70835521 Rate Total $2.85 Payment terms are Net 30 Sub Total Total Tax TOTAL $6,942.60 $6.942.60 $555.41 $7,498.01 Page 1 / 1 City of Temecula 2013-14 CS Funding Program APPLICATION NO. 15 CITY OF TEMECULA RECEIVED FISCAL YEAR 2013-1 4 AUG 3 0 2013 COMMUNITY SERVICE FUNDING PROGRAM APilti ISI I N (Please Print or Tvoe) 2013-14 Program Submission Deadline: Friday, August 30, 2013 (original, plus one copy) PROJECT INFORMATION Amount Requested: $ 5,600 (Maximum allowable $5,000) Project Name: --BYeas-- ((--41.Hici, VI SS kA- C9__, Project Start Date: \s1 an kck-Ar I \ 31)) Project End Date: NIEky\e a014-1 ORGANIZATION INFORMATION Name of Organization: rYt t'ane.A ked P Contact Name: ` i fvl `,-6D 4, v1ok.k- Mailing Address: (c�-- 1\9`-1L-; \1< CCe,(:-"Ov1 Telephone: °\91 (_c4 Cok n r 12-0 11C -e Co -i -t- - Title/Position: C C (Lk q-(4 1 { (eAkor- Year Organization Founded: raOD\ Number of Paid Staff: 1-\ Number of Volunteers: Geographic Area(s) Served: x o'Y i kQ. Q" \ n\VA, Is this organization incorporated in California as a non-profit organization? LL11 Yes No Effective Date: N Vrn t ' 1, 3000 If "yes" (Must provide a copy of your statement of non- profit status from the State of California): Date of incorporation as a non-profit: 1VtDJ-1'a.(,c- ►-1 Dwo Federal identification number: ' If "no": State identification number: ' Name of sponsoring organization: Federal identification number: State identification number: This application has been authorized by the organization's: Executive Committee Board of Directors Application Page 1 Members -at -Large FY 2012-13 COMPLIANCE REQUIREMENT IF YOUR ORGANIZATION WAS A RECIPIENT OF FUNDING FOR FY 2012-13, PLEASE ATTACH COPIES OF INVOICES, RECEIPTS AND CANCELLED CHECKS TO SUBSTANTIATE THOSE FUNDS RECEIVED AND EXPENDED BY YOUR ORGANIZATION. FINANCIAL STATEMENTS PLEASE ATTACH COPIES OF THE CURRENT BUDGET OF THE ORGANIZATION AND FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT). It does not require a CPA's audit, but please submit if available. MISSION STATEMENT Briefly describe the goals and objectives of your organization and community services it provides. Describe the ways your organization meets the criteria listed on page 2 of the CS Funding Policy. <>e c Up.<.hW PROJECT DESCRIPTION Application Page 2 Mission Statement Michelle's Place is a non-profit organization located in Temecula, providing breast health services, support and resources to women. As the only non-profit organization serving women's breast health needs in southern Riverside County, Michelle's Place serves any women needing access to quality screenings, treatment and support. Our mission statement is to provide emotional and educational support to those touched with breast cancer and facilitate breast health care services. As a non-profit agency, our organization relies on donations, grants and sponsorships to provide our services at no cost to our clients. Local support from individual private donors, businesses and local governments has historically funded our programs, indicating a high level of public support. Michelle's Place is a fiscally sound organization with conservative business practices designed for long-term program and agency sustainability. Our agency is governed by a Board of Directors made up of business professionals, community leaders, educators, health professionals and cancer survivors. Their breadth of experience, community involvement and guidance has developed Michelle's Place into an agency that is prepared and able to serve women needing breast health services. In addition, our Executive Director, Kim Goodnough, manages the day to day operations as well as secures partnerships, funding and relationships to steer the agency towards the future. Our program staff, which includes Jamie Goebel, Cheryl Lebowitz and Judee Smith implements our programs, directly serve our clients and handle the administrative tasks necessary to make our agency run smoothly. Michelle's Place has grown significantly over the past few years, demonstrating both our community's need for quality breast health services and our community's positive response to our agency. In 2012, Michelle's Place provided over 7,488 services to nearly 1,800 women. Each year more women and families are seeking services through Michelle's Place because they have no other option. With a rising unemployment rate of over 9% in Riverside County, we expect the number of women needing services to continue to rise, and our agency is committed to ensuring that every woman who has been touched by breast cancer, or who suspects breast cancer has access to breast health services, regardless of her ability to pay. Michelle's Place does not discriminate based on race, color, creed, nationality, sex, marital status, disability, religion or political affiliate, nor does our agency require attendance or participation in any political, religious or social activity. How will your organization use the funding awarded? Describe the project, project objectives, those served, area serviced, and number of volunteers involved. Be specific. Include equipment or services that would be purchased and why. Include a detailed budget and a schedule of significant activities related to this project. You may attach a maximum of one double-spaced typewritten page of information. (Please type or print legibly.) ?CU . ?.0 -41ry-( Application Page 3 Project Description The Breast Health Assistance program began in April of 2004, when Michelle's Place, The Breast Cancer Resource Center received grant funding from the Inland Empire Affiliate of the Susan G. Komen Foundation. Almost 10 years later, more than 6,000 women have been accepted into the Breast Health Assistance program. We have facilitated in the diagnosis of 42 cases of breast cancer. The Breast Health Assistance program provides breast health resources, navigation, financial assistance and support to women and their families in Riverside County. One component of the Breast Health Assistance program is free and low-cost mammograms, ultrasounds and other diagnostic breast health services. Woman who are uninsured, have a symptom of breast cancer and have a prescription for a diagnostic breast health service can apply for the program. Once accepted into the program a woman will receive guidance from our patient navigator who will ensure timely appointments and support through the process. As Michelle's Place continues to be one of the Inland Empire's solo providers for diagnostic services to uninsured women Tess than 40 years old, it is important for Michelle's Place to continue in administering this program. A primary objective of the Breast Health Assistance program is to be available to all clients of any age who need breast health services. The diagnostic program targets women who would otherwise fall through the cracks. These women include uninsured, underinsured women who are less than 40 years old and have a symptom of breast cancer. Although breast cancer is a disease affecting women primarily over the age of 40, a significant number of women under age 40 are affected in this region. At least 60 women will receive diagnostic services directly related to breast health. An additional 2,500 women will receive support resources by directly visiting the Center or calling the Center for resources. Funding from the City of Temecula will directly benefit the residents of Temecula. A minimum of 60 women will receive diagnostic breast health services, navigation and support through our Patient Navigator. There is currently no resource available to uninsured, low-income women of Temecula Valley to receive breast health services. Michelle's Place is meeting that need. Through the generous support of our local practitioners and imaging facilities, Michelle's Place receives a significant discount on all services provided to the participants of the Breast Health Assistance Program. All fees are reimbursable at Medi -Cal rates or a 40% discount, whichever is lower. If any of the participants who receive a screening or diagnostic service are in need of additional tests, surgeon consult or biopsy, they will receive these services free through the Breast Health Assistance program. PAST PROJECT BENEFITS If your organization received City of Temecula funding in the previous year, please explain and show how Temecula residents benefited. 4 Q nc AA. o Application Page 4 Past Proiect Benefits Michelle's Place received $5,000 last year which served 60 women through our Breast Health Assistance program providing life-saving diagnostic imagining services (mammograms, ultrasounds, etc.). Early detection can be the determining factor in survival, and these women would not have otherwise had access to diagnostic services. As a service provider based in Temecula, the majority of women seeking services through Michelle's Place are local residents, however we do not limit services based on geographical location. Any woman seeking services at Michelle's Place receives advice and services, when needed. SIGNATURE PAGE We hereby certify the information contained in this application is true to the best of our knowledge and belief. PREPARED BY: SIGNATURE: fY\ [0-eyk t CDct NAME and TITLE (Fe se Print or Type) fie, t re.c r PRESIDENT or ` AUTHORIZED OFFICER: 11)( be"r�, cQ 1'�`C�-�-%t a l�'� NAME and TIT (Please Print or Type) \ SIGNATURE:.— ORGANIZATION IGNATURE:. ORGANIZATION NAME:( f G,(] a / 1�'0j" UZU MAILING ?f= ADDRESS: 0- 7 H �"' JY� f (�Q_. / 17 ec«1. CA.Gi(S�()- l � / r TELEPHONE: 1 ��( i c'i q �_ 1 EMAIL ADDRESS: C' C.��1 k?�9 LACI A; DATED THIS 3D of r 0 to Sq— , 2013 (Date) onth) BE SURE TO INCLUDE THE ORIGINAL PLUS ONE COPY AND SUBMIT BY AUGUST 30, 2013 TO: Mail Completed Applications to: Or Deliver in Person to: City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office Post Office Box 9033 Temecula, CA 92589-9033 City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office 41000 Main Street Temecula, CA 92590 Application Page 5 Michelle's Place 2013 Budget - 2nd Draft 8/30/2013 Page 1 Komen 12/13 Riverside County CDBG - Murrieta Anticipated Grant funds Administrative Fundraising (Grants) (Grants) (Grants) (Misc. Grants) TOTAL Income Donations - General Donation - Wings of Hope 15,000.00 15,000.00 Newsletter Envelope 8,000.00 8,000.00 Donations - Giving Tree 0.00 lonations - General - Other 100,000.00 100,000.00 . otal Donations - General 123,000.00 123,000.00 Golf Tournament Event Day Income 13,000.00 13,000.00 Golf - Sponsorships 18,000.00 18,000.00 Golfers and Banquet Guests 13,000.00 13,000.00 Total Golf Tournament 44,000.00 44,000.00 Grant Income 0.00 Komen 11/12 34,765.00 34.765.00 Riverside County CDBG 6400 6,400.00 Stator Bros Charities 25000 Komen 13/14 80000 Bank of America 5,000 Total Grant Income 34,765.00 6400 110000 0.00 151,165.00 Interest Income 6,000.00 6,000.00 _ MX Ride For the Cause ponsors 5,000.00 5,000.00 Event Day Income 10,000.00 10,000.00 Total MXRFTC 15,000.00 15,000.00 Other Events - Income Reality Rally 20,000.00 20,000.00 Go Pink 5,000.00 5,000.00 Halloween Bash 6.000.00 6,000.00 Other Events 22,000.00 22,000.00 Total Other Event Income 53,000.00 53,000.00 Pink Ribbon Assistance Program Page 1 Michelle's Place 2013 Budget - 2nd Draft 8/30/2013 Page 2 Komen 12/13 Riverside County CDBG - Murrieta Anticipated Grant funds Administrative Fundraising (Grants) (Grants) (Grants) (Misc. Grants) TOTAL Pink Ribbon Gift Cards 3,000.00 3,000.00 Pink Ribbon Assistance Program - Other 5.000.00 5,000.00 Total Pink Ribbon Assistance Program 8,000.00 8,000.00 'Michelle's Place Boutique 4,800.00 4,800.00 Spring Fundraiser -vent Day Income 15,000.00 15,000.00 .iammogram/Ultrasound Auction 7,000.00 7,000.00 Tickets/Tables 20,000.00 20,000.00 Vendors/Sponsors 8,000.00 8.000.00 Total Spring Fundraiser 54,800.00 54,800.00 Total Income 6,000.00 302.600.00 34.765.00 6,400.00 110,000.00 0.00 453,265.00 Expense Golf Tournament Expense 0.00 Advertising & Promotions 1.500.00 1,500.00 Golf Banquet 4,000.00 4,000.00 Golf Course 6,000.00 6,000.00 Misc. 1,500.00 1,500.00 Total Golf Tournament Expense 13,000.00 13,000.00 MX Ride for the Cause Expenses _ I 'Advertising & Promotion 2,000.00 2,000.00 tage. tent and other rentals 3.500.00 3,500.00 1.500.00 1,500.00 ��Mist Race Insurance 2,000.00 2,000.00 MXRFTC Expense 9,000.00 9,000.00 Office Expenses Auto Insurance (Commercial) 1,143.00 1,143.00 Cellular Phones 1,500.00 1,500.00 Computers/Software/Internet 2,000.00 2,000.00 Dues & Subscriptions 1,500.00 1,500.00 Executive Budget 500.00 500.00 Page 2 Michelle's Place 2013 Budget - 2nd Draft 8/30/2013 Page 3 Komen 12113 Riverside County CDBG - Murrieta Anticipated Grant funds Administrative Fundraising (Grants) (Grants) (Grants) (Misc. Grants) TOTAL Insurance - Directors & Officer 1,250.00 1,250.00 Insurance - Liability 2,608.00 2.608.00 Mileage/Travel 1,426.00 2500 3,926.00 Office Printing 8,000.00 8,000.00 Office Supplies 5,000.00 481 5,481.00 _ ' they Miscellaneous Expense 2,125.00 2,400.00 6000 10,525.00 .stage 1,500.00 1,500.00 Rent 32,000.00 32,000.00 Staff Development 500.00 500.00 Telephone 4,500.00 500 5,000.00 Utilities 4,000.00 4,000.00 Web Development & Maintenanc 1,500.00 1500 1.500.00 Total Office Expenses 69,626.00 0.00 3,826.00 981 7500 73,452.00 Other Events 10,000.00 10,000.00 Professional Fees Bookkeeping 8,000.00 8,000.00 Patient Navigator Asst - Dina 2,200.00 500.00 2000 3000 7.700.00 Total Professional Fees 10,200.00 500.00 2000 3000 15,700.00 Resource Center Community/Patient Education 2,000.00 500 5000 7,500.00 Educational Seminars/Wellness 750 750.00 — 'ealth Fair supplies and educat 2,000.00 1,500.00 4750 8,25C.00 . otal Community/Patient Educ 4,000.00 1,500.00 500 10500 16,500.00 Healthy Steps 4800 4.800.00 Lymphedema Sleeves 3,500.00 8000 11,500.00 Patient Care - Mammogram/fes 10,000.00 12,500.00 35000 57,500.00 Pink Ribbon Assistance Program 0.00 Gift cards 8,000.00 7,500.00 20000 35.500.00 Total Resource Center 12,800.00 10,000.00 17,500.00 63000 0.00 103,300.00 0.00 Salaries Page 3 Michelle's Place 2013 Budget - 2nd Draft 8/30/2013 Page 4 Komen 12/13 Riverside County CDBG - Murrieta Anticipated Grant funds Administrative Fundraising (Grants) (Grants) (Grants) (Misc. Grants) TOTAL d Office Manager - Judee 33,000.00 33,000.00 Executive Director -Kim 43,569.00 4,300.00 10000 57,869.00 Insurance Benefit Allocation 14,400.00 14,400.00 Payroll Tax Expense 8,481.31 8,481.31 Patient Navigator- Cheryl 29,100.00 4,375.00 2900 5000 41,375.00 'jog. Ccord/Fundraising-Jamie 9,800.00 4,264.00 11000 25.064.00 corkers' Comp Insurance 1,143.00 1,143.00 Total Salaries 139,493.31 0.00 12,939.00 2900 26,000.00 181,332.31 Spring Event Advertising & Promotion 1,500.00 1,500.00 Entertainment 2,500.00 2,500.00 Food & Venue 10,0.00.00 10,000.00 Misc. 2,000.00 2,000.00 Total Spring Event 16,000.00 16,000.00 Volunteer Expense 3,000.00 3,000.00 Total Expense 239,119.31 58,000.00 34,765.00 6,381.00 110,000.00 0.00 448,265.31 -233,119.31 244.600.00 0.00 19.00 0.00 0.00 5,000 Page 4 18/30/13 Michelle's Place Profit & Loss Ordinary Income/Expense Income 4001 Donations - General 4002 • Donation - Newsletter Envelope 4003 • Donation - Wings of Hope 4004 • Donations - Restricted 4005 • Donation - 10th Anniversary 4001 • Donations - General - Other Total 4001 • Donations - General 4010 • Endowment 4020 • Golf Tournament 4021 • Event Day Income 4022 • Golf - Sponsorships 4023 • Golfers and Banquet Guests Total 4020 • Golf Tournament 4050 • Grant Income - Current 4051 • Bank of America 4052 • City of Murrieta - CDBG 4053 • City of Temecula - Comm. Grant 4054 • County of Riverside CBGC 4055 • Stater Bros Charities 4056 • Susan G. Komen 4057 • Walmart 4058 • CVS Foundation 4069 • Kaiser Permanente 4060 • Vonsfoundation Total 4050 • Grant Income - Current 4065 • Michelle's Place Boutique 4071 • Other Events - Income 4072 • GO PINK 4073 • Halloween Bash 4074 • MX for the Cause 4071 • Other Events - Income - Other Total 4071 • Other Events - Income 4081 • Pink Ribbon Assistance Program 4091 • Reality Rally 4092 • Auction - Sale of Items 4093 • Event Donations 4094 • Events 4095 • Sponsors 4096 • Teams 4091 • Reality Rally - Other Total 4091 • Reality Rally 4101 • Spring Fundraiser 4102 • Event Day Income 4103 • Tickets/Tables 4104 • Vendors/Sponsors 4105 • Mammograms and Ultrasound 4101 • Spring Fundraiser - Other Total 4101 • Spring Fundraiser Total Income Gross Profit Jan - Dec 12 7,496.80 11,283.48 2,025.00 50.00 92,496.17 113, 351.45 26,702.95 9,075.00 16,230.00 11,990.00 37,295.00 5,000.00 7,490.00 5,000.00 4,346.52 25, 000.00 69,530.00 500.00 1,500.00 25,000.00 5,000.00 148,366.52 7,974.64 2,264.00 6,133.00 13,173.00 22,153.08 43,723.08 3,685.00 4,559.00 44,953.51 34,410.48 19,000.00 6,000.00 2,730.00 111,652.99 10,768.06 16,156.00 14,529.98 5,768.03 618.00 47,840.07 540,591.70 540, 591.70 Page 8/30/13 Michelle's Place Profit & Loss Expense 5000 • Administration Expenses 5001 • Auto Expenses 5002 • Executive Budget 5003 • Miscellaneous 5004 • Office Printing 5005 • Office Supplies 5006 • Other Expense 5007 • Reconciliation Discrepancies 5008 • Staff Development 5009 • Volunteer Expense 5000 • Administration Expenses - Other Total 5000 • Administration Expenses 5016 • Advertising and Promotions 5017 • Wings of Hope 5016 • Advertising and Promotions - Other Total 5016 • Advertising and Promotions 5018 • Bank Charges 5021 • Community Outreach 5022 • Esperanza Expense 5021 • Community Outreach - Other Total 5021 • Community Outreach 5031 • Computers/Software/Internet 5032 • Hardware and Software 5033 • Web Development 5031 • Computers/Software/Internet - Other Total 5031 • Computers/Software/Internet 5041 • Dues and Subscriptions 5042 • Depreciation 5051 • Golf Tournament Expense 5052 • Golf Banquet 5051 • Golf Tournament Expense - Other Total 5051 • Golf Tournament Expense 5060 • Insurance, Business 5062 • Insurance - Directors/Officer 5063 • Insurance - Liability 5064 • Insurance - Workers' Comp Total 5060 • Insurance, Business 5061 • Insurance Benefit Allocation 5071• Interest Expense 5075 • Merchant Fees 5101 • Michelle's Beauty Boutique 5151 • Other Events 5152 • Halloween Bash 5153 • MX for the Cause 5156 • GO PINK 5151 • Other Events - Other Total 5151 • Other Events 5201 • Payroll Expenses 5202 • Postage and Delivery 5221 • Professional Fees 5222 • Accounting Services 5223 • Grant Writer 5224 • Navigation Asstistant 5221 • Professional Fees - Other Jan - Dec 12 2, 007.67 903.74 166.49 8,067.93 6,874.97 3,172.13 0.00 469.14 682.68 570.00 22,914.75 243.88 442.20 686.08 897.97 574.57 9,234.80 9,809.37 575.90 9,499.40 1,647.12 11,722.42 2,282.18 6,064.00 11, 334.32 1,714.40 13,048.72 3,662.00 1,288.00 1,857.00 6,807.00 9,300.00 4,707.98 1,873.47 13,619.68 4,972.53 10,795.39 808.32 5,944.96 22,521.20 2 204.48 1,095.89 8,651.16 7,755.00 11,898.37 650.00 Total 5221 • Professional Fees 28,954.53 Page 18/30/13 Michelle's Place Profit & Loss 5231 • Reality Rally Expenses 5232 • Celebrity Travel 5233 • Marketing/Sponsor Coordinator 5234 Promotional items 5235 • Silent Auction/Auction 5236 • Venue 5237 • Web Develepment 5231 • Reality Rally Expenses - Other Total 5231 • Reality Rally Expenses 5251 • Rent Expense 5260 • Resource Center 5261 • Back on Track 5262 • Community/Patient Education 5263 • Educational Seminars/Wellness 5264 • Healthy Steps 5265 Lymphedema Sleeves 5266 • Patient Care - Mammogram/Tests 5267 • Pink Ribbon Assistance Program 5268 • Pink Gift Cards 5269 • PRA Holiday 5267 • Pink Ribbon Assistance Program - Other Jan - Dec 12 37,030.63 14,470.92 7,774.34 871.24 8,459.18 3,500.00 12,059.79 84,166.10 32,000.00 10,689.00 2,621.56 204.25 5,150.00 2,475.52 40,344.60 26,333.00 1,697.90 3,180.55 Total 5267 • Pink Ribbon Assistance Program 31,211.45 Total 5260 • Resource Center 92,696.38 5281 • Salaries 5282 • Admin & Volunteer Coordinator 5283 - Executive Director 5284• Intern 5285 • Patient Navigator 5286 • Program/Fundraising Coordinator 5281 • Salaries - Other 18,255.80 42,138.75 3,880.00 21,666.71 22,627.34 57,042.83 Total 5281 • Salaries 165,611.43 5301 • Spring Event 5302 Advertising and Promotion 5303 • Entertainment 5304 • Food and Venue 5301 - Spring Event - Other Total 5301 • Spring Event 5321 • Taxes 5322 • Taxes - Payroll 6325 • Telecommunications 5327 • Travel and Lodging 5331 • Uncategorized Expense 5332 • Utilities Total Expense Net Ordinary Income Other Income/Expense Other Income 7001 • Interest Income 1,080.40 7101 • Unrealized Gain!(Loss) 854.01 Total Other Income 1,934.41 Net Other Income 1,934.41 Net Income (35,601.13) 1,942.86 2,540.75 12, 029.41 1,069.07 17, 582.09 (777.91) 14,116.45 9,187.67 354.17 352.30 4,328.84 578,127.24 (37, 535.54) Page: Internal Revenue Service Date: November 8, 2005 WOMENS BREAST CANCER RESOURCE CENTER % MARILYN R WATSON 41538 EASTMAN DR MURRIETA CA 92562 Dear Sir or Madam: Department of the Treasury P. O. Box 2508 Cincinnati, OH 45201 Person to Contact: Steve Brown 31-07422 Customer Service Specialist Toll Free Telephone Number; 877-829-5500 Federal Identification Number: 33-0951216 This is In response to your request of November 8, 2005, regarding your organization's tax-exempt status. In December 2001 we issued a determination letter that recognized your organization as exempt from federal Income tax. Our records Indicate that your organization is currently exempt under section 501(c)(3) of the Internal Revenue Code. Our records indicate that your organization is also classified as a public charity under section 509(a)(2) of the Internal Revenue Code. Our records indicate that contributions to your organization are deductible under section 170 of the Code, and that you are qualified to receive tax deductible bequests, devises, transfers or gifts under section 2055, 2106 or 2522 of the Internal Revenue Code. If you have any questions, please call us at the telephone number shown in the heading of this letter. Sincerely, Avga4LAA) Janna K. Skufca, Director, TE/GE Customer Account Services MICHELLE'S PLACE BREAST CANCER RESOURCE CENTER Radnet Managment 4/1/2013 Resource Center:Patient Care - Mam see attached 2,224.00 4701 SD Credit Union Sm see attached PM]. FXJCT SSLT104 USE WITII O16C3 ENVELOPE _ a -- Z-4 - W nr 4 4' J v•sN ,Q l 1 c A c • 4NDING CHARGES THROUGH FEBRUARY 2013 2,224.00 O; a: _ w .. .. ... T 4.0 O ICIJ-.J ' w J 0 0 C) [ 77052 I V (J' ) C) I ,:AST cn -4, ) C CI C ru O -u rn _ ;TACTIC LOCALIZA .'.AV1Pd4O — - O 0 I C V ) -, N C V) .) ) 1) 1 N RI Al m lJ m In 0 - o - D ' VI 7 G r TO IMAG CEN_ T. o U ti CC oc. C.J '�( i HAD MAMM ON 7/6/12 THIS WAS DONE ON A DIF=ERENT DATE OF SERVIC= 5HO»LDN'T IT SE PA1v O 4NDING CHARGES THROUGH FEBRUARY 2013 2,224.00 MICHELLE'S PLACE BBFAST CANCER RESOURCE CENTER Radnet Managment Resource Center:Patient Care -',Mam see attached SD Credit Union Sm see attached PRODUCT SSLT104 USE WITH 31663 ENVELOPE `' V' 1() —o Cr v.I w — krst V Q Z c pn, t l 5/29/2013 4752 2,600.00 2,600.00 Cn n <n C° CC ' r. ' )1 --1 v W w ,. 00 Ls) CO LO CC CO l0 1 ,' VIC.) p 'BREAST BIOPSY PERCUT_` =^U 'BREAST BIOPSY PERCUTANEOU G) m 61 CI., O co .) s1 m 0 C 2, Z. C7 " IEREAST MR COMPUTER AIDEC IUS BREAST ID'AG MAMMOGRAPHY, DIGITAL :D DETECTION DIAGN > O b1 D - - ': GUIDE FOR E n m O TOTAL: �., S C 1 TR TEMECULA -1 u 1 I w z 1 I 1n Z n ti L0-BRST CTR TE V ECU _A 3E`:'ERLY RAD TV ADVANCED BEVERLY RAD TV ADVANCED IE_'> :.AD-BRSTCTRTLV.ECUr I 1 D-BRST CTR TE , -7, t- (P m t m 1 T1 D .o CO n, " - ✓ w m 'RST CTP T= :IA IBEV RAD-BRST CTR TEMECI LA r- ( i 2 1 to N C o . x bb 0 •1 o ( I. :ii O C) V> N 1» V 11, tO 1, i ✓1 V, x 0' 0 l 5/29/2013 4752 2,600.00 2,600.00 MICHELLE'S PLACE BREAST CANCER RESOURCE CENTER 4751 Radnet Managment 5/29/2013 Resource Center:Patient Care - Mam see attached 1,878.30 SD Credit Union'Sm see attached 1,878.30 PRODUCT SSI.T104 USE WITH 01663 ENVELOPE Y V '0 N `U D 00 Z:1?1-1,0D 0 ..SENT DATE: MAY 16, 2013 RADNET MANAGEMENT PO BOX 240085 LOS ANGELES, CA 90024 MICHELLES PLACE -OUTSTANDING CHARGES ✓ '1- ACC0U1,r,- DOS PATIENT'S NAME DOB CODE'S PROCED,;, LOCATION - :1/14/2011 fit; 335-2- {iZE1) Pd- 2/12/1955 60202 SCREENING MAMMOGRAPHY DIG TEMECULA VLY IMG MENIFEE AMOUNT 601 601 3872448 3956421 601 12/16/2011 ,_9/15/1954 - ---- 76645 U5 BREAST BEV RAD-BRST CTR TEMECULA 5 82.00 3956421 12/16/201.1 9/15/1954 77051 R-2 AIDED DETECTION DIAGN BEV RAD-BRST 'L 5 75.00 $ • 601 3956421 12/16/2011 CSI 9/15/1954 60204 DIAG MAMMOGRADHY, CTR TEr,''C 5- 3956421 12/20/2011 IMMEMPO: 9/15%1954 19103 JIGITA BREAST BIOPSY PERCUTANEOG BEV RAD-BRST CTR TEiv=E :. 1 92.00 BEV RAD-BRST CTR TEMECULA 60; 3956421 12/20/2011 C (.7 J Ic- % 9/15/1954 19103 BREAST BIOPSY PERCUTANEOU REV RAD-9R5T CTR TEMECULA 601 3956421 12/20/2011 �" ' - 9/15/1954 19295 IMAGE GUIDED PLACEMENT ME BEV RAD -9R57 CTR TEMECULA. g - 601 601 3956421 3956421 12/20/2011 ,. .1:-." ., c ' 9/15/1954 19295 IMAGE GUIDED PLACEMENT ME BEV RAD-BRST CTR TEMECL ' �3! 12/20/2011 's=- %'T.r 9/15/1954 19295 IMAGE GUIDED PLACEMENT ME . BEV RAD•BRST CTR TEMECUL:, - 601 3956421 12/20/2011 ":2/20/7011 . 9/15/1954 75942 ECHO GUIDE FOR BIOPSY BEV RAC-BRST CTR TEMECULA 5 3956421 • -- 9/15/1954 00206. MAMMOGRAM, DIA6 DI6ITAL/U BEV RAO•BRST CTR TEMECULA $ 874.300 $ � 74.00 601 Ce_, 601 5112535 3/5/2013 10/29/1989 10022 FINE NEEDLE ASP W GUIDE BEV RAD-BRST CTR TEMECULA 5112535 3/5/2013 10/29/1989 19103 BREAST BIOPSY PERCUTANEOU BEV RAD-BRST CTR TEMECULA $i _ 601 5112535 3/5/2013 • _' ' - 10/29/1989 15295 IMAGE GUIDED PLACEMENT ME BEV RAD BR5T CTR TEMECULA $ - 5112535 3/5/2013 - 10/29/1989 76942 ECHO GUIDE FOR BIOPSY BEV RAJ-BRST CTR TEMECULA $ 601 5107000 3/7/2013 • 4•'i-. 6/17/1973 76645 US BREAST BEV RAD-8P5T CTR TEMECULA $ 850.00 601 5107000 3/7/2013 ... 5/17/1973 77051 R-2 AIDED DETECTION DIAGN BEV RAD-BRST CTR TEMECULA $ 75.00 601 5'107000 3/7/2013 - 6/17/1973 60204 DIAG MAMMOGRAPHY, DIGITAL BEV RAD•BRST CTR TEMECULA 5 - 601 5110165 3/8/2013 •' --- _ 12/19/1979 77051 R-2 AIDED DETECTION DIAGN BEV RAD-BRST CTR TEMECULA S2.00 601 5110165 3/8/2013 12/19/1979 60204 ; DLAG MAMMOGRAPHY, DIGITAL$ BEV RAD-BRST CTR TEMECULA - 601 5118066 3/13/2013 _ - ... 6/3/1982 76645 US BREAST BEV RAD-BRST CTR TEMECULA 5 92.00 5134424 3/15/2013 12/19/1979 77059 MR BREAST, WITHOUT AND OR BEVEP,LY RAD TV $ 75.00 $ 750.00 601 601 5134424 3/15/20133 I 12/19/1979 0159T BREAST MR COMPUTER AIDED ADVANCED BEVERLY RAD TV ADVANCED 601 5132048 3/18/2013 2/29/1984 76645 US BREAST BEV RAD -EAST CTR TEMECULA $ 601 5152014 3/21/2013 allipllimlw 1/16/1985 19103 BREAST BIOPSY PERCUTANEOU BEV RAO-BRST CTR TEMECULA $ 75.00 601 5152014 3/21/2013 1/16/1985 19103 BREAST BIOPSY PERCUTANEOU BEV RAD-BRST CTR TEMECULA S / 601 5152014 3/21/2013 1/16/1985 19295 IMAGE GUIDED PLACEMENT ME BEV RAD BR5T CTR TEMECUL4 $ / 5152014 3/21/2013 1/16/1985 19295 IMAGE GUIDED PLACEMENT ME BEV RAD•BRST CTR TEMECULA $ 601 5152014 3/21/2013 I. I 1/16/1985 76942 ECHO GUIDE FOR BIOPSY BEV RAO-BRST CTR TEMECULA $ 601 5177568 4/3/2013 7 SD )- 1/16/1981 76645 US BREAST SAN $ x75 JACINTO IMAG CENTER City of Temecula 2013-14 CS Funding Program APPLICATION NO. 16 RECEIVED CITY OF TIII ECULI FISCAL YEAR 20 1 3.14 CITY OFFICER s COMMUNITY SERVICE FUNDING PROGRAM APPLICATION (Please Print or Tvoe) 2013-14 Program Submission Deadline: Friday, August 30, 2013 (original, plus one copy) PROJECT INFORMATION Amount Requested: $ 54C-3°Cli Project Name: 4 r1ee dF 0/00 Project Start Date: (Maximum allowable $5,000) Pr -u'\ S - t Project End Date: 1.1iz- ORGANIZATION INFORMATION Name of Organization: O N t LA -5 ,t�JNO i t of Contact Name: k— , JStc't.J'4 i) Title/Position: *sDe Z- 2 Mailing Address: ' f 3 G ` 1 zzy` (.443, Telephone: 9\5) 303 i"- Year Organization Founded: a006 Number of Paid Staff: Number of Volunteers: Geographic Area(s) Served: \ LA Is this organization incorporated in California as a non-profit organization? Yes X ---.No Effective Date: If "yes" (Must provide a copy of your statement of non- profit status from the Stat 9f California): Date of incorporation as a non-profit: 400,o‘i (ll 1l✓, Federal identification number: If "no": Name of sponsoring organization: Federal identification number: State identification number: This application has been authorized by the organization's: Executive Committee Board of Directors X Members -at -Large Application Page 1 FY 2012-13 COMPLIANCE REQUIREMENT IF YOUR ORGANIZATION WAS A RECIPIENT OF FUNDING FOR FY 2012-13, PLEASE ATTACH COPIES OF INVOICES, RECEIPTS AND CANCELLED CHECKS TO SUBSTANTIATE THOSE FUNDS RECEIVED AND EXPENDED BY YOUR ORGANIZATION. FINANCIAL STATEMENTS PLEASE ATTACH COPIES OF THE CURRENT BUDGET OF THE ORGANIZATION AND FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT). It does not require a CPA's audit, but please submit if available. MISSION STATEMENT Briefly describe the goals and objectives of your organization and community services it provides. Describe the ways your organization meets the criteria listed on page 2 of the CS Funding Policy. �> ASSN orl t — 1 ..P rj)r'soSic. Do its G - (t (s (pt f O , P/+,c1.11S s-uip T" Grzwes, is) , IEJ CA -I l D i`t ‹) 2Poizz\-, ---Tk e c 5,rp,P 1 5 1 gar mss, Q t\ C 5 ps-t- �,�� o / \%o w f\-5. PROJECT DESCRIPTION Application Page 2 How will your organization use the funding awarded? Describe the project, project objectives, those served, area serviced, and number of volunteers involved. Be specific. Include equipment or services that would be purchased and why. Include a detailed budget and a schedule of significant activities related to this project. You may attach a maximum of one double-spaced typewritten page of information. (Please type or print legibly.) WE few% *A 6 o Dr t - Le -\..)3 ((Li v� ke-c" Pesti— Are- At,53 U€ N G "Ta QP4-- -r r c rk C cc pre: erzovkoE446.3,0 PA -9 c..Pc_.3 tel-kkAJ t" ;' -✓1 C ,0144114 ‘)Ly("Wre- Cv\-Lt (� te--r fl Xi�Y`; �fi n- �i5 - . �"—C; u.SN cis 1 P c_ �a�r,�N ��r"�' � � OQ.QrtjlefrIcA-t ` : . Application Page 3 PAST PROJECT BENEFITS If your organization received City of Temecula funding in the previous year, please explain and show how Temecula residents benefited. i* _(_ i, :::173,C1--14-)9 1 tJ () ocre14. - s S.0 , t -k -N --k It/ G lD D ki /2- 1 e err -r- D 4g-1-2._ 12.5 L oc4a7t.g-c1 c. c_A-4(4) 42.f -i "s"4-0 iscl--) (2,-)c---0 W 0 \)'2- 2.- eiZ, `1Kr,liPtc__fi1-'' ciA-i (..__p2gN Vn,0 -12--f ki s `rte 2- t ),_ gp5i .>'i._ ALA_ zwt()r-k-12 ?-1T-si ettru-S i ---F,--ht 1 014-\FBS-r-kS V -'L_, Application Page 4 SIGNATURE PAGE We hereby certify the information contained in this application is true to the best of our knowledge and belief. PREPARED BY: Afue_ SIGNATURE: PRESIDENT or AUTHORIZED OFFICER: SIGNATURE: j 547_ k- r(., NAME and TITLE (Prase Print or Type) NAME and TITLE (Please Print or Type) c ORGANIZATION NAME: MAILING V -J ,oto R42 -,Lb -a1.h� ADDRESS: ` n "� �-ev - -0 cam. Com- (.rest Or t_ TELEPHONE:q5A303 aa- EMAIL ADDRESS: ' nt\IF DATED THIS Z oT of P\V, 2013 (Date) (Month) BE SURE TO INCLUDE THE ORIGINAL PLUS ONE COPY AND SUBMIT BY AUGUST 30, 2013 TO: Mall Completed Applications to: Or Deliver in Person to: City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office Post Office Box 9033 Temecula, CA 92589-9033 City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office 41000 Main Street Temecula, CA 92590 Application Page 5 Exempt Organizations Select Check Page 1 of 1 Le? IRS Exempt Organizations Select Check Exempt Orcantzations Select Check Horne Organitelons Eligible to Receive Tex -Deductible Contntxnlens (Pub. 70 data) - Search Results The following WH Includes tax-exempt organizations that ere eligible to receive tax-deductible conbtbutlens. Clck on the "Deductibility Status' column for an explanation of limitations on the deductibility of contilbugons made to different types of tax-exempt organizations. Results ere sorted by EIN. To sort results by another category, clic* on the Icon next to the column heading for that category. Clicking on That Icon a second time will reverse the sort order. Click on a column heading for an explanation of Informalon In that column. 1.1 of 1 mulls EIN. Lagal Nomo (Doing Business As). Onf for Autism Inc. Return to Search) Results Per Page 25 • ( OKI e Prev 11.1 1 Nexi City,. State.Couniry,. DeducUbIllty Status. Temecula CA United States PC �Prey' 1.lINext s http://apps.irs.gov/app/eos/pub78Search.do?ein 1=450950668&names=&city=&state=CA&c... 9/9/2013 INTERNAL REVENUE SERVICE P. 0. BOX 2508 CINCINNATI, OH 45201 Date. OCT 31 2011 ONF FOR AUTISM INC C/0 KATHRYN ANSELMO 31493 RANCHO PUEBLO RD STE 205 TEMECULA, CA 92592 Dear Applicant: DEPARTMENT OF THE TREASURY Employer Identification Number: DLN: Contact Person: SHAWNTEL R SANDERS Contact Telephone Number: (877) 829-5500 Accounting Period Ending: December 31 Public Charity Status: 170 (b) (1) (A) (vi) Form '990 Required: Yes Effective Date of Exemption: February 17, 2011 Contribution Deductibility: Yes Addendum Applies: No ID# 31456 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 501(c)(3) of the Code are further classified as either public charities or private foundations. We determined that you are a public charity under the Code section(s) listed in the heading of this letter. Please see enclosed Publication 4221 -PC, Compliance Guide for 501(c)(3) Public Charities, for some helpful information about your responsibilities as an exempt organization. Enclosure: Publication 4221 -PC Sincerely, CZezosAlcialgetasted Lois G. Lerner Director, Exempt Organizations Letter 947 (DO/CG) r`1): , ^��J$tate of California ,;,,,Franchise Tax Board PO Box 1286 Rancno Cordova CA 95741-1286 ONF FOR AUTISM, INC. ATTN: KATHRYN ANSELMO 31493 RANCHO PUEBLO RD STE 205 TEMECULA CA 92592 Regarding Organization's Name CCN Purpose R&TC § Form of Organization Accounting Period Ending Tax -Exempt Status Effective Tax -Exempt Status ONF For Autism, Inc. 3359806 Charitable 23701d Affirmation Incorporated 12/31 02/17/2011 Exempt Acknowledgement Letter Date: 10.24.12 Case: 26560497718852813 Case Unit: 26560497718852816 In reply refer to: 760:GRW:F120 We have received your federal determination letter that shows tax exemption under Internal Revenue Code (IRC) Section (§) 501(c)(3). Under California law, Revenue and Taxation Code (R&TC) §23701d(c)(1) provides that an organization is exempt from taxes imposed under Part 11 upon submission of the federal determination letter approving the organization's tax-exempt status. Generally, the effective date of an organization's California tax-exempt status is the same date as the federal tax-exempt status under IRC §501(c)(3). To retain tax-exempt status, the organization must be organized and operating for nonprofit - purposes within the provisions of the above R&TC section. An inactive organization is not entitled to tax-exempt status. In order for us to determine any effect on the tax-exempt status, the organization must immediately report to us any change in: • Operation • Character • Purpose • Name • Address FTB 9944 PASS (REV 06-2012) Exempt Application\Correspondence \LTR 001 - EAL November 20, 2012 Mark Anselmo OUR NICHOLAS FOUNDATION 31493 Rancho Pueblo Rd., Suite 205 Temecula, CA 92592 Dear Mr. Anselmo: Congratulations on being selected for funding under the fiscal year 2012-13 Temecula Community Service Funding Program. Your organization has been awarded $5,000 to be used to purchase therapy tools, technology aides, sensory toys, printed resource guides and books, pay for family outings including movie nights, Harvest Festival, Holiday Party, etc., tailor made for families with special needs. Your organization must confirm that these funds are expended in accordance with the above -stated purpose by June 30, 2013. Receipts verifying the expenditures of this year's award must be submitted to the City by September 1, 2013. The City may require access to your accounting records in accordance with this policy. If City funds are not expended as stipulated, the funds must be returned to the City. In order to disburse your fiscal year 2012-13 Community Service Funding Program Award, the City requires back-up documentation (specifically copies of invoices, receipts and cancelled checks) to support last year's 2011-12 grant of $5,000. Please submit your back-up documentation to the address below: Mail or hand deliver to: City of Temecula City Manager's Office Attn: Betsy Lowrey 41000 Main Street Temecula, CA 92590 In order for these funds to be released, you must sign below acknowledging the following statement: "We do not discriminate based on race, color, nationality, sex, marital status, disability, religion, or political affiliation." The City fully supports the efforts of your organization and its services to the citizens of Temecula. Sincerely, Betsy Lowrey Sr. Management Analyst ACKNOWLEDGMENT OF FUNDING CONDITIONS (please sign and return this letter as soon as possible): Print Name/Title Authorized Signature/Title Date City of Temecula 2013-14 CS Funding Program APPLICATION NO. 17 IRECEINVIO CITY OF TEMECULA AUG 3 0 k- FISCAL YEAR 20 13-1 4 Cin MANAGER1 OFFICE COMMUNITY SERVICE FUNDING PROGRAM APPLICATION (Please Print or Tvoe) 2013-14 Program Submission Deadline: Friday, August 30, 2013 (original, plus one copy) PROJECT INFORMATION Amount Requested: $ 5,000 Project Name: Holiday Food Baskets Project Start Date: 11/25/2013 (Maximum allowable $5,000) Project End Date: 12/25/2013 ORGANIZATION INFORMATION Name of Organization: Rotary Club of Temecula Foundation Contact Name: Rachel Mason Mailing Address: P.O. Box 64, Temecula, CA 92593 Telephone: 909.838.8071 Title/Position: Volunteer, Past President Year Organization Founded: 6/30/1999 Number of Paid Staff: 0 Number of Volunteers: 125 Geographic Area(s) Served: Temecula Is this organization incorporated in California as a non-profit organization? Yes X No Effective Date: 6/30/1999 If "yes" (Must provide a copy of your statement of non- profit status from the State of California): Date of incorporation as a non-profit: 5/4/1999 Federal identification number: State identification number: If "no": Name of sponsoring organization: Federal identification number: State identification number: This application has been authorized by the organization's: Executive Committee X Board of Directors Members -at -Large Application Page 1 FY 2012-13 COMPLIANCE REQUIREMENT IF YOUR ORGANIZATION WAS A RECIPIENT OF FUNDING FOR FY 2012-13, PLEASE ATTACH COPIES OF INVOICES, RECEIPTS AND CANCELLED CHECKS TO SUBSTANTIATE THOSE FUNDS RECEIVED AND EXPENDED BY YOUR ORGANIZATION. FINANCIAL STATEMENTS PLEASE ATTACH COPIES OF THE CURRENT BUDGET OF THE ORGANIZATION AND FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT). It does not require a CPA's audit, but please submit if available. MISSION STATEMENT Briefly describe the goals and objectives of your organization and community services it provides. Describe the ways your organization meets the criteria listed on page 2 of the CS Funding Policy. Each year of club members participate on behalf of Rotary in many community events; however, the list below are those programs or services that were sponsored or coordinated by the club. Literacy Program: We currently have a program that delivers books for children under age 5, each month. This program is free to the participants and is paid for by our club's fundraising efforts. We have approximately 350 local children enrolled in the program. Thanksgiving and Christmas Baskets: This program celebrated its 14th year last fall. At Thanksgiving we work with the TVUSD, Michelle's Place, the Boys & Girls Club, SAFE, and Oak Grove to identify families with financial needs. We then collect and deliver all the makings of a traditional Thanksgiving meal (frozen turkey, canned goods, flour & sugar); this year we delivered this meal to 190 families. At Christmas we partner with TV People Helping People and place the names of all the children from our selected families, as described above, on the trees in local businesses. We also collect toys and gift cards from local businesses, and other donors. Then we deliver the gifts to the families, so that each child can celebrate the holiday. This year our program served 424 children. Bike Giveaway: This program gathers new and used bicycles and refurbishes them. Then the bicycles are distributed to children identified by the Boys & Girls Club. Our club members clean, repair and organize this project. Last year we delivered 75 bicycles. Military Family Support Program: We use the funds collected from our coin funnel in the mall to provide resources for local military families. Some of this support has been direct living help to military families with financial challenges, while other support has been to provide babysitting so that military parents can enjoy the Marine Corp. Ball. In 2012, we held a benefit concert at Wilson Creek just for members of the military; where they received dinner, a concert, free childcare, and other entertainment. This Christmas we also provided gifts to about 25 local military families this was a separate group from the traditional Christmas Basket program. InterAct/RYLA/PRYDE: These 3 programs involve local middle school and high school students, and are designed to teach children the value of service to others, leadership skills and community involvement. We currently host 4 Interact clubs: Temecula Valley High School, James Day Middle School, Linfield Christian School, and at Oak Grove Center for Treatment and the Arts. These school programs are open to any student and are not just for children of Rotarians. Scholarships: Each year Rotary works with our local school district and identifies students who receive a $1,000 scholarship, in 2013 we gave away over $5,000 to local high school students. PROJECT DESCRIPTION Application Page 2 How will your organization use the funding awarded? Describe the project, project objectives, those served, area serviced, and number of volunteers involved. Be specific. Include equipment or services that would be purchased and why. Include a detailed budget and a schedule of significant activities related to this project. You may attach a maximum of one double-spaced typewritten page of information. (Please type or print legibly.) If awarded, we would use the entire $5,000 to pay for additional foods to supplement our donated food items to be distributed at Thanksgiving and at Christmas. Unfortunately, our Thanksgiving baskets have gotten smaller as the number of families we serve has increased. While our Rotary Club has always been able to donate or secure donations to meet the basic needs of these families, the "extras" have been cut; such as, pies, marshmallows, and smaller turkeys. Also, in the last few years, we have had to discontinue providing food during our Christmas toy deliveries for lack of funding. Each year we partner with the Temecula Valley Unified School District and several local non -profits; such as Michelle's Place, SAFE, and the Boys and Girls Club, to identify those families that are in need of support. We ask our partners to identify those families that are on the edge, and who are not likely to already be in the system (i.e., food stamps, public assistance). We feel that our support of these families will make the biggest impact. All families are located within Temecula, or along the Murrieta and Winchester borders. During our Thanksgiving program, the bulk of the food is donated by Rotarians and their business partners. It is then stored and organized by a Rotary club member until the Tuesday before Thanksgiving. During the collection period (late September through November) all families are contacted by our volunteers to ensure that they will be home to accept the delivery. The baskets are then delivered by Rotarians and other volunteers directly to the recipients' homes or work places. Typically, we have about 50 to 75 volunteers help on each of the 2 packing and the 2 delivery days. With another several hundred who assist in identifying families, calling families, printing maps, and gathering donations. We encourage all members of the community to come and assist in the packing and delivery of these baskets. this is not a Rotarian specific program. Distribution of the Christmas baskets utilize the same process. However, as mentioned above we have had to eliminate the food component for lack of funds and donations. Instead, we identify each child under the age of 18 (or school age) and bring Christmas gifts to the families' homes. Again, through our partnership with TV People Helping People we are able to supplement the toy and gift donations from Rotarians to ensure that all children receive holiday gifts. Funding from the City of Temecula Community Services Funding program would allow us to include a ham or turkey for Christmas as well as the full meal at Thanksgiving. This is our 15th year running this program and we are very good at getting donations of food and toys for young children; however, each year we must say no to people in need because of lack of funds this year we could say yes. With this funding we could accept 250 families for Thanksgiving and still provide a Christmas meal along with the gifts. Application Page 3 SIGNATURE PAGE We hereby certify the information contained in this application is true to the best of our knowledge and belief. PREPARED BY: Rachel Mason, Past President SIGNATURE:, NAME and TITLE (Please Print or Type) PRESIDENT or Kim Kelliher, President AUTHORIZED OFFICER: SIGNATURE.:` --- NAME and TITLE (Please Print or Type) ORGANIZATION DAME: Rotary Club of Temecula Foundation MAILING ADDRESS: P.O. Box 64, Temecula, CA 92593 TELEPHONE: 909.838.8071 DATED THIS 28th EMAIL ADDRESS: racheltrc2012@yahoo.com yahoo.com of August , 2013 (Date) (Month) BE SURE TO INCLUDE THE ORIGINAL PLUS ONE COPY AND SUBMIT BY AUGUST 30, 2013 TO: Mail Completed Applications to: Or Deliver in Person to: City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office Post Office Box 9033 Temecula, CA 92589-9033 City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office 41000 Main Street Temecula, CA 92590 Application Page 5 PAST PROJECT BENEFITS If your organization received City of Temecula funding in the previous year, please explain and show how Temecula residents benefited. We have not received funding through the City of Temecula Community Services Funding program before. However, we have been fortunate enough to have received funds from the Individual Council Member Grant Funding Program. Funds from that program have been used to support our Military Committee. Those funds were used to cover expenses related to a concert that was provided to local Marine families at Wilson Creek Winery. Application Page 4 STATE OF CALIFORNIA FRANCHISE TAX BOARC PO BOX 942857 SACRAMENTO CA 94257-0540 Entity Status Letter Date: 8/20/2013 ESL ID: According to our records, the following entity information is true and accurate as of the date of this letter. Entity ID: 2163211 Entity Name: ROTARY CLUB OF TEMECULA FOUNDATION ❑X 1. The entity is in good standing with the Franchise Tax Board. 2. The entity is not in good standing with the Franchise Tax Board. El3. The entity is currently exempt from tax under Revenue and Taxation Code (R&TC) Section 23701 d. 4. We do.not have current information about the entity. The above information does not necessarily reflect: • The entity's status with any other agency of the State of California, or other government agency. • If the entity's powers, rights, and privileges were suspended or forfeited at any time in the past, or the entity did business in California at a time when it was not qualified or not registered to do business in California. o The status or voidability of any contracts made in California by the entity at a time when the entity was suspended or forfeited (R&TC Sections 23304.1, 23304.5, 23305a, 23305.1). o For entities revived under R&TC Section 23305b, any time limitations on the revivor or limitation of the functions that can be performed by the entity. Internet and Telephone Assistance Website: ftb.ca.gov Telephone: 800.852.5711 from within the United States 916.845.6500 from outside the United States TTY/TDD: 800.822.6268 for persons with hearing or speech impairments FTB 4263A WEB (NEW 02-2012) 3:41 PM 07/12/13 Accrual Basis Rotary Club of Temecula Foundation Profit & Loss Budget Performance June 2013 Jun 13 Budget Jut 12 - J... YTD Budget Annual Bu... 6500 • INTERNATIONAL SERVICES 6515 • Fistula 0.00 0.00 6525 • Bio -Sand Project 3,500.00 3,500.00 6535 • Tijuana Orphanage Protect 0.00 500.00 6545. 1000 Smites 0.00 1,300.00 6560 • Blankets & Mosquito Nets 0.00 1,530.00 6670 • International Matching Grants 501.00 501.00 6580 • Kenya Orphanage 0.00 1,780.00 6590 • Project Peanut Butter 0.00 0.00 6595 • Performing Life -Bolivia 0.00 3,280.00 6600 • INTERNATIONAL SERVICES - Other 0.00 1,000.00 0.00 10,000.00 10,000.00 Total 6500 • INTERNATIONAL. SERVICES 6600 • TRAINING 6610 • Pets 0.00 0.00 725.00 800.00 800.00 6615 • President's Advance 0.00 0.00 0.00 450.00 450.00 6620 • RI Convention (Pres. Elect) 0.00 0.00 3,021.70 2,750.00 2,750.00 6625 • District Assembly 0.00 0.00 0.00 300.00 300.00 6630 • District Conference/Assembly 0.00 0.00 2,588.47 3,000.00 3,000.00 6640 • Board Retreat/Training 0.00 0.00 110.00 250.00 250.00 4,001.00 1,000.00 12,391.00 10,000.00 10,000.00 Total 6600 • TRAINING 0.00 0.00 6,445.17 7,550.00 7,550.00 6700 • President's Discretion 6710 • Misc. Opportunities 0.00 250.00 0.00 1,000.00 1,000.00 Total 6700 • President's Discretion 0.00 250.00 0.00 1,000.00 1,000.00 6750 • Administration 6760 • Bank Fees/Misc Service Fees 0.00 15.00 0.00 200.00 200.00 6765 • Tax Filing Fees 0.00 0.00 35.00 50.00 50.00 Total 6760 • Administration 0.00 15.00 35.00 250.00 250.00 Total Expense 10,428.40 2,917.50 73,828.17 75,870.00 75,870.00 Net Ordinary Income (8,799.39) (1,107.50) 37,147.86 65.00 65.00 Other Income/Expense Other Income 7900 • Interest Income 11.95 0.00 83.09 0.00 0.00 Total Other Income 11.95 0.00 83.09 0.00 0.00 Net Other Income 11.95 0.00 83.09 0.00 0.00 Net Income (8,787.44) (1,107.50) 37,230.95 65.00 65.00 Page 2 5:23 PM 08/13/13 Accrual Basis Rotary Club of Temecula Foundation Balance Sheet As of July 31, 2013 ASSETS Current Assets Checking/Savings 1000 • Commerce Bank - 2870 1002 • MG -Commerce Bank -2864 Jul 31, 13 46,622.64 42.10 Total Checking/Savings 46,664.74 Other Current Assets 1250 • Receivable -Due From TRC 1254 • Paul Harris Donations (2,000.00) 1255 • Polio Plus (234.63) Total 1250 • Receivable -Due From TRC (2,234.63) Total Other Current Assets (2,234.63) Total Current Assets 44,430.11 TOTAL ASSETS 44,430.11 LIABILITIES & EQUITY Liabilities Current Liabilities Other Current Liabilities 2015 • Scholarships Payable 3,000.00 Total Other Current Liabilities 3,000.00 Total Current Liabilities 3,000.00 Total Liabilities 3,000.00 Equity 3950 • Net Assets 32,713.70 3960 • Temp Restricted -International 7,609.00 3970 • Temp Restricted -Military 3,764.88 Net Income (2,657.47) Total Equity 41,430.11 TOTAL LIABILITIES & EQUITY 44,430.11 Page 1 3:41 PM 07/12/13 Accrual Basis Rotary Club of Temecula Foundation Profit & Loss Budget Performance June 2013 Jun 13 Budget Jul '12 - J... YTD Budget Annual Bu... Ordinary Income/Expense Income 4010 • Rotary Taste of the World 0.00 0.00 46,900.00 45,500.00 45,500.00 4200 • Polio Fundraiser 0.00 50.00 0.00 600.00 600.00 4215 • Donation Income 4216 • Donation to Restricted Funds 0.00 10,000.00 4215 • Donation Income - Other 0.00 1,500.00 23,000.00 8,335.00 8,335.00 Total 4215 • Donation Income 0.00 1,500.00 33,000.00 8,335.00 8,335.00 4260 • Bike Give-away Donations 0.00 0.00 0.00 500.00 500.00 4270 • Holiday Basket Donations 0.00 0.00 2,549.00 2,500.00 2,500.00 4280 • Literacy Donations 0.00 60.00 56.00 1,000.00 1,000.00 4285 • Literacy -Fundraiser 0.00 0.00 21,085.50 15,000.00 15,000.00 4296 • District Grant 0.00 0.00 4306 • Military Families 1,629.01 200.00 7,385.53 2,500.00 2,500.00 Total Income 1,629.01 1,810.00 110,976.03 75,935.00 75,935.00 Expense 6000 • WAYS & MEANS Fundraising 6020 • Literacy Fundraiser Expenses 0.00 0.00 12,623.76 8,770.00 8,770.00 6030 • Taste of the World -Expenses 0.00 0.00 9,551.48 9,500.00 9,500.00 Total 6000 • WAYS & MEANS Fundraising 0.00 0.00 22,175.24 18,270.00 18,270.00 6100 • COMMUNITY SERVICE EXPENSE 6105 • HUMANITARIAN PROJECTS 6110 • Literacy 427.40 812.50 6,966.62 9,750.00 9,750.00 6115 • Boy Scout Program 0.00 0.00 1,000.00 1,000.00 1,000.00 6120 • Day of Caring 0.00 0.00 0.00 0.00 0.00 6125 • Bike Giveaway 0.00 0.00 340.83 500.00 500.00 6140 • Rotarians at Work Day Vest 0.00 200.00 6145 • Special Project 0.00 0.00 0.00 500.00 500.00 6160 • Holiday Baskets 0.00 0.00 2,539.17 2,500.00 2,500.00 6165 • Military Project -Expenses 0.00 250.00 2,500.00 2,500.00 2,500.00 Total 6105 • HUMANITARIAN PROJECTS 427.40 1,062.50 13,546.62 16,750.00 16,750.00 6206 • YOUTH SERVICES EXPENSE 6210 • RYLA 0.00 0.00 4,080.00 4,000.00 4,000.00 6215 • PRYDE 0.00 0.00 2,824.42 3,300.00 3,300.00 6225 • Interact Linfield 250.00 0.00 250.00 400.00 400.00 6227 • Interact Oak Grove 150.00 0.00 400.00 400.00 400.00 6230 • Interact NHS 400.00 400.00 400.00 400.00 400.00 6232 • Interact Day Middle School 200.00 0.00 200.00 200.00 200.00 6240 • Youth Exchange (Inbound) 0.00 100.00 915.00 1,500.00 1,500.00 6241 • Youth Exchange (Outbound) 0.00 0.00 1,000.00 1,000.00 1,000.00 6245 • Student of the Month Sponsorshi 0.00 0.00 1,000.00 1,000.00 1,000.00 6260 • Scholarships 5,000.00 0.00 5,000.00 5,000.00 5,000.00 6265 • Live Scans 0.00 0.00 90.00 150.00 150.00 Total 6205 • YOUTH SERVICES EXPENSE 6,000.00 500.00 16,159.42 17,350.00 17,350.00 6306 • VOCATIONAL 6310 • Vocational Service Awards 0.00 0.00 722.50 400.00 400.00 6315 • Music Contest Awards 0.00 0.00 1,420.00 1,000.00 1,000.00 6320 •4 -Way Speech Contest Awards 0.00 0.00 0.00 400.00 400.00 Total 6305 • VOCATIONAL 0.00 0.00 2,142.50 1,800.00 1,800.00 Total 6100 • COMMUNITY SERVICE EXPENSE 6,427.40 1,562.50 31,848.54 35,900.00 35,900.00 6400 • FOUNDATION EXPENSES 6420 • Polio 0.00 50.00 0.00 600.00 600.00 8430 • Paul Harris Plaques, Pins, etc. 0.00 40.00 38.79 400.00 400.00 6440 • GSE Hosting (Inbound) 0.00 894.43 800.00 800.00 6445 • GSE (Outbound) 0.00 0.00 0.00 500.00 500.00 6450 • Foundation Gala 0.00 0.00 0.00 600.00 600.00 Total 6400 • FOUNDATION EXPENSES 0.00 90.00 933.22 2,900.00 2,900.00 Page 1 3:41 PM 06/17/13 Accrual Basis Rotary Club of Temecula Foundation Budget July 2013 — June 2014 Budget 13-14 Ordinary Income/Expense Income 4010 • Rotary Taste of the World $ 51,000.00 4200 • Polio Fundraiser $ 600.00 4260 • Bike Give-away Donations $ 350.00 4270 • Holiday Basket Donations $ 5,000.00 4280 • Literacy Donations $ 1,000.00 4285 • Literacy - Fundraiser $ 3,500.00 Total lncome $ 61,450.00 Expense 6000 • WAYS & MEANS Fundraising 6020 • Literacy Fundraiser Expenses $ 500.00 6030 • Taste of the World -Expenses $ 10,000.00 Total 6000 • WAYS & MEANS Fundraising 10,500.00 6100 • COMMUNITY SERVICE EXPENSE 6105 • HUMANITARIAN PROJECTS 6110 • Literacy $ 4,500.00 6115 • Boy Scout Program $ 1,000.00 6120 • Day of Caring $ - 6125 • Bike Giveaway $ 350.00 6140 • Rotarians at Work Day Vest $ 6145 • Special Project $ 500.00 6160 • Holiday Baskets $ 5,000.00 6165 • Military Project -Expenses $ Total 6105 • HUMANITARIAN PROJECTS 11,350.00 6205 • YOUTH SERVICES EXPENSE 6210 • RYLA $ 5,100.00 6215 • PRYDE $ 2,800.00 6225 • Interact Linfield $ 400.00 6227 • Interact Oak Grove $ 400.00 6230 • Interact NHS $ 400.00 6232 • Interact Day Middle School $ 200.00 6240 • Youth Exchange (Inbound) $ 1,500.00 6241 • Youth Exchange (Outbound) $ 500.00 6245 • Student of the Month Sponsorshi $ 1,000.00 6250 • Scholarships $ 8,000,00 6255 • Live Scans $ 100.00 Total 6205 • YOUTH SERVICES EXPENSE 20,400.00 6305 • VOCATIONAL Page 1 of 3 3:41 PM 06/17/13 Accrual Basis Rotary Club of Temecula Foundation Budget July 2013 - June 2014 Budget 13-14 6310 • Vocational Service Awards $ 200.00 6315 • Music Contest Awards $ 1,500.00 6320 • 4 -Way Speech Contest Awards $ 400.00 Total 6305 • VOCATIONAL 2,100.00 Total 6100 • COMMUNITY SERVICE EXPENSE 33,850.00 6400 • FOUNDATION EXPENSES 6420 • Polio $ 600.00 6430 • Paul Harris Plaques, Pins, etc. $ 125.00 6440 • GSE Hosting (Inbound) $ 900.00 6445 • GSE (Outbound) $ 6450 • Foundation Gala $ Total 6400 • FOUNDATION EXPENSES 1,625.00 6500 • INTERNATIONAL SERVICES 6515 • Fistula 6525 - BloSand Project 6535 • Tijuana Orphanage Project 6545 • 1000 Smiles 6560 • Blankets 8 Mosquito Nets 6570 - International Matching Grant 6580 • Kenya Orphanage $ 1,500.00 6590 • Project Peanut Butter $ 300.00 6595 • Performing Life -Bolivia $ xxxx- Water Project, Thaliand $ 1,500.00 xxxx-Orhovelani Education Center, S. Africa $ 1,000.00 xxxx-Odowuro Village, Uganda $ 1,500.00 xxxx- Operation Safe House $ 2,700.00 6500 • INTERNATIONAL SERVICES - Other $ 1,500.00 Total 6500 • INTERNATIONAL SERVICES 10,000.00 6600 • TRAINING 6610 • Pets $ 725.00 6615 • President's Advance 6620 • RI Convention (Pres. Elect) $ 3,000.00 6625 • District Assembly $ 6630 • District Conference/Assembly $ 2,150.00 6640 • Board Retreat/Training $ 125.00 Total 6600 • TRAINING 6,000.00 6700 • President's Discretion 6710 • Misc. Opportunities $ 1,000.00 Page 2 of 3 3:41 PM 06/17/13 Accrual Basis Rotary Club of Temecula Foundation Budget July 2013 June 2014 Budget 13-14 Total 6700 • Presidents Discretion 1,000.00 6750 • Administration 6xx: - Admin Accounting Fees $ 4,400.00 6760 • Bank Fees/Misc Service Fees $ 40.00 6765 • Tax Filing Fees $ 35.00 Total 6760 • Administration 4,475.00 Total Expense Net Ordinary Income Other Income/Expense Other Income 7900 • Interest Income Total Other Income 67,450.00 (6,000.00) 0.00 0.00 Net Other Income 0.00 Net Income (6,000.00) *transfer from Club Operating Page 3 of 3 Exempt Organizations Select Check Page 1 of 1 IRS Exempt Organizations Select Check Eerily Organizations Select Check Home Organizations Eligible to Receive Tax -Deductible Contributions (Pub. 78 data) - Search Results The fo8owing Het Includes tax-exempt organizations that are eligible to receive tax-deductible contributions. Click on the "Deductibility Statue column for an explanation of limitations on the deductibility of contributions made to different types of tax-exempt organizations. Results are sorted by EIN. To sort results by another category, dick on the Icon next to the column heeding for that category. Clicking on that Icon a second lime vitil reverse the son order. Click on a column heading for an explanation of Information In Ihet colon. 1.1 of 1 results EIN �. 33-0856109 Rotary Club of Temecula Foundation Legal Name (Doing Business As). [Return to Search Results Per Page 25 OK « Prey 11.11Next* City . State "Country.. Dedudlbllhy Status . Temecula CA United States PC « Prev 11-1 1 Next » http://apps.irs. gov/app/eos/pub78 Search. do?ein 1=3 308 56109&names=&city=&state=CA&c... 9/9/2013 City of Temecula 2013-14 CS Funding Program APPLICATION NO. 18 RECEIVED CITY OF TEMECULA FISCAL YEAR 2013-14 COMMUNITY SERVICE FUNDING PROGRAM APPLICATION (Please Print or Tvoel 2013-14 Program Submission Deadline: Friday, August 30, 2013 (original, plus one copy) AUG 15 2013 CITY MANAGER'S OFFICE PROJECT INFORMATION Amount Requested: $ x,000 Project Name: Royal Family Kids Camp Project Start Date: June 2013 (Maximum allowable $5,000) Project End Date: June 2014 ORGANIZATION INFORMATION Name of Organization: Royal Family Kids of Crossroads Church Contact Name: Lena Canada Title/Position: Fundraising Coordinator Mailing Address: 26090 Ynez Road Suite A Temecula CA 92591 (909) 754-4639 2006 Telephone: Year Organization Founded: 120 0 Number of Paid Staff: Number of Volunteers: Temecula Valley Geographic Area(s) Served: Is this organization incorporated in California as a non-profit organization? Yes X No Effective Date: If "yes" (Must provide a copy of your statement of non- profit status from the State of California): August 3, 1994 Date of incorporation as a non-profit: Federal identification number: State identification number: If "no": Name of sponsoring organization: Federal identification number: State identification number: This application has been authorized by the organization's: Executive Committee X Board of Directors X Members -at -Large Application Page 1 FY 2012-13 COMPLIANCE REQUIREMENT IF YOUR ORGANIZATION WAS A RECIPIENT OF FUNDING FOR FY 2012-13, PLEASE ATTACH COPIES OF INVOICES, RECEIPTS AND CANCELLED CHECKS TO SUBSTANTIATE THOSE FUNDS RECEIVED AND EXPENDED BY YOUR ORGANIZATION. FINANCIAL STATEMENTS PLEASE ATTACH COPIES OF THE CURRENT BUDGET OF THE ORGANIZATION AND FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT). It does not require a CPA's audit, but please submit if available. MISSION STATEMENT Briefly describe the goals and objectives of your organization and community services it provides. Describe the ways your organization meets the criteria listed on page 2 of the CS Funding Policy. Our objective at Royal Family Kids is that every abused and neglected foster child experience a life changing camp, club and mentor. We provide a one week camp experience for hurting children, ages 7 to 11, within the Temecula Valley, as well as a nine month mentor program. Royal Family Kids is run 100% by amazing volunteers, and provides both programs at zero cost to the foster families and foster care agencies. The children that come to our camp and mentor programs are referred through the county's foster care system. Royal Family Kids takes children from all backgrounds, without discrimination of any kind. We do not require the children to attend or participate in any political, religious or social activity in order to be part of our program. At Royal Family Kids, we want to give hope and trust back to the children who need it most. Royal Family Kids has a comprehensive evaluation plan developed to determine the success in meeting our goal of creating life changing moments in the lives of abused and neglected foster children. The evaluation plan includes both formative and summative evaluation to better determine the effectiveness of the camp and mentor programs and to document that project objectives were achieved. Specifically the plan includes items such as surveys for volunteers, foster parents and children as well as mentor club walk through evaluations. For eight years, Royal Family Kids has provided abused and neglected foster children within the Temecula Valley a safe and loving environment entrenched with life changing moments. The letters we receive each year from the children, along with the accolades from the foster parents are a testament to the success of Royal Family Kids, Temecula. PROJECT DESCRIPTION Application Page 2 How will your organization use the funding awarded? Describe the project, project objectives, those served, area serviced, and number of volunteers involved. Be specific. Include equipment or services that would be purchased and why. Include a detailed budget and a schedule of significant activities related to this project. You may attach a maximum of one double-spaced typewritten page of information. (Please type or print legibly.) Royal Family Kids will use the funds awarded from the City of Temecula towards both the camp and mentor programs. We take approximately 50 children each year to camp. Most of the children we serve come from within the Temecula Valley. Royal Family Kids has over 120 volunteers involved in the camp and mentor programs. Every camp volunteer gives over a week of their time to make the camp experience unforgettable for each and every child that attends. Additionally, many other volunteers donate their time continually all year to ensure that the camp and mentor programs receive the necessary funding, volunteers and resources to make the programs a great success for the children. All of our volunteers are 100% dedicated to ensuring the longevity and success of Royal Family Kids. More specifically, the grant would be used towards the camper gifts, transportation costs, the beauty shop, birthday party expenses and the mentor club. Each camper receives two camp shirts and a duffle bag filled with gifts such as a MP3 players, music and water bottles. We take the children to camp in a chartered bus from our offices in Temecula. We include many wonderful activities at camp, such as our beauty shop. The children get to enter a world of fantasy; including makeup and other items that we purchase to make them feel extra special. The birthday party is a magical time as well for the campers. Many of the children have never had a birthday party of their own. We give them a party to remember, including bounce houses, balloons, games, cake and decorations. The mentor program has a club on the first Saturday of every month. For this program we purchase supplies for craft activities, story time and snacks for the children. At Royal Family kids we spend very little of the budget on administrative costs, which includes training and fingerprint background investigations. Over 95% of the income received goes directly towards the program costs. We have only volunteers on staff, who work tirelessly to raise funds for Royal Family Kids. Our board of directors is committed to running a fiscally responsible organization that will meet quarterly to assess the program implementation and the project objectives; to give abused and neglected foster children life changing moments. Attached is a 2013 budget that details all the items required to make Royal Family Kids a success. Application Page 3 PAST PROJECT BENEFITS If your organization received City of Temecula funding in the previous year, please explain and show how Temecula residents benefited. Application Page 4 SIGNATURE PAGE We hereby certify the information contained in this application is true to the best of our knowledge and belief. PREPARED BY: SIGNATURE: Lena Canada, Fundraising Coordinator NAME and TITLE (Please Print or Type) PRESIDENT or AUTHORIZED OFFICER: Natalie Kinsley, Director SIGNATURE.itAkeL ORGANIZATION NAME: NAME and TITLE (Please Print or Type) Royal Family Kids of Crossroads C rch MAILING ADDRESS: 26090 Ynez Road, Suite A Temecula CA 92591 t/ TELEPHONE: (951)852-6830 EMAIL ADDRESS: rfktemecula@gmail.com DATED THIS thirteenth of August , 2013 (Date) (Month) BE SURE TO INCLUDE THE ORIGINAL PLUS ONE COPY AND SUBMIT BY AUGUST 30, 2013 TO: Mail Completed Applications to: Or Deliver in Person to: City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office Post Office Box 9033 Temecula, CA 92589-9033 City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office 41000 Main Street Temecula, CA 92590 Application Page 5 • crossroads C 1-1 11 R C 11 July 12, 2013 Re: Royal Family Kids Affiliation To Whom It May Concern: Crossroads Church has a community outreach program called Royal Family Kids. Royal Family Kids is an international nonprofit organization that has been in operation for over twenty years helping abused and neglected foster children. In 2006, Crossroads Church started Camp #167. Our Tax identification number is 95-4266287. If you having any questions regarding our affiliation with Royal Family Kids, please contact us at 951.695.1123. Scott Anderson Lead Pastor Crossroads Church 26090 YNEZ RD. STE A TEMECULA, CA 92591 ' 951 695 1 123 951 296 0178 office@gotocrossroads.com 315 E. SOUTH ST. BISHOP, CA 93514 ', 760 872 8051 1 bishopoffice@gotocrossroads.com GOTOCROSSROADS.COM U.S. TREASURY DEPARTMENT INTERNAL REVENUE SERVICE WASHINGTON. D.C. 20224 APR 141965 The Southern California District Council of the Assemblies of God Post Office Box 503-M Pasadena, California 91102 Gentlemen: IN REPLY REFER TO T:R:E0:S 0CS This refers to your group ruling of May L, 1944, in which we held that you and your subordinate units are exempt frau Federal income tax as organizations described in section 101(6) of the Internal Revenue Code of 1939 (corresponding to section 501(c) (3) of the Internal Revenue Code of 19511) and to subsequent supplemental group rulings covering your new subordinate units. Our records indicate that you and your subordinate units are also included in a group ruling issued to your parent organization, the General Council of the Assemblies of God, Springfield, Missouri, dated August 31, 1961i, which holds that its subordinate departments, district councils, churches, institutions, organisations, schools and colleges are exempt from Federal income tax under section 501(c) (3) of the 19511 Code. In view of this fact, we have concluded that this ruling super- sedes your group ruling and the supplements thereto referred to in the first paragraph of this letter. Accordingly, you and your subordinate units continue to be ex- empt from Federal income tax in accordance with the group ruling and supplementary rulings issued to your parent organization. This ruling renains in effect so long as your parent organization con- tinues to subrait, on an annual basis, the information necessary to maintain its group ruling. Therefore, it will not be necessary for you to furnish us with the supplemental information required under the terms of your group ruling so long as your exemption remains in effect under the terms of the group ruling issued to your parent organization. Any changes in your status or that of your subordinate units should be reported to your parent organization who in turn will furnish the information to this office. -2 - The Southern California District Council of the Assemblies of God The District Director of Internal Revenue at Los Angeles and the General Council of the Assemblies of God are being advised of this action. Very truly yours, Chief, Exempt Organizations Branch August 3, 1994 To Whom It May Concem: S1Q.t therz oi i r:a ss('1rib Iies o Cod CELEBRATING•75 YEARS OF MINISTRY �gl9-1 95/ OFFICE OF TES SECRFIARY-TREASURER LARRY C1-JAPMAN This letter is to certify that Temecula Valley Christian Center, 43300 Business Park Drive #B-3, Temecula, CA 92590, pastored by Rev. Tim Buttrey, is a part of the Southern California District Council of the Assemblies of God, 17951 Cowan, Irvine, CA 92714, which is a 501(C)(3) Non-profit Corporation. The above designated organization is currently exempt from State franchise and income tax under Section 23701-d, of the Revenue and Taxation Code and is in good standing with this office at the present time. If you have any questions please feel free to call our office. Sincerely, J. Larry Ch man Secretarj,'Treasurer JLC:jm Assemblies of God 17951 COWAN • IRVINE. CALIFORNIA • 92714 • (714) 252-8400 • TDD (714) 251-9625 • FAX (714) 252-84350 SOUTHERN CALIFORNIA DISTRICT COUNCIL ENDORSED -FILED li CERTIFICATE OF AMENDMENT OF ARTICLES OF INCORPORATION Timothy M. Buttrey and Jack Bigpond certify that: ,,JI,, "--":diy 0! $i61,; 1. They are the president and the secretary, respectively, of Temecula Valiey Christian Center. (#C1850769) a Califomia Corporation. 2. Article One, of the Articles of Incorporation, is amended to read as follows: The name of this corporation is Crossroads Church of the Assemblies of God. 3. The foregoing amendment of articles of incorporation has been duly approved by the board of directors. 4. The foregoing amendment of articles of incorporation has been duly approved by the required vote of members. We further declare under penalty of perjury under the laws of the State of California that the matters set forth in this certificate are true an correct of our own knowledge. Date: Timothy M. Buttrey, Presider Jack Bigpond, Secretary Royal "� FamiIyKIDS.. coritortng adze . RFK Temecula Proposed Budget 2013 Income: Dinner & Auction $ 10,000 Walk-a-Thon Fundraiser $ 12,000 Valero Energy $ 5,000 Corporate/Business & Personal Donations $ 25,000 Total: $ 52,000 Expenses: Camp Facility/Camp Food $ 23,000 Transportation (Bus) $ 900 Camp Golf Carts $ 600 RFK Large Camp Order (campers shirts, duffels, etc.) $ 6,000 RFK Small Camp Orders (misc. throughout year) $ 1,000 Camp Themed Supplies $ 1,800 Camper Gifts $ 700 Mentor & Club Expenses $ 5,200 Activity Center Supplies $ 800 Beauty Shop Supplies $ 600 Training Expenses (supplies, binders, speakers, etc.) $ 1,000 Camp Birthday Party Expenses $ 2,800 Breakfast Club Expenses & Daily Story Expenses $ 300 Drama Expenses $ 500 Welcome Home Dinner $ 1,000 Memory Books (developing, supplies, etc.) $ 600 Fundraising Expenses $ 500 Annual Commitment to RFK, Inc. (website, etc.) $ 450 Camp Spending Money (campers needs) $ 850 Fingerprinting Expenses $ 700 Lifeguard Expenses $ 300 Miscellaneous Camp Expenses $ 1,500 Total: $ 51,100 ROYAL FAMILY KIDS, TEMECULA STATEMENT OF ACTIVITIES For the Year Ended December 31, 2012 Unrestricted net assets Support and revenues Contributions $ 17,364 Walk-a-thon 15,076 Auction 6,326 Storm fundraiser 3,739 Other income 630 Total support and revenue 43,135 Expenses Program services 37,730 Supporting services General and administrative 748 Fundraising 3,563 Training 2,425 Total supporting services 6,736 Total expenses 44,466 Net assets, end of year S (1,831) ROYAL FAMILY KIDS, TEMECULA STATEMENT OF FINANCIAL POSITION For the Year Ended December 31, 2012 Assets Unrestricted cash Total assets Liabilities Retained earnings Net income Total liabilities and assets $ 3,633 $ 3,633 $ 4,964 (1331) S 3,633 ROYAL FAMILY KIDS, TEMECULA STATEMENT OF ACTIVITIES As of July 26, 2013 Unrestricted net assets Support and revenues Contributions $ 15,020 Walk -a -thou 10,036 Car show, raffle 3,928 Auction 9,593 Storm fundraiser 1,078 Other income 651 Total support and revenue 40,306 Expenses Program services 35,879 Supporting services General and administrative 1,022 Fundraising 2,017 Training 290 Total supporting services 3,329 Total expenses 39,208 Net assets, current $ 1,098 ROYAL FAMILY KIDS, TEMECULA STATEMENT OF FINANCIAL POSITION As of July 26, 2013 Assets Unrestricted cash Accounts receivable $ 3,731 1,000 Total assets $4,731 Liabilities Retained earnings Net income $ 3,633 1.098 Total liabilities and assets $ 4.731 Citv of Temecula 2013-14 CS Funding Program APPLICATION NO. 19 CITY OF TEMECU.IA RECEIVED AUG 2 9 /[i3 FISCAL YEAR 2013-1 4 CITY MANAGER'S COMMUNITY SERVICE FUNDING PROGRAM APPLICATION (Please Print or Tvoe) 2013-14 Program Submission Deadline: Friday, August 30, 2013 (original, plus one copy) PROJECT INFORMATION Amount Requested: $ 5,000.00 Project Name: Senior Citizens Service Center Food Bank Project Start Date: February 2, 1978 (Maximum allowable $5,000) Project End Date: On Going ORGANIZATION INFORMATION Name of Organization: Senior Citizens Service Center of the Temecula Rancho Area, Inc. President/Director Contact Name: Rosalie Vaccarino Title/Position: Mailing Address: 41538 Eastman Drive, Unit C, Murrieta, CA 92562 Telephone: 951-600-9557 Year Organization Founded: 1978 Number of Paid Staff: Zero Number of Volunteers: 36 Geographic Area(s) Served: Temecula and its surrounding areas Is this organization incorporated in California as a non-profit organization? Yes X No Effective Date: 212/1978 If "no": If "yes" (Must provide a copy of your statement of non- profit status from the State of California): Date of incorporation as a non-profit: February 2, 1978 Federal identification number: State identification number: Name of sponsoring organization: Federal identification number: State identification number: This application has been authorized by the organization's: Executive Committee Board of Directors X Members -at -Large Application Page 1 FY 2012-13 COMPLIANCE REQUIREMENT IF YOUR ORGANIZATION WAS A RECIPIENT OF FUNDING FOR FY 2012-13, PLEASE ATTACH COPIES OF INVOICES, RECEIPTS AND CANCELLED CHECKS TO SUBSTANTIATE THOSE FUNDS RECEIVED AND EXPENDED BY YOUR ORGANIZATION. FINANCIAL STATEMENTS PLEASE ATTACH COPIES OF THE CURRENT BUDGET OF THE ORGANIZATION AND FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT). It does not require a CPA's audit, but please submit if available. MISSION STATEMENT Briefly describe the goals and objectives of your organization and community services it provides. Describe the ways your organization meets the criteria listed on page 2 of the CS Funding Policy. The Senior Citizens Service Center and Food Bank's mission is to solicit, warehouse, and distribute Food products in support of Southwest Riverside County's low-income seniors, families and the Homeless. The center was established February 1978 as a 501 (3)(c) non-profit corporation. This Public charity is equipped to provide services to Temecula and its surrounding area. Our public Acceptance is over whelming, as seen by our growth and longevity, having been a reliable source of Food for over thirty-three years, is evident of the satisfactory services provided to all the city's citizens Regardless of race, color, nationality, sex, martial status, disability, religion or political, religious belief or social activity. Our fiscal management/accounting and financial statements are generated in house by our Board Treasurer of which is retired from the accounting field and is using general accepted accounting principals to generate our financial statements. The financial statements are used by the the Board of Directors for budgeting and forecasting. The center has created strict purchasing guide- lines and an on going program evaluation methods are in place as a tool for recognizing the number of participants, costs, statistics, and areas of improvement, as we continue to reach out to the community. PROJECT DESCRIPTION Application Page 2 How will your organization use the funding awarded? Describe the project, project objectives, those served, area serviced, and number of volunteers involved. Be specific. Include equipment or services that would be purchased and why. Include a detailed budget and a schedule of significant activities related to this project. You may attach a maximum of one double-spaced typewritten page of information. (Please type or print legibly.) Funding provides the Senior Citizens Service Center with monies for warehousing cost. We moved approximately one million pounds of food last fiscal year to over 18,000 low-income seniors, disable, and families. Although the economic crisis has improved slightly our service and needs are still in demand. The Senior Citizens Service Center services the entire community and areas of Southwest Riverside County, including Temecula, Murrieta, Wildomar. Aguanga and Winchester, picking up the s lack from other community centers. We continue to provide food, pet food and holiday food baskets and toys during the Christmas Holiday. The Senior Citizens Service Centers primary objective remains to feed the less fortunate families, homeless, and senior citizens, regardless of race, creed, color. nationality, sex, martial status, disability, religion, or political affiliation. The Senior Citizens Service Center currently has five food programs: Bread, Commodities, Brown Baq, Emergency Food and Pet Food and Holiday Food Baskets, all of which provide low-income families, homeless, and senior citizens with a nutritional and reliable method of obtaining food. The Senior Citizens Service Center and Food Bank operates without any paid staff. The programs are Facilitated by a dedicated staff of 30 plus volunteers and managed by a Volunteer Board of Directors Comprised of retirees from the community wanting to give back to the community. Application Page 3 PAST PROJECT BENEFITS If your organization received City of Temecula funding in the previous year, please explain and show how Temecula residents benefited. The Senior Citizens Service Center Food Bank Program is efficient, cost effective and has a tremendous impact within our community. More than ever the service of food banks such as ours is needed because of government budget cuts and negative changes in the economy such as lob cuts/loss. For many people, the assistance we provide with our food programs enables them to free up money in their budget to help cover the cost of shelter, basic necessities and maintain their personal responsibility until they are able to once again become self-sufficient residents of the community. It also raises the individual's self-esteem during this extremely difficult, humbling experience. Your generous grant donation last year helped the Senior Citizens Service Center purchase food, package and distribute food to part of the over 18,000 individuals served last year. We also distributed 100 Easter Food Baskets, 100 Thanksgiving Food Baskets and 100 Christmas Food Baskets durinq the holidays to less fortunate individuals of our community. With generous support from businesses such as yours we truly can make a difference. Thank you! Application Page 4 SIGNATURE PAGE We hereby certify the information contained in this application is true to the best of our knowledge and belief, PREPARED BY: Betty Castaneda, Treasurer SIGNATURE: NAME and TITLE (Please Print or Type) PRESIDENT or AUTHORIZED OFFICER: Rosalie Vaccarino, President/Drector [DAME and TITLE (Please Print or Type) SIGNATURE: ! -�Lcac ORGANIZATION NAME: Senior Citizens Service Center of The Temecula Rancho Area, Inc. MAILING 41538 Eastman Drive, Unit C, Murrieta, CA 92562 ADDRESS: TELEPHONE: 951-600-9557 EMAIL ADDRESS: scscl 1averizon.net DATED THIS 23rd of August , 2013 (Date) (Month) BE SURE TO INCLUDE THE ORIGINAL PLUS ONE COPY AND SUBMIT BY AUGUST 30, 2013 TO: Mail Completed Applications to: Or Deliver in Person to: City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office Post Office Box 9033 Temecula, CA 92589-9033 City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office 41000 Main Street Temecula, CA 92590 Application Page 5 Internal Revenue Service rte; Aprl 13, 2007 • SENIOR CITIZENS .S1 RVICE•OENTEROF THE TEMECULA RANCHO.AREA INC PO t3OX 6t17 TEMECULA CA £ 2593-G987 1L73 N7'1 titJ 4477 I'. V..) Department of the TroaSury P. O. Box 2508 Cincinnati, OH 45201 Person to Contact: • Ms. Evans 17-53655 Customer Service Representative Tell Free Telephone Number: 877-829-5500 Federal Identification Number:. • 95-321.4774 Deer Si, or Madam: This ie in response to your request of April 13, 2007, regarding your qrganiLstion's tax- exempt status. In September 1978 we issued a determination letter that recognized yr•aur organization as exempt from federal income tax. Our records indicate that your organization is currently exempt under section 5O1(cX3) ate Internal Revenue Code. Ow records indicate that your organization is also classified es a public Charity under sections 509(a)(1) and 170(b)(1)(A}(vi) of the Internal Revenue Code. Dur records Indicate that contribti►tions to your organisation are deductible under seclln 170 of the Code, and that you are Tuanned to receive tax doduoiible bequests, devises, transfers or gifth under section 2055, 2106 or 2522 of the Internal Revenue Code. If you have any questions, please call us et the telephone number shown in the heading of this letter, SlnDarktly, :, cti( Michels M. SuHivtin, Oper. Accounts MAnegarnantOpomtions 1 )UTfL. P.4):'. e mlt to !bratr OFFICE OF THE SECRETARY OF STATE CERTIFICATE OF STATUS DOMESTIC CORPORATION; 1, MARCH FONG EU, Secretary of State of the State of California, hereby certify: That on the 2nd day of February , 19 _78 _ , SENIOR CITIZENS SERVICE CENTER OF THE TEMECULA RANCHO AREA became incorporated under the laws of the State of California by filing its Articles of In- corporation in this office; and That no record exists in this office of a certificate of dissolution of said corporation nor of a court order declaring dissolution thereof, nor of a merger or consolidation which terminated its existence; and That said corporation's corporate powers, rights and privileges are not suspended on the records of this office; and That according to the records of this office, the said corporation is authorized to exer- cise all its corporate powers, rights and privileges and is in good legal standing in the State of California; and That no information is available in this office on the financial condition, business ac- tivity or practices of this corporation. That said corporation is organized under the General Nonprofit Corporation Law. IN WITNESS WHEREOF, 1 execute this certificate and affix the Great Seal of the State of California this 29th day of July, 1993 Secretary of State Return to Search Exempt Organizations Select Check Page 1 of 1 I CSS Exempt Organizations Select Check Demo, Oraanizabons Select Check Home Organizations Eligible to Recelve Tax•Deductibie Contributions (Pub. 78 data) - Search Results The following list includes lax -exempt organizations that are eligible to receive tax-deductible contributions. CHck on the "Deducdbelty Status' column for an explanation of limitations on the deductibility of contributions made to different types of lax -exempt organizations. Results are sorted by EIN, To sort results by another category. click on the icon next to the column heading for that category. Clicking on that Icon a second time wtU reverse the sort order. Click on a column heading for an explanation of Information In that column. 1.1 oft results EIN . Legit!, Name (Doing Business As) . Senior Citizens Service Center of oro Temecute Rancho Area Inc. Results Per Page 25 1 oK l e Prev 11-1 1 Next » CIIX. State &Country. Deductibility Status . Wardell!' CA United States PC . Prev 11.1 1 Next » http://apps.irs.gov/app/eos/pub78Search.do?ein 1=953214774&names=&city=&state=All 9/10/2013 SENIOR CITIZENS SERVICE CENTER OF THE TEMECULA RANCHO AREA, INC. STATEMENT OF FINANCIAL POSITION JUNE 30, 2012 Assets UNRESTRICTED RESTRICTED TOTAL FUND FUND FUND Cash in Bank $ 29,129 29,129 Furniture and Equipment 6,781 6,781 Rent Deposit and Prepaid Rent 2,000 2,000 Total Assets $37,910 $ - $ 37,910 LIABILITIES AND FUND BALANCES Liabilities $ - $ Total Liabilities Fund Balances Undesignated 37.910 37,910 Total Fund Balances 37,910 37,910 Total Liabilities and Fund Balances $ 37,910 $ 37,910 See accompanying notes SENIOR CITIZENS SERVICE CENTER OF THE TEMECULA RANCHO AREA, INC. STATEMENT OF FINANCIAL INCOME & EXPENSE FOR THE FISCAL YEAR ENDED JUNE 30, 2012 UNRESTRICTED RESTRICTED TOTAL FUND FUND FUND PUBLIC SUPPORT AND REVENUE Public Support: City Grants $ 12,878 $ 12,878 Corporate Donations 11,500 11,500 Private Donations 4,798 4,798 Total Public Support 29,176 29,176 REVENUE: Interst Income 7 7 Thrift Store sales 8,810 8,810 Trip Income 3,232 3,232 Total Revenue Total Support and Revenue 12,049 - 12,049 41,225 41,225 OPERATING EXPENSE Emergency Food and Aid 5,050 5,050 Insurance 1,152 1,152 Office Expense and Miscellaneous 2,839 2,839 Rent, Utilities and Refuse 31,197 31,197 Repairs and Maintenance 500 500 Communications 1,721 1,721 Total Expense Excess of Public Support and Revenue Over Expenses Fund Balance, Beginning of The Year 42,459 - 42,459 (1,234) (1,234) 39,144 39,144 Fund Balance, End of The Year $ 37,910 $ $ 37.910 See accompanying notes SENIOR CITIZENS SERVICE CENTER OF THE TEMECULA RANCHO AREA, INC. STATEMENT OF CASH FLOWS FOR THE FISCAL YEAR ENDED JUNE 30, 2012 UNRESTRICTED RESTRICTED TOTAL FUND FUND FUND CASH FLOWS FROM OPERATING ACTIVITIES Excess of Publice Support and Revenue Over Expenses $ (1,234) $ Adjustments To Reconcile Net Cash Provided By Operating Activities Net Cash Flows Provided (Used) by Operating Activities $ (1,234) (1,234) (1,234) CASH FLOWS FROM INVESTING ACTIVITIES Purchased of Freezer (1,000) (1,000) Net Increase (Decrease) in Cash (2,2341. (2,234) Cash - Beginning of The Year 31,363 31,363 Cash - End of The Year $ 29,129 $ - $ 29,129 See accompanying notes SENIOR CITIZENS SERVICE CENTER OF THE TEMECULA RANCHO AREA, INC. NOTES TO FINANCIAL STATEMENTS JUNE 30, 2012 Summary of Significant Accounting Policies The Senior Citizens Service Center of The Temecula Rancho Area, Inc. was incorporated as a non-profit organization under Internal Revenue Code Section 501 (c) (3). The Service Center assists area needy senior citizens with distributing government commodities to the poor and needy in the local area. The Service Center also provides social and recreational activities for senior citizens. Accounting Method The organization maintains its books generally on a modified cash basis of accounting. Expenses and capital expenditures are paid as incurred. Revenues are generally recorded as income as received. Fund Accounting To insure observance of limitations and restrictions placed on the use of certain resources available to the Service Center, the accounts of the Service Center are maintained in accordance with principals of fund accounting. This is the procedure by which resources for various purposes are classified for accounting and reporting purposes into funds established according to their nature and purpose. Separate accounts are maintained for each fund. The assets, liabilities and fund balances of the Service Center are reported in self -balancing groups as follows: Unrestricted funds represent the portion of expendable funds that is available for support of the Service Center's operations. Restricted funds represent resources restricted for facility rent, emergency food, and medical assistance to senior citizens. During the fiscal year ended June 30, 2012, the Service Center did not receive any restricted funds. P. 1 of 2 SENIOR CITIZENS SERVICE CENTER OF THE TEMECULA RANCHO AREA, INC. NOTES TO FINANCIAL STATEMENTS JUNE 30, 2012 Donated Services and Materials A substantial number of unpaid volunteers made significant contributions of their time in conjunction with the Service Center programs and services. These contributions have not been included in these financial statements, as no objective method of valuation has been determined. In addition to volunteer time, most of the food distributed has been donated by various agencies. No record has been kept of the value of these donated items; therefore they are not included in these financial statements. All contributions are considered to be available for unrestricted use unless specifically restricted by the donor. Support donations are recorded as they are received. All items sold in the Thrift Store have been donated. Note B - Federal Income Tax The Service Center is an organization exempt from federal income taxes under Section 501 (c) (3) of the Internal Revenue Code. While the Service Center is generally exempt from income taxes, it is subject to taxes on unrelated trade or business income and on excess lobbying expenses. For the year ended June 30, 2012, the Service Center did not incur any tax liability for unrelated trade or business, or lobbying activities. Note C - Facility Lease The organization is operating in a facility under a five year lease, with payments of $2,000 per month, which will expire May 31, 2014. P. 2 of 2 SENIOR CITIZENS SERVICE CENTER OF THE TEMECULA RANCHO AREA, INC. PROPOSED PROJECT BUDGET FOR THE FISCAL YEAR ENDED JUNE 30, 2013 ASSETS: TOTAL ACTIVITY BUDGET Refrigeration Units $ 10,000 Total Assets Cost 10,000 PERSONNEL EXPENSE Salaries Fring Benefits Consultants & Contract Services Total Personnel Cost OPERATING EXPENSE Emergency Food and Supplies 13,304 Insurance 1,210 Office Expense and Miscellaneous 2,981 Rent, Utilities 24,000 Refuse Service 1,209 Repairs and Maintenance 525 Communications 1,807 Travel & Auto Expense - Other Expense 926 Total Operating Expense 45,962 Total $ 55,962 November 20, 2012 Rosalie Vaccarino SENIOR CITIZEN SERVICE CENTER OF THE TEMECULA RANCHO AREA, INC. 41538 Eastman Drive, Unit C Murrieta, CA 92562 Dear Ms. Vaccarino: Congratulations on being selected for funding under the fiscal year 2012-13 Temecula Community Service Funding Program. Your organization has been awarded $5,000 to be used for the Food Bank providing food for over 13,000 low income seniors and families, pay for cost of refrigeration, repairs and needed warehousing. Your organization must confirm that these funds are expended in accordance with the above -stated purpose by June 30, 2013. Receipts verifying the expenditures of this year's award must be submitted to the City by September 1, 2013. The City may require access to your accounting records in accordance with this policy. If City funds are not expended as stipulated, the funds must be returned to the City. In order to disburse your fiscal year 2012-13 Community Service Funding Program Award, the City requires back-up documentation (specifically copies of invoices, receipts and cancelled checks) to support last year's 2011-12 grant of $5,000. Please submit your back-up documentation to the address below: Mail or hand deliver to: City of Temecula City Manager's Office Attn: Betsy Lowrey 41000 Main Street Temecula, CA 92590 In order for these funds to be released, you must sign below acknowledging the following statement: "We do not discriminate based on race, color, nationality, sex, marital status, disability, religion, or political affiliation." The City fully supports the efforts of your organization and its services to the citizens of Temecula. Sincerely, Betsy Lowrey Sr. Management Analyst ACKNOWLEDGMENT OF FUNDING CONDITIONS (please sign and return this letter as soon as possible): Print Name/Title Authorized Signature/Title Date *** Ths 5maf(ar Fenger Vibrufmuta Store Welcome Tc Oar Murrieta 'tore K*h 'Acre # 469 ****V*K*hK*k/:*R*Kk****Y.**N AK*Kt.y:*'Ak*h See Us On Tla'AtB www.smartindfinal.cov Cashier: Ctrist:ira DATE 09/16/12 "I"IE 14:0 3:56 4 4 5.59 FS Reol 0-t: Sto- B 22.S6 1 4 4 5.59 FS Rec1 ss )al l of B 22.:6 1 4 ; i 9.59 FS 12 In 7,aly W-ap 38.S6 1 Crystal Geyser Oat 4.99 = +CRY 1.75 Crystal Geyser Oat 4.::9 r' +CRV 1.75 Crystal Geyser at 4.99 *CRY 1.75 SJBTOTAL 103.:0 SALES TA)( 6.=4 TOTAL 109.4 Discover TENDER 109.74 Acct # ***A*K/:****K***xx*x.11485 APPRVL CODE: )1654R Cas Ref# 59 CASH )RANGE a TOTAL PLUMBER )= ITEMS THIS '(ISI"--= 15 ****A:*2** k* K ** R*K K****'K**nxx*.:* pent,*'A**A* Smart & Final Store # 469 25060 Madi soil Ave. Murrieta, CA 52552 DATE 09/1.5/12 TIME 13.57:24 Account # *kY.***KK**x*Y.**wv:n*.1'k1485 Tender Type credit Reference N 105477 APPRVL CODE 016543 Reason Code :1MCO Tota' 10;x.7'' Tran:c # 156 Cash ba:=lc. .00 ****l:*'K**K2Rk*MkxK******K'Ar'.t*K*/00:*'A**A* 14:04:18 )='# 115649 D9/16/12 Term:5 Trais # 156 S:o a if 469 THAW. YOU FOR sI)ppa:d YOJR tiUFRIETA SMAR"& I'JA_ STORE'MANAGER: JEFF SfiLI'.8JRY 1 (951) 698-8495 *****K***h'k*R****KK****Y.*KsiCWX f*Knt**X*h** We want tc kiow your 1:ho.aq"tts so Me oar serve you het':e- Complete cur customer su•'vey Fl �d :re entered to w' n a $200 SmartCa;h Card Please vlsi� htt:p://*'wm.srrartandfina' .<<o•a./seiry y Eiter ,^,ode 526332 wit -111 5 days of 'Ors s1oot SENIOR CITIZENS SERVICE CENTER 41538 EASTMAN DR STE B MURRIETA, CA 92562-8007 US PAY O DER OF "? Ke '�' %ELLS LARGO tx0 J i1c> Welts CahfomFop ,. ,M wdkbrpo.com DATE 1680 16-24/1220 4623 0856201777 1 $5o�3z- DOLLARS (21 FOR 1 gA 5a—tia ? 0 �CGflj�r. t- N* vECTAIS .T42 - h, •e.,t� sexes+r.,Harzt-r: :�a.accc' ar-�,1r�etsr��nwrcwa,•uea;; - _ 1�'✓� W-, F000 The True, Everyday! Leader. Lis. 26419 Ynez Rd. (951) 296-5534 YOUR CASHIER WAS Candy H 20 @ O'PRNCL YAMS 19.60 F 24 @ 1.28 30.72 F KRO INST POT 0.00 TAX 50.32 see* BALANCE 704 Food 4 Less 11319 26419 Ynez Rd. Temecula CR 92309 DISCOVER A Purchase ***********1485 TOTAL: 50.32 REF*: 01892R DISCOVER 50.32 CHANGE 0.00 TOTAL NUMBER OF ITEMS SOLD = 44 12/18/12 07:19am 319 6 45 291 MGR: THANKOYOUNFORCHARDSON SHOPPING` FOOD2464 ESS Check us out at: www.Food4Less.COM *********xx*****x**xx*x****xxx*****e** We Value Your Feedback! ENTER TO WIN ONE:OF 20 $100 GIFT CARDS You are invited to complete a survey about your recent visit to F4LESS Answer bw Internet 2 www.telikroser.com You Participe Para saner need this puna odeelas nd 20 tarietvs de resalo de $100 Le invitamos a lienar una encuesta sobre su reciente visits a la tienda F4LESS Responda por Internet, . 1:. 1 i L nnnor rom SENIOR CITIZENS SERV. _CENTER 41538 EASTMAN DR STE B MURRIETA, CA 92562-8007 US PAY ORDER OF u n k1--Vnrl yox/ 5:414‘014, (I erg WI" FA HOU %Rs forgo e r.NA Calfoenla weps4rgccom FOR. 4).4. 6. "r'�-_DD ( •t-r7c' ' DATE 11119 11 r-- 1670 16-24/1220 4523 0856201777 1 $4.5'B DOLLARS 8 x' ,i/tfome6 Fobo4 The True Low Price Leader. Everyday' 26419 Ynez Rd. (951) 296-5534 YOUR CASHIER WAS Roberta A 32 @ 1.28 PRNCL VANS 16 9 0.98 KRO OLIVES 48 @ 0.68 MCCO BRWN GR BC POTATOES BC POTATOES BC POTATOES BC POTATOES BC POTATOES BC POTATOES BC POTATOES BC POTATOES BC POTATOES BC POTATOES BC POTATOES BC POTATOES BC POTATOES BC POTATOES BC POTATOES BC POTATOES BC POTATOES BC POTATOES BC POTATOES BC POTATOES BC POTATOES BC POTATOES BC POTATOES STVTP STFFNG STVTP STFFNG STVTP STFFNG STVTP STFFNG STVTP STFFNG STVTP STFFNG STVTP STFFNG STVTP STFFNG STVTP STFFNG 1 @ 4/5.00 40.96 F 15.68 F 32.64 F 0.98 F 0.98 F 0.98 F 0.98 F 0.98 F 0.98 F 0.98 F 0.98 F 0.98 F 0.98 F 0.98 F 0.98 F 0.98 F 0.98 F 0.98 F 0.98 F 0.98 F 0.98 F 0.98 F 0.98 F 0.98 F 0.98 F 0.98 F 0.98 F 0.98 F 0.98 F 0.98 F 0.98 F 0.98 F 0.98 F 0.98 F 0.98 F u i 54 12.E 4.50`' 0 `'.. 129-",. 262.5w. 15.11 d5rx-A-fc;rc., -rr2E SENIOR CITIZENS SERV' -7 CENTER 41536 EASTMAN DR S MUHRIETA, CA 92562-6.,,., US PAY�� ORDER OF k'\ DATE l 2A b /l7/ I $1534o 1677 1624/1220 4523 0856201777 FOR R -e#' 1 A2..+ :z. '-•= - :s>-sr'.'.srsvcws„�.r rr_ ac�sr..:.;r �:ara ��n..=S� s:+s�wesagav-a,:.1�� i�I�"'.^:_."^`Ca.£'t-sr-n�;�ss ^.zt.ru i`�r3-_Lu.:ir_ ?: r7,_•:47,11/. COTO encueYT■ Irmoicit .a citiuo n• r en espanol en la P681na del Internet THRNK YOU Walmart:!e_ save money. Live better. ( 951 ) 696 - 7135 MANAGER SHAURA OLSEN 41200 MURRIETA HOT SPRINGS RD HURRIETA CR 92562 STI 2952 OP4 00006036 TE8 72 TRU7.6082318 GODDSENSE OF 007119001190 17.63 X G000SENSE DF 007119001190 17.63 X GOODSENSE DF 007119001190 17.63 X 6000SENSE DF 007119001190 17.63 X 0000SENSE OF 007119001190 17 93 X DRY DOG FOOD 068113117663 17 98 X DRY DOG FOOD 068113117663 17.98 X DRY DOG FOOD 06811S117663 UBTOTA! 142.09 TAX 1 7.760 % 11.01 TOTAL 163.10 DISCV TEND 163.10 ACCOUNT I **** **** **** 1485 S APPROVAL 8 01067R REF 1231600086083 TERMINAL 9 34008723 12/10/12 13:15:36 CHANGE DUE 0.00 t ITEMS SOLD 8 TCI 8509 0882 6453 6170 86 Illlplllllllllllllllllll IIIIIIIIIIIIIIIIIIIIIIIIIIIIIilllllllllllllllllllll lllllll�Ill1 II Don t forret Pick 12/10 12ati it13 16y37ec 14 ***CUSTOMER COPY*** v.' ,✓r"i rart lore. C' x_,!:"SA'° ._ t7m-:::414. >•'�id�A; SENIOR CITIZENS SERVICE .INTER 41538 EASTMAN DR STE B MURRIETA, CA 92562-8007 US PAY TO t' %1�..\ 14—; ORDER OF p DATE 1654 16-2411220 4523 0866201777 1 $ ,5i 54. DOLLARS Wel Wok Fine Mat 41A 4alrcn w ewldupo.caw FOR iteMl4]-- (lt1•gpIit� �^c3.?!Te.r<^4'.."•T`_r.�szn�rt:{�}r:.�.eo»{•ay o n PI ▪ sc w0 p•4 . m k -1 :L) A 17 -e D O N y N D+ 7J 0 3 -110113. rt O'T'il -Tl t {;714") T 14% 1 4D -4:1 CD CO A 1g x SOI r� Cn •tn V3 i7 �L�-.-.�(.� ....7_,* OFD v -o.7 �-4 1%_ _ -. N N m4 " = a,-+- a-r.‹gsi.9,0:a rt ID -;1=,0 1'3o m x �_cxC1 N�mfvti� o T o rt V: .+ 3 L0 X C7 x .n O e-4 4,4 T f= = £�? 7 `-`% _ x coi 0"4 m W x. . Uf K w n 1 -4 >F ` 01 +,.. ase � �'? w �^ �r w w.� 4� vJ) - p� N w _ SO rornx� w� nvw_rv„ V? ‘43•-::.' cF' •rL v r. tel �= "= - Yc)? • Wx _ tp7�` c �0, �= x ^ " CD xs r -`n - m ° @x Zo .1.1"..0-. cn in x 1-4c .� -C ems-: C C+I -- X 1U < l X 01 >< --S -C� '� �- . m v m w (i7 al .+ x csm Q x m x a v ---e sY 1 1 C -- -;C-3 f x a� .la �, R PO m x 44.11 `• >t rn i Cm V v 0�1; �n cn x N * z1wa 0-11A 7r 0S - 'c IC*1 y Crn m- 0005 J k .Ls % f./) a .7 ,.� Co .o — % u } % t J0 .E i ... X•, '.) >• coH 04 ▪ A -4 of rUf I7 x • L V - • _ - y �'F • x A x j• •w 4` «5 0�. Lk rt 4' —24 y .(17..i."../ x .y 74:4.) - i,.)• - x R C?? J 1lr'1111 +o iD�4D t00 80 .. o : 1k +l 11 .. : ✓ a CD CJI ■ M -4/1),A f\IP Fo�vJIIE...W Save money. Live better. The True Low Price Leader. Everyday! 26119 Ynez Rd. (951) 296-5534 YOUR CASHIER 18S Roberta A 32 @ 1.28 PRNCL YAMS 16 @ 0.98 KRO OLIVES 18 @ 0.68 MCCO BRWN GR BC POTATOES BC POTATOES BC POTATOES BC POTATOES BC POTATOES BC POTATOES BC POTATOES BC POTATOES BC POTATOES BC POTATOES BC POTATOES BC POTATOES BC POTATOES BC POTATOES BC POTATOES BC POTATOES BC POTATOES BC POTATOES BC POTATOES BC POTATOES BC POTATOES BC POTATOES BC POTATOES STVTP STFFNG STVTP STFFNG STVTP STFFNG STVTP STFFNG STVTP STFFNG STVTP STFFNG STVTP STFFNG STVTP STFFNG STVTP STFFNG 1 @ 4/5,.00 JELLO GELATN 1 @ 4/5,00 JELLO GELATN 1 @ 4/5.00 Jett 0 GELATN 1 @ 1/5.00 JELLO GELATN 1 @ 4/5.00 JELLO GELATN 1 @ 4/5.00 JELLO GELATN 1 @ 1/5.00 JELLO GELATN 1 @ 4/5,00 JELLO GELATN 1 @ 4/5.00 JELLO GELATN 1 @ 4/5.00 JELLO GELATN TAX **** BALANCE 704 Food 4 Less 1t319 26419 Ynez Rd. Temecula CA 92309 DISCOVER Purchase m*********1485 40.96 F 15.68 F 32.64 F 0.98 F 0.58 F 0.98 F 0.98 F 0.98 F 0.98 F 0.98 F 0.98 F 0.98 F 0,98 F 0.98 F 0.98 F 0.98 F 0.98 F 0.98 F 0.98 F 0.98 0,98 0.98 0.98 0.98 0.98 0.98 0.98 0.98 0.98 0.98 0,98 0.98 0.98 0.98 0.98 1.25 1.25 1.25 1.25. 1.25 1.25 1.25 F F F F F F F F F F F F F F F F F F F F F F F 1.25 F 1.25 F 1,25 F 0.00 133.14 ( 951 ) 506 - 7613 MANAGER RANOALL SONDERHOUSE 32225 TEMECULA PKWY 1EMECUL.A CA 92592 ST# 2708 OP# 00003865 TE# 04 TR# 08639 WAFFLES 007874208709 F 1.58 N WAFFLES 007874208708 F 1.58 N WAFFLES 007874208708 F 1.58 N WAFFLES 007874208709 F 1.58 N WAFFLES 007874208706 F 1.58 N WAFFLES 007874208706 F 1.58 N WAFFLES 007874208709 F 1.58 N WAFFLES 007874208706 F 1.58 N WAFFLES 007874208709 F 1.58 N WAFFLES 007874208708 F 1.58 N WAFFLES 007874208709 F 1.58 N WAFFLES 007874208709 F 1.58 N WAFFLES 007874208709 F 1.58 N WAFFLES 007874208709 F 1.58 N WAFFLES 007874208709 F 1.58 N WAFFLES 007874208709 F 1.58 N WAFFLES 007874208708 F 1.58 N WAFFLES 007874208709 F 1.58 N WAFFLES 007874208709 F 1.58 N WAFFLES 007874208709 F 1.58 N WAFFLES 007874208708 F 1.58 N WAFFLES 007874208708 F 1.58 N WAFFLES 007874208709 F 1.58 N WAFFLES 007874208709 F 1.58 N WAFFLES 007874208706 F 1.58 N WAFFLES 007874208706 F 1.58 N WAFFLES 007874208706 F 1.58 N WAFFLES WAFFLES WAFFLES WAFFLES WAFFLES WAFFLES WAFFLES WAFFLES WAFFLES WAFFLES OM FC BACON OM FC BACON OM FC BACON OM FC BACON OM FC BACON OM FC BACON OM FC BACON OM FC BACON 14 AT 1 FOR 007874208706 F 007874208708 F 007874208706 F 007874208706 F 007874208706 F 007874208706 F 0078742.08706 F 007874208706 F 007874208706 F 007874208706 F 004470006647 F 004470006647 F 004470006647 F 004470006647 F 004470006647 F 004470006647 F 004470006647 F 004470006647 F 3.38 SUBTOTAL TOTAL DISCV TEND ACCOUNT # **** **** APPROVAL # 01863R REF # 232300784310 TERMINAL. # 49020596 11/18/12 10:54:13 CHANGE DUE 0.00 1.58 N 1.58 N 1.58 N 1.58 N 1.58 N 1.58 N 1.58 N 1.58 N 1.58 N 1.58 N 3.38 N 3.38 N 3.38 N 3.38 N 3.38 N 3.38 N 3.38 N 47.32 N 129.44 129.44 129.44 **x* 1485 S # ITEMS SOLD 58 TC# 4801 2402 5076 7216 1128 9 11 111 MN III 1111 F'nd low prices on the go. Get the Wa mart app. Ca **WMT. 11/18/12 10:54 13 ***CUSTOMER COPY*** SENIOR CITIZENNSMSAN oR. ICE CENTER 41538TE MURRIETA, CA 92562-8007 PAY ORDER OF Pr -\ N/ F7 a,n.� 1 MGUS 1'Al2OO Wells Few Bank NA wellsfaryot. n DATE 1719 16-24/1220 4523 0856201777 DOLLARS a'^ FOR Ltiv):‘ WQu4°�`-,h,� IAYl.‘ ? ? ?" SENIOR CITIZENS SEF' "OE CENTER 41538 EASTMAN C i B MURRIETA, CA 925.. 407 0 EROF t�0.k C c eNk\ P'1.41 eX1AC WIA tS FARGO Wells Fagg* e:nicM.R. California wellsfrgawm e• . s FOR 3.$.1 1J .�RA'654.' a• A.. 1727 16-24/1220 4523 0856201777 DATE Is 58.8,3 DOLLARS 8 (+• 4rn'arlt ' Final Me Smaller foster Warehouse Stone x*x Wel erre To Our Mur -iota Store xxx Store if 469 xx K*'* A **L'Kxx KX-K'ixx'K*XX* *Xxxxxx*xx *XxxxX See Us On Tha WEB www. sxartandf i nal .cola Cashier: .l.lsti n DATE 04/1E/13 TIME 11:17:43 FS Reel Cal Frzr 8 5.59 T 5.59 T FS Recl Gal Frzr Br 7.39 T FS Recl Crt Frzr B FS Recl Crt Frzr B 7.39 T Tknic Gil cve Free 7.64 T Was $6.99 / YOU SAVED -> $1.35 FS Recl Cal Frzr 6 5.59 1 Tknic. •alcve Free 7.64 T Was $Z.99 ./ YOU SAVED -> $1.35 5.64 1 Tknlc ',1cvs Free Was x:6.99 / YOU SAVED -> $1.35 SJBTOTAL 54.47 SALES TAX 4.36 DTAI. 56.83 ATN / DEBIT CARDS TENDER 58.83 Acct i+ xxxxxxRxx4xxxx*xx*xx3367 APJPYL CCD;.. 121931 Cas RofN 12 CHANGE .00 CASH TOTAL. NU1rBf:I+ 0= 'DENS TIHIS VISIT--> 8 WxxXr•**X*st*KRx•*Sx*'xXxx***W**x K*******x*X Sltar•t R "•iral Store # 439 25060 Nadisoil Ave. MLrrieta, CA 92562 DATE 04/26/13 TIME 11:04:59 Account II Xx**xxx*KxxxXKxxxx*•*x3367 Tender Type Debit Refersres N 122985 APPf1VL. CCU 121931 Reason C;:ce :MOO Tota 56.83 Trans 0 38 Cash back .00 x*Nsl'*L'xXf:**x*x**xw*Xxx KKXxXxx K*xxxx>,x*XK ..... ... ..... nn .u• ..n PAY TO THE ORDER OF SENIOR CITIZENS SEF '' OE CENTER 41538 EASTMAN.[ : B MURRIETA, CA 925,... „007 04-0 tA.0- WELLS FARO Weft Eno bW.NA Catania welhismatom 1721 16-24/1220 4523 0856201777 DATE L/// b/l 3 I$ 9o.6'4 - FOR .c>.510.f'il.ift-Wsi't-Le —1 -El& W- tir Wa'r" !b S lc w 1, 1st, --- C� Glue— 54YJc.- ! 4i -1' o o v V &fv S At`54--- II ..Tehr k �Y�..- k tr (>4't cLSv•F z14-q`f E%rooO1 Q. vI) Y;e i- A 3 t."". UO lb be) c) 1�. v 2.S-10 St: 127 Muriette Madison & Nuriette Hot Springs . r, 25270 Madison Hurietta CA 92562 Headnost-F i sheraensllat*ASST 15 AuntJanes-Di1lPickleRelish/10 CertifiedAspirin/325mg/175ctI CupOGold-hilicChocCandy/1.25oz Cup06old-NilkChocCandy/1.25oz RackYRoadIi lkChoMershCashul .8 RockyRoadMilkChollarshrashul.8 CupOGold-HilkChocCandY/1.25oz SUBTOTAL TAX TOTAL CASH CHANGE 0 99 0.9999 T 9 .9999 0.9999 0 .9999 0.9999 T 0 .5999 0.5999 9 .5999 0.5999 0 .5999 0.5999 9 .5999 0.5999 0 .5999 0.5999 $6 00 SO 16 $6 16 $10 25 S4 09 11 ITENS SOLD 8 03-18-2013 01:33PM 0127 02 3168 Bonita Easto, is Early This Year! „qday March 31st the Easter Aisle Today! tvoAA)' ())tt( • St: 334 TEMECULA-WINCHESTER ROAD Margarita Rd 40355 Winchester Road Temecula CA 92591 6rannyGooseTortiileStrips/9oz 1 0 .9999 0.9999 His Cther Taxable 1 9 .9999 0.9999 T E:..:• .Si tick/0.21oz/3pki0 1 9 53999) 0.9999 T A',E>!► ;,niter/Ye11u/2Pk+1:3pk 1 0 13411 0.9999 T DustPannU/LongHandle/*5101 1 0 .9999 0.9999 T ButterflyNet/AsstCol or/PDQ*06 1 0 .9999 0.9999 T SUBTOTAL TAX TOTAL ASH t6 00 TO 40 $6 40 40 111 J1011113411 Ilil1i0I1h Ilillsn 6N IqY ITEMS SOLD 6 03-05-2013 03:14PH 0334 02 8200 Heed These Items In Bulk? 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Eduard St: 334 TEMECULA-UINCHESTl Margarita Rd 40355 Winchester Ros Temecula CP 07591 Rubbing Alcohol/508/12oz/*120 1 @ Westcott-Finger6ripRulerAssto 1 0 SUBTOTAL TAX TOTAL CASH CHANGE 111 5111111111111 990334020899876291 ITEMS SOLD 2 10-22-2012 03:40PM 0334 02 6291 TO KEEP UP WITH ' 'ATE HEWS AND SAUINL TO WWW.FACEB00K.00N/99CENTS0I AND LIKE US! 11. n Q/ U% Smart The Smaller faster WOrehovae Store *** Welcome To Our Murrieta Store *** Store # 469 *************************************** See Us On The WEB www.smartandfinal.com Cashier: Shelly S DATE 04/09/13 TIME 07:44:14 6 0 3.00 FS Water 18.00 F Was $20.94/ YOU SAVED -> $2.94 6 0 1.20 +CRV 7.20 SUBTOTAL 25.20 SALES TAX .00 TOTAL 25.20 Discover TENDER 25.20 Acct # ********************1485 APPRVL CODE 00994R Cas Ref# 55 CASH CHANGE .00 TOTAL NUMBER OF ITEMS THIS VISIT--> 6 Smart & Final Store # 469 25060 Madison Ave. Murrieta, CA 92562 DATE 04/09/13 TIME 07:30:59 Account # *********************1485 Tender Type Credit Reference # 119028 APPRVL CODE 00994R Reason Code RM00 Total 25.20 Trans # 4 Cash back .00 **************************************** 07:44:42 OP# 8099616 04/09/13 Term:5 Trans # 4 Store # 469 THANK YOU FOR SHOPPING YOUR MURRIETA SMART8FINAL STORE MANAGER: JEFF SALISBURY 1 (951) 698-8495 ****************************************** We want to know your thoughts so we can serve you better. Complete our customer survey and be entered to win a $500 SrnartCash Card Please visit http://www.smartandf1na1.com/survey Enter code 655675 within 5 days of this shop! STORE MGR RICHARD SANDOVA 951-679-0127 THANK YOU FOR SHOPPING WITH US! GROCERY FRISKIES PRTY MIX e RegPrice 2.09 . -' Card Savings .09- J4U Personalized .51- FRISKIES PRTY MIX .1-14 A& 19 1 RegPrice 2.09 i Card Savings .09- J4U Personalized .61- REFRTG/FROZEN 2 QTY BF CHIMICHNGA RegPrice Card Savings 2.50 .50- i 2.0 F d Savings PORK STEW PRODUCE 1.27 lb @ $0.69 /lb WT BANANAS 2.35 lb @ $0.44/1b WT GREEN CABBAGE Re9Price J4U Personalized D 2,09 1.06- HOMESTYLE HOT egPrlce AMER SUB WHOLE `ReOrtce ' - J4U Store eCpn 5 2.99 - SC PR 50% OFF MT OR SF[ **** TAX 64 BAS. 1 67-F 32.09 �L e .24 is -M. ge:? " fleaee5 4 i' c v► Flo f-45 _÷ t'7• vv Aar .,c0.4 1r4.Ae 'L '( '1)1 kttVeWOC ‘C tit /t 3 n kO wry rr, rt'br� ea,� s Gas thitovici i 10, a0 .3/aZ/IS r&itt\ C.4.4 Maui 41 I t.). (5T7 • SENIOR CITIZENS SER E CENTER 41536 EASTMAN DR 3 MURRIETA, CA 92562-8007 US PAY TO THE ORDER OF 4. P141;s 1 k 0 A.., DATE I $5•Ltb DOLLARS WELLS NARGO OffimOi mfthrwm FOR a,4j0A .. WiOd V k eV4—, SV • /J/17Azi.24 1' 1694 16-24/1220 4523 0856201777 0•* 31 •O6+ 14.34 4S -Zi -.0 SALE that was easy. Low prices. Every item. Every day. 25070 Madison Ave. Murrieta, CA 92562 (951) 698-9668 1514625 8 003 52376 0305 01/31/13 11:50 PRICE QTY SKU REWARDS NUMBER 3065618492 1. DURAMARK GRIP PERM 718103129992 1 STAPLES MARKERS BL 718103008709 SUBTOTAL Standard Tax 8.00% TOTAL Debit Tender: Card No.: XXXXXXXXXXX3367 [5] Auth No.: 732874 TOTAL ITEMS 2 4.49 8.79 13.28 Smart& Final. 7Fn, S+1', ffer A'srar tl'oreehowe Store *x* Welcclr,j To Our Mur-ieta Store Store N 469. **x xxx*'A xx*A xft:CA7C'*******XRKN%*******A *Xx'Kx Sea US Or The WEB www.sroartan•Jfinal.com Cashier: Jeff DATE 01/31/13 TIME 11:58:37 FO Latex Glove FS Rec:l Gal Frzr B FS Rccl Gal F.-zr B FS Recl Gal Frzr B SJBrOTAL. SALES TAX TDTAL ATM / DEBIT CARDS TENDER Acct x*xxxxx**'A*xxx*x*xx*3367 1,06 APPRVL ICOF: 313326 Cas Refit 18 CASH CHANGE .00 TOTAL NUPBEP 0: ITEMS THIS VISIT--> 4 xxxxxA*XY.'K**AxK'A,AK**XxKx***x'Kxxx Kx\*'K*Y. Smart 8 Final Store N 469 14.34 25060 l'.adi sol Ave. Murr•i ;eta, CA 9 562 DATE 01/:>1/13 TIME 11:50:57 Account fi xxAx*Axxxx*xxxxx*xx**3367 Tender Type Debit Referarce N 181907 APPRVL CCCE 313326 Reason Coce IM00 Total 31.06 Trams N 70 Cash hark .00 $14.34 11.99 T 5.59 T 5.59 T 5.59 T 28.76 2.30 31.06 31.06 Save with Staples Brand products, the most trusted brand in office products, THANK YOU FOR SHOPPING AT STAPLES ! ** IXx AzAxXAKKKAxx/i XX**NYWA*Ax**x7t%x A** 11:59:01 0'0 3012787 01/31/13 Term:3 Trans N 70 Store N 469 TI-AN4 YOU FOR S1OPPIr 3 YCLl< MIJRRIFIA SMAr1T8FINAL `%T04"F MANAGER: JEF: SALISBURY 1 (951) 698-8495 SENIOR CITIZENNS^S ANpR IBE CENTER 41538 DR CA 92562-6007 PAYUS THE ORDER OF .ic� 7��. �. �-x�_:°,+t��#s �Si?;�*1g^�rr>�-'d�,�'�!YS�ttriI:xa�Y".=•ii �t.6 1695 16-24/1220 4523 0856201777 DATE a �5 / FOR rcaiR «Cl7�TS+i�.+=�` Walmart •,•w Save money. Live better. ( 951 ) 696 - 71:15 MANAGER SHAURA OL!;EN 41200 MURRIETARIETA OT 9256 NGS RD MURDRY 2952 FOOD 060638802287 8 TR1< 04875 20 AT 1 FOR 19.98 399.60 )( ** VOIDED ENTRY ** YDOG FOD53827 20 AT1FOR 19 98 399,60-X DRY DOG FOOD 060538802287 18 1 F001780014342 8 359.64 X 10 AT 1 FOR SUBTOTAL 496,44 X 0* VOIDED ENTRY ** 19 98-X DRY DOG FOOD 060538802287 ** VOIDED ENTRY ** 19.g8_X DRY DOG FOOD 060538802287 UBTOTAL 456.48 TAX 1 8.000 % 36.62 TOTAL 493.00 MCARD TEND 493.00 ACCOUNT $ **** **** 1F*** 5058 S APPROVAL # 00035Z REF * 304600845116 TERMINAL 8 17003167 02/16/13 09:43 46 CHANGE DUE 0.00 # ITEMS SOLO 26 TCS 69 I7 31906 1 1669 7851161 �Illlllll�lllllilllllllll IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII "Like our store on Ftcebook Go to local.wal09art cor 02/16/13 ***CUSTOMER COPY*it* ht. OFFICE•=lIEPOT STORE 609 40441 Winchester RD Temecula, CA 92591 (951) 296-5325 0S/11/20I3 13.1 1:33 PM STR 609 REG2. TRN 5739 EMP 629457 SALE Product ID Description Total 131000 MRIFR,SHARPIE,5 4.89 SS Subtotal: 4.89 Sales Tax: 0.39 Total: 5..28 Cash: 5.28 ****x*******iriiik;i****Ai cit iiil aiirii*Ati ** Shop online at www.officedepot.com ****************************************** „ wPVT .T9AEM _YQI.• .. Participate in our online customer survey and receive a.coupon for :10 off sour next mualifsina purchase of $50 or more on office supplies, furniture and more. (Excludes Technoloss. tinct 1 coupon per household/business.) Visit wvw.officedepot.com/fe&dback and enter the survey code below. Survey Code: 13PV YDNY 1�IN 1 111111111311111111111110 PAY TO THE ORDER OF SENIOR CITIZENS SERVE " CENTER 41538 EASTMAN DR`S MURRIETA, CA 92562-$w. P1,•) I,s CSc,/ 11 DATE ?)1/ 5//3 1707 10-24/1220 4523 0856201777 IS V8rb DOLLARS WELLS FARGO Wells F+po BankNA Calm,* a well mgoom • FOR Res4..6+ +44' witurtln ...02-5.1)t.t,S M 1 mart&Final. nimSnrohrIbmmrlolliveloStots *x* Welcome To Our Murrieta Stoke xxx Store # 469 ****xxxx*******xx*x**x*x***x****x****x* See Us On The WEB www.smartaridfinal.com Cashier: Carmen DATE 03/11/13 TIME 12:40:54 5.59 T 5.59 T. 4.99 F 1.20 4.99 F 1.20 4.99 F 1.20 6.89 T 36.64 1.45 38.09 38.09 FS Recl Gal Frzr B FS Recl Gal Frar B Dasani +CRY '`•Dasani +CRV Dasani +CRV FS 032 Fantail Mop SUBTOTAL SALES TAX TOTAL ATM / DEBIT CARDS TENDER Acct # ****x****xx****xk***3367 APPRVL CODE 190838 Cas Ref # 4 CASH CHANGE .00 TOTAL NUMBER OF ITEMS THIS VISIT -- 6 Imx**x*:t*x*k**x Y.xxx******A.*********xx*xx Smart 8 Final Store # 469 25060 Madison Avo. Murrieta, CA 92562 DATE 03/11/13 TIME 12:33:11 Account # x*x**xx**xxxx*x******3367 Tender Type Debit Reference # 103425 APPRVL CODE 190838 Reason Code RMOO Tota Trans # 14 Ca ***k****x*xkx**Wx*y:**Y*x*x *Xxk****x**:t 12:41:32 OP# 121946 03/11/13 Term:2 Trans # 14 Store # 469 THANK YOU FOR SHOPPING Min W mn•.. .. SENIOR CITIZENS SERVICE CENTER 41538 EASTMAN DR STE 13 MURRIETA, CA 92562-8007 PAY TO THE Q VW1 t -t-,, ORDER OF WELLS FARG0 Wells FMgogydi,NA. Cao1mM+ welhUrwom DATE (/ 4, 3 1758 16.24/1220 4523 0856201777 �$ i.11 -.`e 3 DOLLARS ' hP FOR SALE that was easy. Low prices. Every item. Every day. 25070 Madison Ave. Murrieta, CA 92562 (951) 696-9668 1629692 1 001 66630 0305 06/24/13 08:09 PRICE QTY SKU REWARDS NUMBER 0206291999 1 ENVELOPE PULL & SE 718103031202 22.99 SUBTOTAL 22.99 Standard Tax 8,00% 1,84 TOTAL $24.83 Cash 25.00 Cash Change 0.17 TOTAL ITEMS 1 Save with Staples Brand products, the most trusted brand in office products. THANK YOU FOR SHOPPING AT STAPLES ! Shop online at www.staples.com Rewards members now get: 5% back in rewards on everything! All products and services -even technology. Free shipping on staples.com orders. For full program details visit staplesrewards.com. I I[JIUU[IIi. iJ1t11ijIIiJIflhIJIIUIUiUII IflhIlIII 111 ,._r J ?i/Gli�UCi.=`Y . fir^ SENIOR CITIZENS SE OE CENTER 41538 EASTMAN L.... i E B MURRIETA, CA 92562-8007 TO THE -7-74 7 ORDEA OF NV WELLS FARGO Weals far90 Bm.k N A. California wtlisfar9o.cpm FOR _ 4 " 1FSWrt'•,�"vraa53WE.?�tFln.4SSF`�Yl�f7M�Tc9tc3AQ�b�1°g�sa'n SENIOR CITIZENS SEF, E CENTER 728 is-2an22o 4523 41538 EASTMAN DR a � E B MURRIETA, CA 92562-8007 0856201777 .dig �r TO THE ORDER OF WELLS FARGO Wel4 Fop Bank N A. CaMomta ceifavocom c, FOR �$ DATE 9I is Al 0o4`47d DOLLARS Sootily U. ills City of Temecula 201344 CS Funding Program APPLICATION NO. 20 J RECEIVED CITY OF TEMECULA. CITY MANAGER'S MANAGE FISCAL YEAR 2013-14 COMMUNITY SERVICE FUNDING PROGRAM APPLICATION (Please Print or Type) 2013-14 Program Submission Deadline: Friday, August 30, 2013 (original, plus one copy) PROJECT INFORMATION Amount Requested: $ T3 3 6 1- 9 9 Project Name: tti NL W /EP / CL Eke 7 r? Project Start Date: / — /— .2-0 1,3 (Maximum allowable $5,000) Project End Date: /07 -3/ -62(9 ORGANIZATION INFORMATION Name of OrganizationSO C/ �'T y b EY/9 u 1 itle/Position: �= S Contact Name:Sk /P L /4 A)6 ELL/Lk i( it Mailing Address:/ 3 7 c, Telephone(70 %S 0,26 a — s)O 7 Year Organization Founded: Number of Paid Staff: —0— Number of Volunteers: 7E/2)Lmac( L4, 9 l,z. Geographic Area(s) Served: %l� iii E (t, Ll L Q /993 Is this organization incorporated in California as a non-profit organization? Yes No X Effective Date: If 'yes" (Must provide a copy of your statement of non- profit status from the State of California): Date of Incorporation as a non-profit: Federal identification number: State identification number: If "no": Name of sponsoring organization:SO G/V INCENT ZE l f� G1 C'T S/ 0E ----Sr Federal identification number: This application has been authorized by the organization's: Executive Committee x Board of Directors Members -at -Large Application Page 1 FY 2012-13 COMPLIANCE REQUIREMENT IF YOUR ORGANIZATION WAS A RECIPIENT OF FUNDING FOR FY 2012-13, PLEASE ATTACH COPIES OF INVOICES, RECEIPTS AND CANCELLED CHECKS TO SUBSTANTIATE THOSE FUNDS RECEIVED AND EXPENDED BY YOUR ORGANIZATION. FINANCIAL STATEMENTS PLEASE ATTACH COPIES OF THE CURRENT BUDGET OF THE ORGANIZATION AND FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT). It does not require a CPA's audit, but please submit if available. A?'7/9 G 14✓L--- L MISSION STATEMENT Briefly describe the goals and objectives of your organization and community services it provides. Describe the ways your organization meets the criteria listed on page 2 of the CS Funding Policy. 5 4 -r7- 4Erb PROJECT DESCRIPTION Application Page 2 MISSION STATEMENT The Society of St. Vincent de Paul is a non-profit organization staffed by volunteers from St. Catherine's Catholic Church and Temecula United Methodist Church who are committed to providing food and other assistance to residents of Temecula with limited resources. Our Food Pantry provides food and clothing for families in need on a weekly basis. We also minister to those in prison, maintain dialogue with distressed individuals, and promote human dignity through community recourse awareness. FINANCIALS Attached is a balance sheet and an Income and Expense Statement for the current fiscal Year. We do not have a Budget. We do not have salaries to pay nor do we have any regular income. Income is totally dependent on the charitable inklings of our contributors and whatever we take in we spend on the poor. To forecast this kind of operation is just not possible. Our only two predictable expenses are for our phone bill and the bill for the storage unit that we maintain to store non - perishables that exceed the room available at the church. These total $984 per year. 10:00 AM 07/30/13 Accrual Basis The Society of St.Vincent de Paul,St.Catherine of Alexandri Balance Sheet As of July 30, 2013 ASSETS Current Assets CheckinglSavings 10000 • St. Vincent de Paul Society 10100 • Adopt A Family Total Checking/Savings Total Current Assets TOTAL ASSETS LIABILITIES & EQUITY Equity 30000 • Opening Balance Equity 32000 • Unrestricted Net Assets Net Income Total Equity Jul 30, 13 20,288.44 4,441.34 24,729.78 74,729.78 24,729.78 16,102.54 -2,506.81 11,134.05 24,729.78 TOTAL LIABILITIES & EQUITY 24,729.78 Page 1 3:03 PM 07/30/13 Accrual Basis The Society of St.Vincent de Paul,St.Catherine of Alexandri Statement of Financial Income and Expense October 1, 2012 through July 30, 2013 Ordinary Income/Expense Income 43400 • Direct Public Support 43440 • Gifts in Kind - Goods 43445 • Donated clothing 43446 • Donated Gas Cards 43449 • Gifts In Kind - Food 43441 • Donated Food - Albertson's 43442 • Donated Food - Trader Joe's 43447 • Donated Food - Brown Bag Sunday 43448 • Donated Food - Church Box Unclassified 17,611.00 174,379.00 80,884.00 9,350.00 1,320.00 2,000.00 Total 43449 • Gifts in Kind - Food 265,933.00 Total 43440 • Gifts in Kind - Goods 285,544.00 43450 • Individ, Business Contributions 43451 • Member Donatios 3,070.00 43452 • Church / Poor Box Donations 22,783.13 Total 43450 • Individ, Business Contributions 25,853.13 43470 • Special Events 43471 • Birdies for Bread 3,383.41 43472 • Brown Bag Sunday 5,700.00 43473 • Soup Suppers 10,737.75 Total 43470 • Special Events 19,821.16 Total 43400 • Direct Public Support 331,218.29 Total Income 331,218.29 Cost of Goods Sold 51000 • Cost of Provided Services 51005 • Donated Food Valuation 265,933.00 51008 • Donated clothing valuation 17,611.00 51010 • Cost of Food for Distribution 17,345.43 51020 • Cost of Temp Housing Assistance 3,657.00 51030 • Cost of Temp Travel/Auto Assist 4,863.74 51040 • Cost of Temp Utility Assistance 3,817.27 51050 • Cost of Other Misc Expenses 1,576.30 Total 51000 • Cost of Provided Services 51060 • Cost of Birdies for Bread Total COGS 314,803.74 793.40 315,597.14 Gross Profit 15,621.15 Expense 60900 • Business Expenses 60920 • Business Registration Fees 75.00 60900 • Business Expenses - Other 165.72 Total 60900 • Business Expenses 240.72 62800 • Facilities and Equipment 62840 • Equip Rental and Maintenance 1,967.01 62890 • Rent, Parking, Utilities 564.00 Total 62800 • Facilities and Equipment 2,531.01 65000 • Operations 65005 • Bank Service Charges 30.00 65010 • Books, Subscriptions, Reference 651.60 65020 • Postage, Mailing Service 17.59 65030 • Printing and Copying 233.29 65040 • Supplies 232.89 65050 • Telephone, Telecommunications 350.00 Total 65000 • Operations 1,515.37 Page 1 3:03 PM 07/30/13 Accrual Basis The Society of St.Vincent de Paul,St.Catherine of Alexandri Statement of Financial Income and Expense October 1, 2012 through July 30, 2013 65100 • Other Types of Expenses 65120 • Insurance - Liability, D and 0 Unclassified 200.00 Total 65100 • Other Types of Expenses 200.00 Total Expense 4,487.10 Net Ordinary Income 11,134.05 Net Income 11,134.05 Page 2 How will your organization use the funding awarded? Describe the project, project objectives, those served, area serviced, and number of volunteers involved. Be specific. Include equipment or services that would be purchased and why. Include a detailed budget and a schedule of significant activities related to this project. You may attach a maximum of one double-spaced typewritten page of information. (Please type or print legibly.) Application Page 3 PROJECT DESCRIPTION We currently have 75 volunteers whose duties include food pick up, food sorting and storage, clothing collection and sorting, client interviews, as well as data and financial collection and recording and special projects. The total number of clients served in fiscal year 2012 (Oct 1, 2011— Sept 30, 2012) was 14672 and this year to date we have served 13139. We collect donated perishable food from local supermarkets within the city of Temecula on a daily basis. Additionally, we purchase perishable and non-perishable foods and toiletries using funds donated by parishioners and those funds raised by special projects. Distribution is conducted every Friday morning. Perishable foods are stored in commercial refrigerators and freezers maintained on the St. Catherine Church property. The current volume of perishable food gathered dictates that we obtain an additional refrigerator. The refrigerator we would like to buy is a True TSD -47G 55" Slide Glass Door Reach -in and is quoted at $3261.99, delivered. Your kind attention to this request will enable us to continue to serve those in need in this community. r PAST PROJECT BENEFITS If your organization received City of Temecula funding in the previous year, please explain and show how Temecula residents benefited. N/4 Application Page 4 SIGNATURE PAGE We hereby certify the information contained in this application is true to the best of our knowledge and belief. PREPARED BY: SIGNATURE: PRESIDENT or AUTHORIZED OFFICER: NAME and TITLE (Pleasa PriKt or Type) )21 c 4-J /0 /NA E and TITLE (Please Print or Type) i % SIGNATURE:" ORGANIZATION NAME: o C e C�' Y d r Vic C A)7— ,.1) l F c+ L MAILING (/ Jrcl ADDRESS: 5" g %7" k� C f'l j G L(& fl, C`l Cl a S y TELEPHONE{ �f) c,k7t '& d O 7 EMAIL ADDRESS:SrC,THS Ub P g C7 P1411.. COM DATED THIS c2of k Tu (D te) (Month) , 2013 BE SURE TO INCLUDE THE ORIGINAL PLUS ONE COPY AND SUBMIT BY AUGUST 30, 2013 TO: Mall Completed Applications to: Or Deliver In Person to: City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office Post Office Box 9033 Temecula, CA 92589-9033 City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office 41000 Main Street Temecula, CA 92590 Application Page 5 City of Temecula 2013-14 CS Funding Program APPLICATION NO. 21 RECEIVED CITY OF TEMECULA AUG 7. 8 4W CITY MANAGER'S FISCAL YEAR 2013.14 OFFICE COMMUNITY SERVICE FUNDING PROGRAM APPLICATION (Please Print or Tvoe) 2013-14 Program Submission Deadline: Friday, August 30, 2013 (original, plus one copy) PROJECT INFORMATION Amount Requested: $ 50 0 0 Project Name: Special Olympics Temecula Valley Project Start Date: 1/1/2014 (Maximum allowable $5,000) Project End Date: 12/31/2014 ORGANIZATION INFORMATION Name of Organization: Special Olympics Temecula Valley Contact Name: Sue Reed Title/Position: Area Director Mailing Address: 27475 Ynez Rd Suite 174, Temecula, CA 92591 V 1969 Telephone: (951 ) 4/1- 6 5 6 8 Year Organization Founded: Number of Paid Staff: 0 Geographic Area(s) Served: Number of Volunteers: 250 Temecula Valley Is this organization incorporated in California as a non-profit organization? Yes X No Effective Date: 1995 If "yes" (Must provide a copy of your statement of non- profit status from the State of California): Date of incorporation as a non-profit: May 1996 Federal identification number: If "no": Name of sponsoring organization: Federal identification number: State identification number: This application has been authorized by the organization's: X Board of Directors X Members -at -Large X Executive Committee Application Page 1 FY 2012-13 COMPLIANCE REQUIREMENT IF YOUR ORGANIZATION WAS A RECIPIENT OF FUNDING FOR FY 2012-13, PLEASE ATTACH COPIES OF INVOICES, RECEIPTS AND CANCELLED CHECKS TO SUBSTANTIATE THOSE FUNDS RECEIVED AND EXPENDED BY YOUR ORGANIZATION. FINANCIAL STATEMENTS PLEASE ATTACH COPIES OF THE CURRENT BUDGET OF THE ORGANIZATION AND FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT). It does not require a CPA's audit, but please submit if available. MISSION STATEMENT Briefly describe the goals and objectives of your organization and community services it provides. Describe the ways your organization meets the criteria listed on page 2 of the CS Funding Policy. Special Olympics enriches the lives of more than 200 individuals with intellectual disabilities, their families, and their community in the Temecula Valley area through the power of sports, education, and athlete health. We provide year-round sports programs in the sports of aquatics, athletics, basketball, bocce, bowling, floor hockey, golf, gymnastics, soccer, and tennis. These programs involve training as well as competition programs, at the local, regional, and state levels. The history between Special Olympics and the city of Temecula is long and rich, beginning over 40 years ago. Many athletes have been part of Special Olympics programs for many years, especially because we are the only organization in the Inland Empire that serves individuals with intellectual disabilities of all ages and ability levels. The success of our programs in Temecula Valley would be impossible without the support of the City of Temecula, Temecula Police Department, Temecula Unified School District, and many other local organizations that provide volunteers, in-kind gifts, and cheerleaders for our athletes. PROJECT DESCRIPTION Application Page 2 How will your organization use the funding awarded? Describe the project, project objectives, those served, area serviced, and number of volunteers involved. Be specific. Include equipment or services that would be purchased and why. Include a detailed budget and a schedule of significant activities related to this project. You may attach a maximum of one double-spaced typewritten page of information. (Please type or print legibly.) A grant award from the City of Temecula would be put towards providing access to year-round sports training and competition programs to more than 200 individuals with intellectual disabilities in the Temecula community. Funds awarded will be put towards direct program expenses including sports equipment, team uniforms, transportation, facility rentals, and game fees. The two largest on-going expenses are transportation to local and state competitions and facility rentals. Of our athletes, 80% live at or below the poverty level, working part-time jobs and receiving government assistance to subsidize necessary living expenses such as food and rent. The overwhelming majority of our athletes could not afford the costs associated with participation in a sports program if fees were charged. Because of this, Special Olympics covers all program related expenses for both training and competition including the expenses previously mentioned. Special Olympics would not be able to exist as an organization without the commitment and enthusiasm of the more than 200 volunteers from the community. We are dependent on them to ensure that every athlete has a quality sports training and competition experience. Volunteer involvement is seen in every aspect of our organization from coaches to key leadership roles. Application Page 3 PAST PROJECT BENEFITS If your organization received City of Temecula funding in the previous year, please explain and show how Temecula residents benefited. Our programs have benefits for the athletes that participate, including increased physical health and higher self-confidence. In Temecula area there were 225 athletes participating in Aquatics, Track, Basketball, Bocce, Bowling, Golf, Gymnastics, Soccer, Softball, Tennis, and Volleyball this year. One of those athletes was Andrew. He is 12 years old and a little person. When he began participating in Special Olympics, he was shy and often felt ashamed of his disabilities. Now, he exhibits pride in himself and his accomplishments, which include gold, silver, and bronze medals from various local and Southern California wide competitions. He is a new young man, exhibiting self-confidence in ways his family hadn't seen from him before. Special Olympics taught him how to value himself. Athletes aren't the only ones that gain from our programs though. All her life, Erin watched as her sister Nicole participated in Special Olympics. She was moved by how much Nicole benefitted from being part of swimming, bowling and softball teams. She was so influenced by her sister that she has recently become a Special Education teacher in Murrietta and has become the coach of Nicole's softball and aquatics teams. The community gained through Special Olympics teams is not only life -changing for the athletes. As is clear through Erin's story, it is transformative for the coaches, families, and other volunteers in the city of Temecula. Application Page 4 SIGNATURE PAGE We hereby certify the information contained in this application is true to the best of our knowledge and belief. PREPARED BY: Kelsey Sullivan, Grant Writer and Donor Relations NAME and TITLE (Please Print or Type) g - SIGNATURE: -14).11' PRESIDENT or AUTHORIZED OFFICER: SIGNATURE: Bill Shumard, President and CEO NAME end TjITA (Please Print or Type) ORGANIZATION NAME: Special Olympics Sbuthern California MAILING ADDRESS: 41880 Kalmia Street, #155, Murrieta, CA 92562 TELEPHONE: (951) 703-6502 EMAIL ADDRESS: sreed@sosc.org DATED THIS 21 of August , 2013 (Date) (Month) BE SURE TO INCLUDE THE ORIGINAL PLUS ONE COPY AND SUBMIT BY AUGUST 30, 2013 TO: Mail Completed Applications to: Or Deliver in Person to: City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office Post Office Box 9033 Temecula, CA 92589-9033 City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office 41000 Main Street Temecula, CA 92590 Application Page 5 Temecula Valley Area August 21, 2013 City of Temecula Community Service Funding City Manager's Office P.O. Box 9033 Temecula, CA 92589-9033 RECEIVED AUG 2 e CITY MANAGER'S FICE Special 1��N Olympics Southern California i r To Whom It May Concern: Kevin, 25, was elected prom king in high school, competes in basketball, takes classes at a local community college, and works at Del Taco. He also has Down Syndrome. His family credits his many accomplishments to his participation in Special Olympics where he has been an athlete for over 10 years. Kevin is a walking billboard for the program. Known for his contagious smile and a Special Olympics medal around his neck, people gravitate towards him and routinely ask about his basketball team. He uses this to his advantage to enlist new volunteers and athletes into the programs. Through his recruitment efforts, Kevin has gained a new assistant coach, 15 tournament volunteers, and a large cheering section at his basketball games. In the City of Temecula and the surrounding towns, over 225 individuals with intellectual disabilities just like Kevin find opportunities for improved health, fitness and social interaction through their involvement in Special Olympics. Founded on the belief that people with intellectual disabilities can learn, enjoy and grow from participation in individual and team sports, Special Olympics provides the structure and encouragement critical to their success. Through the mastery of sport, our athletes achieve new levels of self-confidence in their physical, mental, and social abilities. We respectfully request $5,000 over the next year from The City of Temecula Community Service Funding to support sports training and competition in order to help Special Olympics programs in the City of Temecula — and athletes like Kevin — grow and thrive. On behalf of the athletes, families and volunteers of Special Olympics Inland Empire, we would like to thank you for making opportunities such as the one presented by the City of Temecula to assist organizations like ours achieve our goals. Sincerely Kelsey Sullivan Grant Writer Special Olympics Southem California - Temecula Valley Area 27475 Ynez Road Ste 174, Temecula, CA 92591 Tel 951-461-6568 Fax 951-461-1815 www.sosc.org/temecula Created by the Joseph P. Kennedy Jr. Foundation for the benefit of persons with intellectual disabilities Betsy Lowrey From: Betsy Lowrey Sent: Monday, September 30, 2013 5:29 PM To: Chuck Washington; Mike Naggar Cc: Aaron Adams; Kevin Hawkins; Jennifer Hennessy Subject: FW: Special Olympics Mayor Naggar and Council Member Washington - Abbey Leffler of Special Olympics confirmed (below) this morning that the $2500 CSF Grant allocated to Special Olympics during FY12-13 was applied towards the benefit of 80 athletes who reside within the City of Temecula. FYI below. Thank you, Betsy Lowrey Betsy Lowrey Sr. Management Analyst City of Temecula (951) 693-3959 betsy.lowreyAcityoftemecula.orq From: Betsy Lowrey Sent: Monday, September 30, 2013 9:48 AM To: 'Abbey Leffler' Subject: RE: Special Olympics Thanks Abbey — Thank you for clarifying on the phone that the monies below were specifically spent on Temecula Special Olympic residents: • $500 - Uniforms: Uniforms were purchased for athletics and tennis teams. • $750 — Transportation: Vans were rented to transport Temecula athletes to the Summer Games Championship in June. • $500 - Games Fees — Paid a portion of the games fees for City of Temecula athletes to attend Summer Games and Fall Games. • $750 — Facility Rentals — Paid the facility rental for athletics, tennis and golf for weekly practices. Regards, Betsy Lowrey Betsy Lowrey Sr. Management Analyst City of Temecula (951) 693-3959 betsy.IowreyCa?cityoftemecula.orq From: Abbey Leffler [mailto:alefflerPsosc.orq] Sent: Monday, September 30, 2013 9:41 AM To: Betsy Lowrey Subject: Special Olympics Good Morning" It was just brought to my attention that this information was not sent to you while I was out of the office last week. My apologies. Thank you for giving us the opportunity to address this question with more detailed information. If you need more information or have any questions, please feel free to contact me. In 2012, we received a $2,500 grant from the City of Temecula. Funds were vital to supporting our athletes and programs in the City. Last year, we had 80 athletes who lived in the City of Temecula and an additional 150 athletes who live in the surrounding cities in Temecula Valley who competed in the sports of aquatics, athletics (track &field), basketball, bocce, golf, soccer and tennis. Athletes had the opportunity to train in sports on a weekly basis under the supervision of a volunteer coach. During each practice, athletes learned sports skills, improved their physical fitness level, and increased their overall well-being. Each team also had the opportunity to travel to two competitions each season where they competed against athletes of similar age and skill level. Some teams even advanced to the Summer Games Championship at Cal State University Long Beach and the Fall Games Championship in Fountain Valley. Grant funds from the City of Temecula were used to in the following ways: • $500 - Uniforms: Uniforms were purchased for athletics and tennis teams. • $750 — Transportation: Vans were rented to transport Temecula athletes to the Summer Games Championship in June. • $500 - Games Fees — Paid a portion of the games fees for City of Temecula athletes to attend Summer Games and Fall Games. • $750 — Facility Rentals — Paid the facility rental for athletics, tennis and golf for weekly practices. Funding from the City of Temecula also ensured that we were able to offer all programs free of charge to our athletes. We are so thankful for the City of Temecula's on-going support and we look forward to growing our relationship over the coming year. Sincerely, Abbey Leffler Regional Director Special Olympics Southern California Inland Empire Region 41880 Kalmia Street #155 Murrieta, CA 92562 951.703.6502 Office 951.461.0800 Fax 951.236.7050 Cell www.sosc.org 2 1 Return to Search Exempt Organizations Select Check Page 1 of 1 .Ye IRS Exempt Organizations Select Check armlet Oroanizakons Select Check Home Organizations Eligible to Receive Tax -Deductible Contributions (Pub. 78 data) - Search Resuks The following NM Includes tax-exempt organizations that are eligible to receive tax-deductble contdbutlons. Click on the "Dedudtbilly Status` column for an explanation of limitations on the deductltklity of contributions made to different types of tax-exempt organizations. Results are sorted by EIN. To sod results by another category, click on the Icon next to the column heading for that category. Clicking on that icon a second tkne wlk reverse the sort order. Oki( on a column heading for an explanation of Information in that column. 1.1 of 1 moults EIN Le2SiName (Dong 811111111111111 At) A. Special Olympics Southern California inc. Results Per Page 25 gy- long Beach ePrey I1.1!Next » State ..Country D9040.Status A CA United Stales PC e Prev 11.1 I Next » http://apps.irs.gov/app/eo s/pub78Search.do?ein 1=95453 8450&names=&city=&state=CA&c... 9/9/2013 6if �� Depniium ea of the Tr3ury w 6p 1 lulcrnal Itvvolue Servirc P.Q. Box 2508 Cincinnati OH 45201 004302 SPECIAL OLYMPICS SOUTHERN CALIFORNIA INC 6730 E CARSON ST LONG BEACH CA 90808-2256 In reply refer to: 0248662390 May 10, 2011 LTR ',168C E0 95-4538450 000000 00 00023268 BODC: TE Employer Identification Number: Person to Contact: MR. PATTERSON Toll Free Telephone Number: 1-877-829-5500 Dear TAXPAYER: This is in response to your Apr. 29, 2011, request for information regarding your tax-exempt status. Our records indicate that you were recognized as exempt under section 501(c)(3) of the Internal Revenue Code in a determination letter issued in MAY 1996. Our records also indicate that you are not a private foundation within the meaning of section 509(a) of the Code because you are described in section(s) 509(a)(1) and 170(b)(1)(A)(vi). Donors may deduct contributions to you as provided in section 170 of the Code. Bequests, legacies, devises, transfers, or gifts to you or for your use are deductible for Federal estate and gift tax purposes if they meet the applicable provisions of sections 2055, 2106, and 2522 of the Code. Please refer to our website www.irs.gov/eo for information regarding filing requirements. Specifically, section 6033(j) of the Code provides that failure to file an annual information return for three consecutive years results in revocation of tax-exempt status as of the filing due date of the third return for organizations required to file. We will publish a list of organizations whose tax-exempt ctatlte wac ravnkeci under section 6033(i) of the Code on our website If you have any questions, please call us at the telephone number shown in the heading of this letter. Sincerely yours, S. A. Martin, Operations Manager Accounts Management Operations City of Temecula 2013-14 CS Funding Program APPLICATION NO. 22 CITY OF TEMECULA FISCAL YEAR 2 01 3-1 4 GITYOFFICE R'S COMMUNITY SERVICE FUNDING PROGRAM APPLICATION (Please Print or Tvoe) 2013-14 Program Submission Deadline: Friday, August 30, 2013 (original, plus one copy) PROJECT INFORMATION Amount Requested: $ 2,200.00 Project Name: Access to Breast Health Education & Resources Project Start Date: December 1, 2013 (Maximum allowable $5,000) Project End Date: June 29, 2014 ORGANIZATION INFORMATION Name of Organization: Susan G. Komen® Inland Empire Contact Name: Sarah Bryant Title/Position: Mission Programs Manager Mailing Address: 43397 Business Park Dr., Ste. D-9, Temecula, CA 92590 Telephone: 951-676-7465 Number of Paid Staff: 6 Year Organization Founded: 1996 Number of Volunteers: 800+ Geographic Area(s) Served: Riverside and San Bemardino Counties Is this organization incorporated in California as a non-profit organization? Yes X No Effective Date: April 17, 1998 If "yes" (Must provide a copy of your statement of non- profit status from the State of California): Date of incorporation as a non-profit: November 3, 1983 Federal identification number: If "no": Name of sponsoring organization: Federal identification number: State identification number: This application has been authorized by the organization's: Executive Committee X Board of Directors Application Page 1 Members -at -Large FY 2012-13 COMPLIANCE REQUIREMENT IF YOUR ORGANIZATION WAS A RECIPIENT OF FUNDING FOR FY 2012-13, PLEASE ATTACH COPIES OF INVOICES, RECEIPTS AND CANCELLED CHECKS TO SUBSTANTIATE THOSE FUNDS RECEIVED AND EXPENDED BY YOUR ORGANIZATION. FINANCIAL STATEMENTS PLEASE ATTACH COPIES OF THE CURRENT BUDGET OF THE ORGANIZATION AND FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT). It does not require a CPA's audit, but please submit if available. MISSION STATEMENT Briefly describe the goals and objectives of your organization and community services it provides. Describe the ways your organization meets the criteria listed on page 2 of the CS Funding Policy. Please see attached. PROJECT DESCRIPTION Application Page 2 Inland Empire Affiliate of Susan G Komen Current Month Actuals Balance Sheet as of 2013-07-31 Assets Cash - Operating 1 Cash - Operating 2 Cash • Operating 8 Petty Cash 1 Cash & Short Term Investments Current Month Notes: Report Run Date & Time - 8/17/2013 17:53 Inland Empire Affiliate Report Run By 2KBARRALES2 2013-07-31 09 100.00 Union Bank checking 400,575,56 Union Bank Money Market 162,357.73 Chase 250.00 563,283.29 Long Term Investments 0.00 Deposits 1,632.00 Prepaids & Deposits 1,632.00 Credit Cards in Transit )531 CJs-) Receivables (531.00) Inventory Net Inventory 3,970.25 3,970.25 Other Assets 0.00 Equipment Fixed Assets 4,007.00 4,007.00 Amin. Dept - Equipment (4.007 00) Accumulated Depreciation (4.007 00) Total Assets 588,354.54 Liabilities and Net Assets Uebtlltles Accounts Payable Accounts Payable Payables to HO (Att. Use) Sales Tax Payable Other Payables Grants Payable Grants Payable 1,063.25 1,063.25 (1,794 11) Refund of research payment (1 62) (1.795 73) 285,214.04 285,214.04 Deferred Rent Expense 466.67 Other Liabilities 466,67 Total Liabilities 284.848.24 Net Assets Unrestricted 236,891.31 Temporarily Restricted 46,515.00 Permanently Restricted 0.00 Total Net Assets 283,406.31 Total Liabilities end Net Assets 568,354,54 Net Assets Detail Unrestricted Opening Batance Unrestricted Activity 265,066.47 (28.195 16) Temporarily Restricted Opening Balance 46,515,00 Temporarily Restricted Activity 0.00 Permanently Restricted Opening Balance Permanently Restricted Activity 0.00 0.00 Page 1 0 Mission Statement: Kamen Inland Empire was founded in Temecula in 1996, incorporated in 1998, and held its first Race for the Curee in 1999. We continue to serve the community with dedication and passion to further the Komen Promise: to save lives and end breast cancer forever, by empowering people, ensuring quality care for all and energizing science to find the cures. Komen Inland Empire has 4 full time staff, 2 part time staff, and over 800 volunteers annually. Furthermore, we are guided by our working ten Board of Directors. Komen Inland Empire has served the city of Temecula since inception, and has garnered support of more than 10,000 community members annually. We have a four-star Charity Navigator rating, and pride ourselves in our stewardship of donor dollars. All fiscal activities are managed by qualified staff and overseen by our experienced Board of Directors. Seventy-five percent of the net proceeds from our Annual Komen Inland Empire Race for the Cure® remain in the Affiliate's service area to fund programs that provide access to breast health/breast cancer services, while twenty-five percent funds innovative breast cancer research. Additionally, the Affiliate hosts other year round fundraising and educational events to help support our investment to the community. Komen Inland Empire funds programs throughout the region for breast cancer screenings, diagnostic services, patient navigation, financial assistance, and treatment support. As the leader in breast health, Komen Inland Empire dedicates efforts towards education in the community. Our programs are available to all community members, regardless of age, gender, race, creed, color, nationality, marital status, disability, religion, or political affiliation. To receive assistance through Komen-funded programs, individuals are not required to participate in any fundraising activities. Every 2-3 years the Affiliate conducts a community needs assessment. This process involves data collection, surveys, focus groups, key informant interviews, etc. The collection and analysis of the data help us to identify any "gaps in services and programs" within the region and define the needs in our community. The outcome is a document called the "Community Profile", which illustrates the data outcomes and evidence -based plans designed to effectively address the breast health needs of the Inland Empire. The Community Profile serves as the "road map" for the Affiliate's grant funding, advocacy initiatives, education programs, and other strategic areas of our mission programs. All Komen programs undergo continuous quality improvement practices, as well as utilize regular program evaluation tools to determine the impact of our work in the community. 11 Page How will your organization use the funding awarded? Describe the project, project objectives, those served, area serviced, and number of volunteers involved. Be specific. Include equipment or services that would be purchased and why. Include a detailed budget and a schedule of significant activities related to this project. You may attach a maximum of ane double-spaced typewritten page of information. (Please type or print legibly.) Please see attached. Application Page 3 Project Description: Komen Inland Empire has provided breast health education and resources to the city of Temecula for 15 years. We have invested more than $2,090,000 in breast health programs serving Temecula city residents to date. In 2012, Komen iE touched the lives of more than 6,000 Temecula residents through breast health education, screenings, diagnostic services, patient navigation, financial assistance, and treatment support programs. Komen IE desires to increase our outreach efficiency with the use of up to date technology, therefore providing residents with timely resources to make informed decisions about their breast healthcare. Currently, we address linguistic and cultural barriers to understanding good breast health and access to quality breast health care. We teach the community to know your risk, get screened, know what is normal for you, and make healthy lifestyle choices. Our message is congruent with The Temecula 2030 Quality of Life Master Place. We aim to ensure that Temecula residents have access to excellent breast health information, medical facilities, qualified and knowledgeable medical staff, and quality breast health care services along the continuum of care. Komen Inland Empire kindly requests $2,200.00 to assist in the education and outreach efforts in the city of Temecula. With the requested dollars, we plan to purchase two projectors and two iPads to enhance our educational outreach initiatives in the city of Temecula. Komen IE has received one projector as a donation for our Breast Cancer Resource Center in Rancho Mirage, CA to expand our educational programs in the Coachella Valley region. However, we do not have the necessary items to expand in Temecula, the location of our Affiliate office. Komen staff and volunteers utilize projectors for breast health presentations, not only to the community at large, but also to specific groups, such as community health workers, seniors, and medical professionals. Our educational staff is responsible for conducting volunteer trainings in Temecula, engaging residents in activities to support their local community, as well as educational presentations to bring awareness and information about breast cancer. The use of iPads would greatly enhance our ability to directly link Temecula residents with breast health resources and tools in the community. Often times we are at a community outreach event and meet residents that are in need of resources. We are forced only to give them our business card, or take down their phone number to follow up regarding their needs. However, through the use of the iPads, mission staff would be able to directly connect a resident with breast cancer screenings, diagnostic service locations, support groups, financial assistance applications, risk - assessment tools, and more! iPads would assist Komen in reducing barriers to accessing care, helping to link Temecula residents with local businesses and resources to fulfill their breast health needs. Wage PAST PROJECT BENEFITS If your organization received City of Temecula funding in the previous year, please explain and show how Temecula residents benefited. Susan G. Kamen® Inland Empire was not a recipient of funds from the City of Temecula Community Service Funding Program in 2012-2013. Application Page 4 SIGNATURE PAGE We hereby certify the information contained in this application is true to the best of our knowledge and belief. PREPARED BY: Sarah Bryant, Mission Programs Manager SIGNATURE: NAME and TITLE (Please Print or Type) PRESIDENT or AUTHORIZED OFFICER: �b•� Cai I l t - 4 r A PPI. L°- "Prc-� NAME and TtTL (Please Print or Type) SIGNATURE: ORGANIZATION NAME: TtL c„ Susan G. Komen® Inland Empire MAILING ADDRESS: 43397 Business Park Drive, Ste. D-9, Temecula, CA 92590 TELEPHONE: 951-676-7465 EMAIL ADDRESS: sbryant@komenie.org DATED THIS 29 of August (Date) (Month) , 2013 BE SURE TO INCLUDE THE ORIGINAL PLUS ONE COPY AND SUBMIT BY AUGUST 30, 2013 TO: Mail Completed Applications to: Or Deliver in Person to: City of Temecula Community Service Funding Program Attn: Eva Pharis 1 City Manager's Office Post Office Box 9033 Temecula, CA 92589-9033 City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office 41000 Main Street Temecula, CA 92590 Application Page 5 IRS Tax Determination Letter Internal Revenue Service Department of the Treasury District Director Dile: t OV 0 3 1983 The Susan G. Kamen Foundarian, Inc. 2700 Republic Bank Tower Dallas. TX 75201 Employarrdentllfcotlun Nvmbar Accounline Pend Ending; June 30 Vorrn 990 Roquired; 121 Yey n Ne Pian th eantart EO Technical Assistor Compri Tukphone +lumbar. 214 767,2728 E0:7215:MW Dear Applicant: Based an information supplied, and aasusirg your operations will be as Stated to your application for recognition of exemption, we have determined you Are exempt from Federal incoarb tax under section 5024W3) of the Internal Revenue Cods. We have further determined that you are not a private foundation within tri aeaning cf section 5091al cf the Code, boeauso you Urf an organization described in section 509(a)(2) and 170(b)(1)(A)(v1). If your sources of support, or your purposes. character, or method of operation change, please let us know so we can consider the effect of the change On your exempt status and foundation :status, Also, you should inform us of all charigee in your name or address. Generally, you are not liable for aerial security (FICA) tars unless you file a waiver of ezemption certificate as provided in the t" dethi Insurance Contributions Act, If you have paid FICA taxes ,:itreut filing the waiver, you should contact u;_ You aro not liable for the' tax imposed under the Federal Unemployment Tax Act (FUTA). Since you are not a private foundation, you are not subject to the excise !axes Anger Chapter 42 of•the Cade. However, you are not autaratioalLy •xen'+pt from ether 5ederal excise taxes. If you have any questions about excise, seplcyment, or other Federal taxes, please lot us know. Donors may deduct contributions to'you as provided In stiction 170 of the Code. Requeata, legacies, devises. transfers, or gifts to yo•., or for your use are deductible for Federal estate and gift tax purposes if they meet the applicable pravisiene of aectioas 2055, 210e, and 2522 of the Code. Forc T1 of this Tette f 0r saltation xem ax. f Yes s chocks ,._t ••r on ualacco• • a rDU ' of the'fitth month after the east of tour annunt,e in riod. o law im oie� n"ZfWMNTrImPr'S _ . up o a cal. n a Thn unless -there is reasonable cause for the delay. required to file ora 1100 Camrnetcn St,, Dallas, Texas 75242 LetterS47(D0) (5-7 The Susan G. Komen Breast Cancer Foundation 112004 Affiliate President's Guide 158 You are not required to file Federal income tax returns unless you ars subject to the tax on unrelated business income under section 511 of the Code. If you are subject to this tax. you must file an income tax return on Form 990—T. In this letter, we are not determining xhsther any of your present or proposed'aGtivitles are unrelated trade .pr business as defined in section 513 of the Code. You need an employer identification number even if you have ne employees. If an employer identification number was net entorod en your application. a number will be aesigned to you and you will be advised or it. Please use that nutter on alt returns you file and in all correspondence with the InternalI'Rev'enue Service. Eeoause thin letter oeuld help resolve any que�tiona anent your exempt status and foundation statue. you should keep it in your permanent records. • If you have Jny 4ueatlone. please Contact the pv:bu++ wi+c.,e nain:e and to senora number are shown in the heading of this'letter. Sincerely yours, GL$N! .0ACLE• Di5TRLCT DIRECTOR ♦ For tax years ending an and after December ]l, on, organizations vhcse gross receipts are not normally more than $25,000 are excused from filing Form 990. For g.iidance in determining if your gross receipts are 'normally" not more than the $25,000 1tmtt, see the inetrections far the Norm 990. Beginning January 1, 1964, unless specifically extepred, you must pad Laze9 under the Federal Insurance Contributions Act (social security tants) for ee h employe* who to paid $100 or more in n caiondaf year. letter 947(00) (5-•77) The Susan G. Komen Breast Cancer Foundation 1/2004 Affiliate President's Guide 159 Susan G Komen Breast Cancer Foundation Inland Empire Affiliate 2014 Operating Budget Cost of Operations Salaries & Benefits $ 233,068.00 Professional Fees $ 40,868.00 Fundraising exp - other than race $ 1,310.00 Regulatory and Service fee $ 1,600.00 advertising and public relations $ 1,500.00 Occupancy/Office $ 45,952.00 Travel $ 30,390.00 Equipment/Software $ 2,496.00 Total Operating Costs $ 357,184.00 Cost of Event Advertising and Public Relations $ 1,050.00 Race for the Cure Event $ 119,650.00 Mailing/Office/Equipment $ 34,042.00 Professional Fees $ 11,790.00 Service Fees $ 24,000.00 Staffing $ 29,448.00 Total Events Costs $ 219,980.00 Community grants $ 680,684.00 Staffing $ 42,252.00 Community grants $ 722,936.00 Total Affiliate Budget $ 1,300,100.00 Exempt Organizations Select Check Page 1 of 1 IRS Exempt Organizations Select Check Exempt Oraenlzeltons Select Check Home Organizations Eligible to Receive Tax-DeducUble Contributions (Pub. 78 date) - Search Results The following list Includes tax-exempt organizations that are eaglble to receive tax-deductible contributions. CNck on the "Deductibility Statue" cokrmn for an explanation of kmRadon& on the deducUDNity of contributions made to different types of tax-exempt organization, Results ere sorted by EIN To son results by another category, click on the icon next 10 the column heading for that category. Clicking on that Icon a second Erne will reverse the sort order. Click one column heading for an explanation of Information In that column. 1.1 of 1 results Results Per Page 25 1 OK I x Prev I 1-1 I Noxi x Susan G Komen Breast Cancer Foundation Dallas TX United States GROUP 1 Return to Search) it Prev 1.1 Next r http://apps. irs.gov/app/eos/pub78 Search.do?ein 1=75183 5298&names=&city=&state=A11 9/11/2013 City of Temecula 2013-14 CS Funding Program APPLICATION NO. 23 RECEIVED AUG 1 it 2119'; CITY OF TEMECULA FISCAL YEAR 2013-14 COMMUNITY SERVICE FUNDING PROGRAM APPLICATION (Please Print or Tvpe) CITY MANAGER'S OFFICE 2013-14 Program Submission Deadline: Friday, August 30, 2013 (original, plus one copy) PROJECT INFORMATION Amount Requested: $ 5000.00 Project Name: Temecula Pantry (Maximum allowable $5,000) Project Start Date: 7/01/2013 Project End Date: 6/30/2014 ORGANIZATION INFORMATION Name of Organization: TEAM Evangelical Assistance Ministries DBA Temecula Pantry Contact Name: Randy Taylor Title/Position: President Mailing Address: 28922 Pujol Street. Temecula. Ca. 92590 Telephone: 951-676-8022 Year Organization Founded: 1987 Number of Paid Staff: 1 Number of Volunteers: 40 Geographic Area(s) Served: Temecula, Murrieta Is this organization incorporated in California as a non-profit organization? Yes X No Effective Date: 1987 If "yes" (Must provide a copy of your statement of non- profit status from the State of California): Date of incorporation as a non-profit: 2-19-19878 Federal identification number: Name of sponsoring organization: Federal identification number: State identification number: This application has been authorized by the organization's: Executive Committee Board of Directors x Application Page 1 Members -at -Large fatE (California marc but Eu , errettrrg of tante STATEMENT BY DOMESTIC NONPROFIT CORPORATION P.O. Box 2830 Sacramento. CA 95812 Phone: (916) 445.2020 THIS STATEMENT MUST BE FILED Wf1H CALIFORNIA SECRETARY OF STATE (SECTIONS 6210. 8210. 9660 CORPORATIONS COOE) DUE DATE: 2-19-87 1391980 TEAM EVANGELICAL ASSISTANCE MINISTRIES OF RANCHO-TEMECULA-MURRIETA VALLEYS DO NOT ALTER PREPRINTED NAME. IF ITEM 1 1S BLANK. PLEASE ENTER CORPORATE NAME DO NOT WRITE IN THIS SPACE PLEASE READ INSTRUCTIONS ON {SACK OF FORii. PLEASE TYPE C USE Bi_AC2s", INK .":I -;:CH l',!QJLD PE SU/TABLE FOR !.",iC.ROFILNINC. S=EE FOR FLING THIS S T A i Ei.1ENT — S2.50. THE CORPORATION NAMED HEREIN, ORGANIZED UNDER THE LAWS OF THE STATE OF CALIFORNIA, MAKES THE FOLLOWING STATEMENT: STREET ADDRESS Of HIINCYAL OFPICY OF NOM. CO4PL[18 3-30 41945 Fifth St. (Do NOT USE P.O. BOX N0.) /4.111 OR 110014 - 2.A. Temecula, CA CITY AND STATE 20. 92390 ZIP C%OOe i. RAILING ADORI Ia (OPTIONAL) 41945 Fifth St. 'sum( on ROOM - 3A. Temecula, CA CITY ANO STATE 35. 92390 ZIP CODE 1. NAMES OF THE FOLLOWING OFFICERS ARE: John H. Stanley CHIEF EXECUfve OFFICER 4 27895-L Diaz Rd. OUSINESS 011 RESIDENCE ADDRESS (DO NOT USE P.O. 5016 45. Temecula, CA CITY AND STATE T.J. Mercer SECRETARY SA. 28030 Del Rio Rd. BUSINESS OR RESIDENCE ADDRESS (DO NOT USE P.O. 50X) 5e. Temecula, CA Roger Brewer C.IFEF PWANCIAL OFFICER 6A. 29141 Vallejo Ave. BUSINESS OR RESIDENCE ADDRESS (DO NOT USE P.O. 804 AGENT FOR SERVICE OF PROCESS; John H. Stanley CITY ANO STATE 60. Temecula, CA CITY AND STATS 4c. 9239C ZIP CODE Sc. 9239C P Cooc 6C. 9239C AP CODE 27895-L Diaz Rd. Temecula, CA 92390 SMA, OUSWE33 OR ResIDENCE ADDRESS IF AN INDIVIDUAL (DO NOT USE P.O. BOX) ONLY ONE AGENT CAN 5E NAM£O. DO NOT INCLUDE ADDRESS IF AGENT A CORPORATION. I DECLARE TRAY 1 HAVE EXAMINED THIS STATEI/,i.77T ANO TO THE BEST OF NY XNOWLEOGE AND DEUEF. IT 13 TRUE. CORRECjANq COMPIXTE INTERNAL REVENUE SERVICE DISTRICT DIRECTOR 2 CUPANIA CIRCLE MONTEREY PARK, CA 91755-7406 Date: OCT 28 1991 TEAM EVANGELICAL ASSISTANCE MINISTRIES OF RANCHO-TEMECULA- MURRIETA VALLEY P 0 BOX 1002 TEMECULA, CA 92593 Dear Applicant: DEPARTMENT OF THE TREASURY Employer Identification Number: Case Number: 953266046 Contact Person: TERRY IZUMI Contact Telephone Number: (213) 725-6619 Accounting Period Ending: December 31 Form 990 Required: yes Addendum Applies: • Nc Based on information supplied, and assuming 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)(3). we have further determined that you are not a private foundation within the meaning of section 509(a) of the Code, because you are an organization described in sections 509 (a) (1) and 170 (b) (1) (A) (vi) _ If your sources of support, or your purposes, character, or method of operation change, please let us know so we can consider the effect of the change on your exempt status and foundation status. In the case of an amend- ment to your organizational document or bylaws, please send us a copy of the amended document or bylaws. Also, you should inform us of all changes in your name or address. As of January 1, 1984, you are liable for taxes under the Federal Insurance Contributions Act (social security taxes) on remuneration of $100 or more you pay to each of your employees during a calendar year. You are not liable for the tax imposed under the Federal Unemployment Tax Act (FUTA). Since you are not a private foundation, you are not subject to the excise taxes under Chapter 42 of the Code. However, you are not automatically exempt from other Federal excise taxes. If you have any questions about excise, employment, or other Federal taxes, please let us know. Grantors and contributors may rely on this determination unless the Internal Revenue Service publishes notice to the contrary. However, if you lose your section 509(a) (1) status, a grantor or contributor may not rely on this determination if he or she was in part responsible for, or was aware of, the act or failure to act, or the substantial or, material change on the part of the organization that resulted in your loss of such status, or if he or she acquired knowledge that the Internal Revenue Service had given notice that you would no longer be classified as a section 509(a) (1) crganization. Letter 947 (DO/CG) -2 - TEAM EVANGELICAL ASSISTANCE Donors may deduct contributions to you as provided in section 170 of the Code. Bequests, legacies, devises, transfers, or gifts to you or for your use are deductible for Federal estate and gift tax purposes if they meet the applicable provisions of Code sections 2055, 2106, and 2522. Contribution deductions are allowable to donors only to the extent that their contributions are gifts, with no consideration received. Ticket pur- chases and similar payments in conjunction with fundraising events may not necessarily qualify as deductible contributions, depending on the circum- stances. See Revenue Ruling 67-246, published in Cumulative Bulletin 1967-2, on page 104, which sets forth guidelines regarding the deductibility, as chari- table contributions, of payments made by taxpayers for admission to or other' participation in fundraising activities for charity: In the heading of this letter we have indicated whether you must file Form 990, Return of Organization Exempt From Income Tax. If Yes is indicated, you are required to file Form 990 only if your gross receipts each year are normally more than $25,000. However, if you receive a Form 990 package in the mail, please file the return even if you do not exceed the gross receipts test. If you are not required to file, simply attach the label provided, check the box in th€ heading to indicate that your annual gross receipts are normally $25,000 or less, and sign the return. If a return is required, it must be filed by the 15th day of the fifth month after the end of your annual accounting period. A penalty of $10 a day is charged when a return is filed late, unless there is reasonable cause for the delay. However, the maximum penalty charged cannot exceed $5,000 or 5 per- cent of your gross receipts for the year, whichever is less. This penalty may also be charged if a return is -not complete, so please be sure your return is complete before you file it. You are not required to file Federal income tax returns unless you are subject to the tax on unrelated business income under section 511 of the Code. If you are subject to this tax, you must file an income tax return on Form 990-T, Exempt Organization Business Income Tax Return- Ir. this letter we are not determining whether any of your present or proposed activities are unre- lated trade or business as defined in section 513 of the Code. You need an employer identification number even if you have no employees. If an employer identification number was not entered on your application, a number will be assigned to you and you will be advised of it- Please use that number on all returns you file and in all correspondence with the Internal Revenue Service. If we have indicated in the heading of this letter that an addendum applies, the enclosed addendum is an integral part of this letter. Because this letter could help resolve any questions about your exempt status and foundation status, you should keep it in your permanent records. Letter 947 (DO/CG) -3 - TEAM EVANGELICAL ASSISTANCE If you have any questions, please contact the person whose name and telephone number are shown in the heading of this letter, Since • 1 , yours, Richard R. Bros District Director Letter 947 (DO/CG) FY 2012-13 COMPLIANCE REQUIREMENT IF YOUR ORGANIZATION WAS A RECIPIENT OF FUNDING FOR FY 2012-13, PLEASE ATTACH COPIES OF INVOICES, RECEIPTS AND CANCELLED CHECKS TO SUBSTANTIATE THOSE FUNDS RECEIVED AND EXPENDED BY YOUR ORGANIZATION. FINANCIAL STATEMENTS PLEASE ATTACH COPIES OF THE CURRENT BUDGET OF THE ORGANIZATION AND FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT). It does not require a CPA's audit, but please submit if available. MISSION STATEMENT Briefly describe the goals and objectives of your organization and community services it provides. Describe the ways your organization meets the criteria listed on page 2 of the CS Funding Policy. SEE ATTACHMENT PROJECT DESCRIPTION Application Page 2 MISSION STATEMENT TEAM Evangelical Assistance Ministries, DBA Temecula Community Pantry, is a non-profit organization located in Old Town Temecula since 1987. We provide assistance to the homeless and low-income families in Temecula and Murrieta. 90% of the families we serve live in Temecula. We are open Monday, Wednesday and Friday for the distribution of donated food from food drives, surplus foods from local markets, donated clothing and household goods. We are supported by local churches, schools, businesses and individuals. The day-to-day operation is supervised by the Board of Directors. 5 members of the Board are on the premises every day. Our goal is to help our clients with their immediate needs in all areas. We try to reunite the homeless with their families and, with the help of Greyhound Bus, we provide bus tickets for that purpose. We partner with Victory Outreach in Aguanga. They provide homeless men with a year-long rehabilitation program. Any of our Clients can receive free eyeglasses from LensCrafters, we also have local Drs. and Dentists who offer their services at a discounted cost to the Pantry. We refer new Clients to government agencies who can help them and provide assistance until they can receive unemployment, food stamps, etc. If a family needs housing we help them find rentals that they can afford. The Pantry welcomes all who come to our door, regardless of race, sex, marital status, disability, religion or political affiliation. Clients are asked for a picture I.D. showing they live in Temecula or Murrieta. We also ask for proof of income to make sure they fall into the guidelines set by the federal government. If they have children we ask for their ages so they can receive Christmas toys and Easter Baskets and Back -too -School backpacks. TEMECULA-MURRIETA COMMUNITY PANTRY 2013 BUDGET INCOME: CHURCHES $14,000.00 BUSINESSES 6,000.00 GRANTS 20,000.00 INDIVIDUALS 25,000.00 EXPENSES: ADMINISTRATIVE: SALARY $25,800.00 PAYROLL TAXES 2,000.00 INSURANCE 1.500.00 FACILITIES: INSURANCE -LIABILITY $ 2,500.00 TELEPHONE & UTILITIES 5,000.00 MAINTENANCE 1,500.00 OFFICE EXPENSES 2,500.00 AUTO & GAS 2,400.00 MINISTRY: FOOD /SUPPLIES $ 20,000.00 LODGING 300.00 TRANSPORTATION 500.00 SPECIAL NEEDS 1,000.00 $ 65,000.00 $ 29,300.00 $13,900.00 $ 21,800.00 TOTAL ALL EXPENSES $ 65,000.00 10:54 AM 08/05/13 Accrual Basis TEMM EVANGELICAL ASSISTANCE MINISTRY Balance Sheet As of June 30, 2013 ASSETS Current Assets Checking/Savings Bank of America Jun 30, 13 11,491.17 Total Checking/Savings 11,491.17 Total Current Assets 11,491.17 Fixed Assets 1640 • Furniture, fixtures, & equip 8,672.00 1745 • Accum deprec- furn,fix,equlp -2,323.00 Total Fixed Assets 6,349.00 TOTAL ASSETS 17,840.17 LIABILITIES & EQUITY Liabilities Current Liabilities Other Current Liabilities 2112 • Accrued Payroll -State 80.53 2130 • Accrued payroll taxes 978.60 2132 • Accrued FIT 484.28 Total Other Current Liabilities Total Current Liabilities 1,543.41 1,543.41 Total Liabilities 1,543.41 Equity 3001 • Opening Bal Equity 6,701.28 3010 • Unrestrict(retained earnings) 21,572.44 Net Income -11,976.96 Total Equity 16,296.76 TOTAL LIABILITIES & EQUITY 17,840.17 Page 1 10:50 AM TERM EVANGELICAL ASSISTANCE MINISTRY 08/05/13 Profit & Loss Accrual Basis July 2012 through June 2013 Ordinary Income/Expense Income 4 • Contributed support 4010 • Indilviduals 4140 • Donated art, etc 4210 • Business Donation 4230 • Grants 4420 • Churches Total 4 • Contributed support 5 • Earned revenues 5310 • Interest-savings/short-term inv Total 5 • Earned revenues Total Income Expense 7000 • Grant & contract expense 7050 • Specific assistance - ind Total 7000 • Grant & contract expense 7200 • Salaries & related expenses 7210 • Officers & directors salaries 7250 • Payroll taxes Total 7200 • Salaries & related expenses 7500 • Other personnel expenses 7540 • Professional fees - other 7580 • lnsurance-Workmans's Comp Total 7500 • Other personnel expenses 7582 • Insurance -Medical 8100 • Non -personnel expenses 8110 • Office Supplies 8120 • Groceries 8130 • Telephone & telecommunications 8140 • Postage, shipping, delivery 8160 • Supplies 8170 • Backpack Ministry Total 8100 • Non -personnel expenses 8200 - Occupancy expenses 8220 • Utilities 8230 • Real estate taxes Total 8200 • Occupancy expenses 8300 • Travel & meetings expenses 8310 • Gasoline 8320 • Conference,convention,meeting Total 8300 • Travel & meetings expenses 8340 • Car Allowance 8400 • Depreciation & amortization exp 8450 • Deprec & amort - allowable Total 8400 • Depreciation & amortization exp 8500 • Misc expenses 8510 • Interest expense - general 8520 • Insurance 8560 • Outside computer services 8590 • Other expenses 8500 • MIsc expenses - Other Total 8500 Misc expenses Jul '12 - Jun 13 21,151.68 35.00 5,526.19 11, 854.07 14,630.00 53,196.94 1.55 1.55 53,198.49 1,390.20 1,390.20 23,350.00 1,786.22 25,136.22 30.00 772.00 802.00 1,596.00 688.63 10,517.14 3,646.73 51.00 3,013.35 370.00 18,286.85 5,593.46 226.42 5,819.88 2,450.00 40.00 2,490 00 2,460.00 2,323,00 2,323.00 7.50 2,018.50 1,035.59 6.00 28.00 3,095.59 Page 1 10:60 AM TEMM EVANGELICAL ASSISTANCE MINISTRY 08/05/13 Profit & Loss Accrual Basis July 2012 through June 2013 8600 • Business expenses 8650 • Taxes - other Jul '12 - Jun 13 -27.80 Total 8600 • Business expenses -27.80 Total Expense 63,371.94 Net Ordinary Income -10,173.45 Net Income -10,173.45 Page 2 How will your organization use the funding awarded? Describe the project, project objectives, those served, area serviced, and number of volunteers involved. Be specific. Include equipment or services that would be purchased and why. Include a detailed budget and a schedule of significant activities related to this project. You may attach a maximum of one double-spaced typewritten page of information. (Please type or print legibly.) SEE ATTACHMENT Application Page 3 PROJECT DESCRIPTION If the Pantry receives this funding we will use the money to purchase food items. We currently have 903 families registered with the Pantry. In 2012, 531 families received food boxes at least once . These boxes contained 24 meals for each family member, or 29,376 individual meals. These families can come to the Pantry every Monday, Wednesday and Friday and receive fresh food items donated to us. In 2012 7,089 repeat families of 17,957 individuals received 55,236 fresh food bags. At Thanksgiving, Christmas and Easter 697 families, 1823 individuals, received 5,469 meals. We also serve meals to an average of 20 homeless each day. The total value of food distributed in 2012 was $398,000.00. We have to purchase items that we do not receive in food drives or from the local markets, restaurants, bakeries and growers who support us with fresh items each week. Many of our Clients, like our senior neighbors on Pujol St. count on us to supplement their food needs. The average income of our families is $15,000.00 a year. 12% are seniors, 30% homeless, 55% are families with 3.2 members. 50% are White, 30 % Hispanic, 5% African American and 5% Asian. 10% are Other. We hope to restart our "Milk & Eggs Fridays" program. On Fridays we average 80 families who come to us for food for the weekend. We have to purchase the milk and eggs and the cost of this is $300.00 a week. We work together with other organizations and our 40 active volunteers represent many of the churches in the Valley. Local churches, service organizations, and businesses are the major support we have for food drives, toy drives, backpacks supplies, and cash donations. PAST PROJECT BENEFITS If your organization received City of Temecula funding in the previous year, please explain and show how Temecula residents benefited. WE DID NOT RECEIVE FUNDING FOR PRIOR YEAR In all the prior years that we had received funding it was used to pay for utilities. When we didn't get funding this last year, one of our supporting churches, On Eagles Wings, paid for the utilities. This still left us without enough funding to continue our Friday "Milk and Eggs" distribution after January 1, 2013. This meant that approximately 100 families, 350 individuals did rent rereive these cnmmndities each week frnm 1/1/13 through 6/311/13 Application Page 4 SIGNATURE PAGE We hereby certify the information contained in this application is true to the best of our knowledge and belief. PREPARED BY: Carole Murphy, Treasurer NAME and TITLE (Please Print or Type) SIGNATURE: a, Az_ PRESIDENT or AUTHORIZED OFFICER: Randy Taylor, President SIGNATURE: NAME and TITLE (Please Print or Type) 1, clAr ORGANIZATION NAME: TEAM Evangelical Assistance Ministries DBA Temecula Pantry MAILING ADDRESS: 28922 Pujol St. Temecula, Ca. 92590 TELEPHONE: 951-676-8022 EMAIL ADDRESS: VonProsch@aol.com DATED THIS /" of ,e- , 2013 (Date) /(Month) BE SURE TO INCLUDE THE ORIGINAL PLUS ONE COPY AND SUBMIT BY AUGUST 30, 2013 TO: Mail Completed Applications to: Or Deliver in Person to: City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office Post Office Box 9033 Temecula, CA 92589-9033 City of Temecula Community Service Funding program Attn: Eva Pharis / City Manager's Office 41000 Main Street Temecula, CA 92590 Application Page 5 Exempt Organizations Select Check Page 1 of 1 IRS Exempt Organizations Select Check Tempt Organizations Select Check Horne Organizations Eligible to Receive Tax -Deductible Contributions (Pub. 78 data). Search Results The following list Incudes tax-exempt organizations that are eligible to receive tax-deducllble contributions. Click on the "Deductibility Status" column for an explanation of limHallons on the deductibility or contributions made to different types of tax-exempt organlzadons. Results ere sorted by EIN. To sort results by another category. click on the icon next to the column heading for that category. Clicking on that icon a second lime will reverse the sort order. Click on a column heading for an explanation of Information In that column. 1.1 of 1 rsouks Teem Evangelical Assistance Mlniskfes of Rencho- Temecula Legal Name (Doing Business As). Results Per Page 25 Return to Search ol< j City . Temecula • Prey 11.11Next • State .Counlry. DedudibllityStatus . CA United States PC . Prev l 1.1 I Next i> http://apps.irs.gov/app/eos/pub78Search.do?ein 1=330210704&names=&city=&state=CA&c... 9/9/2013 City of Temecula 2013-14 CS Funding Program APPLICATION NO. 24 RECEIVED CITY OF TEMECUL.& AUG 7 7 2w3 FISCAL YEAR 2013-1 4 CITY MANAGER'S OFFICE COMMUNITY SERVICE FUNDING PROGRAM APPLICATION (Please Print or Tvoe) r 2013-14 Program Submission Deadline: Friday, August 30, 2013 (original, plus one copy) PROJECT INFORMATION Amount Requested: $ 5000.00 (Maximum allowable $5,000) Project Name: Temecula Dollars for Scholars Rebrandinq Administrative Funds Project Start Date: September 2013 Project End Date: June 2014 ORGANIZATION INFORMATION Name of Organization: Temecula Dollars for Scholars (Formerly Citizens' Scholarship Foundation of Temecula Valley) Contact Name: Barbara Borpeson Title/Position: Chapter President Mailing Address: 31350 Rancho Vista Road, Temecula, CA 92592 Telephone: 951-694-1713 Number of Paid Staff: 0 Number of Volunteers: 18 Geographic Area(s) Served: City of Temecula Is this organization incorporated in California as a non-profit organization? Yes X No Effective Date: July 21,1987 If "yes" (Must provide a copy of your statement of non- profit status from the State of California): Date of incorporation as a non-profit: July 21,1987 Federal identification number: State identification number: Year Organization Founded: 1987 If "no": Name of sponsoring organization: Federal identification number: State identification number: This application has been authorized by the organization's: Executive Committee Board of Directors X Members -at -Large Application Page 1 FY 2012-13 COMPLIANCE REQUIREMENT IF YOUR ORGANIZATION WAS A RECIPIENT OF FUNDING FOR FY 2012-13, PLEASE ATTACH COPIES OF INVOICES, RECEIPTS AND CANCELLED CHECKS TO SUBSTANTIATE THOSE FUNDS RECEIVED AND EXPENDED BY YOUR ORGANIZATION. FINANCIAL STATEMENTS PLEASE ATTACH COPIES OF THE CURRENT BUDGET OF THE ORGANIZATION AND FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT). It does not require a CPA's audit, but please submit If available. MISSION STATEMENT Briefly describe the goals and objectives of your organization and community services it provides. Describe the ways your organization meets the criteria listed on page 2 of the CS Funding Policy. The mission of Temecula Dollars for Scholars is to expand educational opportunities for resident high school students. Temecula Dollars for Scholars is a non-profit, tax exempt 501(c)3 status organiz- ation chartered in 1987 with Scholarship America as Citizens' Scholarship Foundation of Temecula Valley. Our purpose is to provide local funding for financial aid to the students of Chaparral, Temecula Valley, Great Oak and Rancho Vista/Susan H Nelson High Schools, who aspire to higher education without regard to race, creed, color, sex or national origin. The organization's membership is open to any person, firm, corporation, or organization subscribing to the purpose of the foundation and making voluntary contributions of funds. The funds are managed by the board of directors. All finacial reports are filed with Scholarship America and audits are conducted bi-annually. High school seniors with a minimum GPA of 2.0 are encouraged to apply for local scholarships. Since 1987, when our organization was founded by a small group of local teachers, parents and qen- ous community members, we have provided more than 2.5 million dollars in financial aid to Temecula students. Many of those students come back to Temecula to live, work and become leaders of our community. We have several donors and a current board member who are past recipients of scholarships given through our organization. By providing scholarships, students are encouraged to seek higher education. An educated community is insurance for our city's bright future. PROJECT DESCRIPTION Application Page 2 How will your organization use the funding awarded? Describe the project, project objectives, those served, area serviced, and number of volunteers involved. Be specific. Include equipment or services that would be purchased and why. Include a detailed budget and a schedule of significant activities related to this project. You may attach a maximum of one double-spaced typewritten page of information. (Please type or print legibly.) Our organization, formerly Citizens' Scholarship Foundation of Temecula Valley, is required by our parent organization, Scholarship America, to rebrand as Temecula Dollars for Scholars in order to develop national name -brand recognigiton under the Dollars for Scholars banner. Our local students will benefit from this rebrandinq by having access to all the resources of the Scholarship America. As Temecula students apply for local scholarships through our organization they will also be eligible for national scholarships. This is a huge benefit to our local students and a huge undertaking for Temecula Dollars for Scholars. Our organizaiton has existed in Temecula for 26 years as Citizens' Scholarship Foundation of Temecula Valley. We are the only organization in Temecula that seeks local financial support, in the form of scholarships, for local students seeking higher education. 100% of funds given to us for scholarships are awarded to the student's school for tuition. Temecula Dollars for Scholars has a very small and limited budget for operating expenses, raised through local fundraisers, i.e. garage sales, restaurant fundraisers and interest accrued before scholar- ships are funded. This is often supplemented by personal donations from our 18 board members. As we rebrand, we are in need of all new printed materials, signage and publicity. We also are in need of a new computer and accounting software to dedicate to Temecula Dollars for Scholars. Currently, we use board member's personal computers, most of which have older operating systems which cannot support updated software. As Citizens' Scholarship Foundation of Temecula Valley rebrands to Temecula Dollars for Scholars, opportunities for our local students expand but the costs of this change is significant to our organization. Any financial help the City of Temecula can assists us with would be greatly apprecialted and used to help our city's students reach their goal of higher education. Application Page 3 PAST PROJECT BENEFITS If your organization received City of Temecula funding in the previous year, please explain and show how Temecula residents benefited. Our organization has enjoyed the support of the City of Temecula for many years. Unfortunatly, for the last two years. the city council decided to support only non-profit organizations who offer community- wide services such as food, shelter and medical care. As trustees of Temecula Dollars for Scholars we were disappointed not to recieve funds from the city, but as citizens of the City of Temecula we admired the difficult decision that the council had to make. We hope that funds are available this year to continue to support our organization and our college bound youth. In the past, the City of Temecula has donated as much as $30,000.00 a year for scholarships. That amount decreased substantially in the last few years due to budget and economic constraints. The students and families served by Temecula Dollars for Scholars have felt the same economic constraints and also have been hit by sky -rocketing college tuition costs. Our community benefits financially by the city's support of our scholarship organization, but more importantly those students recognized locally with financial support benefit our community by coming back to Temecula highly educated and enthu- siastic about giving back to their community! Temecula Dollars for Scholars is hopeful that the City of Temecula will be able to support the goal of providing local financial assistance for Temecula college students by helping with the expenses of providing this valuable community service. Application Page 4 SIGNATURE PAGE We hereby certify the information contained in this application is true to the best of our knowledge and belief. PREPARED BY: Barbara Borgeson NAME and TITLE (Please Print or Type) SIGNATURE: 0��L p()))vtD PRESIDENT or AUTHORIZED OFFICER: SIGNATURE: Barbara Borgeson, President NAME and TITLE(Please Print or Type) YWdea0 ORGANIZATION NAME: MAILING ADDRESS: Temecula Dollars for Scholars 31350 Rancho Vista Road, Temecula, CA 92592 TELEPHONE: 951-217-2039 EMAIL ADDRESS: brborgeson®verizon.net DATED THIS 23rd of August (Date) (Month) , 2013 BE SURE TO INCLUDE THE ORIGINAL PLUS ONE COPY AND SUBMIT BY AUGUST 30, 2013 TO: Mall Completed Applications to: Or Deliver in Person to: City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office Post Office Box 9033 Temecula, CA 92589-9033 City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office 41000 Main Street Temecula, CA 92590 Application Page 5 Scholarship AMERICA July 12, 2013 One Scholarship Way, Saint Peter, MN 56082 507.931.1682 1800.537.4180 tf 1507.931.9168 fax ScholarshipAmerica.org To Whom It May Concern: This letter verifies that Temecula Dollars for Scholars, located in Temecula, California, is an affiliate member in good standing of Scholarship America® parent company of Dollars for Scholars®. Through its affiliation with Scholarship America, Temecula Dollars for Scholars is a tax-exempt charitable organization under IRS ruling 501(c)(3) and is a publicly supported charity under IRS ruling 170(b)(1)(A)(vi). Temecula Dollars for Scholars became an affiliate of Scholarship America on July 21, 1987. Temecula Dollars for Scholars's Employer Identification Number is 06-1209452. Scholarship America includes Temecula Dollars for Scholars on its Group Exemption Roster filed annually with the IRS. Scholarship America claims responsibility as the fiscal agent for Temecula Dollars for Scholars. Please note that the Internal Revenue Service will not list Temecula Dollars for Scholars on their web site database of charitable organizations. Only those charities that have an exclusive ruling on their individual status are afforded the opportunity to be listed in the IRS database. Temecula Dollars for Scholars is an affiliate chapter and has been given their exempt status based upon an IRS ruling given to Scholarship America. Please accept this letter, plus the enclosed supporting documentation on the national organization, as proof of the Temecula Dollars for Scholars chapter's 501(c)(3) status. Sincerely, Deborah I. Fichtner National Director of Operations Scholarship America Dollars for Scholars III • • • • • • Temecula Dollars for SCHOLARS* A Program of Scholarship America" Financial Statement 2011 Gifts Received from Donors $145,577.00* Fundraising $1226.32 Interest Income $51.57 Total Income $146,854.89 Scholarships $130,996.00 * Awards Committee $107.53 Awards Night $345.25 Dues and Subscriptions $600.00 Insurance $194.00 Postage $486.45 Printing $1360.84 Total Expense $ 134,090.07 *Fiscal year and scholarship pay -out year do not line-up exactly. 97.14% scholarships 1.197% dues and subscriptions 1.034% printing .386% business expense .245% other Temecula Dollars for SCHOLARS* A Program of Scholarship Americas Rebranding Expenses Printed Material (Letters, Pledges, Envelopes, Brochures, Letterhead, Business Cards) $2000.00 Publicity $1000.00 Computer Hardware $1000.00 Computer software $750.00 Mailings $500.00 Internal Revenue Service Department of the Treasury P.O. Box 2508 Cincinnati, OH 45201 Date: March 1.2003 Person to Contact: Ms. Dalton 31-07425 Customer Service Representative _ Scholarship America Inc Toll Free Telephone Number: Box 297 1505 Riverview RD 8:00 A.M. to 6:30 P.M. EST ST Peter, MN 56082-1556 877-829-5500 Fax Number: 513-263-3756 Federal Identification Number: Dear Sir. This is in response to the amendment to your organization's Articles of Incorporation filed with the state on January 23, 2003. We have updated our records to reflect the name as indicated above. In April 1962 we issued a determination letter that recognized your organization as exempt from federal income tax under section 501(c)(3) of the Internal Revenue Code. That letter is still in effect. Based on the information supplied, we recognized the subordinates named on the list your organization submitted as exempt from federal income tax under section 501(C)(3) of the Code. Additionally, we have classified the subordinates your organization operates, supervises, or controls, and which are covered by written notification to us, as organizations that are not private foundations because they are organizations of the type described in sections 509(a)(2) of the Code. © Donors may deduct contributions to your organization's subordinates as provided in section 170 of the Code. Bequests, legacies, devises, transfers or gifts to the subordinates or for their use are deductible for federal estate and gift tax purposes if they meet the applicable provisions of sections 2055, 2106, and 2522 of the Code. Your organization and its subordinates are required to file Form 990, Return of Organization Exempt from Income Tax, only if the gross receipts each year are normally more than $25,000. If a retum is required, it must be filed by the 15th day of the fifth month after the end of the organization's annual accounting period. The law imposes a penalty of $20 a day, up to a maximum of $10,000, when a retum is filed late, unless there is reasonable cause for the delay. Your organization and its subordinates are not required to file federal income tax retums unless subject to the tax on unrelated business income under section 511 of the Code. If subject to this tax, the organization must file an income tax return on Form 990-T, Exempt Organization Business Income Tax Return. In this letter, we are not determining whether any of your organization or its subordinates' present or proposed activities are unrelated trade or business as defined in section 513 of the Code. -2 - Scholarship America Inc 04-2296967 Unless specifically excepted, your organization and its subordinates are liable for taxes under the Federal Insurance Contributions Act (social security taxes) on remuneration of $100 or more paid to each of its employees during a calendar year. Your organization and its subordinates are not liable for the tax imposed under the Federal UnemploymentTax Act (FUTA). Each year, at least 90 days before the end of your organization's annual accounting period, please send the following items to the Internal Revenue Service Center at the address shown below: 1. A statement describing any changes during the year in the purposes, character, or method of operation of your organization's subordinates; 2. A list showing the names, mailing addresses (including Postal ZIP Codes), actual addresses if different, and employer identification numbers of subordinates that: a_ Changed names or addresses; b. Were deleted from the roster: or c. Were added to the roster. 3. For subordinates to be added, attach: a. A statementthat the information on which your organization's present group exemption letter is based applies to the new subordinates; b. A statement that each has given your organization written authorizationto add its name to the roster; c. A list of those to which the Service previously issued exemption rulings or determination letters; d. A statement that none of the subordinates is a private foundation as defined in section 509(a) of the Code if the group exemption letter covers organizations described in section 501(c)(3); e. The street address of subordinates where the mailing address is a P.O. Box; and -3 - Scholarship America Inc 04-2296967 f. The information required by Revenue -Procedure 75-50, 1975-2 C.B. 587 for each subordinate that is a school claiming exemption under section 501(c)(3). Also include any other information necessary to establish that the school is complying with the requirements of Revenue Ruling 71-447, 1971-2C.B. 230. This is the same information required by Schedule A, Form 1023, Application for Recognition of Exemption Under Section 501(c)(3) of the Internal Revenue Code. 4. If applicable, a statement that your organization's group exemption roster did not change since the previous report. The above information should be sent to the following address: Internal Revenue Service Center Attn: Entity Control Unit Ogden, UT 84409 The law requires you to make your organization's annual return available for public inspection without charge for three years after the due date of the return. If your organization had a copy of its application for recognition of exemption on July 15, 1987, it is also required to make available for public inspection a copy of the exemption application, any supporting documents and the exemption letter to any individual who requests such documents in person or in writing. You can charge only a reasonable fee for reproduction and actual postage costs for the copied materials. The law does not require you to provide copies of public inspection documents that are widely available, such as by posting them on the Internet (World Wide Web). YoU may be liable for a penalty of $20 a day for each day you do not make these documents available for pubiic inspection (up to a maximum of $10,000 in the case of an annual retum). Your organization's Group Exemption Number is 1546. If you have any questions, please call us at the telephone number shown in the heading of this Tetter. Sincerely, ag Z John E Ricketts, Director, TE/GE CustomerAccount Services Exempt Organizations Select Check Page 1 of 1 IRS Exempt Organizations Select Check Exempt Organizations Select Check Horne Organizations Eligible to Receive Tex -Deductible Contributions (Pub. 78 data) - Search Results The following list Incudes lax•exempl organizations That are eligible to receive lex-deductible contributions. Click on the "Deductibility Status' column for en explanation of limitations on the deductibility of contributions made to different types of tax-exempt organizations. Results are sorted by EIN. To son results by another category, dict on the icon next to the column heading for that category. Clicking on that Icon a second time will reverse the son order. Click on a column heeding for an explanation of Information in that column. 1.1 011 results Legal,Namo (Doing Business As). Scholarship America Inc. Return to Search Results Per Page 25 OK j City . Saint Peter .Prev 1 1-1 1 Next State 4 -Country Deductibility, Status. MN United States GROUP e Prev 1 1-1 1 Next x http://apps.irs.gov/app/eos/pub78Scarch.do?ein 1=042296967&names=&city=&state=A11 9/11/2013 City of Temecula 2013-14 CS Funding Program APPLICATION NO. 25 RECEIVED CITY OF TEMECULA AUG 1 9 FISCAL YEAR 2013.14 CITY MANAGER'S OFFICE COMMUNITY SERVICE FUNDING PROGRAM APPLICATION (Please Print or Tvoe) 2013-14 Program Submission Deadline: Friday, August 30, 2013 (original, plus one copy) PROJECT INFORMATION Amount Requested: $ 5,000 (Maximum allowable $5,000) Project Name: Safety Town Project Start Date: July 14, 2014 Project End Date: July 25, 2014 ORGANIZATION INFORMATION Temecula Sunrise Rotary Club Name of Organization: Contact Name: Mailing Address: P.O. Box 2203 Te,eci;a. CA 92593 Telephone: 951-461-8638 Year Organization Founded: 26, r`' `iyo _ Jill Schutte Title/Position: Club President Number of Paid Staff: 0 Number of Volunteers: 12 Geographic Area(s) Served: All of Temecula Valley Is this organization incorporated in California as a non-profit organization? If "no": Yes X No Effective Date: f\ardn (q,4)( qcia, If "yes" (Must provide a copy of your statement of non- profit status from the State of California): Date of incorporation as a non-profit: N\ 1Xv' c \ I Cea l cid' n 1 Gt„ Federal identification number: } -- Name of sponsoring organization: Federal identification number: State identification number: This application has been authorized by the organization's: Executive Committee Board of Directors X Members -at -Large Application Page 1 FY 2012-13 COMPLIANCE REQUIREMENT IF YOUR ORGANIZATION WAS A RECIPIENT OF FUNDING FOR FY 2012-13, PLEASE ATTACH COPIES OF INVOICES, RECEIPTS AND CANCELLED CHECKS TO SUBSTANTIATE THOSE FUNDS RECEIVED AND EXPENDED BY YOUR ORGANIZATION. FINANCIAL STATEMENTS PLEASE ATTACH COPIES OF THE CURRENT BUDGET OF THE ORGANIZATION AND FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT). It does not require a CPA's audit, but please submit if available. L MISSION STATEMENT The community project of the Temecula Sunrise Rotary Club is called Safety Town. The objectives are to teach young children ages 5 to 8 the specific safety lessons concerning - dangers they come in contact with regularly. While attending Safety Town, the children are taught coping skills to handle many types of danger. Experts are enlisted to teach the dangers of fire, electricity, water, guns, traffic including being a pedestrian, poisons and drugs, handling strangers, safety when handling animals, bicycle and scooter safety, 'my body' is mine(self- protection), and how to make 911 emergency calls correctly_ Safety Town is a two week program with each day having a specific theme that is taught by certified teachers and other professionals. They use age-appropriate aids such as movies, books, songs, games and crafts, and drama in an interactive manner to instill each lesson in the children's minds. The goal of Safety Town is to prevent injury, trauma, or death to small children. This is a goal that will serve the entire community of Temecula. Our Rotarian volunteers advertise to the entire Temecula Valley through our website, flyers to TVUSD schools, preschools in the area and through local newspapers and businesses. Enrollment is open to all children regardless of race, color, creed, nationality, sex, or religion or the ability to pay the fee which is used for the supplies. We aim to spend $55 per child for all necessary supplies and activities. We are asking for a fee of $40 per child/ $35 for each sibling after the first child in a family is enrolled_ We will not exclude a child who is unable to pay. Application Page 2 How will your organization use the funding awarded? Describe the project, project objectives, those served, area serviced, and number of volunteers involved. Be specific. Include equipment or services that would be purchased and why. Include a detailed budget and a schedule of significant activities related to this project. You may attach a maximum of one double-spaced typewritten page of information. (Please type or print legibly.) In addition to the qualified teachers in each classroom, we enlist Rotarians from the community to volunteer, teen volunteers from TVHS, CHS, and GOHS, police officers, fire department staff, swimming instructors, nurses, animal handlers, Edison Electric instructors, and a drama teacher to organize skits to enhance each theme. The volunteers set up a small scale village to teach the children the many hazards possible in daily life. The village has streets laid out, buildings that simulate those found in our community, stop signs, traffic lights, pedestrian crossings, railroad crossings, all set up to give the children hands-on experiences. We have child size pedal cars for the children to have turns riding on the streets of the village. There are phone booths with tips on making a 911 call. These cats need constant repair, and we are in need of several new one. Each car costs approximately $500. We have been able to purchase used vehicles in the past for less. This village has been most successful in giving the children first hand experience with what they have learned in class. Upon completion of the course, parents are given a survey. All parents have found the course most valuable to their family. Some have brought their children back the next year for reinforcement of the skills. We have had feedback that Safety Town has saved at least two lives by children using the skills learned in Safety Town. With more funding, we would like to expand the number of children. We would like to purchase more equipment, cars and village structures, and to be able to offer a greater number of scholarships. Application Page 3 PAST PROJECT BENEFITS If your organization received City of Temecula funding in the previous year, please explain and show how Temecula residents benefited. Safety Town is a nationwide program which was begun in 1937 in Ohio. The Temecula Sunrise Rotary Club is 26 years old. We have sponsored this program in Temecula for the past 11 years. This year, our program served 140 students, however we were not able to serve all who applied due to funds. We need to purchase supplies for all the activities and we must maintain the village. We would love to serve more students next year and expand our program. We have the volunteers and we are ready. Safety Town enhances our wonderfully child friendly Temecula Valley. We are a non-profit organization providing a much needed service to the parents and children of our community. Please help us to grow. Our organization has one main fund raising event each year in May. Our event is the annual 2K,5K,10K Run Through the Vineyards. We raise approximately $20,000 per year. However, we have more than one ongoing project. We support two local Title 1 elementary schools with literacy programs and the purchase of eye glasses for needy students. We sponsor competitions in Art, Music, Speech for high school students, and support a local service club for high school students which includes sending students to leadership camp. We have many international projects also. We will continue to hold fund raising events to keep our Safety Town going. I am attaching the budget for the event and as you will see we ran a deficit of $2529 this year. We will run the event again in 2014, however, we will not be able to accommodate as many students as wish to register. Hopefully your committee will be able to give us some assistance. There were 25 adult volunteers, 32 teenage volunteers, and the community agencies involved (i.e. Police dept, fire dept, EMT, swim instructors, Edison, Water Dist. Animal handlers) many additional volunteers. We have not received funding from the City of Temecula previously. -Appivation Page 4 SIGNATURE PAGE We hereby certify the information contained in this application is true to the best of our knowledge and belief. PREPARED BY: Jill C. Schutte Club President SIGNATURE:9a_c NAME and TITLE (Please Print or Type) PRESIDENT or AUTHORIZED OFFICER: SIGNATURE: i Jill C. Schutte Club President NAME and TITLE (Please Print or Type) ,fe d .cztif-j' ORGANIZATION NAME: Temecula Sunrise Rotary Club MAILING ADDRESS: P. 0. Box 2203 Temecula, CA 92593 TELEPHONE: 951461-8638 EMAIL ADDRESS: )azzymoml@verizon.net DATED THIS 12 of August , 2013 (Date) (Month) BE SURE TO INCLUDE THE ORIGINAL PLUS ONE COPY AND SUBMIT BY AUGUST 30, 2013 TO: Mail Completed Applications to: Or Deliver in Person to: City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office Post Office Box 9033 Temecula, CA 92589-9033 City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office 41000 Main Street Temecula, CA 92590 Application Page 5 STATE OF CALIFORNIA FRANCHISE TAX BOARD P.O. BOX 1286 RANCHO CORDOVA, CA. 95741-1286 March 24, 1992 TEMECULA SUNRISE ROTARY FOUNDATION *105 JAMES A. MEYLER 27710 JEFFERSON AVE TEMECULA CA 92590 Purpose Code Section Form of Organization Accounting Period Ending: Organization Number • In reply refer to 340:G :RWM CHARITABLE 23701d Corporation June 30 1694701 TSORF You are exempt from state franchise or income tax under the section of the Revenue and Taxation Code indicated above. This decision is based on information you submitted and assumes that your present operations continue unchanged or conform to those proposed in your application. Any change in operation, character, or purpose of the organization must be reported immediately to this office so that we may determine the effect on your exempt status. Any change of name or address must also be reported. In the event of a change in relevant statutory, Administrative, judicial case law, a change in federal interpretation of federal law in cases where our opinion is based upon such an interpretation, or a change in the material facts or circumstances relating to your application upon which this opinion is based, this opinion may no longer be applicable. It is your responsibility to be aware of these changes should they occur. This paragraph conStitues written advice, other than a chief counsel ruling, within the meaning of Revenue and Taxation Code Section 21012(a)(2). You may be required to file Form 199 (Exempt Organization Annual Information Return) on or before the 15th day of the 5th month (4 1/2 months) after the close of your accounting period. Please see annual instructions with forms for requirements. You are not required to file state franchise or income tax returns unless you have income subject to the unrelated business income tax under Section 23731 of the Code. In this event, you are required to March 24, 1992 TEMECULA SUNRISE ROTARY FOUNDATION Corporate Humber 1694701 TSORF Page 2 file Form 109 (Exempt Organization Business Income Tax Return) by the 15th day of the 5th month (4 1/2 months) after the close of your annual accounting period. Please note that an exemption from federal income or other taxes and other state taxes requires separate applications. A copy of this letter has been sent to the Registry of Charitable Trusts. A SCOTT EXEMPT ORGANIZATION UNIT CORPORATION AUDIT SECTION Telephone (916) 369-4171 EO Safety Town proposed 2014 Budget July 16-27,2014 Revenue Children ages 5-8 Grants Expenses Director salary Teacher salary 200 @ $40 each 50 @ $35 each 50 scholarships $1000 x 4 teachers Safety Town t shirts 300 x $5 Craft and art supplies Advertising banner Registration flyers Presenter gift cards i.e fire,police,water, etc. Snacks for students site/facility rent Pay custodian Maintenance of village Maintenance of cars Purchase new cars $500 x 2 Proposed total expenses Safety Town 2013 Revenue Expenses Deficit The total students served were 140. It is our hope to double enrollment this year. $8,000 $1,750 0 0 $3,000 $4,000 $1,500 $1,500 $200 $300 $300 $150 0 $100 $500 $500 $1,000 $12,750 $4,140 6669 ($2,529) .erd 018 -et d- /. e, t ,use- ,/a- i o 1 SAFETY TOWN Please give us your input! 1. How did you find out about SAFETY TOWN? Flyer — Poster !_ Facebook Our Website Newspaper Word of mouth _ Other 2. What school did your child attend this year? (Please indicate for each child you have enrolled in Safety Town this year): 3. Will you recommend SAFETY TOWN to your friends, neighbors and/or family? YES NO 4. Will the same child or another child in your family attend a future Safety Town? YES NO All have already attended 5. Have you noticed an increase in your child's safety awareness this week? YES NO If yes please tell us about it: 6. Comments and Suggestions: 7. Your Name (Optional) Phone Number (Optional) The Temecula Sunrise Rotary Club thanks you for your participation! Exempt Organizations Select Check Page 1 of 1 IRS Exempt organizations Select Check Exemut ()realizations Select Check Houg Organizations Eligible to Receive Tax -Deductible Contributions (Pub. 78 data) - Search Results The following Net Includes tax-exempt organizations that are eligible to receive tax-deductible contributions. Ctldr on the "Deductibility Status' column for an explanation of WwIatlens on the deductibility of contributions made to different types of tax-exempt organizations. Results are sorted by EIN. To sort results by another category. dldt on the Icon next to the column heeding for that category. Clicking on that Icon a second Hme will reverse the sort order. Click on a column heading for an explanation of Information In that column. 1-1 of 1 result. EIN. toget Name (Doing Business As). Temecula Sunrise Rotary Foundation Raturn to Search Results Per Page 26 OK a Prev 11.1 I Next City. State ..Country,. OedudiI Stale{s. Murrlela CA United Steles PSC a Prev 11.1 I Next http://apps.irs.gov/app/eos/pub78Search.do?ein1=330484340&names=&city=&state=CA&c... 9/9/2013 City of Temecula 2013-14 CS Funding Program APPLICATION NO. 26 CITY OF TEMECULA RECEIVED FISCAL YEAR 2013-14 COMMUNITY SERVICE FUNDING PROGRAM ARKAG TION (Please Print or Tvoe) OFFICE 2013-14 Program Submission Deadline: Friday, August 30, 2013 (original, plus one copy) PROJECT INFORMATION Amount Requested: $ 5,400 Project Name: THTNnS REMF.MRF,RFD (Maximum allowable $5,000) Project Start Date: December 1, 2013 Project End Date: December 1 , 201 4 ORGANIZATION INFORMATION Name of Organization: TEMECULA VALLEY GARDEN CLUB Contact Name: Joan DeFazio Title/Position: Grants/Donations Comm. Chair Mailing Address: 33800 Linda Rosea Road, Temecula, CA 92592 Telephone: 951-676-5434 Year Organization Founded: 1984 Number of Paid Staff: 0 Number of Volunteers: leg mPmhers GeographicArea(s) Served: TPmPcnl a Valley, including heavy emphasis on schools within the low to moderate income census blocks Is this organization incorporated in California as a non-profit organization? Yes x_ No Effective Date: 2002 If "yes" (Must provide a copy of your statement of non- profit status from the State of California): Date of incorporation as a non-profit: 9009 Federal identification number: State identification number: If "no": Name of sponsoring organization: Federal identification number: State identification number: This application has been authorized by the organization's: Executive Committee X Board of Directors Members -at -Large Application Page 1 FY 2012-13 COMPLIANCE REQUIREMENT IF YOUR ORGANIZATION WAS A RECIPIENT OF FUNDING FOR FY 2012-13, PLEASE ATTACH COPIES OF INVOICES, RECEIPTS AND CANCELLED CHECKS TO SUBSTANTIATE THOSE FUNDS RECEIVED AND EXPENDED BY YOUR ORGANIZATION. FINANCIAL STATEMENTS PLEASE ATTACH COPIES OF THE CURRENT BUDGET OF THE ORGANIZATION AND FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT). It does not require a CPA's audit, but please submit If available. MISSION STATEMENT Briefly describe the goals and objectives of your organization and community services it provides. Describe the ways your organization meets the criteria listed on page 2 of the CS Funding Policy. Tg.mirula valley Carden Club's objectives include promoting interests in home gardens for the growing of vegetables and fruits to supplement the diets of low to moderate income households. In furtherance of this objective we have worked with schools in the area, teaching the students how to grow vegetables, even in limited spaces or indoor areas. We have provided the seeds, growing materials and instructions for the students. This upcoming year our annual garden show is entitled Things Remembered and a separate area of the show will be devoted to instructional demon- strations and speeches to provide students with insight into how each home in the past grew and harvested the bulk of their fresh vegetables and fruits, so that even in hard times the families had food on their tables. We believe this concept has been forgotten and in light of the current heavy demands being placed on food banks in the area education relating to growing of edible crops will help substantially to relieve the burden on government agencies and food banks in the upcoming years. PROJECT DESCRIPTION Application Page 2 How will your organization use the funding awarded? Describe the project, project objectives, those served, area serviced, and number of volunteers involved. Be specific. Include equipment or services that would be purchased and why. Include a detailed budget and a schedule of significant activities related to this project. You may attach a maximum of one double-spaced typewritten page of information. (Please type or print legibly.) All funds received will be used to purchase growing materials, seeds, plants and fertilizers to be provided to participating low and moderate income students. Application Page 3 PAST PROJECT BENEFITS If your organization received City of Temecula funding in the previous year, please explain and show how Temecula residents benefited. Not applicable Application Page 4 SIGNATURE PAGE We hereby certify the information contained in this application is true to the best of our knowledge and belief. PREPARED BY: 1.._ a. NAME and TITLE (Please Print or Type) SIGNATURE: PRESIDENT or AUTHORIZED OFFICER: ,V GINIA MURPHY, President NAME and TITLE (Please Print or Type) SIGNATURE: ORGANIZATION NAME: emecula Valley Garde Club MAILING ADDRESS: P.O. Box 1526, Temecula, CA 92593-1526 TELEPHONE: 9t)/4 DATED THIS EMAIL ADDRESS: A ,2_5 i of ate) (Mo'rfth) , 2013 BE SURE TO INCLUDE THE ORIGINAL PLUS ONE COPY AND SUBMIT BY AUGUST 30, 2013 TO: Mail Completed Applications to: Or Deliver in Person to: City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office Post Office Box 9033 Temecula, CA 92589-9033 City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office 41000 Main Street Temecula, CA 92590 Application Page 5 I.r�• � •L� INTERNAL REVENUE SERVICE P. O. BOX 2508 CINCINNATI, OH 45201 Date: MO l8 11101 TffiMECULA VALLEY GARDEN CLUB C/O CAROL J HUDSON 31492 CORTE SALINAS T MECULA, CA 92592 DEPARTMENT OF TRE TREASURY Employer Identification Number: DLN; 17053126033042 Contact Person: DENNIS SAYERS Contact Telephone Number: (877) 829-5500 Accounting Period Ending: August 31 Form 990 Required: pdhedi1 Applies: No ID# 52486 Dear Applicant: Based on information supplied, and assuming 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 50.1(a) of the Internal Revenue Code as am organization described in section 501(c)(3). • We have further determined that you are not a private foundation within the meaning of section 509(a) of the Code, because you are an organization described in section 509(a)(2). If your sources of support, or your purposes, character, or method of operation change, please let u0 know so we can consider the effect of the change on your exempt status and foundation status. In the case of an amend- ment to your organizational document or bylaws, please send us a copy of the amended document or bylaws. Also. you should inform us of all cheneea in your name or address. As of January 1, 1984 -,.you are -liable -for taxes under the Federal Insurance Contributions Act (social security taxes) on remuneration of $100 or more you pay to each -of -your employees during a calendar year. You are not liable for the tax imposed under the Federal Unemployment Tax Act ()• Since you are not a private foundation, you are not subject to the excise taxes under Chapter 42 of the Code. However, if you are i volved in an excess benefit transaction, that transaction might be subject to the excise taxes of section 4958. Additionally, you are not automatically exempt from other federal excise taxes. If you have any questions about excise, employment, or other federal taxes, please contact your key district office. __Ornnters ead antributora may rely+.- on this determination unless the internal Revenue service publishes notice to the contrary- However, if you lose your section 509(a)(2) status, a grantor or contributor may not rely on thin determination if he or she was in part responsible for, or was aware of, the act or failure to act, or the substantial or material change on the Letter 947 (DO/CG) -3- You. 3- TEMECULA VALLEY GARDEN CLUB Yon are not required to file federal income tax returns unless you are subject to the tax on unrelated business income under section 511 of the Code. If you are subject to this tax, you must file an income tax return on Form 990-T, Exempt Organization Business Income Tax Return. In this letter'we are not determining whetber any of your present or proposed activities are unre- lated trade or business as defined in section 513 of the Code. You need an employer identification number even if you have no employees. If an employer identification number was not entered on your application, a number will be assigned to you and you will be advised of it. Please use that 1=0104gitc 'all retuxne you tile.axd in a12 arl.00rrespondence with the Internal Revel Service. In accordance with section 508(a) of the Code, the effective date of this determination letter is July 29, 2002. This determination is based on evidence that your funda are dedicated to the purposes listed in section 501(c)(3) of the Code. To assure your continued exemption, you should keep records to show that funds are expended only for those purposes.. If you distribute funds to other organizations, your records should show whether they are exempt under section Sol(c)(3). In cases where the recipient organization is not exempt under section 501(c)(3), there Should be evidence that the funds will remain dedicated to the required purposes and that they will be used for those purposes by the recipient. If distributions are made to individuals, came histories regarding the recipients ehould be kept showing names, addressee, purposes of awards, manner of selection, relationship (if any) to member, officers, trustees hr• �dopoxa. Q •:.;� fiords to you, so that any and all distributions made to Individuals can be substantiated upon request by the Internal Revenue Service. (Revenue Ruling 56-304, C.B. 1956-2, page 306.) If we have indicated in the heading of this letter that an addendum applies, the enclosed addendum is an integral part of this letter. Because this letter could help resolve any questions about your exempt status and foundation status, you should keep it in your permanent records. -4- TEMSCULA VALLEY GARDEN CLUB If you have any questions, please contact the person whose name and telephone number are shown in the heading of this letter. Sincerely yours, c'ee:es-4 771-4tAa.- Lois 0. Lerner Director, Exempt Organizations ,r ?. :'a:.<�. �1.'J'�h I <•.•.:' L^'• �� •f!. P., ?':1'•: rr. :v...ti/ n•.0 ..,t.�t :.,�.....v., q.G Y`'r`�. .. .f... n•. . t'; ,'.7'x:•1_:2.".'.!7,1,*:LC -2- TEMECULA VALLEY GARDEN CLUB part of the organization that resulted in your logs of such status, or if he or she acquired knowledge that the Internal Revenue Service had given notice that you would no longer be classified as a section 509(a)(2) organization. Donors may deduct contributions to you as provided in section 170 of the Code. Bequests, legacies, devises, transfers, or gifts to you or for your use are deductible for federal estate and gift tax purposes if they meet the applicable provisions of Code sections 2055, 2106, and 2522. Contribution deductions are allowable to donors only to the extent that their contributions are gifts, with no ccmaideration received. Ticket pur- chaeeH and similar payments in conjunction with fundraising events may not necessarily qualify as deductible contributions, depending on the circum- stances. See Revenue Ruling 67-246, published in Cumulative Bulletin 1967-2, on page 104, which sets forth guidelines regarding the deductibility, as chari- table contributions, of payments made by taxpayers for admission to or other participation in fundraising activities for charity. In the heading of this letter we have indicated whether you must file Form 990, Return of Organization Exempt From Income Tax. If Yea is indicated, you are required to file Form 990 only if your groes receipts each year are normally more than $25,000. However, if you receive a Form 990 package in the mail, please file the return even if you do not exceed the gross receipts test. If you are not required to file, simply attach the label provided. check the box in the heading to indicate that your annual gross receipts are normally $25,000 or less, and sign the return. If a return is required, it must be filed by the 15th day of the fifth month after the end of your annual accounting period. A penalty of $20 a day is charged when a return is filed late, unless there is reasonable cause for the delay. However, the maximum penalty charged cannot exceed $10,000 or 5 percent of your gross receipts for the year, whichever is less. For organizations with gross receipts exceeding $1,000,000 in any year, the penalty is $100 per day per return, unless there is reasonable cause for the delay. The maximum penalty for an organization with gross receipts exceeding $1,000,000 shall not exceed $50,000. This penalty may also be charged if a return is not complete, so be sure your return is complete before you file it. You are required to make your annual information return, Form 990 or Form 990 -EZ, available for public inspection for three years after the later of the due date of the return or the date the return is filed. You are also required to make available for public inspection your exemption application, any supporting documents, and your exemption letter. Copies of these documents are also required to be provided to any individual upon written or in person request without charge other than reasonable fees for copying and postage. You may fulfill this requirement by placing these documents on the Intem et Penalties may be imposed_for failure to comply with these requirements. Additional information is available in Publication 557, Tax -Exempt Status for Your Organization, or you may call our toll free number shown above. Letter 947 (DO/CG) Temecula Valley Garden Club FY 2012-13 Income and Expenses Compared to Approved Budget FY 2013-14 Budget Category Membership Income Budget % of Budget Expense Budget % of Budget 4 Income Expense Name Badges Membership Dues Membership Book $ 250.00 $ 250.00 $ 4,145.00 $ 4,500.00 $ 10.00 $ 20.00 100% $ 208.60 $ 250.00 8396 $ 92% $ 50% $ 250.00 $ 250.00 4,300.00 20.00 Office Supplies Book Printing New Members Annual Brunch Total Membership $ 4,405.00 $ 4,770.00 $ 99.51 92% $ 965.93 657.82 Flower Show Donation 150.00 725.00 150.00 1,275.00 $ 150.00 $ 825.00 $ 100.00 4,570.00 $ 1,325.00 Hospitality Opportunity Raffle Plant Sale White Elephant Sale Other Income Facility Rental Insurance Award Ribbons Banners and Signs 5 5 200.00 150.00 $ 100.00 $ 1,500.00 $ 20.00 $ 200.00 $ 200.00 Office Supplies Judges Travel Expenses Publicty Permits for Banners/Signs Youth Division Printing Hospitality Judges Staging Table/Chair Rental Labor 75.00 200.00 175.00 50.00 150.00 500.00 300.00 300.00 300.00 200.00 Flower Show Total $ - $ - $ $ 350.00 $ 4,270.00 Temecula Valley Garden Club FY 2012-13 Income and Expenses Compared to Approved Budget FY 2013-14 Budget Category Income Budget % of Budget Expense Budget % of Budget Income Expense Programs Tours $ 2,080.50 $ 500.00 416% $ 2,079.00 $ 500.00 416% $ 500.00 $ 500.00 Speaker Fees $ 715.54 $ 775.00 92% $ 775.00 Installation $ 115.05 $ 125.00 92%d $ 125.00 Total Programs $ 2,080.50 $ 500.00 416% $ 2,909.59 $ 1,400.00 208%4 $ 500.00 $ 1,400.00 Friends of NGC Website $ - $ 1,000.00 0% $ $ 750.00 Out to Lunch Group $ 30.00 $ - $ $ Donations SW Botanical $ 619.40 $ - $ 800.00 $ $ $ 1,000.00 Friends of NGC Total $ 649.40 $ 1,000.00 65% $ 800.00 $ $ $ 1,750.00 Workshops Workshops $ 266.00 $ 100.00 266% $ 92.30 $ 100.00 92% $ 300.00 $ 300.00 Workshops Total $ 266.00 $ 100.00 266% $ 92.30 $ 100.00 92%i $ 300.00 $ 300.00 Ways and Means Cookbooks $ 954.00 $ 900.00 106% $ 2,500.00 $ - Holiday Botique/Bake Sale $ 106.00 $ 400.00 27% $ - $ Plant and Garden Sale $ 232.25 $ 400.00 58% $ - $ 100.00 0% $ 400.00 $ 100.00 White Elephant Sale $ 220.05 $ 100.00 220% $ 200.00 Opportunity Drawing $ 2,861.20 $ 3,000.00 95% $ 615.44 $ 750.00 82% $ 3,000.00 $ 650.00 Ways and Means Total $ 4,373.50 $ 4,800.00 91% $ 615.44 $ 850.00 72% TIN $ 6,100.00 $ 750.00 2 Temecula Valley Garden Club FY 2012-13 Income and Expenses Compared to Approved Budget FY 2013-14 Budget Category Income Budget % of Budget Expense Budget % of Budget Income Expense CGCI Luncheon Penny Pines Palomar District Dues CGCI Membership Dues CGCI Total $ - $ 100.00 $ 438.00 $ 816.00 $ 438.00 $ 916.00 0% $ - $ 100.00 54% $ 408.00 $ 816.00 $ 312.00 $ 300.00 $ 351.00 $ 350.00 48% $ 1,071.00 $ 1,566.00 0% $ 50% $ 104% r 100% 68%' ~ $ 100.00 $ 100.00 700.00 $ 700.00 $ 350.00 $ 375.00 800.00 $ 1,525.00 Newsletter Postage Office Supplies Newsletter Total Operating Expense Insurance Storage Meeting Facility PO Box Rental Misc. Office Supplies Website Historian Supplies Operating Expense Total 68.40 $ 120.00 - $ 100.00 68.40 $ 220.00 Community Service Youth Gardening Community Service Projects Petals for Patriots Community Service Total 417.00 984.00 965.00 118.00 295.98 36.17 2,816.15 $ 3 875.64 74.06 949.70 $ 400.00 $ 960.00 $ 1,000.00 $ 115.00 $ 200.00 $ 200.00 $ 50.00 $ 2,925.00 $ 50.00 $ 2,000.00 $ 50.00 $ 2,100.00 57% 0%+:. 31% $ 104% 103% 97% 103% 3 148% NI 0%` $ 72%_ i$ 96% $ 0%1 % $ 44% 148%1 45%7 $ 100.00 50.00 150.00 450.00 1,020.00 1,000.00 120.00 400.00 50.00 3,040.00 2,000.00 2,000.00 Temecula Valley Garden Club FY 2012-13 Income and Expenses Compared to Approved Budget FY 2013-14 Budget Category Income Budget % of Budget Expense Budget % of Budget mi Income Expense Hospitality Monthly Meetings VIP Expense Hospitality Total $ 222.90 $ 400.00 56% $ 300.00 Sunshine Horticulture Scholarships $ 222.90 $ 400.00 111 $ 100.00 56%R $ - $ 400.00 $ 211.17 $ 250.00 84% . $ 1,034.65 $ 1,000.00 103% 1 $ 250.00 $ 1,000.00 Total Income and Expense $ 12,212.40 $ 12,086.00 101% $ 11,757.23 $ 12,086.00 97% $ 12,620.00 $ 18,160.00 4 CHASE 0 JPMorgan Chase Bank. N A P O Box 659764 San Antonio. TX 76265-9754 July 20.2013 ihrou9h Augur,' 20. 2013 Account Number CUSTOMER SERVICE INFORMATION Page 9 of 12 Web site: Chese.com Ilrinuldrl,Irltlnulluolldrlrnlrlrllnldrllnllnrl service Center 1-800.935-9935 00093396 ORE 703 14329913 NNNNNNNNNNN T 1 000000000 140000 Deal and Hard of Hearing: 1-800-242.7383 TEMECULA VALLEY GARDEN CLUB Para Espanol: 1-877-312-4273 PO BOX 1528 International Calls: 1-713-262-1679 i TEMECULA CA 92593-1526 Il Pi Mill 1111 Ia i We aro limiting our Retumod Item lees Good Newel We will charge only ono Returned Item leo tor any payment request we retum unpaid more than once per month, even it Iho biller submits the same request multiple trues. This is just one of the ways That we aro working to make banking easier and less expensive for our customers. Wo aro horo to help. If you have any questions, please call us at the number on this statement or visit your nearest branch. CHECKING SUMMARY Beginning Balance Checks Paid Ending Balance CHECKS PAID Chase Total Checking AMOUNT $13,835.63 - 955 37 $12,880.48 CHECK NUMBER DATE PAID 1213 A 08/15 1214 A 08/20 Total Checks Paid AMOUNT $964,00 91 37 $955.37 11 you see a check description in tho Transaction Detail section, it means your check has already been converted for electronic payment. Because of this, we're not able to return the check to you or show you an image on Chase.com. A An Image of This check may be available for you to view on Chase com. P44 1 414 https://oneviewbmchase.net/OneView/stmtPrintSubmitstar 8/26/2013 CHASE O TRANSACTION DETAIL DATE DESCRIPTION Beginning Balance Page 10 of 12 July 20.2013 through August 20. 2013 Account Number: AMOUNT BALANCE $13.835.83 08/15 Check 08/20 Check Ending Balance 11 1213 it 1214 - 864.00 12,971 83 - 91.37 12.880,46 $12,880.48 A monthly Service Fee was 041 charged to your Chase Total Chocking account Hero aro the tour ways you can avoid this leo during any statement period. • Have direct deposits totaling $500.00 or more. (You dki not have a direct deposit this statement period) • OR, keep a minimum daily balance In your checking account of $1,500.00 or more (Your minimum daily balanco was $12,971.00) • Qg, keep an average qualifying deposit and Investment balance of $5.000.00 or more (Your average qualifying deposit and investment balance was $13,700.00) • QR. pay at least $25.00 In quellfying checking -related services or fees. (Your total qualifying checking•reiated services or fees paid were 60.00) r.y,2d4 https://oneviewjpmehase.net/OneView/stmtPrintSubmitstar 8/26/2013 Return to Search] Exempt Organizations Select Check Page 1 of 1 SIRS Exempt Organizations Select Check Exempt Oroanizatlons Select Check Nome Organizations Elpible to Receive Tax -Deductible Contributions (Pub. 78 data) - Search Reeults The folowing Net Includes tax-exempt orpenlzalons that are eligible to reoelve tax-deductible contributions. Click on the "Deductibility Status' coltstm for an explanation of IYnketbns on the deductibility of contributions made to different types of tax-exempt organizations. Resuks ere sorted by EIN. To sort results by another category, dick on the bon next to the column heading for that category. Clicking on that icon a second lime wll reverse the sort order. Cita on a column heading for an explanation of Information in that column. 1.1 of 1 results PRI& Legal Name (Doing Business As). Temecula VeNsy Garden Club Results Per Page 26 OK Clry. Temecula e Prev l 1-1 I Next State49A(ntrya PR.J.liFtki.tilY.tal.us CA United Stales PC c Prov l 1.1 I Next http://apps.irs.gov/app/eos/pub78Search.do?ein 1=710869568&names=&city=&state=CA&c... 9/9/2013 City of Temecula 2013-14 CS Funding Program APPLICATION NO. 27 e CITY OF TEMEC L4 AUG 2 9 is FISCAL YEAR 2013-14 CITY MANAGER'S COMMUNITY SERVICE FUNDING PROGRAM APPLICATION (Please Print or Tvoe) 2013-14 Program Submission Deadline: Friday, August 30, 2013 (original, plus one copy) PROJECT INFORMATION Amount Requested: $ Project Name: Project Start Date: 5,000 TVINA (Maximum allowable $5,000) 11-15-2013 Project End Date: 12-15-2013 ORGANIZATION INFORMATION Name of Organization: Temecula Valley Inline Hockey Association Contact Name: Dan Lewis Title/Position: Marketing Director Mailing Address: P.O. Box893593 Temecula, Ca 92589 Telephone: 714-608-4771 Year Organization Founded: 1994 Number of Paid Staff: 0 Number of Volunteers: 16 Geographic Area(s) Served: Temecula Valley Is this organization incorporated in California as a non-profit organization? If "no": Yes X No Effective Date: 1995 If "yes" (Must provide a copy of your statement of non- profit status from the State of California): Date of incorporation as a non-profit: 1995 Federal identification number: Name of sponsoring organization: Federal identification number: State identification number: This application has been authorized by the organization's: Executive Committee Board of Directors X Members -at -Large Application Page 1 FY 2012-13 COMPLIANCE REQUIREMENT IF YOUR ORGANIZATION WAS A RECIPIENT OF FUNDING FOR FY 2012-13, PLEASE ATTACH COPIES OF INVOICES, RECEIPTS AND CANCELLED CHECKS TO SUBSTANTIATE THOSE FUNDS RECEIVED AND EXPENDED BY YOUR ORGANIZATION. FINANCIAL STATEMENTS PLEASE ATTACH COPIES OF THE CURRENT BUDGET OF THE ORGANIZATION AND FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT). It does not require a CPA's audit, but please submit if available. MISSION STATEMENT Briefly describe the goals and objectives of your organization and community services it provides. Describe the ways your organization meets the criteria listed on page 2 of the CS Funding Policy. Temecula Valley Inline Hockey Association is the only inline hockey league in the Temecula and Murrieta Valley. The objective of the Temecula Valley InLine Ilockey Association is to teach the youth ot the community the Iundamcntals ot inline hockey, the ideals of good sportsmanship as well as team work_ commitment, and respect. We have been growing and developing kids in the sport of hockey of ages from 5 to 15 years old. We provide Ample coaching and equipment for the advanced player or the first lime player. Por several years the community 01 1 emecula has embraced TVIHA for its contribution of sporting development. When it comes to fiscal development TVIHA has maintained a outstanding record of increasing player registration and financial responsibility since 1996. With the help of a $100000 donation from the nonprofit Community Recreation Center I3uilding Foundation — the city of Temecula built an Inline hockey rink at the sports park. The league averages about130 players both boys and girls from ages 5 to 15 spread between 4 divisions, Having a diverse sport in the valley allows kids to learn valuable skills they can apply throughout their lives. This also applies to school and social skills. Leagues held in the fall and spring are more recreational and instructional while the winter leagues, made up of teams from middle and high schools in the area and are highly competitive. Some of the very best attributes about TVIHA is that any child can play, race, religion, creed, or even disability does not make a dif l:rence. All kids can play and get equal time playing it sloes not matter the skill level, we have some of the very best coaches that have played all levels of hockey. Some have played semi -pro ice hockey and others are still invvlvecl iu inlinre huekey leagues. All kids can play and get equal time playing. Tlrere is no political attendance required by our league or any type of affiliation as well. Financial statements, records, accounting can be submitted upon request. All accounting and IRS procedures are followed. TVIIIA uperates uil a anima l budget set furtlr try the buaid of cliiCLturs. TVIHA services are available to all of those interested. PROJECT DESCRIPTION Application Page 2 How will your organization use the funding awarded? Describe the project, project objectives, those served, area serviced, and number of volunteers involved. Be specific. Include equipment or services that would be purchased and why. Include a detailed budget and a schedule of significant activities related to this project. You may attach a maximum of one double-spaced typewritten page of information. (Please type or print legibly.) TVIHA if awarded the grant, is looking forward to improving our lighting of the rink since most of the games are played at night and poor lighting could pose a safety issue for our players . New hockey nets are also needed for both rinks (Ronald Regan and Margarita) that are being used by the league. - -' .1 1 1 -• .• , -r ,. 11 . - .i. '- , ,•' . • . • t .- • 1 - equipment for kids who don't have the finances to buy on their own and we would like to have at minimum of one set of gear for each division. Application Page 3 PAST PROJECT BENEFITS If your organization received City of Temecula funding in the previous year, please explain and show how Temecula residents benefited. Application Page 4 SIGNATURE PAGE We hereby certify the information contained in this application is true to the best of our knowledge and belief. PREPARED BY: SIGNATURE: Dan Lewis Marketing Qirector NAMES d TITLE (Please Print or Type) PRESIDENT or AUTHORIZED OFFICER: Teresa Ewing President NAME and TITLE (Please Print or Type) SIGNATURE: iL/L& ORGANIZATION NAME: Temecual Valley Inline Hockey Association MAILING ADDRESS: P.O.Box 893593 Temecula, CA 92589 TELEPHONE: 949-742-2605 EMAIL ADDRESS: president@tviha.com DATED THIS 15 of August , 2013 (Date) (Month) BE SURE TO INCLUDE THE ORIGINAL PLUS ONE COPY AND SUBMIT BY AUGUST 30, 2013 TO: Mail Completed Applications to: Or Deliver in Person to: City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office Post Office Box 9033 Temecula, CA 92589-9033 City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office 41000 Main Street Temecula, CA 92590 Application Page 5 9:54 PM 08127113 Cash Basis TVIHA Profit & Loss July 2013 Ordinary Income/Expense Income Fundraiser Registration Fall Registration Total Registration Snack Shack Sales Total Income Expense Bank Service Charges Dues and Subscriptions Game Supplies Meeting Exp Rink Lights Rink Supplies /Maintenance Snack Shack Supplies Unallocated Funds Total Expense Net Ordinary Income Net Income Jul 13 0.00 5,070.00 5,070.00 94.00 5,164.00 346.28 153.00 283.38 64.00 147.50 126.52 200.00 300.00 1,620.68 3,543.32 3,543.32 Page 1 9:58 PM 08/27/13 Cash Basis TVIHA Balance Sheet As of July 31, 2013 Jul 31,13 ASSETS Current Assets Checking/Savings Checking•Paciflc Western 9,464.68 Savings 6,312.16 Total Checking/Savings 15,776.84 Total Current Assets 15,776.84 TOTAL ASSETS 15,776.84 LIABILITIES & EQUITY Equity Opening Bal Equity 10,000.00 Retained Earnings 6,043.38 Net Income -266.54 Total Equity 15,776.64 TOTAL LIABILITIES & EQUITY 16,776.84 Paye 1 STATE OF CALIFORNIA FRANCHISE TAX BOARD . P.O, BOX 1286 • RANCHO CORDOVA, CA. 95741-1286 June 13, 1995 In reply refer to 340:G :CDC • TEMECULA VALLEY IH -LIRE HOCKEY ASSOCIATION STE. C-235 26489 YHEZ RD TEMECULA CA 92591 Purpose Code Section Form of Organization Accounting Period. Ending: Organization Humber CHARITABLE 23701d Corporation April 30 You are exempt from state franchise or income tax. under the section of the Revenue and Taxation Code. indicated above. This decision -is -based on information you submitted and assumes that your present operations continue unchanged - or conform to those proposed in your application.• Any change in operation, ,character, o.r purpose of the organization.must be reported immediately to this office so that we may determine the effect on your exempt status. Any change'of name or address also must be reported. In the event of a change. in relevant statutory, administrative, judicial case law, a change in federal interpretation of federal law in cases , where our opinion is based upon such an interpretation, or a change in the material facts or circumstances relating to your application upon - which' this opinion is based, this opinion may no longer be applicable. It is your responsibility -to be aware"of these changes should they occur. This paragraph constitutes written advice, other than a chief counsel ruling, within the meaning. of Revenue and -Taxation Code Section 21012 (a)(2). You may be recjuired .to 'file Form 199 (Exempt Organization Annual - Information Return) on or before the -15th day of the 5th month (4 1/2 months) after the close of your accounting period. See annual instructions with forms for requirements. You are not required to.file state franchise or income tax returns unless you have, income sub-iect to the unrelated business income tax under Section 23731 of the Code. In this event, you 'are required to file Form 109 (Exempt Organization Business Income Tax Return) by the 15th .day of the 5th month- (4 1/2 months) after the close of. your annual accounting -pexiod.'. ' June 13, 1995 TEMECULA 'VALLEY' IN-LINE HOCKEY ASSOCIATION Page 2. • • If the organization is incorporating,• this approval will• expire unless incorporation is completed .with the Secretary of State within 60 days. Exemption from federal income or other taxes and other state taxes requires separate applications..' A copy of this letter has been sent .to the Office of the Secretary of State and to. the Registry of Charitable Trusts.. • C CORBIN EXEMPT ORGANIZATION UNIT CORPORATION AUDIT SECTION Telephone (916) 845-4171 EO 'cc: BRIAN P. MEADOUCROFT Exempt Organizations Select Check IRS Page 1 of 1 Exempt Organlzatlons Select Check Exempt Ornenizatlons Select Check Home Organizations Eligible to Receive Tax -Deductible Contributions (Pub. 78 data) - Search Results The following lel Includes tax-exempt organizations that are ellglbbe to receive tax-deductible contributions. Click on the "Deductibility Status column for an explanation of Ilmtiadons on the deductibility of contributions made to different types of tax-exempt orgardzatlons. Results are sorted by EIN. To sort results by another category. dick on the Icon next to the column heading for that category. Clicking on that Icon a second time vAII reverse the sort order. Click on a column heading for an explanation of informetion In that column. 1.1 of 1 results Results Per Page 26 • n « Prev I 1-1 I Next • EW Lep_,el Name (Doing Business As). City. State &County. DeductIbIllty Status Temecula Valley In -Line Hockey Association Temecula CA Untied States PC Retyrm Oo Search « Ptev 1 1-1 1 Next r http://apps.irs.gov/app/eos/pub78Search.do?ein 1=330604041 &names=&city=&state=CA&c... 9/9/2013 1123/13 Deductibility Status Results Help MRS Deductibility Status In general, an individual who itemizes deductions may deduct contributions to most charitable organizations up to 50% of his or her adjusted gross income computed without regard to net operating Toss carrybacks. Individuals generally may deduct charitable contributions to other organizations up to 30% of their adjusted gross income (computed without regard to net operating Toss carrybacks). These limitations (and organizational status) are indicated as follows: Code Type of organization and use of contribution. Deductibility Limitation PC A public charity. 50% Close • Pir 194246 ARTICLES OF INCORPORATION The name of this corporation is Temecula Valley In -Line Hockey Association II ENDORSED FILED In the office of the Secretary of Stalo of the State of California JuN 13 7995 BILL JONES SECRETARY OF STATE A.This corporation is a nonprofit public benefit corporation and is not organized for the private gain of any person.tt is organized under the Nonprofit Public Benefit Corporation Law for charitable purposes. B.The specific purpose of this corporation is to implant firmly in the children of the community the ideals of good sportsmanship,honesty,Ioyalty,courage and respect for authority,so that they may be well adjusted,stronger and happier children and will grow to be good,decent,healthy and tnistworthy citizens. III The name and address in the State of California of this corporations initial agent for service of process is: Brian P. Meadowcroft 26489 Ynez Rd. Suite C-235 Temecula,California 92591-4655 1V A.This corporation is organized and operated exclusively for charitable purposes within the meaning of section 501(C)(3) of the Internal Revenue Code. B.No substantial part of the activities of this corporation shall consist of carrying on propaganda,or otherwise attempting to influence Iegislation,and the corporation shall not participate or intervene in any political campaign (including the publishing or distribution of statements) on behalf of any candidate for public office. V The property of this corporation is irrevocably dedicated to charitable purposes and no part of the net income or assets of this corporation shall ever inure to the benefit of any director,officer or member thereof or to the benefit of any private person.Upon the dissolution or winding up of the corporation,its assets remaining after payment,or provision for payment,of all debts and liabilities of this corporation shall be distributed to a nonprofit fund,foundation or corporation which is organized and operated exclusively for charitable purposes and which has established its tax exempt status under section 501(C)(3) of the Internal Revenue Code. Apri1,5,1995 Brian P. Meadowcroft I hereby declare that I am the person who executed the foregoing Articles. of Inco oration,‘ hich execution is my act and deed. City of Temecula 2013-14 CS Funding Program APPLICATION NO. 28 CITY OF TEMECULA FISCAL YEAR 2013.1 4 COMMUNITY SERVICE FUNDING PROGRAM APPLICATION (Please Print or Type) 1 (� 2013-14 Program Submission Deadline: Friday, August 30, 2013 (original, plus one copy) PROJECT INFORMATION Amount Requested: $ $5,000 Project Name: Field Trip Outreach Program/Community Outreach Program Project Start Date: Jan. 1, 2014 Project End Date: June 30, 2014 (Maximum allowable $5,000) ORGANIZATION INFORMATION Name of Organization: Temecula Valley Museum Contact Name: Mariann Byers Title/Position: President Mailing Address: P.O.Box 792, Temecula, CA 93593 Telephone: 951 694-6450 Year Organization Founded: 1987 Number of Paid Staff: 0 Number of Volunteers: 60 Geographic Area(s) Served: Southwest Riverside County Is this organization incorporated in California as a non-profit organization? Yes X No Effective Date: If "no": If "yes" (Must provide a copy of your statement of non- profit status from the State of California): Date of incorporation as a non-profit: June 2, 1987 Federal identification number: Name of sponsoring organization: Federal identification number: State identification number: This application has been authorized by the organization's: Executive Committee Board of Directors X Members -at -Large Application Page 1 PAST PROJECT BENEFITS If your organization received City of Temecula funding in the previous year, please explain and show how Temecula residents benefited. Funding of $5,000 for the TVM Field Trip Outreach Program was received in the previous year (2013-2014). Due to difficulties with the start-up of this program, making schools and school districts and their transportation departments aware of the existence of the program, as well as a delayed start on contacting these entities for the school year 2012/13 only eleven classes participated in the program. Enclosed please find receipts from schools and transportation departments and companies that reflect direct expenses incurred in implementing the program. The beneficial impact on the local community is evidenced in the growth of annual visits and people who have been touched by TVM from 14,000 to well over 21.000. Awareness is growing of the Temecula Valley Museum and the opportunity it offers community students and residents to learn about our rich cultural and natural history. Despite a slow start-up the program has been very well received by the school community and we look forward to continuing the Field Trip Outreach Program during the next grant program year (2013/2014) Application Page 4 SIGNATURE PAGE We hereby certify the information contained in this application is true to the best of our knowledge and belief. PREPARED BY: SIGNATURE: Mariann Byers, President NAM and TfTLE (Please Print or Type) PRESIDENT or AUTHORIZED OFFICER: ariann Byers, President NA�nd TITLE (Please Print or Type) SIGNATURE: ORGANIZATION NAME: _TEMECUNA VAL MUSEUM, INC. MAILING ADDRESS:_P.O. BOX 792, TEMECULA, CA 92593 TELEPHONE:_ 951-694-6450 EMAIL ADDRESS:jmejk@aol.com DATED THIS Eighth of October , 2013 (Date) (Month) BE SURE TO INCLUDE THE ORIGINAL PLUS ONE COPY AND SUBMIT BY AUGUST 30, 2013 TO: Mail Completed Applications to: Or Deliver in Person to: City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office Post Office Box 9033 Temecula, CA 92589-9033 City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office 41000 Main Street Temecula, CA 92590 Application Page 5 Return to Searehl Exempt Organizations Select Check Page 1 of 1 IRS Exempt Organizations Select Check Exempt Qrnantzalions Select Check Home Organizations Eligible to Receive Tex -Deductible Contributions (Pub. 78 date) - Search Results The following list Includes lex-exempt organization That are ellglble to receive tax-deductible conMbubons. Click on the "Deductibility Status" column for an explanation of limitations on the deductibility of contributions made to different types of tax-exempt organizations. Results are sorted by EIN. To sort results by another category. dick on the loon next to the column heading for that category. ClIddng on that Icon a second tine will reverse the Bort order. Click on a coksnn heeding for an explanation of information h that column. 1.1 of 1 results EIN. Legal Name (Going Bushiest; As) Temeaia Vey Museum Results Per Page 25 - I OK Cllx Temecula Slate aCount% CA United Slates « Prev 11.1 1 Next s DeduclibON.SIalus. PC « Prev 1 1-1 1 Next s http://apps.irs.gov/app/eos/pub78Search.do?ein 1=330152755&names=&city=&state=CA&c... 9/9/2013 City of Temecula City Manager's Office 41000 Main Street • Temecula, CA 92590 Mailing Address: P.O. Box 9033 • Temecula, CA 92589-9033 Phone (951) 506-5100 • Fax (951) 694-6499 • www.cityoftemecula.org September 30, 2013 Mariann Byers, President TEMECULA VALLEY MUSEUM, INC. P.O. Box 792 Temecula, CA 92593 RE: Temecula Community Service Funding Program FY 2012-13 Dear Mariann This is a follow-up with regard to your organization's Community Service Funding award for fiscal year 2012-13 of $5,000 which was to be used for your "Museum Field Trip Outreach Program", to fund for busing elementary school students from surrounding, underserved school districts on field trips to the Temecula Valley Museum. As stated in the Compliance section of the attached Community Services Funding Program Policy, funds received from the City should have been expended prior to June 30, 2013, and documentation to substantiate the funds received and expended should have been provided to the City by September 1, 2013. As of this date we have received documentation to substantiate $920 of the $5,000 award your organization received on or about December 21, 2012. If the remaining balance in the amount of $4,080 were not expended in accordance with the above -stated purpose, the organization is required to refund those funds. Failure to provide proper documentation may jeopardize any future funding. If you have any questions or concerns, please do not hesitate to contact me at 951-693-3959. Thank you for your prompt attention to this matter. Sincerely, (:__12)--A))" • 1 ` (J Betsy t.ow'o, Sr. Management Analyst BL:ep Enclosure: as stated e -e &LA p1- S ()N.' �.. t - i,SGa. qt) Invoi ;: o„feipt LAKE EL.SINORE UNIFIED SCHOOL DISTRICT 545 CHANEY STREET LAKE ELSIissIORE CA 92530 Received From: Customer Number: 3 EES 512 IN SUMMER ST LAKE ELS ORE , CA 92530 Invoice i37voice Number I ;ate P.O. Number Service Name 2013 / 573 08/11/2013 FIELD TRIP Receipt Date: Receipt Number: Received By: Page 1 of 1 RECEIPT 08/09/2013 2014 / 193 Signature Accounts Receivable (951)2537000 Check Number: 1096 Description TEMECULA VALLEY MUSEUM ON 05/20/13 TOTAL: Account in: ' ; -taition (internal On(y) Account Accrual Number Amount 06-500-7230-0-0000-3600-8699 AR2013570 159.65 Service Payment Amount Amount 159.65 159.65 159.65 60 a r 6/ M t ez( ll'/ !/ L 7 L-' (I t c c-'--- 1,0,46 w- t (j 1,/0L c G,, 0 ae (�- -e re -1 Fn b Lil r e tz.h, 1/`t_t-_ M 8� 0)1/0-0-d k -Q- iii. .4,J e 0 c if el t_n L At) r- 60..0/1_/ - LGz-t L .e? kva-t. i http://galaxy.rcoe. k 12.ca.us/Galaxy/SilverStream/Pages/AR_pg_InvoiceReceipt.html?query... 8/9/2013 Invoice JURUPA UNIFIED SCHOOL DISTRICT ,�U 17 4850 PEDLEY ROAD C 2,1°.,k19 417 JURUPA VALLEY CA 92509 BILL TO: TEMECULA VALLEY MUSEUM ATTN: SUE BLANCH/GRANT INVOICE 28314 MERCEDES ST. TEMECULA CA 92590 Invoice Date: Invoice Number: Contact Information: Make check or warrant payable to: PO Number Terms JURUPA UNIFIED SCHOOL DISTRICT 4850 PEDLEY ROAD JURUPA VALLEY, CA 92509 Remit To: Service Name MISC. Description REIMBURSEMENT FOR TRANSPORTATION; INA ARBUCKLE FIELD TRIP Accounting Information (Internal Only) Page 1 of 1 INVOICE 05/21/2013 2013 / 383 Customer Message Quantity Rate 1 481.20 Sales Tax: TOTAL: Account 03-115-0600-0-1110-1000-5804 Type INR Amount 481.20 Trans Type 3 Amount 481.20 0.00 481.20 http://galaxy.rcoe.k12.ca.us/Galaxy/SilverStream/Pages/ARpg_Invoice.html?query=AR ... 5/21/2013 /1:16AM; ELSINORE UNIFIED SCHOOL /STRICT 545 CHANEY STREET LAKE ELSINORE CA 925300000 BILL TO: TEMECULA VALLEY MUSEUM ATTN: TRACY FRICK 28314 MERCEDES STREET TEMECULA CA 92590 (951) 6946650 Make check or warrant payable to: A\ PO Number ;9512537194 # 2/ 2 • 4b'H • VA 1 Invoice Date: Invoice Number: Contact Information: INVOICE 05/22/2013 2013 / 503 Tenns Customer Message LAKE ELSINORE UNIFIED SCHOOL DISTRICT 545 CHANEY STREET LAKE ELSINORE , CA 925300000 Remit To: Service Name Description FIELD TRIP EARL WARREN ELEMENTARY TO TEMECULA VALLEY MUSEUM Accounting informationInternal OnI ccount (08-500.7230.0.0000.3600-8899 yl Quantity Rate 1 , 209.50 Sides Tax: TOTAL: Type Amount Trans'Type 209.50 2 y Amount 209.50 0.00 209.50 http://galaxy.rcoe.k12.ca.us/Galaxy/SilverStream/Pages/AR_pg_Invoice.html?query=AR ... 5/22/2013 Invoice Page 1 of 1 LAKE ELSINORE UNIFIED SCHOOL DISTRICT 545 CHANEY STREET LAKE ELSINORE CA 925300000 BILL TO: TEMECULA VALLEY MUSEUM ATTN: TRACY FRICK 28314 MERCEDES STREET TEMECULA CA 92590 (951) 6946650 Invoice Date: nvoice Number: Contact Information: Make check or warrant payable to: PO Number Terms LAKE ELSINORE UNIFIED SCHOOL DISTRICT 545 CHANEY STREET LAKE ELSINORE , CA 925300000 Remit To: Service Name Description FIELD TRIP WILLIAM COLLIER ELEM TO THE MUSEUM ON 05/28/13 FIELD TRIP WILLIAM COLLIER ELEM TO THE MUSEUM ON 06/04/13 Accounting Information (Internal OnI INVOICE 06/18/2013 2013 / 639 Customer Message Quantity 1 Rate Amount 139.95 139.95 1 151.60 Sales Tax: 151.60 0.00 TOTAL: 291.55 Account ICType Amount Trans Type 06-500-7230-0-0000-3600-8699 NR 139.95 2 2 06-500-7230-0-0000-3600-8699R 151.6 http://galaxy.rcoe.kl2.ca.us/Galaxy/SilverStream/Pages/AR_pg_Invoice.html?query=AR_INV.AR_INV FISC... 6/18/2013 ,s8:49AM; ;9512537194 # 2/ 2 Lake Elsinore Unified School District Fiscal Support Services 545 Chaney Street, Lake Elsinore, CA 92530 (951) 253-7000 FAX (951) 253-7194 Bill to: Temecula 'Va l ley Museu m 28314 Mercedes Street, Temecula, CA 92590 Attn: Tracy Frick Invoice Invoice Date: June 30, 2013 Invoice # 2014.68 )description of Invoice: Quantity Description Qty Amount 1 Earl Warren to Temecula Valley Museum 1 419.00 (2 Buses) Total of Invoice: 419.00 Budget Code: Fund School Resource Yr Goal Function Object 06 500 7230 0 0000 3600 8699 City of Temecula 2013-14 CS Funding Program APPLICATION NO. 29 CITY OF TEMECUL4 FISCAL YEAR 2013-14 COMMUNITY SERVICE FUNDING PROGRAM APPLICATION (Please Print or Tvoel RECEIVED AUG 152013 CITY MANAGER'S OFFICE 2013-14 Program Submission Deadline: Friday, August 30, 2013 (original, plus one copy) Amount Requested: $ 5000 00 PROJECT INFORMATION Project Name: Care to Share Holiday Programs Project Start Date: Sept, 1. 2013 (Maximum allowable $5,000) Project End Date: Dec. 31. 2013 ORGANIZATION INFORMATION Name of Organization: TVPHP Group - Temecula Valley People Helping People Contact Name: Denny Mighell Title/Position: PreQident / CEO Mailing Address: 37887 Spur Drive, Murriota, CA 82663 Telephone: 951-757-5212 Number of Paid Staff: 0 Year Organization Founded: 1499 Number of Volunteers: 100 to 200 Geographic Area(s) Served: City of TemAcula - Southwest RlversidP Cotmty Is this organization incorporated in California as a non-profit organization? Yes X No Effective Date: Nov 11, 1997 If "yes" (Must provide a copy of your statement of non- profit status from the State of California): Date of incorporation as a non-profit: 12 -R -199A Federal identification number: If "no": Name of sponsoring organization:. Federal identification number: State identification number: This application has been authorized by the organization's: Executive Committee X Board of Directors x Members -at -Large Application Page 1 FY 2012-13 COMPLIANCE REQUIREMENT IF YOUR ORGANIZATION WAS A RECIPIENT OF FUNDING FOR FY 2012-13, PLEASE ATTACH COPIES OF INVOICES, RECEIPTS AND CANCELLED CHECKS TO SUBSTANTIATE THOSE FUNDS RECEIVED AND EXPENDED BY YOUR ORGANIZATION. FINANCIAL STATEMENTS PLEASE ATTACH COPIES OF THE CURRENT BUDGET OF THE ORGANIZATION AND FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT). It does not require a CPA's audit, but please submit if available. MISSION STATEMENT Briefly describe the goals and objectives of your organization and community services it provides. Describe the ways your organization meets the criteria listed on page 2 of the CS Funding Policy. Our mission, as a nonprofit charity and information services, is to actively serve to the people in our communiry (Temecula and SouthwestRiverside County) by building permanent charitable capital, And prnviriing sPrvires that contrihutp to the health anri vitality of the community Through collaboration with others service organizations, city and government officials, and other caring individuals, TVPHP will continue to unite resources, experience, and Mort to work towards a mutual goal in assisting those in- need in our community PROJECT DESCRIPTION Application Page 2 How will your organization use the funding awarded? Describe the project, project objectives, those served, area serviced, and number of volunteers involved. Be specific. Include equipment or services that would be purchased and why. Include a detailed budget and a schedule of significant activities related to this project. You may attach a maximum of one double-spaced typewritten page of information. (Please type or print legibly.) TVPHP is in our 21st year of service. TVPHP Care to Share Holiday Programs has helped thousands o needed children, seniors, families and Vets of our community for the past 21 years. -We help provide food -for -Thanksgiving and New -Christmas Gifts for the children, seniors, families and vets for the holidays. We work with over 60 organizations, groups, schools and more through the years. We work DPSS for foster children in Riverside County. Tho g - •- : - -- ! - :. - : : : - City of Temecula area, only! TVPHP has helped thousands over the past 21 years in the City of Temecula. The grant funds will not be used -to purche3c any equipment or services. Application Page 3 PAST PROJECT BENEFITS If your organization received City of Temecula funding in the previous year, please explain and show how Temecula residents benefited. Temecula Valley People Helping People have been partner with the City of Temecula, since 1992 and have received grant funding from the city in the past. -. ,, - - • . - - . . . . - • - :-.. 1 - . • - - .. years. The city refers all the clients to TVPHP (Care to Share Program) for the holidays. ram) for TVPNP tiaiitiies ail ttie wist1 list frurn ttie etiitdren, sernruis, farrnhes arid vets. The residents sign up for the holidays on our web site (www.tvphp.org) and provides a wish list to TVPHP for to make a wish come true. TVPHP has thousands over the past 2-I years. A vital service to our community for the holidays, by providing food. new clothing. new gifts and more. This is service for those in need in our community and allows the community to get involved as well, by being able to volunteer for the holiday program (the whole family can vaunteer tb help TVPHP. Application Page 4 SIGNATURE PAGE We hereby certify the information contained in this application is true to the best of our knowledge and belief. PREPARED BY: Denny Mighell - President/CEO NAME and TITLE (Please Print or Type) SIGNATURE: PRESIDENT or AUTHORIZED OFFICER:Denny Mi hell NAME and TITLE (Please Print or Type) SIGNATURE:___ / ORGANIZATION NAME: MAILING ADDRESS:371187 pur . ri t Murrieta, CA 92563 TELEPHONE: 951-757-5212 - - ■ _ - EMAIL ADDRESS: tvppnplPhPlringpnnplp amnil corn DATED THIS _ 13 of August _.. __., 2013 (Date) (Month) BE SURE TO INCLUDE THE ORIGINAL PLUS ONE COPY AND SUBMIT BY AUGUST 30, 2013 TO: Mall Completed Applications to: Or Deliver In Person to: City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office Post Office Box 9033 Temecula, CA 92589-9033 City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager s Office 41000 Main Street Temecula, CA 92590 Application Page 5 867 015349 I17 Dep iinwnl or the 'llr,�snry. I� Inlrrnul Kcvcuue Service P.O. Box 2508 Cincinnati OH 45201 TEMECULA VALLEY PEOPLE HELPING PEOPLE PEOPLE HELPING PEOPLE 37887 SPUR DR MURRIETA CA 92563-4784 In reply refer to: 0248467579 June 04, 2013 LTR 4168C EO 33-0754195 000000 00 00033607 BODC: TE Employer Identification Number: Person to Contact: Mr. Gerding Toll Free Telephone Number: 1-877-829-5500 Dear Taxpayer: This is in response to your May 23, 2013, request for information regarding your tax-exempt status. Our records indicate that you were recognized as exempt under section 501(c)(3) of the Internal Revenue Code in a determination letter issued in May 1997. Our records also indicate that you are not a private foundation within the meaning of section 509(a) of the Code because you are described in section(s) 509(a)(1) and 170(b)(1)(A)(vi). Donors may deduct contributions to you as provided in section 170 of the Code. Bequests, legacies, devises, transfers, or gifts to you or for your use are deductible for Federal estate and gift tax purposes if they meet the applicable provisions of sections 2055, 2106, and 2522 of the Code. Please refer to our website www.irs.gov/eo for information regarding filing requirements. Specifically, section 6033(j) of the Code provides that failure to file an annual information return for three consecutive years results in revocation of tax-exempt status as of the filing due date of the third return for organizations required to file. We will publish a list of organizations whose tax-exempt status was revoked under section 6033(j) of the Code on our website beginning in early 2011. 015349 '(U.p,,rinlenlthe'frusu,p RS lnlernnl Revenue Service P.0, Box 2508 Cincinnati OH 45201 015349.333027.0069.002 1 AT 0.384 530 11111111111 111111118IIIIIIIi11II1111i11I111hIi111IiIIi11.11 TEMECULA VALLEY PEOPLE HELPING PEOPLE PEOPLE HELPING PEOPLE 37887 SPUR DR MURRIETA CA 92563-4784 CUT OUT AND RETURN THE VOUCHER AT THE BOTTOM OF THIS PAGE IF YOU ARE MAKING A PAYMENT, EVEN IF YOU ALSO HAVE AN INQUIRY. c5; . the IRS address must appear in the window. BODCD-TE INTERNAL REVENUE SERVICE P.O. Box 2508 Cincinnati OH 45201 I,I„I,I,I,,,I,nI iii„i,i Use for payments Letter Number: Letter Date . Tax Period 11111111 II 11 1111 *330754195* TEMECULA VALLEY PEOPLE HELPING PEOPLE PEOPLE HELPING PEOPLE 37887 SPUR DR MURRIETA CA 92563-4784 330754195 RL TEME 00 2 000000 670 00000000000 LTR4168C 2013-06-04 000000 Exempt Organizations Select Check Page 1 of 1 SIRS Exempt Organizations Select Check Exemo( Omanizattons Select Check Nome Organizations ElgIbte lo Receive Tax -Deductible Contributions (Pub. 78 dela)- Search Results The following list includes tax-exempt orgardzations that are eligible to receive lax -deductible oonb(bu ions. Click on the 'Deductibility Status" column for en explanation of limitations on the deductibility of contributions made to different types of tax-exempt organizations. Results ere sorted by EIN. To sort mulls by another category, did( on the Icon next to the column heading for that category. Citddng on that Icon a second Ume vrlll reverse 1M sort order. Click on a column heeding for an explanation of Information In that column. 14 of 1 results Results Per Page 26 .. t^' ( OKI « Prev I t -t I Nerd s EIN. Leal Name (Doing Business As). Glx Sukte.Counf). DeduG011#1Pais Temecula Valley People Helping People Murrk(a CA United Stales PC e Prev 11-11 Next s mto http://apps.irs.gov/app/eos/pub78Search.do?ein1=330754195&names=&city=&state=CA&c... 9/9/2013 Executive goard of Directors Dewwo Mighel.6 presidewt/cEo Marjaww Mighell ist vice Presidewt Keith Mitis 214v vice Presidewt Sheri Sachar Secretarj Tivu Nash Treasure Directors: Steve 4ibsow Christiwe McAllister Melissa Ao..alersow Kimberly Rawls LARYA verstratew Advisory Board: Diavtie Sitar Ma rle Sitar Bryce ebeliwg Herb patwaude Mellissa LaRocca Sophia Maxwell May 22, 2013 Mailing Address Only: 37887 Spur Drive, Murrieta, Ca 92563 951-757-5212 Office Email: tvpeoplehelpingpeople®groail.com Web Sites: www.tvphp.org Non-profit group: 501-C3 509 -Al & 170 -B -1-A &VI City of Temecula Betsy Lowrey - Senior Management Analyst 41000 Main Street Temecula, CA 92590 RE: 2012 - 2013 Grant for $5000.00 2(7 • 0"'"" • RECEIVED MAY 2 8 2013 CITY MANAGER'S OFFICE Dear Betsy, I have placed in this letter copies of some of the recipes for monies spend on the 2012 Care to Share Holiday Program. If you need any questions or need more copies of anything paper work. Please fill free to contact me anytime for any questions you may have. Remember we are a non-profit organization (501 C-3) and like everyone else, money is tight with today's economy. Please fill free to contact me anytime for any questions you may have. Thank you and God Bless! Denny & Maryann Mighell President and CEO Ci of Temecula 43200 BusinessPark Park Drive j e69¢6499�www9 . illmgg Address: g PC. Box 9033•Temecula, CA 92589-9033 X89 .�� ,t November 20, 2012 Denny Mighell, President/CEO TEMECULA VALLEY PEOPLE HELPING PEOPLE 37887 Spur Drive Murrieta, CA 92563 Dear Mr. Mighell: Congratulations on being selected for funding under the fiscal year 2012-2013 Temecula Community Service Funding Program. Your organization has been awarded $5,000 to be used for Care to Share Program providing food for Thanksgiving and Christmas, gifts for children, seniors and vets, and other items for those in need. Your organization must confirm that these funds are expended in accordance with the above -stated purpose by June 30, 2013. Receipts verifying the expenditures of this year's award must be submitted to the City by September 1, 2013. The City may require access to your accounting records in accordance with this policy. If City funds are not expended as stipulated, the funds must be retumed to the City. Mail or hand deliver to: City of Temecula City Manager's Office Attn: Betsy Lowrey 41000 Main Street Temecula, CA 92590 In order for these funds to be released, you must sign below acknowledging the following statement We do not discriminate based on race, color, nationality, sex, marital status, disability, religion, or political affiliation." The City fully supports the efforts of your organization and its services to the citizens of Temecula. Sincerely, etsy Lowry Sr. Management Analyst ACKNOWLEDGMENT OF FUNDING CONDITIONS (please sign and return this letter as soon as possible): 0e,Oiu / lyohe."—/ Print Name l le «/ Ruled on Recycle,' Paper 1185'! CI'e Auth• .• ( Signature(Title /NC" iLDate .140 WalmartI,.. Save money.Live better. (9511 506.-160 Mai k;i222RANDA5 Ctf(�A ER1100SI- 1EM1:CUlA CA 92592 SIR 2708 04111 00(05256 11g 04 1101 0111 GRAVE A 1H_N 0201936412;15 F 12.35 N GRADE A IR -.N 0201936412,5 F 12.35 p 29 N GRAM: A tIN 1)201936110.9 F 9 F 1 79 N Gll All 0�01.1010119F 1009N GRAN A p N 020193611117 F 11 11 N CRAM). A 11N 020193611129 F_ 11.29 N GRAM' A 11F N 0201936711 l7 F 11.17 N GRAMA 11FN 020193620978 F 9.78 N (1lAEA A 11114 R 020193681080 F 10 80 N 6RAOt. A I Q. N 8.61 N WADI A 11N (12019365113/ F_ 11.37 N 61 AOl . A 11114. 020193631129 F 11.29 N 011AO[. A 16N 12019.)11910 7) F 10.70 N UP 11 A 11LN 0201936112.13 F 12.33 N 01714 A f4 -N 020193631114 F 11.34 N GRAN A IA_N11.25 N GRAN A I ll N 020193691125 F 10.3409 N GRAN A 1EN 02019367102.0t93691t00 F 120 33 N GIIAIIE. A LIEN 0201936712:13 F WADI A l N 02fit936712:6 1 11.23 N CPA VIN 020193601143 f 8.61 14 CPO A ItEN 0201936411861 1 12 13 N GRAMA 1111 020193691213 1 GRA AIIN 128914 GRAN A 11L•N 020193641235 IE 12.335 14 (1 14 11A1 A 1174 020193641235 I' 10.29 GRAVE A IIC.N 020193671029 f 11.19 N GRADE A IIN 0201.93681119 1 10.09 14 GRA A 11:11 11t20193691009 I 11.11 14 GRAN A 11114 02019361'1111 f GRADE A GRADE'_ A I II N 020193690992 F 9.92 N 020193671117 F 11.1714 WADI.A NEN 020193620918 F 9.78 N WO. 1A A I ENIIIN 020193681080 E 10.80 N GRAElf. A N N 020193640861 F 8.61 N GRADE- A 1 EN 0201936511)7 F 11.31 N GRAD)_ A 1I N 0201936311.'9 F 11.29 N GRADE_ A HEN 0201936910!0 F 10.70 N CRAZY: A 11F.N12.33 N GWd)l. A IFN 020193671213 F 11.34 N ( (AOI A 111 N 020193(1311:14 F GRAD! A 11EN 020193691125 F 11..5 N WAD. A ZEN 020193671014 F GRADE A 1EN 020193691009 F 10 0.9 (,RAVE A NFN 020193671213 F 12.262.143 N GRAD)- A I1EN 020193671226 F GRADE A I2[N 0201936011,13 F 11.43 N GRAVE A NEN 020193640861 F 81 N GRADE. A f 641 020193691213 F 12.1312.09 N GRAM A 11119 0201936911X19 1 12 �'9i N 61110A NEN 11201936412•)5 f J5 14 (t GRADE A 112.1 0201936`412 t5 1 10.29 12.35 N 1101. A NEN 02019.361102.9 f 11.79 N G12A01 A 111_14 020193681179 f 10.09 14 011Al1EA 1M.N 020193691009 I". 11.1 N 611111-1flf 11 I LEN 20193690992 F 9.92 N GRAM A FEN11-14 11.17 N GRAM A f I N 020193611111 f 9.78 14 MADE A DEN 02019:3620978 1 l0-78 14 GRAN A 11E1J (120193681080 F 0.81 14 GRAM681101 A 11114 0201936511137 1 11.31 N GRAVE A IFN 11.29 N GRADE81101 A 11114 020193591010 1 10.70 N GRAY A 11114 N 12.33 N (181111 A (ZEN 020193671233 I- GRADE A IIEN 020193631134 I 11.34 N WADI . 11 25 14 GRAD( Ex136710:34 F 10.34 N GRAD( A 111:4 1)20193691009 F 10.09 N GRADE A I LEN 020193611213 1 12.33 14 G111101. A 11114 020193671226 F 12.26 N 0111191. A 11E14 020193601143 F 11.43 N GRAN' A 11E1 020193640061 F 8 61 N GRADE A DEN 020193691213 F 12.13 N GRADE. A HEN 02019369:10119 1 10.09 N 9 N GRAM: A LIEN 020193641241`-I. •_._1'2..31). N .Giat1L_A_�trN [121U93Gn 614AOI: A I IFN 0201936/102.9 1- 10.29 N tl GRA( A 1IEN 020193691009 10.09 N G1(A01: A 11EN 0201936111/1 F 11 77 N MO A 11EN 020193690992 F 9.92 N GRAIX A (EN 020193671111 F 11.17 N 0121101 A I H_N 020193620318 F 9.78 N GRAM A 11E N 020193681080 F 10.80 N GRAD A ([N 0201936408(1 F GRAVE A HEN 020193651137 F 11.37 N G(20. A 1[N 0201 9363 1 129 F 11.29 N GRAM. A 11EN 020 19369 10 70 F 10.70 N MAOf. A 1EN 02019363104 F 11.34 N GE (A1)I : A I iF N 020193691125 F 11.25 N (11(A11I A ((£N 0201936710:x4 F 10.34 N GRAM A FEN 02019369100) F 1012.0933 N GRAN' A 11EN 020193671233 t GRAM A liEN (120193611226 F 12.26 N GRADE A (IFN 020193601143 F 11.43 N GRAN' A II[N 020193640801 F 8.61 N GRAN A 1EN 020193691213 f 12.13 N G11AD[A (LN 0201936910119 1 10.09 N GRAN-. A IU -N 020193641235 F 12.35 N 011A01 A t IL N 020193641715 F 12.35 N 011A0E. A HEN 0201936811'19 F 11.79 N 0111101F A ([P4 020193691009 F 10.09 N 018101 A 1. 11fN 02019361111) F. 11.77 N GRAN. A ([N 02019369(1992 F, 9.92 N 7 N GWAR A FEN RANA 1EN 02019362091£ F 19.78 N 14 (MAN A1)) A I EN 020193640821 F 18.61 N GRAN A 1EN 020193651131 F 11.37 N GRAD( A 1(I -.N 020193631129 F_ 11.29 N GRANA 11 N 0201936910 70 E 10.70 N 70 14 G1(All. A If -.N 0201936712:33 F O(1101 A LIEN 0201936311:14 F 11.34 N O11101 A EU_N 020193691126 1 11.25 N (11A01- A t(N 0201936710:34 F GRADE A 1[N 020193691009 F 10.09 N GRAM(- A I If N 020193671233 F 12.33 N GRAOI A FEN 020193671226 F 12.26 N (FAAO(. A 11EN 02019364118(1 1 F 18.61 3 N GRAIN A lU N 0201936912.13 F 12.13 N 0111134 A If_N 020193691009 F 10.09 N GRAD( A I(1_N 020 19364 17 3.`'1, F 12.35 N WAIT. A 1EN 020193641235 F 12.35 N GRAN A FEN A (ICN 020190201933681119 F 11.79 1 9 N 601101 A 111N 020193691009 F 10.09 N 0(1AOF A 1EN 0201936111/1 F 1177 GRADE: A HEN 020193690992 F 9.92 N 0(A01 ABB 020193671117 F 11.17 N 01(11011 A ((f N 020193620978 F 9.78 N G111101 A OIN 020193681000 F 0.8 10.80 O(A1)l A 11EN 02019364118(;1 F (1.37 61 N N GRAIIi. A (K N 020193651137 F GRA01A Ilf N 020193631129 F 11.29 N O(A(IF A ([P4 020193691070 f 10 70 N GRADE A I IF N 020193671233 F 2.34 N WADE A 1EN 0201936311:34 F 1.3 3`4 N (10111*1 A (lGRADF. A HEN 020193671034 1250.34N 020193691125 F N GRAM* A iq.N 020193691009 F 0.09 N 01(1101* A ([N 0201936712:13 F 2.33 N 0(11101 A 13FN 020193671226 F 2.26 N (1110(. A ICN 020193601143 F 1.43 N GRAN' A (([P4 020193640861 i 8.61 N Off. A HEN 020193691213 1- 12.13 14 GRAM A ([EN 020193691009 F 10183 9 N 10 .58 TOM 021025622551 1- I)R1.M111M FOM 021025622558 f 25.58 N SIXITOIA1 1.(;2 TOIAI 1,699.41 0A311 1I140 1.700.00 CHAN(1 DUE # ITEMS SOLD 152 100 8109 6983 6748 588 12.2b 93 ' I �� IIIII�N��1111111�IIIUINIIIIullilllllllll 11111i�llllilllllllll,►ulllll�ll � ,Get �,- Savemotst1reandno �+ �.: ,, TAC "NMT AI P to 63257. Walmart Save money. live better. ( 951 ) 506 - 7613 MANAGER RAN)ALI. SONOERHOUSL :i2225 TEME CtL. A PKWY TEMkeaN A CA 92592 SIN 2/08 UPM 01)i.10601/ 1 EN 16 ION 05240 12PRINCESS 01173914514511( 58.00 X 20 G BIKE 0118/87610499K 114.00 X 20 0 BIKE 003386/)22528K 149.00 X 20 G BIKE 0387876610539K 61.97 X 166 H t.ARS GB 002391151803K 71.00 X 20CINCINNATI 002891453001K 159 00 X SUBT01AL 624.97 1AX 1 7.750 X 48.44 TUTAI. 613.41 AMEK 1EM 6fl. 1 AcCottNI # a�as MAX* "14411 S APPROVAL N 52228/ REF N 235500660210 TERMINAL N 49002932 1112 2it:50:56 CHANGE DUE 0.00 it ITEMS SOLD 6 lel 5611 941.3 2034 1246 1520 9 PEPRINT BY OPq 3796 Low prices Every day On everyth ng Backed by our Ad Mat<.h Guarantee. 12/19/12 20:50:57 ai*CtJ';IOtiR COPY*N* it; Walniart:!`_ Save money. Live better. ( 951 i 506 - 7613 MANAGER RAN(IALt SOMfRHOtJSI 32225 TEMECULA PKWY TEM[CULA CA 92592 SIM 2/08 OP# 00005982 TEM 32 180 01322 VICIOUS 6-7 008595506430 39.96 X VICIOUS 6.7 008595506430 19.96 X COME SET 0675/1633249 14.96 X COME SET 067571634897 34.96 X COME SE 1 067571637147 34.96 X 20PC FL A I WAR 087521700399 12.91 X SIM RV 1.5 076131502044 12.97 X 18 PC. SH 001601705792 39.97 X RZ GRA CK 111 084542300542 29.00 X STATIONERY 001234E48138 2.97 X C04011 BOOK 978030797769 1.00 X ILEI LO KITTY 076594(26596 3.97 X GIFI CARD 087458603021 25.00 0 GIFT CARD 08/158603027 25.00 0 MASTL.RCARO 079936679386 105.44 N SUBTOTAL 443.09 IWIW ROCKER 07344189715() 27.97 X DORA PLAYTIM 0740)7512372 21.97 X T000L.ER DOLL 067835215027 19.9/ X HERSHET CANE 003400000456 i 1.00 N HERSHET CANE 003400001456 F 1 00 N MLP ROYAL CA 065356966033 14.97 X HOT WHEELS 074677515876 9.47 X AIR HOGS 2 077898800336 39.97 X 1 24 CARS 005021102423 9.97 X AVG IRON MAN 065356972666 19.96 X HERSHET CANE 003400010456 f 1.00 N HERSHET CANE 003400000456 f 1.00 N CHILD TOY 061423908220 29.97 X RA2 SPK BL 084542300328 49.94 X HERSHET CANE 00341;0000456 F 1.00 N HERSHET T CANE 003400000456 F 1.00 N HERSHET CAN[ 003400000456 F 1.00 N HERSHET CANE 0034C0000456 1 1.00 N ffRSHE1 CANE 003400001456 E 1.00 N HERSHET CANE 003100000456E 1.00 N HERSTTET CAN[ 0034110000456 1 1.00 N SCOUT LAPPUP 070843119197 17.97 X VIKING 086424401259 59.97 X SUBTOTAL 776.19 TAY 1 7.750 % 47.26 TOTAL. 823.45 Atfx TEND 8:3.45 ACCOLJN F# t. t R t t t. **II 02§110 APPROVAL_ 11 56b330 REF # 2353(X)228706 TERMINAL # 39002303 12/18/12 14.34:50 CFANGF DUE 0.00 SHOP.;:ARD ACTIVATION 25.(0 ACCOUNT 6080551521663125 APPR. CODE - 56708 REF #0954497 Beg Bal Iran Ant End Bal 0.00 25.00 25.00 12/18/12 14:27:54 SHOP.CARD ACTIVAIION ACCOUNT 608055.15216' APPR. CODE 288013 REF #0952755 Beg Bal Fran Ant krd Bal 0.00 25.0(1 25.00 12/18/12 14:21:42 # ITEMS SOLD 36 REPRINT BY WN 3203 11 11 1il 111 11 1 11 111 11 IH 1I Walmart "i° Save money. Live better. ( 951 ) 506 - 7613 MANAGER RANDALL SONDF.RHOUSE 32225 TEMECUL A PKWY TEMECULA CA 92592 SIM 2108 OPO 00005935 TEM 28 ERM 00465 PRUDUCI SERIAL M LCA00240921 1EAPS1ERGS 070843139700 59.91 X I.AP1OP TOTE 007978429824 29.97 X PENCIL 007206712060 4.96 X WOW BP ASST 007251223404 2.48 X GRAPH N181( 002622977105 1.88 X C0MP800K 002622946012 0.94 X 5STAR 7X5 004310009575 1.97 X KARAOKE 002133140639 59.96 X CROOUET 081541901240 18.86 X CBG PTCH KD 003989740672 24.97 X ART TUB 007166241907 9.91 X PAPERMATE 004154093334 0.94 X WC PNCL EASL 007166200627 2.97 X AR1 CRAFT 004517304790 1.94 X SHARPENER 002600053020 7.97 X SCI-LWRKS 51N 002033503512 0.97 X PAPERMATE 004154093334 0.94 X 18CT MARKERS 007234849344 2.97 X PENCIL BOX 001314917230 0.97 X ZIPPER BINDR 004310088006 10.74 X XACTO SHARP 002600053019 6.97 X 1RAVEL. DESK 008492014506 9.97 X PENCIL 007206712060 4.96 X PAPERMATE 004154093334 0.94 X WC PNCL. EAST 007166200627 2.97 X PENCIL BOX 007314917230 0.97 X POSTER 001768174619 5.00 X LPS SPIDER 065356961362 8.97 X LPS SING CAT 065356974099 9.97 X LPS HOUND 06 065356974098 9.97 X OIETZALCOAIL 400508614518 11.97 X ALLOSAURUS 400508614512 6.88 X APATOSAURUS 400508614514 24.97 X OCTOPUS 065356975180 8.97 X ONE DIRECTIO 088768411922 11.E X BILBER JUST1 060253701673 ONE DIRECTIO 088725439722 18C1 MARKERS 007234849344 SUBTOTAL 398.43 LAWN GAMES 081541901030 28.00 X HM STUNT PAR 074617509717 49.97 X Cf ART TUB 007166211811 15.00 T SUBT0TA1 491.40 TAX 1 1.750 % 38.08 TOTAL 529.48 AMEX TEND 529.48 11.88 X 11.88 X 2.97 X ACCOUNT M Mt MR APPROVAL M 545593 REF M 235300316763 TERMINAL M 23001294 12/18/12 14:49:18 CHANGE DUE 0.00 t*=1 011 S # ITEMS SOLD 41 ICM 1120 4631 0284 9498 094/ 5 REPRINT BY WX 3203 11 low prices Every day On everything Backed by our Ad Mitch Guarantee. 12/18/12 14:49:18 **RCUSTOMER COPY*t* Walmart ::. Save money. Live better. ( 951 ` 506 - 7613 MANAGER RANUAI_t SONDERHIX)SI. 32225 TE:Mf CUL.A PKWY T[MECUI/3 CA 92592 SIN 2106 OPN (XX)05982 lEN 32 1R11 01323 AIR BOGS 0111358692833 34.97 X IF COASIER 014447651539 30.00 X MONOP 1 -BANK 065356910159 24.76 X BLOCK WAGON 006554100530 24.97 X .JD MNSTR 1RD 00:3688137528 19.96 X SOCCFRBAII 088381:59243 8.97 X SHIN GUARD 1X)2638E189198 7.97 X BB PUP PARK 0/46/7`11640 22.97 X 111 TNG STUDIO 063099E83500 1.9.91 X BARBIE PS 0746)7`_04111 26.47 X YAMAHA RC 0/1/6041/139 20.00 X B13 POPSIAIi 0/46)7512672 25.97 X 11W DRAGON 0/46)751/816 19.9/ X PI. AYL ANI) 061423S088/1 29.97 X /PM( PANTY 00452990/324 9.94 X 2 PC PJ 088616630958 5.27 X 2 PC PJ 088616642695 5.27 X 15111 RC 005021101580 25.88 X CAR CARRf111 005021101325 20.00 X CYO CASTLE 0/65Si4043442 19.97 X 11111E 11113 S 005074:162636 39.97 X 51N1 EASE' 088>152014017 9.97 X 2 EER SHIRE 068218643011 8.48 X BOYS PANI 068218642984 8.48 X 2 PC PJ 088616642654 5.27 X 2 PC PJ 088616E-42668 5.27 X CAMO MOOD 001325926080 3.88 X lWlll PANI 00135925348 3.88 X PC 500 UNS 007874208207 8.97 X DIAPER`i 00361(:0(;30492 22.94 X PLA WALK N R 003224505545 1.5.00 X DP 071956529304 5.00 X PINK C0M30 074279774803 5.00 X SWEET PEA SC 084542-00227 :4.94 X BRAT? 00351:5141529 29-97 X FAME CASE. 067604580556 20.00 X L3URGUNI)Y SEH 083612600539 5.00 X MAKEUP 0676(:4580552 10.00 X JEWE1.RY 065651442019 5.00 X VALUE SE1 011926766775 5.00 f EAR-POS1 012/83380484 5.28 X EA1-P0S1 0/2/83380485 5.28 X MEMO BOARD 064262816995 6,97 )( YZBLKSHi)WBOx 0044C2160)07 5.96 X YZMUI.TIFI.4X6 (X)44C2160003 4.96 X MS PP1. ON 008180621611 29.96 X f110W 0784E5150968 4.96 X BACKREST 004/21809321 12.00 T HALO FIGt!!31 0/8/92618912 7.00 T SUBTOTAL 737.64 fAX 1 ).750 X 57.17 fOTAI 194.81 AMEX TEND 794.81 ACCOUNT Y 414xr ■■=r s=tl' APPROVAL N 588924 REF N 235310:3191* TERMINAL N 390023(:3 12/18/12 14:50:27 c1 ANGE DILE 0.00 # ITEMS SOLD 49 CCM 16ti8 578! 6F7ti 3tl79 X884 I REPRINT BY OP# 3203 11111111 11111 11111i Low pr c,es. Every day. Or everyth >A Backed by our AO Match Guarantee. 12/18/12 14:50:28 mitTCUSTOMER COPY=xx WaImart'"�: Save money. Live better. ` t 951 f 696 - 7135 MANAGER SHAURA OLSEN 41200 MIIRRIEIA HOT SPRINGS RD MURRIETA CA 92662 Sfil 2952 OPS 00006868 TES 04 TRS 0?282 RD LTD BOW 072722399737 11.38 X PRNCS GITPPN 007166202611 9 36 X CARS RCT BK 001166236801 4.37 X BARBIL ACT B 007166226816 1.37 X FAIRY ACT BK 007166236816 1.37 X CW PRINCESS 007166232133 7 37 X CW TOY STORY 007166222136 7 97 X CMS GIFT BAG 007162316221 6 )0 X CHS GIFT BAG 007162316222 6.)0 X CMS GIFT BAIT 007162316223 6.)0 X POINSETTIA 6 009285203802 3 38 X POINSETTIA 6 009286203802 3 38 X POINSETTIA 6 009286203802 3 38 X POINSETTIA 6 009285203802 3 38 X 21C1 WSHCRYN 007166206924 2 47 X 21C1 WSHCRYN 007166206921 2 47 X 21C1 WSHCRYN 007166206921 2 47 X 21C1 WSHCRYN 007166206921 2 47 X CANDY 00701620825 F 0.38 N CANDY 00101620826 F 0.38 N CANDY 00704620825 F 0.38 N CANDY 00704620826 F 0.38 N CANDY 00704620826 F 0,38 N CANDY 00704620826 F 0.38 N CANDY 00701620826 F 0.38 N CANDY 00704620825 F 0.38 N CANDY 00704620826 F 0.38 N CANDY 00701620826 F 0.38 N CANDY 00704620826 F 0.38 N CANDY 00704620826 F 0 38 N TISSUE 8SHT 061029034233 1.17 X TISSUE 8SHT 061029034233 1 17 X TISSUE 8SHT 061029034721 1.17 K TISSUE 8SHT 061029034721 1 47 X STRAYS 017994220091 0.37 X STRAYS 017994220091 0.37 K STRAYS 017994220091 0.37 X TISSUE 10SHT 061029031435 3.37 X 00G STOCKING 081024200262 4.37 X TRAVEL PLW 081802301100 7 37 X VASE 003100910167 3.37 X VASE 003100910167 3 37 X VASE 003100910467 3.37 X JERGENS ORIG 001910011247 4.37 X SUBTOTAL 153 33 TAX 1 7,760 X 11 )2 TOTAL 161 36 AMEX TEND 160; ACCOUNT 8 **** ***w 0*(1 023' APPROVAL 1 546494 REF 8 231100611870 - TERMINAL 144000106 12/06/12 08:04:27 CHANGE DUE 0.)0 * ITEMS SOLD 44 TCI 8689 662 6167 6600 9262 9 1111 IM Ill il IIith IIII IJ Don't Forget - a ck up lauaeae 1 ens b4 Dec 14 12/06/12 08:04.27 ***CUSTOMER COPY*** oii WaImart1:_ Save money. Live better. ( 951 ) 5C6 - 7613 MANAGER RANDALL 1ONOERHOUSE 32225 TEMECULA PKWY TEMECULA CA 92592 STM 2/08 OPO 00005982 TEN 32 TRO 01324 LEGO SET 067341909318 29.88 X TOYS SET 069856784617 19.97 X MINNIE MOUSE 002911692290 5.97 X MINIPUS 033 OTY 1 5.00 X MINNT E BOWI0 o/4677505618 34.97 X S.BTOTAI 95.79 IAx 1 / 150 X 7.42 TOTAL 103.21 AMEM !ENO 103.21 ACCO(INI M VI** :R** APPROVAL N 544653 REF M 235300324814 TERMINAL N 39002303 12/18/12 14:52:53 CI 40IG1. OUE 0.00 .1*1 023 S # ITEMS SOLD 5 TCM 0533 2019 3.03 6102 1113 8 REPRINT BY OPX 3203 11 Low pr'ces Every day On everything. Backed by o.r Ae Match Gtkraniee. 12/18/12 14:52:54 ***CUSTONEP COPY*** WaImart,: Save money. Live better. ( 951 ) 506 /613 MANALATR RANDAL 1. SOW:1ERtKX3S1 32225 1FKCul A PKWY TEEItECUTA CA 92592 SIM 7/08 UPM 0000601/ ILII 16 IRM 05239 90S0 WRAP 0025/4384333 2.47 X 90S0 WRAP 002574384332 2.47 X WWRRAAPPWRAP PINGNG PAP 002574384289 2.47. X GIFT WRAP 034034156158 4.9/ X CMS VAI11' BAGS 00018600652 1.50. X VAI L* BAGS 0091869900656 0.91 X 22P1( ( I R BAG 0 /5103208141 2.50 I2.50 X 2PK '.SIR BAG 0)5103208141 2.50 X CM; 4t3 I [sAG 00/162344747 2.50 X GTF 1 BAG 002574373453 2.50 X 1SS01 PAPER 075883482006 3.00 X ISSul PAPER 075883182798 0.97 X [SStW PAPER PAPER X1/55883482811 3.00 K ISSUE PAPER 075883482806 3 00 X ISSUE. PAPER 015883482802 3.00 X ISSUE PAPER 0/5883482802 I 52.206 X SUBTG B31)2347741511 3.00 X G B 002347)42640 3.50 X G B 002347717511 3.00 X G B 00234//11511 3.00 X BW 42C1 BEG 01186901329 4.97 X BOW BAG 008630202027 2.47 X BW 42CT BHG 009186901327 4.97 X BW 42C1 BBG 0 )9186 132/ 84.97 X SUBABEN) FLAI 00918690093/ 2.47 X GREEN W/ G S 002652193811 1.48 X RED W/ GO 002652193/97 1.48 X DK RED FBRIC 009186900964 2.47 X MULTICHANNEL E1ClX009622.47 NDl 188690096( X RIBBON 002908312038 2.98 X G SNER W/14) 00265219380() 1.48 X CMS GUT l AG 007162344166 3.00 X GREEN 007316852286 3 00 X BACKI1I SI 004/2180931B 12.00 I SUBTOTAL 117.44 20 6 8111E 008187610499 114.00 X CHAOS BIKE001675152090K 79.97 X 166 PRINCESS 002891451973 17.00 X 20 6 1311(E 008787610539 67.97 X SPIRIT 003867521538 99.00 X 20 6 l3[K1 0113867521531 99.00 X 20C[1t:[NNA11 002391.453001 159.00 X SUBTOTAL 813.38 lAX 1 /./500% (3637.04 2 AMEA LEND 876.42 ACCOUNT M X4Xi APPROVAL I/ 503632 'EF 0 235500711)729 1Z ilNA1_ Y 4901)2932 ,J 20:48:43 CHANGE DUE 0.00 STEMS SOLD 46 1b / 35 1 Tiff lin II�I�I I II ifIlllhl day On everyth no ' Match Guarantee. 20:48:43 r.:a .t COPY*x; ( r., t 51X> /613 NANAU It IiAN1AI 1 5(XW1RINX)LI 322. 11141 COI A PKWY 11/11(311 A CA 2 ';(H 0101P11;/00 '00(X)5S3/ffN59311 U 0/'..9/ N AK9 5 08 11107609116 26 81 X 1111111Y .4 AN (611/845/5085 23.93 X 0131 k Nf 1 INT (kill /645(Ni592 23.93 X K I0') `;tKX 060530801321 19.00 X N01841 IIKI'K (x)209885413/Ai x);'0%8 4I37Ai 38.7:1 18.819 X Il Atk1I0N S 081127501931 1 139.88 X SP D 11 RNN ILMI (k)350119:3416 19 96 X AYi; II10N NAN 0653%9726661A1 653%99772666 119.9.`, 9 SUBTOTAI 192 4 X 1 ',133;i:t It 14A1 080:Ib 1311655 19.88 X Pim' fx)2980/89)15 4 88 X S')CI:t Il(3A11 088381359241 H 9i X 1311 C)31 SI 08113028119/5 14.9, X 251.09 13,11 1 AtiNC11 (1/46/)51 133/1 32 88 x 114r)111 tam/43905/39A1 286.9i X fun; 111 0/21321350299 7.9/ X II V1 [A4' (t84168)826262 15.86 X CAI 10/ER 0()1154332652 10.06 x 31(5314 .1/Ir 011 0)0 1/00/0860 1 920 98 N IiiillY .1/H (111 (33)10/1:0/0860 1 0.98 N I:f u MI AU 0/4677503354 6.97 X I1t it h 1.!R 1;11 (K i t 01 0 0860 I s 33.72 0.98 N '• 'OflitI1 INIRY •• t#(SIIY .1.4I OU (1401/00/08631 1 0.98 N Kutlo III 0730/72513295 6.97 X SUBIOTAI 0.69 WY 1 1 t 1. /;4121350258 s�1 l l7.97 X IIIV DKRf .1 ANS 3 LGI*d 0741117/511292 19.9 X 811/13A1f ASR/ 0/4677517463 9 97 X K llh `.i3 !PP) R (M4643/803I . y X BOOK 978081099313 9 50 X 813(X( 978081099313 9.50 X � V011)E(1 INTI3Y •r 8t Sl* t 3 Pt•A sC 08415423009 227 34.94 X sUBroTA1 438 89 311tSH .1/33 till 00:r224404658K(00186I 10.98 N 10.4 i1E 0605880275.97 X 1161111111/8 t;U 0010070086600 1 0.98 N 1[%11441 C( 1 9/0(8)06443x178 7.9/ x A'/t NU RSSC I R 01)2891428003 19.88 X S13111 SPK to (184542300328 449.50 MA 11;1 II S 075304829688 18.88 X [[GO 96// (161341916809 9.97 X 96C1 CRAYONS 007166200096 4.91 X ARIISI Pm 978140376851 3.9/ X ')OCI SUPRlIP 017166250504 6.96 X BNWN11 ACI 13 00/1662251315 4.97 X N31I`'1 PAD 9/1140376848 3.97 X P0114 SI 1 074677517218 21.97 X ITT) 9498 067341916790 29.97 X It 21497HPtIOfR 0 (6535697324 . X 131: 14111111 06` 356974614 18.0(1 X A1; I l 1 I T Y K (I U/65940441411 /11.01 12.97 X 0K8 1103111 07467751/745 5.88 X 551291 121N(0 (3* UNO 0/46/7 7 8.97 x St3TOIAI /38.83 IA ! /( fOTA1 /95.1, AMEX TEM) /95.7.. N axaa it** AI>PI3OVAI. N 51 l)i / 11H N 235300183605 11RMINA) N 200)2N50 12/18/12 14:34:5,3 C33ANC1? WI: 0 00 tt*1 003 S "Nalmart�':_ .ve money. live better. ( 95I > 506 1b13 HANAGI k lA1111A11 sotilX u i xr I :12215 ft MEC(A A PKWY INT CIA A CA 92592 ',IN :1111 OPN (1111X1593/ FUN 311 If<N 0/t.98 I Ix aril (16E189558I81x) 19 0(1 X SOB (O I Al 19 00 11KR ►IYIXtu WN 0141,11511282 8 9i X MARY 9/(031581365 14.97 X 131)01( 9/1;141971)584 9 7f. X SUB fOTAI 52. /0 DM Al K AAii 004133382501 5 9, x IH(IRKI 1(;414 (041» N)I 1300 970700 I9 1 9, 1. X S118(01AI /9.8(i 188 INA 1811 (1/40/1516719 21.9i X IC MINI BP 0611119556/422 12.0(1 X 1'111 ('w .it 1 (16(1895566528 12 88 X !Cu t.16014 0/111;/1511742 51 125 . a x 11;0 1111/ (xi/341916859 /4 9, X Al AIt. (1 (CK (11)1935378693 1.96 X 8,1`,K1 1 (4):1861504591 7 96 X 1 I.1 R4: RAI (4)'d12101331514 1/3 20.0(1 X II Q0 3818 06/341916835 49.97 X SIIA 118fA141s (x)85955500 /310 124.9/ X 111GOAOf 068895581800 19 (X1 X SOCK!. ()0428255/072 5.8') X S0cx,. (10130964/165 5.84 X PINI HAND UH (14)9650631036 15.4/ X 0251,4394/1 /9 (102592594 711 5.00 X 0:5925436604 002592543660 5.00 X AI:C1'SOME '; (1077210413065 7.88 X 8313115011335 083134500133 14.80 X CUR I NG IRON U0/410811 0098 s49, 96 X PERI- PUSH IIS 00965063 (000 19.27 X 51111 RV 1 UW sf 1 5 (16(18995566 P 111 528 12.88 X 1111X 11 SI UCH 078485751474 11.97 X 1432 1.9119: CASE 06/60455880556 420.00 X (A* CAS( 06;W4580556 20.00 X 51R01 LER (0025217720022550 4 9.88 X S f R(x 1 EH 00252 1 /20250 9.88 X 'a VOIE)EU F.NIRY ■• SRN 1 ER (x)252172025() 9.88 X 1 ECA 9463 (167341916764 19.97 X St)CCt MALI 088381359245 8.97 X 0118 Al K AA8 001133382501 5.97 X (X1R A1.X AA8 004133382501 5 97 X 1 In TRUCK 005021111688 19.97 X MIX BRU NE 1 I (65356977821 42.96 X .11AI 568.01 1 16 I RIX:K 005025110 1688 19.97 X SUB587.98 M I I1:AN (:1U' 06'1'310697390 12.00 X XIS`; CANE 003400000542 T 2.00 N M(N[ CAN 003400000411 F 2.00 N PfECEE S CAM 000'00000ANt 418 8 F 1.0000 14 U4 KfA331 10.88 1A1A8 004138250 5.97 X 01W1-1 I 0828839829 76 6.00 X 140011 088706216450 12.47 X M SI. I Kt k 060538802879 5.97 X MAPS CONVE R 1 (167255241100 10.00 X SUB I07AE 667.27 I AX 1 1.750 /1 51.251 AMEX TEENO 7 s AI:CO NVI N ass* sass mil 063 S AI1{'R0VA1 N 504440 Kt N 2353(10311472 1112111 NA! N 20002556 12/1(/12 14:47:06 (3IANGE DUE 0.00 H TTCh4C cru ri C♦ vvaimart ; Save money. Live better. i ( 951 ) 506 -• 7613 MANAGER RANOA11 SONDE.R11(XJS( 32225 TFMECU.A PKWY TEMECULA CA SIN 2/08 OPN 00005935 TEN92 28 fkN 00464 6x5 0 0830025 22.91 x ?VI IAGN00NA 07464/1513505 17.4/ X TENNIS BALI. 00/248901001 2.18 X M11VPURSKACTV 000021816/80125 12.97 X CRIKE 07467/503401 25 88 X SUBIOTA! 82.47 1211 Ulf OVEN 065356959540 39.96 X CIfI)ERLNNIS I L BAIL 07461/511851 11 14.97 X AMCGC25C 0/99116649/46 25.00 0 MAVERICK CD (X)4118/01205 1.00 X EZ GUARD ICK 00601186144 4.96 X SOCOURALKAA16 0(k113335237 8.97 X 3700464 9.97 X NFL FOOTBALL 00263884475/ 14.86 X 14.30 LEGO SET 06/349318 229.6 X BB 1081 0041 0746)/512670 25.91 X 1.1 DC SUPER 003009911433 5.00 X MAVERICK CO 004118701205 1.00 X CHILDREN STO 97814530)568 2.49 X NUMBER STK 978276430354 1.00 X TENNIS BALL 007248901001 2.18 X PWR FIGURE 004555/35102 7.77 X i WR 1 T GUM' 004555735101 7.77 X 1081 IXTLSs 0886144831411 X19.9 X MAVERICK CO 004118/01205 1.00 X INFANT TOY 0021084436Th 9.97 X 10 MARBLE 003314903113 1.50 X 11TILE TIKES 005074362759 9.97 X RAPI1VZF1 074677505883 28.97 X 360 GAN 00088888552720 3TO9.96 X WEB KINZ 06613710843/ 9.98 X I II KIN/ PESH 066137105264 4.98 X WFOWFOKKIN/�1 006581083973 1 9.98 X X WI BKIN2 PLSI-I 006581036901 9.98 X WEBKIN/ PLSH 006581034347 9.98 X BUBBLE 6A6 084090302229 10.00 X BUBBLE BAG 084090302083 10.00 X PENCIL BOX 007314917230 0.97 X ART TUB 001166241907 9.97 X SPECIAL CRYN 007166210640 2.97 X PENCIL 007166204036 4,97 X MARKER 007166208106 3.97 X STATIONERY 071496314897 1.97 X JEWELRBARBIEY2 0746775222 4 35651442020 9.87 X ACTACTIVITY KIf 016594044887 5 4 9 97 X TODDLER 001.1 067835215026 19.97 X ACTIACTIVITY KIT 076594044141 12.97 X _= VOIDED FNS 00151462 23.97 X ilit DOLLS 003505151462 23.97-X GIRLS R013E5 000071617200 12.47 X 2 PC PC PJ 0886J 16645362 11.97 X DOLLS SIC !RAP 009107406925 23.978 X DASH 065356968865 18.97 X B�OSCNS OO(X I1 065356973562 5563 28.01 X BB DSGN D011 074677516719 21.97 X f AX 1 1 15500 OT '5566.68 TOTAL 813.00 AMEX TEND 813.00 ALI'OUNI N ***x **x= ***1 003 S APPROVAI N ?39568 118 1RMINAI. 1 23001294 12/18/12 14:42:46 CHANGE DUE• 11 nn Jl•�� ,••v•••., • • •••• •._.. • i 9'0 1 'It. .613 ,. , i',1 8 it‘1.11111 1 ',1'NI4R1401/it t.'2,'-, 11 P1 GUI A 1 KWY iMI•1411 CA 92'•92 , .1 a al(10E 064 II , 14 IRff Ik,/ba :1 ,):'8f:.,92',059• 15.(X1 X tAl ,s.sitt4.4)b629. 14 97 K ,• Av1 • it'1/c:ct83$2' 5.(10 X • . I : IIA'll s 1,s‘//0:.,68.11Y • 5.00 x ,t 1304I 1,9 1t"'I 1 1.. 1 '" (K) K -I i MT 1 .1 ";t ''TI.' r • 19 96 X 131141 1 • • r..,.1 1 4 91 X M,:0111f4 •s,+•1 •'.(k • 1/ 88 K •TI)'. k)i ,n,tr, •• 1•(11 ,t 19 (10 X All Ib. I121'1011'41•' IIt" 12 84 K JAR .1'1 till:'11,0' / 6 94 X 34 11 111 00:v44.1.1.1' 7 24 X 411e, t:, .1.I8fs• ,:11t4r 13 (10 X ,:A11•• t 1A„ ►• ,1b16i1•.I1)!(N• 6 88 X •01141✓ : , '4' 00'42' •:l,l81 4 97 X `.01 1 1 I A • •( ' 1'r1.:u 4I; v . 34 94 K tA' 'il•• 'ti 11:105li :(41.i', 49 94 X ' I. • • • •Alil •l311i 0:411.11 29 88 X A • •)1:'IL. it,;',t • 4.1(8 X [1i, • ,P,115'i> ::•1 19.0Kl X k1 . k '1tx'•'t•t.t••'� ` 1 , tJl:• i 11'' • `1 116 X igtr,.1••t••1 1:3 (10 K . 1, .It1 ,11:11•1' i 3'.10 K iq 1 1 ii.,14.t 4" . 1 91 X 1, ,. itt i►t,l4'•1.• 1 - 9 f(9 X • t41. , '11l?/1.n11)t1I! 3 47 K f CO -. • •Ib' (41'.It,r. 19 t/ A ::?', 14 • ' • :I't:ii(11s')• I', t10 11 ., 1 • . , f 19fW'. •l 97 K , .I►, • • 1j',l4.:it 5.9/ X 1. • 1 I6640t 3•. 22.97 K 1 , 'I I/46775048r, 10.88 K K U110155573501111 97 X 4 00.155F•135(11.: 11 97 X . 1 Oli134191675t. 12.97 K p• 1• 0045E7253904. 20 (X) K i.10 .1 0/46/150474i 10.97 X )1 '(1 1i'i291:(,1899311 3 510 K E'1 . ' '),g3(i`2401?6Y 9 97 X t)1 I5i I 118191' 4.88 X 0,,v (1 'ANI 0/15;1116481•• 4.88 K Y:41 • •r1141 0/W.111842'1 4 88 X . 1 .31I5. 111817i•. 4.88 X 11%� ,:, Ai 111'►, t 9t.b17, 5 (10 1 it At111tcM1l' •". ,ui 1 ' 1l27'• 3.88 X •t: 41411tAl' • (.' 114127• • 3 (38 X VAI 111 it 1 . • t it 676t. 5.(10 1 •3,4 t:I 1CiA. r . 1 :`'.924' 8 91 X :14411. t i :Ai, • .4 769; 12.96 X 411n1 )V' 1- ' •141i:3it 12.96 X XII i,AMI ')11 ,t 1574: 19.96 X -11Z/13't r tivI1 q,.,1::1 146551 7.96 X : WPM: ' I'111 • . •J.•tr2178'•1 9.96 K • 1 •,,1,y • • ..123416:. 19.96 X . . It,Y 'IAY 1(:648596u 17.88 K . ,s11 •11. MI 1 U1',.,'•t•.,9778:1 11.96 X tAIlt 1:' II", 001,64...I•141261 3.88 K X 11 A•4A 011.15(1 725739'' *IA MVA Win 009/3E447574 14 96 X ANIi0 )V►) Im973€354834 12 96 X 4J1 K 11 0663293 1046.'0 19.96 X I h R RAI 0050711'1' 1 20.(0 X 11 Mt V (ON r, 11 7 97 X 3Aill31E M RHA 0/41,/m4.4 t 5 97 K '39 KFN DI 0bl(>1, ; ' ls• 11.87 X 49 111 Al 1 '.1 0)293'l73(141 • 9.96 K tkA0WRAf 0I!i6514412/.1 3 88 X a4J4IRI1 1 CAN 01467150501;' 26 •17 X 30111( 9/111419/022. 9 17 K •1AR811 01'16)190431:' 1 '33 KFN 1141 0/467151813(• 5 91 X s 3 131 At:N (K 01467751813:• 5.9/ X .1V 00Y16640684; 10.00 K 5L8T01/3 t381 53 IAN 1 1.750 % 68.32 TOTM 949.85 VISA TEND 949 85 A.:1:0UN( 4 xsxx xx., xx:x 059(1 S 1'PROVA1 N 015')/0 1• N 23'40053.3832 13(ANs XD (0823.5401811 r,49 i -� 7c' (,i / �5 v� monoy, llvo b�tt�r. i ')10 G1f ( 951) 506 7613 MANAGUR RANDALL. SONOERNOt 32225 TEMECULA PKWY TE! CUA CA 92592 2/08 OP# 00005938 TEN 29 1 CAS 087458603042 SUBTOTAL TOIAL [L1311 TEND CHANGE_ _ 00 1SU T R0 02239 75.00 0 75.00 75.00 75.00 0.00 111 01011 PAY FROM PRIMARY (( 11,5 {fit 101 Al lit IRO lA Sf ACi.OIIN N **AA *AAA � {t �►;s`� 1t.Jt�►Q 105.#01 10. A CODE 555109 TERMINAL $ 39002014 xxxA 1485 S 15:28:58 SHOP . C - 1 Y541 513596 51(%) ACCOUNT 6080434 411 APPR. CODU 022 RF 00140 Beg_lid 1 (r an Amt 0.1 5.00 12/22/12 15:28:39 End Hal 75.00 1111.1110mfiliJil(1111:1,111101)!!ij!!1111111111y�N��p�IM�IM�AN RANCHO CALIFORNIA = 951-676-2668 12/12/2012`11 48 AM. EXPIRES 03/12/13 CLOTHING HING , 046131406 046131 67 rovn1585 HOME 070010386 070010458 11111111111.1111 IiOi1 11111111111 B CH PANT 0H PANT RB LIC PJ 3PC FRYPAN 30T SAUCE TOYS -SPORTING GOODS T $8.99 087062406 HERO MASK Saved $1.00 off $9.99 MISSION T $8.99 TONKA T $6.29 I Saved $0.70 o f f $6.99 PULL N ZOOM T $10.99 T $18.99 T $14.99 08706240/ 08 70 70163 204030191 SUBTOTAL T = CA TAX 7.7500% on $1i5.70 CASH PAYMENT CHANGE DUE Igs $115.70 $8.97 $124.67 $140.67 $16.00 'c s�rwra,n l rr lr ?'''iYlc1 ' r A City of Temecula 2013-14 CS Funding Program APPLICATION NO. 30 02-3O-13 Al2:54 H CITY OF TEMECULA AUG 3 0 AM FISCAL YEAR 201 3.1 4 CITY MANAGER'S COMMUNITY SERVICE FUNDING PROGRAM APPLICATION (Please Print or Tune) (tet) L.te R sEIVED 2013-14 Program Submission Deadline: Friday, August 30, 2013 (original, plus one copy) PROJECT INFORMATION Amount Requested: $ p f )T) Project Name: Project Start Date: •J t9 02-0/ (Maximum allowable $5,000) Project End Date: x/17 ORGANIZATION INFORMATION Name of Organization: (/F--h.f Contact Name:541-4,v Title/Position: ?o 75 1/-z Rte, `-nom Year Organization Founded: / le/ Number of Volunteers: 021.1° ��I�i�� 5 �J Mailing Address: Telephone: Number of Paid Staff: — D Geographic Area(s) Served: IJI� Is this organization incorporated in California as a non-profit organization? Yes ✓ No Effective Date: .-7--,P-5-e7/ If "yes" (Must provide a copy of your statement of non- profit status from the State of California): Date of incorporation as a non-profit: Federal identification number: If "no": Name of sponsoring organization: Federal identification number: State identification number: This application has been authorized by the organization's: Executive Committee X Board of Directors Members -at -Large Application Page 1 Department of Me keasr • r Internal Revenue Sen& •F'$H'SHO, - C. . 9388O--- OF 388g....- OF cd3IFOBM t9.O0D.P..U3tL._ .__ _. TEl"IECULL- CS '92390. • _r In rlitay xeSipx t* _ $9.0$55' Sep- -26, .1989 LTB 147C .7-- •' __..... 33--4026024• 0000 00 040.:. 1 03a: Employer identification Numbers Dear Taxpayers Your employer idenfiiLf3.aation number is 33-0088084_ please keep this 'number in your permanent records_ You should enter you= nye and roux identification number. exactly as shown, on all Federal tax tore that require its use. and on any related correspondence: or documents. if you have any eeestions about this letter, please 'rite to us at the address shown on this letter_ If you pLefezr you may call the 1] telephone number listed in Your local directory_ Rn IHS employee thexe may be able to hel'you. but the tkl:+t youroffice eeat the address shown on this lettez is most if you write to us with questions about this letter, please provide your telephone number and the most convenient time for us to call so we can contact you if we need additional Information_ Please attach this letter to any correspondence to help us identify your case_ Xeen the Dopy fox your records_ Thank -you fox your cooperation_ Sincerely yours, Slrep_ @_ L_ Joly Chief. IncLuiry and Support Section Enclosure (s) _ Copy of this letter 1 1: - 'Veterans: of : Foreign T:w7cii Pam t: 4084: Teu• ...l ... . 42820. Tierra Robles -.:.._ ? I cu1s.,CR 92390 • PA -Bait 2.380tafis . ontaConiatt- .. 8.,4 Penton Cr 1=hr :+ ;..... . teunr: (211):.08 -•4553,.._ _ • •— Defer Reply*: ISP/DQ iOG-2 • Data: JUL 5 5 1984 . Dear Applicant: Tour 'application for exemption from Federal income tax as "aa organisation described IQ asct ion 501(c) (3) of the Internal Revenue Code has bean considered Information eubmitted discloses that you are affiliated mitis the Veterans of Foreign Mars Department of Callfozide_ Our -records indicate that In. Jane of 19514 a group exemption mast issued to that' orgeoizatiou, holding it and its subordinates to be exempt. • You sbQuld contact the above organization to eastablish your exempt/0a frost Federal Income tar under their groeip exemption. Very truly pours. _....-r-. 10°64 Ce16'76-1-414- District Director t. Mission Statement: To actively assist veterans and families, families of POW/MIA's, troops and their families who reside in Temecula Valley, with monthly food boxes, newborn baby supplies, eligible medical and disability compensation, support of school programs promoting patriotism, troop supplies, supportive events for troops and veterans, holiday baskets of turkeys and food items to families in the community; to show support and gratitude for veterans and troops sacrifices for the United States and its communities. Our goals are to continue the above named projects: For example, the monthly food boxes; we have been conducting this program for 5 years and the Veterans of Foreign Wars, Post 4089, gives additional monies to this project and carries out its work each month. A total of 3,696 meals were delivered this year (2013) to date to families and seniors in the City of Temecula. (see exhibit) We award cash/checks to students participating in the VFW Voice of Democracy and Patriot's Pen competitions. This program is offered to all students in schools throughout the city of Temecula. We support more than one troop with families residing in Temecula, through the VFW Adopt -A -Unit program supported by VFW National Military Services. In addition, VFW National Military Services is in charge of Operation Uplink (offering free phone cards to active military personnel) and Unmet Needs (offering emergency funds for military families). We try to make all veterans and military personnel aware of the many programs to assist them in their daily lives. a) Yes, we are a non-profit organization, chartered in Temecula Valley since 1981. b) Yes, we are a non-discriminatory organization and provide services to families, seniors, troops and veterans residing in the City of Temecula. c) Yes, the VFW Post has over 400 members, with 40 hard-working volunteers dedicated to carrying out the above-named projects within the community. d) Yes, we have had several articles in the papers over the last 4 years reflecting on the good works of the Post 4089 and its Ladies Auxiliary. We are well liked by the public and often invited to participate with other organizations in their projects. e) Both the VFW Post 4089 and Ladies Auxiliary have a chain of command, officers and responsibilities in addition to (3) trustees to oversee and double check the records and works of the organization. Post 4089 Commander is John Thomas and Ladies Auxiliary President is Irene Klockenteger. Post Quartermaster Jim McLeod and Treasurer Cheryl Peterson's records are audited on a quarterly basis. f) The VFW Post 4089 and Ladies Auxiliary have been chartered since 1981 in Temecula Valley and we hope to remain for many more years an active group in Temecula Valley. g) Yes, our service and works have been most appreciated by those we serve each month. We respect the confidentiality and privacy of those we serve, so the list of names, addresses and phone numbers are kept confidential. h) Yes, it is in our VFW By-laws that we cannot discriminate based on race, color, creed, nationality, sex, marital status, disability, religion or political affiliation. i) We do encourage members to attend our monthly meetings, but we do NOT require attendance or participation in any political, religious or social activity. j) Yes, we can provide monthly fmancial statements and are so required to do so and read aloud at each monthly meeting. k) While we do not have a formal budget, as a group we are always looking for the best possible places to purchase supplies when giving to others. If one avenue does not work out or is too costly, we immediately switch to another vendor and/or supplier. All monies have to be approved each month to spend on each and every project, and we have to record monies according to accounting standards. 1) Our organization has a main focus of veterans, troops and families residing within Temecula Valley, but we assist others in the community when requested or there is a need to do so. We take our "helping" role very seriously in this community. m) Each program is evaluated yearly, one to see if we have funds to carry out the project again the following year, was the program beneficial to those in the community, how can we do a better job of offering a helping hand. Proiect Description: to carry out a monthly food box project, which feeds approximately 22 households per month, cost of $28.00 each food box, total monthly expenditure of $616.00. Annual cost for a 12 month period is $7,392.00. A team of 5 volunteers carries out this project, making phone calls to families to schedule delivery, purchasing of goods, actual delivery and administrative paperwork. In addition, we try to provide additional food baskets for the holidays. Past Proiect Benefits: Yes, we received a check in the amount of $5,000.00 this year in late February 2013 and individual council member grant funding from MaryAnn Edwards in the amount of $2,250.00 and immediately applied the funds to the Food Box project. A spreadsheet is attached showing quantities of food boxes/meals delivered. More detailed spreadsheets are kept in our records as they contain confidential information of those we serve, but may be reviewed by a city official upon request. Since this project has been in effect for the last 6 years, our veterans, troops, seniors and families have come to depend on our assistance each month and we provide it, whether we have obtained public funding or not. We take this project seriously, as we care about our veterans, troops, seniors and families within the City of Temecula. TRUS1t.ro3 REPORT OF AUDIT OF The Books and Records of the Quartermaster and Adjutant of Department of California FISCAL QUARTERS: FUNDS 23 / Riverside / 4089 (District / County / Post No.) for the Fiscal Quarter ending December 31, 2012 • 1. National and Department Dues (Per Capita Tax) 2. _Admission or Application Fees (Department) '3. Post General Fund __... '4. Post Relief Fund (Poppy Profits, Donations, etc.) , $ 5. Post Dues Reserve Fund (See Sec. 218, -Manual of Procedu{ $ :Net Cash Balances i at Beginning of 10. Quarter 111. 74.80 $ $ 69.80 $ $ $ $ 6. National Home 7. Post Canteen or Club Fund 8. Grant Fund 9. Building Fund" 10. Commands relief fund" p•" As voted by IWembership"" 11. Bonds and Investments Not Credited to Funds 3,122.04 836.81 14. TOTALS:. $ 16._ OPERATIONS Have required payroll d : NIA Have payments been made to the proper State and Federa X Have sales taxes been X Are club employees Doi X Amount of outstanding $ N/A Value of Real Estate $ NIA ;Amount of liability insur $ 1,000,00.0.001 Owed on mortgages an $ N/A Value of personal prop( $ 20,000.00 ;Amount of property Inst S N/A 861.08 561.00 1,200.00 1,580.53 105.00 439.59 0.00 0.00 0.00 8,850.65 Receipts Expenditures 'Net Cash Balances During Quarter During Quarter:at End of Quarter 12. 113 80.0c,$ $ $0.0c i $ $ $4,416.81 i $ $6,464.90 $ $50.00 $ $0 00 $ $94.5C $ $0.00 $ $112.00 $ $561.00 $ $7,239.02 $ S5,986.13 $ $0.0C $ $1,580.53 $ $110.0! $ $0.00 1 $ $0.00 $ $0.00 74.80 69.80 1,073.95 886.81 955.58 112.00 2,452.89 0.00 215.05 439.59 $ 12,022.33 14,592.56: $ 6,280.47 6,280.471 400.00i 6,680.47! 17. RECONCILIATION OF FUND BALAf ICES Checking Account Balance $ 6,280.47; Less Outstanding Checks _ Actual Balance Savings Account Balance Cash on Hand Total Bonds and Investments (cost value) Total 18. TRUSTEES' AND COMMANDER'S CERTIFICATE OF AUDIT Date January 8, 2013 This is to certify that we (or qualified accountants) have audited the books and records of the Adjutant and Quartermaster of 23 / Riverside / 4089 for the Fiscal Quarter endin in accordance of the National By -Laws and that this Report is a true and corned statement thereof to the best of our knowledge and belief. All vouchers and checks have been examined and found to be property approved and checks properly countersigned 'ost Quartermaste D 1 28075 Diaz Road Temecula . CA 92590 (Address) This is to certify that the Office of the Quartermaster is bonded with the amount of $ 19.000 until August 2013 and belief. Signed: z,t Signed: Trustee Signed: �%�=�✓� ? Trustee Signed: ~ Trustee Traveler's Casualty & Surety Co. of America Commander 6.680.471 in We are delivering boxes to the seniors this week. Here is our year to date totals: The family meals are the certs we give to the VA center. The seniors are the meals we deliver every month. Family Meals per Senior Meals per Total Jan 14 392 10 70 462 Feb 14 392 10 70 462 Mar 14 392 10 70 462 Apr 14 392 10 70 462 May 14 392 10 70 462 Jun 14 392 10 70 462 Jul 14 392 10 70 462 Aug 14 392 10 70 462 Sep 0 0 0 0 0 Oct 0 0 0 0 0 Nov 0 0 0 0 0 Dec 0 0 0 0 0 Total 112 3136 80 560 3696 The family meals are the certs we give to the VA center. The seniors are the meals we deliver every month. SIGNATURE PAGE We hereby certify the information contained in this application is true to the best of our knowledge and belief. BY: (2-11- efees-rd- 3 f---1;/6',1--r-teL-4/ PREPARED SIGNATURE: (hj2,1 s NAME and TfTLE (Please Print or Type) PRESIDENT or AUTHORIZED OFFICER: `'�iL 1."Z79)' S Velf7-'c.— NAME and TITLE (Please Piiht or Type) SIGNATURE: ORGANIZATION NAME: 1/f /'V (l , _S-` 7Lii/ MAILING ADDRESS: £ re) /5 ))/,'Lz_ TELEPHONE: ( e)1./) 7/ `� - 0'21 EMAIL ADDRESS: ()Ai 7/5(7meA/,2/ 6.1.), yom/ Corn; DATED THIS , 8) aof , 2013 (Date) onth) BE SURE TO INCLUDE THE ORIGINAL PLUS ONE COPY AND SUBMIT BY AUGUST 30, 2013 TO: Mall Completed Applications to: Or Deliver in Person to: City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office Post Office Box 9033 Temecula, CA 92589-9033 City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office 41000 Main Street Temecula, CA 92590 Application Page 5 Exempt Organizations Select Check Page 1 of 1 I RS Exempt Organizations Select Check Exemol Oroanizelions Select Check Home Organizations Eligible to Receive Tax -Deductible Contributions (Pub. 78 dela) - Search Results The following list includes tax-exempt orgenizelions that are eligible to receive tax-deductible contributions. Click on the "Deductibility Status" column for an explanation of limitations on Inc deductibility of contributions made to different types of tax-exempt organizations. Results are sorted by EIN, To eon results by another category. dick on the Icon next 10 the column heading for that category. Clicking on that Icon a second time will reverse the son order. Click on a column heading for en explanation of Information in that column. 1.1 of 1 results EIN. L04 -al Name (Doing Business As). Veterans of foreign Wars Department of California Results Per Page 25 Return to Search OK City. Ek Grove Stele .Country CA United States R Prev 11.1 I Nexi a DeduUibiI y Slalus EO;GROYP R Prev 11-1 I Next http://apps.irs.gov/app/eos/pub78 Search.do?ein 1=940955210&names=veterans+of+foreig... 9/11/2013 November 20, 2012 Commander John Thomas VETERANS OF FOREIGN WARS, POST 4089 28075 Diaz Rd. Temecula, CA 92590-3436 Dear Commander Thomas: Congratulations on being selected for funding under the fiscal year 2012-13 Temecula Community Service Funding Program. Your organization has been awarded $5,000 to be used for the Food Box Program assisting veterans and families, families of POW/MIA's, troops and their families who reside in Temecula with monthly food boxes, baby supplies, eligible medical and disability compensation, support of school programs promoting patriotism, troop supplies, supportive events, and holiday baskets. Your organization must confirm that these funds are expended in accordance with the above -stated purpose by June 30, 2013. Receipts verifying the expenditures of this year's award must be submitted to the City by September 1, 2013. The City may require access to your accounting records in accordance with this policy. If City funds are not expended as stipulated, the funds must be returned to the City. In order to disburse your fiscal year 2012-13 Community Service Funding Program Award, the City requires back-up documentation (specifically copies of invoices, receipts and cancelled checks) to support last year's 2011-12 grant of $5,000. Please submit your back-up documentation to the address below: Mail or hand deliver to: City of Temecula City Manager's Office Attn: Betsy Lowrey 41000 Main Street Temecula, CA 92590 In order for these funds to be released, you must sign below acknowledging the following statement: "We do not discriminate based on race, color, nationality, sex, marital status, disability, religion, or political affiliation." The City fully supports the efforts of your organization and its services to the citizens of Temecula. Sincerely, Betsy Lowrey Sr. Management Analyst ACKNOWLEDGMENT OF FUNDING CONDITIONS (please sign and return this letter as soon as possible): Print NamelTitle Authorized Signature/Title Date City of Temecula 2013-14 CS Funding Program APPLICATION NO. 31 CITY OF TEMECULA FISCAL YEAR 2013-14 COMMUNITY SERVICE FUNDING PROGRAM APPLICATION (Please Print or Type) 2013-14 Program Submission Deadline: Thursday, August 30,2013 (original, plus one) PROJECT INFORMATION RECEIVED AUG 2 o 2013 CITY MANAGER'S FFICE Amount Requested: $5,000 (Maximum allowable $5,000) Project Name: Food Distribution Project Start Date: September 1999 Project End Date: Ongoing ORGANIZATION INFORMATION Name of Organization: VNW-Circle of Care, Inc. Contact Name: Terri Keim Title/Position: Director/Co-Founder Mailing Address: P.O. Box 218, Temecula, CA 92593 Telephone: 951 973-3582 Year Organization Founded: 1999 Number of Paid Staff: 1 Number of Volunteers: 60 Geographic Area(s) Served: City of Temecula and Southwest Riverside County Is this organization incorporated in Califomia as a non-profit organization? Yes X No Effective Date: 10/2003 If "yes" (Must provide a copy of your statement of non-profit status from the State of California): Date of incorporation as a non-profit: 10/30/2003 Federal identification number: Name of sponsoring organization: Federal identification number: State identification number: This application has been authorized by the organization's: Executive Committee Board of Directors X Members -at -Large If "no": Application - Page 1 FY 2012-13 COMPLIANCE REQUIREMENT IF YOUR ORGANZATION WAS A RECIPIENT OF FUNDING FOR FY 2012-13, PLEASEATTACH COPIES OF INVOICES, RECEIPTS AND CANCELLED CHECKS TO SUBSTAINTIATE THOSE FUNDS RECEIVED AND EXPENDED BY YOUR ORGANZATION. Please see Att: I II III FINANCIAL STATEMENTS PLEASE ATTACH COPIES OF CURRENT BUDGET OF THE ORGANZATION ANI) FINANCIAL STATEMENTS (BALANCE STATEMENTS AND INCOME STATEMENT). It does not require a CPA's audit, but please submit if available. Please see ATT: IV& V MISSION STATEMENT Briefly describe the goals and objectives of your organization and community services it provides. Describe the ways your organization meets the criteria listed on page 2 of the CS Funding Policy. Circle of Care's goal is to care for people in tangible ways and restore hope. This is done through the distribution of food, gently used clothing, furniture and other necessities, as well as Holiday Food Baskets and gifts. It is our objective to assist families up and out of their negative situations. We address the entire needs of the family and collaborate with other organizations to meet those other needs. For the last fourteen years Circle of Care has been providing emergency food to low income families. Last calendar year distribution of over V2 million pounds of product was distributed by Circle of Care in Southwest Riverside County; we have done this consecutively for the last 4 years. Circle of Care operates from a warehouse and administrative offices. We distribute groceries from remote locations for easy accessibility for families in need. Most of the remote location for distribution are near public transportation and on different days. We endeavor to match up the right distribution site with the availability and needs for each family or individual. Families can be served at any of the distribution sites, there is no eeojraphic limitations. whatever location best fits their schedule is where we serve them. We have had enough equipment, volunteers and resources to get a tremendous amount of product to families. We have every expectation that the volunteers that we currently have will be continuing with us. We are always seeking other funding for the improvement and maintenance of our equipment, normally everything is up and operational, as it is now. We also on an ongoing basis network to increase the resources we have for distribution. Many families currently being served are those that have never been in situations that they needed emergency food assistance. Typically these families are victims of the current economical down turn. Many have lost their lobs and or their homes. In Southwest Riverside County there are many small businesses that have closed, displacing the employees. Also we have seen an increase in professionals that we normally do not see, i.e. car salesman, Real-estate agents, mortgage processors. These professions were very prosperous in the past in our communities. Many of these people are losing their homes and trying everything to save it. We also have seen an increase of minimum wage earners as there are less of these positions available currently. Application — Page 2 'CIRCLE OF CARE BUDGET 2013-2014 IT JU_ LY AUG SEPT OCT MOVING EXPENSES _ 0 RENT 0 UTLILITES 250 TRANSPORTATION 100 HOLIDAY SPIRIT FUEL 350 350 350 OFFICE SUPP 50 50 50 WAREHOUSE SUPPLIES 50 50 50 PRINTING 200 200 200 LIABILITY INS 863 PHONE 200 200 200 200 SALARY 24K 200 500 2000 2000 0 0 0 0 0 0' 250 250 250 100 100 100 350 50 50 200 TOTALS 2263 1700 3200 3200 NOV ' DEC 2000 1300 250 100 2000 350 50 50 200 200 2000 0 1300 250 100 JAN 1300 250 100 350 350 50 50 50 50 200, 200 FEB ' MAR APRIL MAY JUNE TOTALS 0 0 0 0 0 2000 _ 1300 1300 1300 1300 1300 10400 250 250 250 250 250 3000 100 100 100 100 100 1200 350 50 50 200 200; 200 200 2000 2000 2000 8500 4500 1 4500 4500 350 50 50 200 200 2000 350 50 50 200 200 2000 4500 4500 350 50 50 200 200 2000 4500 350 50 50 200 200 2000 4500 4200 600 600 2400 863 2400 20700 48363 4:29 PM Circle of Care 08/15/13 Profit & Loss Cash Basis July 2012 through June 2013 Jul '12 -Jun 13 Ordinary Income/Expense Income Contribution Income 15,494.60 Fundraiser 1,632.00 Grant Income 7,000.00 Total Income 24,126.60 Expense Bank Charges 261.00 Building Supplies & Maintenance 288.19 Cell Phones 1,368.87 Diesel Fuel 50.00 Equipment Repair & Maintenance 62.66 Fees 450.00 Groceries 30.07 Misc. Expenses 519.80 Office Supplies 133.85 Payroll Expenses Director Salary 3,129.76 Housing Allowance 400.00 Total Payroll Expenses 3,529.76 Permits 10.00 Pest Control 349.00 Phone 873.22 Postage 59.00 Printing 176.48 Rent 10,000.00 Supplies 889.71 Taxes Paid 10.00 Unleaded Fuel 1,673.37 Vehicle Malntence 315.42 Vehicle Registration 92.00 Void 0.00 Volunteer Appreciation 572.45 Website 118.65 Total Expense 21,833.50 Net Ordinary Income 2,293.10 Other Income/Expense Other Income Interest Income 1.87 Other Income 0.00 Total Other Income 1.87 Net Other Income Net Income 1.87 2,294.97 Page 1 4:30 PM 08/15/13 Accrual Basis Circle of Care Balance Sheet As of June 30, 2013 Jun 30,13 ASSETS Current Assets Checking/Savings Provident Bank 2,308.48 Total Checking/Savings 2,308.48 Total Current Assets 2,308.48 Fixed Assets Fixed Asset Accum Depr -5,312.00 Forklift 1,850.00 Furniture 6,000.00 Furniture and Equipment Other 1,413.03 Office Equipment 2,703.14 Refrigerator Unit 500.00 Trailer 1,000.00 Total Fixed Assets 8,154.17 TOTAL ASSETS 10,462.65 LIABILITIES & EQUITY Liabilities Current Liabilities Other Current Liabilities (care Program Cards 140.00 Total Other Current Liabilities 140.00 Total Current Liabilities 140.00 Total Liabilities 140.00 Equity Opening Balance Equity Retained Earnings Unrestricted Net Assets Net Income Total Equity -1,004.17 -19,003.76 29,129.42 1,201.16 10,322.65 TOTAL LIABILITIES & EQUITY 10,462.65 Page 1 Many families being served by Circle of Care are the unemployed. for many this is the first time they have been on unemployment. For some of our families the food that we are distributing is the only groceries that they have. In those cases we encourage these families to receive provisions more than once a week. We are also seeing a longer duration of time that families are needing assistance. The other demographics still exist, the elderly, disabled. and single parents. We believe that public reaction is positive and most families are expressing their gratitude and how much the groceries have helped. The fiscal management of Circle of Care is high. We have a bookkeeper that does our monthly book keeping, Rhoda Harris. we have a CAP. that files our 990 each year. We use Ouick Books for all our financial information. Circle of Care has been a part of the City of Temecula for the past 14 years: we do believe that we have many safeguards in place to continue. We are currently working towards mentoring volunteers that could take the place of the Director and Executive Directors when and if that day comes when they retire. We are also working with another non-profit that could envelop Circle of Care and continue on with our daily operations. Currently we do not have any inclination to retire but it is very important for this organization to be generational and out live the Founders. The only evidence we have that the citizens of our City are satisfied with our services is their returning to be served a> ai their level of a• • re iatio - n • their kind words to e • ura - us t• kee • of . In 2 i 2 we did an survey of 90% of our clients. the results were very favorable to Circle of Care. we are planning to do another survey this fall. Application — Page 3 PROJECT DESCRIPTION How will your organization use the funding awarded? Describe the project, project objectives, those served, area serviced, and number of volunteers involved. Be specific. Include equipment or services that would be purchased and why. Include a detailed budget and a schedule of significant activities related to this project. You may attach a maximum of one double-spaced typewritten page of information. (Please type or print legibly.) Circle of Care would use awarded funds towards operational expenses, namely rent for our facilities, office and warehouse space. The building we are currently in has been foreclosed and we will be moving by the end or October 2013. We have looked at some buildings in Temecula and are waiting on the decision of the landlords to okay our application. We would move our entire operation to the new location, where we would have about 1500 square feet of warehouse space and about 300 square feet of office space. The rent is .62 cents per square foot. We would house our refrigeration and dry product in the warehouse area and have space for administration. Circle of Care like other non -profits are finding it more difficult to find donors for operational expenses. We have not missed a day of service for 14 yrs and plan to continue. This Grant would be a blessing to Circle of Care as it would relieve some of the financial strains we are currently experiencing. As always Circle of Care serves all that are in need regardless of race, color, creed, nationality, sex, disability. religion or political affiliation, without any demands being made to the recipients. PAST PROJECT BENEFITS If your organization received City of Temecula funding in the previous year, please explain and show how Temecula residents benefited. Last grant cycle we were awarded $5000; this enabled us to pay our rent at the Southwest Traders facility. The City of Temecula residents benefited, by Circle of Care having a presence in our city and by having the facility to operate from. Last year we served over 15thousand families, which represents about 62 thousand people in which many of those people were children the elderly, disabled and families that fall thru the cracks of red tape from the County government and or other o ganizations that they cannot gualify for. We are extremely thankful to the City of Temecula always having Circle of Care's best interest, as we do the same for our City. The continued support from our City is very much appreciated and gives us the impetus to keep going. It is not an easy.task to help those in need, but it is a right thing to do, thank you again for all that this City does for so many. Application — Page 4 SIGNATURE PAGE We hereby certify the information contained in this application is true to the best of our knowledge and belief. PREPARED BY: SIGNATURE: e __ , r NAME and TITLE (diease Print or Type) PRESIDENT or AUTHORIZED OFFICER: C k -r I e s /� , YY\ """2 C- s,�/ NAME and TITLE (Please Print or Type) SIGNATURE: C-tfe/7 ORGANIZATION NAME: V ,11 LO • C r'c ie o- rC j'1 Q MAILING ADDRESS: r - gevk 021g TELEPHONE: �� ►� e 6 , cif 902_9 DATED THIS 4 95/ (Date) EMAIL ADDRESS: //?t0Cetr-e rdv,)w of A 4 C4 ,2013 (Month) BE SURE TO INCLUDE THE ORIGINAL PLUS ONE COPY AND SUBMIT BY AUGUST 30, 2013 TO: Mail Completed Applications to: Or Deliver in Person to: City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office Post Office Box 9033 Temecula, CA 92589-9033 City of Temecula Community Service Funding Program Attn: Eva Pharis / City Manager's Office 41000 Main Street Temecula, CA 92590 Application Page 5 _ :-,- REVENUE =CF .DEPARTMENT OF THE •! R=7-1 YP. =DX 2508 OR 45201 1-17.4 --= - OP CARE INC PT S_:; --8 777.7.7771A., Ca 92593 Dear Applicant: oyer Identification Number: ..-_ _cnoac= Person: Telephone Number: (877.1 829-5500 Acccu_t_ Period Ending: December 31 Public Charity Status: - (1) (A) _. Form 990 Required: Yes Effective Dace of Exemption: October 30, 2003 Contribution Deductibility: Yes + ID* 31536 We are pleased to inform you that upon review of your application for tax exexmz t status we have determined that you are exemmt from Federal income tax under section 501(0)(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 is in your permanent records. Organizations exempt under section_ 501c) (3) of the Code are further classified as either public charities or private foundations. We determined that you are a public charity under the Code section(s) listed in the heading of this letter. Please see enclosed Information for Exempt Oraanizations Under Section 501(c)(3) for some helpful information about your responsibilities as an exempt organization. Sincerely, • • - Lots G. Lerner Director- Exempt Organizations Rulings aad Agreements Enclosures: Information for Organizations Exempt finder Section 501(c)(3) Letter 947 (DO/CG) 7 C;� 1286 ��. Ph�i RC CORDCVA CA 95741-1286 Ju -y 27, 2007 V4 ` CIRCLE OF CARE INC PO BOX 218 TEMECULA CA 92593-0218 _Purpose Code Section Form of Organization Accounting Period Ending: Organization Number CUARITABLE 2370Id Corporation December 31 2527781 In reply refer to 755:6 :DI You are exempt from state franchise or income tax under the section of --.the Revenue and Taxation Code indicated above. This decision is based on information you submitted and assumes that Your present operations continue unchanged or conform to those proposed in your application. Any change in operation, character, or purpose of the organization must be reported immediately to this office so that we may determine the effect on your exenpt status. Any change of name or address must also be reported. In the event of a change in relevant statutory, administrative, judicial case law, a change in federal interpretation of federal law in cases where our opinion is based upon such an interpretation, or a change in the material facts or circumstances relating to your application upon which this opinion is basad, this opinion may no longer oe applicable. It is your responsibility to be aware of these changes should they occur This paragraph constitutes written advice, other than a chief counsel ruling, within the meaning of Revenue and Taxation Code Section 21012(a)(2). You may be required to file Fora 199 £Exezpt Organization Annual Information Return) on or before the 15th day of the 5th month (4 1/2 months) after the close of your accounting period. Please see annual instructions with forms for requirements You are not required to file state franchise or income tax returns Exempt Organizations Select Check Page 1 of 1 ,.v IRS Exempt Organizations Select Check )rxemot Oraanizetions Select Check Home Organizations Eligible to Receive Tax -Deductible Contributions (Pub. 78 date) - Search Results The following Ilsl Includes tax-exempt organizations that are eligible to receive lax -deductible contrlbutlons. Click on the "Dedudibifily Status' column for an explanation of Wnitations on the deductibltty of contributions made to different types of tax-exempt organizations.. Results are sorted by EIN. To Bort results by another category, dick on the Icon next to the column heading for that category. Clicklng on Mut Icon a second lime will reverse Me sort order. Click on a column heeding for an explanation of IrrfomuUon In that column. 1.1 of 1 results EIN. Legal Name (Doing Business As) - Yew Ckde of Care eturn Results Per Page 25 n; n s Prev 11.1 1 Next City. State.Countral. Dcducliblkty.Status. Temecula CA United States P9 a Prey 11-1 I Next a http://apps.irs.gov/app/eos/pub78 Search.do?ein 1=731691246&names=&city=&state=CA&c... 9/9/2013 November 20, 2012 Terri Keim, Director/Co-Founder VNW-CIRCLE OF CARE, INC. P.O. Box 218 Temecula, CA 92593 Dear Terri: Congratulations on being selected for funding under the fiscal year 2012-13 Temecula Community Service Funding Program. Your organization has been awarded $5,000 to be used for the Circle of Care "Food Distribution', operational expenses, rent for facilities, office, and warehouse space. Your organization must confirm that these funds are expended in accordance with the above -stated purpose by June 30, 2013. Receipts verifying the expenditures of this year's award must be submitted to the City by September 1, 2013. The City may require access to your accounting records in accordance with this policy. If City funds are not expended as stipulated, the funds must be returned to the City. In order to disburse your fiscal year 2012-13 Community Service Funding Program Award, the City requires back-up documentation (specifically copies of invoices, receipts and cancelled checks) to support last year's 2011-12 grant of $5,000. Please submit your back-up documentation to the address below: Mail or hand deliver to: City of Temecula City Manager's Office Attn: Betsy Lowrey 41000 Main Street Temecula, CA 92590 In order for these funds to be released, you must sign below acknowledging the following statement: "We do not discriminate based on race, color, nationality, sex, marital status, disability, religion, or political affiliation." The City fully supports the efforts of your organization and its services to the citizens of Temecula. Sincerely, Betsy Lowrey Sr. Management Analyst ACKNOWLEDGMENT OF FUNDING CONDITIONS (please sign and return this letter as soon as possible): Print Name/Title Authorized Signature/Title Date VNW Circle of Care 28125 Bradley Rd. Suite 180A Sun City CA 92586 Date /.,,a? D//�• PROVIDENT . 3756 Central Ave Averside, CA 92506 ;a00) 442-5201 203 90-705113222 -Dollars SIGNED ,fL ar4, Item No. 11 Approvals City Attorney Finance Director City Manager CITY OF TEMECULA AGENDA REPORT TO: City Manager/City Council FROM: Amer Attar, Acting City Engineer DATE: October 22, 2013 SUBJECT: Declaration of Intention to Conditionally Vacate a portion of Jedediah Smith Road and setting a Public Hearing thereon PREPARED BY: Mayra De La Torre, Senior Engineer Steve Charette, Associate Engineer RECOMMENDATION: Adopt a resolution entitled: RESOLUTION NO. 13- A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF TEMECULA DECLARING ITS INTENTION TO CONDITIONALLY VACATE A PORTION OF JEDEDIAH SMITH ROAD AND SETTING A PUBLIC HEARING THEREON BACKGROUND: Wolf Valley Creek Channel Stage 1 — City Project No. PW99-11SD has been completed by the City's contractor and Riverside County Flood Control & Water Conservation District (District) is now prepared to accept the channel improvements for maintenance. The District is prepared to accept the channel improvements in accordance with the terms of the Infrastructure Funding and Acquisition Agreement - Wolf Valley Creek Channel ("Agreement"), entered into by the District, the City of Temecula, Temecula Public Financing Authority, and Wolf Creek Development, LLC, on March 1, 2004. Pursuant to the Agreement, the City agreed to construct said facilities and the District agreed to assume ownership and maintenance responsibility for the creek channel improvements after satisfactory completion. The required flood control facilities included construction of approximately 2,600 lineal feet of triple -box culvert improvements ("Improvements") within an unimproved portion of Jedediah Smith Road right-of-way (ROW). The ROW containing the Improvements is located between Pechanga Parkway and Temecula Parkway and more particularly described in Exhibits "A" and "B" to the Resolution of Intention. The ROW was originally dedicated as real property for "public road purposes, including public utility and public service uses" to the County of Riverside by the property owner, Kaiser Rancho California, recorded on April 9, 1975 as document number 040378 of official records. Under Streets and Highways Code Section 8306(a), "storm drains and drainage" are considered "public service uses." Prior to final acceptance of the Improvements, the District requires that the Improvements be located within an area designated exclusively for drainage purposes and owned solely by the District. Accordingly, the City will vacate the dedicated rights for "public road purposes" within the ROW while retaining the dedicated rights for "drainage and utility purposes" on behalf of the District. After the proposed conditional vacation with reservations, the City plans to convey to the District its interests in the subject area by separate Council action. The above proposed actions will not impact existing public utility uses because the conditional vacation is subject to reservation of the rights for public utility purposes. Pursuant to Street and Highways Code Section 8300 et seq., the City may vacate its interest in public streets or portions of public streets if the City finds that such vacation conforms to the General Plan, that the subject streets or portions of streets are no longer necessary for present or prospective public use, and that the subject portions are not useful for non -motorized transportation facilities. The Planning Commission considered the General Plan and by its adoption of Planning Commission Resolution No. 12-24 on November 7, 2012, found that the proposed vacation of a portion of Jedediah Smith Road is consistent with the General Plan. The portion of Jedediah Smith Road dedicated for "public roadway purposes" that the City intends to vacate is described and depicted on Exhibits "A" and "B" to the Resolution. The proposed conditional vacation will not impact necessary access to public utility, service, and drainage facilities for the purposes of constructing, placing, operating, inspecting, maintaining, repairing, replacing, and removing such underground facilities. Necessary access will be provided by reserving easements for these purposes as provided under Streets and Highways Code Section 8330. Specifically, the City Council intends to conditionally vacate the portion of the public street easement on Jedediah Smith Road described on Exhibit "A" to the Resolution and depicted on Exhibit "B" to the Resolution. The conditional vacation would vacate the right-of-way for "public roadway purposes" and reserve the dedicated rights for public service and public utility purposes as needed for the Improvements and existing public utilities within the area of the ROW. Staff has determined that the old street alignment is no longer necessary for public roadway purposes and therefore recommends vacating the portion of Jedediah Smith Road dedicated for public roadway purposes, which is described and depicted on Exhibits "A" and "B" to the Resolution. With the adoption of the Resolution of Intention, the City Council declares its intention to conditionally vacate the portion of Jedediah Smith Road dedicated for public roadway purposes described on Exhibit "A" and depicted on Exhibit "B" to the Resolution, and sets a public hearing to be held on November 12, 2013, at 7:00 p.m. in the Council Chambers at Temecula City Hall. At the public hearing, any and all interested persons may present evidence or object to the proposed vacation of the portion of Jedediah Smith Road dedicated for public roadway purposes. In addition, the Resolution of Intention directs the City Clerk to publish, mail and post notices of the hearing at least two (2) successive weeks before the scheduled hearing, all in conformity with and in the manner provided by Streets and Highway Code Sections 8320, 8322 and 8323. Such notices shall be posted no more than 300 feet apart and at least three such notices shall be posted in the manner set forth in Streets and Highways Code Section 8320 et seq. FISCAL IMPACT: None ATTACHMENT: Resolution RESOLUTION NO. 13- A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF TEMECULA DECLARING ITS INTENTION TO CONDITIONALLY VACATE A PORTION OF JEDEDIAH SMITH ROAD AND SETTING A PUBLIC HEARING THEREON THE CITY COUNCIL OF THE CITY OF TEMECULA DOES HEREBY RESOLVE AS FOLLOWS: Section 1. The City of Temecula declares its intention pursuant to Chapter 3, Part 3, Division 9, commencing at Streets and Highways Code Section 8300) to order the conditional vacation of an unimproved portion of Jedediah Smith Road located between Pechanga Parkway and Temecula Parkway ("ROW"). The ROW was formally dedicated to the County of Riverside pursuant to a Declaration of Dedication recorded on April 9, 1975 as Document Number 040378 of Official Records of the County of Riverside. The Declaration of Dedication irrevocably dedicated in perpetuity to the County of Riverside the ROW for "public road purposes, including public utility and public service uses." On July 28, 1981, the County of Riverside formally accepted the portion of Jedediah Smith Road for "public road purposes and utility uses" only. The City of Temecula is the successor to the interests of the County. On December 11, 2012, the City of Temecula formally accepted the dedication of the ROW for "public service" uses pursuant to Streets and Highways Code Section 8306(a). Public service uses include drainage purposes. The conditional vacation of the portion of the ROW for "public roadway purposes" would vacate the interest that is not needed for public roadway purposes and reserve the rights in the ROW for public service and public utility purposes. The City plans to convey, at a later date, its remaining rights in the dedicated ROW to the Riverside County Flood Control & Water Conservation District ("District") by separate Council action in connection with the Wolf Creek Channel Stage 1 — City Project No. PW99-11 SD. The portion of Jedediah Smith Road dedicated for "public roadway purposes" that the City intends to conditionally vacate is more particularly described and depicted on Exhibits "A" and "B" hereto. Said Exhibits are incorporated herein by this reference. Section 2. Wolf Valley Creek Channel Stage 1 — City Project No. PW99-11 SD has been completed by the City's contractor and the District is now prepared to accept the channel improvements for ownership and maintenance. The District is prepared to accept the channel improvements in accordance with the terms of the Infrastructure Funding and Acquisition Agreement - Wolf Valley Creek Channel ("Agreement") entered into by the District, the City of Temecula, Temecula Public Financing Authority and Wolf Creek Development, LLC on March 1, 2004. The channel improvements consist of approximately 2,600 lineal feet of triple -box culvert improvements ("Improvements") within the ROW. Section 3. Prior to final acceptance of the Improvements, the District requires that the Improvements be located within an area designated for drainage purposes and owned solely by the District. Accordingly, the City intends to vacate the rights for "public road purposes" within the dedicated ROW and expressly reserve the rights for public service and public utility purposes on behalf of the District. Section 4. The Planning Commission has considered the General Plan and by its adoption of Planning Commission Resolution No. 12-24 on November 7, 2012, found that the proposed vacation of a portion of Jedediah Smith Road is consistent with the General Plan. Section 5. In accordance with the California Environmental Quality Act, Public Resources Code Section 21000 et seq. (CEQA) and the CEQA Guidelines, 14 Cal. Code Regs. § 15000 et seq. (CEQA Guidelines), the City Council has considered the proposed conditional vacation of portions of Jedediah Smith Road for "public roadway purposes" as described on Exhibits "A" and "B" hereto and determined that the proposed conditional vacation is categorically exempt from further environmental review pursuant to Section 15301, Class 1 of the CEQA Guidelines. The proposed conditional street vacation is that of an existing facility and does not involve any expansion of use beyond that which currently exists. Section 6. Necessary access to public utility, service and drainage facilities for the purposes of constructing, placing, operating, inspecting, maintaining, repairing, replacing and removing such aerial and underground facilities will be provided by reserving the dedicated rights in the ROW for public service and public utility purposes pursuant to Streets and Highways Code Section 8340. Section 7. The City Council hereby sets a public hearing on the vacation of the said portions of Jedediah Smith Road for November 12, 2013, at 7:00 p.m. at the City Council Chambers, 41000 Main Street, Temecula, California, for the purpose of hearing evidence from interested person on the proposed conditional vacation. The date of the public hearing shall not be less than 15 days from the date of this Resolution. Section 8. The City Clerk is hereby authorized and directed to publish a "Notice of Public Hearing" in a newspaper of general circulation within the City of Temecula and shall be published twice in two (2) successive weeks prior to the hearing pursuant to Streets and Highways Code Section 8322. The notice of public hearing shall contain the information set forth in the text of this Resolution. Section 9. No less than 14 days prior to the public hearing on the conditional vacation, the Director of Public Works/City Engineer shall post conspicuously notices of the public hearing on the conditional vacation of the rights for "public roadway purposes" on the dedicated ROW along the line of the subject portion of Jedediah Smith Road that the City proposes to conditionally vacate. The notices shall be posted not more than 300 feet apart, but at least three notices shall be posted. The notices posted shall contain the information set forth in the text of this Resolution. Section 10. With the adoption of Resolution of Intention, the City Council declares its intention to conditionally vacate the portion of the dedicated ROW for "public roadway purposes" and to expressly reserve, pursuant to Streets and Highways Code Section 8340, the dedicated rights for public service and public utility purposes of said portion of Jedediah Smith Road more particularly described and depicted on Exhibits "A" and "B" hereto, and incorporated herein by this reference. Section 11. The City Clerk shall certify the adoption of this resolution and shall cause a certified copy of this resolution to be recorded in the Office of the Recorder of Riverside County, California. PASSED, APPROVED, AND ADOPTED by the City Council of the City of Temecula this 22nd day of October, 2013. Michael S. Naggar, Mayor ATTEST: Susan W. Jones, MMC City Clerk [SEAL] STATE OF CALIFORNIA ) COUNTY OF RIVERSIDE ) ss CITY OF TEMECULA ) I, Susan W. Jones, MMC, City Clerk of the City of Temecula, do hereby certify that the foregoing Resolution No. 13- was duly and regularly adopted by the City Council of the City of Temecula at a meeting thereof held on the 22nd day of October, 2013, by the following vote: AYES: COUNCIL MEMBERS: NOES: COUNCIL MEMBERS: ABSENT: COUNCIL MEMBERS: ABSTAIN: COUNCIL MEMBERS: Susan W. Jones, MMC City Clerk EXHIBIT "A" Sheet 1 of 2 PROPERTY DESCRIPTION FOR A STORM DRAIN EASEMENT PARCEL 7260-517 All that certain parcel of land situated in the City of Temecula, County of Riverside, state of California, as show in the Declaration of Dedication recorded April 9, 1975 as Instrument No. 40378 in the office of the County Recorder of the County of Riverside, State of California, also being a portion of Rancho Temecula as shown on the map recorded in Book 1, Page 37 of Patents in the office of the County Recorder of the County of San Diego, State of California described as follows: BEGINNING at the Southeasterly terminus of that certain course having a bearing and distance of South 47°44'36" East 2543.13 feet as described in the deed to John A. Murdy Jr. and Norma L. Murdy recorded December 30, 1966, as Instrument No. 123991, in the office of the County Recorder of said County of Riverside, said certain course also being the center line of Pala Road, 60.00 feet wide, as shown on the Record of Survey filed in Book 54, Pages 89 and 90 of Record of Surveys in the office of the County Recorder of said County of Riverside; Thence North 42°35'01" East, 55.00 feet to a line parallel with and distant 55.00 feet Northeasterly, measured at right angles, from said center line of Pala Road; Thence along said parallel line North 47°44'36" West, 932.52 feet to the TRUE POINT OF BEGINNING, said True Point of Beginning being the beginning of a Tangent curve, concave Northeasterly and having a radius of 1945.00 feet; Thence Northwesterly along said curve through a central angel of 44°13'33" an arc distance of 1501.32 feet; Thence North 3°31'03" West, 564.09 feet to a point in the Northerly boundary of the land described as the "Purchase Parcel" in the deed to Edward W. Forbes and Jacqueline S. Forbes recorded December 29, 1967 as Instrument No. 115528, in the office of the County Recorder of said County of Riverside, said point being in a non -tangent curve, concave Southerly and having a radius of 2300.00 feet, a radial line to said point bears North 11 °06'06" East; Thence Westerly along said curve in said Northerly boundary through a central angle of 1 °24'42", an arc length of 56.67 feet to an angle point in said Northerly boundary; Thence along said boundary South 3°31'03" East, 335.36 feet to an angle point therein, said last mentioned angle point being a point in a curve, concave Southerly and having a radius of 1975.00 feet and being concentric with that certain curve hereinbefore described as having a radius of 2300.00 feet; Thence Westerly along said curve, in said Northerly boundary through a central angle of 1°38' 56", an arc distance of 56.84 feet to a line parallel with and distant Westerly at right angles, 110.00 feet from that certain course hereinbefore described as having a bearing of North 3°31'03" West and a length of 564.09 feet; Thence along said last mentioned parallel line South 3°31'03" East, 256.69 feet to the beginning of a tangent curve, concave Northeasterly and having a radius of 2055.00 feet, said curve also Sheet 2of2 being concentric with that certain course hereinbefore described as having a radius feet; Thence Southwesterly along said curve through a central angle of 25°23'40", an arc 910.81 feet to said first mentioned parallel line hereinbefore described as being Northeasterly of the center line of said Pala Road; Thence along said parallel line South 47°44'36" East, 663.32 feet to the TRUE BEGINNING. This parcel contains 3.812 acres, more or less. SEE EXHIBIT "B" attached hereto. This was prepared by me or under my direction. ,/ Kris R. Winchak, L.S. 6240 Date of 1945.00 distance of 55.00 feet POINT OF EXHIBIT "B" PARCEL 7260-5/7 .,E (R) PAGE 1 OF 2 SCALE. l"= 500' PARCEL 1 PM 17/72 NO. (3) 0 DATA TABLE BEARING/DELTA N42°35'01 "E 44°13'33" NO3°31'03"W 01°24'42" S03°31'03"E 01 °38'56" S03°31'03"E 25°23'40" S47°44'36"E BASIS OF BEARING: THE BEARING N47°44'36"W AS SHOWN FOR THE CENTERLINE OF PECHANGA PKWY (PALA ROAD) PER R/S 54 - 89 & 90, RECORDS OF RIVERSIDE COUNTY, CALIFORNIA RADIUS 1945.00 2300.00 1975.00 2055.00 LENGTH 55.00' 1501.32' 564.09' 56.67' 335.36' 56.84' 256.69' 910.81' 663.32' LEGEND: P.O.B. T.P.O.B. (R) POINT OF BEGINNING TRUE POINT OF BEGINNING INDICATES RADIAL BEARING LINE ACCEPTED AS SOUTHEASTERLY TERMINUS OF THAT CERTAIN COURSE HAVING A BEARING & DISTANCE OF S47° 44'36"E, 2543.13 FT DESCRIBED IN DEED REC. 12-30-66 AS INST. NO. 123991 RIVERSIDE COUNTY FLOOD CONTROL 8 WATER CONSERVATION DISTRICT 1995 MARKET STREET RIVERS/DE, CALIFORNIA 9250/ PREPARED BY: CITY OF TEMECULA PUBLIC WORKS DEPT. 4/000 MAIN STREET TEMECULA, CALIFORNIA 92590 THIS PLAT IS SOLELY AN AID IN LOCATING THE PARCEL(S) DESCRIBED IN THE ATTACHED DOCUMENT. IT IS NOT PART OF THE WRITTEN DESCRIPTION THEREIN. e7;04A.die f13-/3 KRIS R. WIN HAK0 DATE EXHIBIT "B" PARCEL 7260-5/7 BOUNDARY AND EA SEMEN T NOTES PAGE 2 OF 2 INDICATES THE NORTHERLY BOUNDARY OF LANDS DESCRIBED IN DEED TO EDWARD W FORBES AND JACQELINE S. FORBES, RECORDED DECEMBER 29, 1967 AS INSTRUMENT NO. 115528 /2\ INDICATES THE SOUTHERLY LINE OF EASEMENT FOR FLOOD CONTROL & SANITARY SEWER PURPOSES, 650 FT WIDE AS RESERVED IN DEED RECORDED DECEMBER 29, 1967 AS INSTRUMENT NO. 115528 INDICATES A 110' WIDE OFFER OF DEDICATION FOR PUBLIC ROAD PURPOSES TO THE COUNTY OF RIVERSIDE PER INSTRUMENT NO. 40378, RECORDED APRIL 9, 1975 INDICATES THE NORTHWESTERLY BOUNDARY OF LAND IN GRANT DEED TO JOHN A. MURD Y AND NORMA L. MURDY RECORDED 12/30/66 AS INSTRUMENT NO. 123991 RIVERSIDE COUNTY FLOOD CONTROL 8 WATER CONSERVATION DISTRICT 1995 MARKET STREET RIVERSIDE, CALIFORNIA 9250/ THIS PLAT IS SOLELY AN AID IN LOCATING THE PARCEL(S) DESCRIBED IN THE ATTACHED DOCUMENT. IT IS NOT PART OF THE WRITTEN DESCRIPTION THEREIN. NE PREPARED BY: CITY OF TEMECULA PUBLIC WORKS DEPT. 41000 MAIN STREET TEMECULA, CALIFORNIA 92590 KrR1 R. W1NC AK, L.S. 6240 DATE DEPARTMENTAL REPORTS Item No. 12 Approvals City Attorney Finance Director City Manager CITY OF TEMECULA AGENDA REPORT TO: City Manager/City Council FROM: Patrick Richardson, Director of Community Development DATE: October 22, 2013 SUBJECT: Community Development Department Monthly Report PREPARED BY: Lynn Kelly -Lehner, Senior Management Analyst RECOMMENDATION: Receive and file. The following are the recent highlights for the Community Development Department in September. CURRENT PLANNING ACTIVITIES New Cases: Planning received 50 new applications for administrative review, minor cases, and home occupations, including eight applications for public hearings, during the month of September. A detailed account of current planning activities is attached to this report. Roripaugh Ranch Specific Plan: KB Home plans to construct 98 single-family homes within the Roripaugh Ranch Specific Plan Area. On May 15, 2013, the Planning Commission approved KB Home's application for Pinnacle. The model home complex is under construction and 21 building permits have been pulled. On June 19, 2013, the Planning Commission approved Home Product Review Applications for Standard Pacific and Van Daele Development. Standard Pacific will build 200 single-family homes under the marketing names Montego and Cambridge. Van Daele Development will construct 113 single-family homes, 56 marketed as Verona and 57 as Sorrento. The three builders will construct 411 homes in four of five available planning areas in the panhandle. An application has not been filed for the remaining planning area, Planning Area 2. (PETERS) Mercedes-Benz of Temecula: Mercedes-Benz of Temecula, located at Temecula Center Drive (northwest corner of Ynez Road and Waverly Lane), was approved at the July 9, 2008 Planning Commission hearing. A Supplemental EIR was also adopted at that hearing. The Planning Commission approved a Major Modification on February 20, 2013 to reduce the size of the dealership building from approximately 80,000 square feet to 50,258 square feet, and revise the architecture of the building. The grading permit was issued to the applicant on April 1, 2013, and the building permit was issued on April 23, 2013. Construction of the project is ongoing and opening of the dealership is anticipated in Spring 2014. (RICHARDSON, FISK) Temecula Valley Hospital: City Council approved the Temecula Valley Hospital project on January 22, 2008. Vertical construction for the first hospital bed tower began on February 13, 2012 and was substantially complete on May 16, 2012. A Certificate of Occupancy for the Phase I hospital bed tower was received from the Office of Statewide Health Planning and Development (OSHPD) on July 19, 2013. United Health Services, who owns and operates the hospital, obtained State licensing to open for patients on October 14, 2013. On May 31, 2013, staff received a Major Modification application to modify the site plan and heliport Conditional Use Permit to relocate the heliport from an area near the northeast corner of the hospital building. UHS has indicated that the heliport needs to be relocated based on concerns from the FAA and the aeronautical division of Caltrans. UHS is proposing two phases of movement for the heliport: Phase I would place the heliport to the west of the hospital building, in one of the parking lot areas. Phase II would place the heliport on the roof of the second hospital tower. In both cases the proposed locations result in a change to the flight path that move it away from the Summerhouse residential project and changes the path to either head directly into or away from the prevailing wind direction (rather that perpendicular to the prevailing winds), as directed by the FAA and Caltrans. This application is under review, and will require the preparation of a Supplemental EIR before the project is scheduled for a public hearing. (FISK) LONG RANGE PLANNING The Long Range Planning Division works toward larger scale and longer time -frame projects. These activities can range from an environmental review to a new specific plan or a General Plan amendment. Some of the major projects and long-range planning activities currently in progress are described below. Hike Bike Temecula (Multi -Use Trails and Bikeways Master Plan Update): On October 9, 2012, City Council adopted a resolution to reaffirm and clarify the Bike Lane and Trail Program Map. The map identifies existing bike lanes and trails, but also identifies missing gaps needed to complete a citywide network. The map classifies future bike lanes and trail routes to develop an Old Town to Wine Country Trail, a Lake Skinner Trail, and a Temecula Loop around the entire City. In February 2013, the Trails Subcommittee, consisting of Mayor Naggar and Council Member Washington, directed staff to solicit proposals for an update to the Multi -Use Trails and Bikeways Master Plan. City Council awarded the contract to KTU+A on May 14. Phase I will focus on public outreach and workshops and Phase II will update the new Multi -Use Trails and Bikeways Master Plan. On August 27, City Council approved an amendment to the contract to include a sidewalk gap analysis within the Master Plan Update. A community workshop is scheduled for October 26, 2013. Community input is being collected through a survey, which can be found on the project website www.hikebiketemecula.orq. (PETERS, LEHNER) Uptown Jefferson Specific Plan: The Uptown Jefferson Specific Plan Area encompasses approximately 560 acres and is located north of Rancho California Road, west of Interstate 15, south of Cherry Street, and east of Diaz Road. In January 2011, City Council established the Jefferson Avenue Ad Hoc Subcommittee, comprised of Council Members Roberts and Comerchero. The Specific Plan is intended to guide the revitalization of this area over the next 30 years. A project website, www.envisionjefferson.orq, tracks the visioning process, Steering Committee meetings, and provides updates to the public. Staff is developing the Specific Plan based on the eight recommendations that emerged from the public visioning process. The Environmental Impact Report will be prepared simultaneously. Plan completion is anticipated in early 2014. On June 13, 2013, staff held a Developer Focus Group to determine the feasibility of the Specific Plan based upon anticipated market conditions, economic demands, demographic trends, and available financing mechanisms. On July 16, 2013, staff held the first of six public Uptown Jefferson Specific Plan Steering Committee Meetings. Two commissioners from the Planning Commission, Community Services Commission, Public/Traffic Safety Commission sit on the Steering Committee. Staff presented a recap of the visioning process, the eight visioning recommendations, overview of form -based code principles, draft districts map, building heights, residential density, and the anticipated 30 -year build out scenario. On August 28, 2013, staff held the second Steering Committee meeting and gave a presentation on the draft districts, anticipated land use mix, draft land use matrix, administration of legal non -conforming land uses, building types, frontage types, and build -to line requirements. On September 19, 2013, staff held the third Steering Committee meeting. There were approximately 30 attendees. Staff presented a discussion of the future hypothetical street -grid concept, block size standards, future street cross sections, and public realm. The next Uptown Jefferson Specific Plan Steering Committee meeting will be held on October 29, 2013 at 6:00 p.m. in the Conference Center. (RICHARDSON, WATSON, INNES, WEST) Uptown Jefferson Specific Plan Environmental Impact Report: The preparation of a Program Environmental Impact Report (EIR) is underway for the Uptown Jefferson Specific Plan. Environmental Science Associates is preparing the EIR document. The Initial Study and Notice of Preparation (NOP) were routed for circulation to responsible, trustee agencies and the Office of Planning and Research on June 10, 2013. The NOP comment period ended July 12, 2013. An EIR Scoping meeting was held on June 27, 2013, providing interested parties the opportunity to submit their comments related to EIR. All property owners within the Specific Plan area were noticed for this meeting. The Administrative Draft EIR was submitted on August 28, 2013 and staff is reviewing the draft document. (RICHARDSON, WATSON, INNES, WEST) COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) & HOUSING Community Development Block Grant (CDBG): The total anticipated Fiscal Year 2013-14 CDBG allocation for the City of Temecula was $380,446. The Finance Subcommittee, consisting of Mayor Naggar and Councilmember Washington, recommended allocating 20 percent for program administration and fair housing services ($76,089), 15 percent for public services ($57,067) to be divided evenly between seven non-profit service providers, and the remaining 65 percent for infrastructure improvements ($247,290). The City Council adopted the Action Plan with the recommendations made by the Finance Subcommittee on April 23, 2013. The approved Annual Action Plan was submitted to HUD in May. In June, the City was notified that the total Fiscal Year 2013-14 CDBG funding amount would be $517,195. (WATSON, WEAVER) 2014-2021 Housing Element Update: State law requires the City to adopt an updated Housing Element and have it certified by the State Department of Housing and Community Development (HCD). City staff is collaborating with Pacific Municipal Consultants to assist with the update of the Housing Element. Public outreach efforts include one workshop, a public review period, and two public hearings. In December 2012, the City held a community workshop to discuss the Housing Element update, and receive input from residents regarding housing needs. The preliminary administrative draft was submitted to HCD in late March. The administrative draft was resubmitted on September 27, 2013 to address HCD comments related to density. The project is on schedule for adoption by the City Council in January 2014. (WATSON, WEAVER) ENERGY & CONSERVATION PROGRAM ACTIVITIES Western Riverside Energy Leadership Partnership: This Partnership consists of 11 WRCOG member cities, Southern California Edison (SCE), and Southern California Gas (SCG). The Partnership provides incentives for participating cities, businesses, and residents to develop energy efficiency programs. In March, Temecula was the first city to achieve a Gold Level status by completing 13 energy efficiency projects in FY 2012-13, while increasing total kWh savings to 813,037, and resulted in nearly $100,000 of annual utility cost savings. In August, SCE approved a rebate incentive of $1,983 to replace 29 parking lot fixtures at the Community Recreation Center (CRC) with energy efficient induction lighting technology. The CRC lighting retrofit project will reduce the annual energy consumption by 15,000 kWh. The SCE rebate and estimated annual utility savings will be deposited into the Temecula Energy and Asset Management Fund for future energy efficiency projects. (WEST) Energy Action Plans (EAP): A draft Municipal Energy Action Plan and draft Community Energy Action Plan have been prepared for the City of Temecula. The preparation of these plans was funded through the Energy Partnership as part of the first year program development. The Municipal EAP establishes the baseline energy use and forecast energy demand of City owned and operated facilities, while the Community EAP establishes the baseline energy use and demand within the community. Both EAPs establish energy reduction goals, policies, and implementation actions to achieve the goals of the EAP. Staff has identified potential energy reduction measures to achieve the proposed goals within each EAP and is waiting for comments from SCE. (WEST) Green House Gas (GHG) Emissions Inventory/Climate Action Plan: A draft Municipal GHG inventory and Community GHG inventory has been prepared for the City of Temecula. The preparation of the inventories was funded through the Energy Partnership. Baseline energy and forecast energy data from the Energy Action Plans were used to establish a baseline for the emission inventories. The inventories will be incorporated into the Western Riverside County Climate Action Plan for implementation of strategies that address state legislation AB 32 and SB 375. The Climate Action Plan proposes to address overall greenhouse gas emissions in Western Riverside County by identifying emission reduction targets, and by developing GHG emissions reduction measures. Staff has provided comments to the Municipal and Community GHG inventories and to the Climate Action Plan. (WEST) Temecula Energy and Asset Management (TEAM) Fund: Staff is working with Public Financial Management Inc., a consultant funded through the Energy Partnership, to develop an administrative policy and procedure manual for the TEAM Fund. The TEAM Fund is designed to be self-sustaining by depositing utility rebate incentives directly into the Fund and by re -directing annual utility costs savings from energy efficiency projects into the Fund. The TEAM brings together the efforts of the Municipal Facility Energy Benchmarking and the Energy Action Plan to identify the most appropriate energy efficiency projects for programming with TEAM funds. At the June 25, 2013 City Council Meeting, City Council established the TEAM Fund, and redirected $119,728.90 in SCE and SCG rebates received in Fiscal Year 2012-13 into the Fund. A final report will be brought forward to City Council for approval. (WEST) Solid Waste and Recycling: Staff manages the City's Solid Waste and Recycling Franchise Agreement with CR&R and acts as a liaison between the City and CR&R and their customers. Staff is currently working with CR&R to establish a special disposal rate for the City's Capital Improvement Program (CIP) projects. The new rate will reduce the City's overall cost of CIP projects. City staff and CR&R coordinate two Citywide Clean-up events each year. The next Citywide Clean-up is scheduled for October 5, 2013 at Chaparral High School from 8:00 A.M to 2:00 P.M. City of Temecula residents can bring electronic waste, appliances, and large miscellaneous hard to handle items to these events. City staff also assists with outreach for the Riverside County Mobile Household Hazardous Waste Collection Events (HHWE) and the Backyard Composting Workshops. These programs are open to all Riverside County residents. An HHWE event occurred on September 7, 2013 at Murrieta City Hall. (WEST) SPECIAL PROJECTS Old Town Trolley: On April 9, 2013, the Old Town Steering Committee Meeting, consisting of Mayor Naggar and Council Member Roberts, approved a pilot program for the Old Town Trolley with Brewen's Empire Trolley. The pilot program, which ran from May4 through August 3, provided free, public transportation throughout Old Town that is convenient to restaurants, shops, and the Civic Center. The trolley encourages visitors to park in the public Civic Center parking garage. The Old Town Steering Committee met for pilot program updates on June 17`" and July 24`". On August 1, 2013, the Steering Committee proposed to extend the Old Town Trolley Program to cover five Hot Summer Nights in August and Saturday service until January 2014. (RICHARDSON, LEHNER) BUILDING & SAFETY Inspections: During the month of September, Building and Safety conducted 2,031 inspections. On average, there were 101.55 inspections per day, or 25.38 per inspector per day. Permits: During the month of September, Building and Safety issued 335 construction permits. Of these permits, 23 were dwelling units. Some of these permits included: Tenant Improvements Abbott Vascular — 26531 Ynez Road Trattoria Toscana Restaurant — 26485 Ynez Road Suite N Dr. Kenneth Hguten Dentist — 42210 Lyndie Lane Suite B Musicology — 29700 Rancho California Road Suite G9 Subway — 26490 Ynez Road Suite D Liberty Tax Service — 31821 Temecula Parkway Suite 3 Non -Construction Certificate of Occupancy Loss Prevention Systems, Inc. — 43234 Business Park Drive Suite 101 The Chiropractic Studio — 41920 6th Street Suite C Medical Transport Service — 42072 5th Street Suite 201 JV Design and Engraving — 41743 Enterprise Circle N Suite 105A The Running Center — 28751 Rancho California Road Brookside Winery - 43162 Blackdeer Loop Suite E Temecula Speed and Marine — 28075 Diaz Rd Chris Clayton Salon — 33175 Temecula Parkway Suite F The Cuban Hut Restaurant — 41790 Winchester Road Suite F Foreclosure Tracking: Building & Safety works with the local real estate community to monitor foreclosures, real estate owned properties, and properties in default in both commercial and residential development. The following charts demonstrate the past six months of foreclosure tracking activities in Temecula. Both residential and commercial foreclosures continue to decline in Temecula as the economy improves. Residential Foreclosure Tracking Commercial Foreclosure Tracking APRIL 2013 MAY 2013 JUNE 2013 JULY 2013 AUGUST 2013 SEPTEMBER 2013 DEFAULT 147 137 140 136 110 100 FORECLOSED 189 156 154 137 120 116 REO 98 83 76 79 71 60 TOTALS 434 376 370 352 301 276 Commercial Foreclosure Tracking CODE ENFORCEMENT In the month of September, Code Enforcement responded to 63 web complaints from constituents. In addition, they opened 139 cases, 105 of which were residential and 34 were commercial. Code Enforcement also pulled 800 non -conforming signs in the community. The breakdown of Code Enforcement responses can be found in the chart below.. Code Enforcement worked with Temecula Police Department, regarding 17 vehicles (cars, boats, trailers, and RVs). These vehicles were illegally parked, abandoned, or blocking the public right of way. Twenty-three people were assisted at the Community Development counter. Office staff also drafted and issued letters for taxicab drivers and owners not in compliance with Temecula Municipal Code in regards to permits. SEPTEMBER 2013 - Code Enforcement Cases TYPE OF CODE CASE APRIL 2013 MAY 2013 JUNE 2013 JULY 2013 AUGUST 2013 SEPTEMBER 2013 DEFAULT 6 8 7 7 7 7 FORECLOSED 4 3 6 3 3 3 REO 68 41 58 59 40 34 TOTALS 78 52 71 69 50 44 CODE ENFORCEMENT In the month of September, Code Enforcement responded to 63 web complaints from constituents. In addition, they opened 139 cases, 105 of which were residential and 34 were commercial. Code Enforcement also pulled 800 non -conforming signs in the community. The breakdown of Code Enforcement responses can be found in the chart below.. Code Enforcement worked with Temecula Police Department, regarding 17 vehicles (cars, boats, trailers, and RVs). These vehicles were illegally parked, abandoned, or blocking the public right of way. Twenty-three people were assisted at the Community Development counter. Office staff also drafted and issued letters for taxicab drivers and owners not in compliance with Temecula Municipal Code in regards to permits. SEPTEMBER 2013 - Code Enforcement Cases TYPE OF CODE CASE RESIDENTIAL COMMERCIAL TYPE TOTAL Abandoned or Inoperable Vehicle 5 0 5 Vacant Home / Property Maintenance / Rodent infested 14 2 16 Business or Home Occupation w/o license 1 20 21 Abandoned Home / Vandalism 2 0 2 Trash and Debris / Parking lot maintenance 9 0 9 Overgrown Vegetation / Weeds / Fire Hazard 18 0 18 Green Pool / Vector Control 3 0 3 Graffiti 3 2 5 Noise 2 1 3 Trailer / RV Stored 9 0 9 Construction w/o Permit 4 5 9 Encroach Public ROW / Trash Cans 27 0 27 Other / Nameless Encampment 4 0 4 Other / Smoking Ordinance / Safety Issue 0 0 0 Other / Safety Issue - Pool no fence/gate 3 0 3 Other/Parking 4 0 4 Signs Pulled - Violations 0 4 4 108 34 142 Web Complaints 63 TOTAL NUMBER OF CASES 205 Planning Agenda Report 9/1/2013 through 9/30/2013 • PA13-0191 Jumpin' Pumpkins TUP APN # 910130075 VICTORIA HERNANDEZ A Major Temporary Use Permit for Jumpin' Pumpkins, Inc to have a pumpkin patch, inflatable rides, tractor rides, food vendors, carnival games, face painting, music, petting zoo, obstacle course and hay maze from September 29 through October 31, 2013, at 40640 Winchester Road. Submitted Date Approved Date Aug 14 2013 Sep 10 2013 • PA13-0201 Refuge Brewery TUP APN # 921040018 VICTORIA HERNANDEZ A Major TUP to allow Refuge Brewery to hold a private event for the 120 Club, serving food and alcohol from 5 p.m. to 8 p.m. on October 6, 2013 at 43040 Rancho Way, Suite 200. Submitted Date Approved Date Aug 28 2013 Sep 242013 • PA13-0223 Big Horse Harvest Festival APN # 965410003 KENNY TAYLOR A Major Temporary Use Permit for the Big Horse Corn Maze and Harvest Festival to include pumpkin picking, corn maze, face painting, pony rides, carnival games, 5k run, and classic car show, from October 5, 2013 through October 31, 2013, located on a vacant lot at 33320 Temecula Parkway. Submitted Date Approved Date Sep 23 2013 Sep 30 2013 1 of 7 • PA11-0157 Planning Agenda Report 9/1/2013 through 9/30/2013 Arco Major Modification ERIC JONES A Major Modification application to allow an existing gas station/convenience store to add 1,000 square feet to the existing store for a deli and outdoor seating at 44239 Margarita Road. Submitted Date Anticipated DRC Meeting Date Directors Hearing Jun 6 2011 Nov 7 2013 APN # • PA11-0275 Bela Linda DP 961450012 ERIC JONES A Development Plan Application for a residential project. Consisting of 325 multi -family apartment units. The project will also feature 49 single-family cluster units (senior units). The project totals 25.56 acres and is located on the northeast corner of Pechanga Parkway and Loma Linda Road (APNs 961-450-012, 013, 003) (Related Applications: PA11-0276, 0277). Submitted Date Anticipated DRC Meeting Date City Council Oct 27 2011 Nov 26 2013 • PA11-0276 Bella Linda Zone Change, PDO APN # 961450012 ERIC JONES A Zone Change and Planned Development Overlay (PDO) Application for a two phased residential project. Both the General Plan and Zoning designations are currently Professional Office (PO). The application proposes to create a Medium Density Residential section (Courtyard Housing) and a High Density Residential Section (Apartments). The PDO will provide architectural and landscape design guidelines. The project is located on the northeast corner of Pechanga Parkway and Loma Linda Road and totals 25.56 acres (APNs: 961-450-012, 013, 003) (Related Applications: PA11-0275 and PA11-0277). Submitted Date Anticipated DRC Meeting Date City Council Oct 27 2011 Nov 26 2013 • PA11-0277 Bela Linda TTM APN # 961450012 ERIC JONES A Tentative Tract Map Application to create 54 separate residential Tots from three existing lots. Four additional Tots will also be created: Lots A - C will contain the public right-of-way through the center lines of Pechanga Parkway and Loma Linda Road, and Lot D will consist of a private road. The project totals 22.73 acres and is located on the northeast corner of Pechanga Parkway and Loma Linda Road (APNs 961-450-012, 013, 003) (Related Applications: PA11-0276 & PA11-0275). Submitted Date Anticipated DRC Meeting Date City Council Oct 27 2011 Nov 26 2013 • PA13-0166 United Surgery Major Mod APN # 959070031 ERIC JONES A Major Modification application to revise a previously approved 6,000 square foot restaurant (that has not been constructed) to a 12,543 square foot surgery center. The project site is generally located on the northeast corner of Temecula Parkway and Rancho Pueblo Road at 31469 Rancho Pueblo Submitted Date Anticipated DRC Meeting Date Planning Commision Jul 9 2013 Nov 6 2013 • PA13-0175 Happy Days Hookah 2 of 7 APN # 920100030 KENNY TAYLOR Planning Agenda Report 9/1/2013 through 9/30/2013 A Minor Conditional Use Permit for Happy Days Hookah and Vapor Lounge to allow indoor smoking of hookah and tobacco products for members age 18 and over within an existing building. Proposed hours of operations are from 1 p.m. to 12 a.m. seven days per week at 27287 Nicolas Road (Chaparral Village). Submitted Date Anticipated DRC Meeting Date Directors Hearing Jul 18 2013 Oct 24 2013 • PA13-0187 Belle Maison Home Product APN # 953390007 ERIC JONES A Home Product Review application for Bella Maison by Lennar Homes. The tract features one and two story homes on 37 lots generally located on the northwest corner of Butterfield Stage Road and Chemin Clinet. Submitted Date Anticipated DRC Meeting Date Planning Commision Aug 1 2013 Oct 16 2013 3 of 7 Planning Agenda Report 9/1/2013 through 9/30/2013 • PA10-0213 ew Submittals Pending DRC Mee Simms TTM APN # 945120001 ERIC JONES A Tentative Tract Map application to create 5 residential lots from 4 lots with lot size ranging from 1.31 acres to 2.80 acres on vacant property generally located on the south side of Santiago Road, approximately 1,500 feet east of Ynez Road. Submitted Date Anticipated DRC Meeting Date Hearing Planned Jul 14 2010 8/12/2010 TBD • PA12-0131 Arbor Vista GPA APN # 919350017 ERIC JONES A General Plan Land Use map change from Very Low (VL) density residential to Low (L) density residential. The project site is located on 73 acres at the southeast corner of Nicolas and Via Lobo Roads. (APN 919-350-0117, - 0118, -0119, -120) (Associated applications: PA12-0132, Zone Change to PDO; PA12-0133, TTM 36479; and PA12-0134, Home Product Review). Submitted Date Anticipated DRC Meeting Date Hearing Planned Jul 12 2012 8/9/2012 TBD • PA12-0132 Arbor Vista ZC to PDO APN # 919350017 ERIC JONES A Zoning Map and Text change from Very Low (VL) density residential to a Planned Development Overlay (PDO) based on the standards of the Low (L) density residential designation with provisions for a cluster development. The project site is located on 73 acres at the southeast corner of Nicolas and Via Lobo Roads (APN 919-350-017, -018, - 019, -120) (Associated applications: PA12-0131, GPA; PA12-0133, TTM 36479; and PA12-0134, Home Product Review). Submitted Date Anticipated DRC Meeting Date Hearing Planned Jul 12 2012 8/9/2012 TBD • PA12-0133 Arbor Vista TTM 36479 APN # 919350017 ERIC JONES A Tentative Tract Map (No. 36479) to subdivide 73 acres into 83 single-family cluster lots. Minimum lot size for the residential Tots is 5,500 square feet. Approximately 59% of the site will be preserved as permanent open space to preserve the existing drainage on-site. Access to the site will be provided from Nicolas and Via Lobo Roads. The project site is located at the southeast corner of Nicolas and Via Lobo Roads (APN 919-350-017, -018, -019, -120) (Associated applications: PA12-0131, GPA; PA12-0132, Zone Change to PDO; and PA12-0134, Home Product Review). Submitted Date Anticipated DRC Meeting Date Hearing Planned Jul 12 2012 8/9/2012 TBD • PA12-0134 Arbor Vista HPR APN # 919350017 ERIC JONES A Residential Home Product review for 83 lots to be created with TTM 36479 (PA10-0133) for 4 floor plans ranging in size from approximately 2,700 to 3,500 square feet with three elevation types each including Craftsman, Spanish and Traditional. The project site is located at the southeast corner of Nicolas and Via Lobo Roads (APN 919-350- 017, -018, -019, -120) (Associated applications: PA12-0131, GPA; PA12-0132, Zone Change to PDO; and PA12- 0133, TTM 36479). Submitted Date Anticipated DRC Meeting Date Hearing Planned Jul 12 2012 8/9/2012 TBD 4 of 7 Planning Agenda Report 9/1/2013 through 9/30/2013 • PA13-0068 Tower Plaza Addition and Mod APN # 921260022 KENNY TAYLOR A Major Modification to add 1,564 square feet of new restaurant and professional office space at 27423 Ynez Road (Tower Plaza Center). Submitted Date Anticipated DRC Meeting Date Hearing Planned Mar 26 2013 6/27/2013 TBD APN # • PA13-0141 UHS Heliport Major Mod 959080001 STUART FISK Major Modification and Supplemental EIR for the Temecula Valley Hospital Development Plan and Heliport Conditional Use Permit to relocate the heliport from the east side of the project site to the west side of the site at 31700 Temecula Parkway. Submitted Date Anticipated DRC Meeting Date Hearing Planned May 31 2013 6/27/2013 TBD • PA13-0155 APN # Shearwater Creek DP 922110013 ERIC JONES A Development Plan to construct a 141 unit attached residential project with a pool and clubhouse for project residents, located on the west side of Pujol Street at the southern end of Pujol Street (APNs: 922-110-013, 922-110- 014) (Related Application: PA13-0156 - Condo Map) Submitted Date Anticipated DRC Meeting Date Hearing Planned Jun 182013 TBD APN # • PA13-0167 River Springs CUP 921750014 KENNY TAYLOR A Minor Conditional Use Permit allowing River Springs Charter School to occupy an existing 16,978 square foot building for charter school educational services to adolescent students Kindergarten thru 8th grade located at the southeast corner of Ynez Road and Ynez Court at 26770 Ynez Court Submitted Date Anticipated DRC Meeting Date Hearing Planned Jul 10 2013 TBD • PA13-0203 Relentless Brewing CUP APN # 909252011 KENNY TAYLOR a Minor Conditional Use Permit for Relentless Brewing to operate a beer manufacturing facility with a 495 square foot retail sales and tasting area located at 42030 Avenida Alvarado, Suite E & F. Submitted Date Anticipated DRC Meeting Date Hearing Planned Aug 29 2013 9/19/2013 TBD APN # • PA13-0206 Redhawk RDP 962020012 KENNY TAYLOR A Development Plan application for Ashbrook Communities to construct 77 single family homes on a condominum lot consisting of three elevations and four floor plans ranging in size from 2,294 square feet to 2,542 square feet. The project is located in Tract 34715 of the Redhawk Specific Plan, generally located at the southeast corner of Peach Tree Street and Deer Hollow Way. (Related Application: PA13-0207 - Tentative Tract Map) Submitted Date Anticipated DRC Meeting Date Hearing Planned 5 of 7 Planning Agenda Report 9/1/2013 through 9/30/2013 Sep 3 2013 10/3/2013 TBD • PA13-0207 Redhawk Residential Condo Map APN # 962020012 KENNY TAYLOR A Tentative Tract Map for condominium purposes for 77 detached residential units on 7.72 acres generally located at the southeast corner of Peach Tree Street and Deer Hollow Way. (Related Application: PA13-0206 - Development Plan) Submitted Date Anticipated DRC Meeting Date Hearing Planned Sep 3 2013 10/3/2013 TBD APN # • PA13-0216 T -Mobile TUP 961080007 KENNY TAYLOR A Major Temporary Use Permit to allow T -Mobile to install a temporary wireless telecommunication facility within the McDonald's Restaurant parking lot at 31853 Temecula Parkway during remodeling of the building. (Vail Ranch Shopping Center) Submitted Date Anticipated DRC Meeting Date Hearing Planned Sep 12 2013 TBD • PA13-0217 Rancho Vista Vlg TTM Revision APN # 944060006 STUART FISK A Tentative Tract Map revision application for condominium purposes to change the number of lots from 4 lots (one condominium lot, one recreation building lot, and two open space lots) to 3 lots (one condominium lot, one recreation building lot, and one open space lot) for 59 detached condominium units located at the northeast corner of Rancho Vista Road and Mira Loma Road. Submitted Date Anticipated DRC Meeting Date Hearing Planned Sep 12 2013 10/10/2013 TBD • PA13-0224 EJ Dental and Ortho TUP APN # 961080021 MATTHEW PETERS A Major Temporary Use Permit for EJ Dental and Orthodontic to hold a grand opening event on October 26, 2013 from 10:30 a.m. to 4:00 p.m. at 31773 Temecula Parkway, Suite A. Estimated attendance at 200-300 people. Food and non-alcoholic beverages will be provided. There will be music provided by KFROG radio station. Submitted Date Anticipated DRC Meeting Date Hearing Planned Sep 23 2013 TBD APN # • PA13-0227 Tri Pointe MHC 959390009 MATTHEW PETERS A Model Home Complex application for Tri Pointe Homes rowhome and motorcourt units located in Planning Area 6A of the Paloma del Sol Specific Plan at the southwest corner of De Portola Road and Meadows Parkway. Associated with Tentative Tract Map No. 36212 and PA11-0180. Submitted Date Anticipated DRC Meeting Date Hearing Planned Sep 26 2013 TBD APN # • PA13-0228 Petco MOD 910470015 KENNY TAYLOR A Major Modification for Petco to change the front and south side elevation facades to the existing store including new entry doors, aluminum awnings, and modified storefront windows at 40474 Winchester Road (Temecula Power Center). 6 of 7 Planning Agenda Report 9/1/2013 through 9/30/2013 • PA13-0233 AT&T Cellular Tower APN # 920100016 KENNY TAYLOR A Wireless Telecommunications Facility Application to allow a new 45 -foot stealth bell tower to be constructed and operated within the existing Chaparral Self Storage facility located at 27380 Nicolas Road. Submitted Date Anticipated DRC Meeting Date Hearing Planned Sep 30 2013 TBD • PA13-0235 Crossroads Fall Family Festiva APN # 910110042 FAHMIDA RASHID A two hour family festival for the community on October 31, 2013, providing food and activities at the Crossroads Church located at 26090 Ynez Road. Submitted Date Anticipated DRC Meeting Date Hearing Planned Sep 30 2013 TBD • PA13-0244 Belle Maison Model Home App APN # 953390007 ERIC JONES A Model Home Complex application to allow Lennar homes to have 2 models for Belle Maison generally located on the northwest corner of Butterfield Stage Road and Chemin Clinet Submitted Date Anticipated DRC Meeting Date Hearing Planned Oct 14 2013 TBD 7 of 7 Submitted Date Anticipated DRC Meeting Date Hearing Planned Sep 26 2013 TBD • PA13-0233 AT&T Cellular Tower APN # 920100016 KENNY TAYLOR A Wireless Telecommunications Facility Application to allow a new 45 -foot stealth bell tower to be constructed and operated within the existing Chaparral Self Storage facility located at 27380 Nicolas Road. Submitted Date Anticipated DRC Meeting Date Hearing Planned Sep 30 2013 TBD • PA13-0235 Crossroads Fall Family Festiva APN # 910110042 FAHMIDA RASHID A two hour family festival for the community on October 31, 2013, providing food and activities at the Crossroads Church located at 26090 Ynez Road. Submitted Date Anticipated DRC Meeting Date Hearing Planned Sep 30 2013 TBD • PA13-0244 Belle Maison Model Home App APN # 953390007 ERIC JONES A Model Home Complex application to allow Lennar homes to have 2 models for Belle Maison generally located on the northwest corner of Butterfield Stage Road and Chemin Clinet Submitted Date Anticipated DRC Meeting Date Hearing Planned Oct 14 2013 TBD 7 of 7 SIA 21 4 `NRIT WY PA13-0233 PA13-0175��• PA12-0134 PA12-0133--- i PA12-0131 4.018ZAL merown qii� P.II mkt*47‘141 v°4 "AOCvlbtoimpal411 IMAIVive illrowswq p-Aravism NOW :niriiirr �� ►t M ' Iat, 041 1� fr Av,rotto k �:� : Wit: � k►�` 'rirwq.Wice: e� ►moi PA11-0157- PA(13-0141 PA13-0221.; PR-103-016.6.--PA-(S --PAA 3 0224., • IMO 1. Recently Approved 2. Scheduled for Hearing 3. New Submittals Pending DRC Meeting Item No. 13 Approvals City Attorney Finance Director City Manager CITY OF TEMECULA AGENDA REPORT TO: City Manager/City Council FROM: Jeffrey Kubel, Chief of Police DATE: October 22, 2013 SUBJECT: Police Department Monthly Report PREPARED BY: Will Edwards, Sergeant RECOMMENDATION: Receive and file. The following report reflects the activity of the Temecula Police Department for the month of September 2013. PATROL SERVICES Overall calls for police service 2,815 "Priority One" calls for service 67 Average response time for "Priority One" calls 6.66 Minutes VOLUNTEERS Volunteer administration hours 204 Special Events hours 109 Community Action Patrol (CAP) hours 799 Reserve officer hours (patrol) 25 Training hours 86 Total Volunteer hours 1141 CRIME PREVENTION Crime prevention workshops /Neighborhood watch meetings conducted 14/6 Residential/Business security surveys conducted 4/7 Businesses visited 8 Residences/Businesses visited for past crime follow-up 0/9 Station Tour 3 Planning Review Projects/Temp Outdoor Use Permits 7/10 Square Footage of Graffiti Removed 2,382 OLD TOWN STOREFRONT Total customers served 270 Sets of fingerprints taken 52 Police reports filed 12 Citations signed off 10 Car Seat Inspections 0 Total receipts $2,333.00 SPECIAL TEAMS (POP / SET) On sight felony arrests 10 On sight misdemeanor arrests 8 Felony arrest warrants served 3 Misdemeanor arrest warrants served 0 Follow-up investigations 7 Parole/Probation Searches 0/7 Pedestrian Checks 56 Traffic Stops/Vehicle Checks 12 Crime Free Housing Checks 51 TRAFFIC Citations issued for hazardous violations 935 Grant funded D.U.I. / Traffic safety checkpoints 0 Grant funded traffic click it or ticket 0 D.U.I. Arrests 20 Non -hazardous citations 602 Stop Light Abuse/Intersection Program (S.L.A.P.) citations 41 Neighborhood Enforcement Team (N.E.T.) citations 35 Parking citations 133 School Zone 106 Seatbelts 90 Cell Phone Cites 333 Injury collisions 31 INVESTIGATIONS Beginning Caseload 162 Total Cases Assigned 74 Total Cases Closed 71 Search Warrants Served 9 Arrests 1 PROMENADE MALL TEAM Calls for service 972 Felony arrest/filings 3 Misdemeanor arrest/filings 13 Traffic Citations 86 Fingerprints/Livescans 183 Total receipts $9,109.00 SCHOOL RESOURCE OFFICERS Felony arrests 0 Misdemeanor arrests 10 Reports 20 Youth counseled 156 Meetings 74 Item No. 14 Approvals City Attorney Finance Director City Manager CITY OF TEMECULA AGENDA REPORT TO: City Manager/City Council FROM: Amer Attar, Acting City Engineer DATE: October 22, 2013 SUBJECT: Public Works Department Monthly Reports RECOMMENDATION: Receive and file Public Works Department Activity Reports for Capital Improvement Projects for the second half of September 2013, and the first half of October 2013, Street Maintenance report for the month of September 2013, and Land Development report for the quarter ending September 30, 2013. CAPITAL IMPROVEMENT PROJECTS Monthly Activity Report September / October Prepared by: Amer Attar Submitted by: Amer Attar Date: 10/22/2013 PROJECTS UNDER CONSTRUCTION Old Town Civic Center This project constructed the Old Town Civic Center. Dedication ceremony was held on December 9, 2010, and the City started operations from the new structure on December 20, 2010. Resolution of punchlist and added work items are complete. Closure of the project is being delayed by business concerns of the general contractor. Pechanga Parkway Storm Drain Improvements - Environmental Mitigation This project includes construction of a mitigation site for the Wolf Valley Creek Channel Improvements - Stage I. At the February 12, 2013 meeting, the City Council approved the plans and specifications and authorized the Department of Public Works to advertise for construction bids for the 3.4 acres of riparian habitat. Bids were opened on June 13, 2013, and the construction contract was awarded by City Council to Nature's Image on July 24, 2013. Work started after the nesting season ended on September 15, 2013. Main Street Bridge Over Murrieta Creek (Replacement) This project will replace the existing Main Street Bridge over Murrieta Creek. Construction is in progress. Concrete placement for bridge abutment main walls is complete - backfilling operations continue. Assembling of bridge structure in place is to begin mid-October. Pedestrian/Bicycle Bridge Over Santa Gertrudis Creek This project includes the construction of an approximately 150 foot long pedestrian/bike bridge over Santa Gertrudis Creek near Chaparral High School. This portion of the project is complete. The mitigation/monitoring portion of the project, which involves removal of invasive plant species from the creek channel and a subsequent two-year monitoring period, began on September 17, 2012. Maintenance and monitoring is ongoing. French Valley Parkway / Interstate 15 Over -Crossing and Interchange Improvements - Phase I This Project includes widening of southbound Interstate 15 from Warm Springs Creek to the Winchester Road off -ramp, widening of the Winchester Road off -ramp, construction of the new southbound off -ramp at French Valley Parkway, and construction of the westbound portion of French Valley Parkway from the off -ramp to Jefferson Avenue. This Project is under construction from June 2012 through December 2013. See project web page for construction updates: http://www. cityofte mecu la. o rg/Temecula/Govern ment/Publ icWo rks/French Va I ley. htm. 1 Ronald Reagan Sports Park Desilting Basin Environmental Mitigation This project installed landscape and irrigation improvements on a 0.26 acre Habitat Creation Area and maintaining it for five years in accordance with a Habitat Mitigation and Monitoring Program. The work was completed on January 20, 2011. The project is now in the five-year maintenance/monitoring program. Great Oak High School Tennis Court Lighting This project will install lights around the tennis courts at Great Oaks High School. Bids were opened on May 23, 2013. At the June 11, 2013 meeting, the City Council awarded the contract to MDE Group, Inc. This project started construction on July 31, 2013, and is expected to be completed the second week of October 2013. Pavement Rehabilitation Program - Ynez Road This project will rehabilitate Ynez Road from Winchester Road to Solana Way. Project was awarded to All American Asphalt at the June 26, 2012 City Council Meeting. Construction is on-going. It is scheduled for completion by mid-October 2013. Temecula Community Center Renovation City Council awarded the contract to LDCO, Inc. on June 11, 2013. First day of work was July 15, 2013. Demolition work has been completed. Structural upgrades and framing are ongoing. French Valley Parkway Environmental Mitigation This project implemented the riparian mitigation requirement of the HMMP that was developed for the French Valley Parkway Interchange project. Work involved creation of a 2.73 acre riparian site through planting native plant species and removing non-native and invasive plant species. Construction started on October 2, 2012 and was completed November 5, 2012. This site will be monitored and maintained for five years. Roripaugh Ranch Street Improvements Phase II Contract was awarded on December 11, 2012. First day of work was January 14, 2013. Mass grading, retaining walls and underground utility work is ongoing. Theater Energy Efficient Lighting Including Technology and Equipment Upgrade The Notice to Proceed was issued for the procurement of the equipment on January 2, 2013. The vendor has provided all purchased equipment. Theater staff has installed all the lights and equipment and the new system is up and running as of August 12, 2013. Project acceptance and Notice of Completion is scheduled for the October 22, 2013 City Council meeting. Citywide Slurry Seal Fiscal Year 2012-13 This annual maintenance project will slurry various street throughout the City. The project was awarded to American Asphalt South at the May 28, 2013 City Council Meeting. Construction is complete. Project acceptance and Notice of Completion is scheduled for the October 22, 2013 City Council meeting. Pavement Rehabilitation Program - Rancho Vista Road 2 This project rehabilitated Rancho Vista Road from Margarita Road to Paseo Goleta. This Project was awarded at the April 9, 2013 City Council Meeting to R.J. Noble Company. Construction was substantially complete on August 13, 2013, just prior to the start of the school year at the nearby Temecula Valley High. Fire Station 84 Roof Replacement This project will replace the roof at Fire Station 84. Bids were opened on July 25, 2013. The contract was awarded to All Weather Roofing on August 13, 2013. Construction is expected to start in October. Community Recreation Center Picket Ornamental Fence Replacement This project will replace the picket ornamental fence at the Community Recreation Center (CRC). The fence is being manufactured now and construction activities are to begin after that is complete. Pavement Rehabilitation Program - Rancho California Road This project will rehabilitate Rancho California Road from Jefferson Avenue to Ynez Road. Project was awarded to R.J. Noble at the July 23, 2013 City Council Meeting. Contractor is preparing the Traffic Control Plans and in the process of obtaining the Encroachment Permit from Caltrans. CITYWIDE CONCRETE REPAIRS FY 2013-14 The City Council approved the solicitation of bids at the June 11, 2013 City Council meeting. Bids were opened on August 8, 2013. The City Council awarded the contract to Above All Names Construction Service at the August 27, 2013 City Council meeting. A Pre -Construction meeting was held on October 9, 2013. Project is scheduled to start in late October. Pavement Rehabilitation Program - Bridge Decks A Contract was awarded to Peterson -Chase General Engineering at the September 24, 2013 City Council meeting. Traffic control plans being prepared, scheduling of pre -construction meeting is being coordinated with contractor. Murrieta Creek Bridge -Overland Drive Phase 1 Demolition A Pre -Construction meeting is tentatively set for mid October of 2013. 3 PROJECTS BEING ADVERTISED FOR BIDS Special Needs Play Structure This project will install play structure for youth and special needs kids upon completion. The Park and Recreation Subcommittee chose Margarita Park as the site of the improvements based on the conceptual plan. An RFP has been sent out for a purchase/install vendor. Responses were received on May 15, 2013 and are under review. 4 PROJECTS IN DESIGN Murrieta Creek Bridge and Overland Drive Extension from Commerce Center to Diaz Rd The project includes the extension of Overland Drive from Commerce Center Drive to Diaz Road with a bridge over Murrieta Creek. Consultant is preparing an Environmental Assessment and Individual Permit Application for USACE. These applications should be approved by mid March of 2014. An amendment to the agreement must be created to extend the term of the agreement. Western Bypass Bridge Over Murrieta Creek This project involves the design, environmental clearance, and construction of a new bridge over Murrieta Creek at the westerly terminus of Western Bypass and an extension of Pujol Street to the new structure. Once constructed, this will serve as the southerly connection of the Western Bypass Corridor. The Mitigated Negative Declaration was adopted. Applications to the various environmental agencies have been submitted. Review of the 100% Plans and Specs is on-going. Old Town Gymnasium This projects involves the design of the approximately 9,000 square foot gymnasium adjacent the Boys & Girls Club on Pujol Street. Consultant is finalizing the design plans. Santa Gertrudis Creek Pedestrian/Bicycle Trail Extension and Interconnect The project will provide a Class I bicycle trail that connects the existing Santa Gertrudis Creek Pedestrian/Bicycle Trail at Ynez Road to the Murrieta Creek Multi -Purpose Trail at Diaz Road. The alignment study has been completed. Extension of time for the Bicycle Transportation Account funds was approved on May 1, 2009. The consultant is working on 90% plans, specifications and estimate. 1-15 / SR -79S Ultimate Interchange Caltrans review of 95% PS&E (6th) is complete. Target submittal of 100% PS&E is October 2013. Pavement Rehabilitation Program - Winchester Road This project will rehabilitate the portion of Winchester between Jefferson Avenue and Ynez Road. Caltrans has approved the plans and will issue the encroachment permits shortly. Winchester Road is scheduled to bid on the first quarter of 2014. French Valley Parkway / Interstate -15 OverCrossing and Interchange Improvements - Phase II Caltrans review of 60% PS&E complete. Target submittal of 90% PS&E is November 2013. Old Town Temecula Community Theater Remediation City Council approved the plans and specifications at the 04/23/2013 meeting. The project will be rebid. PAVEMENT REHABILITATION PROGRAM - CITYWIDE, FY 2012/2013 5 This project will rehabilitate portions of Margarita Road, Ynez Road, Temecula Parkway, Overland Drive and Old Town Front Street. Consultant submitted 90% plans in mid July. They are under City review and will be returned to consultant in mid October. Old Town Front Street Storm Drain This project involves replacement of the cross gutter in Old Town Front Street, approx. 800' north of Temecula Parkway. Design alternative involving catch basins on Old Town Front Street and a 'bubbler' system to discharge into the existing parking lot ribbon gutter has been selected. Design work continues. Old YMCA Building Remediation Council approved a design agreement with Meyer and Associates at their September 10, 2013 meeting. Design work is ongoing. 6 DEPARTMENT OF PUBLIC WORKS MONTHLY ACTIVITY REPORT STREET MAINTENANCE DIVISION FISCAL YEAR 2013 - 2014 Date Submitted: October 8, 2013 Submitted By: Amer Attar Prepared By: Rodney Tidwell 1ST QUARTER Jul -13 Auj-13 S[ep-13 [ FISCAL YEAR TO DATE SCOPE OF WORK Unit Cost WORK COST COMPLETEDi WORK t COST COMPLETED i WORK : COST COMPLETED I WORK COMPLETED COST TOTAL COST FOR LAST FISCAL YEAR ASPHALT CONCRETE Square Footage: Tons: Parking Lot Slurry Seal Square Footage Gallons $2 97 17,310 94 0 0 $ 51,410.70 8,040 71 $ 23,878.80 I 30,419 ( $ 90,344.43 20 i 1 720 55,769 185 $ 165.633 93 $ 233,623.17 PORTLAND CEMENT CONCRETE Square Footage: PCC Yards: $2.97 0 0 $ - $ - 0 0 $ - $ - Et 0 ! $ - 0 : $ - 0 0 $ - $ - t $ $ - - STRIPING & PAVEMENT MARKINGS: Curb & Lines (linear feet): Painted Legends(each): Median Noses (each): Raised Pavement Markers (each): Thermo Plastic Legends (each): $0.07 $8.00 0 243 0 0 49 i• $ j $ 1,944.00 1 1 23,162 229 102 0 0 $ 1,621.34 $ 1,832.00 31,605 2 0 26 0 $ 2,212.35 $ 16.00 54,767 474 102 26 49 4 $ 3,833.69 It $ 3,792.00 $ - $ - $ - $ $ $ • • 10,171.70 38,624.00 424.97 SIGNS & BANNERS No. of Signs REPLACED: Material (cost per sign): No. of Signs INSTALLED: Material (cost per sign): No. of Signs REPAIRED: Material (cost per sign): No. of BANNERS installed: $26.39 550.00 526.39 550.00 S26.39 550.00 526.39 30 5 30 70 $ 791.70 !4 $ 1,500.00 1 $ 131.95 j $ 250.00 i $ 791.70 $ 1,500.00 $ 1,847.30 38 7 121 6 $ 1,002.82 $ 1,900.00 $ 184.73 $ 350.00 {{ ' $ 3,193.19 $ 6,050.00 $ 158.34 43 2 67 0 $ 1,134.77 $ 2,150.00 $ 52.78 $ 100,00 $ 1,768.13 $ 3,350.00 $ - 111 14 218 76 ' : $ 2,929.29 ' $ 5,550.00 $ 369.46 $ 700.00 $ 5,753.02 $ 10,900.00 $ 2,005.64 $ $ $ $ $ $ $ 16,071.51 30,450.00 4,750.20 9,000.00 24,463.53 46,350.00 23,434.32 GRAFFITI REMOVAL No. of Locations: Square Footage: 137 36,193 i j 169 j 2,623 if 138 2,382 444 41.198 DRAINAGE FACILITIES CLEANED Catch Basins: Down Drains: Under sidewalk Drains Detention Basins: 526.39 526.39 526.39 526.39 216 0 86 14 $ 5,700.24 i $ - i $ 2,269.54 1 $ 369.46 183 ; $ 4,829.37 0 i $ - 0 ! $ - 4 i $ 105.56 153 0 0 11 $ 4,037.67 $ - $ - $ 290.29 552 0 86 29 $ 14,567.28 $ - $ 2,269.54 $ 765.31 $ $ $ $ 42,672.63 26.39 13,960.31 2,955.68 TREES TRIMMED'• No. of Trees Trimmed: S26.39 98 i $ 2,586.22 72 1 $ 1,900.08 i 36 $ 950.04 206 $ 5,436.34 $ 22,273.16 R.O.W. WEED ABATEMENT Area Abated (square feet): S0.034 3,000 ' $ 102.00 l 0 i $ - 0 $ - 3,000 $ 102.00 $ 2,891.16 The Street Maintenance Division also responds to service requests for SERVICE ORDER REQUESTS No. of SOR's: a variety of other reasons, the total i 54 } number of Service 61 Order Requests, some of which include 51 work reported above Is reported 166 monthly. Personnel assigned to the Street Maintenance Division are on-call and Overtime Hours: $39.59 respond to after 189 hours emergencies $ 7,482 51 or support City 42 sponsored special $ 1,662.78 events 58 $ 2,276.43 289 $ 11,421.72 $ 32,681.55 TOTALS } : $ 78,677.32 $ 48,669.01 i $ 108,682.89 $ 236,029.22 $ 554,824.28 R:IMAINTAIN MOACRPTUULY AUG SEPT STREET MAINTENANCE CONTRACTORS The following contractors have performed the following projects for the month of September, 2013 DATE STREET/CHANNEL/BRIDGE DESCRIPTION TOTAL, COST ACCOUNT OF WORK SIZE CONTRACTOR: WEST COAST ARBORISTS, INC. Date: 08.31.13 # 5402 CII'YWID1'. REMOVAL OF DEAD TREES TOTAL COST $ 4,104.00 Date: 09.15.13 Jt 5402 CITYWIDE REMOVAL OF DEAD TREES TO'T'AL COST $ 1,302.00 Date: TOTAL. COST Date: TOTAL COST CONTRACTOR: Date: # TOTAI. COST Date: # I TOTAL COST CONTRACTOR: Date: TOTAL COSI' Date: # TOTAL COST 'T'OTAL COST ACCOUNT #5401 TOTAL COST ACCOUNT #5402 TOTAL COST ACCOUNT #99-5402 - 0 - $5,406.00 - 0 - R:1MAI NTAJN\MOACTRPT DEPARTMENT OF PUBLIC WORKS CONTRACTED MAINTENANCE WORK COMPLETED FISCAL YEAR 2013-2014 Date Submitted: October 8, 2013 Submitted By: Amer Attar Prepared By: Rodney Tidwell SCOPE OF WORK JULY AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER Year to Date ASPHALT CONCRETE Square Footage _ 0_____ ........ _ 0 _______ _________ _______0 ___ 0 Cost $ - $ '�_-_--'----'��--�$L - �'�-'--'-'__-�''-��----__' 3L—'---'—'—'---'$ - PORTLAND CEMENT CONCRETE Square Footage '-_--�>-'-'--'__---'{L---_-_---''-{0L-----'---'-'----------'-- ------__� 0 -- Cost$ - '�'-----'---�_-�L'-_-_�-'—�-_-�'--'-----'----�'�-------'_'---'-��---__- ��_-- —_-'�'-- DRw|NAGE FACILITIES Channels (each) _0 __----'{L'-__----'{L'-0 ---'_-��- ----------- ______________ —..... ________ _____________________ 0 Cost$ ' -�'-___'-'-'-��L--'- - -'�-'-'----'-__�L---'---'- '�L----------�i—'---___---'-_-- STRIPING AND PAVEMENT MARKINGS Striping (linear feaV- '___---''--_--_�-_---- 0 --'-- _-'------'------------'----'-- �-------'-D-----'--_- Sandblasting (linear feet) Q___ _______ ______0 _ Legends (each) —__ —'_'----- _____________�____�____�____ _ _____'—__ ..... --...... _____ ___________________________�_____ '----''--'--'---_ Cost �L_� 8,500.00 $ --'--�-_�'$-'----''_�_'- � - --$i-_�'--_---'-_$L$_---_'-_8 �Ol0' TREES Trees Trimmed ______�_________ _� ________3�________________________________�_______ _________��_ __. Trees Removed 0 ________Q_______ _ ________________ 0 __ Cost ��__'__��_'$ - �__—��'�� __ _-�-�'�_'__-_�'_�___-_-�_�_____��L WEED ABATEMENT ROW Area Abated (Square Feet) ______ ---�'--__'---'-'-----'-----'--_--'-�--'--_-'--__' -- — ' --'---_ ___ --O—----. 0 Other Public Lands Abated (Square Feet) U__ __ V � Cost $_ �-_�___��'�_-___�__$�__-_�_'�_____�_��____�__$ __-��0� MISC. MAINT ACTIVITES Cost �L-'---' '_'_�'—_$L'--'-'-'--��-'�L - $ - $ - $ - TOTAL CONTRACTED MAINT COSTS $ 8.500.00 $ 7.430.00 $ 5.406.00 $ - $ - $ - $ 21`338.00 CITY OF TEMECULA DEPARTMENT OF PUBLIC WORKS STREET MAINTENANCE DIVISION GRAFFITI REMOVAL FISCAL YEAR 2013-2014 Month Number Square of Calls Footage Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Totals 137 169 138 3,193 2,623 2,382 444 8,198 3,500 3,000 2,500 12,000 N g 1,500 1,000 500 0 - Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Square Number Footage of Calls 180 160 140 120 80 6 z 60 40 20 0 CITY OF TEMECULA Land Development Project Activity Report First Quarter Ending September 30, 2013 for Fiscal Year 2013-14 Temecula Valley Hospital — The construction of the Temecula Valley Hospital is complete. All offsite (public) improvements are complete and include, but are riot limited to, the following: asphalt concrete pavement, curb and gutter, sidewalk, streetlights, parkway slopes, traffic signals, landscaped medians, signage and striping, etc. All onsite (private) improvements are also complete and include, but are riot limited to, the following: underground utilities, grading, drainage facilities, WQMP facilities, parking lots, building, striping and signage, etc. The project may commence its operation upon completion of the interior improvements of the building. Mercedes Benz of Temecula — The construction of onsite improvements such as the installation of utilities and drainage provisions are on-going. Construction of the buildings / structures is in progress and the conveyance documents associated with the City Monument sign have been given to the developer. Islamic Center of Temecula — The earthwork activity for the Islamic Center of Temecula was initiated a year ago and the building pad was established. Thereafter, the project has remained inactive. Recently, the Applicant has expressed inclination to resume the grading activity, which is projected to start sometime in October. Belle Maison — The Belle Maison development consists of TM23103-2. The grading and improvement plans for this 37 -lot residential subdivision are complete. The mass grading of the development and construction of the infrastructure improvements are underway. The developer has submitted their Home Product plans for City review. Roripaugh Ranch (Panhandle) Development - The Roripaugh Ranch panhandle development includes three developers: KB Homes, Standard Pacific and Van Daele Development. These Developers have completed all infrastructure including underground utilities, grading, streets, curb & gutter, sidewalks, etc. KB Homes has diligently been working on TM29661-1. Their model homes have been completed and are now open. They started production and are landscaping. Standard Pacific has been working on TM29661-3 and -4. Their model homes will open in mid-October. They are in production and have received occupancy on the clubhouse with access conditions, and have substantially completed the traffic signal installation at Pourroy and Murrieta Hot Springs Road. Van Daele has been working on TM29661. It is anticipated their model homes will open in mid-October and they are also in production. Land Development Quarterly Activity Report First Quarter Ending September 30, 2013 Plan Check Services Plan Check Type Total Utilities Construction Grading Maps Plancheck 13 17 2 32 Approved 3 6 9 Issued 54 24 10 88 Out 4 5 9 Complete 1 2 3 Permits Initialized 58 48 18 124 Total Project Services " 265 REQUESTS TO SPEAK City Council Meeting 10/22/13 REQUEST TO SPEAK CITY OF TEMECULA After completing, please return to the City Clerk. The City Clerk will call your name when the matter comes up. Please go to the public podium and state your name for the record. Date / Q - Z Z — �3 I wish to speak on Agenda Item No. Subject f,, (1- � For n Against Public Comment Please note that all information presented at a City Council meeting becomes public record. �,� All information provided is optional. 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