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11152022 CC Agenda
In 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 11]. AGENDA TEMECULA CITY COUNCIL REGULAR ADJOURNED MEETING COUNCIL CHAMBERS 41000 MAIN STREET TEMECULA, CALIFORNIA NOVEMBER 15, 2022 - 6:00 PM CLOSED SESSION - 5:30 PM CONFERENCE WITH LEGAL COUNSEL — POTENTIAL LITIGATION. The City Council will meet in closed session with the City Attorney pursuant to Government Code Section 54956.9(d)(4) with respect to three matters of potential litigation. A point has been reached where, in the opinion of the City Attorney, based on existing facts and circumstances, there is a significant exposure to litigation involving the City. Based on existing facts and circumstances, the City Council will decide whether to initiate litigation. CALL TO ORDER: Mayor Matt Rahn INVOCATION: Apostle Terrence Hundley of The Place City of Miracles Cathedral FLAG SALUTE: Mayor Matt Rahn ROLL CALL: Alexander, Edwards, Rahn, Schwank, Stewart PRESENTATIONS Proclamation for Native American Heritage Month Proclamation for Pu'6ska Mountain Day BOARD / COMMISSION REPORTS Planning Commission and Public/Traffic Safety Commission PUBLIC SAFETY REPORT California Department of Forestry and Fire Protection PUBLIC COMMENTS - NON -AGENDA ITEMS A total of 30 minutes is provided for members of the public to address the City Council on matters not listed on the agenda. Each speaker is limited to 3 minutes. Public comments may be made in person at Page 1 City Council Agenda November 15, 2022 the meeting by submitting a speaker card to the City Clerk or by submitting an email to be read aloud into the record at the meeting. Email comments must be submitted to CouncilComments@temeculaca.gov. Speaker cards for in -person comments will be called in the order received by the City Clerk and then, if time remains, email comments will be read. Email comments on all matters must be received prior to the time the item is called for public comments. All public participation is governed by the Council Policy regarding Public Participation at Meetings adopted by Resolution No. 2021-54. 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, ten minutes will be devoted to these reports. CONSENT CALENDAR 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. A total of 30 minutes is provided for members of the public to address the City Council on items that appear on the Consent Calendar. Each speaker is limited to 3 minutes. Public comments may be made in person at the meeting by submitting a speaker card to the City Clerk or by submitting an email to be read aloud into the record at the meeting. Email comments must be submitted to CouncilComments@temeculaca.gov. Speaker cards for in -person comments will be called in the order received by the City Clerk and then, if time remains, email comments will be read. Email comments on all matters must be received prior to the time the item is called for public comments. All public participation is governed by the Council Policy regarding Public Participation at Meetings adopted by Resolution No. 2021-54. 1. Waive Reading of Standard Ordinances and Resolutions Recommendation: That the City Council waive the reading of the text of all standard ordinances and resolutions included in the agenda except as specifically required by the Government Code. Attachments: Agenda Report 2. Approve Action Minutes of October 25, 2022 Recommendation That the City Council approve the action minutes of October 25, 2022. Attachments: Action Minutes 3. Approve List of Demands Recommendation: That the City Council adopt a resolution entitled: RESOLUTION NO. A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF TEMECULA ALLOWING CERTAIN CLAIMS AND DEMANDS AS SET FORTH IN EXHIBIT A Page 2 City Council Agenda November 15, 2022 4. 5. 6. 7. Attachments: Agenda Report Resolution List of Demands AUUrove Citv Treasurer's Report as of Julv 31. 2022 and AuLyust 31. 2022 Recommendation: That the City Council approve and file the City Treasurer's Report as of July 31, 2022 and August 31, 2022. Attachments: Agenda Report July Treasurer's Report August Treasurer's Report Adopt the 2022 Conflict of Interest Code Recommendation: That the City Council adopt a resolution entitled: RESOLUTION NO. A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF TEMECULA ADOPTING THE CITY' S 2022 CONFLICT OF INTEREST CODE Attachments: Agenda Report Biennial Notice Resolution Exhibit A Notice of Intent Aaarove Amendment to the Citv of Temecula Section 125 Cafeteria Plan Recommendation: That the City Council adopt a resolution entitled: RESOLUTION NO. A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF TEMECULA AMENDING THE CITY OF TEMECULA SECTION 125 CAFETERIA PLAN Attachments: Agenda Report Resolution Cafeteria Plan Amendment Adopt Resolution Declaring City Owned Parcels Located at 28725 and 28731 Pujol Street to be Exempt from the Surplus Land Act Recommendation: That the City Council adopt a resolution entitled: Page 3 City Council Agenda November 15, 2022 8. 9. 10. RESOLUTION NO. A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF TEMECULA DECLARING A CITY -OWNED PARCEL LOCATED AT 28725 AND 28731 PUJOL STREET IN THE CITY OF TEMECULA TO BE EXEMPT SURPLUS LAND PURSUANT TO GOVERNMENT CODE SECTIONS 54221(b)(1) AND 54221(f)(1)(A), FINDING THE DECLARATION EXEMPT FROM THE CALIFORNIA ENVIRONMENTAL QUALITY ACT, AND TAKING RELATED ACTIONS Attachments: Agenda Report Resolution Exhibit A HCD Approval of Surplus Land Act Approve First Amendment to the Minor Maintenance Agreement with Craftsmen Plumbing Heating & Cooling Inc. Recommendation: That the City Council approve the first amendment to the minor maintenance agreement with Craftsmen Plumbing Heating & Cooling, Inc., to amend the scope of services to include additional general contracting services, and to amend the payment terms for a total agreement value for the term of the agreement. Attachments: Agenda Report Amendment Approve First Amendment for General Plan Update City -Wide Traffic Analysis Services Recommendation: That the City Council approve the first amendment to the agreement with Fehr and Peers for General Plan Update City -Wide Traffic Analysis Services and increase the agreement amount by $7,500, for a total contract amount of $137,500. Attachments: Agenda Report Amendment Approve Increase to Contingency Authorization for Fiber Optic Communication System Upgrade Project, PW 18-05 Recommendation That the City Council: 1. Approve an increase to the contingency for the Fiber Optic Communication System Upgrade Project, PW 18-05 by $40,000; and 2. Increase the City Manager Authority to approve change orders to the contract by $40,000. Page 4 City Council Agenda November 15, 2022 Attachments: Agenda Report CIP Budget Sheet 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/OR THE TEMECULA PUBLIC FINANCING AUTHORITY Page 5 City Council Agenda November 15, 2022 TEMECULA COMMUNITY SERVICES DISTRICT MEETING CALL TO ORDER: President James Stewart ROLL CALL: Alexander, Edwards, Rahn, Schwank, Stewart CSD PUBLIC COMMENTS - NON -AGENDA ITEMS A total of 30 minutes is provided for members of the public to address the Board of Directors on matters not listed on the agenda. Each speaker is limited to 3 minutes. Public comments may be made in person at the meeting by submitting a speaker card to the City Clerk or by submitting an email to be read aloud into the record at the meeting. Email comments must be submitted to CouncilComments@temeculaca.gov. Speaker cards for in -person comments will be called in the order received by the City Clerk and then, if time remains, email comments will be read. Email comments on all matters must be received prior to the time the item is called for public comments. All public participation is governed by the Council Policy regarding Public Participation at Meetings adopted by Resolution No. 2021-54. CSD CONSENT CALENDAR 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 Community Services District request specific items be removed from the Consent Calendar for separate action. A total of 30 minutes is provided for members of the public to address the Board of Directors on items that appear on the Consent Calendar. Each speaker is limited to 3 minutes. Public comments may be made in person at the meeting by submitting a speaker card to the City Clerk or by submitting an email to be read aloud into the record at the meeting. Email comments must be submitted to CouncilComments@temeculaca.gov. Speaker cards for in -person comments will be called in the order received by the City Clerk and then, if time remains, email comments will be read. Email comments on all matters must be received prior to the time the item is called for public comments. All public participation is governed by the Council Policy regarding Public Participation at Meetings adopted by Resolution No. 2021-54. 11. Approve Action Minutes of October 25, 2022 Recommendation: That the Board of Directors approve the action minutes of October 25, 2022. Attachments: Action Minutes CSD DIRECTOR OF COMMUNITY SERVICES REPORT CSD GENERAL MANAGER REPORT CSD BOARD OF DIRECTOR REPORTS Page 6 City Council Agenda November 15, 2022 CSD ADJOURNMENT The next regular meeting of the Temecula Community Services District will be held on Tuesday, November 29, 2022, at 4:30 p.m., for a Closed Session, with regular session commencing at 6:00 p.m., at the Council Chambers located at 41000 Main Street, Temecula, California. Page 7 City Council Agenda November 15, 2022 SUCCESSOR AGENCY TO THE REDEVELOPMENT AGENCY - NO MEETING TEMECULA HOUSING AUTHORITY - NO MEETING TEMECULA PUBLIC FINANCING AUTHORITY - NO MEETING RECONVENE TEMECULA CITY COUNCIL PUBLIC HEARING Any person may submit written comments to the City Council before a public hearing or may appear and be heard in support of or in opposition to the approval of a project at the time of the hearing. If you challenge a project in court, you may be limited to raising only those issues you or someone else raised at the public hearing or in written correspondence delivered to the City Clerk at or prior to the public hearing. For public hearings each speaker is limited to 5 minutes. Public comments may be made in person at the meeting by submitting a speaker card to the City Clerk or by submitting an email to be read aloud into the record at the meeting. Email comments must be submitted to CouncilComments@temeculaca.gov. Email comments on all matters, including those not on the agenda, must be received prior to the time the item is called for public comments. At public hearings involving land use matters, the property owner and/or applicant has the burden of proof and, therefore, shall be allowed 15 minutes for an initial presentation, and an additional 10 minutes for rebuttal by its development team following other comments on the matter. An appellant, other than the property owner and/or applicant, and the spokesperson for an organized group of residents residing within the noticed area of the property, which is the subject of the public hearing, shall be allowed 15 minutes to present the appellant's position to the Council. The Mayor may allow more time if required to provide due process for the property owner, applicant or appellant. All other members of the public may speak during the public hearing for a maximum period of 5 minutes each. Deferral of one speaker's time to another is not permitted. In the event of a large number of speakers, the Mayor may reduce the maximum time limit for members of the public to speak. All public participation is governed by the Council Policy regarding Public Participation at Meetings adopted by Resolution No. 2021-54. 12. Approve Community Development Block Grant (CDBG) Substantial Amendment to the 2022-23 CDBG Annual Action Plan for the Reallocation of CDBG Funds to the Mary Phillips Senior Center Recommendation That the City Council adopt the resolution entitled: RESOLUTION NO. A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF TEMECULA APPROVING THE SUBSTANTIAL AMENDMENT TO THE 2022-23 COMMUNITY DEVELOPMENT BLOCK GRANT ANNUAL ACTION PLAN AND FINDING THE ACTIONS TO BE EXEMPT FROM FURTHER ENVIRONMENTAL REVIEW UNDER THE CALIFORNIA ENVIRONMENTAL QUALITY ACT (CEQA) AND NATIONAL ENVIRONMENTAL PROTECTION ACT (NEPA) Page 8 City Council Agenda November 15, 2022 Attachments: RITSINESS Agenda Report Resolution Exhibit A - Substantial Amendment Notice of Public Hearing Any member of the public may address the City Council on items that appear on the Business portion of the agenda. Each speaker is limited to 5 minutes. Public comments may be made in person at the meeting by submitting a speaker card to the City Clerk or by submitting an email to be read aloud into the record at the meeting. Email comments must be submitted to CouncilComments@temeculaca.gov. Speaker cards for in -person comments will be called in the order received by the City Clerk and then, if time remains, email comments will be read. Email comments on all matters must be received prior to the time the item is called for public comments. All public participation is governed by the Council Policy regarding Public Participation at Meetings adopted by Resolution No. 2021-54. 13. Approve Recommendation for Community Service Funding - Reinvestment in Temecula Grant Program for Fiscal Year 2022-23 (At the Request of Subcommittee Members Mayor Pro Tern Schwank and Council Member Stewart) Recommendation: Attachments: That the City Council: 1. Approve the Community Service Funding Ad Hoc Subcommittee's recommendation to allocate a total of $1,090,500 to fund grant applications received from nonprofit organizations for the Community Service Funding - Reinvestment in Temecula Grant Program Fiscal Year 2022-23; and 2. Approve a budget transfer of $1,000,000 from Fund 110 - Community Reinvestment Program Fund to Fund 001 - General Fund to program towards the Community Services Funding Program. Agenda Report Application Summary Applications 1-20 Applications 21-40 Applications 41-66 14. Receive and File the Recommended Updated Allocations from Community Reinvestment Program Funding (At the Request of Subcommittee Members Mayor Rahn and Council Member Edwards Recommendation: That the City Council receive and file the recommended updated allocations from Community Reinvestment Program (CRP) Funding and provide general direction regarding the same. Attachments: Agenda Report Summary Page 9 City Council Agenda November 15, 2022 15. Approve Quality of Life Master Plan (At the Request of Subcommittee Members Mayor Rahn and Council Member Edwards) Recommendation That the City Council approve, in substantial form, the Quality of Life Master Plan 2040. Attachments: Agenda Report Quality of Life Master Plan 2040 Citizens' 20-year Priorities Timeline Exhibit A - 07/14/2020 City Council Agenda Report Exhibit B - Commissions Meetings SummarX ITEMS FOR FUTURE CITY COUNCIL AGENDAS Any Council Member, including the Mayor, may request an item be placed on a future agenda. Any such request will be discussed under this section. In making the request, a Council Member may briefly describe the topic of the proposed agenda item and any timing associated with the placement of the item on the agenda. This description shall not exceed 3 minutes unless extended by a majority vote of the City Council. No substantive discussion on the subject of the motion may occur. General discussion amongst the City Council on items listed under this section of the agenda shall be limited to 15 minutes. Items may only be placed on the agenda by Council Members pursuant to policy or by the City Manager based on administrative or operational needs of the City. Public comments on the placement of these agenda items shall be limited to a maximum of 30 minutes. Individual comments shall not exceed 3 minutes. All public participation is governed by the Council Policy regarding Public Participation at Meetings and Agenda Placements by Council Members adopted by Resolution No. 2021-54. CITY MANAGER REPORT CITY ATTORNEY REPORT ADJOURNMENT The next regular adjourned meeting of the City Council will be held on Tuesday, November 29, 2022, at 4:30 p.m., for a Closed Session, with regular session commencing at 6:00 p.m., at the Council Chambers located at 41000 Main Street, Temecula, California. NOTICE TO THE PUBLIC The full agenda packet (including staff reports, public closed session information, and any supplemental material available after the original posting of the agenda), distributed to a majority of the City Council regarding any item on the agenda, will be available for public viewing in the main reception area of the Temecula Civic Center during normal business hours at least 72 hours prior to the meeting. The material will also be available on the City's website at TemeculaCa.gov. and available for review at the respective meeting. If you have questions regarding any item on the agenda, please contact the City Clerk's Department at (951) 694-6444. Page 10 Item No. 1 CITY OF TEMECULA AGENDA REPORT TO: City Manager/City Council FROM: Randi Johl, Director of Legislative Affairs/City Clerk DATE: November 15, 2022 SUBJECT: Waive Reading of Standard Ordinances and Resolutions PREPARED BY: Randi Johl, Director of Legislative Affairs/City Clerk RECOMMENDATION: That the City Council waive the reading of the text of all standard ordinances and resolutions included in the agenda except as specifically required by the Government Code. BACKGROUND: The City of Temecula is a general law city formed under the laws of the State of California. With respect to adoption of ordinances and resolutions, the City adheres to the requirements set forth in the Government Code. Unless otherwise required, the full reading of the text of standard ordinances and resolutions is waived. FISCAL IMPACT: None ATTACHMENTS: None Item No. 2 ACTION MINUTES TEMECULA CITY COUNCIL REGULAR MEETING COUNCIL CHAMBERS 41000 MAIN STREET TEMECULA, CALIFORNIA OCTOBER 25, 2022 - 6:00 PM CLOSED SESSION - 5:00 PM CONFERENCE WITH LEGAL COUNSEL — POTENTIAL LITIGATION. The City Council convened in closed session with the City Attorney pursuant to Government Code Section 54956.9(d)(4) with respect to three matters of potential litigation. A point has been reached where, in the opinion of the City Attorney, based on existing facts and circumstances, there is a significant exposure to litigation involving the City. Based on existing facts and circumstances, the City Council will decide whether to initiate litigation. CONFERENCE WITH LEGAL COUNSEL — POTENTIAL LITIGATION. The City Council convened in closed session with the City Attorney pursuant to Government Code Section 54956.9(d)(2) with respect to one matter of potential litigation. A point has been reached where, in the opinion of the City Attorney, based on existing facts and circumstances, there is a significant exposure to litigation involving the City from MCM Construction, Inc., with respect to bids for the project known as I-15/French Valley Parkway Improvements —Phase II (Project No. PW16-01). The October 14, 2022 letter from Attorney D. Michael Schoenfeld of Murphy Austin on behalf of MCM Construction, Inc., objecting to the bid process and threatening litigation is on file in the office of the City Clerk and is attached to the agenda packet with Item #9 on the Consent Calendar. CALL TO ORDER: Mayor Matt Rahn INVOCATION: Dr. Brenda Harper of AACTS International Ministries FLAG SALUTE: Council Member Maryann Edwards ROLL CALL: Alexander, Edwards, Rahn, Schwank, Stewart (Left Meeting at 7:40 PM) PRESENTATIONS Proclamation for Domestic Violence Awareness Month Presentation Regarding Girl Scout Recognition for Scout's Closet Presentation by National Association of Hispanic Real Estate Professionals for Dia De Los Muertos BOARD / COMMISSION REPORTS Planning Commission and Race, Equity, Diversity and Inclusion Commission PUBLIC SAFETY REPORT Riverside County Sheriffs Department PUBLIC COMMENTS - NON -AGENDA ITEMS The following individual(s) addressed the City Council: • Bob Kowell • Pam Barrett • Carol Brown • Dan Brown • Mick Sobczak • Greg Langworthy PUBLIC COMMENTS - AGENDA ITEMS • Simon Cooper • Payam Daneshvar • James & Janice Richardson • Steven G. Sidlovsky • Bernard Budney • Bryant Rumbaugh The following individual(s) addressed the City Council: • Michael Roe (Item #9) • Sean Ashburn (Item #9) • Tyler Cesar (Item #9) • Bob Kowell (Item #14) • Mario Martinez (Item #9) PUBLIC COMMENTS — FUTURE AGENDA ITEMS The following individual(s) addressed the City Council: • Porsche Pold • Amber Doesburg • Theresa Brennan • Laurel Lamont • Gabriel Renfro Christine Massa • Shalini Renfro Allison Donahoe -Beggs • Allison Aranda Jennifer Krumm • Jennifer Reeves PUBLIC COMMENTS — RECEIVED ELECTRONICALLY Electronically submitted comments have been made part of the record. CITY COUNCIL REPORTS CONSENT CALENDAR Unless otherwise indicated below, the following pertains to all items on the Consent Calendar. Approved the Staff Recommendation (5-0): Motion by Edwards, Second by Schwank. The vote reflected unanimous approval. 1. Waive Reading of Standard Ordinances and Resolutions Recommendation: That the City Council waive the reading of the text of all standard ordinances and resolutions included in the agenda except as specifically required by the Government Code. 2. Approve Action Minutes of October 11, 2022 Recommendation: That the City Council approve the action minutes of October 11, 2022. 2 3. Approve List of Demands Recommendation: That the City Council adopt a resolution entitled: RESOLUTION NO. 2022-80 A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF TEMECULA ALLOWING CERTAIN CLAIMS AND DEMANDS AS SET FORTH IN EXHIBIT A 4. Approve City Council Meeting Schedule for November and December 2022 Recommendation: That the City Council 1. Approve the cancellation of the regular meetings in November 2022; and 2. Conduct adjourned regular meetings on November 15, 2022 and November 29, 2022; and 3. Approve the cancellation of the December 27, 2022 meeting. 5. Approve Site Access for Research Agreement with Center for Natural Lands Management, Riverside Conservation Authority and Riverside County Transportation Commission on City -Owned Properties within Roripaugh Ranch Recommendation: That the City Council approve the site access for research agreement with the Center for Natural Lands Management, Riverside Conservation Authority, Riverside County Transportation Commission, Riverside County Habitat Conservation Agency and City of Temecula on city -owned properties within Roripaugh Ranch. 6. Approve License Agreement with Eastern Municipal Water District for Facilities Removal on Pujol Street Recommendation: That the City Council approve the license agreement with Eastern Municipal Water District for removal of facilities on Pujol Street. 7. Approve First Amendment to Non -Exclusive Commodity Agreement with SWARCO McCain, Inc. Recommendation: That the City Council approve the first amendment to the agreement with SWARCO McCain, Inc., in the amount of $500,000, and extend the terms of the agreement to June 30, 2025, for the purchase of traffic signal equipment maintenance supplies for operations and maintenance, and to support the City's Capital Improvement Program Project, Traffic Signal Equipment Enhancement Program -Citywide. 8. Accept Improvements and File Notice of Completion for Pedestrian Signalquipment Upgrade -Citywide, PW19-10 Recommendation: That the City Council: 1. Accept the improvements for the Pedestrian Signal Equipment Upgrade -Citywide, PW19-10, as complete; and 2. Direct the City Clerk to file and record the Notice of Completion, release the Performance Bond; and 3. Release the Labor and Materials Bond seven months after filing the Notice of Completion if no liens have been filed. 9. Reject All Construction Bids Received for the I-15 / French Valley Parkway Improvements - Phase 11, PW 16-01 and Authorize Construction Contract to be Rebid Recommendation: That the City Council: Reject all construction bids received for the I-15 / French Valley Parkway Improvements - Phase II, PW 16-01; and 2. Authorize the Department of Public Works to re -advertise construction contract for the I-15 / French Valley Parkway Improvements - Phase II, PW16-01. Approved the Staff Recommendation (4-0, Alexander abstained): Motion by Edwards, Second by Schwank. The vote reflected unanimous approval with Alexander abstaining. 10. Receive and File Temporary Street Closures for 2022 Winterfest Events Recommendation: That the City Council receive and file the temporary closure of certain streets for the following 2022 Winterfest Events: HOLIDAY DECORATION INSTALLATION PU'ESKA MOUNTAIN DAY EMERGENCY PREPAREDNESS FAIR SANTA' S ELECTRIC LIGHT PARADE TEMECULA ON ICE NEW YEAR'S EVE GRAPE DROP RECONVENE TEMECULA CITY COUNCIL PUBLIC HEARING 12. Conduct Public Hearing, Adopt Resolution Making Certain Findings, and Adopt Ordinance No. 2022-12 Adopting the 2022 California Fire Code (Second Reading) Recommendation: That the City Council conduct a public hearing and adopt a resolution and ordinance entitled: RESOLUTION NO. 2022-81 A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF TEMECULA MAKING EXPRESS FINDINGS AND DETERMINATIONS THAT MODIFICATIONS TO THE CALIFORNIA FIRE CODE, 2022 EDITION, ARE REASONABLY NECESSARY BECAUSE OF LOCAL CLIMATIC, GEOLOGICAL AND/OR TOPOGRAPHICAL CONDITIONS ORDINANCE NO. 2022-12 AN ORDINANCE OF THE CITY COUNCIL OF THE CITY OF TEMECULA ADOPTING BY REFERENCE THE 2022 EDITION OF THE CALIFORNIA FIRE CODE BASED ON THE 2021 INTERNATIONAL FIRE CODE, IN ITS ENTIRETY, REGULATING AND GOVERNING THE SAFEGUARD OF LIFE AND PROPERTY FROM FIRE AND EXPLOSION HAZARDS ARISING FROM THE STORAGE, HANDLING AND USE OF HAZARDOUS SUBSTANCES, MATERIALS AND DEVICES, AND FROM CONDITIONS HAZARDOUS TO LIFE OR PROPERTY IN THE OCCUPANCY OF BUILDINGS AND PREMISES IN THE CITY OF TEMECULA, INCLUDING CERTAIN AMENDMENTS, ADDITIONS, AND DELETIONS, AND PROVIDING FOR THE ISSUANCE OF PERMITS AND THE COLLECTION OF FEES Approved the Staff Recommendation (5-0): Motion by Edwards, Second by Schwank. The vote reflected unanimous approval. 13. Conduct Public Hearin-, Adopt Resolution Making Certain Findings, and Adopt Ordinance No. 2022-13 Adopting the 2022 California Building Codes (Second Reading] Recommendation: That the City Council conduct a public hearing and adopt a resolution and ordinance entitled: RESOLUTION NO. 2022-82 A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF TEMECULA MAKING EXPRESS FINDINGS AND DETERMINATIONS THAT MODIFICATIONS TO THE 2022 CALIFORNIA BUILDING CODE; CALIFORNIA MECHANICAL CODE; CALIFORNIA PLUMBING CODE; CALIFORNIA ELECTRICAL CODE; AND CALIFORNIA RESIDENTIAL CODE, AS ADOPTED BY THE CITY OF TEMECULA, ARE REASONABLY NECESSARY BECAUSE OF LOCAL CLIMATIC, GEOLOGICAL AND/OR TOPOGRAPHICAL CONDITIONS 5 ORDINANCE 2022-13 AN ORDINANCE OF THE CITY COUNCIL OF THE CITY OF TEMECULA ADOPTING BY REFERENCE THE 2022 EDITIONS OF THE CALIFORNIA BUILDING CODE; CALIFORNIA MECHANICAL CODE; CALIFORNIA PLUMBING CODE; CALIFORNIA ELECTRICAL CODE; CALIFORNIA ADMINISTRATIVE CODE; CALIFORNIA ENERGY CODE; CALIFORNIA GREEN BUILDING STANDARDS CODE; CALIFORNIA HISTORICAL BUILDING CODE; CALIFORNIA EXISTING BUILDING CODE; CALIFORNIA RESIDENTIAL CODE; AND CALIFORNIA REFERENCED STANDARDS CODE; TOGETHER WITH CERTAIN AMENDMENTS AND DELETIONS, AND AMENDING TITLE 15 OF THE TEMECULA MUNICIPAL CODE Approved the Staff Recommendation (5-0): Motion by Edwards, Second by Schwank. The vote reflected unanimous approval. BUSINESS 14. Receive and File Update Regarding County of Riverside Winchester Community Plan and Recent Development Applications in the Interstate (I-215) Policy Area Related to the 2003 Settlement Agreement and 2005 Cooperative Agreement Between the City of Temecula and County of Riverside Recommendation: That the City Council receive and file the update on the County of Riverside's proposed Winchester Community Plan and recent development applications in the I-215 Policy Area related to an increase of residential density by 33,000 units, traffic impacts, road and freeway mitigation measures, public service infrastructure, compliance with California Environmental Quality Act, and the 2003 Settlement Agreement and the 2005 Cooperative Agreement between the City of Temecula and the County of Riverside, and provide direction to staff. Receive and file only. DEPARTMENTAL REPORTS (RECEIVE AND FILE) 15. City Council Travel/Conference Report 16. Community Development Department Monthly Report 17. Fire Department Monthly Report 18. Public Works Department Monthly Report ITEMS FOR FUTURE CITY COUNCIL AGENDAS A. Resolution Opposing Proposition 1 (At the Request of Council Member Jessica Alexander) Motion by Alexander to place on the City Council agenda, motion failed for lack of a second. CITY MANAGER REPORT CITY ATTORNEY REPORT The City Attorney stated there was no reportable actions from closed session. ADJOURNMENT At 9:01 PM, the City Council meeting was formally adjourned to Tuesday, November 15, 2022, at 4:30 PM for Closed Session, with regular session commencing at 6:00 PM, City Council Chambers, 41000 Main Street, Temecula, California. Matt Rahn, Mayor ATTEST: Randi Johl, City Clerk [SEAL] Item No. 3 CITY OF TEMECULA AGENDA REPORT TO: City Manager/City Council FROM: Jennifer Hennessy, Director of Finance DATE: November 15, 2022 SUBJECT: Approve List of Demands PREPARED BY: Pam Espinoza, Accounting Technician II RECOMMENDATION: That the City Council adopt a resolution entitled: RESOLUTION NO. 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.2022- 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 $ 21,162,986.47. 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 15th day of November, 2022. Matt Rahn, Mayor ATTEST: Randi Johl, City Clerk [SEAL] STATE OF CALIFORNIA ) COUNTY OF RIVERSIDE ) ss CITY OF TEMECULA ) I, Randi Johl, City Clerk of the City of Temecula, do hereby certify that the foregoing Resolution No. 2022- was duly and regularly adopted by the City Council of the City of Temecula at a meeting thereof held on the 15th day of November, 2022, by the following vote: AYES: COUNCIL MEMBERS: NOES: COUNCIL MEMBERS: ABSTAIN: COUNCIL MEMBERS: ABSENT: COUNCIL MEMBERS: Randi Johl, City Clerk CITY OF TEMECULA LIST OF DEMANDS 10/11/2022 TOTAL CHECK RUN: 10/13/2022 TOTAL CHECK RUN: 10/18/2022 TOTAL CHECK RUN: 10/19/2022 TOTAL CHECK RUN: 10/20/2022 TOTAL CHECK RUN: 10/21/2022 TOTAL CHECK RUN: 10/25/2022 TOTAL CHECK RUN: 10/27/2022 TOTAL CHECK RUN: 10/27/2022 TOTAL PAYROLL RUN: 92,827.39 7,919,177.38 190,534.69 7,356.70 10,882,536.89 57,016.27 218,167.35 1,158,352.52 637,017.28 TOTAL LIST OF DEMANDS FOR 11/15/2022 COUNCIL MEETING: $ 21,162,986.47 DISBURSEMENTS BY FUND: CHECKS: 001 GENERAL FUND 14,185,169.04 110 RANCHO CALIF ROAD REIMB DIST 296.66 125 PEG PUBLIC EDUCATION & GOVERNMENT 1,356.27 140 COMMUNITY DEV BLOCK GRANT 2,385.14 165 RDA AFFORDABLE HOUSING 20% SET ASIDE 7,286.03 190 TEMECULA COMMUNITY SERVICES DISTRICT 420,758.37 192 TCSD SERVICE LEVEL B STREET LIGHTS 23,414.00 194 TCSD SERVICE LEVEL D REFUSE RECYCLING 2,986.33 196 TCSD SERVICE LEVEL "L" LAKE PARK MAINT. 14,300.67 197 TEMECULA LIBRARY FUND 12,026.46 210 CAPITAL IMPROVEMENT PROJECTS FUND 703,189.07 300 INSURANCE FUND 168,550.46 305 WORKER'S COMPENSATION 28,925.33 320 INFORMATION SYSTEMS 157,707.84 330 CENTRAL SERVICES 11,568.61 340 FACILITIES 29,315.75 380 SARDA DEBT SERVICE FUND 4,137,968.37 395 2011 FINANCING LEASE 2001 & 2008 COPS 400,688.65 396 2018 FINANCING LEASE MRC 138,951.55 472 CFD 01-2 HARVESTON A&B DEBT SERVICE 2,715.00 473 CFD 03-1 CROWNE HILL DEBT SERVICE FUND 3,830.00 475 CFD 03-3 WOLF CREEK DEBT SERVICE FUND 3,500.68 477 CFD 03-02 RORIPAUGH DEBT SERVICE FUND 2,585.00 478 CFD 16-01 RORIPAUGH PHASE II 2,980.50 501 SERVICE LEVEL"C"ZONE 1 SADDLEWOOD 1,378.95 502 SERVICE LEVEL"C"ZONE 2 WINCHESTER CREEK 750.58 503 SERVICE LEVEL"C"ZONE 3 RANCHO HIGHLANDS 1,046.32 504 SERVICE LEVEL"C"ZONE 4 THE VINEYARDS 215.31 505 SERVICE LEVEL"C"ZONE 5 SIGNET SERIES 1,400.03 506 SERVICE LEVEL"C"ZONE 6 WOODCREST COUNTRY 754.34 507 SERVICE LEVEL"C"ZONE 7 RIDGEVIEW 486.78 508 SERVICE LEVEL"C"ZONE 8 VILLAGE GROVE 5,391.20 509 SERVICE LEVEL"C"ZONE 9 RANCHO SOLANA 121.81 510 SERVICE LEVEL"C"ZONE 10 MARTINIQUE 275.49 511 SERVICE LEVEL"C"ZONE 11 MEADOWVIEW 121.95 512 SERVICE LEVEL"C"ZONE 12 VINTAGE HILLS 2,121.03 513 SERVICE LEVEL"C"ZONE 13 PRESLEY DEVELOP 1,082.02 514 SERVICE LEVEL"C"ZONE 14 MORRISON HOMES 671.72 515 SERVICE LEVEL"C"ZONE 15 BARCLAY ESTATE 18.54 516 SERVICE LEVEL"C"ZONE 16 TRADEWINDS 325.30 517 SERVICE LEVEL"C"ZONE 17 MONTE VISTA 69.35 518 SERVICE LEVEL"C"ZONE 18 TEMEKU HILLS 1,171.53 519 SERVICE LEVEL"C"ZONE 19 CHANTEMAR 1,153.01 520 SERVICE LEVEL"C"ZONE 20 CROWNE HILL 6,402.37 521 SERVICE LEVEL"C"ZONE 21 VAIL RANCH 4,426.03 522 SERVICE LEVEL"C"ZONE 22 SUTTON PLACE 242.95 523 SERVICE LEVEL"C"ZONE 23 PHEASENT RUN 145.65 524 SERVICE LEVEL"C"ZONE 24 HARVESTON 13,870.14 525 SERVICE LEVEL"C"ZONE 25 SERENA HILLS 844.24 526 SERVICE LEVEL"C"ZONE 26 GALLERYTRADITION 84.09 527 SERVICE LEVEL"C"ZONE 27 AVONDALE 649.48 528 SERVICE LEVEL"C"ZONE 28 WOLF CREEK 5,840.08 529 SERVICE LEVEL"C"ZONE 29 GALLERY PORTRAIT 86.12 700 CERBT CALIFORNIA EE RETIREE-GASB45 12,367.00 $ 20,525,969.19 001 GENERAL FUND 110 RANCHO CALIF ROAD REIMB DIST 140 COMMUNITY DEV BLOCK GRANT 165 AFFORDABLE HOUSING 190 TEMECULA COMMUNITY SERVICES DISTRICT 194 TCSD SERVICE LEVEL D REFUSE RECYCLING 196 TCSD SERVICE LEVEL "L" LAKE PARK MAINT. 197 TEMECULA LIBRARY FUND 300 INSURANCE FUND 305 WORKERS' COMPENSATION 320 INFORMATION TECHNOLOGY 330 SUPPORT SERVICES 340 FACILITIES TOTAL BY FUND: 368,318.02 642.67 643.24 4,162.76 191,837.02 1,505.09 201.93 4,441.32 3,100.10 3,100.12 45,328.24 4,536.02 9,200.75 $ 637,017.28 21,162,986.47 apChkLst Final Check List Page: 1 10/11/2022 12:31:33PM CITY OF TEMECULA Bank: eunion EFT UNION BANK Check # Date Vendor Description 503247 10/13/2022 009374 ALLEGRO MUSICAL VENTURES PIANO TUNING/MAINT. THEATER DBA, ALLEGRO PIANO SERVICE 503248 10/13/2022 000936 AMERICAN RED CROSS, STAFF/LIFEGUARDS CERTS: HEALTH AND SAFETY SVCS AQUATICS 503249 10/13/2022 022651 BRAND ASSASSINS QRTRLY STORAGE/CLEANING/INVENTORY FEES 503250 10/13/2022 021588 BRAUN PETER, DBA OCT PLANTSCAPE SVC: CIVIC CTR TEMECULA PLANTSCAPE OCT PLANTSCAPE SVC: LIBRARY 503251 10/13/2022 022670 BROWN, JAMAL DEON, DBA TCSD INSTRUCTOR EARNINGS JDB TRAINING 503252 10/13/2022 021502 BUCHER, BRET PHILLIP TCSD INSTRUCTOR EARNINGS 503253 10/13/2022 022790 CLEARSTAR INC PRE -EMPLOYMENT SCREENINGS: HR PRE -EMPLOYMENT SCREENINGS: HR 503254 10/13/2022 020648 DG INVESTMENT HOLDINGS 2 CITYWIDE SURVEILLANCE: INFO TECH INC, CONVERGINT TECHNOLOGIES CITYWIDE SURVEILLANCE: INFO TECH MAINT & REPAIR OF SECURITY SYSTEM 503255 10/13/2022 003945 DIAMOND ENVIRONMENTAL PORTABLE RESTROOM SVCS: TEM SRVCS SHERIFF 503256 10/13/2022 004192 DOWNS ENERGY FUEL FUEL FOR CITY VEHICLES: PARKS: PW FUEL FOR CITY VEHICLES: STREET MAI FUEL FOR CITY VEHICLES: TRAFFIC: PVC FUEL FOR CITY VEHICLES: TCSD FUEL FOR CITY VEHICLES: CIP: PW FUEL FOR CITY VEHICLES: LAND DEV: P FUEL FOR CITY VEHICLES: POLICE FUEL FOR CITY VEHICLES: LAND DEV: P 503257 10/13/2022 018098 ELITE CLAIMS MANAGEMENT SEP'22 3RD PARTY CLAIMADMIN: WC INC 503258 10/13/2022 022726 FORENSIC NURSING OF SART EXAM: TEM SHERIFF SOCAL INC 503259 10/13/2022 014865 FREIZE UHLER KIMBERLY DBA, PROMOTIONAL ITEMS: HEALTH FAIR: CLEAR BLUE PROMOTIONS HR Amount Paid Check Total 480.00 480.00 513.00 513.00 1,909.05 1,909.05 500.00 200.00 700.00 2,541.53 2,541.53 1,050.00 1,050.00 106.69 76.69 183.38 6,680.88 838.00 550.00 8,068.88 133.21 133.21 2,509.31 1,484.02 634.62 529.84 246.69 154.45 151.29 83.24 5,793.46 1,250.00 1,250.00 1,200.00 1,200.00 751.58 751.58 Page-1 apChkLst Final Check List Page: 2 10/11/2022 12:31:33PM CITY OF TEMECULA Bank: eunion EFT UNION BANK (Continued) Check # Date Vendor Description 503260 10/13/2022 021365 GEORGE HILLS COMPANY INC SEP CLAIMS ADMINISTRATION: HR ANNUAL MEDICARE/CMS REPORT FEE: 503261 10/13/2022 020628 HASA INC POOL SANITIZING CHEMICALS: VARI POOLS 503262 10/13/2022 001135 HEALTHPOINTE MEDICAL Medical Screenings GROUP INC, DBA: FIRST CARE INDUSTRIA 503263 10/13/2022 006914 INNOVATIVE DOCUMENT JUL COPIER MAINT/REPAIR/USAGE: SOLUTIONS CITYWIDE DESKTOP PRINTER:TCSD SOMMERS BE JUL COPIER MAINT/REPAIR/USAGE: LIBF 503264 10/13/2022 012285 JOHNSTONE SUPPLY MAINT SUPPLIES: MPSC 503265 10/13/2022 020907 MICHELLE MEDINA, DBA TCSD INSTRUCTOR EARNINGS MICHELLE O MEDINA 503266 10/13/2022 012264 MIRANDA, JULIO C TCSD INSTRUCTOR EARNINGS 503267 10/13/2022 004043 MISSION ELECTRIC SUPPLY ELECTRICAL SUPPLIES: STA 95 INC 503268 10/13/2022 004040 MORAMARCO ANTHONY J, TCSD INSTRUCTOR EARNINGS DBA BIGFOOT GRAPHICS 503269 10/13/2022 019019 MUSIC CONNECTION LLC SPEAKEASY @ THE MERC 10/8 503270 10/13/2022 021998 OLD TOWN TIRE AND SERVICE VEHICLE REPAIRS: FACILITIES INC 503271 10/13/2022 005075 PRUDENTIAL OVERALL FLOOR MATS/TOWEL RENTALS: CIVIC SUPPLY CTR UNIFORM SVCS: STREET MAINT: PW FLOOR MATS/TOWEL RENTALS: CRC FLOOR MATS/TOWEL RENTALS: TCC FLOOR MATS/TOWEL RENTALS: MUSEUI FLOOR MATS/TOWEL RENTALS: FOC FLOOR MATS/TOWEL RENTALS: THEATE FLOOR MATS/TOWEL RENTALS: JRC Amount Paid Check Total 3,013.40 500.00 3,513.40 263.39 263.39 190.00 190.00 4,130.38 1,160.32 520.41 5,811.11 225.59 225.59 1,925.00 1,925.00 1,915.20 1,915.20 2,650.98 2,650.98 1,688.40 1,688.40 565.60 565.60 444.73 444.73 95.70 45.51 29.51 12.96 11.37 9.70 9.10 8.28 222.13 Paget apChkLst 10/11/2022 12:31:33PM Final Check List CITY OF TEMECULA Page: 3 Bank: eunion EFT UNION BANK (Continued) Check # Date Vendor Description Amount Paid Check Total 503272 10/13/2022 022537 REFRIGERATION SUPPLIES, MISC HVAC SUPPLIES: SENIOR CTR 397.96 DISTRIBUTOR MAINT SUPPLIES: AQUATICS 376.86 MISC HVAC SUPPLIES: CIVIC CTR 374.53 MISC HVAC SUPPLIES: CRC 78.57 MISC HVAC SUPPLIES: PARKING GARAC 38.02 MISC HVAC SUPPLIES: THEATER 20.85 1,286.79 503273 10/13/2022 004274 SAFE AND SECURE LOCKSMITH SVCS: CIVIC CTR 451.83 LOCKSMITH SRVC LOCKSMITH SVCS: CIVIC CTR 60.60 512.43 503274 10/13/2022 009213 SHERRY BERRY MUSIC JAZZ @ THE MERC 10/06 800.00 JAZZ @ THE MERC 9/29 550.00 1,350.00 503275 10/13/2022 022051 SINGH GROUP INC HOMELESS ENCAMPMENT CLEAN-UP 7,277.00 HOMELESS ENCAMPMENT CLEAN-UP 7,227.00 HOMELESS ENCAMPMENT CLEAN-UP 7,202.00 HOMELESS ENCAMPMENT CLEAN-UP 7,202.00 28,908.00 503276 10/13/2022 000645 SMARTAND FINAL INC MISC SUPPLIES: SPECIAL EVENTS: 214.13 TCSD MISC SUPPLIES: WORKFORCE PRGM: T 21.08 235.21 503277 10/13/2022 014783 SOFTRESOURCES, LLC CONSULTING: FINANCIAL SYS 462.48 462.48 UPGRADE MUNIS 503278 10/13/2022 009452 EMPLOYEE #00427 REIMB: SUPPLIES FOR COMMUNITY 228.36 228.36 THEATER 503279 10/13/2022 016311 TIERCE, NICHOLAS GRAPHIC DESIGN SVCS: THEATER 2,640.00 2,640.00 503280 10/13/2022 000668 TIMMY D PRODUCTIONS INC DJ SVCS: ART OF THE WALLS: TCSD 800.00 800.00 503281 10/13/2022 021580 TOWNSEND PUBLIC AFFAIRS OCT CONSULTING SVCS: CITY CLERK 6,000.00 6,000.00 INC 503282 10/13/2022 009101 VISION ONE INC, DBA SEP SHOWARE TICKETING SVCS: 2,914.50 2,914.50 ACCESSO THEATER 503283 10/13/2022 021442 WHOOSTER INC Cell phone web data access: Tern Sheriff 3,500.00 3,500.00 Grand total for EFT UNION BANK: 92,827.39 Page:3 apChkLst Final Check List Page: 4 10/11/2022 12:31:33PM CITY OF TEMECULA 37 checks in this report. Grand Total All Checks: 92,827.39 Page:4 apChkLst Final Check List Page: 1 10/13/2022 4:38:18PM CITY OF TEMECULA Bank: union UNION BANK Check # Date Vendor Description 14244 9/19/2022 000537 SO CALIF EDISON AUGUST 600001004059 41320 BUTTERFIELD 14250 9/21/2022 000537 SO CALIF EDISON AUGUST 700030933344 26706 YNEZ RD 14251 9/21/2022 000537 SO CALIF EDISON AUGUST 700145715868 30499 RANCHO 14252 9/21/2022 000537 SO CALIF EDISON AUGUST 700246548782 26953 YNEZ RD 14253 9/21/2022 000537 SO CALIF EDISON AUGUST 700246573943 26953 YNEZ RD 14254 9/21/2022 000537 SO CALIF EDISON AUGUST 700475634086 26036 YNEZ 14255 9/21/2022 000537 SO CALIF EDISON AUGUST 70003696937040820 WINCHESTER RD 14256 9/21/2022 000537 SO CALIF EDISON AUGUST 700408183926 40233 VILLAGE RD 14257 9/30/2022 000262 RANCHO CALIF WATER VAR AUG WATER 3031158 NACKE DR DISTRICT 14261 9/21/2022 018098 ELITE CLAIMS MANAGEMENT FUNDS FOR WORKERS COMP CLAIMS INC 14272 9/23/2022 001212 SO CALIF GAS COMPANY AUG 091-085-1632-0: 41951 MORAGA RD 14273 9/23/2022 010276 TIME WARNER CABLE SEPTEMBER INTERNET SVCS: 30600 PAUBA RD 14274 9/26/2022 002390 EASTERN MUNICIPAL WATER AUGUST WATER SVCS MURRIETA HOT DIST SPRINGS 14275 9/26/2022 002390 EASTERN MUNICIPAL WATER AUGUST WATER SVCS MURRIETA HOT DIST SPRINGS 14276 9/26/2022 002390 EASTERN MUNICIPAL WATER AUGUST WATER SVCS 39569 DIST SERAPHINA RD 14277 9/26/2022 000537 SO CALIF EDISON SEPTEMBER 700252118808 29721 RYECREST Amount Paid Check Total 5,997.40 5,997.40 80.46 80.46 98.59 98.59 109.76 109.76 173.11 173.11 397.23 397.23 1,425.83 1,425.83 4,635.14 4,635.14 33,829.97 33,829.97 20,000.00 20,000.00 231.84 231.84 625.16 625.16 89.57 89.57 532.16 532.16 630.72 630.72 20.32 20.32 Page:1 apChkLst Final Check List Page: 2 10/13/2022 4:38:18PM CITY OF TEMECULA Bank: union UNION BANK Check # Date Vendor 14278 9/26/2022 010276 TIME WARNER CABLE 14279 9/26/2022 010276 TIME WARNER CABLE 14280 9/27/2022 000537 SO CALIF EDISON 14281 9/28/2022 000537 SO CALIF EDISON 14282 9/28/2022 010276 TIME WARNER CABLE 14283 9/29/2022 018858 FRONTIER CALIFORNIA INC 14284 9/29/2022 018858 FRONTIER CALIFORNIA INC 14285 9/30/2022 018858 FRONTIER CALIFORNIA INC 14286 9/30/2022 018858 FRONTIER CALIFORNIA INC 14287 9/30/2022 018858 FRONTIER CALIFORNIA INC 14288 9/30/2022 018858 FRONTIER CALIFORNIA INC 14289 9/30/2022 018858 FRONTIER CALIFORNIA INC 14290 9/30/2022 018858 FRONTIER CALIFORNIA INC 14291 9/30/2022 018858 FRONTIER CALIFORNIA INC 14293 9/1/2022 014685 COMPASS BANK 14294 9/1/2022 014685 COMPASS BANK 14295 9/26/2022 005460 U S BANK (Continued) Description Amount Paid Check Total SEPTEMBER INTERNET SVCS 32380 600.91 600.91 DEER SEPTEMBER INTERNET SVCS:42569 857.09 857.09 MARGARITA AUGUST 700606072010 46679 672.51 672.51 PRIMROSE AVE SEPTEMBER 700066386743 32805 99.38 99.38 PAUBA RD SEPTEMBER INTERNET SVCS 28922 600.91 600.91 PUJOL ST SEPT INTERNET SVCS: SKATE PARK & 191.01 191.01 SR SEPT INTERNET SVCS: CITY HALL 295.98 295.98 SEPT INTERNET SVCS: CITY HALL 82.29 82.29 SEPT INTERNET SVCS: CITY HALL 86.26 86.26 SEPT INTERNET SVCS: COMMUNITY 130.99 130.99 CENTER SEPT INTERNET SVCS: SENIOR 150.98 150.98 CENTER SEPT INTERNET SVCS: CITY HALL 1,955.20 1,955.20 OCT INTERNET SVCS: CITY HALL 5,066.49 5,066.49 SEPT INTERNET SVCS: CITY HALL 280.21 280.21 2018 MRC DEBT SVC 138,951.55 138,951.55 '11 REFUNDING 01/08 CERT PART 400,688.65 400,688.65 DEBT SVC 17 TAX ALLOCATION BONDS DEBT 4,137,968.37 4,137,968.37 SRVC Paget apChkLst 10/13/2022 4:38:18PM Final Check List CITY OF TEMECULA Page: 3 Bank: union UNION BANK (Continued) Check # Date Vendor Description Amount Paid Check Total 14296 9/22/2022 013286 INTRADO LIFE & SAFETY INC JULY ENTERPRISES 911 SVC: IT 300.00 300.00 14297 8/8/2022 010276 TIME WARNER CABLE AUGUST INTERNET SVCS 32211 WOLF 194.54 194.54 VALLEY 210315 10/7/2022 000161 TYLER TECHNOLOGIES, INC MUNIS MIGRATION SVCS: FINANCE 14,817.95 14,817.95 210316 10/13/2022 004594 2 HOT UNIFORMS INC UNIFORMS: TCC: FIRE DEPT 312.58 UNIFORMS: TCC: FIRE DEPT 312.58 UNIFORMS: TCC: FIRE DEPT 312.58 UNIFORMS: TCC: FIRE DEPT 329.98 UNIFORMS: TCC: FIRE DEPT 312.58 1,580.30 210317 10/13/2022 001517 AETNA BEHAVIORAL HEALTH OCT EMPLOYEE ASSISTANCE PRGM: 1,289.20 1,289.20 LLC, DBAAETNA RESOURCES HR 210318 10/13/2022 003552 AFLAC PREMIUM HOLDING, AFLAC ACCIDENT INDEMNITY 3,153.28 3,153.28 C/O BNB BANK LOCKBOX PAYMENT 210319 10/13/2022 007282 AMAZON CAPITAL SERVICES REC SUPPLIES: HUMAN SVCS: TCSD 208.24 INC MISC OFC SUPPLIES: EOC 84.60 REC SUPPLIES: CRC 136.74 MISC SUPPLIES: FIRE STA 12 17.10 MISC OFC SUPPLIES: EOC 21.72 REC SUPPLIES: HUMAN SVCS: TCSD 337.43 MISC BOOKS: RHRTPL: TCSD 31.80 SUPPLIES: RECREATION: CRC 122.82 SUPPLIES: SKATE PARK PRGM: TCSD 308.79 MISC SUPPLIES: HUMAN SVCS: TCSD 93.40 MISC BOOKS: RHRTPL: TCSD 549.18 MISC SUPPLIES: TVM: TCSD 18.87 MISC SUPPLIES: FIRE STA 12 71.03 MISC SUPPLIES: SPECIAL EVENTS: TCS 223.63 MISC OFC SUPPLIES: CMO 89.94 MISC SUPPLIES: 2ND SAT: TVM: TCSD 284.61 MISC SUPPLIES: AQUATICS: TCSD 168.90 MISC SUPPLIES: TVM: TCSD 44.53 MISC SUPPLIES: SPECIAL EVENTS: TCS 39.30 MISC BOOKS: RHRTPL: TCSD 115.73 2,968.36 210320 10/13/2022 020691 ANN M HOWELL, DBAANN MILITARY BANNER PROGRAM: TCSD 637.50 637.50 HOWELL DESIGN 210321 10/13/2022 022025 ARTHUR J GALLAGHER, RISK BROKERAGE FEE: RISK MGMT 15,425.00 15,425.00 MANAGMENT SRVCS INC Page:3 apChkLst Final Check List Page: 4 10/13/2022 4:38:18PM CITY OF TEMECULA Bank: union UNION BANK Check # Date Vendor 210322 10/13/2022 017149 B G P RECREATION INC 210323 10/13/2022 013105 BACKHAUSDANCE 210324 10/13/2022 013105 BACKHAUSDANCE 210325 10/13/2022 006254 BALLET FOLKLORICO, AKA LORENA HANCOCK (Continued) Description TCSD INSTRUCTOR EARNINGS ADV PMT PERFORMANCE: 11/19/22 THEATER PERF: DANCE SCHOLAR TCSD INSTRUCTOR EARNINGS 210326 10/13/2022 015592 BAMM PROMOTIONAL STAFF UNIFORMS: STREET MAINT: PW PRODUCTS INC STAFF UNIFORMS: SPECIAL EVENTS: TC INSPECTOR UNIFORMS: B&S 210327 10/13/2022 023049 BETTS, KENNETH TCSD INSTRUCTOR EARNINGS 210328 10/13/2022 023035 BIKE TEMECULA VALLEY CORP CC DISCRETIONARY FUNDS: JS 210329 10/13/2022 022568 BIO CLEAN ENVIRONMENTAL, INLET FILTER & INSTALLATION: SERVICES INC NPDES: PW 210330 10/13/2022 001323 BLUETRITON BRANDS INC, 8/23-9/22 WTR DLVRY SVCS: DBA READYREFRESH HARVESTON PK 210331 10/13/2022 022948 BRYANT, ROBERT TCSD INSTRUCTOR EARNINGS 210332 10/13/2022 013098 CADENCE ARTS NETWORK INC THEATER PERFORMANCE: 11/19/2022 210333 10/13/2022 021054 CANTRELL, TINA J TCSD INSTRUCTOR EARNINGS 210334 10/13/2022 005417 CINTAS PROTECTION NO2, FIRST AID KIT MAINT: RISK MGMT CINTAS FIRE 636525 FIRST AID KIT MAINT: RISK MGMT FIRST AID KIT MAINT: RISK MGMT FIRST AID KIT MAINT: RISK MGMT FIRST AID KIT MAINT: RISK MGMT FIRST AID KIT MAINT: RISK MGMT FIRST AID KIT MAINT: RISK MGMT 210335 10/13/2022 022992 CLEMENTSMITH, KATINKA UTILITY BOX ARTIST: TVM: TCSD 210336 10/13/2022 017429 COBRAADVANTAGE INC, DBA SEP COBRA ADMINISTRATION FEES: THE ADVANTAGE GROUP HR Amount Paid Check Total 4,704.00 7,500.00 1,200.00 504.00 136.11 415.01 98.96 3,662.75 1,000.00 366,439.92 34.85 315.00 7,500.00 280.00 ivz'WAi 125.56 131.78 128.26 46.60 208.89 233.70 400.00 631.70 4,704.00 7,500.00 1,200.00 504.00 650.08 3,662.75 1,000.00 366,439.92 34.85 315.00 7,500.00 280.00 999.00 400.00 631.70 Page:4 apChkLst Final Check List Page: 5 10/13/2022 4:38:18PM CITY OF TEMECULA Bank: union UNION BANK Check # Date Vendor 210337 10/13/2022 022962 COLLIN, BARBARA 210338 10/13/2022 013379 COSSOU, CELINE 210339 10/13/2022 014521 COSTAR REALTY INFORMATION INC 210340 10/13/2022 004329 COSTCO TEMECULA 491 210341 10/13/2022 004329 COSTCO TEMECULA 491 210342 10/13/2022 022830 VOID 210343 10/13/2022 021191 DOUGLAS CO INC 210344 10/13/2022 008532 DREAM SHAPERS 210345 10/13/2022 017432 EYEMED VISION CARE 210346 10/13/2022 000165 FEDERAL EXPRESS INC 210347 10/13/2022 002982 FRANCHISE TAX BOARD 210348 10/13/2022 022024 GERARD, TAMRAA., DBA GERARD DESIGN 210349 10/13/2022 023082 GUERRERO, ROBERT 210350 10/13/2022 023090 HUBBARD, BROOKS 210351 10/13/2022 018352 JAMES ELLIOTT ENTERTAINMENT 210352 10/13/2022 021896 JP HANDMADE CORP, DBA MINUTEMAN PRESS 210353 10/13/2022 023100 LAW OFFICES OF S.SEAN BRAL, & ASSOC. (Continued) Description Amount Paid Check Total Theater Performance: JAN 14, 2023 1,750.00 1,750.00 TCSD INSTRUCTOR EARNINGS 1,808.10 1,808.10 OCT'22 WEB SUBSCRIPTION: ECO 1,296.00 1,296.00 DEV SUPPLIES: MPSC/HUMAN SVCS: TCSD 325.32 325.32 MEMBERSHIP RENEWAL: TCSD 180.00 180.00 MEMBERSHIP APPLICATION: EOC 0.00 0.00 MERCHANDISE: TVM GIFT SHOP 618.24 618.24 COMM PRGRM: ECUADORIAN DANCE: 500.00 500.00 TCSD VISION PLAN PAYMENT 1,788.99 1,788.99 EXPRESS MAIL SVCS: THEATER: TCSD 11.77 11.77 SUPPORT PAYMENT 50.00 50.00 UTILITY BOX ARTISIT: TVM: TCSD 400.00 400.00 REFUND: WEST SIDE STORY 52.00 52.00 CANCELLED CLAIMS SETTLEMENT: RISK MGMT 946.60 946.60 STTLMNT: THE LONG RUN: 09/29 5,717.12 5,717.12 BUSINESS CARDS: B&S 76.44 76.44 RELEASE CLAIMS SETTLEMENT: RISK 25,000.00 25,000.00 MGMT Page:5 apChkLst 10/13/2022 4:38:18PM Final Check List CITY OF TEMECULA Page: 6 Bank: union UNION BANK (Continued) Check # Date Vendor Description Amount Paid Check Total 210354 10/13/2022 003782 MAIN STREET SIGNS, DBA SIGN EQUIP: PW TRAFFIC MAINT 1,184.71 1,184.71 ATHACO INC 210355 10/13/2022 017427 MATCHETT, VIVIAN TCSD INSTRUCTOR EARNINGS 291.20 291.20 210356 10/13/2022 003076 MET LIFE INSURANCE DENTAL PAYMENT 13,682.61 13,682.61 COMPANY 210357 10/13/2022 023060 MINNOY, TERRANCE AIRMAN SPEAKER ENGAGEMENT: RISK MGMT 6,000.00 6,000.00 210358 10/13/2022 018099 NATIONAL SAFETY DOT TESTING: HR 54.00 54.00 COMPLIANCE INC 210359 10/13/2022 022982 PASSINI, COLLETTE UTILITY BOX ARTISIT: TVM: TCSD 400.00 400.00 210360 10/13/2022 022981 RICH, JENNIFER ROXANNE UTILITY BOX ARTISIT: TVM: TCSD 400.00 400.00 210361 10/13/2022 017391 RISE INTERPRETING INC AUG SIGN LANGUAGE INTERPRETING: 750.00 CLASSES SEP SIGN LANGUAGE INTERPRETING: C 1,120.00 JUL SIGN LANGUAGE INTERPRETING: C 1,050.00 2,920.00 210362 10/13/2022 000406 RIVERSIDE CO SHERIFFS 07/28-08/24 LAW ENFORCEMENT 2,578,596.23 DEPT 07/01-09/30 TOWING SVCS: POLICE 3,227.45 2,581,823.68 210363 10/13/2022 023095 ROSA, ASHLEY BROOK REFUND: SMARTPAY: TPL 12.99 12.99 210364 10/13/2022 023099 EMPLOYEE #614 REIMB: SMALL/TOOLS EQUIPMENT 99.00 99.00 210365 10/13/2022 009980 SANBORN GWYNETH A, CO COUNTRY LIVE! @ THE MERC 10/01 795.00 795.00 TEMECULA MUSIC ACADEMY 210366 10/13/2022 017699 SARNOWSKI SHAWNA M PHOTOGRAPHY SVCS: SANTA 200.00 PRESTON GERTRUDIS:TCSD PHOTOGRAPHY SVCS: MERC: TCSD 225.00 PHOTOGRAPHY SVCS: HEALTH FAIR: TC 400.00 PHOTOGRAPHY SVCS: COLOR RUN: TSi 100.00 PHOTOGRAPHY SVCS: SEP THEATER: T 650.00 1,575.00 210367 10/13/2022 015457 SHAW HR CONSULTING, INC. CONSULTING SVCS: HR 1,675.00 1,675.00 210368 10/13/2022 023092 SILVA, LEAH THEATER PERF: REVERB TAP CO 7,000.00 7,000.00 01 /07/23 Page6 apChkLst Final Check List Page: 7 10/13/2022 4:38:18PM CITY OF TEMECULA Bank: union UNION BANK (Continued) Check # Date Vendor Description 210369 10/13/2022 000293 STADIUM PIZZA INC RFRSHMNTS: TEEN ZONE ACTIVITIES: TCSD 210370 10/13/2022 007762 STANDARD INSURANCE BASIC LIFE INSURANCE PAYMENT COMPANY 210371 10/13/2022 012723 STANDARD INSURANCE VOLUNTARY SUPP LIFE INSURANCE COMPANY PAYMENT 210372 10/13/2022 008337 STAPLES BUSINESS CREDIT MISC OFC SUPPLIES: TCSD MISC OFC SUPPLIES: MALL STOREFROP MISC SUPPLIES: RHRTPL:TCSD MISC OFC SUPPLIES: HUMAN SVCS: TC; MISC OFC SUPPLIES: MALL STOREFROf 210373 10/13/2022 009061 STURDIVANT, ANGELA P TCSD INSTRUCTOR EARNINGS 210374 10/13/2022 012937 TARGETSOLUTIONS LEARNING TARGET SOLUTIONS MEMBERSHIP LLC, DBA VECTOR SOLUTIONS FEE: HR 210375 10/13/2022 005970 TEMECULAVALLEY STTLMNT: WEST SIDE STORY PLAYHOUSE, DBATEMECULA 9/15-9/18/22 VLY PLAYERS 210376 10/13/2022 021242 TWOS COMPANY INC WHOLESALE GIFT PRODUCTS: GIFT SHOP:TVM WHOLESALE GIFT PRODUCTS: GIFT SHi 210377 10/13/2022 005460 U S BANK TRUSTEE ADMIN FEES: CFD 03-02 RORIPAUGH TRUSTEE ADMIN FEES: CFD 16-01 RORI TRUSTEE ADMIN FEES: CFD 01-2 HARVE TRUSTEE ADMIN FEES: CFD 03-1 CROW TRUSTEE ADMIN FEES: CFD 03-03 W CR 210378 10/13/2022 019793 URBANE CAFE, TGH RFRSHMNTS: ACE EVENT 10/7/22 ENTERPRISES LLC 210379 10/13/2022 002702 USPS - POC, CITYWIDE VOTING LOCATIONS: CITY ACCOUNT#8089685 CLERK 210380 10/13/2022 023097 VICKERS, DIERDRE REIMB: WOMEN LEADERS IN LAW ENF 210381 10/13/2022 007987 WALMART MISC SUPPLIES: MPSC: TCSD MISC SUPPLIES: CRC: TCSD MISC SUPPLIES: CRC: TCSD 210382 10/13/2022 023002 WELTY, EVELYN UTILITY BOXARTISIT: TVM: TCSD Amount Paid Check Total 81.57 81.57 10,649.13 10,649.13 1,215.38 1,215.38 84.72 -40.57 54.98 326.91 40.57 466.61 945.00 945.00 5,991.84 5,991.84 20,670.45 20,670.45 158.63 203.86 362.49 2,585.00 2,715.00 2,715.00 3,830.00 3,500.68 15,345.68 129.19 129.19 7,333.33 7,333.33 215.40 215.40 351.39 157.73 102.12 611.24 400.00 400.00 Page:? apChkLst Final Check List Page: 8 10/13/2022 4:38:18PM CITY OF TEMECULA Bank: union UNION BANK Check # Date Vendor 210383 10/13/2022 021148 WEX BANK (Continued) Description Amount Paid Check Total 09/07-10/06 FUEL USAGE: POLICE 2,582.83 2,582.83 Grand total for UNION BANK: 7,919,202.38 Void Check # 210342 25.00 Revised Total 7,919,177.38 Page:8 apChkLst Final Check List Page: 9 10/13/2022 4:38:18PM CITY OF TEMECULA 104 checks in this report. Grand Total All Checks: 7,919,202.38 Page9 apChkLst Final Check List Page: 1 10/18/2022 3:22:15PM CITY OF TEMECULA Bank: eunion EFT UNION BANK Check # Date Vendor Description 503284 10/20/2022 016450 AIR EXCHANGE INC PLYMOVENT REPAIR: STA 92: FIRE 503285 10/20/2022 009374 ALLEGRO MUSICAL VENTURES PIANO TUNING/MAINT: LIBRARY: TCSD DBA, ALLEGRO PIANO SERVICE 503286 10/20/2022 021843 ALLISON CONTRERAS, FLEET TRUCK REPAIRS: STREET MAINT: PW TRUCK & AUTO SHOP 503287 10/20/2022 004240 AMERICAN FORENSIC NURSES DRUG/ALCOHOL ANALYSIS: TEM AFN SHERIFF DRUG/ALCOHOL ANALYSIS: TEM SHERIF DRUG/ALCOHOL ANALYSIS: TEM SHERIF DRUG/ALCOHOL ANALYSIS: TEM SHERIF 503288 10/20/2022 012951 APPLIED DEVELOPMENT QUALITY OF LIFE MASTER PLAN: ECONOMICS PLANNING 503289 10/20/2022 013950 AQUA CHILL OF SAN DIEGO OCT DRINKING WTR SYS MAINT: STOREFRONT OCT DRINKING WTR SYS MAINT: FOC OCT DRINKING WTR SYS MAINT: MPSC OCT DRINKING WTR SYS MAINT: LIBRAF OCT DRINKING WTR SYS MAINT: PW OCT DRINKING WTR SYS MAINT: TCC OCT DRINKING WTR SYST MAINT: THEA OCT DRINKING WTR SYS MAINT: STORE 503290 10/20/2022 021400 AYERS ELECTRIC INC LABOR SVC: THEATER FOUNTAIN: PW 503291 10/20/2022 012859 BARRETT ENGINEERED PUMP PARTS: OLD TOWN FOUNTAIN PUMPS PUMP PARTS: OLD TOWN FOUNTAIN 503292 10/20/2022 018408 BOB CALLAHAN'S POOL OCT POOL MAINT: OLD TOWN SERVICE FOUNTAIN OCT POOL MAINT: CRC & TES 503293 10/20/2022 004248 CALIF DEPT OF AUG FINGERPRINTING SVC: JUSTICE-ACCTING CONTRACT/VOLUNTE JUL FINGERPRINTING SVC: CONTRACT/ AUG FINGERPRINTING SVC: POLICE JUL FINGERPRINTING SVC: POLICE JUL FINGERPRINTING SVC: HR AUG FINGERPRINTING SVC: HR Amount Paid Check Total 562.49 562.49 280.00 280.00 6,067.49 6,067.49 62.01 310.05 120.40 124.02 616.48 7,243.42 7,243.42 61.96 28.28 35.89 28.28 29.09 28.28 28.55 62.53 302.86 700.00 700.00 3,900.97 1,560.08 5,461.05 950.00 1,100.00 2,050.00 588.00 816.00 3,646.00 3,470.00 49.00 392.00 8,961.00 Page:1 apChkLst 10/18/2022 3:22:15PM Final Check List CITY OF TEMECULA Page: 2 Bank: eunion EFT UNION BANK (Continued) Check # Date Vendor Description Amount Paid Check Total 503294 10/20/2022 010650 CRAFTSMEN PLUMBING & PLUMBING SVCS: MPSC 285.00 HVAC INC PLUMBING SVCS: MPSC 285.00 PLUMBING SVCS: TVE2: PW 999.83 PLUMBING REPAIR: STA 92: FIRE 401.85 PLUMBING REPAIR: STA 84: FIRE 469.98 LABOR: EPDXY FLOORING: FOC 8,850.00 PLUMBING SERVICES: PARKS 1,520.00 PLUMBING REPAIR: STA 95: FIRE 285.00 PLUMBING REPAIR: STA 92: FIRE 977.13 PLUMBING SVCS: MPSC 420.17 14,493.96 503295 10/20/2022 003945 DIAMOND ENVIRONMENTAL TEMP RESTROOM SVCS: TES POOL 325.76 SRVCS RENOVATION TEMPORARY FENCING: JRC 95.00 420.76 503296 10/20/2022 019720 DIVERSIFIED WATERSCAPES AIR COMPRESSOR REPAIR: 2,700.00 2,700.00 INC HARVESTON LAKE 503297 10/20/2022 004192 DOWNS ENERGY FUEL FUEL FOR CITY VEHICLES: LAND DEV: 262.94 PW FUEL FOR CITY VEHICLES: TRAFFIC: PN 515.15 FUEL FOR CITY VEHICLES: TCSD 404.55 FUEL FOR CITY VEHICLES: EOC 135.46 FUEL FOR CITY VEHICLES: STREET MAI 1,008.69 FUEL FOR CITY VEHICLES: CIP: PW 73.71 FUEL FOR CITY VEHICLES: FIRE DEPT 196.97 FUEL FOR CITY VEHICLES: PARKS: PW 1,760.89 FUEL FOR CITY VEHICLES: POLICE 133.03 FUEL FOR CITY VEHICLES: FIRE DEPT 329.83 FUEL FOR CITY VEHICLES: BLDG INSPE 548.64 FUEL FOR CITY VEHICLES: CODE ENFOI 211.67 5,581.53 503298 10/20/2022 012217 DUDEK AUG URBAN FOREST MGMT PLAN & 1,113.07 1,113.07 INVENTORY 503299 10/20/2022 012747 EMERGENCY LIGHTING BATTERY LIGHTING SYS: THEATER 1,250.00 1,250.00 EQUIPMENT, SERVICE COMPANY INC DBA: 503300 10/20/2022 020921 EMPLOYEE #00539 REIMB: NEOGOV CONF 10/4-10/7/22 98.73 98.73 503301 10/20/2022 013211 EMPLOYEE #00307 REIMB: RFRSHMNTS: DEPT MEETING: 93.87 93.87 FINANCE 503302 10/20/2022 022526 EMPLOYEE #00594 REIMB: NEOGOV CONF 10/4-10/7/22 171.21 171.21 503303 10/20/2022 022726 FORENSIC NURSING OF SART EXAM: TEM SHERIFF 800.00 800.00 SOCAL INC Paget apChkLst Final Check List Page: 3 10/18/2022 3:22:15PM CITY OF TEMECULA Bank: eunion EFT UNION BANK (Continued) Check # Date Vendor Description 503304 10/20/2022 000177 GLENNIES OFFICE PRODUCTS MISC OFC SUPPLIES: PLANNING INC MISC OFC SUPPLIES: PLANNING MISC OFC SUPPLIES: PLANNING 503305 10/20/2022 020628 HASA INC POOL SANITIZING CHEMICALS: VARI POOLS 503306 10/20/2022 012883 JACOB'S HOUSE INC EMPLOYEE CHARITY DONATIONS PAYMENT 503307 10/20/2022 011841 JOE RHODES MAINTENANCE, FUEL PUMP MAINT: STA 84 SERVICE INC 503308 10/20/2022 022716 KOEPFLI, TRISTAN H. HELMET PAINT SVCS: TEM SHERIFF 503309 10/20/2022 022664 MARIPOSATREE TREE SVCS: S-27 SERAPHINA: PARKS MANAGEMENT INC TREE SVCS: P-06 RIVERTONE: PARKS ANNUAL TREE TRIMMING: ROW: PARKS TREE SVCS: P-06 RIVERTON: PARKS TREE SVCS: S-24 HARVESTON SLOPE: F TREE SVCS: S-08 VILLAGES SLOPE: PAF TREE SVCS: SP-01 RRSP: PARKS TREE SVCS: P-29 WOLF CREEK TRAIL: F 503310 10/20/2022 004043 MISSION ELECTRIC SUPPLY ELECTRICAL SUPPLIES: PARKS INC ELECTRICAL SUPPLIES: CIVIC CTR ELECTRICAL SUPPLIES: PARKS: PW 503311 10/20/2022 004586 MOORE FENCE COMPANY INC FENCE REPAIR: VETERANS PARK 503312 10/20/2022 002925 NAPAAUTO PARTS AUTO PARTS: STREET MAINT: PW AUTO PARTS: STREET MAINT: PW 503313 10/20/2022 021998 OLD TOWN TIRE AND SERVICE VEHICLE REPAIRS: PARKS: PW INC VEHICLE REPAIRS: PARKS: PW VEHICLE MAINT: STREET MAINT: PW VEHICLE MAINT: PARKS: PW VEHICLE MAINT: BLDG & SAFETY VEHICLE REPAIRS: FACILITIES VEHICLE REPAIRS: PARKS: PW VEHICLE REPAIRS: PARKS: PW VEHICLE SERVICE: MPSC BUS: TCSD VEHICLE REPAIRS: CIP: PW VEHICLE MAINT: PARKS: PW VEHICLE MAINT: PARKS: PW Amount Paid Check Total 53.44 52.36 228.21 334.01 395.09 395.09 40.00 40.00 1,340.20 1,340.20 350.00 350.00 10,199.84 755.84 6,189.54 404.00 10,100.00 2,015.36 2,264.20 16,463.00 48,391.78 1,480.36 -512.67 39.88 1,007.57 5,581.36 5,581.36 91.45 28.95 120.40 52.46 78.54 76.99 1,866.99 261.91 248.54 214.84 65.83 178.50 182.55 1,575.68 150.43 4,953.26 Page:3 apChkLst 10/18/2022 3:22:15PM Final Check List CITY OF TEMECULA Page: 4 Bank: eunion EFT UNION BANK (Continued) Check # Date Vendor Description Amount Paid Check Total 503314 10/20/2022 020544 PARKHOUSE TIRE SERVICE TIRE SVC: STREET MAINT: PW 1,449.88 1,449.88 INC 503315 10/20/2022 012904 PRO ACTIVE FIRE DESIGN SEP PLAN REVIEW SVCS: FIRE PREV 9,407.00 9,407.00 AND, CONSULTING 503316 10/20/2022 005075 PRUDENTIAL OVERALL FLOOR MATS/TOWEL RENTALS: FOC 9.70 SUPPLY UNIFORM SVCS: STREET MAINT: PW 46.61 FLOOR MATS/TOWEL RENTALS: TVM 11.37 FLOOR MATS/TOWEL RENTALS: JRC 8.28 FLOOR MATS/TOWEL RENTALS: TCC 12.96 FLOOR MATS/TOWEL RENTALS: MPSC 23.15 FLOOR MATS/TOWEL RENTALS: THEATE 9.10 FLOOR MATS/TOWEL RENTALS: IWTCM 21.37 UNIFORM SVCS: PARKS MAINT: PW 61.38 203.92 503317 10/20/2022 022537 REFRIGERATION SUPPLIES, MISC HVAC SUPPLIES: FIRE 48.22 DISTRIBUTOR MISC HVAC SUPPLIES: CIVIC CTR 69.36 MISC HVAC SUPPLIES: STA 95 38.81 156.39 503318 10/20/2022 021981 EMPLOYEE #606 REIMB: NEOGOV CONF 10/4-10/7/22 100.24 100.24 503319 10/20/2022 004274 SAFE AND SECURE LOCKSMITH SVCS: CIVIC CTR 64.73 LOCKSMITH SRVC LOCKSMITH SVCS: CIVIC CTR 228.76 LOCKSMITH SVCS: CIVIC CTR 70.80 LOCKSMITH SVCS: PARKS: PW 409.00 773.29 503320 10/20/2022 009746 SIGNS BY TOMORROW SIGN POSTING SVCS: PA22-0996: 213.75 PLNG SIGN POSTING SVCS: PA22-0593: PLNG 213.75 SIGN POSTING SVCS: PLANNING 427.50 SIGN POSTING SVCS: PA22-0595: PLNG 213.75 SIGN POSTING SVCS: PA22-0594: PLNG 213.75 SIGN POSTING SVCS: LR21-0279: PLNG 855.00 2,137.50 503321 10/20/2022 013482 SILVERMAN ENTERPRISES 9/26-10/16 OVERNIGH SECURITY: 3,507.00 3,507.00 INC, DBA BAS SECURITY TCSD 503322 10/20/2022 022051 SINGH GROUP INC HOMELESS ENCAMPMENT CLEAN-UP 12,641.00 HOMELESS ENCAMPMENT CLEAN-UP 1,813.00 14,454.00 503323 10/20/2022 000645 SMART AND FINAL INC SUPPLIES: COLOR RUN: TCSD 565.04 RFRSHMNTS: COLOR RUN: TCSD 364.08 RFRSHMNTS: HIGH HOPES EVENT: MPS 197.07 RFRSHMNTS: VITICULTURE COOKING C 130.34 RFRSHMNTS: COLOR RUN: TCSD 143.43 1,399.96 Page:4 apChkLst Final Check List Page: 5 10/18/2022 3:22:15PM CITY OF TEMECULA Bank: eunion EFT UNION BANK (Continued) Check # Date Vendor Description Amount Paid Check Total 503324 10/20/2022 000944 SWARCO MCCAIN INC TRAFFIC CABINET REPLACEMENT: PW 20,982.33 503325 10/20/2022 003849 TERRYBERRY COMPANY EMPLOYEE SVC RECOGNITION: HR 346.10 503326 10/20/2022 021603 TITAN RENTALS GROUP INC, RENTALS: SPECIAL EVENTS: TCSD 14,066.24 TITAN TENT & EVENT RENTAL 503327 10/20/2022 021549 EMPLOYEE #00534 SUPPLIES: TEAM PACE 69.25 Grand total for EFT UNION BANK: 20,982.33 346.10 14,066.24 69.25 190,534.69 Page:5 apChkLst Final Check List Page: 6 10/18/2022 3:22:15PM CITY OF TEMECULA 44 checks in this report. Grand Total All Checks: 190,534.69 Page6 apChkLst 10/ 19/2022 11:46:35AM Final Check List CITY OF TEMECULA Bank: eunion EFT UNION BANK Check # Date Vendor Description 503328 10/20/2022 009374 ALLEGRO MUSICAL VENTURES PIANO TUNING/MAINT: THEATER DBA, ALLEGRO PIANO SERVICE 503329 10/20/2022 021502 BUCHER, BRET PHILLIP TCSD INSTRUCTOR EARNINGS 503330 10/20/2022 017542 COX, KRISTI LYN TCSD INSTRUCTOR EARNINGS 503331 10/20/2022 004192 DOWNS ENERGY FUEL FUEL FOR CITY VEHICLES: INFO TECH 503332 10/20/2022 020907 MICHELLE MEDINA, DBA TCSD INSTRUCTOR EARNINGS MICHELLE Q MEDINA 503333 10/20/2022 001868 MIYAMOTO JURKOSKY SUSAN, TCSD INSTRUCTOR EARNINGS DBA MIYAMOTO MUSIC STUDIO 503334 10/20/2022 004040 MORAMARCO ANTHONY J, TCSD INSTRUCTOR EARNINGS DBA BIGFOOT GRAPHICS Amount Paid 315.00 2,226.00 200.00 119.60 2,148.30 1.036.00 126.00 503335 10/20/2022 018147 WADDLETON, JEFFREY L. TCSD INSTRUCTOR EARNINGS 660.80 DJ/MC SOUND SVC: RRSP RIBBON CUT- 525.00 Grand total for EFT UNION BANK: Page: 1 Check Total 315.00 2,226.00 200.00 119.60 2,148.30 1,036.00 126.00 1,185.80 7.356.70 Page:1 apChkLst Final Check List Page: 2 10/19/2022 11:46:35AM CITY OF TEMECULA 6 checks in this report. Grand Total All Checks: 7,356.70 Paget apChkLst Final Check List Page: 1 10/20/2022 3:55:13PM CITY OF TEMECULA Bank: union UNION BANK Check # Date Vendor Description 14271 9/29/2022 000246 PERS (EMPLOYEES' PERS RETIREMENT PAYMENT RETIREMENT) 14298 10/7/2022 001212 SO CALIF GAS COMPANY SEPT 125-244-2108-3: 30600 PAUBA RD 14299 10/7/2022 001212 SO CALIF GAS COMPANY AUG 095-167-7907-2: 30650 PAUBA RD 14302 10/5/2022 018858 FRONTIER CALIFORNIA INC OCT INTERNET SVCS: STA 73 14306 10/3/2022 000537 SO CALIF EDISON SEPTEMBER 700187069897 44173 14311 10/3/2022 000537 SO CALIF EDISON SEPTEMBER 700295838526 44747 REDHAWK 14312 10/3/2022 000537 SO CALIF EDISON SEPTEMBER 700376130476 29429 TEMECULA 14314 10/3/2022 000537 SO CALIF EDISON SEPTEMBER 600000000717 31885 MONIQUE CIR 14315 10/3/2022 000537 SO CALIF EDISON SEPTEMBER 700316536912 32131 S LOOP RD 14319 9/27/2022 001212 SO CALIF GAS COMPANY AUG 055-475-6169-5: 32380 DEER HOLLOW 14320 9/27/2022 001212 SO CALIF GAS COMPANY AUG 015-575-0195-2: 32211 WOLF VALLEY RD 14323 10/13/2022 010349 CALIF DEPT OF CHILD SUPPORT PAYMENT SUPPORT 14324 10/13/2022 017429 COBRAADVANTAGE INC, DBA FSA REIMBURSEMENT PAYMENT THE ADVANTAGE GROUP 14325 10/13/2022 021301 I C M A RETIREMENT -PLAN ICMA- 401(A) RETIREMENT PLAN 106474 PAYMENT 14326 10/13/2022 000194 I C M A RETIREMENT -PLAN ICMA-RC RETIREMENT TRUST 457 303355 PAYMENT 14327 10/13/2022 000444 INSTATAX (EDD) STATE TAX PAYMENT Amount Paid Check Total 137, 854.03 137, 854.03 30.84 30.84 149.14 149.14 171.84 171.84 18.58 18.58 37.66 37.66 98.94 98.94 1,749.54 1,749.54 4,273.93 4,273.93 15.78 15.78 153.53 153.53 138.92 138.92 24,134.18 24,134.18 384.62 384.62 17,628.44 17,628.44 42,485.32 42,485.32 Page:1 apChkLst Final Check List Page: 2 10/20/2022 3:55:13PM CITY OF TEMECULA Bank: union UNION BANK (Continued) Check # Date Vendor Description 14328 10/13/2022 000283 INSTATAX (IRS) FEDERAL TAX PAYMENT 14332 10/13/2022 000245 PERS - HEALTH INSUR PERS HEALTH PAYMENT PREMIUM PERS HEALTH PAYMENT 14334 10/11/2022 006887 UNION BANK OF CALIFORNIA 020829 MURRIETA CHAMBER OF REGISTRATION: MURRIETA STATE OF COMMERCE THE CITY 14335 10/11/2022 006887 UNION BANK OF CALIFORNIA 020829 MURRIETA CHAMBER OF REGISTRATION: MURRIETA STATE OF COMMERCE THE CITY 015626 EVENTBRITE.COM REGIST: EVENING WITH SHERIFF BIANCO 14336 10/11/2022 006887 UNION BANK OF CALIFORNIA 020829 MURRIETA CHAMBER OF REGISTRATION: MURRIETA STATE OF COMMERCE THE CITY 004380 BOY SCOUTS OF AMERICA, REGISTRATION: CITIZEN OF THE YEAR CAL.INLAND EMPIRE COUNCIL 015626 EVENTBRITE.COM REGIST: EVENING WITH SHERIFF BIANCO 14337 10/11/2022 006887 UNION BANK OF CALIFORNIA 010514 CAMPINI'S ITALIAN DELI RFRSHMNTS: HOMELESS OUTREACH: TCSD 020489 GREYHOUND LINES HOMELESS OUTREACH: BUS PASS: TCSD 003198 HOME DEPOT MISC SUPPLIES: HELP CTR: TCSD 007987 WALMART MISC SUPPLIES: HELP CTR: TCSD 020489 GREYHOUND LINES HOMELESS OUTREACH: BUS PASS: TCSD 14338 10/11/2022 006887 UNION BANK OF CALIFORNIA 008669 VONS RFRSHMNTS: COUNCIL CANDIDATES: CLERK 005531 FRONT STREET BAR & GRILL RFRSHMNTS: CITY COUNCIL MTG DBA, BAILY WINE COUNTRY 8/23/22 CAFE 000254 PRESS ENTERPRISE ONLINE SUBSCRIPTION: CITY CLERK COMPANY INC 14339 10/11/2022 006887 UNION BANK OF CALIFORNIA 021262 CALIF POLICE CHIEFS ASSOC REGIST: WOMEN LEADERS IN LAW ENF Amount Paid Check Total 126, 030.48 126, 030.48 154,647.58 0.00 154,647.58 35.00 35.00 35.00 107.72 142.72 35.00 150.00 107.72 292.72 97.79 39.99 76.08 112.05 18.99 344.90 59.69 271.88 14.00 345.57 450.00 450.00 Paget apChkLst Final Check List Page: 3 10/20/2022 3:55:13PM CITY OF TEMECULA Bank: union UNION BANK (Continued) Check # Date Vendor Description Amount Paid Check Total 14340 10/11/2022 006887 UNION BANK OF CALIFORNIA 001264 COSTCO TEMECULA 491 SYMPATHY FLOWERS: FIRE DEPT -59.80 BOSCPROPERTIES - CREDIT RECEIVED 10.30 023088 BORN PRIMITIVE UNIFORM SAMPLES: FIRE DEPT 241.88 010046 TV CONVENTION &VISITORS REGIST: STATE OF THE DISTRICT: 100.00 BUREAU, DBA VISIT TEMECULA FIRE VALLEY 013338 APPLE STORE ADD'L PHONE STORAGE: FIRE DEPT 0.99 021342 RING.COM SUBSCRIPTION: OVERLAND TRAIL: 100.00 FIRE 001264 COSTCO TEMECULA 491 SYMPATHY FLOWERS: FIRE DEPT 59.80 453.17 14341 10/11/2022 006887 UNION BANK OF CALIFORNIA 003198 HOME DEPOT MISC SUPPLIES: FAIRVIEW FIRE 537.07 003198 HOME DEPOT MISC SUPPLIES: FAIRVIEW FIRE -525.07 001060 HYATT LODGING: LEAGUE OF CA CITIES 592.44 604.44 CONF 14343 10/11/2022 006887 UNION BANK OF CALIFORNIA 020829 MURRIETA CHAMBER OF REGISTRATION: MURRIETA STATE OF 140.00 COMMERCE THE CITY 006952 PAYPAL REGISTRATION: SPVSR WA STATE OF 500.00 DISTRICT 001264 COSTCO TEMECULA 491 RFRSHMNTS: COUNCIL MEETINGS 18.97 020074 LA COCINA BAR AND GRILL RFRSHMNTS: CITY OF MURRIETA 48.29 MEETING 001060 HYATT RFRSHMNTS: LEAGUE OF CA CITIES 20.87 CONF 001060 HYATT LODGING: LEAGUE OF CA CITIES 277.72 1,005.85 CONF Page:3 apChkLst Final Check List Page: 4 10/20/2022 3:55:13PM CITY OF TEMECULA Bank: union UNION BANK Check # Date Vendor 14344 10/11/2022 006887 UNION BANK OF CALIFORNIA 007594 EXPEDIA.COM 007287 UNITED AIRLINES 000398 CALIF MUNI TREASURERS ASSN 000175 GOVERNMENT FINANCE OFFICERS, ASSOCIATION, GFOA 023086 BOSWELL SAFE & VAULT INC 006952 PAYPAL 000924 CALIF ASSOC PUBLIC PROCUREMENT, OFFICIALS (CAPPO) 019159 CALPERS EDUCATION FORUM 2016 007837 ALASKAAIRLINES 14345 10/11/2022 006887 UNION BANK OF CALIFORNIA 023048 TAP'S TACO CATERING INC 001060 HYATT 023071 PACIFIC CAFE 001060 HYATT 001060 HYATT 013338 APPLE STORE 013338 APPLE STORE 000515 TEMECULA VALLEY CHAMBER OF, COMMERCE 017736 FEAST CALIFORNIA CAFE LLC, DBA CORNER BAKERY CAFE (Continued) Description Amount Paid Check Total AIRFARE: CAPPO CONF: FINANCE 2.13 AIRFARE: CAPPO CONF: FINANCE 168.60 INVESTMENT POLICY APP FEE: 175.00 FINANCE ELECTRONIC GAAFR 2022 EDITION 129.00 DELIVERY OF SAFE: FINANCE 250.00 VERISIGN PAYFLOW PRO 25.00 TRANSACTION REGISTRATION: CONFERENCE: 495.00 FINANCE REGISTRATION: EDUCATION FORUM: 499.00 FINANCE AIRFARE: CAPPO CONF: FINANCE 99.00 1,842.73 RFRSHMNTS: PIO MEETING: ECON 859.12 DEV RFRSHMNTS: LEAGUE OF CA CITIES 38.62 CONF RFRSHMNTS: LEAGUE OF CA CITIES 71.53 CONF RFRSHMNTS: LEAGUE OF CA CITIES 25.91 CONF LODGING: LEAGUE OF CA CITIES 629.44 CONF ADD'L PHONE STORAGE: SOCIAL 2.99 MEDIA APP CHARGES: SOCIAL MEDIA: ECON 2.99 DEV REGISTRATION: ECO FORECAST 60.00 EVENT RFRSHMNTS: WAYFINDING WALK: 172.31 1,862.91 ECO DEV Page:4 apChkLst Final Check List Page: 5 10/20/2022 3:55:13PM CITY OF TEMECULA Bank: union UNION BANK Check # Date Vendor 14347 10/11/2022 006887 UNION BANK OF CALIFORNIA 023075 RIVERSIDE POLICE FOUNDATION 010307 CHICK FILA INC 012550 MARRIOTT, COURTYARD BY MARRIOTT 023076 TEMECULA RECYCLING &, SURPLUS CORNER STORE 010366 SAN DIEGO COUNTY MOTOR, OFFICERS ASSOCIATION 14348 10/11/2022 006887 UNION BANK OF CALIFORNIA 019967 MISAC 023063 A2Z RECOGNITION PRODUCTS 023064 MASTERAIRSCREW 023065 TIMELAPSECAMERAS.COM 022789 SCHNEIDER ELECTRIC, IT CORPORATION (Continued) Description Amount Paid Check Total REGISTRATION: EXPLORER 800.00 COMPETITION RFRSHMNTS: VOLUNTEERS: DUI 71.32 CKPOINT LODGING: WOMEN IN LAW 657.27 ENFORCEMENT SUPPLIES: METAL SHELVING UNITS: 652.50 PD REGISTRATION: TERRY BENNETT 640.00 2,821.09 MEMORIAL AWARD APP FEE: INFO TECH 100.00 SUPPLIES: AV MOBILE CART: INFO 450.00 TECH REPLACEMENT ROTORS DRONES: 108.27 INFO TECH TIME LAPSE CAMERAS: INFO TECH 798.00 REPLACEMENT PARTS: DATA CTR: 1,460.25 2,916.52 INFO TECH Page:5 apChkLst Final Check List Page: 6 10/20/2022 3:55:13PM CITY OF TEMECULA Bank: union UNION BANK (Continued) Check # Date Vendor Description 14349 10/11/2022 006887 UNION BANK OF CALIFORNIA 012085 ISTOCK INT'L INC. SUBSCRIPTION: PROMO IMAGES: TCSD 020249 LAUND3R.COM LLC LAUNDRY XVCS: ACE/TVM: TCSD 020792 CANVA.COM MONTHLY SUBSCRIPTION: TCSD 001365 RIVERSIDE, COUNTY OF, HEALTH PERMIT: NAT'L ENVIRONMENTAL HEALTH PREPAREDNESS FAIR: DEPT 001365 RIVERSIDE, COUNTY OF, HEALTH PERMIT: NAT'L ENVIRONMENTAL HEALTH PREPAREDNESS FAIR: DEPT 000254 PRESS ENTERPRISE ONLINE SUBSCRIPTION: TCSD COMPANY INC 020886 NETFLIX.COM MONTHLY SVC CHARGE: TEEN ZONE: CRC 006952 PAYPAL VERISIGN PAYFLOW PRO TRANSACTION: TCSD 023072 SIGNUPGENIUS.COM SUBSCRIPTION: VOLUNTEER MGMT: TCSD 009612 BJS RESTAURANTS INC RFRSHMNTS: INSTRUCTOR TRAINING: TCSD 021095 NORA'S EMPANADA FACTORY RFRSHMNTS: 2ND SATURDAY 9/10/22: TCSD 000293 STADIUM PIZZA INC RFRSHMNTS: FIRE VICTIMS: PD PERSONNEL 020792 CANVA.COM MONTHLY SUBSCRIPTION: TCSD 017736 FEAST CALIFORNIA CAFE LLC, RFRSHMNTS: POLICE PERSONNEL: DBA CORNER BAKERY CAFE TCSD 14355 10/11/2022 001212 SO CALIF GAS COMPANY SEPT 196-025-0344-3: 42081 MAIN ST 14356 10/11/2022 001212 SO CALIF GAS COMPANY SEPT 101-525-0950-0: 28816 PUJOL ST 14357 10/11/2022 001212 SO CALIF GAS COMPANY SEPT 060-293-3315-7: 28922 PUJOL ST 14358 10/11/2022 001212 SO CALIF GAS COMPANY SEPT 026-671-2909-8: 42051 MAIN ST 14359 10/11/2022 001212 SO CALIF GAS COMPANY SEPT 181-383-8881-6: 28314 MERCEES ST 14360 10/11/2022 001212 SO CALIF GAS COMPANY SEPT 028-025-1468-3: 41375 MCCABE CT 14361 10/11/2022 001212 SO CALIF GAS COMPANY SEPT 133-040-7373-0: 43210 BUSINESS Amount Paid Check Total 120.00 260.50 12.99 207.00 4.91 18.00 9.99 361.40 97.10 200.75 150.85 838.37 12.99 2,288.37 4,583.22 2.15 2.15 15.78 15.78 15.78 15.78 17.93 17.93 22.24 22.24 24.38 24.38 24.38 24.38 Page.-6 apChkLst Final Check List Page: 7 10/20/2022 3:55:13PM CITY OF TEMECULA Bank: union UNION BANK Check # Date Vendor 14362 10/11/2022 001212 SO CALIF GAS COMPANY 14363 10/11/2022 001212 SO CALIF GAS COMPANY 14364 10/11/2022 001212 SO CALIF GAS COMPANY 14365 10/11/2022 001212 SO CALIF GAS COMPANY 14366 10/11/2022 001212 SO CALIF GAS COMPANY 14367 10/11/2022 001212 SO CALIF GAS COMPANY 14369 10/5/2022 005460 U S BANK 210384 10/20/2022 021668 A LAU LANGUAGE LLC 210385 10/20/2022 007282 AMAZON CAPITAL SERVICES INC 210386 10/20/2022 011954 BAKER AND TAYLOR INC 210387 10/20/2022 021278 BEAR DESIGNZ 210388 10/20/2022 023094 BLAIR, CHRIS 210389 10/20/2022 023102 EMPLOYEE #00615 210390 10/20/2022 022948 BRYANT, ROBERT 210391 10/20/2022 003138 CAL MAT, DBA VULCAN MATERIALS CO 210392 10/20/2022 001054 CALIF BUILDING OFFICIALS, (CALBO) (Continued) Description SEPT 129-582-9784-3: 43230 BUSINESS SEPT 021-725-0775-4: 41845 6TH ST SEP 117-188-6393-6: 32131 S LOOP RD SEP 101-525-1560-6: 27415 ENTERPRISE SEPT 091-024-9300-5: 30875 RANCHO VISTA SEPT 129-535-4236-7: 41000 MAIN ST INVESTMENT PURCHASE: FINANCE INTERPRETING SVCS: CITY CLERK DBL CREDIT TAKEN: FIRE DEPT SPORTS EQUIPMENT: TCSD SPORTS EQUIPMENT: TCSD MISC SUPPLIES: 2ND SAT: TVM: TCSD MISC OFC SUPPLIES: STREETS: PW BOOK COLLECTIONS: RHRTPL: TCSD BOOK COLLECTIONS: RHRTPL: TCSD SPECIAL EVENT ITEMS: BATTALION 15: FIRE ENG REFUNDABLE DEP: LD20-3942 REIMB: POOL OPERATOR COURSE: PW TCSD INSTRUCTOR EARNINGS TCSD INSTRUCTOR EARNINGS ASPHALT SUPPLIES: STREET MAINT: PW ASPHALT SUPPLIES: STREET MAINT: PV1 ASPHALT SUPPLIES: STREET MAINT: PV1 ED WEEK REGISTRATION: ONTARIO: BLDG Amount Paid Check Total 45.90 97.52 118.01 143.82 981.08 1,858.28 10,000,000.00 400.00 0XI-1i 684.51 1,239.66 35.79 58.81 1,812.32 2,275.36 1,088.86 3,000.00 247.73 1,193.50 210.00 200.64 247.13 534.64 130.00 45.90 97.52 118.01 143.82 981.08 1,858.28 10,000,000.00 400.00 2,051.38 4,087.68 1,088.86 3,000.00 247.73 1,403.50 982.41 130.00 Page:? apChkLst Final Check List Page: 8 10/20/2022 3:55:13PM CITY OF TEMECULA Bank: union UNION BANK (Continued) Check # Date Vendor Description 210393 10/20/2022 021851 CALIF NEWSPAPERS LGL PUBS REF 9173/9896/0205/0774: PARTNERSHIP, DBA SO CALIF CLERK NEWS GROUP 210394 10/20/2022 021011 EMPLOYEE #00526 REIMB: NEOGOV CONF 10/4-10/7/22 210395 10/20/2022 017867 CAPITOL ENQUIRY 2023 POCKET DIRECTORY CA LEGISLATURE 210396 10/20/2022 018828 CASC ENGINEERING AND, NPDES COMPLIANCE SVCS: PW20-11 CONSULTING INC 210397 10/20/2022 004462 CDW LLC, DBA CDW MISC SMALL TOOLS & EQUIP: INFO GOVERNMENT LLC TECH MICROSOFT SURFACE: CODE ENFORCE MISC SMALL TOOLS & EQUIP: INFO TEC 210398 10/20/2022 010307 CHICK FILA INC RFRSHMNTS: HIGH HOPES & SKIP: TCSD 210399 10/20/2022 016446 CHRISTIAN STITCHERY INC, COLOR RUN EVENT: CRC: TCSD DBA SO CAL IMPRESSIONS 210400 10/20/2022 010792 CLARK EQUIPMENT COMPANY, BOBCAT SKID -STEER LOADER: DBA BOBCAT COMPANY STREETS: PW 210401 10/20/2022 011922 CORELOGIC INC, DBA AUG SOFTWARE SUBSCRIPTION: CORELOGIC SOLUTIONS CODE ENF SEP SOFTWARE SUBSCRIPTION: CODE 210402 10/20/2022 013379 COSSOU, CELINE TCSD INSTRUCTOR EARNINGS 210403 10/20/2022 001264 COSTCO TEMECULA 491 SUPPLIES: PREVENTION: FIRE DEPT MISC SUPPLIES: CERT: FIRE DEPT 210404 10/20/2022 004329 COSTCO TEMECULA491 MISC SUPPLIES: TVM: TCSD MISC SUPPLIES: CLASSES: TCSD 210405 10/20/2022 021077 EMPLOYEE #00542 REIMB: RFRSHMNTS: RIBBON CUTTING EVENT 210406 10/20/2022 022731 CRISP ENTERPRISES INC, DBA REPROGRAPHIC SVCS: FVP PH II: CRISP IMAGING PW16-01 210407 10/20/2022 001233 DANS FEED AND SEED INC MISC SUPPLIES: STREET MAINT: PW 210408 10/20/2022 002990 DAVID TURCH AND SEP FEDERAL LOBBYING SVCS: CITY ASSOCIATES MGR Amount Paid Check Total 1,067.97 1,067.97 253.87 253.87 24.70 24.70 1,624.25 1,624.25 81.13 2,024.23 74.21 2,179.57 1,433.32 1,433.32 3,773.57 3,773.57 67,234.32 67,234.32 383.50 279.00 662.50 218.40 218.40 555.66 793.59 1,349.25 835.97 407.50 1,243.47 163.13 163.13 280.17 280.17 33.16 33.16 5,500.00 5,500.00 Pages apChkLst Final Check List Page: 9 10/20/2022 3:55:13PM CITY OF TEMECULA Bank: union UNION BANK (Continued) Check # Date Vendor Description 210409 10/20/2022 023106 DONINE, MICHAEL REFUND: BALADJ FOR DISMISSAL 210410 10/20/2022 000164 ESGIL LLC JUL PLAN CK SVCS: COMDEV 210411 10/20/2022 000165 FEDERAL EXPRESS INC EXP MAIL SVCS: ECO DEV 210412 10/20/2022 013937 FIRST AMERICAN TITLE TITLE REPORTS: VINE CREEK INSURANCE PROJECT 210413 10/20/2022 022934 GILLMORE, LAUREN BROOKE TCSD INSTRUCTOR EARNINGS 210414 10/20/2022 021953 GLOBAL MUSIC RIGHTS LLC MUSIC LICENSE: TCSD 210415 10/20/2022 019901 GREAT OAK PRESS BOOKS: TVM GIFTSHOP: TCSD 210416 10/20/2022 000186 HANKS HARDWARE INC MISC MAINT SUPPLIES: STREETS: PW SMALL TOOLS AND EQUIP: TRAFFIC: PV\ 210417 10/20/2022 003198 HOME DEPOT MISC SUPPLIES: TCSD 210418 10/20/2022 014062 ID CARD GROUP PROXIMITY CARD SUPPLIES: INFO TECH 210419 10/20/2022 014435 INLAND EROSION CONTROL EROSION CONTROL SUPPLIES: SRVCS STREETS:PW 210420 10/20/2022 003296 INTL CODE COUNCIL 2022 CODE BOOKS: PREVENTION: FIRE 210421 10/20/2022 020893 JEFF KATZ ARCHITECTURAL DSGN SVCS: CRC SPLASH PADS: CORP PW21-07 210422 10/20/2022 017118 KRACH BREE B, DBA INNOVATION FAST PITCH AWARDS: TEMECULA TROPHY & DES ECON DEV RIC TAGS: STATIONS: FIRE 210423 10/20/2022 013982 M C I COMM SERVICE AUGUST 7DK90589 XXX-0346 GEN USAGE AUGUST 7DK89878 XXX-0714 GEN USAC Amount Paid Check Total 10.00 10.00 76,200.92 76,200.92 13.35 13.35 1,900.00 1,900.00 497.00 497.00 2,000.00 2,000.00 268.65 268.65 834.86 147.61 982.47 218.37 218.37 1,071.27 1,071.27 770.00 770.00 287.10 287.10 13,674.00 13,674.00 141.38 324.08 465.46 37.63 39.35 76.98 Page9 apChkLst 10/20/2022 3:55:13PM Final Check List CITY OF TEMECULA Page: 10 Bank: union UNION BANK (Continued) Check # Date Vendor Description Amount Paid Check Total 210424 10/20/2022 003782 MAIN STREET SIGNS, DBA VARI SIGNS & SUPPLIES: STREETS: 1,635.81 ATHACO INC PW VARI SIGNS & SUPPLIES: STREETS: PW 6,216.15 VARI SIGNS & SUPPLIES: STREETS: PW 1,453.82 VARI SIGNS & SUPPLIES: STREETS: PW 1,131.38 VARI SIGNS & SUPPLIES: STREETS: PW 177.79 VARI SIGNS & SUPPLIES: STREETS: PW 2,828.44 VARI SIGNS & SUPPLIES: STREETS: PW 107.64 13,551.03 210425 10/20/2022 009812 EMPLOYEE #00425 REIMB: POOL OPERATOR COURSE: 252.42 252.42 PW 210426 10/20/2022 023107 MCCOOL, DAVID REFUND: BALADJ FOR OVERPMT 305.00 305.00 210427 10/20/2022 018925 MEMORABLE BITES LLC, DBA RFRSHMNTS: CERT CLASS TRAINING: 899.77 899.77 FIREHOUSE SUBS FIRE 210428 10/20/2022 000209 NUTRIEN AG SOLUTIONS INC EQUIPMENT REPAIR: STREET MAINT: 239.77 239.77 PW 210429 10/20/2022 016585 PACIFIC PLAY SYSTEMS INC PLAYGROUND PARTS: MIKE NAGGAR: 1,250.00 1,250.00 PARKS 210430 10/20/2022 021152 EMPLOYEE #00596 REIMB: AOAP CONFERENCE 519.00 519.00 REGISTRATION 210431 10/20/2022 021026 QUESTICA LTD QUESTICA SOFTWARE 40,070.27 40,070.27 SUBSCRIPTION: IT 210432 10/20/2022 023101 EMPLOYEE #00585 REIMB: POOL OPERATOR COURSE: 328.03 328.03 PW 210433 10/20/2022 000411 RIVERSIDE CO FLOOD ADDITIONAL DEP REQ: MURRRIETA 1,000.00 1,000.00 CONTROLAND, WATER CREEK: CIP CONSERVATION DIST 210434 10/20/2022 009980 SANBORN GWYNETH A, CO COUNTRY LIVE! @ THE MERC 10/15 877.50 877.50 TEMECULA MUSIC ACADEMY 210435 10/20/2022 017699 SARNOWSKI SHAWNA M PHOTOGRPAHY SVCS: SAFE PROJ: 300.00 300.00 PRESTON ECO DEV 210436 10/20/2022 023105 SHELDON, TRISH REFUND: BEGINNING PICKLEBALL 55.00 55.00 210437 10/20/2022 013695 SHRED -IT US JV LLC, DBA: 8/8-8/11 DOC SHRED SVCS: CITY FACS 254.00 SHRED -IT USA LLC 9/6-9/8 DOC SHRED SVCS: CITY FACS 248.96 502.96 Page:10 apChkLst 10/20/2022 3:55:13PM Final Check List CITY OF TEMECULA Page: 11 Bank: union UNION BANK (Continued) Check # Date Vendor Description Amount Paid Check Total 210438 10/20/2022 000537 SO CALIF EDISON SEP 700116137841 VARIOUS 33,068.40 33,068.40 LOCATIONS 210439 10/20/2022 002503 SOUTH COAST AIR QUALITY, FY22/23 FLAT EMISSIONS FEE: STA 84 151.85 MANAGEMENT DISTRICT LIQUID FUEL DISPENSING SYSTEM: STA 138.56 290.41 210440 10/20/2022 007341 SOUTH COAST WINERY, INC. RFRSHMNTS: PROMOTIONAL ITEM: 2,592.00 2,592.00 ECO DEV 210441 10/20/2022 000519 SOUTH COUNTY PEST PEST CONTROL SVCS: WEST WING 40.00 CONTROL INC PEST CONTROL SVCS: TVE2 56.00 PEST CONTOL SVCS: PARKING GARAGE 90.00 PEST CONTROL SVCS: HARVESTON PK 95.00 PEST CONTROL SVCS: CIVIC CENTER 120.00 PEST CONTROL SVCS: TES 59.00 PEST CONTROL SVCS: MUSEUM 42.00 PEST CONTROL SVCS: OATC 48.00 PEST CONTROL SVCS: STA 95 80.00 PEST CONTROL SVCS: CHILDRENS MU: 36.00 PEST CONTOL SVCS: THEATER 90.00 PEST CONTROL SVCS: STA 12 74.00 PEST CONTROL SVCS: DUCK POND 49.00 PEST CONTROL SVCS: WEDDING CHAR 32.00 911.00 210442 10/20/2022 012789 STUART, JENNIFER SARAH TCSD INSTRUCTOR EARNINGS 12,480.00 12,480.00 210443 10/20/2022 023108 SUN, LIE FU REFUND: BALANCE ADJ FOR 1,000.00 1,000.00 OVERPAYMENT 210444 10/20/2022 003599 TY LIN INTERNATIONAL 8/16-9/30 CONSULT: FV PKWY/1-15: PH 11 12,779.00 12,779.00 210445 10/20/2022 020301 EMPLOYEE #00515 REIMB: POOL OPERATOR COURSE: 270.03 270.03 PW 210446 10/20/2022 001547 TEAMSTERS LOCAL 911 UNION MEMBERSHIP DUES PAYMENT 4,769.96 4,769.96 210447 10/20/2022 022895 THE STRING QUEENS LLC ADV PMT THEATER PERF: FEB 25, 5,580.00 5,580.00 2023 210448 10/20/2022 022939 TRANSPORTATION CHARTER TRANSPORTATION: SUMMER PRGM: 5,333.79 SRVS TCSD TRANSPORTATION: SUMMER PRGM: TC 4,689.36 TRANSPORTATION: SUMMER PRGM: TC 4,524.51 TRANSPORTATION: SUMMER PRGM: TC 964.08 15,511.74 Page-11 apChkLst Final Check List Page: 12 10/20/2022 3:55:13PM CITY OF TEMECULA Bank: union UNION BANK Check # Date Vendor 210449 10/20/2022 000161 TYLER TECHNOLOGIES, INC 210450 10/20/2022 007987 WALMART 210451 10/20/2022 019773 EMPLOYEE #06719 (Continued) Description Amount Paid Check Total MUNIS MIGRATION SVCS: FINANCE 2,381.97 2,381.97 MISC SUPPLIES: MPSC: TCSD 75.81 MISC OFC SUPPLIES: CLASSES: TCSD 54.77 130.58 REIMB: APA CONFERENCE 680.83 680.83 Grand total for UNION BANK: 10,882,536.89 Page:12 apChkLst Final Check List Page: 13 10/20/2022 3:55:13PM CITY OF TEMECULA 114 checks in this report. Grand Total All Checks: 10,882,536.89 Page:13 apChkLst 10/21/2022 12:14:14PM Final Check List CITY OF TEMECULA Page: 1 Bank: union UNION BANK Check # Date Vendor Description Amount Paid Check Total 14146 9/9/2022 001212 SO CALIF GAS COMPANY AUG 026-671-2909-8: 42051 MAIN ST 16.38 16.38 14278 9/26/2022 010276 TIME WARNER CABLE SEP INTERNET SVCS: 28300 600.91 600.91 MERCEDES ST 14300 10/3/2022 010276 TIME WARNER CABLE SEPTEMBER INTERNET SVCS 29119 1,200.00 1,200.00 MARGARITA 14303 10/5/2022 018858 FRONTIER CALIFORNIA INC OCT INTERNET SVCS: LIBRARY 249.99 249.99 14304 10/4/2022 010276 TIME WARNER CABLE SEPTEMBER INTERNET SVCS 32364 119.99 119.99 OVERLAND 14305 10/4/2022 010276 TIME WARNER CABLE SEPTEMBER INTERNET SVCS 40820 600.91 600.91 WINCHESTER 14316 9/27/2022 010276 TIME WARNER CABLE SEPTEMBER INTERNET SVCS: 41000 49.93 49.93 MAIN ST 14317 9/22/2022 018858 FRONTIER CALIFORNIA INC SEPT INTERNET SVCS: DMV LINE 100.98 100.98 14318 9/22/2022 018858 FRONTIER CALIFORNIA INC SEPT INTERNET SVCS: CHILDREN'S 130.98 130.98 MUSEUM 14321 9/29/2022 010276 TIME WARNER CABLE SEPTEMBER INTERNET SVCS 41845 600.91 600.91 6TH ST 14329 10/13/2022 001065 NATIONWIDE RETIREMENT NATIONWIDE RETIREMENT PAYMENT 14,137.21 14,137.21 SOLUTION 14330 10/13/2022 019088 NATIONWIDE RETIREMENT NATIONWIDE LOAN REPAYMENT 427.79 427.79 SOLUTION PAYMENT 14331 10/13/2022 000389 NATIONWIDE RETIREMENT OBRA- PROJECT RETIREMENT 4,589.56 4,589.56 SOLUTION PAYMENT Page:1 apChkLst Final Check List Page: 2 10/21/2022 12:14:14PM CITY OF TEMECULA Bank: union UNION BANK (Continued) Check # Date Vendor Description 14350 10/11/2022 006887 UNION BANK OF CALIFORNIA 022853 IMOVR OFFICE EQUIPMENT: RISK 001264 COSTCO TEMECULA 491 EMPLOYEE RECOGNITION: HR 000871 HILTON LODGING: NSC CONFERENCE: RISK 009623 PUBLIC AGENCY RISK MGMT REGISTRATION: CONFERENCE: RISK ASSN, (PARMA) 009623 PUBLIC AGENCY RISK MGMT REGISTRATION: CONFERENCE: RISK ASSN, (PARMA) 005363 GRAPELINE, THE EMPLOYEE RECOGNITION: HR 001264 COSTCO TEMECULA 491 RFRSHMNTS: LHMP MTG: RISK 023089 IROBOT EMPLOYEE RECOGNITION: HR 000871 HILTON LODGING: NSC CONFERENCE: RISK 017038 CPS HR CONSULTING REGISTRATION: CYBER TRAINING: HR 000175 GOVERNMENT FINANCE RECRUITMENT ADVERTISING: FIN OFC OFFICERS, ASSOCIATION, MGR GFOA 007282 AMAZON CAPITAL SERVICES EMPLOYEE RECOGNITION: HR INC 005244 SOCIETY FOR HUMAN MEMBERSHIP RENEWAL: HR RESOURCE MGM, THE S H R M STORE 008668 WES FLOWERS SUNSHINE FUND 008668 WES FLOWERS SUNSHINE FUND 011090 TEMECULAVALLEY TRANSP: HR EVENT TRANSPORTATION, DBA STRYDER TRANSPORT. 14351 10/11/2022 010276 TIME WARNER CABLE OCT INTERNET SVCS: 32211 WOLF 14352 10/11/2022 010276 TIME WARNER CABLE 14353 10/11/2022 010276 TIME WARNER CABLE 14354 10/11/2022 010276 TIME WARNER CABLE 14368 10/7/2022 014486 VERIZON WIRELESS 14370 10/6/2022 000166 FIRST AMERICAN TITLE COMPANY VALLEY RD OCT INTERNET SVCS: 41973 6TH ST OCT INTERNET SVCS: 30755 AULD RD OCT INTERNET SVCS: 41000 MAIN ST O8/16-09/15 CELLULAR/BROADBAN D:CITYW I DE LAND ACQUISITION: 26201 YNEZ RD Amount Paid Check Total 1,957.50 455.29 363.45 350.00 320.00 273.48 242.99 217.49 181.73 150.00 150.00 100.00 100.00 91.11 91.11 -237.50 194.54 758.75 758.75 3,163.19 11,323.86 1,553.00 4,806.65 194.54 758.75 758.75 3,163.19 11,323.86 1,553.00 Paget apChkLst Final Check List 10/21/2022 12:14:14PM CITY OF TEMECULA Bank: union UNION BANK Check # Date Vendor 14372 10/18/2022 010276 TIME WARNER CABLE 14373 10/18/2022 018858 FRONTIER CALIFORNIA INC 14374 10/17/2022 010276 TIME WARNER CABLE 14375 10/17/2022 010276 TIME WARNER CABLE 14376 10/17/2022 018858 FRONTIER CALIFORNIA INC 14378 10/19/2022 010276 TIME WARNER CABLE 210452 10/21/2022 022830 VOID 210453 10/21/2022 000186 HANKS HARDWARE INC 210454 10/21/2022 022963 EMPLOYEE #00595 Page: 3 (Continued) Description Amount Paid Check Total OCT INTERNET SVCS: 28816 PUJOL ST 600.91 OCT INTERNET SVCS: CIVIC CENTER 102.89 OCT INTERNET SVCS: 40820 5.34 WINCHESTER OCT INTERNET SVCS: 41000 MAIN ST 1,079.33 OCT INTERNET SVCS: EOC 168.16 OCT INTERNET SVCS: 32131 S LOOP 282.73 RD MEMBERSHIP APPLICATION: EOC 0.00 MISC MAINT SUPPLIES: CIVIC CTR 4,676.99 MISC MAINT SUPPLIES: PARKS: PW 2,055.06 MISC MAINT SUPPLIES: AQUATICS 1,467.39 MISC SMALL TOOLS & EQUIP: CIP: PW 253.28 MISC MAINT SUPPLIES: CRC 120.76 MISC MAINT SUPPLIES: OLD TOWN 101.47 MISC MAINT SUPPLIES: MPSC 75.97 MISC MAINT SUPPLIES: TPL 64.72 MISC MAINT SUPPLIS: MAINT FAC: PW 55.36 MISC MAINT SUPPLIES: THEATER 54.35 MISC SMALL TOOLS & EQUIP: NPDES: P' 50.00 MISC MAINT SUPPLIES: HARVESTON LA 38.01 MISC MAINT SUPPLIES: TVM 23.91 MISC MAINT SUPPLIES: IWTCM 10.53 REIMB: TEAM PACE 344.83 Grand total for UNION BANK 600.91 102.89 5.34 1,079.33 168.16 282.73 0.00 9,047.80 344.83 57,041.27 Page:3 apChkLst Final Check List Page: 4 10/21/2022 12:14:14PM CITY OF TEMECULA 29 checks in this report. Grand Total All Checks: 57,041.27 Void Ck# 210452 25.00 Revised Total: 57,016.27 Page:4 apChkLst Final Check List Page: 1 10/25/2022 2:39:17PM CITY OF TEMECULA Bank: eunion EFT UNION BANK Check # Date Vendor Description Amount Paid Check Total 503336 10/27/2022 004240 AMERICAN FORENSIC NURSES DRUG/ALCOHOL ANALYSIS: TEM 682.11 AFN SHERIFF DRUG/ALCOHOL ANALYSIS: TEM SF 62.01 744.12 503337 10/27/2022 000936 AMERICAN RED CROSS, STAFF/LIFEGUARDS CERTS: 648.35 648.35 HEALTH AND SAFETY SVCS AQUATICS 503338 10/27/2022 013950 AQUA CHILL OF SAN DIEGO OCT DRINKING WTR SYS MAINT: IT 28.28 28.28 503339 10/27/2022 014293 BIBLIOTHECA LLC ANNUAL SUPPORT/MAINT OF EQUIP: 21,348.63 21,348.63 TPL 503340 10/27/2022 004248 CALIF DEPT OF JUL FINGERPRINTING SVC: 343.00 JUSTICE-ACCTING CUSTODIAL JUN FINGERPRINTING SVC: CONTR 98.00 AUG FINGERPRINT SVC: CUSTODIA 49.00 490.00 503341 10/27/2022 000442 COMPUTER ALERT SYSTEMS JUL-SEPT ALARM SYS MONITORING: 211.42 211.42 CONVIS 503342 10/27/2022 010650 CRAFTSMEN PLUMBING & GYM WALL FLOORING: STA 92 3,300.00 3,300.00 HVAC INC 503343 10/27/2022 004192 DOWNS ENERGY FUEL FUEL FOR CITY VEHICLES: BLDG 326.61 INSPECTORS FUEL FOR CITY VEHICLES: CODE E 66.34 FUEL FOR CITY VEHICLES: CITY MC 54.11 447.06 503344 10/27/2022 012217 DUDEK CONSULTANT SVCS: PW19-16 29,818.75 29,818.75 503345 10/27/2022 022726 FORENSIC NURSING OF SART EXAMS: TEM SHERIFF 800.00 800.00 SOCAL INC 503346 10/27/2022 014865 FREIZE UHLER KIMBERLY DBA, MISC PROMOTIONAL ITEMS: TVE2 681.55 CLEAR BLUE PROMOTIONS PROMOTIONAL ITEMS: ECO DEV 663.06 1,344.61 503347 10/27/2022 021365 GEORGE HILLS COMPANY INC SUBROGATION RECOVERY FEE: RISK 6,871.63 6,871.63 MGMT 503348 10/27/2022 021308 GILLIS + PANICHAPAN ARCHITECTURAL SVCS: CRC: PW19-07 960.00 ARCHITECTS, INC ARCHITECTURAL SVCS: CRC: PW1f 150.00 1,110.00 503349 10/27/2022 000177 GLENNIES OFFICE PRODUCTS MISC OFC SUPPLIES: MEDIC: FIRE 252.60 252.60 INC 503350 10/27/2022 020628 HASA INC POOL SANITIZING CHEMICALS: VARI 458.99 458.99 POOLS Page:1 apChkLst Final Check List Page: 2 10/25/2022 2:39:17PM CITY OF TEMECULA Bank: eunion EFT UNION BANK (Continued) Check # Date Vendor Description Amount Paid Check Total 503351 10/27/2022 000520 HDL COREN AND CONE ACFR STATISCAL PACKAGE 695.00 695.00 503352 10/27/2022 003726 LIFE ASSIST INC TEACHING SUPPLIES: MEDIC: FIRE 1,177.87 MEDICAL SUPPLIES: MEDIC: FIRE 387.30 1,565.17 503353 10/27/2022 010204 M T G L INC MATERIALS TESTING: PW22-02 4,026.75 MATERIALS TESTING: PW22-02 3,690.00 7,716.75 503354 10/27/2022 004043 MISSION ELECTRIC SUPPLY ELECTRICAL SUPPLIES: MUSEUM 128.87 INC ELECTRICAL SUPPLIES: CIVIC CEN- 119.38 248.25 503355 10/27/2022 010334 EMPLOYEE #00354 REIMB: NEOGOV CONF 10/4-10/7/22 151.25 151.25 503356 10/27/2022 005075 PRUDENTIAL OVERALL FLOOR MATS/TOWEL RENTALS: JRC 8.28 8.28 SUPPLY 503357 10/27/2022 022537 REFRIGERATION SUPPLIES, MISC HVAC SUPPLIES: STA 92 321.71 DISTRIBUTOR MISC HVAC SUPPLIES: STA92 38.81 MISC HVAC SUPPLIES: STA 73 32.86 393.38 503358 10/27/2022 002412 RICHARDS WATSON AND SEP 2022 LEGAL SERVICES 53,253.21 GERSHON SEP 2022 LEGAL SERVICES 38,631.74 SEP 2022 LEGAL SERVICES 6,278.00 SEP 2022 LEGAL SERVICES 6,165.50 SEP 2022 LEGAL SERVICES 5,093.59 SEP 2022 LEGAL SERVICES 4,374.00 SEP 2022 LEGAL SERVICES 4,032.00 SEP 2022 LEGAL SERVICES 2,960.00 SEP 2022 LEGAL SERVICES 1,923.00 SEP 2022 LEGAL SERVICES 1,472.00 SEP 2022 LEGAL SERVICES 1,215.00 SEP 2022 LEGAL SERVICES 324.00 SEP 2022 LEGAL SERVICES 265.50 SEP 2022 LEGAL SERVICES 132.50 SEP 2022 LEGAL SERVICES 121.50 SEP 2022 LEGAL SERVICES 79.50 SEP 2022 LEGAL SERVICES 29.50 126,350.54 503359 10/27/2022 020922 EMPLOYEE #00529 REIMB: ROUNDTABLE MTG 10/6 93.44 93.44 503360 10/27/2022 009213 SHERRY BERRY MUSIC JAZZ @ THE MERC 10/13 525.00 525.00 503361 10/27/2022 007766 UNDERGROUND SERVICE SEP DIG SAFE BRD BILLABLE TIX: PW 262.00 ALERT, OF SOUTHERN CALIFORNIA SEP UNDERGRND UTILITY LOCATOI 70.85 332.85 Paget apChkLst Final Check List Page: 3 10/25/2022 2:39:17PM CITY OF TEMECULA Bank: eunion EFT UNION BANK Check # Date Vendor 503362 10/27/2022 020275 WALLACE & ASSOC CONSULTING LLC, ANSER ADVISORY MNGMT LLC (Continued) Description Amount Paid Check Total CONSTRUCTION INSP SVCS: PW 22-02 12,213.00 12,213.00 Grand total for EFT UNION BANK: 218,167.35 Page:3 apChkLst Final Check List Page: 4 10/25/2022 2:39:17PM CITY OF TEMECULA 27 checks in this report. Grand Total All Checks: 218,167.35 Page:4 apChkLst Final Check List Page: 1 10/27/2022 3:45:08PM CITY OF TEMECULA Bank: union UNION BANK Check # Date Vendor Description 14292 10/14/2022 000262 RANCHO CALIF WATER VAR SEP WATER 3015553 DEER DISTRICT HOLLOW WAY 14342 10/11/2022 006887 UNION BANK OF CALIFORNIA 023112 THE TINT SHOP INC WORK TRUCKS TINTING: EOC 022546 AIRWAVE COMMUNICATIONS, UPDATE COMMUNICATIONS VEHICLE: ENTERPRISES EOC 017118 KRACH BREE B, DBA RECOGNITION PROGRAM: TCC TEMECULA TROPHY& DES 14371 10/21/2022 000262 RANCHO CALIF WATER VAR SEP WATER 3003793 28250 YNEZ DISTRICT RD LAKE 14379 9/13/2022 001212 SO CALIF GAS COMPANY AUG 117-188-6393-6: 32131 S LOOP RD 14380 10/20/2022 010276 TIME WARNER CABLE OCT INTERNET SVCS: 41000 MAIN ST 14381 10/20/2022 018858 FRONTIER CALIFORNIA INC OCT INTERNET SVCS: LIBRARY 14382 10/20/2022 018858 FRONTIER CALIFORNIA INC OCT INTERNET SVCS: LIBRARY 14384 10/24/2022 010276 TIME WARNER CABLE OCT INTERNET SVCS: 30600 PAUBA RD 14388 10/27/2022 000444 INSTATAX (EDD) STATE TAX PAYMENT 14389 10/27/2022 000283 INSTATAX (IRS) FEDERAL TAX PAYMENT 102133 10/21/2022 023113 CHINO VALLEY ACOUSTICS REFUND: PD INCORRECT INVOICE 210455 10/27/2022 013387 ADAME LANDSCAPE INC, DBA OCT SWEEPING SVCS: PARKING SWEEPING UNLIMITED GARAGE Amount Paid Check Total 58,528.55 58,528.55 319.00 543.27 118.54 980.81 20,998.76 20,998.76 113.45 113.45 298.38 298.38 5.31 5.31 5.31 5.31 623.62 623.62 40,122.74 40,122.74 118, 613.72 118, 613.72 86.00 86.00 540.00 540.00 Page:1 apChkLst Final Check List Page: 2 10/27/2022 3:45:08PM CITY OF TEMECULA Bank: union UNION BANK Check # Date Vendor 210456 10/27/2022 007282 AMAZON CAPITAL SERVICES INC 210457 10/27/2022 002187 ANIMAL FRIENDS OF THE VALLEYS 210458 10/27/2022 020691 ANN M HOWELL, DBAANN HOWELL DESIGN 210459 10/27/2022 000101 APPLE ONE INC (Continued) Description MISC OFC SUPPLIES: ECON DEV REC SUPPLIES: CRC: TCSD MISC OFC SUPPLIES: MALL STOREFROP MISC SMALL TOOLS/EQUIP: TEM SHERIF MISC OFC SUPPLIES: ECON DEV MISC OFC SUPPLIES: MALL STOREFROr MISC SUPPLIES: RISK MGMT MISC SMALL TOOLS & EQUIP: RISK MISC OFC SUPPLIES: RISK MISC OFC SUPPLIES: CITY CLERK MISC SUPPLIES: 2ND SAT: TVM: TCSD MISC SUPPLIES: RISK MGMT MISC SMALL TOOLS & EQUIP: TEM SHEF MISC SUPPLIES: HR AUG ANIMAL CONTROL SVCS: TEMECULA SEP ANIMAL CONTROL SVCS: TEMECUL MISC GRAPHIC DSGN SVCS: ECO DEV GRAPHIC DSGN SVCS: CITY MGR JUL TEMP HELP: PW 210460 10/27/2022 022888 ARAMARK SERVICES INC, DBA RFRSHMNT SVCS: FOC: PW ARAMARK REFRESHMENT RFRSHMNT SVCS: CITY HALL: PW RFRSHMNT SVCS: FOC: PW RFRSHMNT SVCS: CITY HALL: PW RFRSHMNT SVCS: CITY HALL: PW 210461 10/27/2022 017149 B G P RECREATION INC TCSD INSTRUCTOR EARNINGS TCSD INSTRUCTOR EARNINGS 210462 10/27/2022 001323 BLUETRITON BRANDS INC, 9/7-10/6 WTR DLVRY SVC: TVE2 DBA READYREFRESH 8/23-9/22 WTR DLVRY SVC: TES POOL 8/11-9/10 WATER DELIVERY SVCS: FOC 9/11-10/10 WATER DELIVERY SVCS: FOC 210463 10/27/2022 023115 CACATIAN, OSWALD REFUND: RESERVATION: TCC 210464 10/27/2022 021851 CALIF NEWSPAPERS BID ADVRTSMT: REF:0979: PW21-04 PARTNERSHIP, DBA SO CALIF NEWS GROUP 210465 10/27/2022 000152 CALIF PARKS AND MEMBERSHIP RENEWAL: PARKS: PW RECREATION SOC, C P R S Amount Paid Check Total 119.16 177.24 90.75 754.10 149.29 -26.96 493.33 154.60 64.15 227.32 149.79 1,337.64 813.30 -69.20 10,500.00 10,500.00 233.75 361.25 2,830.33 69.97 60.00 18.14 787.88 63.39 3,250.80 4,939.20 85.46 28.69 139.79 192.24 700.00 1,238.76 700.00 4,434.51 21,000.00 595.00 2,830.33 999.38 8,190.00 446.18 700.00 1,238.76 700.00 Paget apChkLst Final Check List Page: 3 10/27/2022 3:45:08PM CITY OF TEMECULA Bank: union UNION BANK (Continued) Check # Date Vendor Description 210466 10/27/2022 022930 CCS SAN DIEGO JANITORIAL NOV JANITORIAL SVCS: OTSF POLICE INC, DBA CCS FACILITY SERVICES 210467 10/27/2022 002945 CONSOLIDATED ELECTRICAL ELECTRICAL SUPPLIES: CIVIC CTR DIST 210468 10/27/2022 022830 COUNTY OF RIVERSIDE, MEMBERSHIP APPLICATION: EOC EMERGENCY SVCS DIVISION 210469 10/27/2022 022731 CRISP ENTERPRISES INC, DBA REPROGRAPHIC SVCS: MPSC: CIP CRISP IMAGING REPROGRAPHIC SVCS: FIRE STA 84: CIF 210470 10/27/2022 012600 DAVID EVANS AND ENG DSGN SVCS: HOCKEY RINK: ASSOCIATES INC RRSP SEP DSGN SVCS: DIAZ RD PROJ: PW17- 210471 10/27/2022 022798 DS SERVICES OF AMERICA WATER DELIVERY: CMO INC, SPARKLETTS 210472 10/27/2022 019681 EJK CORPORATION, DBA BEST PET WASTE BAGS FOR PARKS - PW BAG COMPANY 210473 10/27/2022 015330 FAIR HOUSING COUNCIL, OF SEP SUB -RECIPIENT: FAIR HOUSING RIVERSIDE COUNTY INC SVCS 210474 10/27/2022 019469 FALCON ENGINEERING CONSTRUCTION MGMT SVCS: SERVICES PW08-04 210475 10/27/2022 000165 FEDERAL EXPRESS INC EXPRESS MAIL SVCS: CIP EXP MAIL SVCS: CIP: PW 210476 10/27/2022 002982 FRANCHISE TAX BOARD SUPPORT PAYMENT 210477 10/27/2022 008469 EMPLOYEE #06203 REIMB: APA CONF: PLAN COMMISSION 210478 10/27/2022 003198 HOME DEPOT MISC SUPPLIES: CITY HALL MISC SUPPLIES: CIVIC CENTER MISC SUPPLIES: CIVIC CENTER HARDWARE SUPPLIES: PARKS: PW HARDWARE SUPPLIES: TCC 210479 10/27/2022 010607 INTL SOCIETY OF ISA MEMEBERSHIP RENEWAL: PARKS ARBORICULTURE 210480 10/27/2022 001091 KEYSER MARSTON ON CALL CONSULTANT SVCS: ASSOCIATES INC PLANNING Amount Paid Check Total 616.04 616.04 146.81 146.81 25.00 25.00 309.83 402.60 712.43 3,327.00 13,997.10 17,324.10 48.21 48.21 5,356.95 5,356.95 1,624.22 1,624.22 25,666.90 25,666.90 15.08 6.29 21.37 50.00 50.00 340.19 340.19 311.94 -433.91 433.91 129.41 98.93 540.28 280.00 280.00 6,118.75 6,118.75 Page:3 apChkLst 10/27/2022 3:45:08PM Final Check List CITY OF TEMECULA Page: 4 Bank: union UNION BANK (Continued) Check # Date Vendor Description Amount Paid Check Total 210481 10/27/2022 019884 LEONIDA BUILDERS INC SANTA GERTRUDIS CRK PEDESTRIAN 492,555.94 492,555.94 EXT 210482 10/27/2022 021434 MATRIX TELECOM LLC DBA AUGUST 800 SERVICES: CIVIC 70.80 70.80 LINGO CENTER 210483 10/27/2022 020300 NCBOA, INC Adult Basketball Officiating:TCSD: 1,143.00 1,143.00 210484 10/27/2022 003964 OFFICE DEPOT BUSINESS SVS MISC OFC SUPPLIES: EOC 19.07 DIV MISC OFC SUPPLIES: EOC 105.31 MISC OFC SUPPLIES: EOC 61.95 MISC OFFICE SUPPLIES: TRAFFIC: PW 36.96 223.29 210485 10/27/2022 010338 POOL AND ELECTRICAL, POOL SUPPLIES: AQUATICS 632.71 PRODUCTS INC VARIOUS SUPPLIES: SPLASH PAD: PW 1,428.28 POOL SUPPLIES: AQUATICS 50.69 POOL SUPPLIES: AQUATICS 600.00 POOL SUPPLIES: AQUATICS -40.00 2,671.68 210486 10/27/2022 005820 PRE -PAID LEGAL SERVICES PREPAID LEGAL SERVICES PAYMENT 213.65 213.65 INC, DBA LEGALSHIELD 210487 10/27/2022 021853 PROPAC INC SHSP GRANT: AIRLIGHT ITEMS: EOC 3,738.05 3,738.05 210488 10/27/2022 014494 RAND R CONTROLS, INC HVAC PARTS: VARIOUS LOCATIONS 4,846.06 4,846.06 210489 10/27/2022 023116 RESIDENCE MUTUAL RELASE & SETTLMENT OF CLAIM: 5,000.00 5,000.00 INSURANCE CO RISK 210490 10/27/2022 004822 RIVERSIDE TRANSIT AGENCY SEP TROLLEY SVCS: CITY MGR 2,198.60 2,198.60 210491 10/27/2022 021964 RUSSELL SIGLER INC, DBA HVAC SUPPLIES: THEATER 109.03 109.03 SIGLER WHOLESALE DIST 210492 10/27/2022 017699 SARNOWSKI SHAWNA M PHOTOGRAPHY SVCS: CITY MGR 75.00 PRESTON PHOTOGRAPHY SVCS: SKIP: TCSD 200.00 PHOTOGRAPHY SVCS: TVM: TCSD 225.00 PHOTOGRAPHY SVCS: SPEC EVENTS: l 200.00 PHOTOGRAPHY SVCS: MPSC: TCSD 200.00 PHOTOGRAPHY SVCS: UTILITY BOX ARl 600.00 PHOTOGRAPHY SVCS: VITICULTURE: T( 175.00 PHOTOGRAPHY SVCS: MERC: TCSD 225.00 PHOTOGRAPHY SVCS: CITY COUNCIL 225.00 2,125.00 Page:4 apChkLst Final Check List Page: 5 10/27/2022 3:45:08PM CITY OF TEMECULA Bank: union UNION BANK (Continued) Check # Date Vendor Description 210493 10/27/2022 021309 SB&O INC DSGN, ENVIRO & SURVEY SVS: RRSP TRAILS 210494 10/27/2022 017113 SCHOLASTIC INC EDUCATION MISC BOOKS: RHRTPL: TCSD 210495 10/27/2022 013695 SHRED -IT US JV LLC, DBA: 9/14-9/27 DOC SHRED SVCS: POLICE SHRED -IT USA LLC 10/11-11/8 DOC SHRED SVCS: POLICE 8/15-8/29 DOC SHRED SVCS: POLICE 7/18-8/1 DOC SHRED SVCS: POLICE 6/20-7/5 DOC SHRED SVCS: POLICE 210496 10/27/2022 015235 SMOKE GUARD CALIFORNIA, SMOKE GUARD SVCS: PW INC. 210497 10/27/2022 000537 SO CALIF EDISON RELEASE & STTLMNT OF CLAIM 202204882 210498 10/27/2022 000537 SO CALIF EDISON SEP 700276704365 MAIN ST SEP 700039423268 VARI LOCATIONS 210499 10/27/2022 008337 STAPLES BUSINESS CREDIT MISC OFC SUPPLIES: THEATER: TCSD MISC OFC SUPPLIES: LAND DEV 210500 10/27/2022 017814 STC TRAFFIC INC PROF SVCS: ROUNDABOUT DSGN: PW 210501 10/27/2022 003599 T Y LIN INTERNATIONAL ENG & CONSULT SVCS: FVP PH II 210502 10/27/2022 014885 TEMECULA CATERING RFRSHMNTS: TVE2 ANNIVERSARY 210503 10/27/2022 022046 TURBOSCAPE INC LANDSCAPE MULCH: SANTA GERTRUDIS: PW 210504 10/27/2022 010046 TV CONVENTION &VISITORS AUG '22 BUS. IMPRV DISTRICT BUREAU, DBA VISIT TEMECULA ASMNTS VALLEY 210505 10/27/2022 011659 ULINE INC STORAGE SHELVING: CLASSES: TCSD 210506 10/27/2022 002110 UNITED RENTALNORTH MAINT EQUIP RENTAL: FACILITIES AMERICA INC 210507 10/27/2022 002702 USPS - POC, AUG '22 POSTAGE METER DEPOSIT ACCOUNT#8089685 Amount Paid Check Total 2,612.51 2,612.51 946.03 946.03 44.36 66.54 46.58 46.58 38.07 242.13 1,500.00 1,500.00 50,000.00 50,000.00 479.52 1,030.32 1,509.84 216.85 37.46 254.31 13,889.00 13,889.00 31,209.50 31,209.50 1,187.03 1,187.03 2,480.00 2,480.00 192, 662.57 192, 662.57 440.11 440.11 151.74 151.74 1,174.73 1,174.73 Page:5 apChkLst Final Check List Page: 6 10/27/2022 3:45:08PM CITY OF TEMECULA Bank: union UNION BANK (Continued) Check # Date Vendor Description Amount Paid Check Total 210508 10/27/2022 014850 VALLEY PRINTING SERVICES, PRINTING SVCS: CITY MGR 169.65 169.65 INC. 210509 10/27/2022 001890 VORTEX INDUSTRIES INC ROLL UP DOOR REPAIR: JRC 1,269.60 1,269.60 210510 10/27/2022 001342 WAXIE SANITARY SUPPLY INC CLEANING SUPPLIES: CIVIC CENTER 836.61 836.61 Grand total for UNION BANK: 1,158,352.52 Page6 apChkLst Final Check List Page: 7 10/27/2022 3:45:08PM CITY OF TEMECULA 87 checks in this report. Grand Total All Checks: 1,158,352.52 Page:? Item No. 4 CITY OF TEMECULA AGENDA REPORT TO: City Manager/City Council FROM: Jennifer Hennessy, Director of Finance DATE: November 15, 2022 SUBJECT: Approve City Treasurer's Report as of July 31, 2022 and August 31, 2022 PREPARED BY: Jordan Snider, Senior Accountant RECOMMENDATION: That the City Council approve and file the City Treasurer's Report as of July 31, 2022 and August 31, 2022. BACKGROUND: Government Code Sections 53646 and 41004 require reports to the City Council regarding the City's investment portfolio, receipts, and disbursements respectively. Adequate funds will be available to meet budgeted and actual expenditures of the City for the next six months. Current market values are derived from the Local Agency Investment Fund (LAIF) reports, Union Bank of California trust and custody statements, and from US Bank trust statements. Attached is the City Treasurer's Report that provides this information. The City's investment portfolio is in compliance with the statement of investment policy and Government Code Sections 53601 and 53635 as of as of July 31, 2022 and August 31, 2022. FISCAL IMPACT: None ATTACHMENTS: City Treasurer's Report as of July 31, 2022 and August 31, 2022 Portfolio Managment Treasury Report Portfolio Management Portfolio Summary July 31, 2022 City of Temecula 41000 Main Street Temecula, CA 92590 (951)694-6430 Par Market Book % of Days to YTM YTM Investments Value Value Value Portfolio Term Maturity 360 Equiv. 365 Equiv. Managed Pool Accounts 50,077,839.48 50,077,839.48 50,077,839.48 23.85 1 1 0.860 0.872 Retention Escrow Account 653,457.18 653,457.18 653,457.18 0.31 1 1 0.062 0.063 Letter of Credit 3.00 3.00 3.00 0.00 1 1 0.000 0.000 Trust Accounts 17,293,394.59 17,293,394.59 17,293,394.59 8.24 1 1 1.509 1.530 Local Agency Investment Funds 121,948,954.16 120,378,911.86 121,948,954.16 58.08 1 1 0.287 0.291 Federal Agency Callable Securities 17,000,000.00 15,931,380.00 16,997,500.00 8.10 1,590 1,172 0.723 0.733 Federal Agency Bullet Securities 3,000,000.00 2,906,490.00 3,000,000.00 1.43 1,278 594 0.999 1.013 209,973,648.41 207,241,476.11 209,971,148.41 100.00% 148 104 0.569 0.577 Investments Cash Passbook/Checking (not included in yield calculations) Total Cash and Investments Total Earnings 21, 953,428.98 231,927,077.39 July 31 Month Ending 21,953,428.98 21,953,428.98 229,194,905.09 Fiscal Year To Date Current Year 93,782.70 93,782.70 Average Daily Balance 235,102,437.39 235,102,437.39 Effective Rate of Return 0.47% 0.47% 231,924,577.39 1 1 0.000 0.000 Reporting period 07/01/2022-07/3112022 Portfolio TEME Data Updated: SET_MTH: 10/19/2022 10:16 NL! CP Run Date: 10/19/2022 - 10:16 PM (PRF_PM1) 7.3.0 Report Ver. 7.3.6.1 Portfolio Managment Treasury Report Portfolio Management Portfolio Details - Investments July 31, 2022 Page 1 Average Purchase Stated YTM YTM Days to Maturity CUSIP Investment # Issuer Balance Date Par Value Market Value Book Value Rate 360 365 Maturity Date Managed Pool Accounts 233358001-6 01-2 BOND F First Amer Govt Oblig Fund Cl 5,675.84 5,675.84 5,675.84 1.830 1.805 1.830 1 233358006-6 01-2 REF RES First Amer Govt Oblig Fund Cl 503,940.87 503,940.87 503,940.87 1.830 1.805 1.830 1 233358000-6 01-2 REF ST First Amer Govt Oblig Fund Cl 892,444.61 892,444.61 892,444.61 1.830 1.805 1.830 1 276213009-6 03-02 COI First Amer Govt Oblig Fund Cl 07/01/2022 0.00 0.00 0.00 0.000 0.000 1 276213008-6 03-02 IMPR First Amer Govt Oblig Fund Cl 518.07 518.07 518.07 1.830 1.805 1.830 1 276213006-6 03-02 RES First Amer Govt Oblig Fund Cl 742,111.94 742,111.94 742,111.94 1.830 1.805 1.830 1 164741029-0 03-03 22 COI First Amer Govt Oblig Fund Cl 13,247.25 13,247.25 13,247.25 1.830 1.805 1.830 1 164741028-0 03-03 22 IF First Amer Govt Oblig Fund Cl 194,392.82 194,392.82 194,392.82 1.830 1.805 1.830 1 164741010-0 03-03 22 SPE First Amer Govt Oblig Fund Cl 07/01/2022 18,296,931.25 18,296,931.25 18,296,931.25 0.000 0.000 1 164741026-6 03-03 22 SRB First Amer Govt Oblig Fund Cl 413,704.54 413,704.54 413,704.54 1.830 1.805 1.830 1 164741020-0 03-03 22 STIR First Amer Govt Oblig Fund Cl 844,032.77 844,032.77 844,032.77 1.830 1.805 1.830 1 164741002-6 03-03 BOND F First Amer Govt Oblig Fund Cl 14.83 14.83 14.83 0.620 0.612 0.620 1 164741008-6 03-03IMP First Amer Govt Oblig Fund Cl 23.51 23.51 23.51 0.620 0.612 0.620 1 164741006-6 03-03RES First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.180 0.178 0.180 1 164741000-6 03-03SPEC First Amer Govt Oblig Fund Cl 111.30 111.30 111.30 0.620 0.612 0.620 1 164742002-6 03-06 BOND F First Amer Govt Oblig Fund Cl 26,054.38 26,054.38 26,054.38 1.830 1.805 1.830 1 164742000-6 03-06SPEC First Amer Govt Oblig Fund Cl 261,096.93 261,096.93 261,096.93 1.830 1.805 1.830 1 229462007-6 03-1 2012 RF First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.000 0.000 1 229462002--6 03-1 BOND FD First Amer Govt Oblig Fund Cl 2,595.20 2,595.20 2,595.20 1.830 1.805 1.830 1 229462009-6 03-1 COI First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.000 0.000 1 229462006-6 03-1 RESERV First Amer Govt Oblig Fund Cl 17,241.49 17,241.49 17,241.49 1.830 1.805 1.830 1 229462000-6 03-1 SPECF First Amer Govt Oblig Fund Cl 751,309.85 751,309.85 751,309.85 1.830 1.805 1.830 1 94669921-6 03-1ACQ11 First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.870 0.858 0.870 1 94669911-6 03-1ACQA11 First Amer Govt Oblig Fund Cl 07/01/2022 0.00 0.00 0.00 0.000 0.000 1 94669917-6 03-1 RES First Amer Govt Oblig Fund Cl 07/01/2022 0.00 0.00 0.00 0.000 0.000 1 94669916-6 03-1 RESB11 First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.000 0.000 1 94669000-6 03-1 SPTAX11 First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.000 0.000 1 276213002-6 03-2 REFU First Amer Govt Oblig Fund Cl 227.37 227.37 227.37 1.820 1.795 1.820 1 276213000-6 03-2 SPEC First Amer Govt Oblig Fund Cl 650,324.10 650,324.10 650,324.10 1.830 1.805 1.830 1 94686001-6 03-4ADMIN11 First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.060 0.059 0.060 1 94686005-6 03-4PREP11 First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.070 0.069 0.070 1 94686000-6 03-4RED11 First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.050 0.049 0.050 1 94686006-6 03-4RES11 First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.060 0.059 0.060 1 276213022-6 16-01 BOND F First Amer Govt Oblig Fund Cl 967.36 967.36 967.36 1.830 1.805 1.830 1 276213023-6 16-01 CAPINT First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.870 0.858 0.870 1 276213029-6 16-01 COI First Amer Govt Oblig Fund Cl 07/01/2022 0.00 0.00 0.00 0.000 0.000 1 Data Updated: SET_MTH: 10/19/2022 10:16 Run Date: 10/19/2022 - 10:16 Portfolio TEME NL! CP PM (PRF_PM2) 7.3.0 Report Ver. 7.3.6.1 Portfolio Managment Treasury Report Portfolio Management Portfolio Details - Investments July 31, 2022 Page 2 Average Purchase Stated YTM YTM Days to Maturity CUSIP Investment # Issuer Balance Date Par Value Market Value Book Value Rate 360 365 Maturity Date Managed Pool Accounts 276213028-6 16-01 IMP First Amer Govt Oblig Fund Cl 6,734,034.94 6,734,034.94 6,734,034.94 1.830 1.805 1.830 1 276213026-6 16-01 RESERV First Amer Govt Oblig Fund Cl 3,157,961.62 3,157,961.62 3,157,961.62 1.830 1.805 1.830 1 276213020-6 16-01 SPECF First Amer Govt Oblig Fund Cl 2,054,829.57 2,054,829.57 2,054,829.57 1.830 1.805 1.830 1 218848001-6 2017A&B INT First Amer Govt Oblig Fund Cl 143.29 143.29 143.29 1.830 1.805 1.830 1 218848008-6 2017ABPRIORP First Amer Govt Oblig Fund Cl 17,986.03 17,986.03 17,986.03 1.830 1.805 1.830 1 218848013-2 2017B COI First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.000 0.000 1 218848000-6 2017B IDS First Amer Govt Oblig Fund Cl 1,033.59 1,033.59 1,033.59 1.830 1.805 1.830 1 218848002-6 2017B PRIN First Amer Govt Oblig Fund Cl 992.30 992.30 992.30 1.830 1.805 1.830 1 218848009-6 2017B_PROJ First Amer Govt Oblig Fund Cl 5,185,170.77 5,185,170.77 5,185,170.77 1.830 1.805 1.830 1 233358009-6 233358009-6 First Amer Govt Oblig Fund Cl 07/01/2022 0.00 0.00 0.00 0.000 0.000 1 94434160-6 RDA-021NT First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.000 0.000 1 94434161-6 RDA-02PRIN First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.000 0.000 1 107886000-6 RDA-06AINT First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.000 0.000 1 107886001-6 RDA06APRIN First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.000 0.000 1 107886010-6 RDA06BINT First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.000 0.000 1 107886011-6 RDA06BPRIN First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.680 0.671 0.680 1 107886016-6 RDA06BRES First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.940 0.927 0.940 1 107886020-6 RDA071NT First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.000 0.000 1 107886021-6 RDA07PRIN First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.930 0.917 0.930 1 107886028-6 RDA07PROJ First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.940 0.927 0.940 1 107886026-6 RDA07RES First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.940 0.927 0.940 1 136343008-6 RDA10APROJ First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.000 0.000 1 136343018-6 RDA10BPROJ First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.000 0.000 1 136343000-6 RDA10INT First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.000 0.000 1 136343001-6 RDA10PRIN First Amer Govt Oblig Fund Cl 07/01/2022 0.00 0.00 0.00 0.000 0.000 1 136343006-6 RDA10RSRV First Amer Govt Oblig Fund Cl 07/01/2022 0.00 0.00 0.00 0.000 0.000 1 146161000-6 RDA11AINT First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.000 0.000 1 146161001-6 RDA11APRIN First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.000 0.000 1 94669902-3 03-1 BOND3 First American Treasury 07/01/2022 0.00 0.00 0.00 0.000 0.000 1 94434160-1 RDA 02 INT1 First American Treasury 0.00 0.00 0.00 0.010 0.010 0.010 1 94434161-2 RDA 02 PRIN2 First American Treasury 0.00 0.00 0.00 0.010 0.010 0.010 1 136343018-2 RDA 10B CIP2 First American Treasury 0.00 0.00 0.00 0.010 0.010 0.010 1 146161008-3 RDA11APROJ Federated Institutional Tax Fr 0.00 0.00 0.00 0.800 0.789 0.800 1 146161006-3 RDA11ARSRV Federated Institutional Tax Fr 07/01/2022 0.00 0.00 0.00 0.000 0.000 1 94669921-5 03-01 ACQ11 Federated Tax Free Obligations 0.00 0.00 0.00 0.250 0.247 0.250 1 94669911-5 03-01 ACQA11 Federated Tax Free Obligations 0.00 0.00 0.00 0.250 0.247 0.250 1 Data Updated: SET_MTH: 10/19/2022 10:16 Run Date: 10/19/2022 - 10:16 Portfolio TEME NL! CP PM (PRF_PM2) 7.3.0 Portfolio Managment Treasury Report Portfolio Management Portfolio Details - Investments July 31, 2022 Page 3 CUSIP Investment # Average Issuer Balance Purchase Date Par Value Market Value Book Value Stated Rate YTM 360 YTM 365 Days to Maturity Maturity Date Managed Pool Accounts 94669917-5 03-01 RES Federated Tax Free Obligations 07/01/2022 0.00 0.00 0.00 0.000 0.000 1 94669906-5 03-01 RESA11 Federated Tax Free Obligations 0.00 0.00 0.00 0.001 0.001 0.001 1 94669916-5 03-01 RESB11 Federated Tax Free Obligations 0.00 0.00 0.00 0.250 0.247 0.250 1 94669000-5 03-01SPTAX11 Federated Tax Free Obligations 0.00 0.00 0.00 0.250 0.247 0.250 1 164742006-5 03-06 RES Federated Tax Free Obligations 07/01/2022 0.00 0.00 0.00 0.000 0.000 1 164742000-5 03-06 SPEC Federated Tax Free Obligations 0.00 0.00 0.00 0.250 0.247 0.250 1 94669902-5 03-1bond fd Federated Tax Free Obligations 07/01/2022 0.00 0.00 0.00 0.000 0.000 1 94686001-5 03-4 ADMIN11 Federated Tax Free Obligations 0.00 0.00 0.00 0.250 0.247 0.250 1 94686005-5 03-4 PREP11 Federated Tax Free Obligations 07/01/2022 0.00 0.00 0.00 0.000 0.000 1 94686006-5 03-4 RES11 Federated Tax Free Obligations 0.00 0.00 0.00 0.250 0.247 0.250 1 94669917-1 03-01-1 RES CA Local Agency Investment Fun 0.00 0.00 0.00 0.339 0.334 0.339 1 276213008-1 03-02 IMP CA Local Agency Investment Fun 8,182,048.80 8,182,048.80 8,182,048.80 0.221 0.218 0.221 1 164742006-1 03-06 RES-1 CA Local Agency Investment Fun 307,572.28 307,572.28 307,572.28 1.830 1.805 1.830 1 229462007-1 03-1 2012 RE CA Local Agency Investment Fun 818,664.58 818,664.58 818,664.58 0.221 0.218 0.221 1 94669911-1 03-1 ACQ A2 CA Local Agency Investment Fun 0.00 0.00 0.00 0.339 0.334 0.339 1 94669921-1 03-1 ACQ B2 CA Local Agency Investment Fun 0.00 0.00 0.00 0.339 0.334 0.339 1 744727011-1 03-3 ACQ 2 CA Local Agency Investment Fun 0.00 0.00 0.00 0.339 0.334 0.339 1 164741006-1 0303-1 RES CA Local Agency Investment Fun 172.03 172.03 172.03 0.620 0.612 0.620 1 107886028-1 RDA 07 PRO-1 CA Local Agency Investment Fun 0.00 0.00 0.00 0.339 0.334 0.339 1 107886026-1 RDA 07 RES-1 CA Local Agency Investment Fun 0.00 0.00 0.00 0.339 0.334 0.339 1 136343018-1 RDA 10B CIP1 CA Local Agency Investment Fun 0.00 0.00 0.00 0.339 0.334 0.339 1 229462020-0 03-01 CASH USBANK 263.40 263.40 263.40 0.000 0.000 1 164742006-0 03-06 Cash USBANK 07/01/2022 0.00 0.00 0.00 0.000 0.000 1 233358050-1 01-2 SPECESC U.S. Treasury 0.00 0.00 0.00 0.360 0.355 0.360 1 Subtotal and Average 50,189,247.40 50,077,839.48 50,077,839.48 50,077,839.48 0.860 0.872 1 Retention Escrow Account NOBEL COMPANY 3354 Banner Bank 0.00 0.00 0.00 0.150 0.148 0.150 1 218848050-0 2002 ESCROW USBANK 07/01/2022 0.00 0.00 0.00 0.000 0.000 1 218848060-0 2006AESCRO USBANK 07/01/2022 0.00 0.00 0.00 0.000 0.000 1 218848070-0 2006BESCRO USBANK 07/01/2022 0.00 0.00 0.00 0.000 0.000 1 218848080-0 2007ESCROW USBANK 07/01/2022 0.00 0.00 0.00 0.000 0.000 1 229462020-2 03-01 ESCROW U.S. Treasury 653,457.18 653,457.18 653,457.18 0.063 0.062 0.063 1 Subtotal and Average 653,457.18 653,457.18 653,457.18 653,457.18 0.062 0.063 1 Portfolio TEME Data Updated: SET_MTH: 10/19/2022 10:16 NL! CP Run Date: 10/19/2022 - 10:16 PM (PRF_PM2) 7.3.0 Portfolio Managment Treasury Report Portfolio Management Portfolio Details - Investments July 31, 2022 Page 4 Average Purchase Stated YTM YTM Days to Maturity CUSIP Investment # Issuer Balance Date Par Value Market Value Book Value Rate 360 365 Maturity Date Letter of Credit 164741026-1 03-03 22 Res ASSURED GUARANTY MUNICIPAL COR 07/01/2022 1.00 1.00 1.00 0.000 0.000 1 218848006-1 2017B RESER ASSURED GUARANTY MUNICIPAL COR 07/01/2022 1.00 1.00 1.00 0.000 0.000 1 233358006-1 01-2 REFRESI ASSURANCE CO BOND INSURANCE 07/01/2022 1.00 1.00 1.00 0.000 0.000 1 Subtotal and Average 3.00 3.00 3.00 3.00 0.000 0.000 1 Trust Accounts 6746058700 PARS Pension US Bank Trust 17,293,394.59 17,293,394.59 17,293,394.59 1.530 1.509 1.530 1 Subtotal and Average 16,535,872.19 17,293,394.59 17,293,394.59 17,293,394.59 1.509 1.530 1 Local Agency Investment Funds SYSCITY CITY CA Local Agency Investment Fun 56,872,004.11 56,139,800.60 56,872,004.11 0.206 0.203 0.206 1 SYSRDA RDA CA Local Agency Investment Fun 1,898.30 1,873.86 1,898.30 0.365 0.360 0.365 1 SYSTCSD TCSD CA Local Agency Investment Fun 65,075,051.75 64,237,237.40 65,075,051.75 0.365 0.360 0.365 1 Subtotal and Average 136,236,286.57 121,948,954.16 120,378,911.86 121,948,954.16 0.287 0.291 1 Federal Agency Callable Securities 3133EMQGO 01259 Federal Farm Credit Bank 02/10/2021 1,000,000.00 935,600.00 1,000,000.00 0.320 0.316 0.320 924 02/10/2025 3133EMK92 01265 Federal Farm Credit Bank 06/23/2021 1,000,000.00 932,590.00 1,000,000.00 0.580 0.572 0.580 1,057 06/23/2025 3133EMN57 01266 Federal Farm Credit Bank 06/28/2021 1,000,000.00 949,650.00 1,000,000.00 0.440 0.434 0.440 697 06/28/2024 3133EMP22 01267 Federal Farm Credit Bank 06/30/2021 1,000,000.00 934,230.00 1,000,000.00 0.910 0.898 0.910 1,429 06/30/2026 3133ENAP5 01273 Federal Farm Credit Bank 10/14/2021 1,000,000.00 936,020.00 1,000,000.00 0.800 0.789 0.800 1,170 10/14/2025 313OAKQ41 01258 Federal Home Loan Bank 01/28/2021 1,000,000.00 923,320.00 1,000,000.00 0.520 0.513 0.520 1,276 01/28/2026 3130ALEU4 01260 Federal Home Loan Bank 02/25/2021 1,000,000.00 937,760.00 1,000,000.00 0.350 0.345 0.350 847 11/25/2024 3130ALWV2 01261 Federal Home Loan Bank 04/21/2021 1,000,000.00 948,070.00 1,000,000.00 0.550 1.011 1.025 1,359 04/21/2026 3130AM2V3 01262 Federal Home Loan Bank 04/29/2021 1,000,000.00 947,590.00 1,000,000.00 0.700 0.690 0.700 1,002 04/29/2025 3130AMNMO 01263 Federal Home Loan Bank 05/27/2021 1,000,000.00 935,690.00 1,000,000.00 0.500 0.493 0.500 1,395 05/27/2026 3130AMM90 01264 Federal Home Loan Bank 06/10/2021 1,000,000.00 945,750.00 1,000,000.00 0.500 1.973 2.000 1,409 06/10/2026 3130AN4N7 01268 Federal Home Loan Bank 07/14/2021 1,000,000.00 938,440.00 1,000,000.00 0.720 0.710 0.720 1,078 07/14/2025 3130ANAZ3 01269 Federal Home Loan Bank 07/28/2021 1,000,000.00 942,390.00 1,000,000.00 0.600 0.592 0.600 1,001 04/28/2025 3130AP3M5 01270 Federal Home Loan Bank 09/28/2021 1,000,000.00 934,510.00 1,000,000.00 0.550 0.542 0.550 970 03/28/2025 3134GXJL9 01257 Federal Home Loan Mtg Corp 12/30/2020 1,000,000.00 929,480.00 1,000,000.00 0.500 0.493 0.500 1,247 12/30/2025 3130APBV6 01271 Union Bank 10/07/2021 1,000,000.00 934,560.00 999,000.00 1.000 1.007 1.021 1,528 10/07/2026 3130APAM7 01272 Union Bank 10/14/2021 1,000,000.00 925,730.00 998,500.00 0.900 0.918 0.931 1,535 10/14/2026 Subtotal and Average 16,997,500.00 17,000,000.00 15,931,380.00 16,997,500.00 0.723 0.733 1,172 Portfolio TEME Data Updated: SET_MTH: 10/19/2022 10:16 NL! CP Run Date: 10/19/2022 - 10:16 PM (PRF_PM2) 7.3.0 Portfolio Managment Treasury Report Portfolio Management Portfolio Details - Investments July 31, 2022 Page 5 Average Purchase Stated YTM YTM Days to Maturity CUSIP Investment # Issuer Balance Date Par Value Market Value Book Value Rate 360 365 Maturity Date Federal Agency Bullet Securities 3133ELMA9 01254 Federal Farm Credit Bank 02/07/2020 1,000,000.00 984,420.00 1,000,000.00 1.420 1.401 1.420 371 08/07/2023 3133ELTU8 01256 Federal Farm Credit Bank 03/18/2020 1,000,000.00 970,250.00 1,000,000.00 0.920 0.907 0.920 595 03/18/2024 3133ENCA6 01274 Federal Farm Credit Bank 10/25/2021 1.000.000.00 951,820.00 1.000.000.00 0.700 0.690 0.700 816 10/25/2024 Subtotal and Average Total and Average Data Updated: SET_MTH: 10/19/2022 10:16 Run Date: 10/19/2022 - 10:16 3,000,000.00 235,102,437.39 3,000,000.00 2,906,490.00 3,000,000.00 0.999 1.013 594 209,973,648.41 207,241,476.11 209,971,148.41 0.569 0.577 104 Portfolio TEME NL! CP PM (PRF_PM2) 7.3.0 Portfolio Managment Treasury Report Portfolio Management Portfolio Details - Cash July 31, 2022 Page 6 Average Purchase Stated YTM YTM Days to CUSIP Investment # Issuer Balance Date Par Value Market Value Book Value Rate 360 365 Maturity Passbook/Checking Accounts 1453718479 WORKERS BANK OF AMERICA MERRILL LYNC 07/01/2022 7,333.90 7,333.90 7,333.90 0.000 0.000 1 SYSPetty Cash Petty Cash City of Temecula 07/01/2022 3,911.00 3,911.00 3,911.00 0.000 0.000 1 SYSGen Ck Acct Gen Ck Acct Union Bank of California 21,905,965.51 21,905,965.51 21,905,965.51 0.000 0.000 1 SYSParking Ck PARKING CITA Union Bank of California 07/01/2022 36,218.57 36,218.57 36,218.57 0.000 0.000 1 Average Balance 0.00 Total Cash and Investments 235,102,437.39 0 231,927,077.39 229,194,905.09 231,924,577.39 0.569 0.577 104 Portfolio TEME Data Updated: SET_MTH: 10/19/2022 10:16 NL! CP Run Date: 10/19/2022 - 10:16 PM (PRF_PM2) 7.3.0 Cash and Investments Report CITY OF TEMECULA Through July 2022 Fund 9 Fund Name Beginning Balance Receipts Disbursements Fund Total 001 GENERAL FUND $ 61,852,506.94 $ 15,544,075.28 $ 20,078,497.14 $ 57,318,085.08 002 MEASURE S FUND 36,120,017.25 4,255,400.66 8,333,257.54 32,042,160.37 006 FIRE FACILITY ACQUISITION FUND 1,500,000.00 1,752.59 - $ 1,501,752.59 100 STATE GAS TAX FUND 2,559,041.65 210,549.40 2,559,041.65 210,549.40 102 RMRA-ROAD MAINTENANCE REHABILITATION ACT 3,604,131.94 206,336.86 2,248,004.49 1,562,464.31 103 STREETS MAINTENANCE FUND 4,911,425.72 517,840.79 5,429,266.51 105 NPDES 1,937.94 3.79 1,941.73 106 UPTOWN TEMECULA NEW STREETS IN LIEU FEES 886,276.68 3,329.55 - 889,606.23 110 COVID-19 PANDEMIC COMMUNITY REINVESTMENT 7,037,759.21 - 4,409.12 7,033,350.09 120 DEVELOPMENT IMPACT FUND 7,769,809.63 410,467.72 113,178.90 8,067,098.45 125 PEG PUBLIC EDUCATION & GOVERNMENT 663,353.06 36,621.66 20,893.19 679,081.53 145 TEMECULA ENERGY EFFICIENCY ASSET TEAM 831,140.98 3,130.26 - 834,271.24 150 AB 2766 FUND 256,303.61 641.61 6,513.54 250,431.68 160 SUPPLEMENTAL LAW ENFORCEMENT SERVICES 363,917.40 412.15 363,917.40 412.15 161 TEMECULA MAJOR CRIMES REWARD FUND 26,923.23 41.24 26,923.23 41.24 165 AFFORDABLE HOUSING 1,827,961.33 3,720,604.21 23,195.68 5,525,369.86 170 MEASURE A FUND 11,096,299.17 795,680.89 2,825,000.15 9,066,979.91 190 TEMECULA COMMUNITY SERVICES DISTRICT 2,511,741.80 889,254.60 1,286,689.72 2,114,306.68 191 TCSD SERVICE LEVEL "B" STREET LIGHT REPLACEMENT 853,926.46 87.42 853,839.04 192 TCSD SERVICE LEVEL "B" STREET LIGHTS 1,123,316.39 1,841.24 875,533.26 249,624.37 194 TCSD SERVICE LEVEL "D" REFUSE/RECYCLING 175,145.15 163,112.09 10,873.50 327,383.74 195 TCSD SERVICE LEVEL "R" STREET/ROAD MAINT 27,191.45 103.39 - 27,294.84 196 TCSD SERVICE LEVEL "L" LAKE PARK MAINT. 451,092.45 2,001.07 21,566.68 431,526.84 197 TEMECULA LIBRARY FUND 462,186.13 170,599.79 82,349.89 550,436.03 198 PUBLIC ART 131,664.17 5,468.27 - 137,132.44 210 CAPITAL IMPROVEMENT PROJECT FUND 1,754,110.62 12,202,435.03 1,719,087.26 12,237,458.39 275 CFD 03-3 WOLF CREEK IMPROVEMENT FUND 211,377.28 213.42 211,590.70 277 CFD-RORIPAUGH 8,309,949.31 15,827.62 8,325,776.93 278 CFD-RORIPAUGH II 6,728,874.60 5,160.34 - 6,734,034.94 300 INSURANCE FUND 1,068,284.82 378,992.60 153,595.09 1,293,682.33 305 WORKER'S COMPENSATION 1,697,925.76 4,596.51 29,720.89 1,672,801.38 310 VEHICLES AND EQUIPMENT FUND 2,629,822.02 220,150.72 - 2,849,972.74 320 INFORMATION TECHNOLOGY 1,033,072.95 676,965.58 515,075.67 1,194,962.86 325 TECHNOLOGY REPLACEMENT FUND 2,023,840.60 182,236.21 - 2,206,076.81 330 CENTRAL SERVICES - 87,121.52 57,843.28 29,278.24 335 CENTRAL SERVICES 277,790.60 42,419.15 - 320,209.75 340 FACILITIES 409,075.25 357,481.07 121,899.56 644,656.76 350 FACILITY REPLACEMENT FUND 216,198.38 129,338.54 - 345,536.92 380 SARDA DEBT SERVICE FUND 5,981,473.49 5,031.12 1,076,176.63 4,910,327.98 381 REDEVELOPMEN PROPERTY TAX TRUST 3,878,727.65 3,539.99 3,734,995.20 147,272.44 460 CFD 88-12 DEBT SERVICE FUND 94,422.98 355.63 - 94,778.61 472 CFD 01-2 HARVESTON A&B DEBT SERVICE 1,642,042.58 2,317.50 1,678.50 1,642,681.58 473 CFD 03-1 CROWNE HILL DEBT SERVICE FUND 2,260,630.64 2,867.02 1,678.50 2,261,819.16 474 AD 034 JOHN WARNER ROAD DEBT SERVICE 4,945.16 18.63 - 4,963.79 475 CFD 03-3 WOLF CREEK DEBT SERVICE FUND 19,639,693.19 1,700.87 3,588.51 19,637,805.55 476 CFD 03-6 HARVESTON 2 DEBT SERVICE FUND 628,627.13 944.32 1,690.22 627,881.23 477 CFD 03-02 RORIPAUGH DEBT SERVICE FUND 1,411,388.85 1,265.77 1,814.55 1,410,840.07 478 CFD-RORIPAUGH II 5,925,836.64 6,452.13 1,678.92 5,930,609.85 479 CFD 19-01 CYPRESS RIDGE 1,147.50 - 1,147.50 - 501 SERVICE LEVEL"C"ZONE 1 SADDLEWOOD 22,137.06 55.15 5,532.72 16,659.49 502 SERVICE LEVEL"C"ZONE 2 WINCHESTER CREEK 120,240.86 435.75 4,511.60 116,165.01 503 SERVICE LEVEL"C"ZONE 3 RANCHO HIGHLANDS 61,461.38 192.86 4,387.59 57,266.65 504 SERVICE LEVEL"C"ZONE 4 THE VINEYARDS 6,467.23 15.03 714.46 5,767.80 505 SERVICE LEVEL"C"ZONE 5 SIGNET SERIES 25,381.28 95.03 4,359.91 21,116.40 506 SERVICE LEVEL"C"ZONE 6 WOODCREST COUNTRY 41,372.80 147.10 2,016.92 39,502.98 507 SERVICE LEVEL"C"ZONE 7 RIDGEVIEW 9,089.97 34.91 1,733.83 7,391.05 508 SERVICE LEVEL"C"ZONE 8 VILLAGE GROVE 135,780.75 311.69 20,350.36 115,742.08 509 SERVICE LEVEL"C"ZONE 9 RANCHO SOLANA 32,248.58 119.59 277.08 32,091.09 510 SERVICE LEVEL"C"ZONE 10 MARTINIQUE 15,073.06 50.60 881.06 14,242.60 511 SERVICE LEVEL"C"ZONE 11 MEADOWVIEW 3,699.43 13.39 223.10 3,489.72 512 SERVICE LEVEL"C"ZONE 12 VINTAGE HILLS 96,422.68 270.57 12,396.87 84,296.38 513 SERVICE LEVEL"C"ZONE 13 PRESLEY DEVELOP 37,635.93 90.20 3,325.90 34,400.23 514 SERVICE LEVEL"C"ZONE 14 MORRISON HOMES 16,125.95 46.59 4,211.38 11,961.16 515 SERVICE LEVEL"C"ZONE 15 BARCLAY ESTATES 12,630.86 44.38 933.91 11,741.33 516 SERVICE LEVEL"C"ZONE 16 TRADEWINDS 84,021.43 221.15 2,499.51 81,743.07 517 SERVICE LEVEL"C"ZONE 17 MONTE VISTA 2,735.57 8.53 199.91 2,544.19 518 SERVICE LEVEL"C"ZONE 18 TEMEKU HILLS 60,313.51 175.80 9,498.66 50,990.65 519 SERVICE LEVEL"C"ZONE 19 CHANTEMAR 93,587.67 233.74 6,662.94 87,158.47 520 SERVICE LEVEL"C"ZONE 20 CROWNE HILL 274,060.57 677.52 20,890.15 253,847.94 521 SERVICE LEVEL"C"ZONE 21 VAIL RANCH 2O8,447.81 504.98 27,178.00 181,774.79 522 SERVICE LEVEL"C"ZONE 22 SUTTON PLACE 11,600.40 40.15 506.55 11,134.00 523 SERVICE LEVEL"C"ZONE 23 PHEASENT RUN 27,804.64 92.80 595.43 27,302.01 524 SERVICE LEVEL"C"ZONE 24 HARVESTON 75,717.84 163.65 15,606.01 60,275.48 525 SERVICE LEVEL"C"ZONE 25 SERENA HILLS 74,462.52 190.52 4,626.64 70,026.40 526 SERVICE LEVEL"C"ZONE 26 GALLERYTRADITION 2,141.22 6.54 280.98 1,866.78 527 SERVICE LEVEL"C"ZONE 27 AVONDALE 10,831.36 32.47 1,225.63 9,638.20 528 SERVICE LEVEL"C"ZONE 28 WOLF CREEK 665,878.19 1,703.53 59,938.35 607,643.37 529 SERVICE LEVEL"C"ZONE 29 GALLERY PORTRAIT 8,612.07 26.97 394.50 8,244.54 530 SERVICE LEVEL"C"ZONE 30 FUTURE ZONES 35,925.98 135.30 - 36,061.28 701 PENSION RATE STABILIZATION FUND $ 16,510,621.44 782,773.15 - $ 17,293,394.59 Grand Total: $ 232,802,931.32 $ 42,909,536.50 $ 46,517,562.73 $ 229,194,905.09 Journal Entries completed after June's Treasurer's Report was issued are reflected in the Receipts I Disbursements columns. Portfolio Managment Treasury Report Portfolio Management Portfolio Summary August 31, 2022 City of Temecula 41000 Main Street Temecula, CA 92590 (951)694-6430 Par Market Book % of Days to YTM YTM Investments Value Value Value Portfolio Term Maturity 360 Equiv. 365 Equiv. Managed Pool Accounts 49,317,957.02 49,317,957.02 49,317,957.02 22.34 1 1 1.218 1.235 Retention Escrow Account 654,000.00 654,000.00 654,000.00 0.30 1 1 0.062 0.063 Letter of Credit 3.00 3.00 3.00 0.00 1 1 0.000 0.000 Trust Accounts 16,828,470.50 16,828,470.50 16,828,470.50 7.62 1 1 1.509 1.530 Local Agency Investment Funds 128,948,954.16 127,288,789.76 128,948,954.16 58.42 1 1 0.282 0.286 Money Market 1,008,466.67 1,008,466.67 1,008,466.67 0.46 1 1 2.091 2.120 Medium Term Notes 2,000,000.00 2,001,100.00 2,000,000.00 0.91 257 256 3.398 3.445 Federal Agency Callable Securities 17,000,000.00 15,556,050.00 16,997,500.00 7.70 1,590 1,141 0.723 0.733 Federal Agency Bullet Securities 3,000,000.00 2,885,810.00 3,000,000.00 1.36 1,278 563 0.999 1.013 Miscellaneous Discounts -At Cost 2,000,000.00 1,980,220.00 1,980,208.33 0.90 125 119 2.878 2.918 220,757,851.35 217,520,866.95 220,735,559.68 100.00% 144 100 0.688 0.697 Investments Cash Passbook/Checking (not included in yield calculations) Total Cash and Investments 14,453,302.08 14,453,302.08 14,453,302.08 1 1 0.000 0.000 235,211,153.43 231,974,169.03 235,188,861.76 144 100 0.688 0.697 Total Earnings August 31 Month Ending Fiscal Year To Date Current Year 104,678.04 198,543.61 Average Daily Balance 235,675,329.18 235,452,616.19 Effective Rate of Return 0.52% 0.50% Reporting period 08/01/2022-08/31/2022 Portfolio TEME Data Updated: SET_MTH: 10/19/2022 07:39 NLI CP Run Date: 10/19/2022 - 07:39 PM (PRF_PM1) 7.3.0 Report Ver. 7.3.6.1 Portfolio Managment Treasury Report Portfolio Management Portfolio Details - Investments August 31, 2022 Page 1 Average Purchase Stated YTM YTM Days to Maturity CUSIP Investment # Issuer Balance Date Par Value Market Value Book Value Rate 360 365 Maturity Date Managed Pool Accounts 233358001-6 01-2 BOND F First Amer Govt Oblig Fund Cl 7,054.91 7,054.91 7,054.91 2.010 1.982 2.010 1 233358006-6 01-2 REF RES First Amer Govt Oblig Fund Cl 503,156.10 503,156.10 503,156.10 2.010 1.982 2.010 1 233358000-6 01-2 REF ST First Amer Govt Oblig Fund Cl 902,630.15 902,630.15 902,630.15 2.010 1.982 2.010 1 276213009-6 03-02 COI First Amer Govt Oblig Fund Cl 07/01/2022 0.00 0.00 0.00 0.000 0.000 1 276213008-6 03-02 IMPR First Amer Govt Oblig Fund Cl 518.67 518.67 518.67 1.830 1.805 1.830 1 276213006-6 03-02 RES First Amer Govt Oblig Fund Cl 742,518.75 742,518.75 742,518.75 2.010 1.982 2.010 1 164741029-0 03-03 22 COI First Amer Govt Oblig Fund Cl 13,262.70 13,262.70 13,262.70 2.010 1.982 2.010 1 164741028-0 03-03 22 IF First Amer Govt Oblig Fund Cl 194,643.03 194,643.03 194,643.03 2.010 1.982 2.010 1 164741010-0 03-03 22 SPE First Amer Govt Oblig Fund Cl 07/01/2022 18,296,931.25 18,296,931.25 18,296,931.25 0.000 0.000 1 164741026-6 03-03 22 SRB First Amer Govt Oblig Fund Cl 414,187.00 414,187.00 414,187.00 2.010 1.982 2.010 1 164741020-0 03-03 22 STIR First Amer Govt Oblig Fund Cl 877,664.47 877,664.47 877,664.47 2.010 1.982 2.010 1 164741002-6 03-03 BOND F First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.620 0.612 0.620 1 164741022 03-03STRB First Amer Govt Oblig Fund Cl 08/01/2022 1,408.76 1,408.76 1,408.76 2.010 1.982 2.010 1 164741008-6 03-03IMP First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.620 0.612 0.620 1 164741006-6 03-03RES First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.180 0.178 0.180 1 164741000-6 03-03SPEC First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.620 0.612 0.620 1 164742002-6 03-06 BOND F First Amer Govt Oblig Fund Cl 26,084.76 26,084.76 26,084.76 2.010 1.982 2.010 1 164742000-6 03-06SPEC First Amer Govt Oblig Fund Cl 263,778.96 263,778.96 263,778.96 2.010 1.982 2.010 1 229462007-6 03-1 2012 RF First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.000 0.000 1 229462002--6 03-1 BOND FD First Amer Govt Oblig Fund Cl 2,598.23 2,598.23 2,598.23 2.010 1.982 2.010 1 229462009-6 03-1 COI First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.000 0.000 1 229462006-6 03-1 RESERV First Amer Govt Oblig Fund Cl 17,261.60 17,261.60 17,261.60 2.010 1.982 2.010 1 229462000-6 03-1 SPECF First Amer Govt Oblig Fund Cl 763,462.16 763,462.16 763,462.16 2.010 1.982 2.010 1 94669921-6 03-1ACQ11 First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.870 0.858 0.870 1 94669911-6 03-1ACQA11 First Amer Govt Oblig Fund Cl 07/01/2022 0.00 0.00 0.00 0.000 0.000 1 94669917-6 03-1 RES First Amer Govt Oblig Fund Cl 07/01/2022 0.00 0.00 0.00 0.000 0.000 1 94669916-6 03-1 RESB11 First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.000 0.000 1 94669000-6 03-1 SPTAX11 First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.000 0.000 1 276213002-6 03-2 REFU First Amer Govt Oblig Fund Cl 686.26 686.26 686.26 2.010 1.982 2.010 1 276213000-6 03-2 SPEC First Amer Govt Oblig Fund Cl 670,654.79 670,654.79 670,654.79 2.010 1.982 2.010 1 94686001-6 03-4ADMIN11 First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.060 0.059 0.060 1 94686005-6 03-4PREP11 First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.070 0.069 0.070 1 94686000-6 03-4RED11 First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.050 0.049 0.050 1 94686006-6 03-4RES11 First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.060 0.059 0.060 1 276213022-6 16-01 BOND F First Amer Govt Oblig Fund Cl 968.49 968.49 968.49 2.010 1.982 2.010 1 276213023-6 16-01 CAPINT First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.870 0.858 0.870 1 Data Updated: SET_MTH: 10/19/2022 07:39 Run Date: 10/19/2022 - 07:39 Portfolio TEME NL! CP PM (PRF_PM2) 7.3.0 Report Ver. 7.3.6.1 Portfolio Managment Treasury Report Portfolio Management Portfolio Details - Investments August 31, 2022 Page 2 Average Purchase Stated YTM YTM Days to Maturity CUSIP Investment # Issuer Balance Date Par Value Market Value Book Value Rate 360 365 Maturity Date Managed Pool Accounts 276213029-6 16-01 COI First Amer Govt Oblig Fund Cl 07/01/2022 0.00 0.00 0.00 0.000 0.000 1 276213028-6 16-01 IMP First Amer Govt Oblig Fund Cl 6,741,887.94 6,741,887.94 6,741,887.94 2.010 1.982 2.010 1 276213026-6 16-01RESERV First Amer Govt Oblig Fund Cl 3,161,644.33 3,161,644.33 3,161,644.33 2.010 1.982 2.010 1 276213020-6 16-01 SPECF First Amer Govt Oblig Fund Cl 2,090,308.86 2,090,308.86 2,090,308.86 2.010 1.982 2.010 1 218848001-6 2017A&B INT First Amer Govt Oblig Fund Cl 143.44 143.44 143.44 2.010 1.982 2.010 1 218848008-6 2017ABPRIORP First Amer Govt Oblig Fund Cl 18,007.00 18,007.00 18,007.00 2.010 1.982 2.010 1 218848013-2 2017B COI First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.000 0.000 1 218848000-6 2017B IDS First Amer Govt Oblig Fund Cl 1,034.76 1,034.76 1,034.76 2.010 1.982 2.010 1 218848002-6 2017B PRIN First Amer Govt Oblig Fund Cl 993.46 993.46 993.46 2.010 1.982 2.010 1 218848009-6 2017B_PROJ First Amer Govt Oblig Fund Cl 4,295,916.67 4,295,916.67 4,295,916.67 2.010 1.982 2.010 1 233358009-6 233358009-6 First Amer Govt Oblig Fund Cl 07/01/2022 0.00 0.00 0.00 0.000 0.000 1 94434160-6 RDA-021NT First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.000 0.000 1 94434161-6 RDA-02PRIN First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.000 0.000 1 107886000-6 RDA-06AINT First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.000 0.000 1 107886001-6 RDA06APRIN First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.000 0.000 1 107886010-6 RDA06BINT First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.000 0.000 1 107886011-6 RDA06BPRIN First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.680 0.671 0.680 1 107886016-6 RDA06BRES First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.940 0.927 0.940 1 107886020-6 RDA071NT First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.000 0.000 1 107886021-6 RDA07PRIN First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.930 0.917 0.930 1 107886028-6 RDA07PROJ First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.940 0.927 0.940 1 107886026-6 RDA07RES First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.940 0.927 0.940 1 136343008-6 RDA10APROJ First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.000 0.000 1 136343018-6 RDA10BPROJ First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.000 0.000 1 136343000-6 RDA10INT First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.000 0.000 1 136343001-6 RDA10PRIN First Amer Govt Oblig Fund Cl 07/01/2022 0.00 0.00 0.00 0.000 0.000 1 136343006-6 RDA10RSRV First Amer Govt Oblig Fund Cl 07/01/2022 0.00 0.00 0.00 0.000 0.000 1 146161000-6 RDA11AINT First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.000 0.000 1 146161001-6 RDA11APRIN First Amer Govt Oblig Fund Cl 0.00 0.00 0.00 0.000 0.000 1 94669902-3 03-1 BOND3 First American Treasury 07/01/2022 0.00 0.00 0.00 0.000 0.000 1 94434160-1 RDA 02 INT1 First American Treasury 0.00 0.00 0.00 0.010 0.010 0.010 1 94434161-2 RDA 02 PRIN2 First American Treasury 0.00 0.00 0.00 0.010 0.010 0.010 1 136343018-2 RDA 10B CIP2 First American Treasury 0.00 0.00 0.00 0.010 0.010 0.010 1 146161008-3 RDA11APROJ Federated Institutional Tax Fr 0.00 0.00 0.00 0.800 0.789 0.800 1 146161006-3 RDA11ARSRV Federated Institutional Tax Fr 07/01/2022 0.00 0.00 0.00 0.000 0.000 1 94669921-5 03-01 ACQ11 Federated Tax Free Obligations 0.00 0.00 0.00 0.250 0.247 0.250 1 Data Updated: SET_MTH: 10/19/2022 07:39 Run Date: 10/19/2022 - 07:39 Portfolio TEME NL! CP PM (PRF_PM2) 7.3.0 Portfolio Managment Treasury Report Portfolio Management Portfolio Details - Investments August 31, 2022 Page 3 CUSIP Investment # Average Issuer Balance Purchase Date Par Value Market Value Book Value Stated Rate YTM 360 YTM 365 Days to Maturity Maturity Date Managed Pool Accounts 94669911-5 03-01 ACQA11 Federated Tax Free Obligations 0.00 0.00 0.00 0.250 0.247 0.250 1 94669917-5 03-01 RES Federated Tax Free Obligations 07/01/2022 0.00 0.00 0.00 0.000 0.000 1 94669906-5 03-01 RESA11 Federated Tax Free Obligations 0.00 0.00 0.00 0.001 0.001 0.001 1 94669916-5 03-01 RESB11 Federated Tax Free Obligations 0.00 0.00 0.00 0.250 0.247 0.250 1 94669000-5 03-01SPTAX11 Federated Tax Free Obligations 0.00 0.00 0.00 0.250 0.247 0.250 1 164742006-5 03-06 RES Federated Tax Free Obligations 07/01/2022 0.00 0.00 0.00 0.000 0.000 1 164742000-5 03-06 SPEC Federated Tax Free Obligations 0.00 0.00 0.00 0.250 0.247 0.250 1 94669902-5 03-1bond fd Federated Tax Free Obligations 07/01/2022 0.00 0.00 0.00 0.000 0.000 1 94686001-5 03-4 ADMIN11 Federated Tax Free Obligations 0.00 0.00 0.00 0.250 0.247 0.250 1 94686005-5 03-4 PREP11 Federated Tax Free Obligations 07/01/2022 0.00 0.00 0.00 0.000 0.000 1 94686006-5 03-4 RES11 Federated Tax Free Obligations 0.00 0.00 0.00 0.250 0.247 0.250 1 94669917-1 03-01-1 RES CA Local Agency Investment Fun 0.00 0.00 0.00 0.339 0.334 0.339 1 276213008-1 03-02 IMP CA Local Agency Investment Fun 8,182,048.80 8,182,048.80 8,182,048.80 2.010 1.982 2.010 1 164742006-1 03-06 RES-1 CA Local Agency Investment Fun 307,572.74 307,572.74 307,572.74 2.010 1.982 2.010 1 229462007-1 03-1 2012 RE CA Local Agency Investment Fun 818,664.58 818,664.58 818,664.58 0.221 0.218 0.221 1 94669911-1 03-1 ACQ A2 CA Local Agency Investment Fun 0.00 0.00 0.00 0.339 0.334 0.339 1 94669921-1 03-1 ACQ B2 CA Local Agency Investment Fun 0.00 0.00 0.00 0.339 0.334 0.339 1 744727011-1 03-3 ACQ 2 CA Local Agency Investment Fun 0.00 0.00 0.00 0.339 0.334 0.339 1 164741006-1 0303-1 RES CA Local Agency Investment Fun 0.00 0.00 0.00 0.620 0.612 0.620 1 107886028-1 RDA 07 PRO-1 CA Local Agency Investment Fun 0.00 0.00 0.00 0.339 0.334 0.339 1 107886026-1 RDA 07 RES-1 CA Local Agency Investment Fun 0.00 0.00 0.00 0.339 0.334 0.339 1 136343018-1 RDA 10B CIP1 CA Local Agency Investment Fun 0.00 0.00 0.00 0.339 0.334 0.339 1 229462020-0 03-01 CASH USBANK 263.40 263.40 263.40 0.000 0.000 1 164742006-0 03-06 Cash USBANK 07/01/2022 0.00 0.00 0.00 0.000 0.000 1 233358050-1 01-2 SPECESC U.S. Treasury 0.00 0.00 0.00 0.360 0.355 0.360 1 Subtotal and Average 49,555,416.51 49,317,957.02 49,317,957.02 49,317,957.02 1.218 1.235 1 Retention Escrow Account NOBEL COMPANY 3354 Banner Bank 0.00 0.00 0.00 0.150 0.148 0.150 1 218848050-0 2002 ESCROW USBANK 07/01/2022 0.00 0.00 0.00 0.000 0.000 1 218848060-0 2006AESCRO USBANK 07/01/2022 0.00 0.00 0.00 0.000 0.000 1 218848070-0 2006BESCRO USBANK 07/01/2022 0.00 0.00 0.00 0.000 0.000 1 218848080-0 2007ESCROW USBANK 07/01/2022 0.00 0.00 0.00 0.000 0.000 1 229462020-2 03-01 ESCROW U.S. Treasury 654,000.00 654,000.00 654,000.00 0.063 0.062 0.063 1 Subtotal and Average 653,474.69 654,000.00 654,000.00 654,000.00 0.062 0.063 1 Portfolio TEME Data Updated: SET_MTH: 10/19/2022 07:39 NL! CP Run Date: 10/19/2022 - 07:39 PM (PRF_PM2) 7.3.0 Portfolio Managment Treasury Report Portfolio Management Page Portfolio Details - Investments August 31, 2022 Average Purchase Stated YTM YTM Days to Maturity CUSIP Investment # Issuer Balance Date Par Value Market Value Book Value Rate 360 365 Maturity Date Letter of Credit 164741026-1 03-03 22 Res ASSURED GUARANTY MUNICIPAL COR 07/01/2022 1.00 1.00 1.00 0.000 0.000 1 218848006-1 2017B RESER ASSURED GUARANTY MUNICIPAL COR 07/01/2022 1.00 1.00 1.00 0.000 0.000 1 233358006-1 01-2 REFRESI ASSURANCE CO BOND INSURANCE 07/01/2022 1.00 1.00 1.00 0.000 0.000 1 Subtotal and Average 3.00 3.00 3.00 3.00 0.000 0.000 1 Trust Accounts 6746058700 PARS Pension US Bank Trust 16,828,470.50 16,828,470.50 16,828,470.50 1.530 1.509 1.530 1 Subtotal and Average 17,278,397.04 16,828,470.50 16,828,470.50 16,828,470.50 1.509 1.530 1 Local Agency Investment Funds SYSCITY CITY CA Local Agency Investment Fun 63,872,004.11 63,049,678.50 63,872,004.11 0.206 0.203 0.206 1 SYSRDA RDA CA Local Agency Investment Fun 1,898.30 1,873.86 1,898.30 0.365 0.360 0.365 1 SYSTCSD TCSD CA Local Agency Investment Fun 65,075,051.75 64,237,237.40 65,075,051.75 0.365 0.360 0.365 1 Subtotal and Average 136,462,093.02 128,948,954.16 127,288,789.76 128,948,954.16 0.282 0.286 1 Money Market 31846V542 Money Mkt USBANK 08/31/2022 1,008,466.67 1,008,466.67 1,008,466.67 2.120 2.091 2.120 1 Subtotal and Average 32,531.18 1,008,466.67 1,008,466.67 1,008,466.67 2.091 2.120 1 Medium Term Notes 14913Q2L2 01276 Caterpillar Financial Service 08/31/2022 2,000,000.00 2,001,100.00 2,000,000.00 3.450 3.398 3.445 256 05/15/2023 Subtotal and Average 64,516.13 2,000,000.00 2,001,100.00 2,000,000.00 3.398 3.445 256 Federal Agency Callable Securities 3133EMQGO 01259 Federal Farm Credit Bank 3133EMK92 01265 Federal Farm Credit Bank 3133EMN57 01266 Federal Farm Credit Bank 3133EMP22 01267 Federal Farm Credit Bank 3133ENAP5 01273 Federal Farm Credit Bank 313OAKQ41 01258 Federal Home Loan Bank 3130ALEU4 01260 Federal Home Loan Bank 3130ALWV2 01261 Federal Home Loan Bank 3130AM2V3 01262 Federal Home Loan Bank 3130AMNMO 01263 Federal Home Loan Bank 3130AMM90 01264 Federal Home Loan Bank Data Updated: SET_MTH: 10/19/2022 07:39 Run Date: 10/19/2022 - 07:39 02/10/2021 1,000,000.00 920,720.00 06/23/2021 1,000,000.00 915,960.00 06/28/2021 1,000,000.00 942,270.00 06/30/2021 1,000,000.00 900,850.00 10/14/2021 1,000,000.00 913,590.00 01/28/2021 1,000,000.00 905,480.00 02/25/2021 1,000,000.00 927,160.00 04/21/2021 1,000,000.00 913,630.00 04/29/2021 1,000,000.00 933,980.00 05/27/2021 1,000,000.00 915,790.00 06/10/2021 1,000,000.00 913,460.00 1,000,000.00 0.320 0.316 0.320 893 02/10/2025 1,000,000.00 0.580 0.572 0.580 1,026 06/23/2025 1,000,000.00 0.440 0.434 0.440 666 06/28/2024 1,000,000.00 0.910 0.898 0.910 1,398 06/30/2026 1,000,000.00 0.800 0.789 0.800 1,139 10/14/2025 1,000,000.00 0.520 0.513 0.520 1,245 01/28/2026 1,000,000.00 0.350 0.345 0.350 816 11/25/2024 1,000,000.00 0.550 1.011 1.025 1,328 04/21/2026 1,000,000.00 0.700 0.690 0.700 971 04/29/2025 1,000,000.00 0.500 0.493 0.500 1,364 05/27/2026 1,000,000.00 0.500 1.973 2.000 1,378 06/10/2026 Portfolio TEME NL! CP PM (PRF_PM2) 7.3.0 Portfolio Managment Treasury Report Portfolio Management Portfolio Details - Investments August 31, 2022 Page 5 Average Purchase Stated YTM YTM Days to Maturity CUSIP Investment # Issuer Balance Date Par Value Market Value Book Value Rate 360 365 Maturity Date Federal Agency Callable Securities 3130AN4N7 01268 Federal Home Loan Bank 07/14/2021 1,000,000.00 913,990.00 1,000,000.00 0.720 0.710 0.720 1,047 07/14/2025 3130ANAZ3 01269 Federal Home Loan Bank 07/28/2021 1,000,000.00 929,030.00 1,000,000.00 0.600 0.592 0.600 970 04/28/2025 3130AP3M5 01270 Federal Home Loan Bank 09/28/2021 1,000,000.00 921,180.00 1,000,000.00 0.550 0.542 0.550 939 03/28/2025 3134GXJL9 01257 Federal Home Loan Mtg Corp 12/30/2020 1,000,000.00 899,370.00 1,000,000.00 0.500 0.493 0.500 1,216 12/30/2025 3130APBV6 01271 Union Bank 10/07/2021 1,000,000.00 896,650.00 999,000.00 1.000 1.007 1.021 1,497 10/07/2026 3130APAM7 01272 Union Bank 10/14/2021 1,000,000.00 892,940.00 998,500.00 0.900 0.918 0.931 1,504 10/14/2026 Subtotal and Average 16,997,500.00 17,000,000.00 15,556,050.00 16,997,500.00 0.723 0.733 1,141 Federal Agency Bullet Securities 3133ELMA9 01254 Federal Farm Credit Bank 02/07/2020 1,000,000.00 980,370.00 1,000,000.00 1.420 1.401 1.420 340 08/07/2023 3133ELTU8 01256 Federal Farm Credit Bank 03/18/2020 1,000,000.00 963,260.00 1,000,000.00 0.920 0.907 0.920 564 03/18/2024 3133ENCA6 01274 Federal Farm Credit Bank 10/25/2021 1,000,000.00 942,180.00 1,000,000.00 0.700 0.690 0.700 785 10/25/2024 Subtotal and Average 3,000,000.00 3,000,000.00 2,885,810.00 3,000,000.00 0.999 1.013 563 Miscellaneous Discounts -At Cost 912796R27 01275 U.S. Treasury 08/26/2022 2,000,000.00 1,980,220.00 1,980,208.33 2.850 2.878 2.918 119 12/29/2022 Subtotal and Average 383,266.13 2,000,000.00 1,980,220.00 1,980,208.33 2.878 2.918 119 Total and Average Data Updated: SET_MTH: 10/19/2022 07:39 Run Date: 10/19/2022 - 07:39 235,675,329.18 220,757,851.35 217,520,866.95 220,735,559.68 0.688 0.697 100 Portfolio TEME NL! CP PM (PRF_PM2) 7.3.0 Portfolio Managment Treasury Report Portfolio Management Portfolio Details - Cash August 31, 2022 Page 6 Average Purchase Stated YTM YTM Days to CUSIP Investment # Issuer Balance Date Par Value Market Value Book Value Rate 360 365 Maturity Passbook/Checking Accounts 1453718479 WORKERS BANK OF AMERICA MERRILL LYNC 07/01/2022 18,098.76 18,098.76 18,098.76 0.000 0.000 1 SYSPetty Cash Petty Cash City of Temecula 07/01/2022 3,711.00 3,711.00 3,711.00 0.000 0.000 1 SYSGen Ck Acct Gen Ck Acct Union Bank of California 14,395,965.32 14,395,965.32 14,395,965.32 0.000 0.000 1 SYSParking Ck PARKING CITA Union Bank of California 07/01/2022 35,527.00 35,527.00 35,527.00 0.000 0.000 1 Average Balance 0.00 Total Cash and Investments 235,675,329.18 0 235,211,153.43 231,974,169.03 235,188,861.76 0.688 0.697 100 Portfolio TEME Data Updated: SET_MTH: 10/19/2022 07:39 NL! CP Run Date: 10/19/2022 - 07:39 PM (PRF_PM2) 7.3.0 Cash and Investments Report CITY OF TEMECULA Through August 2022 Fund 9 Fund Name Beginning Balance Receipts Disbursements Fund Total 001 GENERAL FUND $ 57,318,085.08 $ 21,054,955.25 $ 24,817,071.97 $ 53,555,968.36 002 MEASURE S FUND 32,042,160.37 2,664,190.74 22,988.68 34,683,362.43 006 FIRE FACILITY ACQUISITION FUND 1,501,752.59 - 994.73 $ 1,500,757.86 100 STATE GAS TAX FUND 210,549.40 250,833.38 - 461,382.78 102 RMRA-ROAD MAINTENANCE REHABILITATION ACT 1,562,464.31 184,541.53 1,157.18 1,745,848.66 103 STREETS MAINTENANCE FUND 5,429,266.51 - 3,596.22 5,425,670.29 105 NPDES 1,941.73 1.29 1,940.44 106 UPTOWN TEMECULA NEW STREETS IN LIEU FEES 889,606.23 589.25 889,016.98 108 ARPA - 7,039,753.50 - 7,039,753.50 110 COVID-19 PANDEMIC COMMUNITY REINVESTMENT 7,033,350.09 - 2,911.85 7,030,438.24 120 DEVELOPMENT IMPACT FUND 8,067,098.45 620,802.29 5,754.66 8,682,146.08 125 PEG PUBLIC EDUCATION & GOVERNMENT 679,081.53 34,509.42 6,248.94 707,342.01 145 TEMECULA ENERGY EFFICIENCY ASSET TEAM 834,271.24 - 552.60 833,718.64 150 AB 2766 FUND 250,431.68 165.88 250,265.80 160 SUPPLEMENTAL LAW ENFORCEMENT SERVICES 412.15 - 412.15 161 TEMECULA MAJOR CRIMES REWARD FUND 41.24 0.03 41.21 165 AFFORDABLE HOUSING 5,525,369.86 26,493.07 5,498,876.79 170 MEASURE A FUND 9,066,979.91 - 7,217.43 9,059,762.48 190 TEMECULA COMMUNITY SERVICES DISTRICT 2,114,306.68 422,460.24 1,398,263.53 1,138,503.39 191 TCSD SERVICE LEVEL "B" STREET LIGHT REPLACEMENT 853,839.04 - 565.56 853,273.48 192 TCSD SERVICE LEVEL "B" STREET LIGHTS 249,624.37 7,874.99 23,569.05 233,930.31 194 TCSD SERVICE LEVEL "D" REFUSE/RECYCLING 327,383.74 129,138.31 6,525.19 449,996.86 195 TCSD SERVICE LEVEL "R" STREET/ROAD MAINT 27,294.84 - 18.08 27,276.76 196 TCSD SERVICE LEVEL "L" LAKE PARK MAINT. 431,526.84 4,501.36 33,395.45 402,632.75 197 TEMECULA LIBRARY FUND 550,436.03 5,822.75 58,879.64 497,379.14 198 PUBLIC ART 137,132.44 7,089.45 95.53 144,126.36 210 CAPITAL IMPROVEMENT PROJECT FUND 12,237,458.39 47,612.63 854,643.29 11,430,427.73 275 CFD 03-3 WOLF CREEK IMPROVEMENT FUND 211,590.70 226.70 11.38 211,806.02 277 CFD-RORIPAUGH 8,325,776.93 0.60 94.86 8,325,682.67 278 CFD-RORIPAUGH II 6,734,034.94 7,853.00 - 6,741,887.94 300 INSURANCE FUND 1,293,682.33 92,096.98 1,385,779.31 305 WORKER'S COMPENSATION 1,672,801.38 22,230.95 232,572.10 1,462,460.23 310 VEHICLES AND EQUIPMENT FUND 2,849,972.74 - 1,887.76 2,848,084.98 320 INFORMATION TECHNOLOGY 1,194,962.86 393.56 380,480.02 814,876.40 325 TECHNOLOGY REPLACEMENT FUND 2,206,076.81 - 1,461.25 2,204,615.56 330 CENTRAL SERVICES 29,278.24 5,884.35 35,162.59 - 335 CENTRAL SERVICES 320,209.75 - 6,092.55 314,117.20 340 FACILITIES 644,656.76 1,547.63 150,467.45 495,736.94 350 FACILITY REPLACEMENT FUND 345,536.92 - 4,364.15 341,172.77 380 SARDA DEBT SERVICE FUND 4,910,327.98 901,640.77 895,435.71 4,916,533.04 381 REDEVELOPMEN PROPERTY TAX TRUST 147,272.44 - - 147,272.44 460 CFD 88-12 DEBT SERVICE FUND 94,778.61 - 62.78 94,715.83 472 CFD 01-2 HARVESTON A&B DEBT SERVICE 1,642,681.58 19,924.63 9,304.17 1,653,302.04 473 CFD 03-1 CROWNE HILL DEBT SERVICE FUND 2,261,819.16 78,603.42 65,897.26 2,274,525.32 474 AD 034 JOHN WARNER ROAD DEBT SERVICE 4,963.79 2,182.38 4.73 7,141.44 475 CFD 03-3 WOLF CREEK DEBT SERVICE FUND 19,637,805.55 67,887.61 32,693.50 19,672,999.66 476 CFD 03-6 HARVESTON 2 DEBT SERVICE FUND 627,881.23 5,450.23 2,759.32 630,572.14 477 CFD 03-02 RORIPAUGH DEBT SERVICE FUND 1,410,840.07 40,768.69 19,584.34 1,432,024.42 478 CFD-RORIPAUGH II 5,930,609.85 159,096.13 33,615.35 6,056,090.63 501 SERVICE LEVEL"C"ZONE 1 SADDLEWOOD 16,659.49 946.87 7,576.65 10,029.71 502 SERVICE LEVEL"C"ZONE 2 WINCHESTER CREEK 116,165.01 651.16 2,222.75 114,593.42 503 SERVICE LEVEL"C"ZONE 3 RANCHO HIGHLANDS 57,266.65 838.63 3,437.20 54,668.08 504 SERVICE LEVEL"C"ZONE 4 THE VINEYARDS 5,767.80 46.00 397.74 5,416.06 505 SERVICE LEVEL"C"ZONE 5 SIGNET SERIES 21,116.40 810.19 2,772.42 19,154.17 506 SERVICE LEVEL"C"ZONE 6 WOODCREST COUNTRY 39,502.98 303.56 1,281.04 38,525.50 507 SERVICE LEVEL"C"ZONE 7 RIDGEVIEW 7,391.05 89.00 1,040.21 6,439.84 508 SERVICE LEVEL"C"ZONE 8 VILLAGE GROVE 115,742.08 2,052.78 9,578.40 108,216.46 509 SERVICE LEVEL"C"ZONE 9 RANCHO SOLANA 32,091.09 69.00 216.60 31,943.49 510 SERVICE LEVEL"C"ZONE 10 MARTINIQUE 14,242.60 58.00 606.00 13,694.60 511 SERVICE LEVEL"C"ZONE 11 MEADOWVIEW 3,489.72 - 190.42 3,299.30 512 SERVICE LEVEL"C"ZONE 12 VINTAGE HILLS 84,296.38 1,940.85 6,127.48 80,109.75 513 SERVICE LEVEL"C"ZONE 13 PRESLEY DEVELOP 34,400.23 307.15 2,908.37 31,799.01 514 SERVICE LEVEL"C"ZONE 14 MORRISON HOMES 11,961.16 226.95 1,097.42 11,090.69 515 SERVICE LEVEL"C"ZONE 15 BARCLAY ESTATES 11,741.33 - 584.81 11,156.52 516 SERVICE LEVEL"C"ZONE 16 TRADEWINDS 81,743.07 366.62 1,393.95 80,715.74 517 SERVICE LEVEL"C"ZONE 17 MONTE VISTA 2,544.19 23.00 160.35 2,406.84 518 SERVICE LEVEL"C"ZONE 18 TEMEKU HILLS 50,990.65 1,279.82 5,912.00 46,358.47 519 SERVICE LEVEL"C"ZONE 19 CHANTEMAR 87,158.47 923.06 5,158.35 82,923.18 520 SERVICE LEVEL"C"ZONE 20 CROWNE HILL 253,847.94 1,986.97 12,624.18 243,210.73 521 SERVICE LEVEL"C"ZONE 21 VAIL RANCH 181,774.79 3,494.08 17,003.11 168,265.76 522 SERVICE LEVEL"C"ZONE 22 SUTTON PLACE 11,134.00 116.00 371.09 10,878.91 523 SERVICE LEVEL"C"ZONE 23 PHEASENT RUN 27,302.01 100.00 467.78 26,934.23 524 SERVICE LEVEL"C"ZONE 24 HARVESTON 60,275.48 1,371.68 21,595.77 40,051.39 525 SERVICE LEVEL"C"ZONE 25 SERENA HILLS 70,026.40 910.98 2,808.01 68,129.37 526 SERVICE LEVEL"C"ZONE 26 GALLERYTRADITION 1,866.78 135.00 166.03 1,835.75 527 SERVICE LEVEL"C"ZONE 27 AVONDALE 9,638.20 - 890.42 8,747.78 528 SERVICE LEVEL"C"ZONE 28 WOLF CREEK 607,643.37 3,833.99 20,303.87 591,173.49 529 SERVICE LEVEL"C"ZONE 29 GALLERY PORTRAIT 8,244.54 - 220.79 8,023.75 530 SERVICE LEVEL"C"ZONE 30 FUTURE ZONES 36,061.28 23.89 36,037.39 701 PENSION RATE STABILIZATION FUND $ 17,293,394.59 464,924.09 $ 16,828,470.50 Grand Total: $ 229,194,905.09 $ 33,902,754.81 $ 31,123,490.87 $ 231,974,169.03 Journal Entries completed after July's Treasurer's Report was issued are reflected in the Receipts I Disbursements columns. Item No. 5 CITY OF TEMECULA AGENDA REPORT TO: City Manager/City Council FROM: Randi Johl, Director of Legislative Affairs/City Clerk DATE: November 15, 2022 SUBJECT: Adopt the 2022 Conflict of Interest Code PREPARED BY: Randi Johl, Director of Legislative Affairs/City Clerk RECOMMENDATION: That the City Council adopt a resolution entitled: RESOLUTION NO. 2022- A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF TEMECULA ADOPTING THE CITY' S 2022 CONFLICT OF INTEREST CODE BACKGROUND: Government Code Section 87306.5 requires the biennial adoption of a Conflict of Interest Code. As the Code reviewing body under the Political Reform Act, the City Council accepted the Notice of Draft Amendments and reviewed the proposed changes to the City's Conflict of Interest Code at its September 13, 2022 City Council meeting. The attached resolution makes the proposed changes to the Code based on conditions occurring since the last update in 2020. The Notice of Intent was published for the requisite public comment period. No comments were received. The proposed amendments reflect title changes of positions that already exist in the Code and/or the addition of positions based on an examination of their involvement in the decision -making process. The City Attorney, City Clerk and Executive Management staff have reviewed the proposed changes and concur with the recommendation. FISCAL IMPACT: None ATTACHMENTS: 1. Biennial Notice 2. Resolution 3. Exhibit A 4. Notice of Intent 2022 Local Agency Biennial Notice Name of Agency: City Of Temecula Mailing Address: Contact Person 41000 Main Street, Temecula, CA 92590 Randi Johl, City Clerk Email: randi.johI@temeculaca.gov Phone No Alternate Email: 951-694-6444 N/A Accurate disclosure is essential to monitor whether officials have conflicts of interest and to help ensure public trust in government. The biennial review examines current programs to ensure that the agency's code includes disclosure by those agency officials who make or participate in making governmental decisions. This agency has reviewed its conflict of interest code and has determined that (check one BOX): ❑ An amendment is required. The following amendments are necessary: (Check all that apply.) 0 Include new positions ❑ Revise disclosure categories ❑ Revise the titles of existing positions 0 Delete titles of positions that have been abolished and/or positions that no longer make or participate in making governmental decisions ❑ Other (describe) ❑ The code is currently under review by the code reviewing body. ❑ No amendment is required. (If your code is over five years old, amendments may be necessary.) Verification (to be completed if no amendment is required) This agency's code accurately designates all positions that make or participate in the making of governmental decisions. The disclosure assigned to those positions accurately requires that all investments, business positions, interests in real property, and sources of income that may foreseeably be affected materially by the decisions made by those holding designated positions are reported. The code includes all other provisions required by Government Code Section 87302. Signature of Chief Executive Officer Date All agencies must complete and return this notice regardless of how recently your code was approved or amended. Please return this notice no later than October 3, 2022, or by the date specified by your agency, if earlier, to: (PLACE RETURN ADDRESS OF CODE REVIEWING BODY HERE) PLEASE DO NOT RETURN THIS FORM TO THE FPPC. www.fppc.ca.gov FPPC Advice: adviceC@fppc.ca.gov (866.275.3772) Page 1 of 1 RESOLUTION NO. 2022- A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF TEMECULA ADOPTING THE CITY'S 2022 CONFLICT OF INTEREST CODE THE CITY COUNCIL OF THE CITY OF TEMECULA DOES HEREBY RESOLVE AS FOLLOWS: Section 1. The City Council of the City of Temecula has previously adopted a Conflict of Interest Code to apply to certain officers and employees of the City with an Exhibit A designating certain positions within the City that require the filing of economic disclosure forms. Section 2. The City Council of the City of Temecula does hereby amend the Conflict of Interest Code for the City of Temecula by deleting Exhibit A and substituting in its place a new Exhibit A, which is attached hereto and incorporated herein by this reference. Section 3. The City Clerk shall certify the adoption of this resolution. PASSED, APPROVED, AND ADOPTED by the City Council of the City of Temecula this 15th day of November, 2022. ATTEST: Randi Johl, City Clerk [SEAL] Matt Rahn, Mayor 1 STATE OF CALIFORNIA ) COUNTY OF RIVERSIDE ) ss CITY OF TEMECULA ) I, Randi Johl, City Clerk of the City of Temecula, do hereby certify that the foregoing Resolution No. 2022- was duly and regularly adopted by the City Council of the City of Temecula at a meeting thereof held on the 15th day of November, 2022, by the following vote: AYES: COUNCIL MEMBERS: NOES: COUNCIL MEMBERS: ABSTAIN: COUNCIL MEMBERS: ABSENT: COUNCIL MEMBERS: Randi Johl, City Clerk SECTION 2. EXHIBIT A DESIGNATED CITY OF TEMECULA EMPLOYEES AND DISCLOSURE CATEGORIES The following positions entail the making or participating in the making of decisions which could have a material effect on financial interests. Designated Position Disclosure Categories Assistant City Manager 1 Assistant Director of Community Development 1 Assistant Director of Community Services 1 Assistant Director of Finance 1 Assistant Director of Information Technology and Support Services 1 Assistant to the City Manager 1 Building Official 1 Chief of Police 1 Community Services Superintendent 1 Deputy City Manager 1 Designated Consultant* 1 Director of Community Development 1 Director of Community Services 1 Director of Finance 1 Director of Human Resources and Risk Management 1 Director of Information Technology and Support Services 1 Director of Legislative Affairs / City Clerk 1 Director of Public Works/City Engineer 1 Economic Development Manager 1 Engineering Manager 1 Exempt Officials 0 Fire Chief Finance Manager Fiscal Services Manager Information Technology Manager Maintenance Manager Planning Manager Principal Civil Engineer Principal Management Analyst Senior Civil Engineer Senior Management Analyst Senior Planner Members of all City Commissions, Boards, and Committees (Other than Government 87200 Filers) DESIGNATED CONSULTANTS: Consultants who fit into one or more of the following categories shall be included in the list of designated employees as "Designated Consultants": 1. Consultants who make (not just recommend) governmental decisions, such as whether to approve a rate, rule, or regulation, whether to issue, deny, suspend, or revoke any permit, license, application, certificate or similar authorization, adopt or grant City approval to a plan, design, report, study, or adopt or grant City approval of policies, standards, or guidelines for the City or any subdivision thereof. 2. Consultants who serve in a staff capacity with the City, and in that capacity participate in making a governmental decision by providing information, an opinion, or a recommendation for the purpose of affecting the decision without significant intervening substantive review. 3. Consultants who perform the same or substantially all the same duties for the City that would otherwise be performed by an individual holding a designated position in the City's Conflict of Interest Code. When the consultant is a corporation, partnership, or limited liability company, only individuals who fit into one of the three categories of "Designated Consultants" described above must file disclosure statements. Designated Consultant shall report all reportable interests in real property in the jurisdiction; reportable income and business positions; reportable investments; and reportable gifts within the disclosure category applicable to Designated Consultants unless the City Manager determines in writing that a particular consultant is hired to perform a range of duties that is limited in scope and thus is not required to fully comply with the disclosure requirements described in the section. If the City Manager determines in writing that a particular consultant is not required to fully comply with the requisite disclosure requirements, then such written determination shall include a description of the consultant's duties and based upon that description, a statement of the extent of disclosure requirements. The City Manager's determination is a public record and shall be retained for public inspection in the same manner and location as this Conflict of Interest Code. ** The Mayor, City Council, Members of the Planning Commission, City Manager, City Attorney, and City Treasurer are all required to file disclosure statements pursuant to (Government Code 87200) and are thus not included herein. NOTICE OF INTENT TO AMEND THE CONFLICT OF INTEREST CODE NOTICE IS HEREBY GIVEN that the City of Temecula intends to amend its existing conflict of interest code. Revisions to the existing conflict of interest code and list of designated employees who are required to file Statement of Economic Interests may include position title changes, reclassifications, vacancies, and/or the addition and deletion of positions based on an examination of their involvement in the decision making process. A full copy of the proposed amended conflict of interest code is available in the Office of the City Clerk for review and inspection. NOTICE IS FURTHER GIVEN that the City of Temecula has established a written comment period for interested persons to submit comments pertaining to the proposed amended conflict of interest code. Comments must be submitted in writing to the Office of the City Clerk no later than November 8, 2022, at 5:00 p.m. to be considered by the City Council when it takes action on the proposed amended conflict of interest code. The City Council is scheduled to take action on the proposed conflict of interest code on November 15, 2022, at 6:00 p.m. Inquiries concerning the proposed amended conflict of interest code may be directed to the Office of the City Clerk at (951) 694-6444 or by email to rand i.iohl(a�temeculaca.gov. Item No. 6 CITY OF TEMECULA AGENDA REPORT TO: City Manager/City Council FROM: Isaac Garibay, Director of Human Resources and Risk Management DATE: November 15, 2022 SUBJECT: Approve Amendment to the City of Temecula Section 125 Cafeteria Plan PREPARED BY: Nicole Collins, Senior Human Resources Analyst RECOMMENDATION: That the City Council adopt a resolution entitled: RESOLUTION NO. 2022- A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF TEMECULA AMENDING THE CITY OF TEMECULA SECTION 125 CAFETERIA PLAN BACKGROUND: The City Council originally adopted the City of Temecula Flexible Benefits Plan document on September 18, 1990, to provide a benefit plan compliant with Internal Revenue Code Section 125. The plan includes Healthcare Flexible Spending Accounts, a Dependent Care Assistance Program, and group health, dental and vision insurance for eligible employees. The Amendment being recommended by staff is only an administrative update to be in compliance with IRS regulations, and does not enhance or reduce any benefits provided to City employees by the City. In response to the COVID-19 pandemic, the Consolidated Appropriation Act of 2021 was signed into law providing temporary relief for Healthcare and Dependent Care Flexible Spending Accounts (FSA's) for the 2020 and 2021 plan years. The Plan Document has been amended for the 2020 plan year as follows: A. To allow prospective election changes for Healthcare and Dependent Care FSA's; B. To incorporate an unlimited carryover of unused Healthcare FSA funds; C. To extend the grace period for Dependent Care Assistance Program Extended Grace Period/Claims Extension Period; and D. To allow the Spend Down of Healthcare FSA once participation has ceased. Approval of the Adoption Agreement will provide the framework for staff to take such actions that are deemed necessary and proper in order to implement the Plan, and to setup adequate accounting and administrative procedures to provide employee benefits under the Plan. FISCAL IMPACT: No fiscal impact. ATTACHMENTS: 1. Resolution 2. Section 125 Cafeteria Plan Document Amendment RESOLUTION NO.2022- A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF TEMECULA AMENDING THE CITY OF TEMECULA SECTION 125 CAFETERIA PLAN THE CITY COUNCIL OF THE CITY OF TEMECULA DOES HEREBY RESOLVE AS FOLLOWS: Section 1. The City Council adopted the City of Temecula Flexible Benefits Plan Document on September 18, 1990, to provide a Section 125 Cafeteria plan, including any applicable Healthcare Flexible Spending Account Plan, Dependent Care Assistance Program, and group health, dental and vision insurance to eligible employees. Section 2. The attached Amendment to City of Temecula Section 125 Cafeteria Plan Document revises the Plan Document as follows: A. To allow prospective election changes for Healthcare and Dependent Care Flexible Spending Accounts; B. To incorporate an unlimited carryover of unused Healthcare Flexible Spending Account funds; C. To extend the grace period for Dependent Care Assistance Program Extended Grace Period/Claims Extension Period; and D. To allow the Spend Down of Healthcare Flexible Spending Account once participation has ceased. Section 3. Approval of the Plan Document Amendment will provide the framework for staff to take such actions that are deemed necessary and proper in order to implement the Plan, and to setup adequate accounting and administrative procedures to provide employee benefits under the Plan. PASSED, APPROVED, AND ADOPTED by the City Council of the City of Temecula this 15th day of November, 2022. Matt Rahn, Mayor ATTEST: Randi Johl, City Clerk [SEAL] STATE OF CALIFORNIA ) COUNTY OF RIVERSIDE ) ss CITY OF TEMECULA ) I, Randi Johl, City Clerk of the City of Temecula, do hereby certify that the foregoing Resolution No. 2022- was duly and regularly adopted by the City Council of the City of Temecula at a meeting thereof held on the 151h day of November, 2022, by the following vote: AYES: COUNCIL MEMBERS: NOES: COUNCIL MEMBERS: ABSTAIN: COUNCIL MEMBERS: ABSENT: COUNCIL MEMBERS: Randi Johl, City Clerk AMENDMENT TO CITY OF TEMECULA SECTION 125 CAFETERIA PLAN DOCUMENT, AS AMENDED AND RESTATED ON JANUARY 1, 2019 CONSOLIDATED APPROPRIATIONS ACT OF 2021 AMENDMENT 1.1 AMENDMENT TO PLAN The City of Temecula ("Employer") hereby amends the Section 125 Cafeteria Plan Document, as amended and restatement on January 1, 2019 (the "Plan"), in good faith compliance with the Consolidated Appropriations Act of 2021 (CAA, 2021), IRS Notice 2021-15, the American Rescue Plan Act of 2021 (ARPA), and other applicable law and guidance, unless otherwise specifically stated herein. This amendment supersedes any inconsistent provisions of the Plan for eligible Plan Years provided by the CAA, IRS Notice 2021-15, the ARPA, and other applicable law and guidance. a) Prospective Change of Election Prospective election changes can be made to a Participant's Healthcare Flexible Spending Account and/or Dependent Care Assistance Program accounts during the 2020 Plan Year. 2. This Amendment is effective on January 1, 2020, and is in effect for eligible Plan Years provided by the CAA, IRS Notice 2021-15, the ARPA, and other applicable law and guidance. b) Healthcare Flexible Spending Account Carryover 1. The maximum amount Participants may carryover in their Healthcare Flexible Spending Account from the plan year beginning in 2020 to the plan year beginning in 2021 is unlimited up to the amount of contributions for the plan year beginning in 2020. 2. This Amendment is effective on January 1, 2020, and is in effect for eligible Plan Years provided by the CAA, IRS Notice 2021-15, the ARPA, and other applicable law and guidance. c) Dependent Care Assistance Program Extended Grace Period/Claims Extension Period The claims extension period (grace period) for participants to use funds in their Dependent Care Assistant Program from the plan year beginning in 2020 to the plan year beginning in 2021 is extended from 2'/2 months to 12 months after the end of the plan year beginning in 2020. 10171500.1 TE060-011-8/22/22 2. This Amendment is effective on January 1, 2020, and is in effect for eligible Plan Years provided by the CAA, IRS Notice 2021-15, the ARPA, and other applicable law and guidance. d) Spend Down of Healthcare Flexible Spending Account 1. The Participants may continue to receive reimbursements from unused contributions in their Healthcare Flexible Spending Account for expenses incurred through the end of the plan year in which such Participant ceased participation. 2. This Amendment is effective on January 1, 2020, and is in effect for eligible Plan Years provided by the CAA, IRS Notice 2021-15, the ARPA, and other applicable law and guidance. 2 10171500.1 TE060-011-8/22/22 Item No. 7 CITY OF TEMECULA AGENDA REPORT TO: City Manager/City Council FROM: Luke Watson, Deputy City Manager DATE: November 15, 2022 SUBJECT: Adopt Resolution Declaring City Owned Parcels Located at 28725 and 28731 Pujol Street to be Exempt from the Surplus Land Act PREPARED BY: Haide Urias, Housing and Real Estate Analyst RECOMMENDATION: That the City Council adopt a resolution entitled: RESOLUTION NO. A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF TEMECULA DECLARING A CITY -OWNED PARCEL LOCATED AT 28725 AND 28731 PUJOL STREET IN THE CITY OF TEMECULA TO BE EXEMPT SURPLUS LAND PURSUANT TO GOVERNMENT CODE SECTIONS 54221(b)(1) AND 54221(f)(1)(A), FINDING THE DECLARATION EXEMPT FROM THE CALIFORNIA ENVIRONMENTAL QUALITY ACT, AND TAKING RELATED ACTIONS BACKGROUND: The City of Temecula is the owner of vacant property located at 28725 and 28731 Pujol Street. The Property is approximately 0.46 acres in size, located within the Old Town Specific Plan and is zoned Neighborhood Residential (NR). The City desires to sell the Property to Habitat for Humanity Inland Valley, Inc., a California nonprofit public benefit corporation, for the development of an affordable housing project. Per the Surplus Land Act (Government Code Sections 54220-54234), the City Council must declare the property to be surplus land or exempt surplus land before any action is taken. As part of the Surplus Land Act guidelines the City has requested approval of exempt surplus land from the California Department of Housing and Community Development (HCD). On September 29th, 2022, HCD has determined that the property located at 28725 and 28731 Pujol Street qualifies as exempt surplus land. FISCAL IMPACT: There is no current fiscal impact. ATTACHMENTS: 1. Resolution 2. HCD Approval of Surplus Land Act RESOLUTION NO.2022- A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF TEMECULA DECLARING A CITY -OWNED PARCEL LOCATED AT 28725 AND 28731 PUJOL STREET IN THE CITY OF TEMECULA TO BE EXEMPT SURPLUS LAND PURSUANT TO GOVERNMENT CODE SECTIONS 54221(b)(1) AND 54221(f)(1)(A), FINDING THE DECLARATION EXEMPT FROM THE CALIFORNIA ENVIRONMENTAL QUALITY ACT, RELATED ACTIONS RECITALS: AND TAKING WHEREAS, the City of Temecula ("City") is the owner in fee simple of that certain real property in the City located at 28725 and 28731 Pujol Street and described on Exhibit "A", which is attached hereto and incorporated herein by reference ("Property"). The Property is currently vacant, is approximately 0.46 acres in size, and is zoned Neighborhood Residential; and WHEREAS, the City desires to sell the Property for the development of an affordable housing project thereon in order to provide needed housing in the City and to meet its Regional Housing Needs Assessment allocations for people of all income levels; and WHEREAS, pursuant to Section 54221(b)(1) of the Surplus Land Act (Government Code Sections 54220-54234), the City Council must declare the Property to be "surplus land" or "exempt surplus land" before the City Council takes action to dispose of the Property; and WHEREAS, Government Code Section 54221(f)(1)(A) defines "exempt surplus land" to include surplus land that is transferred pursuant to Government Code Section 37364; and WHEREAS, Government Code Section 37364 authorizes a city to sell, lease, exchange, quitclaim, convey, or otherwise dispose of real property to provide housing affordable to persons and families of low or moderate income provided that the following conditions are met: (a) Not less than 80 percent of the area of the parcel will be used for the development of housing; and (b) Not less than 40 percent of the total number of those housing units developed on the parcel shall be affordable to households whose incomes are equal to, or less than, 75 percent of the maximum income of lower income households, and at least half of which shall be affordable to very low income households; and (c) Dwelling units produced for persons and families of low or moderate income under Government Code Section 37364 shall be restricted by regulatory agreement to remain continually affordable to those persons and families for the longest feasible time, but not less than 30 years, with such regulatory agreement recorded in the office of the county recorder in which the housing development is located; and WHEREAS, Habitat for Humanity Inland Valley, Inc., a California nonprofit public benefit corporation, has proposed to purchase the Property from the City for the purpose of developing an affordable housing project on the Property that complies with Government Code Section 37364; and WHEREAS, because the proposed housing development will meet the requirements of Government Code Section 37364, staff has recommended that the City Council declare the Property to be exempt surplus land pursuant to Government Code Section 542221(f)(1)(A). THE CITY COUNCIL OF THE CITY OF TEMECULA DOES HEREBY RESOLVE AS FOLLOWS: Section 1. The above recitals are true and correct and are a substantive part of this Resolution. Section 2. The City Council hereby declares pursuant to Government Code Sections 54221(b)(1) and 5422 1 (f)(1)(A) that the Property is exempt surplus land because the City intends to sell the Property to Habitat for Humanity Inland Valley, Inc., a California nonprofit public benefit corporation, pursuant to Government Code Section 37364 for the development of an affordable housing project on the Property that complies with the requirements of Section 37364. Section 3. The City Council finds that it can be seen with certainty that there is no possibility that declaring the Property exempt surplus land may have a significant effect on the environment, and thus this declaration is not subject to the California Environmental Quality Act (CEQA). Further, any proposed project on the Property will be subject to environmental review as required by CEQA. Section 4. Staff is hereby authorized and directed to provide a copy of this Resolution to the Department of Housing and Community Development ("HCD") in the manner required by HCD. Section 5. The staff and officers of the City are hereby authorized, jointly and severally, to take such actions as they deem necessary or proper to effectuate the purposes of this Resolution and all actions previously taken are hereby ratified Section 6. The City Clerk shall certify as to the adoption of this Resolution. PASSED, APPROVED, AND ADOPTED by the City Council of the City of Temecula this 15th day of November, 2022. Matt Rahn, Mayor ATTEST: Randi Johl, City Clerk [SEAL] STATE OF CALIFORNIA ) COUNTY OF RIVERSIDE ) ss CITY OF TEMECULA ) I, Randi Johl, City Clerk of the City of Temecula, do hereby certify that the foregoing Resolution No. 2022- was duly and regularly adopted by the City Council of the City of Temecula at a meeting thereof held on the 15th day of November, 2022, by the following vote: AYES: COUNCIL MEMBERS: NOES: COUNCIL MEMBERS: ABSTAIN: COUNCIL MEMBERS: ABSENT: COUNCIL MEMBERS: Randi Johl, City Clerk EXHIBIT "A" LEGAL DESCRIPTION OF SITE THE LAND REFERRED TO HEREIN BELOW IS SITUATED IN THE CITY OF TEMECULA, COUNTY OF RIVERSIDE, STATE OF CALIFORNIA AND IS DESCRIBED AS FOLLOWS: LOT 5 OF BLOCK 34 OF THE TOWNSITE OF TEMECULA, IN THE CITY OF TEMECULA, COUNTY OF RIVERSIDE, STATE OF CALIFORNIA, AS SHOWN BY MAP ON FILE IN BOOK 15, PAGE 726 OF MAPS, RECORDS OF SAN DIEGO COUNTY, CALIFORNIA. TOGETHER WITH THAT PORTION OF AN ANNEXED STREET ADJACENT AND ON THE SOUTH SIDE OF SAID LOTS, AS VACATED BY RESOLUTION FILED DECEMBER 8,1936 IN BOOK 304, PAGE 356 OF OFFICIAL RECORDS OF RIVERSIDE COUNTY, CALIFORNIA. (APN: 922-062-016) AND LOT 6 OF BLOCK 34 OF THE TOWNSITE OF TEMECULA, IN THE CITY OF TEMECULA, COUNTY OF RIVERSIDE, STATE OF CALIFORNIA, AS SHOWN BY MAP ON FILE IN BOOK 15, PAGE 726 OF MAPS, -IN THE OFFICE OF THE COUNTY RECORDER OF SAID COUNTY. TOGETHER WITH THAT PORTION OF AN ANNEXED STREET ADJACENT AND ON THE SOUTH SIDE OF SAID LOT AS VACATED BY RESOLUTION FILED DECEMBER 8,1936 IN BOOK 304, PAGE 356 OF OFFICIAL RECORDS OF RIVERSIDE COUNTY, CALIFORNIA. (APN: 922-062-010) -5- 11086-0111 \25 57672v l . doc Haide Urias From: Wahid, Imaez@HCD <Imaez.Wahid@hcd.ca.gov> Sent: Thursday, September 29, 2022 7:34 AM To: Haide Urias Cc: Luke Watson Subject: RE: HCD Approval of Surplus Land Act Attachments: Temecula - Pujol - CC Resolution Declaring Property Exempt Surplus Land.DOCX CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe. Dear Haide, Thank you for notifying the California Department of Housing and Community Development of the City of Temecula's (City) determination of the property located at 28725 and 28731 Pujol Street (Property) as "exempt surplus land." And thank you for submitting the attached draft Resolution (Resolution) to HCD pursuant to Section 400(e)(2) of the Surplus Land Act (SLA) Guidelines. My name is Imaez Wahid. I am a housing specialist with the Surplus Land Act team. I process notices of determination of exempt surplus land. The Resolution provides that the City intends to sell the Property to Habitat for Humanity Inland Valley, Inc., a California nonprofit public benefit corporation, for the development of an affordable housing project on the Property pursuant to Government Code section 37364. Based on this information, the Property qualifies as "exempt surplus land" under Government Code section 54221(f)(1)(A). As required by Section 400(e) of the SLA Guidelines, please submit the adopted and approved Resolution to HCD at least 30 days prior to disposition. HCD will complete its formal review of the Resolution and issue a finding letter. Please feel free to reach out to me if you have any questions. Sincerely, V ��trpoze�'4'• HOUSING IS KEY Imaez Wahid Housing Specialist I, Housing Policy Development Housing and Community Development 2020 W. El Camino Avenue, Suite 500 1 Sacramento, CA 95833 Phone: 916.776.7496 From: Haide Urias <Haide.Urias@temeculaca.gov> Sent: Wednesday, September 21, 2022 12:17 PM To: PublicLands@HCD <publiclands@hcd.ca.gov> Cc: Luke Watson <luke.watson@temeculaca.gov> Subject: HCD Approval of Surplus Land Act To whom it may concern, The City of Temecula is looking to receive your approval of the attached resolution relating to releasing City owned land for the development of affordable housing. Feel free to reach out to me directly if you have any questions or concerns. Haide Urias Housing Analyst City of Temecula (951)693-3918 Haide.Urias@temeculaca.gov 41nnn Main St TPmPridn CA 9?59O Please note that email correspondence with the City of Temecula, along with attachments, may be subject to the California Public Records Act, and therefore may be subject to disclosure unless otherwise exempt. Item No. 8 CITY OF TEMECULA AGENDA REPORT TO: City Manager/City Council FROM: Patrick Thomas, Director of Public Works/City Engineer DATE: November 15, 2022 SUBJECT: Approve First Amendment to the Minor Maintenance Agreement with Craftsmen Plumbing Heating & Cooling, Inc. PREPARED BY: Stacey Biddle, Management Assistant Julie Tarrant, Principal Management Analyst RECOMMENDATION: That the City Council approve the first amendment to the minor maintenance agreement with Craftsmen Plumbing Heating & Cooling, Inc., to amend the scope of services to include additional general contracting services, and to amend the payment terms for a total agreement value for the term of the agreement. BACKGROUND: On July 1, 2020, City Council approved a Minor Maintenance Agreement with Craftsmen Plumbing, Heating, & Cooling, Inc., for the repairs and maintenance of plumbing, heating, and cooling systems at the various locations upon real and personal property of the City. Craftsmen Plumbing Heating & Cooling, Inc., has proven to be one of our most reliable contractors, providing exceptional service at a competitive price. Additional general contracting services are needed to support all divisions of the Public Works Department to include, but are not limited to, concrete, roofing, building and tenant improvements, electrical and fire systems services, inspections, various materials and supplies, and installations, renovations, and rehabilitations. Craftsmen Plumbing Heating & Cooling, Inc. has shown they are capable and responsive to the needs of the city to provide a variety of maintenance services and offer an efficient and economical means of completing the work. The First Amendment will also amend the Payment Terms to allow for a total Agreement value, removing the annual allowance that is currently limited to $325,000 per fiscal year. The original term of the Agreement will remain unchanged and will be in effect through June 30, 2025, unless otherwise amended in the future. FISCAL IMPACT: There is no fiscal impact to amend the Minor Maintenance Agreement to expand the scope of services for general contracting services. ATTACHMENTS: First Amendment FIRST AMENDMENT TO AGREEMENT BETWEEN CITY OF TEMECULA AND CRAFTSMEN PLUMBING HEATING & COOLING, INC. ROUTINE MAINTENANCE SERVICES THIS FIRST AMENDMENT is made and entered into as of November 15, 2022 by and between the City of Temecula , a municipal corporation (hereinafter referred to as "City"), and Craftsmen Plumbing Heating & Cooling, Inc., a Corporation (hereinafter referred to as "Contractor"). In consideration of the mutual covenants and conditions set forth herein, the parties agree as follows: This Amendment is made with the respect to the following facts and purposes: a. On July 1, 2020, the City and Contractor entered into that certain Agreement entitled "Agreement for Routine Maintenance Services," in the amount of $325,000 each fiscal year, for a total Agreement amount of $1,625,000. b. The parties now desire to update the scope of work and to amend the Agreement as set forth in this Amendment. 2. Section 3 of the Agreement entitled "PAYMENT" at paragraph "a" is hereby amended to read as follows: The City agrees to pay Contractor 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. This amount shall not exceed One Million Six Hundred Twenty - Five Thousand Dollars ($1,625,000) for the total term of this agreement unless additional payment is approved as provided in this Agreement. 3. Exhibit A Scope of Work and Exhibit B Payment Rates and Schedule to the Agreement is hereby amended by adding thereto the items set forth on Attachment "A" to this Amendment, which is attached hereto and incorporated herein as though set forth in full. 4. Except for the changes specifically set forth herein, all other terms and conditions of the Agreement shall remain in full force and effect. 08/09/2021 IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed the day and year first above written. CITY OF TEMECULA By: Matt Rahn, Mayor ATTEST: By: Randi Johl, City Clerk APPROVED AS TO FORM: By: CRAFTSMEN PLUMBING HEATING & COOLING, INC. (Two Signatures of corporate officers required unless corporate documents authorize only one person to sign the agreement on behalf of the corporation.) By: Laura McKee, Treasurer Peter M. Thorson, City Attorney CONTRACTOR Craftsmen Plumbing Contact Person: Dan 27636 Ynez Road Heatinc,�& Cooling, Inc. iv McKee Temecula, CA 92591 Phone Number: (951) 676-6838 craftsmeninc@hotmail.com City Purchasing Mgr. Initials and Date�2- - _2 -- r. 08/09/2021 ATTACHMENT A EXHIBIT A Contractor recognizes and agrees that this Agreement is for the purpose of establishing a contractual relationship between the City of Temecula and the Contractor for the future repairs, and maintenance of plumbing, heating and cooling systems, and a variety of general contracting services to include, but not limited to; concrete, roofing, building & tenant improvements, electrical services, fire systems, inspections, various materials and supplies, and installations, renovations, and rehabilitations at the various locations upon real and personal property of the City. Work will also include maintenance services, and emergency call -out. The procedure for assigning work is set forth as follows: 1. The City Manager or his designee shall submit to Contractor a written "Request for Work". The Request for Work shall include a description of the work to be completed, the time for completion of the work, and the plans and specifications, if any, work. 2. Within five (5) business days of the date of the Request for Work, Contractor shall respond in writing to the Request for Work and advise the City Manager whether it can perform the work and specify the cost of material which will be required and the estimated cost of labor and equipment necessary to complete the work in accordance with the labor and equipment rates set forth in Exhibit "B" to this Agreement. 3. In the event emergency work is required, the City Manager may transmit the Request for Work orally to the Contractor. As soon as practical following the emergency, the Contractor and Director shall in good faith confirm in writing the scope of the emergency work undertaken. 4. Upon acceptance of the Contractor's response by the City Manager, the Contractor shall proceed with the work. The performance of the work shall be pursuant to the terms of this Agreement. 08/09/2021 EXHIBIT "B" PAYMENT RATES AND SCHEDULE The cost of such services, labor, materials or supplies, while not guaranteed per Section 3 of this Agreement, shall not exceed $1,625,000 for the total term of the Agreement, unless additional payment is approved as provided in this Agreement. General Contracting Services to include, but not limited to: Plumbing, heating and cooling systems, and a variety of general contracting services to include, but not limited to; concrete, roofing, building & tenant improvements, electrical services, fire systems, inspections, various materials and supplies, and installations, renovations, and rehabilitations. Contractor will provide to the City a quote or estimate for the work to be performed, when and as requested by city staff/representatives for each work task, inclusive of total cost of work to complete the task or project. 08/09/2021 Item No. 9 CITY OF TEMECULA AGENDA REPORT TO: City Manager/City Council FROM: Luke Watson, Deputy City Manager DATE: November 15, 2022 SUBJECT: Approve First Amendment for General Plan Update City -Wide Traffic Analysis Services PREPARED BY: Brandon Rabidou, Principal Management Analyst RECOMMENDATION: That the City Council approve the first amendment to the agreement with Fehr and Peers for General Plan Update City -Wide Traffic Analysis Services and increase the agreement amount by $7,500, for a total contract amount of $137,500. BACKGROUND: Fehr and Peers is provided comprehensive Community Transportation Benchmarking Services for the City of Temecula. These services are provided in anticipation of a future General Plan update. Staff has requested additional work on the project, resulting in the need for a contract amendment. FISCAL IMPACT: $7,500, which has been adequately budgeted in 210.265.777.5801 ATTACHMENTS: 1 st Amendment FIRST AMENDMENT TO AGREEMENT BETWEEN CITY OF TEMECULA AND FEHR & PEERS INC. TRANSPORTATION DISCOVERY/BENCHMARKING EXISTING CONDITIONS TO SUPPORT CIRCULATION ELEMENT UPDATE THIS FIRST AMENDMENT is made and entered into as of November 15, 2022, by and between the City of Temecula, a municipal corporation (hereinafter referred to as "City"), and Fehr and Peers Inc., a Corporation (hereinafter referred to as "Consultant"). In consideration of the mutual covenants and conditions set forth herein, the parties agree as follows: This Amendment is made with the respect to the following facts and purposes: a. On December 1, 2020, the City and Consultant entered into that certain Agreement entitled "Agreement for Transportation Discovery/Benchmarking Existing Conditions to Support Circulation Element Update," in the amount of $130,000.00. b. The parties now desire to add scope of work, extend the term of the agreement to June 30, 2023, increase the payment in the amount of $7,500.00, and to amend the Agreement as set forth in this Amendment. 2. Section 1 of the Agreement entitled "TERM" is hereby amended to read as follows: "This Agreement shall remain and continue in effect until tasks herein are completed, but in no event later than June 30, 2023, unless sooner terminated pursuant to the provisions of this Agreement. 3. Section 4 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 First Amendment amount shall not exceed Seven Thousand Five Hundred Dollars and Zero Cents ($7,500.00), for additional scope of work for a total Agreement amount of One Hundred Thirty -Seven Thousand Five Hundred Dollars and Zero Cents ($137,500.00). 4. Exhibit A to the Agreement is hereby amended by adding thereto the items set forth on Attachment "A" to this Amendment, which is attached hereto and incorporated herein as though set forth in full. 5. Except for the changes specifically set forth herein, all other terms and conditions of the Agreement shall remain in full force and effect. 08/09/2021 IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed the day and year first above written. CITY OF TEMECULA By: Matt Rahn, Mayor ATTEST: By: Rand! Johl, City Clerk APPROVED AS TO FORM: FEHR & PEERS INC. By: QJ'1z' rah randenberg, Prin ' al By: Steve Brown, Principal By: Peter M. Thorson, City Attorney CONSULTANT Fehr & Peers Inc. Attn: Katy Cole, Principal 555 West Beech Street Suite 302 San Diego, CA 92101 k.cole@fehrandpeers.com 619 234-3190 City Purchasing Mgr. Initials and Date: 2'- 2 08/09/2021 ATTACHMENT A EXHIBIT A Attached hereto and incorporated herein as though set forth in full is the additional scope of work as provided by the Consultant. 08/09/2021 FEHR� PEERS Se pte m be r 15, 2022 Matt Peters, Principal Planner City of Temecu la 41000 Main Street Temecula, CA 92590 Subject: Additional Services for Temecula Discovery /6enchmarking Dear Matt: We appreciate the continued partnership with the City of Temecula. This proposal is for additional services to respond to City requests related to the transportation discovery/bench marking projects. We will perform the following tasks: • Create an Executive Summary document suitable for use in public settings and/or Council briefings. • Attend City meeting to review Executive Summary. • Respond to two rounds of comments on the Executive Summary. • Attend additional weekly''/2 hourcheck-In meetings (10). • Provide an online CIS Web -map in additional to the written report. • Provide AM and PM peak hour level ofservlceestimates using available data for up to three (3) Intersections under existing and future baseline conditions. Fee and Schedule These services will be performed based on the Agreement for Consultant Services dated December 1, 2020. The additional services will be performed on a time and materials basis per our contract for a maximum cost of $7,500. This Includes approximately 36 hours of professional staff time. 555 West Beech Street l Suite 302 1 San Diego, CA gzioi l (61g) 234-3190 1 Fax-(619) 702-9345 l w .fehrandpeers.com 4 08/09/2021 Matt Peters September 15, 2022 FT ,T Page 2 of 2 Please call Katy Cole at (619) 158-3001 if you have any questions. We appreciate the opportunityto assist the city with transportation study review. Sincerely, FEHR & PEERRSS K!1�1 aty Principal (D ur mission is to empower every employee to develop effective and innovative transportation solutions that improve communities 08/09/2021 Item No. 10 CITY OF TEMECULA AGENDA REPORT TO: City Manager/City Council FROM: Patrick Thomas, Director of Public Works/City Engineer DATE: November 15, 2022 SUBJECT: Approve Increase to Contingency Authorization for Fiber Optic Communication System Upgrade Project, PW18-05 PREPARED BY: Nick Minicilli, Senior Civil Engineer Julie Tarrant, Principal Management Analyst RECOMMENDATION: That the City Council: 1. Approve an increase to the contingency for the Fiber Optic Communication System Upgrade Project, PW18-05 by $40,000; and 2. Increase the City Manager Authority to approve change orders to the contract by $40,000. BACKGROUND: The Fiber Optic Communication System Upgrade Project is a Capital Improvement Program (CIP) project that will upgrade the City's fiber optic communication and traffic signal system. Currently, the construction phase is nearing completion and the signal timing coordination is about to commence. The Fiber Optic Communication System Upgrade project will install fiber optic communication system upgrades including conduits, cables, closed circuit television (CCTV) cameras, traffic signal controllers, and related communication equipment to improve safety and operations along the corridors of Winchester Road, Rancho California Road, and Temecula Parkway. As part of the project, the corridors will be optimized with traffic signal coordination timing to enhance safety and operations. On September 14, 2021, the City Council awarded the construction contract to JFL Electric, Inc (JFL), Inc in the amount of $690,340.50 and authorized the City Manager to approve contract change orders up to $69,034.05 for the project. During construction, the contractor has encountered existing fiber optic cable slack issues that necessitates ordering additional fiber optic cable to continue the fiber splicing work. Additional contractor work includes proofing the existing fiber optic cable along all project corridors, repulling existing fiber, installation of new fiber optic cable, and additional construction work required by Caltrans within their Right -of -Way. These additions exceed the original contingency amount and staff therefore recommends to approve an increase to the contingency, and to increase City Manager's authority to approve change orders up to a total contingency amount of $109,034.05. FISCAL IMPACT: The Fiber Optic Communication System Upgrade Project is identified in the City's Capital Improvement Program (CIP) Budget for Fiscal Years 2023-2027 with funds including Highway Safety Improvement Program (HSIP) grant funding and Measure S. There are sufficient funds in the project budget to allow for an increase of $40,000 to the contingency. ATTACHMENTS: CIP Budget Sheet ANk Tf,F �•-.�r. r�' S:,u�I,Frn i.:: f::rni� City of Temecula Fiscal Years 2023-27 Capital Improvement Program FIBER OPTIC COMMUNICATION SYSTEM UPGRADE Infrastructure Project Project Description: This project will install fiber optic communication system upgrades including conduit, cable, closed circuit television (CCTV) cameras, traffic signal controllers and related communication equipment to improve safety and operations with optimized traffic signal timing coordination. Various signalized intersections will be improved along the Winchester Road, Rancho California Road and Temecula Parkway corridors. Benefit: This project will upgrade the City's fiber optic communication and traffic signal system equipment. Core Value: A Safe and Prepared Community Project Status: This project will be completed in Fiscal Year2022-23. Department: Public Works - Account No. 210.265.999.550 / PW18-05 Level: I A Project Cost: Prior Years Actuals 2022-23 2021-22 Adopted 2023-24 2024-25 2025-26 2026-27 Adjusted Budget Projected Projected Projected Projected Total Project Cost Administration 254 25,000 25,254 Construction 842,446 842,446 Construction Engineering 275,100 275,100 Design & Environmental 119,770 30 119,800 Furnishings & Equipment 338,600 338,600 Total Expenditures 1 120,0241 1,481,176 1,601,200 Source of Funds: HSIP-Highway Safety 1,208,200 1,208,200 Improvement Program Measure S 113,000 280,000 393,000 Total Funding 113,000 1,488,200 - 1,601,200 Future Operating & Maintenance Costs: Total Operating Costs Notes : 1. The negative budget amount in FY21-22 reflects the transfer of Construction costs to Furnishings & Equipment costs. 2. Highway Safety Improvement Program - HSIPL 5459(026) 3. Fiscal Year2021-22 adds construction oversight costs - City administration, consultant -construction management/inspection services and the purchase of specialized equipment (FF&E). 135 Item No. 11 ACTION MINUTES TEMECULA COMMUNITY SERVICES DISTRICT MEETING COUNCIL CHAMBERS 41000 MAIN STREET TEMECULA, CALIFORNIA OCTOBER 25, 2022 CALL TO ORDER at 7:32 PM: Vice President Zak Schwank ROLL CALL: Alexander, Edwards, Rahn, Schwank, Stewart CSD PUBLIC COMMENTS -None CSD CONSENT CALENDAR Unless otherwise indicated below, the following pertains to all items on the Consent Calendar. Approved the Staff Recommendation (5-0): Motion by Edwards, Second by Rahn. The vote reflected unanimous approval. 11. Approve Action Minutes of October 11, 2022 Recommendation: That the Board of Directors approve the action minutes of October 11, 2022. CSD DIRECTOR OF COMMUNITY SERVICES REPORT CSD GENERAL MANAGER REPORT CSD BOARD OF DIRECTORS REPORTS CSD ADJOURNMENT At 7:34 PM, the Community Services District meeting was formally adjourned to Tuesday, November 15, 2022 at 4:30 PM for a Closed Session, with a regular session commencing at 6:00 PM, City Council Chambers, 41000 Main Street, Temecula, California. James Stewart, President ATTEST: Randi Johl, Secretary [SEAL] Item No. 12 CITY OF TEMECULA AGENDA REPORT TO: City Manager/City Council FROM: Luke Watson, Deputy City Manager DATE: November 15, 2022 SUBJECT: Approve Community Development Block Grant (CDBG) Substantial Amendment to the 2022-23 CDBG Annual Action Plan for the Reallocation of CDBG Funds to the Mary Phillips Senior Center PREPARED BY: Brandon Rabidou, Principal Management Analyst RECOMMENDATION: That the City Council adopt the resolution entitled: RESOLUTION NO. A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF TEMECULA APPROVING THE SUBSTANTIAL AMENDMENT TO THE 2022-23 COMMUNITY DEVELOPMENT BLOCK GRANT ANNUAL ACTION PLAN AND FINDING THE ACTIONS TO BE EXEMPT FROM FURTHER ENVIRONMENTAL REVIEW UNDER THE CALIFORNIA ENVIRONMENTAL QUALITY ACT (CEQA) AND NATIONAL ENVIRONMENTAL PROTECTION ACT (NEPA) BACKGROUND: The U.S. Department of Housing and Urban Development (HUD) requires all entitlement communities receiving Community Development Block Grant (CDBG) funds, such as the City of Temecula, to prepare and submit a Consolidated Plan every five years to establish a unified, strategic vision for community development, housing and economic development actions. The Consolidated Plan encompasses the analysis of local community needs and coordinates appropriate responses to those needs and priorities. The Temecula City Council adopted its most recent Five -Year Consolidated Plan for Fiscal years 2022-26 on April 26, 2022, which also includes the first Action Plan of that cycle (2022-23 Annual Action Plan) on April 26, 2022. The Consolidated Plan is carried out through Annual Action Plans, which provide a concise summary of the actions, activities, and the specific federal and non-federal resources that will be used each year to address the priority needs and specific goals identified by the Consolidated Plan. Per the City's Citizen Participation Plan, a Substantial Amendment to an Annual Action Plan is required when a "substantial" change is proposed, which includes: • To carry out a project not previously described in the Annual Action Plan using funds covered by the Consolidated Plan, including program income. • To substantially amend the purpose, scope, location, or beneficiaries of a project. • To substantially amend the allocation priorities or the method of distributing funds. SUBSTANTIAL AMENDMENT PROPOSED CHANGES: The Substantial Amendment to the 2022-2023 Action Plan is necessary because the City is proposing to carry out a project not previously described in the Annual Action Plan using funds covered by the Annual Action Plan. The City's 2022-2023 annual action plan previously accounted for the funds to be used for the "removal of architectural barriers for public right of ways in roadways, public facilities" on a capital improvement project. This Substantial Amendment No. 1 to the 2022-2023 Annual Action Plan officially assigns these funds ($331,014) identified in the Action Plan to the ADA Improvements Project at the Mary Phillips Senior Center (PW20-13). The project's current CDBG budget is $726,569.78, with the additional assignment of funds the projects total CDBG contribution is $1,057,583.78. Measure S funds in the amount of $258,425 are also being provided for the project. NOTICING A Notice of Public Hearing and the commencement of the 30-day public review period was published in the Press Enterprise on October 15, 2022, informing the public of the proposed substantial amendment. FISCAL IMPACT: The approval of the Substantial Amendment will allow the expenditure of the City's appropriation of federal CDBG funds for the 2022-23 Program year. ATTACHMENTS: 1. Resolution — Substantial Amendment No. 1 to the 2022-2023 Annual Action Plan 2. Exhibit A — Substantial Amendment 3. Notice of Public Hearing RESOLUTION NO. 2022- A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF TEMECULA APPROVING THE SUBSTANTIAL AMENDMENT TO THE 2022-23 COMMUNITY DEVELOPMENT BLOCK GRANT ANNUAL ACTION PLAN AND FINDING THE ACTIONS TO BE EXEMPT FROM FURTHER ENVIRONMENTAL REVIEW UNDER THE CALIFORNIA ENVIRONMENTAL QUALITY ACT (CEQA) AND NATIONAL ENVIRONMENTAL PROTECTION ACT (NEPA) THE CITY COUNCIL OF THE CITY OF TEMECULA DOES HEREBY RESOLVE AS FOLLOWS: Section 1. Procedural Findings. The City Council of the City of Temecula does hereby find, determine and declare that: A. The City of Temecula has participated directly within the federal Department of Housing and Urban Development (HUD) as an entitlement jurisdiction for Community Development Block Grant (CDBG) funds since July 1, 2012; B. The City of Temecula has prepared all documents, notices, and forms required by HUD for participation in the CDBG Program by entitlement jurisdictions; C. On April 26, 2022, the City Council adopted the updated Citizen Participation Plan that sets forth the City's policies and procedures for citizen participation in the development of its Five -Year Consolidated Plan, Annual Action Plans, Annual Performance Reports, and any substantial amendments deemed necessary for direct administration of federal CDBG funds; D The Citizen Participation Plan included policies and procedures for amending Annual Action Plans where CDBG-funded activities may be added or deleted, and funding for activities may be increased; E. It was determined that the changes for activities listed required a substantial amendment in accordance with the City's adopted Citizen Participation Plan; F. The Substantial Amendment was presented to the City Council at a public hearing held on November 15, 2022; G. The City Council, at a regular meeting, considered the Substantial Amendment on November 15, 2022, at a duly noticed public hearing as prescribed by law, at which time the City staff and interested persons had an opportunity to and did testify either in support or in opposition to this matter. H. At the conclusion of the City Council hearing and after due consideration of the testimony, the City Council approved the Substantial Amendment, subject to and based upon the findings set forth hereunder. I. All legal preconditions to the adoption of this Resolution have occurred. Section 2. Further Findings. The City Council, in approving the Plan hereby finds, determines and declares that: A. Pursuant to Title 24, Housing and Urban Development, of the Code of Federal Regulations, Subtitle A Office of the Secretary, Department of Housing and Urban Development, Part 91 Consolidated Submissions For Community Planning And Development Programs (24 CFR Part 91) each entitlement jurisdiction shall amend its approved Annual Action plan whenever it plans to carry out a project not previously described in the Annual Action Plan using funds covered by the Consolidated Plan, including program income, to substantially amend the purpose, scope, location, or beneficiaries of a project, and when it plans to substantially amend the allocation priorities or the method of distributing funds. Section 3. Environmental Findings. The proposed action on the Substantial Amendment is exempt ftom National Environmental Policy Act (NEPA) pursuant to the provisions of the National Environmental Policy Act and specifically 24 CFR 58.34(a)(1) because the Substantial Amendment is a resource identification study and the development of plans and strategies for the prioritization and funding of proposed programs through CDBG and the proposed action involves the feasibility and planning studies to determine prioritization and CDBG funding to begin the development of certain projects. The potential projects discussed in the proposed actions that might involve physical activity have been reviewed under NEPA or the California Environmental Quality Act (CEQA) as part of the development of those projects. The proposed action is also exempt from CEQA per CEQA Guidelines Section 15262 and 15378(b)(4). Section 4. Approvals. A. The City Council hereby approves the Substantial Amendment as set forth as Exhibit A attached hereto, and any and all other documents deemed necessary by HUD to obtain the annual CDBG allocation of the federal CDBG funds and authorizes and directs the City Manager, or his designee, to serve as the Certifying Officer for all environmental review procedures associated with the various CDBG projects, and Certifying Officer for the purpose of signing correspondence, agreements, and other required documents. B. The City Council hereby approves the reprogram of the funds as set forth in Exhibit A. Section 5. Certification. The City Clerk shall certify to the adoption of this Resolution. 2 PASSED, APPROVED, AND ADOPTED by the City Council of the City of Temecula this 15th day of November, 2022. Matt Rahn, Mayor ATTEST: Randi Johl, City Clerk [SEAL] STATE OF CALIFORNIA ) COUNTY OF RIVERSIDE ) ss CITY OF TEMECULA ) I, Randi Johl, City Clerk of the City of Temecula, of the City of Temecula, do hereby certify that the foregoing Resolution No. 2022- was duly and regularly adopted by the City Council of the City of Temecula at a meeting thereof held on the 15th day of November, 2022, by the following vote: AYES: COUNCIL MEMBERS: NOES: COUNCIL MEMBERS: ABSTAIN: COUNCIL MEMBERS: ABSENT: COUNCIL MEMBERS: Randi Johl, City Clerk SUBSTANTIAL AMENDMENT TO 2022-2023 ANNUAL ACTION PLAN A. EXECUTIVE SUMMARY The U.S. Department of Housing and Urban Development (HUD) requires all entitlement communities receiving Community Development Block Grant (CDBG) funds, such as the City of Temecula, to prepare and submit a Consolidated Plan every five years to establish a unified, strategic vision for community development, housing and economic development actions. The Consolidated Plan encompasses the analysis of local community needs and coordinates appropriate responses to those needs and priorities. The Temecula City Council adopted its most recent Five Year Consolidated Plan for Fiscal years 2022-26 on April 26, 2022 which also includes the first Action Plan of that cycle (2022-23 Annual Action Plan) on April 26, 2022. The Consolidated Plan is carried out through Annual Action Plans, which provide a concise summary of the actions, activities, and the specific federal and non-federal resources that will be used each year to address the priority needs and specific goals identified by the Consolidated Plan. Per the City's Citizen Participation Plan, a Substantial Amendment to an Annual Action Plan is required when a "substantial" change is proposed, which includes: a. To carry out a project not previously described in the Annual Action Plan using funds covered by the Consolidated Plan, including program income. b. To substantially amend the purpose, scope, location, or beneficiaries of a project. c. To substantially amend the allocation priorities or the method of distributing funds. The Substantial Amendment to the 2022-2023 Action Plan is necessary because the City is proposing to carry out a project not previously described in the Annual Action Plan using funds covered by the Annual Action Plan. The City's 2022-2023 annual action plan previously accounted for the funds to be used for the "removal of architectural barriers for public right of ways in roadways, public facilities" on a capital improvement project. This Substantial Amendment No. 1 to the 2022-2023 Annual Action Plan officially assigns these funds ($331,014) identified in the Action Plan to the ADA Improvements Project at the Mary Phillips Senior Center (PW20-13). The projects current CDBG budget is $726,569.78, with the additional assignment of funds the projects total CDBG contribution is $1,057,583.78. Measure S funds in the amount of $258,425 are also being provided for the project. B. CITIZEN PARTICIPATION A Notice of Public Hearing and the commencement of the 30-day public review period was published in the newspaper on October 15, 2022, informing the public of the proposed Substantial Amendment and inviting comments at the public hearing that will be held on November 15, 2022, at City of Temecula City Council Chambers. The public review period began on October 15, 2022, and ends November 15, 2022. Citizens were able to review copies of the Draft Substantial Amendment at the Ronald H. Roberts Temecula Public Library, Temecula City Hall (City Clerk's Office and Community Development Department) City of Temecula 2022-2023 Action Plan Pg. 1 Substantial Amendment— November 15, 2022 and on the City's website at http://www.TemeculaCA.gov/CDBG On November 15, 2022, the Temecula City Council will hear public comments regarding the Substantial Amendment. C. CHANGES TO THE 2022-2023 ANNUAL ACTION PLAN ACTIVITIES This Substantial Amendment proposed to the following changes: Project Name CDBG Budget Proposed New CDBG Budget ADA Improvements Project (Unassigned Location) $331,014 $0 Mary Phillips Senior Center ADA Improvements (PW20-13) $726,569.78 *$1,057,583.78 *Proposed new CDBG budget does not include the proposed amount of Measure S funds to be included. Original CIP Project Description Proposed New CIP Project Description Removal of architectural barriers for public right Project funds will be assigned to remove of ways in roadways, public facilities. architectural barriers and ensure safe and proper access to those in need located at the Mary Phillips Senior Center. Project identified as (PW20-13). D. PUBLIC COMMENTS Any and all public comments made on this item will be summarized and included in the final version updated to the City's 2022-2023 Annual Action that is submitted to HUD. City of Temecula 2022-2023 Action Plan Pg. 2 Substantial Amendment— November 15, 2022 NOTICE OF PUBLIC HEARING AND AVAILABILITY FOR REVIEW OF DRAFT SUBSTANTIAL AMENDMENT NO. 1 TO THE 2022-2023 ANNUAL ACTION PLAN NOTICE IS HEREBY GIVEN that the City of Temecula has prepared a draft Substantial Amendment No. 1 to the 2022-2023 Annual Action Plan. The publication of this notice is the beginning of the 30-day public review period required under Federal Regulation 21 CFR 91.105 (b) (2). The public review and written comment period begins on October 15, 2022 and runs through November 15, 2022. NOTICE IS HEREBY FURTHER GIVEN that the City will conduct a Public Hearing when the Substantial Amendment is presented to the City Council for approval, on following date: DATE: Tuesday, November 15, 2022 TIME: 6:00 p.m. LOCATION: City of Temecula, Council Chambers, 41000 Main Street, Temecula, CA 92590 DRAFT 2022-2023 ANNUAL ACTION PLAN SUBSTANTIAL AMENDMENT NO. 1 The One -Year Action Plan sets forth specific activities to be funded through the Community Development Block Grant (CDBG) Program. The City proposes the following draft changes to activities included in the 2022-2023 Action Plan: Assign Program Year 2022-2023 Capital Improvement Project Funds in the amount of $331,014 to the ADA Improvements Project set to take place the City's Mary Phillips Senior Center (PW20-13). The City's 2022-2023 annual action plan previously accounted for the funds to be used for the "removal of architectural barriers for public right of ways in roadways, public facilities". This Substantial Amendment No. 1 to the 2022-2023 Annual Action Plan officially assigns these funds identified above to the ADA Improvements Project at the Mary Phillips Senior Center (PW20-13). The projects current CDBG budget is $726,569.78, with the additional assignment of funds the projects total CDBG contribution is $1,057,583.70. PUBLIC COMMENT Copies of the Draft Substantial Amendment will be available for public review at the following locations: City Hall, (Community Development Dept. & City Clerk's Office), 41000 Main Street, Temecula, CA 92590 • Ronald H. Roberts Temecula Public Library, 30600 Pauba Road, Temecula, CA 92592 http://www.TemeculaCA.gov/CDBG The public is invited to submit written comments on the Draft Substantial Amendment. Questions and written comments regarding the Draft Substantial Amendment may be addressed to Brandon Rabidou, Senior Management Analyst, Community Development Department, 41000 Main Street, Temecula, California 92590. You may also call (951) 506-5142 with any questions concerning the above documents. All comments relative to the draft document should be submitted no later than 4:00 p.m. November 15, 2022. ACCESSIBILITY TO MEETINGS AND DOCUMENTS It is the objective of the City to comply with Section 504 of the Rehabilitation Act of 1973, as amended, the Americans with Disabilities Act (ADA) of 1990 and the ADA Amendment Act of 2008, the Fair Housing Act, and the Architectural Barriers Act in all respects. If you require public documents in an accessible format, the City will make reasonable efforts to accommodate your request. If you require a disability -related accommodation to attend or participate in a hearing or meeting, including auxiliary aids or services, please contact the City Clerk's Office at least 48 hours prior to the meeting at (951) 694-6444. LIMITED ENGLISH PROFICIENCY (LEP) Si necesita mas informaci6n sobre este aviso o la traducci6n de documentos en espanol, comuniquese con Brandon Rabidou al (951) 506-5142 (TTY: 951 308-6344) Kung kailangan mo ng higit pang impormasyon tungkol sa abisong ito o sa salin ng mga dokumento sa Tagalog, tawagan si Brandon Rabidou sa 951-506-5142 (TTY: 951-308-6344) Publish: October 15, 2022 Item No. 13 CITY OF TEMECULA AGENDA REPORT TO: City Council FROM: Aaron Adams, City Manager DATE: November 15, 2022 SUBJECT: Approve Recommendation for Community Service Funding - Reinvestment in Temecula Grant Program for Fiscal Year 2022-23 (At the Request of Subcommittee Members Mayor Pro Tern Schwank and Council Member Stewart) PREPARED BY: Betsy Lowrey, Assistant to the City Manager RECOMMENDATION: That the City Council: 1. Approve the Community Service Funding Ad Hoc Subcommittee's recommendation to allocate a total of $1,090,500 to fund grant applications received from nonprofit organizations for the Community Service Funding - Reinvestment in Temecula Grant Program Fiscal Year 2022-23; and 2. Approve a budget transfer of $1,000,000 from Fund 110 -Community Reinvestment Program Fund to Fund 001 - General Fund to program towards the Community Services Funding Program. BACKGROUND: The City Council appointed Mayor Pro Tem Zak Schwank and Council Member James Stewart to the Fiscal Year 2022-23 Community Service Funding Ad Hoc Subcommittee to recommend grant fund allocations up to $50,000 per non-profit organization for programs that provide services to the citizens of Temecula (only). The Community Service Funding Program adopted Fiscal Year 2022-23 budget is $1,100,000 inclusive of $1,000,000 from the Community Reinvestment Program budget. Community Service Funding has historically awarded up to $5,000 per nonprofit organization, for a total of $100,000 budgeted annually. This Fiscal Year, beginning July 1, 2022, and next Fiscal Year, beginning July 1, 2023, the program has been revitalized as "Community Service Funding — Reinvestment in Temecula," as part of the City's adopted $14,080,000 Community Reinvestment Program. Thus, the budgeted amount increased from $100,000 to $1,100,000 each Fiscal Year, for a total of $2,200,000 over two years, and nonprofit organizations can be awarded up to $50,000 each year. The "Community Service Funding - Reinvestment in Temecula Grant" Program information was e-mailed to non-profit organizations in the Temecula Valley area including all community -based charities in the City's database. In addition, advertisements were sent via a press release to the media, posted to the City's social media, emailed through eblast to approximately 42,000 recipients, and promoted on video shown at a Temecula Valley Chamber of Commerce event. The application and guidelines were also posted on the City's website. A total of 68 applications from 66 non-profit organizations were submitted to the City requesting a total of $1,090,500 in grant funding. The Ad Hoc Subcommittee, along with staff members, reviewed the requests for funding based on criteria adopted by the City Council to support non-profit organizations who offer charitable community -wide programs and services such as food, clothing, shelter, medical care, and are supportive of the arts, special needs community and similar types of charitable needs that must benefit Temecula citizens only. The Ad Hoc Subcommittee recommends that 51 programs receive grant funding ranging from $5,000 to $50,000 each, totaling $1,090,500 of the available $1,100,000 budget. Council Member Alexander will not participate in the Council discussion and action on the Birth Choice application. Birth Choice, Inc., has submitted an application for Community Reinvestment Funding. Council Member Alexander is an employee of Birth Choice and supervises its Temecula operations. Therefore, under State law, Council Member Alexander cannot participate in the Council's discussion and action on the Birth Choice application. In order to fulfill these obligations, the following procedures will be in place for this item: 1. The Mayor will call Item 13. 2. The City Attorney will explain that Council Member Alexander will not participate in the Council discussion or action on the Birth Choice application because she is employed by Birth Choice. 3. Council Member Alexander will leave the dais and the Council Chamber. 4. Staff will present the Agenda Report on Item 13 and Council will receive public comments on Item 13. 5. Following public comments on Item 13, Council will discuss the Birth Choice application and decide whether to approve, modify or deny the application. 6. Following Council action on the Birth Choice application, Council Member Alexander may return to the Council Chamber and take her place on the dais. 7. At this point, the Council, with Council Member Alexander participating, will consider the other applications for Community Reinvestment Funding. FISCAL IMPACT: Funds are available in the Fiscal Year 2022-23 Community Service Funding line item 001.101.999.5267 in the amount of $100,000 and in the Community Reinvestment Program line item in the amount of 1,000,0000. ATTACHMENTS: 1. Fiscal Year 2022-23 Application Summary Spreadsheet 2. Fiscal Year 2022-23 Applications COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA SUB- COMMITTEE RECOM- MENDATION TOTAL$ DIRECTORS OR :..•. MEMBERS OF ANY NONPROFIT ORGANIZATION 1,090,500 1a A PLACE FOR ALL 27890 Clinton Keith Rd, # D151, TEMECULA YOUTH BASKETBALL CHAMPIONS. Serves the special needs $ 5,000 $ - PIECES Murrieta, CA 92562 community with an 11-week program for K-12. Funding to be used for court Website: rental, pictures, facilitator, liability insurance, buddy shirts, materials, and end APLACEFORALLPIECES.ORG of season party. Estimated number of Temecula residents to benefit: 25-40. 1b A PLACE FOR ALL 27890 Clinton Keith Rd, # D151, INCLUSIVE HALLOWEEN TEEN/ADULT DANCE EVENT. Provide social skills, peer- NEW APPLICANT $ 51000 $ PIECES Murrieta, CA 92562 to -peer support for Temecula special needs families. Funds to be used for venue Website: ($1,600), decorations ($3,500), food ($1,500), DJ ($300). Estimated number of APLACEFORALLPIECES.ORG Temecula residents to benefit: 50-75. 2 AIM FOR GOOD NEW APPLICANT; $ 50,000 31493 Rancho Pueblo Road # 205 AIM FOR GOOD. For local individuals and nonprofits in need -- financial, public $ 10,000 Temecula, CA 92592 awareness, or volunteer support. Funds to be used for food, video marketing, SUBCOMMITTEE Website: AIMFORGOOD.ORG Autism art camps, video production equipment, and online marketing that RECOMMENDATION LIMITS supports special needs art camp, special needs programs and arts programs. FUNDS STRICTLY TO ASSIST Estimated number of Temecula residents to benefit: not identified "sky's the SPECIAL NEEDS ART CAMP; limit". Covid, inflation, and recession will, and does, impact all nonprofit SPECIAL NEEDS contributions. We haven't actively fundraised as we didn't want to compete for PROGRAMS; ARTS local dollars as local nonprofits build their strategies going forward. >$5K Our COMMUNITY PROGRAMS goal is to help whomever we can without red tape, so this grant would help kickstart that goal and funnel support via financial, marketing/promoting of needs, direct partnerships, and more. 3 ANIMAL FRIENDS 33571 Mission Trail Rd., Wildomar, TEMECULA HAS HEART FOR ANIMALS. Provides spay/neuter pet sterilization -- $ 50,000 $ 40,000 OF THE VALLEYS CA 92595 costing $60-130 (averaging $80) per dog and $50-60 per cat. The funds will Website: cover 100 spay/neuter surgeries (and stop an average of 570 animals from ANIMALFRINEDSOFTHEVALLEYS.0 roaming the streets or ending up in the shelter), pet micro -chipping, senior OM living visits, pet reading program to school -aged children in libraries. Estimated number of Temecula residents to benefit: 900. AFV lost over $170K, possibly more by not having three signature events during COVID. >$5K Will allow AFV to create a new Pet Walk event for citizens in Temecula. This will bring in much needed funding to the shelter for other Temecula events while supporting Temecula citizens, their pets and Temecula businesses. The grant will also allow AFV to offer the new Reading and Pet Education Program a few times a year, free of charge to Temecula Elementary School children and Temecula Families at both Temecula libraries. COUNCIL CSF ON N N N 0 0 0 0 Ql N O N N N N 0 0 0 0 L}L L}L L}L L}L 1,500 CDBG O O N 41 r O LL O N O N N L}L N O N N N O LL M O N N N O LL Page 1 of 18 Legend: "-" = Applied and Not Awarded No Number = Did Not Apply COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA 4 ASSISTANCE LEAGUE OF TEMECULA VALLEY 5 BIKE TEMECULA VALLEY CORP (BTV) I 28720 Via Montezuma, Temecula, 5 POINTS. Funding to reimburse $17,000 (March 2020 - present): Christmas presents at CA 92590 Rancho Damacitas, Emergency Clothing for foster children, supplies for Exceptional Website: Children's Christmas Program, Christmas presents and household items for Temecula ASSISTANCELEAGUE.ORG/TEMECU transitional housing (non -Minor dependents), backpacks for Community Mission of Hope, LA -VALLEY fidget toys/stress balls for Temecula School Counselors to hand out, clothing for students at Temecula Elementary School, Movie tickets for HUGS Foster Family Agency, Teddy Bears for Temecula Valley Hospital children in crisis, computer tablets for youth at Rancho Damacitas, Student Body ID Cards for foster/homeless at Great Oak High School, Famous Footwear Gift Cards for families residing at Rancho Damacitas, Mini refrigerator and microwave for Great Oak High School ROOTS program, Old Navy gift cards for Temecula Middle School students. Funding for 23K to go towards future programs including LCAP Program at Temecula Schools (Local Control and Accountability Plan) for foster/homeless, second language learners and youth in poverty, Support for Temecula Elementary Schools, Support for Special Needs Pre -School in TVUSD, support for Foster/Homeless Youth in Temecula, Rancho Damacitas families, Exceptional Children's Christmas Program, ALTV's Assist -Teens, Support CMOH, support children receiving care at TVH, - examples include healthy snacks, school supplies, student body cards, senior packages, special classes, hygiene kits, computer tablet, incentives for learning, support for extra programs, fidget toys/stress balls, food voucher, food, school supplies, emergency clothing, books, manipulatives (sensory and support), STEM items, social emotional learning supports, flexible seating, gross motor/fine motor equipment/supplies, (LCAP), educational support (special classes/programs or counseling), movie tickets, mini refrigerator & microwave for GOHS ROOTS program. Estimated number of Temecula residents to benefit: 2,100. >$5K COVID closures required ALTV to close their thrift store, which is the primary sources of income. ALTV has been in recovery since this loss. Also, inflation has significantly increased the costs to operate philanthropic programs. This grant will allow ALTV to continue providing the needs, services, and materials to children and families of Temecula. 31311 Canterbury Court, 'CYCLE FOR HOPE. Cycling event Fundraiser including three bicycle rides through Temecula, CA 92591 Temecula neighborhoods and wine country 8-11am October 2, 2022. The routes Website: TVBIKECOALITION.COM are 15, 25, or 50 miles for entry fees of $39, $85, and $125, respectively. The cycling event is to benefit the Community Mission of Hope/Rancho Damacitas to feed the hungry and help the homeless. Funds will purchase materials for route signage, sign frame holders, volunteer (100+) visibility vests & t-shirts, participant commemorative t-shirts, bike racks, Bike Temecula Valley accessories for sponsors and participants, and CHP and Temecula PD Traffic Division for route safety. Estimated number of Temecula residents to benefit: 500+. SUB- COMMITTEE RECOM- MENDATION $ 1,090,500 50,000 1 $ 50,000 5,000 1 $ 7,500 COUNCIL CSF ON 14 N r1i N N O O O O Ql 1-1 O N 14 N N N o N O N O N O N > LL > LL > LL > LL 920 3,420 3,500 CDBG C'4 N N N O O O O ON r O N 14 N N N 0 N o N O N O N LL LLLL LL LL 5,538 5,491 6,969.61 72,726 Page 2 of 18 Legend: "-" = Applied and Not Awarded No Number = Did Not Apply COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA SUB- COMMITTEE RECOM- MENDATION TOTAL$ DIRECTORS OR :..•. MEMBERS OF ANY NONPROFIT ORGANIZATION 1,090,500 6 BIRTH CHOICE OF 1 Ridge Gate Dr. #220, Temecula CLIENT CARE PROGRAMS. Client GaFe and fatheFheed PFOgFaFnS effeF SUBCOMMITTEE $ 50,000 $ 25,000 TEMECULA CA 92590 ffegnaney, paFenting, "`e `kills edueatien, ene en ene FnentOFORg, FnateFial RECOMMENDATION LIMITS Website: _,.sist_ne gFiegIes.......peFt and ...l_.ed .......: F.._,,:_.....:11 h..used to FUNDS. GRANT SHALL NOT BIRTHCHOICECENTERS.ORG Feplaee eld eampwteFS, IT Wppek goods for parenting BE USED FOR ANY PRINTED (needs (hygiene kits, diapers, wipes, formula, car seats, Park'n Plays, strollers, MATERIALS AND/OR clothing, gas, and food cards), MARKETING AND/OR OUTREACH. GRANT FUNDS lease ). Estimated number of Temecula residents to benefit: 120. >$5K For SHALL INCLUDE ONLY 2023, it is our intention to expand our existing programs and projects. Our ITEMS NEEDED FOR reality is that our programs are expanding without us trying to expand them. PREGNANT MOTHERS/NEW This grant will give us the ability to serve all residents without having to PARENTS AND decrease supplies to make them last. Over the last two years we provided BABIES/TODDLERS AS families with over $15K diapers, approx. 500 cans of formula and 500 bags of FOLLOWS: DIAPERS, WIPES, clothing as well as hundreds of goods, and 2022 is near surpassing this amount. FORMULA, CAR SEATS, PACK 'N PLAYS (PLAYPENS), needed goods f8F eUF families as 8UF seFViees aFe gFeatly expanding. Funds STROLLERS, MATERNAL ° . If the BeaFd AND/OR BABY/TODDLER wishes that the funds be used do ff .Fenti., (than e ffset leasing chaF. es) CLOTHING, GAS CARDS/ FOOD CARDS, HYGIENE NEEDS/KITS. *COUNCIL MEMBER ALEXANDER WILL NEED TO ABSTAIN 7 BNAI CHAIM 29500 Via Princesa, Murrieta, CA FIGHT ANTISEMITISM WITH EDUCATION. Inclusive culture learning hub $ 32,000 $ 92563 welcomes Temecula residents of all beliefs to the only standing Jewish Website: BNAICAIM.COM synagogue within 38-mile zone (Temecula & Murrieta border), to deter antisemitism through education at annual events including Hanukkah, Purim, and Passover. Funds will be used to help maintain safe events with security cameras, emergency roof access safe door, and a perimeter outside gate; replacement of air conditioning unit; and food, supplies, and decor for events. There is only one building built as a synagogue for all of the Temecula and Murrieta Jewish Community. We have experienced seven acts of vandalism in two years and wish to provide a safe place. Estimated number of Temecula residents to benefit: 180+ (30-80 per event) and will encourage more. >$5K More educational programs against antisemitism; more people will attend. More is being asked for security and being able to cool/keep building well ventilated. 8 BOY SCOUTS OF 2351 W. Lugonia Ave. Suite F, SCOUTING IN TEMECULA. Funding will cover the costs for membership and $ 50,000 $ AMERICA CA IE Temecula, CA 92374 fund the transportation costs (and food) for Scouts who live in Temecula's Sister COUNCIL 045 Website: CIECBSA.ORG City in Japan to travel to Temecula bringing international tourism revenue (TAHQUITZ through site -seeing and local businesses and shops in the City. Costs also DISTRICT) include materials shipping costs, food, and host family supplies. Estimated number of Temecula residents to benefit: 50-100. >$5K. These funds will help expand engagement with the residents of Temecula and give back to the community through Eagle Scout projects and a variety of other community service opportunities. These funds will additionally enable our program to provide Temecula's sister city in Japan the opportunity to visit Temecula and bring international awareness. COUNCIL CSF ON N N N O O O O M O N N N N o N O N O N o N > LL > LL > LL > LL 2,500 1,000 1,000 CDBG C'4 O N O N O N O M r 0 N O N o N 14 N O N N N O N > I LL > LL > LL > LL Page 3 of 18 Legend: "-" = Applied and Not Awarded No Number = Did Not Apply COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA SUB- COMMITTEE RECOM- MENDATION —TOTAL$ BOARDDIRECTORS OR 1,090,500 9 BOYS & GIRLS CLUB PO BOX 892349, Temecula, CA BEFORE & AFTER SCHOOL / DAY CAMP PROGRAM. Year -around for youth ages $ 50,000 $ 50,000 OF SOUTHWEST 92589 Website: BGCSWC.ORG 6-17. Funds will be used for supplies, equipment (including safety equipment), COUNTY transportation, food, marketing, and other necessary costs including insurance costs. Fund before and after school programs, and day camp. Estimated number of Temecula residents to benefit: 80. >$SKThe organization's annual revenue in 2020 decreased 60% or $900K from 2019 and had to lay off President/CEO and Director of Marketing; and faced capacity restrictions due to social distancing. Awarded funds will allow BGCSWC to continue existing programming. 10 CADENZA STRING 31927 Corte Pollensa, Temecula, YOUNG MUSICIAN DEVELOPMENT FUND. To provide more cultural events and $ 20,000 $ 5,000 ORCHESTRA CA 92592 provide quality music lessons to students in need at local and interstate competitions. Funds will be used for musical instruments (such as violin, viola, cello), rehearsal space rental, recording equipment (microphones, cables, generators, computer interface, computers), music accessories (such as strings, music stands), sheet music, and copyright licenses. Estimated number of Temecula residents to benefit: 300. $>5K Lost students due to parents not having income to go to music lessons; some students also moved out of state due to cost of living in CA. In need of financial support to provide free lessons and promote cultural arts in Temecula. The funding will provide jobs to local music teachers for lessons given to underprivileged students. It will promote cultural events. 11 CANINE SUPPORT 24480 Jenny Ln, Murrieta, CA PAWZ FOR WOUNDED VETERANS. Train dogs to support disabled veterans who $ 50,000 $ 25,000 TEAMS INC. 92562 are seeking enhanced mobility, independence, and companionship. It costs an Website: estimated 25k to prepare a dog for a life of service, so full funding will provide 2 CANINESUPPORTTEAMS.ORG veterans with a service dog. Funds will be spent on training equipment (leashes, collars, harnesses, vests, and training tools), canine care equipment (grooming, crates, microchip, housing), dog food, training supplies (treats, consumable tools, equipment), kennel supplies (food dishes, storage containers, specialized cleaning supplies), and veterinary care and prescriptions (monthly flea/tick/heartworm pills, general health, and emergency illness). Estimated number of Temecula residents to benefit: 9. >$5K Cost to raise/train a service dog is $25K. Over the next year, two eligible Temecula Veterans would be granted a service dog at not cost with these funds. 12 CAUSE FUR PAWS, 47200 DE PORTOLA, TEMECULA, CAUSE FUR PAWS HELPING ANIMALS WITH DIABETES. Provides Temecula pet NEW APPLICANT $ 10,000 $ 7,500 INC. CA 92592 owners with financial assistance for the cost of their pet with diabetes. Funds Website:CAUSEFURPAWS.ORG will be used to pay for (1) diabetic treatment for animals ($200-600), through the Temecula veterinarian's office, or reimbursement to the Temecula pet owner with verified Temecula receipt, (2) marketing and media, and (3) Temecula promotional event/fundraising costs. Estimated number of Temecula residents to benefit: 10,000. >$5K We will have the funds to educate (create pamphlets) the community about canine diabetes and distribute to all animal hospitals, vet offices. Petco. etc. COUNCIL CSF ON N N N O O O O M .--I O N N N N o N O N O N O N > LL > LL > LL > LL 2,160 CDBG ON N N N O O O O Ql r O N N N N 0 N o N O N O N LL LL LL LL 5,538 5,491 6,970 7,226 5,538 5,491 Page 4 of 18 Legend: "-" = Applied and Not Awarded No Number = Did Not Apply COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA 13 CULTIVATING INCLUSION INC 14 DORLAND MOUNTAIN ARTS COLONY INC. SUB- COMMITTEE RECOM- MENDATION DIRECTORS��, BOARD MEMBERS OF ANY NONPROFIT ORGANIZATION $ 1,090,500 31430 Loma Linda Rd. Temecula, CULTIVATING INCLUSION. Special needs adult programs to work in a garden. TVUSD $ 7,500 $ - CA 92592-1604 special needs students with the Adult Transition Programs (ATP) & special needs adults Website: CULTIVATING are clients of Care -Rite, Toward Max Independence (TMI) (day & vocational programs). INCLUSION FARM.COM Funds will be used for: (1) the property: weed abatement, pest control, tools, starter plants, shrubs, trees, & soil, and (2) the participants: water, healthy snacks, arts & crafts, copy services, & adult coloring books. Produce is donated to local food banks, St. Vincent de Paul, Western Eagle & CMOH. Estimated number of Temecula residents to benefit: 350. >$5K In addition to promotional items, supplies, general repairs, we would like to make Cultivating Inclusion accessible to those special needs adults who have mobility issues. The request for mobility has come from teachers and parents of special needs adults. As a result, we are providing a center walk at the farm, meaning from front fence to back of fence a strip of concrete to enable all special needs adults (i.e. wheelchair) the gardening experience. PO BOX 6 Temecula, CA 92593 Website: DORLANDARTSCOLONY.COM 15 1FINE ARTS THEATER 41391 Kalmia St. #200, Murrieta, NETWORK CA 92562 16 dba FIRST TEE INLAND EMPIRE (BRIGHTON HILL ACADEMY SPORTS AND LEARNING CENTER) Website: FANTHEATER.COM 215 N. D Street, #304, San Bernardino, CA 92401 Website: FIRSTTEEINLAN DEMPIRE.ORG 17 FRED FINCH CARES 8787 Complex Dr., #300, San INC. Diego, CA 92123 Website: FREDFINCH.ORG/CARES ASSOCIATE ARTIST PROGRAM. Supports local artists with exhibits at the Merc Gallery, INEWAPPLICANT Temecula Valley Museum, and others. Funding will be used for supplies, marketing, and the Community Studio/Gallery: new flooring and utility sink, facilities/rent/insurance. Estimated number of Temecula residents to benefit: 800-1,000. PUMP UP THE VOLUME. Provide wireless mic units to Old Town Temecula Community Theater (OTTCT). Funds will purchase 24 body microphone kits which includes the elements, battery pack, transmitter, and case to house all 24 units. Estimated number of Temecula residents to benefit: 50-100 annually. >$5K the funds will complement and replace seriously outdated equipment that verges on being obsolete. It will allow new and existing programs/productions to maintain the high caliber of sound expected. The pandemic stripped us of our reserves and any ability to purchase this equipment directly. The pandemic created a situation where we feel we are at ground zero, starting all over again building audiences, networking with performers, and training young theatrical enthusiasts. FIRST TEE INLAND EMPIRE. Teaches golf and character development to children ages 5- 18 during after -school programs on local golf courses. Curriculum focuses on social and emotional learning objectives, building higher self esteem and confidence (helps to reduce juvenile delinquency, gang affiliation, crime). Funding will be used for curriculum, supplies, hats, shirts, insurance, service costs, and snacks. Additional coaches will be needed which require background checks, training and additional program expenses. Estimated number of Temecula residents to benefit: 650. >$SK FTIE lost 60% of committed funds during COVID 19 resulting in reduced staff and programming. Inflation is impacting all costs. Charles Schwab is offering to match grant funds if Chapter receives 50% more donations than year before. FTIE will receive $32,500 in 2023. Objectives: Grow participant base by 50%; increase girl participation by 15%, and BIPOC by 25%; grow coach base by 50% to reach 650 more participants while increasing diversity of staff/coach/volunteers; increase after school programming location by 35%. TEMECULA BEHAVIOR EDUCATION & SKILLS TRAINING (BEST) EQUIPMENT AND MATERIALS. The BEST program will provide 10 participants with a paid training experience that will enhance their knowledge and skills in serving children, youth and families with developmental disabilities. We are seeking to train qualified bilingual providers in the Temecula area who can deliver high quality services Funds will purchase support material and equipment costs for the training. This program is in response to a dire need for cultural and linguistic diversity in mental health care. Fred Finch CARES seeks funding to support a bilingual behavior education and skills training program in order to meet the growing need for behavioral health workers in Temecula. Estimated number of Temecula residents to benefit: 10. 1►I��i%19l�[�7_1►11 4,558 $ 5,000 50,000 $ 10,000 50,000 $ 3,960 25,000 ANNUAL CSF Cn 1 O N N N N O O O O N N N N 00 of o N e CD N 0 0 0 0 COUNCIL CSF ON O 0 o N > LL N O N O N > LL N O N O N > LL N O N o N > LL 4,000 2,500 CDBG C'4 O Ql r 0 N > LL N O O N o N > LL N O N O N > LL N O N N O N > LL Page 5 of 18 Legend: "-" = Applied and Not Awarded No Number = Did Not Apply COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA 18 GOOD SAMARITAN 32127 Camino Rabago, Temecula, TEMECULA HUNGER RELIEF PROGRAM. For Temecula residents (families & pets) with NEW APPLICANT COMMUNITY FOOD CA 92592 food insecurity. Funding will be used to purchase food, meat, grains, dairy, fresh fruits, PANTRY Website: and vegetables. We drop off exclusively to Temecula residents in need directly to their GOODSAMARITANCOMMUNITY.O doorstep weekly and biweekly. We have found that many residents do not have RG reliable transportation so delivering food and essentials directly. Estimated number of Temecula residents to benefit: 1,000. >$5K By focusing on specific areas in Temecula we can provide residents with special dietary needs and restrictions for some. Food prices have doubled and the food we drop off weekly/biweekly has to be replenished. Funds from this grant will allow us to create new ways to add more residents in need and families with special needs. We can continue "Adopt a Family" "Adopt a Senior" programs during the Holidays. In addition to food, paper goods, cleaning supplies and pet food/supplies are also provided to families in need. 19 GREEN ACRES �35750 De Portola Road, Temecula, WALK, RIDE, RUN FOR GAIT. Therapeutic riding program. Funds will be used for horse I NEW APPLICANT INTERACTIVE CA 92592 boarding, care, and feeding; safety equipment (helmets, gloves, tack); clearing the trail; THERAPY INC. Website: GAITPROGRAM.ORG and water, snacks, and t-shirts. With funding, we can open up the ranch to Temecula residents to get involved with the program that might not have the funds to participate; serves special needs, PTSD for Veterans and other public servants, and families in need of group therapy because of adoption or group home facilities. Estimated number of Temecula residents to benefit: 75 >$5K During COVID, shut down facility, laid off employees and could not secure volunteers when doors opened again; had to use extensive funds to make environment safe; dealing with rising costs of fuel, horse feed and vet care but have not raised our prices to keep it affordable; the additional funds will help expand out program from virtual to a physical event (Walk Ride, Run for Gait - Virtual, 10K or 10 Mile Walk, Ride, Run Fundraiser) that the City of Temecula can participate in. 20 HABITAT FOR 27475 Ynez Rd #390, Temecula, CA TEMECULA REAL ESTATE AND EDUCATION CENTER. Provide home -buyer orientations, HUMANITY INLAND 92591 resource fairs, financial literacy training, and counseling services to help 371 Temecula VALLEY INC Website: HABITATIV.ORG residents with affordable homeownership. Funds will be spent on the Center's facility costs, rent, utilities, liability insurance; classroom supplies; materials for the workshops, including tables & chairs, minor improvements like shelving and partitions for the educational space; and marketing materials and signage for the Center and resource fairs. Estimated number of Temecula residents to benefit: 371. >$5K COVID impacted our ReStores, which provides a substantial source of revenue used to support and launch programs. The launch of the Temecula Real Estate and Education Center is part of a broader affordable homeownership solution as we collaborate with other agencies and advocate for residents by combining resources, along with Habitat IV support, to impact the affordable homeownership crisis. The Funding would launch the Temecula Real Estate and Education Center by providing funds for facilities along with classroom materials supplies, and marketing/signage. 21 HIS LITTLE FEET INC. 3445 N. Studebaker Rd., Long NEW ATHLETIC SHOES FOR YOUTH. His Little Feet (HLF) Program will use the funds to NEW APPLICANT Beach, CA 90808 purchase over 300 pairs of shoes: 100 pairs of shoes for Rose Again Foundation, 80 pairs Website: HISLITTLEFEET.ORG of shoes for Michelle's Place, 100 pairs of shoes for Oak Grove Center, and 100 pairs of shoes for SAFE Families. Estimated number of Temecula residents to benefit: 300. >$5K Inflation has caused the price of shoes to dramatically rise, even with HLF's discounts at partner retailers, the cost of each pair is approximately $50 now compared to $35. A grant of $10K will allow HLF to grow its scope of work in Temecula, almost tripling the number of those served and support the high cost of new shoes. SUB- COMMITTEE RECOM- MENDATION $ 1,090,500 50,000 1 $ 25,000 50,000 1 $ 44,094 1 $ 10,000 1 $ 30,000 45,000 ANNUAL CSF G1 1 O N N N N O O O O N N N N 00 of o N CD 0 N 0 0 0 0 COUNCIL CSF ON O 0) 1-1 o N > LL 14 N O O N O N > LL r1i N O 14 N O N > LL N O N N O N > LL CDBG C'4 N N N O O O O M r O N 14 N N N 0 N o N O N O N > LL > LL > LL > LL 52,662.72 49,724 Page 6 of 18 Legend: "-" = Applied and Not Awarded No Number = Did Not Apply COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA SUB- COMMITTEE RECOM- MENDATION TOTAL$ BOARDDIRECTORS OR 1,090,500 22 HOSPICE OF THE 25240 Hancock Ave #120, SENIOR ASSISTANCE PROGRAM. Provides compassionate hospice to the terminally ill $ 50,000 $ 50,000 VALLEYS Murrieta, CA 92562 patients and support to their families during times when end of life is imminent. Funds Website: will be used for patient care and costs not covered by Medicare, or other insurances HOSPICEOFTHEVALLEYS.ORG including /not limited to: medication delivery services, incontinence supplies, overbed tables, medication co -pays, and mobile shower equipment. Estimated number of Temecula residents to benefit: 240. >$5K An estimated 11,639 senior citizens in the City continue to age, there is a greater need for hospice services. In order to meet this anticipated demand, Hospice of the Valleys will continue to raise funds through grants, donations, fundraisers, community support and our planned giving program. 23 INLAND VALLEY PO BOX 637, Temecula, CA 92593 SEASON OF HOPE. Focuses on providing free concert tickets to local Temecula HAS NOT APPLIED $ 50,000 $ 5,000 SYMPHONY aka Website: residents: elderly, students & their families. Funds will be used for marketing and RECEENTLY TEMECULA VALLEY TEMECULAVALLEYSYMPHONY.OR outreach materials, website improvements, payment to various musicians for SYMPHONY G participating in the program; Some music selections composed by minority or female composers and include educational elements in the presentation of materials and/or the music performance itself. Estimated number of Temecula residents to benefit: 1,056. >$SK Were it not for a couple of pandemic related relief grants received from the State and County, we would have been forced to close down our organization completely. Due to lack of funds, we were unable to resume full concert scheduling for both the last and the upcoming season. Inflationary pressures have increased most of our basic general operating expenses as well as the cost of musicians because of the higher cost of living, especially gas prices. 24 INTERNATIONAL 41745 Rider Way, Suite 2, COMMUNITY COUNSELING. For those struggling with mental and behavioral concerns, NEW APPLICANT $ 18,160 $ 15,000 CHRISTIAN Temecula, CA 92590 trauma, and grief. Funds will be used for 80 sessions (8 client/family units at an average ADOPTIONS (ICA) Website: 4ACHILD.ORG of 10 sessions per client/family unit). Most of our counseling clients/families are referred through Riverside County for Foster Care and two other sources funded by California Dept. of Social Services (Unaccompanied Refugee Minor Foster Care Program and Trafficking Victim Assistance Program). The Child Trauma and Learning Center at ICA is to offer counseling services despite a client's inability to pay and depends on funding from other State and Grant programs to support its professional services and has a deficit of over 23K. Temecula residents to benefit: 8 families at an average of 10 sessions. >$5K In hopes of receiving grant funding from the City, and in order to continue providing existing services, ICA has expanded its program to include Purchase of 4 Ipad Pros for client use. The cost of $900 per Ipad is a small cost compared to the loss of services for the family members who could not afford electronic devices or for those who may not have transportation for inhouse services. 25 JACOB'S HOUSE 31525 Jedediah Smith Road, JACOB'S HOUSE. Funds will support operational costs for Temecula 170 guests seeking $ 50,000 $ 25,000 INC. Temecula, CA 92592 refuge while caring for a loved one in the hospital. Funds will support operational Website: expenses that include: inventory, maintenance, repairs, marketing, equipment, and JACOBSHOUSETEMECULA.ORG furnishings. Estimated number of Temecula residents to benefit: 170. >$5K Occupancy in 2021 increased 102% from 2020, and 2022 is turning out to be higher and services are being readjusted to accommodate the demand. With these funds, Jacobs House will be able to meet the increased demand/expansion of services. 26 JDS CREATIVE 39870 Camden Court, Temecula, DIGIFEST. Digital media festival, conference, and fundraising event that reinvents, in $ 48,000 $ 30,000 ACADEMY CA 92591 Temecula, the International Film and Music Festival 3-day event. Funding will pay for Website: speakers, travel, hotel accommodations, social media ads, Google ads, television JDSCREATIVEACADEMY.ORG commercial airtime, billboards, and new equipment such as lighting control boards, a camera, and LED lights. Estimated number of Temecula residents to benefit: 111,985. >$5K Expand JDS Creative Academy's efforts to bring high level speakers to DigiFest Temecula, and expand the organization's marketing and advertising efforts for the event. 2020 and 2021, due to COVID, JDS Creative Academy was unable to host in - person DigiFest Temecula. This caused the organization to miss out on its largest fundraising events. JDS hopes the funding will bring back in -person attendance. COUNCIL CSF ON O Ql o N > LL N O O N O N > LL N O N O N > LL N O N N O N > LL CDBG C'4 N N N O O O O M r O N 14 N N N 0 N o N O N O N LL LLLL LL LL 5,538 5,491 7,226 Applied and Not Awarded Aln AI. - A IUnt A—k, 1- �Vlaly COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA 27 LIVE CARE FOUNDATION INC. 43460 RIDGEPARK DRIVE, SUITE TEMECULA VALLEY SUPPORT PROJECT. Will subsidize the cost of assisted care with 200-S, TEMECULA, CA 92590 $100-500 monthly grants to Temecula -based licensed, certified, professional caregiving Website: LIVE CAR EGRANTS.ORG service providers that serve Temecula seniors, disabled persons, and veterans. This financial support reduces the out-of-pocket costs for Temecula care recipients and their families for a 3-6 month period. Assisted Care Grants are typically awarded in small increments which do not exceed $500 monthly, and are awarded with 3-6 month minimum support periods. Estimated number of Temecula residents to benefit: 25-50 care recipients, 50-100 family members. >$5K During COVID, demand spiked and ifundraisers curtailed. One of our care support programs provides assistance with burial and funeral costs on needs basis which needs spiked in requests. The project will limit is support to Temecula based senior citizens, veterans, disabled persons as well as Temecula -based families who currently provide monetary support for their loved ones with assisted care needs. To clarify, while the population are the ultimate beneficiaries, they are not direct grantees. Grants are exclusively issued to certified and licensed care - giving organizations. The grants are made on behalf of the intended beneficiaries in order to reduce the amount of direct cost billed to the recipient or his/her family. MAKE -A -WISH 13230 El Camino Real #100, Irvine, FOUNDATION OF CA 92602 ORANGE COUNTY Website: OCIE.ORG INC. (Federal) MAKE -A -WISH FOUNDATION OF ORANGE COUNTY AND THE INLAND EMPIRE INC. (State) WISH GRANTING IN CITY OF TEMECULA. Expands wish granting to Riverside and San Bernardino counties. Grant Funding will be used to fund expenses directly associated with granting the waiting wishes of Temecula wish children. Currently there are 9 Temecula children with critical illnesses waiting for their wishes to be granted. Funding for this project will allow us to grant a minimum of 2 wishes for children in the City of Temecula. >$5K Over 70% of the wishes we grant involve some sort of public transportation and/or large gatherings and given the health concerns for our immuno- compromised families, many wishes were put on hold. Make A Wish OCIE is in the midst of a 5 year strategic plan to expand and grant 450 wishes per year by 2025. 29 MICHELLE'S PLACE 41669 Winchester Rd., Temecula, CANCER SUPPORT SERVICES. Providing Temecula residents facing cancer with free CANCER RESOURCE CA 92590 Website: resources including early detection and patient navigation. MP will spend funding on CENTER MICHELLESPLACE.ORG supplies for support group/class (such as art therapy, cooking classes, yoga, and caregiver grief group), chemo kits & mastectomy kits, temporary financial assistance, transportation to medical appointments, and MRI & Lymphedema supplies not covered by insurance. Estimated number of Temecula residents to benefit: 425. >$5k During pandemic, many cancer patients struggled financially. The increased need added a financial burden to Michelle's Place. Transportation to medical appointments also became a huge need but was unavailable due to restrictions on the transportation companies. Now fuel costs are creating new financial hardships. Funding will expand the current programs for Temecula residents and be able to provide more transportation, more people in classes/programs and ensure families receive financial assistance through a new Program Calendar. This funding will enhance the program experience as well as serve all who need help with cancer in Temecula. NEW APPLICANT 1► I �titl_1» � i:�1_1► � � SUB- COMMITTEE RECOM- MENDATION $ 1,090,500 50,000 1 $ 25,000 20,000 1 $ 50,000 $ 50,000 30 MILVET 30777 Rancho CA RD #892521, 1- VETERAN CLAIM ASSISTANCE. Provides help with filing for veteran claims, rate HAS NOT APPLIED $ 10,000 $ 10,000 Temecula CA 92589 increases, and survivor benefits. Funding will purchase computers, printer, ink and RECEENTLY Website: MILVET.ORG supplies. 2- VETERAN EMERGENCY FUND. Provides immediate emergency financial support to veterans in need. Funding will purchase food and gas cards. BOTH PROGRAMS: Estimated number of Temecula residents to benefit: 1,000. >$5K COVID created a massive backlog in veteran benefit claims resulting in many veterans at risk of severe poverty and homelessness; our goal is to proactively reduce disadvantages in a post COVID economy; funding will enable us to continue our programs including veteran claim assistance support and emergency assistance for those who need it most. Funding will also provide 2 new computers, a printer and much needed supplies as well as the ability to help those in emergency situations. Our programs provide critical support and resources to encourage sustainability for those who served our country. n--- Q „- o ANNUAL CSF Cn 1 O N N N N O O O O N N N N 00 of o 1-1 N CD 0 N 0 0 0 0 COUNCIL CSF ON 14 N r1i N N O O O O 0) -I O N 14 N N N o N O N O N O N > LL > LL > LL > LL 2,000 500 2,000 CDBG C'4 N N N O O O O M r O N 14 N N N 0 N o N O N O N > LL > LL > LL > LL Legend: "-" = Applied and Not Awarded AI- Alin — A Mnt A—k, COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA SUB- COMMITTEE RECOM- MENDATION TOTAL$ BOARDDIRECTORS OR 1,090,500 31 MOTHERHOOD 44731 Corte Gutierrez, Temecula, RENTAL ASSISTANCE & FINANCIAL PROGRAM. Helps with housing attainment and NEW APPLICANT $ 50,000 $ - STEPS CA 92592 sustainability. Funding will be used for rental deposits, and financial/ budgeting/ credit Website: books, paper, ink, file folders, and marketing brochures for PowerPoint class. Estimated MOTH ERHOODSTEPS.ORG number of Temecula residents to benefit: 1-15. >$5k Being awarded this grant will give us ample opportunity to assist those in financial hardships associated with housing. Our program is still in infancy stage and with proper funding we can grow into fulfilling our vision to bring stability within the community. Providing rental assistance coupled with budgeting courses is our approach to guide citizens from homelessness towards a self- sufficient lifestyle. Motherhood Steps was born in 2021 painfully evident that families faced homelessness; donations have been low only allowing us to serve families with basic needs (food, diapers). This grant will relieve recipients the burden of possibly living on the streets by helping them attain and maintain housing. 32 MY SISTER'S KEEPER 41765 Rider Way, Temecula, CA MATH GENIUS PROGRAM. Pilot math tutoring hub at TVSUD high schools that will NEW APPLICANT $ 35,000 $ SUCCESS INSTITUTE 92590 provide mentoring, tutoring, and SEL coaching Temecula students in Math. Grant INC. Website: MSKSI.COM funding will purchase training for tutors/participating teachers, coaching/curriculum materials & online curriculum, insurance, copy/printing, and meals/snacks. Estimated number of Temecula residents to benefit: 500+. >$5K We will expand our program beyond 100%virtual participation to a hybrid program with 2 community hubs at participating Temecula schools to provide online instruction and in -person mentoring/tutoring, and family support services/coaching to ensure parents are partnering with kids. COVID impacted ability to serve Temecula because of reduction in volunteer staff. Inflationary concerns exacerbate the issue; space rental prices are increasing; gas costs are prohibitive for some parents to continue with in -person programming not hosted at their child's school. 33 NATIONAL CHARITY PO BOX 891381, Temecula, CA PROJECT WARIOR BAGS. Mastectomy kits for Michelle's Place clients who have $ 4,000 $ 5,000 LEAGUE - 92589 undergone mastectomies. Funds will purchase materials to make handmade items TEMECULA Website: (heart pillows, tote bags, rice packs, drain pockets, seat belt covers) fabric, pillow filling, CHAPTER MEMBERS.NATIONALCHARITYLEA rice, Velcro, belt material, batting, paper, printing, thread, journals, pens, grippy socks, GUE.ORG Chapstick, and ribbon. Estimated number of Temecula residents to benefit: 150. 34 NAVY LEAGUE OF PO BOX 361, Temecula, CA 92593- NAVY LEAGUE NJROTC/SEA CADET SUPPORT. TVUSD Chaparral High School program NEW APPLICANT $ 50,000 $ 10,000 THE UNITED 0361 supports activities for students from TVUSD Bella Vista Middle School. These activities STATES, INLAND Website: NAVYLEAGUE.ORG for — 200 Temecula youth ages 10-18 include SeaPerch (underwater robotics) and EMPIRE COUNCIL CyberPatriot (drone/UAS). Funds will be used for drone soccer classroom bundles, SeaPerch kits & tool kits, trophies, laptops, and uniforms. Estimated number of Temecula residents to benefit: 200. <$5K COVID forced cancellation of our annual fundraiser benefit night at Europa Village, as well as other fundraising opportunities. Funds will support the founding of a Sea Cadet program in Temecula. Sea Cadet Programs is a volunteer run leadership program for teens and relies upon volunteers and donors for their uniforms and activities; the IE Council has been organizing the Southern California SeaPerch Challenge since 2016; the intent is for the 2023 competition to be housed at Chaparral High School; the IE Council also sponsors local CyberPatriot (cybers security) teams and summer camps. The funds will allow the Council to expand those offerings. ANNUAL CSF Cn 1 O N N N N O O O O N N N N 00 of o N CD 0 N 0 0 0 0 COUNCIL CSF ON O Q1 o N > LL N O O N O N > LL N O 14 N O N > LL N O N N O N > LL CDBG C'4 O Ql r 0 N > LL N O O N o N > LL N O N O N > LL N O N N O N > LL Page 9 of 18 Legend: "-" = Applied and Not Awarded No Number = Did Not Apply COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA SUB- COMMITTEE RECOM- MENDATION TOTAL$ BOARDDIRECTORS OR 1,090,500 35 NEIGHBORHOOD 1 425 N Date St, Escondido, CA NHC GREAT STARTS PROGRAM. Provides prenatal and baby health and wellness NEW APPLICANT $ 50,000 $ - HEALTHCARE 92025 education, advertising, community outreach, baby care items to needy families, and Website: NHCARE.ORG two baby wellness events adjacent to the Temecula Health Centers. Funds will purchase: 70 infant car seats, 100 playpens, 120 highchairs, 100 strollers, 150 packages of diapers (size N-3), 300 packages of wipes, 150 new mother kits, 150 welcome baby kits, promotional items, brochures, and advertising & marketing. Estimated number of Temecula residents to benefit: 500. >$5K Covid triggered unemployment caused the percentage of uninsured patients to increase in 2020 and 2021; Medicaid (Med-Cal), the primary insurance for patients was slow in determining reimbursements for telehealth visits. If funds are granted, the program will be extended; will reach out to the Temecula community with critical information related to prenatal and infant care and provide infant supplies including diapers. 36 OAK GROVE 24275 Jefferson Ave., Murrieta, CULINARY CREATIONS PROGRAM. Unique vocational program designed to build $ 50,000 $ 30,000 CENTER CA 92562 vocational and hands-on culinary experience/skills, as well as provide jobs for at -risk, Website: OAKGROVECENTER.ORG vulnerable, special needs and disabled youth and toward maximum independence (TMI) young adults through a retail store in Temecula. Funds will be spent on the operating costs of the Bakery: rent, utilities, food for preparation, marketing, mileage, supplies (baking & kitchen supplies, takeout containers, bags, etc.), and telephone expenses. Estimated number of Temecula residents to benefit: 70. >$5K We could not accomplish this in 2021 due to pandemic; raising funds for the program will help offset costs and continue an existing program serving 70 Temecula students. 37 dba PROJECT 30141 Antelope Road, D103, EMERGENCY GAS/FOOD/SHELTER. Program to help (200 homeless) reunite families $ 50,000 $ 35,000 TOUCH Menifee, CA 92584 together with funding to purchase gasoline cards, bus passes, airline tickets. Program (GOD'S FAN CLUB) Website: for homeless prevention with funding to pay for rental assistance, seek and keep PROJECTTOUCHONLINE.COM employment for self-sufficiency. Program for purchase of food, necessities, and gift cards from local grocery stores for infants, children, seniors, veterans, and diabetics. Estimated number of Temecula residents to benefit: 200. >$5k clients of Project TOUCH had increased needs (masks, cleaning supplies, food) as many fell ill with COVID; in -kind donations decreased; concerns about funding leases with higher rents or landlords not willing to lease housing to homeless; funds will assist in continuing existing programs and also providing gas cards and bus passes to either be reunited with family or keep/gain employment. 38 ROCK YOUR RED 45571 Ponderosa Court, ROCK YOUR RED. Organizes defibrillator and blood pressure training to high schools, NEW APPLICANT $ 25,000 $ 5,000 Temecula, CA 92592 community, seniors, and those with special needs. Has outreach programs teaching Website: ROCKYOURRED.INFO warning signs of heart attacks, strokes, provides Blood pressure toolkits, dietitian, fitness coach, TVH, and ADA, has annual screening & assessment event with doctors & nurses. Funding will purchase medical kits, training & education, portable AEDs, dietitian, fitness coach, meal cards for post surgery cardiovascular patients, tickets to health event. Estimated number of Temecula residents to benefit: 15-25. >$5k Due to Pandemic, we were not able to host face to face events and this funding will allow our annual event to occur which provides one on one questions/answers with cardiologist, stroke physicians, nurses; Health fair attendees for Temecula community free of charge; a new program will purchase AED units and train residents, HOAs, schools, etc., on how to use; provide screening to lower income and special needs/disadvantaged. ANNUAL CSF Cn 1 O N N N N O O O O N N N N 00 of o N e CD N 0 0 0 0 COUNCIL CSF O N 14 N r4 N N O O O O Q1 O N 14 N N N o N O N O N O N > LL > LL > LL > LL 1,000 1,000 CDBG C'4 O M r 0 N > LL N O O N o N > LL N O 14 N O N > LL N O N N O N > LL Page 10 of 18 Legend: "-" = Applied and Not Awarded No Number = Did Not Apply COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA SUB- COMMITTEE RECOM- MENDATION TOTAL$ BOARDDIRECTORS OR 1,090,500 39 ROTARY CLUB OF PO BOX 64, Temecula, CA 92593 FOOD FOR LOW-INCOME SENIORS, VETERANS, AND STUDENTS. Monthly and/or $ 30,000 $ 30,000 TEMECULA Website: during cold weather months. TRANSPORTATION ASSISTANCE FOR LOW-INCOME FOUNDATION ROTARTYOFTEMECULA.COM SENIORS to access healthcare. Funding will be used for food boxes from local agency 5k, and food from local grocery store 5k, grocery gift cards 5k, transportation vouchers, 15k (for services like GOGO Grandparents, LYFT, UBER, and bus passes). Estimated number of Temecula residents to benefit: 660. >$5K Rotary Club of Temecula began the senior supplemental food box deliveries during COVID to help low income seniors (at risk) receive food at their home; now after the pandemic seniors still need food as food is much more expensive than prior to COVID and transportation is still another challenge. Funds will expand the existing programs by providing/serving an additional 25% of low income seniors, veterans, military and TVUSD students/families with either food boxes or grocery gift cards on an annual basis. Additional funds will support transportation assistance for low-income seniors needing access to healthcare appointments. 40 SANTA ROSA PO BOX 941, Murrieta, CA 92564 PROMOTION ENVIRONMENTAL PROTECTION THROUGH EDUCATION (PEPE). Engages $ 13,000 $ 13,000 PLATEAU Website: SRPNEF.ORG TVUSD high school students in a year -long research project studying climate change and EDUCATION fire on threatened and endangered plants and animals. Funding will purchase FOUNDATION equipment and services: transportation, Pocket Labs, backpacks, intern costs (excluding salaries), journaling supplies, chrome notebooks, and binoculars. Estimated number of Temecula residents to benefit: 100. >$5K closure of the Reserve from the Tenaja Fire coupled with COVID presented hardships. Onsite classroom programs were eliminated and we saw first-hand that children learn best about nature in nature in person. This program will focus on high school students gaining knowledge of climate change working with TVUSD and in person. 41 SCORE 503 3985 University Ave., Riverside, CA ENTREPRENEUR & LEADERSHIP SERIES. Help —150 entrepreneurs in business 0-3 years NEW APPLICANT $ 50,000 $ (SERVICE CORPS OF 92501 Website: via workshops; certified mentor sessions; expert panels; and resources. Funds will be RETIRED INLANDEMPIRESCORE.ORG used on a series of workshops; start-up business training materials resource kits 15k; EXECUTIVES food for ten days 10k; water & refreshments for 10 days 2k; marketing using social ASSOCIATION) media/text services/Alliance Marketing 7.5k; specialized business -related speaker fee; and materials 10k; >$5K SCORE Inland Empire partnered with SBA to respond to businesses in need during pandemic; we are now being asked to help navigate post covid with protocols/new business norms and this has drastically made our budget swell; we will serve Temecula community via webinars and mentoring. Funds will allow us to expand our service offering to include live in -person series of workshops designed to educate and support entrepreneurs in business 0-3 years. 42 SKYROCKET 43406 Calle Carabana, Temecula, PEDIATRIC DEVELOPMENT OUTREACH PROGRAM. Increases knowledge and resources NEW APPLICANT $ 50,000 $ PEDIATRIC THERAPY CA 92592 to identify children who may benefit from developmental services and utilize services FOUNDATION Website: already available in the community. Funds will be used to promote and expand current SKYROCKETTHERAPY.ORG outreach program by purchasing professional design and printing services (for brochures, flyers, signs, etc.), search engine optimization, targeted advertising on social media, educational in -services, equipment & supplies for in -services, and consultation costs. Estimated number of Temecula residents to benefit: 25,000 families. >$5k Skyrocket incorporated in 2021 and was not impacted by COVID; the grant will allow Skyrocket to expand the current capacity and reach of Pediatric Development Outreach Program. Since inception in June 2022, the Pediatric Outreach Program has been met by high demand beyond our capacity of volunteers. Grant funding would allow for expansion of current program to meet growing demand. COUNCIL CSF ON N N N O O O O M O N N N N o N O N O N o N > LL > LL > LL > LL 1,000 3,500 - CDBG ON O M r 0 N > LL N O O N o N > LL N O 14 N O N > LL N O N N O N > LL Page 11 of 18 Legend: "-" = Applied and Not Awarded No Number = Did Not Apply COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA x Z a NAME OF ADDRESS TO MAIL CHECK PROGRAM/PROJECT DESCRIPTION REQUESTED Li Nonprofits located outside Temecula NOTES J ORGANIZATION can still serve Temecula residents. can $ a „ � ri 43 SMILES BY ANGELS 42248 Via Nortada, Temecula, CA TEMECULA SMILES. Strengthen and expand relationships with Oak Grove, public FOUNDATION 92590 schools, Koinonia Family Services, Brandywood Foundation, youth of disadvantaged families, foster care, USA armed forces youth, and at -risk youth. Funding will be spent on buying 10,000 books (focused on skill development, community enhancement, self- improvement, diversity, etc.), clothing/food/entertainment for disadvantaged and at - risk students, internships, mentors, curriculum, and tutors. >$5k We moved to Temecula from LA in 2021; COVID impacted our ability to raise funds through events and other types of campaigns; inflation is limiting cash flow; this grant will help us create new programs and partnerships with local organizations for ongoing programs. NEW APPLICANT 44 SOUTHWEST 41145 Eagelmann Oak Street, EMPOWERING YOUNG WOMEN - FIND YOUR VOICE THROUGH SONG. Community NEW APPLICANT WOMEN'S CHORUS Murrieta, CA 92562 Event teaches three songs (middle and high school students and beyond); a one -day Website: seminar of three songs culminating in a performance at the Old Town Community SOUTHWESTWOMENSCHORUS.OR Theater. Funds will be used for rental of seminar venue, sheet music, meals, t-shirts, G accompanist, office supplies, and publicity. Estimated number of Temecula residents to benefit: 30-50. 45 SPECIAL OLYMPICS 41880 Kalmia St. #140, Murrieta, SPECIAL OLYMPICS SO. CAL TEMECULA. Cover facility rental fees, athlete uniforms, and SOUTHERN CA CA 92562 equipment for basketball, bocce, and flag football. Estimated number of Temecula INLAND EMPIRE residents to benefit: 90. 46 SPEECH & 43385 Business Park Drive #140, DEVELOPMENTAL SCREENINGS / THERAPIES. 80 children from low income families to LANGUAGE Temecula, CA 92590 receive developmental assessments, social skills classes, behavioral counseling and DEVELOPMENT Website: SLDC.NET intervention. Funds will be spent on assessments, screenings, and rent. Virtually all of CENTER INC. the assessment and session costs are to pay licensed teachers and therapists; there is a lack of these services in Temecula. Through our research, we found that families needing these services had to travel 40 miles; we'll deliver in Temecula. Estimated number of Temecula residents to benefit: 80. >$5K we launched Stage 1 of our program in Dec. 2021. The virus impacted us financially and in our physical environment and there is an even greater need for services. The program is now in Stage 2 and SLDC has committed to building out its services in the Temecula Valley over the next 3 years. We look to continue to provide speech, language/behavior services and also provide occupational/physical/mental/family therapy. 47 SPERO VINEYARDS 2076 Lincoln Ave., Pasadena, CA SPERO VINEYARDS. Provides instruction and meaningful workforce development and INC. 91103 training for young adults with disabilities interested in careers in Temecula's wine and hospitality industry including history, science, hospitality, business/marketing, and agriculture aspects of the wine making business. Funds will be used to purchase equipment, and expand curriculum beyond the essential elements of viticulture and hospitality. Estimated number of Temecula residents to benefit: 15-30+. >$5K The pandemic displaced a significant portion of our volunteer and donor base; rising fuel, water and vineyard management costs threaten the program; the wine lab curriculum will expand necessary training opportunities and allow us to offer next level skill training Ito students. 48 dba TEDX TEMECULA - INLAND VALLEY BUSINESS & COMMUNITY FOUNDATION 40497 Winsor Road, Temecula, CA TEDX TEMECULA. Local TEDx event in Old Town where public speakers give talks that 92591 have received over 2 million views. Funds will be used to pay for lunch, printing Website: TEDXTEMECULA.COM (program & other promotion), table and chair rental for theater courtyard, and video production. NEW APPLICANT $ 1,090,500 50,000 1 $ 5,000 I $ $ 5,000 $ $ 10,000 $ N 37,100 1 $ 5,000 1 $ 5,000 5,000 5,000 37,000 5,000 COUNCIL CSF ON O -I O } LL N O ON O } LL N O N O } LL N O N O } LL 1,000 CDBG C'4 O O N } LL N O ON O N } LL N O N O N } LL N O N O N } LL [Legend] "-" = Applied and N t Awarde Page 12 of 18 No Number = Did Not Apply COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA SUB- COMMITTEE RECOM- MENDATION TOTAL$ BOARDDIRECTORS OR 1,090,500 49 TEMECULA PLAY 42690 Margarita Rd., Temecula, PALS BUDGET RELIEF. Co-op preschool for children ages 3-5 at Temecula United NEW APPLICANT $ 50,000 $ - AND LEARN CA 92592 Methodist Church. Funds will be invested in learning materials, educational toys, school SCHOOL INC. (PALS) Website: TEMECULAPALS.ORG supplies, parent training, update worn down furniture, office equipment, field trips, school events, and new playground equipment including a new sandbox and a new shade cover. Estimated number of Temecula residents to benefit: 30 families. >$5K Enrollment declined during pandemic but have increased again; as a nonprofit we rely on tuition, fundraising, personal donations and community support. This funding will support continuation of a safe environment, quality school supplies, equipment, furniture, field trip experiences, special events and educational opportunities. 50 TEMECULA SUNRISE PO BOX 2203 Temecula, CA 92590 CHRISTMAS DINNER. Funding will be used to purchase dinner -related equipment and $ 15,000 $ 15,000 ROTARY supplies including cargo trailer, oven, restaurant -quality pots/pans/utensils, and food. FOUNDATION This year's 2022 dinner will be at the MSJC Cafeteria (since Mary Phillips Senior Center is under construction). There are many Temecula families that depend on the Temecula Community Christmas Dinner. Estimated number of Temecula residents to benefit: 1,200. >$5K In early 2022, our 28 foot cargo trailer with all our equipment was stolen and we need to replace it with the oven, restaurant quality pots, pans and utensils. We need to purchase food and supplies. Estimate cost for all of this is approximately $42K. COVID restricted our ability to hold sit down dinners in 2020 and full capacity dinner in 2021; Now 2022 inflation has significantly increased the cost of food and supplies for this event. Grant will allow us to purchase necessary equipment to continue this event and provide food and supplies for the 2022 dinner. 51 TEMECULA 42051 Main Street, Temecula, CA ARTS CONNECTION NEW WORKS. Supports and expands outreach offering K-12 NEW APPLICANT $ 50,000 $ 50,000 THEATER 92590 Temecula students opportunities to experience theatrical productions/see live FOUNDATION Website: performances (multi -cultural productions in dance, music, plays, musicals) for free. TEMECULATHEATERFOUNDATION. Additionally, students will see work in its unfinished phase and be part of the process ORG through discussion, essay critique, and visual appreciation. Funds will be used for expenses including payment to presenting organizations, artists, curriculum materials for the teachers, and in-house production costs. Estimated number of Temecula residents to benefit: 4,000+ annually. >$5K March 2020-Sept. 2022 we have been unable to offer programs to our youth due to school's guidelines of social distancing. We are starting the program again, now that those restrictions have been lifted. Additionally, we have been unable to do annual fundraising or galas due to COVID; the addition of funds will supplement our currently depleted reserves, allow us to bring in more students, and create our New Works program. 52 TEMECULA VALLEY 27470 Commerce Center Dr. C, TV ALANO CLUB. Guides and supports coming out of rehabilitation centers for drugs or NEW APPLICANT $ 50,000 $ 5,000 ALANO CLUB Temecula, CA 92590 alcoholism. Funding will be used on rent for the facility, 12-step books, information pamphlets, workbooks, new coffee bar, new tables & chairs for the meeting hall used for 12-step meetings, pool table for fundraising events, cable & internet, couches, and tables. Estimated number of Temecula residents to benefit: 1,200-1,300. >$5K Most funding came from donations which decreased during COVID; and restrictions lessened the amount of people who could meet so members relapsed; costs of all supplies and utilities have increased. This funding would allow a new fundraising event and continuing to provide literature, books, outreach to those involved in the 12-step ANNUAL CSF Cn 1 O N N N N O O O O N N N N 00 of o N CD 0 N 0 0 0 0 COUNCIL CSF ON O Q1 o N > LL N O O N O N > LL N O 14 N O N > LL N O N N O N > LL CDBG C'4 O Ql r 0 N > LL N O O N o N > LL N O N O N > LL N O N N O N > LL Page 13 of 18 Legend: "-" = Applied and Not Awarded No Number = Did Not Apply COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA 53 TEMECULA VALLEY 28780 Old Town Front St., C1, TEMECULA BAND PROJECT. This is an expansion of the Temecula String Project and CONSERVATORY OF Temecula, CA 92593 offers free band class to 5th grade students at 2 TVUSD elementary schools during non - THE ARTS school hours, and open to all students. Funds will be used to purchase band instruments (7 flutes, 7 clarinets, 7 saxophones, 7 trumpets, 2 trombones) and to rent climate - controlled storage space to store instruments during the summer months when not in use. Estimated number of Temecula residents to benefit: 40 students/year. >$5K Pandemic prevented TVCA from conducting in -person events/fundraisers which reduced revenue for 2 years; also restricted TVCA's ability to do string classes in -person. TVCA will purchase new instruments for the beginning band program which is an expansion of the instrumental music program which has been a string program for the past 5 years. These instruments are expected to last many years. The 5-year goal is to make the 5th grade instrumental music program more equitable by offering either strings or band at every elementary school in the district. 54 TVHS GOLDEN BEAR PO BOX 892072, Temecula, CA AMPLIFY - CELEBRATION OF BLACK HISTORY. Inaugural attempt to bring FOUNDATION 92589-2072 students/families/community member to learn first person account stories from those who rode on the busses that we now refer to as the "The Freedom Riders." An organization from San Diego has artifacts, exhibit featuring a life-size replica of the bus, and a father -and -son -team to speak about their experiences. The 2nd night we hear from Director of Alabama Tourism/author/expert on The Road to Birmingham Lee Sentell. Each night will have music, poetry, reading, dancing, and re-enactments. Funds will be spent on: "The Buses are Coming" exhibit (10k), African drum dancers from Los Angeles (2k), Lee Sentell from Director of Alabama (500), A Poetic Tribute to the Freedom Riders" (500), David Dennis Sr. & Jr. speakers (3k), flights, housing, food for guest speakers (1,750), workshop for 10-12 graders by Miss Misipeka (1.5k). Estimated number of Temecula residents to benefit: 2,000 students/800 community. >$5K Pandemic info N/A. This will be the 1st year TVHS has attempted to host a Black History Celebration that is intentionally serving students and the community. The aim is to charge community members a minimal fee to access the evening programs so the program can expand and aim toward self-sufficiency. The aim is to continue this program year-to-year and have students and the community grow value and respect the contributions and sacrifices to the black community. 55 'TEMECULA VALLEY PO BOX 1293. Temecula, CA 92593 TEMECULA TALENT REVIVED. Funding will be spent on advertising/outreach, NEW APPLICANT PLAYHOUSE dba production costs, sound and lighting design, Penske truck rentals, furniture, costumes, TEMECULA VALLEY set items (lumber, paint, brushes, rollers, nails, screws, casters, etc.), set decorating PLAYERS items, batteries (for microphones), props, costumes, microphone rentals, dry ice machine and dry ice, rehearsal space, and other rental equipment. Estimated number of (Temecula residents to benefit: 2,500 based on attendance, business, creative team, actors. >$5K TVP completely shut down 3/20 — 8/21 during the pandemic. The remaining show for the 19/20 season were canceled and all 5 productions for the 20/21 season were canceled. Revenue comes predominately from ticket sales and the financial loss was devastating, reduced from a 190k average to $17,881. To remain solvent, TVP closed the warehouse and rented local storage for items required in future productions. Warehouse inventory was donated or stored at private residences of Board Members. TVP is applying for >$5K to create the project "Temecula Talent Revived!" TVP will actively cultivate partners during this time for advertising, fundraising, and other grant opportunities in order to sustain the project after grant funding has ended. Temecula actors will learn from industry professionals/quality theatre performers, providing intensive instruction in all areas of theatre including direction, musical direction, choreography (and receive feedback on acting, vocal and dance capabilities). SUB- COMMITTEE RECOM- MENDATION $ 1,090,500 27,000 1 $ 27,000 10,000 1 $ 47,000 1 $ 5,000 30,000 ANNUAL CSF Cn 1 O N N N N O O O O N N N N 00 of o N CD 0 N 0 0 0 0 COUNCIL CSF O N 14 N r4 N N O O O O 0) -I O N 14 N N N o N O N O N O N > LL > LL > LL > LL 1,000 CDBG C'4 O N O N O N O M r 0 N O N o N 14 N O N N N O N > LL > LL > LL > LL Page 14 of 18 Legend: "-" = Applied and Not Awarded No Number = Did Not Apply COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA 56 'TEMECULA VALLEY 'PO BOX 890367, Temecula, CA 1- PEACE AND FRIENDSHIP GARDEN. Six peace poles with a message: May Peace ROSE SOCIETY Website: Prevail on Earth" in 42 languages. An effort bean in 1955 by a Japanese philosopher TEMECULAVALLEYROSESOCIETY.O after WW2. The message is on each pole. Funds will be used for rose bushes, mulch, RG construction of pathways with maintenance, irrigation system & Equipment with maintenance, 6 peace poles with shipping, addition of 42 languages plus a Braille plaque, display case to recognize donors. 2 - GARDEN GAZEBO REPLACEMENT. For structure after 25 years of deterioration. Funds will be used for a gazebo unit, shipping, and installation. BOTH PROGRAMS - Estimated number of Temecula residents to benefit: 1,500. >$5K COVID involvement changed everything. Meetings and activities for both adults and children shut down. Outdoor meetings were attempted with little participation. Annual dues were not collected in 2021 resulting in a loss of revenue and membership interest. 1- PEACE AND FRIENDSHIP GARDEN was initiated in 2020. It will need constant maintenance by volunteers. 2 - GARDEN GAZEBO REPLACEMENT. The original decorative garden gazebo was installed about 25 years ago. It now needs to be replaced due to deterioration, as simple repair is not possible. This unit is important for income, is it is rented for family events, weddings, proposals, and is one of the main attractions for visitors on a hill for a spectacular view. 57 GFWC TEMECULA PO BOX 1056, Temecula, CA 92593 FUNDRAISER CANCELLATION COMPENSATION PROJECT. will increase membership and VALLEY WOMAN'S Website: TVWC.COM fundraising capabilities to host larger fundraisers, increase volunteering, contributing, CLUB and donating to the community. Funding would pay for operational costs of monthly meetings, fundraising events, membership engagement, public relations and local non- profit projects. Funding will be used for the HOME TOUR FUNDRAISER such as homemade soup/gourmet food/bakery supplies, waste management rentals, van rentals, traffic control rentals, print advertising, brochure printing, ticket & poster printing, catering, rentals (table & chair, portable toilet facility, venue), insurance fees, licenses, and permit costs. Estimated number of Temecula residents to benefit: 250,000. [to double-check; Temecula population—110K). >$5K At the end of 2019 TVWC had 120 members. In 2022, membership has declined to 80 members. The decreased membership reduced the number of charities supported, dollars donated, and hours volunteered to the community. This grant would assist TVWC in increasing membership and paying for fundraising costs to get back to pre -pandemic membership and return TVWC's contribution to the community to the higher level again. 58 THE 27262 Via Industria, Temecula, CA YOUTH MENTAL HEALTH COMMUNITY HEALTH WORKER PROGRAM. The EMPOWERMENT 92592 Empowerment Center's Mission is to help youth and families develop the resilience CENTER Website: THEEMPOWERMENT necessary to overcome challenges, discover the best of themselves and create healthier, CENTERINTL.COM happier patterns of living. An innovative approach to providing peer -to -peer mental health support for Temecula's youth. Grant funds will be used to cover the cost of mental health training, curriculum materials, and program participation incentives including meal provision for evening and weekend trainings and gift cards. Estimated number of Temecula residents to benefit: 100. >$5K The COVID-19 pandemic allowed the TEC to pivot services to virtual platforms, removing the barriers to attendance. Although TEC shut the doors to in -person programming, the pandemic allowed TEC to reach the most youth and families that have been reached in the last 5 years. The pivot has allowed TEC to expand service across the county, state, and country. The grant funds will create new programming. TEC has been invited by the California Workforce Development Board to provide Mental Health Worker training and employment preparation services to the adult workforce. It is TEC's goal to provide youth with the same opportunities through this Youth Mental Health Worker Project. SUB- COMMITTEE RECOM- MENDATION $ 1,090,500 50,000 1 $ 10,000 50,000 1 $ 50,000 $ 25,000 25,000 ANNUAL CSF Cn 1 O N N N N O O O O N N N N 00 of o 1-1 N CD 0 N 0 0 0 0 COUNCIL CSF ON O 14 N O r1i N O N O 0) -I o N O N O N 14 N O N N N O N > LL > LL > LL > LL CDBG C'4 O N O N O N O M r O N 14 N N N 0 N o N O N O N > LL > LL > LL > LL Legend] "-" = Apollied and N t Awarde Page 15 of 18 No Number = Did Not Apply COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA 59a THE SALVATION ARMY -1OF2 APPLICATIONS 59L THE SALVATION ARMY -2OF2 APPLICATIONS 60 THE SHELLA FOUNDATION 40270 Los Alamos Rd., Murrieta, 'TEMECULA CHILD SPREE. Back -to -school event gives school aged children books a NEW APPLICANT CA 92562 breakfast and the opportunity to pick out $125 worth of new clothes, shoes, backpacks, Website: i and school supplies. Funding will assist with August 2022 & August 2023 expenses MURRIETA.SALVATIONARMY.ORG —$25/child for school supplies, $125 JC Penny gift cards (spent on the day of the spree). Targeted recipients are children (in low income families) living in the City of Temecula . Estimated number of Temecula residents to benefit: 90. >$5K Over the course of the COVID-19 pandemic TSA was called upon to serve significantly higher numbers of people with food, clothing and financial assistance more than any other time in its 25 years in SW Riverside County. While service needs, and as a result, program expenses increased dramatically, private donations have begun to decrease, combined with inflation (food & fuel), TSA has been challenged in operating its programs. The pandemic further affected the ability to utilize volunteers in carrying out programs, including Child Spree, which now have parents shopping with their children instead of volunteers. With the requested funding, the number of Temecula children served will increase the annual average of 15-50 (and overall total of 200 to 250 each year). The Child Spree will be the 25th year in 2023 and anticipate a big event with news coverage and more participation from Temecula children. 40270 Los Alamos Rd., Murrieta, TEMECULA HOMELESS PREVENTION. Provides up to 2 months of rental assistance, paid NEW APPLICANT CA 92562 directly to landlords (rental property owners and/or management companies) on behalf Website: of Temecula residents with past -due rent, experiencing financial crisis and are set for MURRIETA.SALVATIONARMY.ORG eviction, thus preventing homelessness. Estimated number of Temecula residents to benefit: 42. >$5K Over the course of the COVID-19 pandemic TSA was called upon to serve significantly higher numbers of people with food, clothing and financial assistance more than any other time in its 25 years in SW Riverside County. While service needs, and as a result, program expenses increased dramatically, private donations have begun to decrease, combined with inflation (food & fuel), TSA has been challenged in operating its programs. Funding will allow the homeless prevention program to expand from serving —18 Temecula residents annually to 42 residents during the proposed program term. PO BOX 263, Menifee, CA 92586 Website: SHELLAFOUNDATION.ORG IN -HOME PERSONAL CARE RESPITE SCHOLARSHIP. Helps those requiring care either NEW APPLICANT diagnosed at birth with disabilities or have been in an accident that caused a disability, or are senior citizens who cannot care for themselves. Funds will be used to provide —70 families with 24 hours of in -home personal care and respite support to Temecula families. Estimated number of Temecula residents to benefit: 70. >$5K The Shella Foundation receives 100% from donations. The pandemic prevented holding fundraising events due to lockdowns and social distancing. This also prevented providing in -home care. The monies used form this grant will be used to continue an existing program, providing in -home personal care respite reserved exclusively for Temecula populations, and awarding personal care scholarships to those that qualify. SUB- COMMITTEE RECOM- MENDATION $ 1,090,500 13,500 1 $ 23,500 36,500 1 $ 50,000 1 $ 20,000 5,000 ANNUAL CSF 01 1 O N N N N O O O O N N N N 00 of o N CD 0 N 0 0 0 0 COUNCIL CSF ON O N O N O N O 0) -I o N O N O N 14 N O N N N O N > LL > LL > LL > LL CDBG C'4 O N O N O N O M r 0 N O N o N 14 N O N N N O N > LL > LL > LL > LL Page 16 of 18 Legend: "-" = Applied and Not Awarded No Number = Did Not Apply COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA 61 'THE TEMECULA VALLEY MASTER CHORALE 62 THESSALONIKA PO BOX 890204, Temecula, CA MASTER CHORALE SEASON 22-23. Provides concerts through collaboration with I NEW APPLICANT 92589-0204 Temecula schools and businesses. Funding will be spent on concert venues, competition Website: venues, musical score purchases, program and flyer printing, independent contract TEMECUALVALLEYMASTERCHORA instrumentalists, food, and vendors. Estimated number of Temecula residents to LE.ORG benefit: 500. >$5K When the COVID-19 quarantine first started the season was cut short and not able to have the final concert. The next season had some members patriciate online practices with limited you tube video performance (no public performances). Last season (Sept 2021-April 2022) Master Chorale, with less members returning, practiced with masks, and had outdoor concerts. Fundraising activities were also limited. Grant funds would expand Master Chorale's opportunities to reach more of the Temecula community through involvement in choir, in audience capacity or as vendor of venues, supplies, or services. This creates an opportunity to collaborate with Temecula school choirs (public and private) and orchestras and their families. The dream is to eventually host a fine arts festival at the Community Recreation Center that would include school choirs, orchestras, and local vendors. 38950 Mesa Road, Temecula, CA FAMILY SERVICES 92592-8753 63 VETERANS SUPPLEMENTAL SUPPORT NETWORK (VSSN) Website: INFO@CMOH.NET CMOH FOOD PROGRAMS. Maintains food distribution warehouse and upkeep equipment to provide local food distribution services, paying drivers, rental fees for food delivery vans, workshop supplies, supplemental food items, and volunteer training costs [no salaries]. CMOH HOUSING is a residential program for homeless single mothers and their young children. Funds will be spent on capital expenditures [possibly; City needs more details] to improve classroom and childcare spaces at Empowerment Village - a residential program for homeless single mothers and their young children. Estimated number of Temecula residents to benefit: 2,000. >$5K Exacerbated by the pandemic, CMOH clients continue to face difficulty paying for basic needs. Today, more families than ever before are turning to CMOH. This increase in demand coupled with rising costs, necessitates that CMOH needs more funding to serve the community. Funding will allow CMOH to continue the Food Pantry and Housing Programs. CMOH annually spends over 2,700,000 on program costs, funded primarily though the generosity of the philanthropic community and in -kind donations. $50K in support from the City of Temecula will allow CMOH to continue its food pantry and housing programs. 41593 Winchester Rd #200, STOMPING THE STIGMA VETERAN OUTREACH. Hosts military and veteran family Temecula, CA 92590 outreach resource events to include annual Winter Wonderland, Cards for Vets, Daisy Website: VETSUPPORTNET.ORG Monument Walk, and the Hiring and Volunteer Fair. Funding will be used for storage unit rental space—$1800, equipment rental for events (tables, chairs, linen, canopies, sandbags, pipes, drapes) averaging—$6800, postcards printing & distributing (Cards for Vets)—$1400. Estimated number of Temecula residents to benefit: 11,698. >$5K When the COVID-19 pandemic hit, VSSN sprung into action to provide vital services including food deliveries, virtual mental health readjustment, suicide prevention case management, and resource and referrals. Core outreach events, which fuel the service delivery, were halted due to safety and budget restrictions; however, many volunteers continued to play key roles in regular services, including pandemic -related ones: vaccine education, without adequate funding. Since the pandemic VSSN experienced a 33% increase in demand. The rising inflation is continually impacting in -kind and monetary donations. Funds will help cover the costs of VSSN's well -attended outreach events and increasing warehouse storage fees. SUB- COMMITTEE RECOM- MENDATION $ 1,090,500 22,000 1 $ 50,000 $ 10,000 1 $ 50,000 10,000 ANNUAL CSF Cn 1 O N N N N O O O O N N N N 00 of o 1-1 N CD 0 N 0 0 0 0 COUNCIL CSF ON 14 N r1i N N O O O O 0) -I O N 14 N N N o N O N O N O N > LL > LL > LL > LL 2,000 CDBG C'4 O N O N O N O M r 0 N O N o N 14 N O N N N O N > LL > LL > LL > LL Page 17 of 18 Legend: "-" = Applied and Not Awarded No Number = Did Not Apply COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA SUB- COMMITTEE RECOM- MENDATION TOTAL$ 1,090,500 BOARDDIRECTORS OR 64 WESTERN EAGLE 40940 County Center Drive, FOOD BOXES. For-220 Temecula residents/month filled with staples: canned NEW APPLICANT $ 50,000 $ 50,000 FOUNDATION Temecula, CA 92591 vegetables and fruits, dry pasta and rice, cereals, spaghetti sauce, dried beans, soups, peanut butter, tostada shells, and packaged dinners. At an operational cost of $25/box times 220 Temecula residents take advantage of the food box a month. $5,500 per month. Annual Cost is $66K. Estimated number of Temecula residents to benefit: 2,640. >$5K COVID-19 affected Western Eagle's ability to get donated food from growers, farmers, and suppliers. Inventory and overflow of food was down; there was a lot of competition for donated food from other food banks ad transportation was costly and not always on schedule. Suppliers began charging for their overstock rather than just giving it away as they did before the pandemic. Western Eagle began buying more "staples" for the food box program and the store. This has caused an increase in operating and program expenses. Inflation has caused Western Eagle to let go of the truck driver, due to high cost of gasoline and employee retention. Western Eagle now uses a transportation service to pick up food and goods from suppliers, which causes delay in getting food picked up and brought back to the Western Eagle store. 65 WISHERS AND 31915 Rancho California Ro 200- VOLUNTEER SEWING EVENTS. Donates gowns to local hospitals. Funds will be used to NEW APPLICANT MUST $ 51000 $ DREAMERS INC 407, Temecula, CA 92591 purchase fabric and supplies including (not limited to) scissors, thread, packaging ONLY SERVE TEMECULA Website: WISHERSAND materials, postage, shipping, and sewing machines. Hosts in -person sewing events in ONLY MEDICAL DREAMERS.ORG the City of Temecula several times a year. Volunteers make and package hundreds of OFFICES/HOSPITALS FOR gowns donated to children and hospitals. The gowns from this grant will be earmarked THE BENEFIT OF TEMECULA to be donated to our local medical community including but not limited to LLUMC, CITIZENS Rady's Children, Temecula Valley Hospital, SW Healthcare System and local pediatric doctors and surgical centers Estimated number of Temecula residents to benefit: 1,000. 66 I WOMEN PO BOX 1382, Temecula, CA THE LYDIA PROJECT. Designed to educate, equip, and prepare young women to become self- NEW APPLICANT $ 50,000 $ 5,000 ORGANIZING 92593 reliant and/or self-employed. Learn strategies necessary for becoming successful business WOMEN INC Webslte: owners. Aid women in overcoming barriers/codependency on welfare systems; life coaching to become self-sufficient WOMENORGANIZINGWOMENINC. THE MOBILE KITCHEN SOCIAL ENTERPRISE. Break generational cycle of poverty. The Mobile ORG Kitchen is a food truck that is used to bring awareness, resources, tools and support. Food truck that provides revenues to fund local philanthropic missions (mission: evangelical outreach, mentoring/coaching, support for women & children). Funds will be spent on a commercial refrigerator —$2k, double deck commercial oven, commercial fryer, compartment sink —$700, freshwater tank —$200, grey water tank —$350, generator,—$1500, hand sink —$500, burner countertop range —$1k, burner griddle top —$250, countertop with backsplash —4k, pantry shelves—$2100, electric water heater—$1400, propane cylinder —$200, service window—$1500, hood with fan /fire suppression system—$5500, rear door—$1300, engineering & state licenses —$6500, storage fees for 1 year—$3k, maintenance supplies (pots &pans) and gas —$800. Estimated number of Temecula residents to benefit: 8,144 annually. >$5K Faith -based nonprofit that does not discriminate based on another belief system. Food insecurities are real. Project will create jobs, establish business partnerships, inspire entrepreneurs, work alongside other nonprofits, secure foods sources to local families. COVID-19 affected WOW's ability to serve the Temecula community based on the fear of the pandemic to interact with the public. Although not able to have annual fundraising events, WOW stayed diligent in praying for those grieving and suffering form depression, provided grief counselling, and connected virtually through social media outlets. WOW was able to give 2 grants (for $500 each) in 2021. Community inflationary concerns impact the small business owner and nonprofit organization from receiving business or $20 donations towards an organization mission initiative. The project will be one vehicle in providing a food source to families, income to small business, and donations to nonprofit organizations. TOTAL I I I $ 2,278,372 1 $ 1,090,500 ANNUAL CSF Cn 1 O N N N N O O O O N N N N 00 of o 1-1 N CD 0 N 0 0 0 0 COUNCIL CSF ON O N O N O N O Q1 o N O N O N 14 N O N N N O N > LL > LL > LL > LL CDBG C'4 O N O N O N O Q� r 0 N O N o N N O N N N O N > LL > LL > LL > LL Page 18 of 18 Legend: "-" = Applied and Not Awarded No Number = Did Not Apply FY 2022/2023 COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA GRANT APPLICATION # la A PLACE FOR ALL PIECES (A: YOUTH BASKETBALL) CITY OF TFAMECUTA FISCAL YEAR 2022 - 2023 COMMUNITY SERVICE FUNDING - REINVESTMENT IN TEMECULA PROGRAM APPLICATION (Please Print or Type) DUE ON OR BEFORE: MONDAY, SEPTEMBER 12, 2022 L__ PROJECT/PROGRAM INFORMATION Amount Requested: $ 5,000 MAXIMUM ALLOWABLE: $50,000 PER ORGANIZATION Project/Program Title: TEMECULA YOUTH BASKETBALL CHAMPIONS Start Date: 12I0122 End Date: 2111123 Physical Address of Project/Program: TO BE DETERMINED (PREVIOUS LOCATION WAS TEMECULA CRC INCLUDE IF DIFFERENT THAN ORGANIZATION'S MAILING ADDRESS If Grant is Awarded, Make Check Payable to: A PLACE FOR ALL PIECES Mailing Address: 27880 CLINTON KEITH RD, SUITED 0151 MURRIETA, CA 82562 IORGANIZATION AND GEOGRAPHIC AREA SERVED Name of Applicant A PLACE FOR ALL PIECES Organization: Website: aplaceforallpleces.org Number of Paid Staff: 0 Year Founded: 2013 Social Media: FACEBOOK, INSTAGRAM Number of Volunteers: 30+ Geographic Area(s) the Organization Serves: TEMECULA VALLEY Geographic Area(s) the Project/Program Serves: TEMECULA VALLEY NOTE: COMMUNITY SERVICE FUNDING GRANT PROGRAM FUNDING MUST BE EXCLUSIVELY USED TO SERVE TEMECULA. Contact Name: _ IVY KIRSHBERG _ Title/Position: PRESIDENT Contact Person's Direct Telephone: 714 724 1010 Contact Person's Email: ikirshberg@yahoo.com NONPROFIT STATUS Is this organization incorporated as a nonprofit? Yes K] Date of Incorporation as a Nonprofit: "1212013 No ❑ IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING Federal Identification Number: 46-2012269 State Identification Number: 3646151 PRINT OUT AND ATTACH TO THIS APPLICATION VERIFICATION FROM FEDERAL (IRS) AND STATE (FTB) AS FOLLOWS: 1. ❑ Attach IRS Deductibility Status using this link: littpllapps.ii-s.gov/apr)/eosi 2. ❑ Attach State Entity Status Letter using this link: Iit[PS:l/www ftb.ca.gQ%/online/self serve entity status letter/index.asp 3. ❑ Attach first page only of most recent IRS Form 990 or attach print out of detailed info about your charity found on this State Registry's Search Tool h tp./Irct__d6 ca.goylVeri€ication/Web/Search_aspx?[aciliiv Y City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 5 of 13 APPLICATION AUTHORIZATION Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over $500 including any business transactions, negotiations, investments, or interests in real property with a Temecula City Council Member during the past 12 months? No © Yes ❑ IF YES, BRIEFLY DESCRIBE: Is a Temecula City Council Member a member of the Board of Directors or an Officer of the organization? No 0 Yes ❑ IF YES, PROVIDE COUNCIL MEMBER'S NAME AND TITLE WITHIN THE ORGANIZATION: This Application has been authorized by the organization's: Executive Committee 0 Board of Directors ❑ Members -at -Large ❑ MISSION STATEMENT OF ORGANIZATION BRIEFLY DESCRIBE THE ORGANIZATION'S MISSION/GOALS AND OBJECTIVES. A Place for All Pieces fosters a community of empowered children and adults. Our goal is to Increase the quality of life for people on the spectrum. By providing opportunities for social motivation, initiations, and peer to peer interaction. FINANCIAL STATEMENTS UPON REQUEST, COPIES OF THE ORGANIZATION'S CURRENT BUDGET/FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT), AND IF AVAILABLE CPA'S AUDIT, MAY BE NEEDED UPON REQUEST TO DEMONSTRATE SOUND FINANCIAL MANAGEMENT. DO NOT SUBMIT NOW. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 6 of 13 FUNDING SOURCES CITY OF TEMECULA—SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM THE CITY FOR ANY PROGRAM? No 0 Yes ❑ IF YES, PROVIDE BELOW. NAME OF PROGRAM/PROJECT y AMOUNT MONTH + YEAR NAME OF CITY GRANT FUNDED BY THE CITY GRANT OR SPONSORSHIP FUNDING RECEIVED OR SPONSORSHIP $ $ I $ J $ I OTHER OUTSIDE SOURCES —SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM ENTITIES (NOT INCLUDING THE CITY) FOR THE SAME PROJECTIPROGRAM IN THIS APPLICATION? No [X] Yes ❑ IF YES, PROVIDE INFORMATION IN TABLE BELOW. AMOUNT J f r' MONTH 'YEAR o�^ 1 .-��„�., NAME OF ENITY J City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 7 of 13 GRANT PROJECT/PROGRAM DESCRIPTION IMPORTANT- RECEIPTS/INVOICES IS REQUIRED TO BE SUBMITTED TO THE CITY TO VALIDATE THE ORGANIZATION SPENT GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE PROJECT/PROGRAM AS DESCRIBED HERE 1 DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT. TYBL serves the disabled community In the Temecula Valley area. The demand for the program has doubled from last year. The 11 week program is geared towards children K-12 with special needs. Temecula High School volunteers receive volunteers hours, while gaining meaning relationship, learning compassion, and patience. Special Needs players learn social skills, and peer -to -peer Interactions. 2 DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED. ALSO, INCLUDE A LIST OF GOODS, EQUIPMEMENT, AND/OR SERVICES THIS ORGANIZATION HAS PURCHASED OR PLANS TO PURCHASE WITH AWARDED FUNDS TO SUPPORT THIS PROGRAM/PROJECT. The fee to join the program has increased since Inception. Cost of $120 per player includes court rental, pictures, facilitator, liability insurance. Additional cost for buddy shirts, materials, end of the season party. - -- - - 3 TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS. Temecula Youth Basketball Champions League Is Temecula based. Temecula residents have participated in the past. Temecula residents specifically benefits from the program because of the proximity of the court location. Local volunteers have also learned how to peer mentor special needs players. 3b ESTIMATED NUMBER OF PEOPLE FROM TEMECULA EXPECTED TO BENEFIT 25-40 FROM THIS PROJECT/PROGRAM: 3c ESTIMATED NUMBER OF VOLUNTEERS INVOLVED IN THIS PROJECT/PROGRAM: 25-50 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 8 of 13 PROJECT/PROGRAM DESCRIPTION CONTINUED 4 SUMMARY STATEMENT- SUMMARIZE ANSWERS 1 - 3 ABOVE IN 50 WORDS OR LESS. Our event focuses on a positive environment. It helps develop social skills for the special needs, while {peer volunteers continue to learn compassion and patience. Physical activity is very important for health,especially for the disadvantaged community. 5 IF APPLYING FOR MORE THAN $5,000, PLEASE EXPLAIN HOW THE COVID-19 PANDEMIC AFFECTED THIS NONPROFIT ORGANIZATION'S ABILITY TO SERVE THE TEMECULA COMMUNITY. YOU MAY ALSO INCLUDE INFLATIONARY CONCERNS. 6 IF APPLYING FOR MORE THAN $5,000, EXPLAIN HOW FUNDS HAVE OR WILL: (1) CREATE NEW PROJECT/PROGRAM, (2) EXPAND EXISTING PROJECT/PROGRAM, AND/OR (3) CONTINUE EXISTING PROJECT/PROGRAM. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 9 of 13 PROJECT/PROGRAM BUDGET (do not fill in shaded areas) LINE ITEMS FOR PROJECT/PROGRAM REVENUES EXPENSES LIST REVENUES/INCOME FOR PROJECT/PROGRAM Amount of money requested from this City of Temecula $ Community Services Grant (Not to exceed $50,000) 5,000 Amount contributed to the Project/Program by the Applicant $ Organization 1,000 Other grants or funding already awarded for Project/Program, if any $f D In -Kind match amount or volunteer credit hours estimated amount $ 560 hrs TOTAL REVENUE $ 6,000 LIST OF EXPENSES FOR PROJECT/PROGRAM Tools/Equipment $ 750 Facilities/Rent/Insurance f $ Supplies $ soo Marketing $ Services $ Food 1,000 Other cost to Join: $120x40 $ 4,800 Staffing Expense THIS IS INELIGIBLE TO BE FUNDED BY CITY'S GRANT; HOWEVER PLEASE INCLUDE. $ is TOTAL EXPENSES TOTAL BUDGET $ $ 7,050 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 10 of 13 PREVIOUS* FISCAL YEAR (FY) 2021-2022 COMPLIANCE REPORT IF YOUR ORGANIZATION WAS NOT AWARDED A COMMUNITY SERVICE FUNDING GRANT IN FY 21/22 (LAST YEAR), THEN SKIP THIS PAGE. If your organization was awarded a Community Service Funding Grant in FY 2021-2022 (last year) by the City of Temecula, please submit this information. I If your organization was awarded a Community Service Funding Grant in Fiscal Year 2021-2022 by the City of Temecula, all grant funds received must have been expended anytime on or between July 1, 2021, and June 30, 2022. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any future funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent. If the funds were not spent in accordance with the approved/awarded application, the organization will be required to return the amount of funds to the City. To substantiate that Fiscal Year 2021-2022 funds received from the City were spent appropriately, proper back-up documentation including the completed table below with accompanying receipts/invoices, must be submitted to the City on or before due date: September 12, 2022. 1. Fill out table below (make additional copies if needed to explain all expenditures.) 2. Attach copies of receipts/invoices (in the same order as listed in this table.) 3 Send to: City of Temecula, 41000 Main St., Temecula, CA 92590 Attn: City Manager's Office —CSF Organization: EXPENDITURE REPORT due on or before September 12, 2022 Name of Project/Program: FY 2021-2022 Amount of $ CSF Grant Fund Awarded: - Month & Year CSF Grant Received from City: Number of Beneficiaries Living in 92590, 92591, 92592 that Directly Benefitted from this Program/Project (approximate number of beneficiarles if you do not have precise number): v 1 Date on E Name of Company Receipt/invoice on Receipt or Invoice MUST BE ON OR BETWEEN JULY 1, 2021 - JUNE 30, 2022 QZ 1 2 3 4 1 5 6 City of Temecula Amount Expenditure Description I Purpose DESCRIBE THE EXPENDITURE PURPOSE OF EXPENDITURE EXPENDITURE TOTAL EXPENDITURE TOTAL MUST BE EQUAL TO (OR GREATER) THAN TOTAL AWARD AMOUNT Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 11 of 13 FISCAL YEAR (FY) 2022-2023 COMPLIANCE REPORT If your organization is awarded a Community Service Funding - REINVESTMENT IN TEMECULA Grant in FY2022-2023 by the City of Temecula follow these instructions. If your organization is awarded a Community Service Funding Grant - REINVESTMENT IN TEMECULA in FY2022-2023 by the City of Temecula, all grant funds received must be expended anytime on or between March 20, 2020 and June 30, 2024. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent. If the funds are not spent in accordance with the approved/awarded application, the organization may not receive and/or will be required to return said amount of funds to the City. To substantiate that grant funds from the City are spent appropriately, proper back-up documentation including the table below with accompanying receipts/invoices, must be submitted to the City as outlined on this page. 1. Fill out Expenditure Report table below. Make additional copies if needed to explain all expenditures. A. If awarded $5,000. Submit the following Expenditure Report within 60 days after spending $5,000 no later than June 30, 2024, to demonstrate grant funds were spent in accordance with the Application. [If you were awarded less than $5,000, submit Expenditure Report for that amount.) B. If awarded grant funds exceeding $5,000. A) Follow #1.A above first. B) To receive grant funds exceeding $5,000 (between $5K-$50K), submit the following Expenditure Report to be reimbursed for the remaining balance of award to demonstrate funds were spent in accordance with the Application. This report can be submitted in $10,000 increments (but no less than $10,000 unless the remaining grant award funding amount is less than $10K). This report must be submitted to the City no later than June 30, 2024 to receive remaining grant funds. 2. Attach copies of receipts/invoices (in the same order listed in table below). 3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590, Attn: City Manager's Dept. "CSF-Reinvestment in Temecula" EXPENDITURE REPORT DATED Organization: TOTAL FY 2022-2023 Amount of Grant Fund Awarded: $ Name of Project/Program:, Month & Year FIRST $6,000 check was received from City: 1. Is this Expenditure Report is to provide documentation for first $5,000 awarded and received? Yes_ or No (already submitted). 2. My organization has already received $ of the total FY 2022-23 Grant Fund awarded by the City 3. Is this Expenditure Report is submitted to request reimbursement of funds? No or Yes If yes, Amount of Request $ Number of beneficiaries living in 92590, 92591, 92592 that directly benefitted from this Program/Project (approximate number of beneficiaries if you do not have precise number) EName of Company Eon Receipt or Invoice QZ OA 3 Date on Receipt/Invoice MUST BE ON OR BETWEEN March 20, 2020 - JUNE 30, 2024 Expenditure MUST SUPPORT PROJECT/PROGRAM IN APPLICATION & AWARD LETTER Amount Description Purpose W EXPENDITURE TOTAL $ EXPENDITURE TOTAL City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 12 of 13 ACKNOWLEDGEMENT/SIGNATURE PAGE The applicant acknowledges and agrees to the following: Recipient is subject to all Community Service Funding Program requirements including submittal deadlines and payment disbursements. Every Community Service Funding application is considered individually and on its own merit. Awards will be given to organizations and activities that directly benefit the residents of Temecula. • Funding is not immediately available to the recipient, and requires an award letter signature upon approval. Please allow time for checks to be processed. ■ The awarding of Community Service Funding does not constitute an automatic annual allocation. The recognition for Community Service Funding should accrue to the City of Temecula. Community Service Funding must be spent as specified on the Application and records may be requested by the City of Temecula to ensure the funds were used appropriately. Community Service Funding grants will not be awarded or announced within the 60 days before an election in which an awarding Council Member is on the ballot. The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. If awarded a Community Service Funding Grant by the City of Temecula last year, then compliance receipts must be submitted on or before this application's due date or this application may be rejected as incomplete. I/we hereby certify the information contained in this Application is true to the best of our knowledge and belief. ORGANIZATION NAME: A PLACE FOR ALL PIECES MAILING ADDRESS: 27890 CLINTON KEITH RD, SUITE D 8150 MURRIETA, CA 92562 PRESIDENT / AUTHORIZED OFFICER: IVY KIRSHBERG MAT NAVE PHONE:( 714 ) 724-1010 EMAIL: Ikimhberg@yahoo.com SIGNATURE: _ DATE: IF DIFFERENT THAN ABOVE, APPICATION PREPARED BY. -RIr.li �JAPl1F PRESIDENT �IfLC. 8/29/2022 iV10liiN W., Y111F. 1iri SUBMIT ORIGINAL APPLICATION BY MONDAY, SEPTEMBER 12, 2022, TO: City of Temecula Community Service Funding Attn: City Manager's Office 41000 MAIN STREET TEMECULA, CA 92590 Questions: Stacey.Brown@TemeculaCA.gov (951) 694-6413 Betsy. Lowrey@TemeculaCA.gov (951) 693-3959 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 13 of 13 INTERNAL REVENUE SERVICE P. O. BOX 2508 CINCINNATI, OH 45201 DEPARTMENT OF THE TREASURY Employer Identification Number: Date: NOV` 46-2012269 u 2013 DLN : 17053098339043 A PLACE FOR ALL PIECES Contact Person: C/O JEFFREY KIRSHBERG MR. DAVIS ID# 31636 27775 BOTTLE BRUSH WAY Contact Telephone Number: MURRIETA, CA 92562 (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 12, 2013 Contribution Deductibility: Yes Addendum Applies: No Dear Applicant: We are pleased to inform you that upon review of your application for tax exempt status we have determined that you are exempt from Federal income tax under section 501(c)(3) of the Internal Revenue Code. Contributions to you are deductible under section 170 of the Code. You are also qualified to receive tax deductible bequests, devises, transfers or gifts under section 2055, 2106 or 2522 of the Code. Because this letter could help resolve any questions regarding your exempt status, you should keep it in your permanent records. Organizations exempt under section 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, Director, Exempt Organizations Letter 947 (DO/CG) STATE OF CALIFORNIA + FRANCHISE TAX BOARD C SABOX 942T57 BJ1 SACRAM 4285 CA 94257-0540 Entity Status Letter Date: 8/29/2022 ESL ID: 8818358920 Why You Received This Letter According to our records, the following entity information is true and accurate as of the date of this letter. Entity ID: 3546151 Entity Name: A PLACE FOR ALL PIECES 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. ❑ 5. The entity was administratively dissolved/cancelled on through the Franchise Tax Board Administrative Dissolution process. Important Information This information does not necessarily reflect the entity's current legal or administrative status with any other agency of the state of California or other governmental agency or body. If the entity's powers, rights, and privileges were suspended or forfeited at any time in the past, or if the entity did business in California at a time when it was not qualified or not registered to do business in California, this information does not reflect the status or voidability of contracts made by the entity in California during the period the entity was suspended or forfeited (R&TC Sections 23304.1, 23304.5, 23305a, 23305.1). The entity certificate of revivor may have a time limitation or may limit the functions the revived entity can perform, or both (R&TC Section 23305b). Connect With Us Web: ftb.ca.gov Phone: 800-852-5711 from 7 a.m. to 5 p.m. weekdays, except state holidays 916-845-6500 from outside the United States California Relay Service: 711 or 800-735-2929 (For persons with hearing or speech impairments) FTB 4263A WEB (REV 12-2019) Q HELPO MENU Home > Tax ExemptOrpnization Search > A Place For All Pieces < Back to 5ur-r. Results A Place For All Pieces E I N: 46-2012269 1 Murrieta, CA, United States Form 990-N (e-Postcard) 8 Organizations who have filed a 990-N (e-Postcard) annual electronic notice. Most small organizations that receive less than $50,000 fall into this category. Tax Year 2021 Form 990-N (e-Postcard) Tax Period: 2021 (01/01/2021 - 12/31/2021) EIN: 46-2012269 Legal Name (Doing Business as): A Place For All Pieces Mailing Address: 27890 Clinton Keith Rd Suite D151 Murrieta, CA 92562 United States Principal Officer's Name and Address: Ivy Kirshberg 27890 Clinton Keith Rd Suite D151 Murrieta, CA 92562 United States Gross receipts not greater than: $50,000 FY 2022/2023 COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA GRANT APPLICATION # 1b A PLACE FOR ALL PIECES (B: HALLOWEEN DANCE) N_w 11b W11) ail 11 FISCAL YEAR 2022 M 2023 COMMUNITY SERVICE FUNDING - REINVESTMENT IN TEMECULA PROGRAM APPLICATION (Please Print or Type) DUE ON OR BEFORE: MONDAY, SEPTEMBER 12, 2022 Amount Requested: $ PROJECT/PROGRAM INFORMATION MAXIMUM ALLOWABLE: $50,000 PER ORGANIZATION Project/Program Title: INCLUSIVE HALLOWEEN TEENIADULT DANCE EVENT Start Date: 10/28122 End Date: 10/28/22 Physical Address of Project/Program: THE CORPORATE ROOM INCLUDE IF DIFFERENT THAN ORGANIZATION'S MAILING ADDRESS If Grant is Awarded, Make Check Payable to: A PLACE FOR ALL PIECES Mailing Address: 27890 CLINTON KEITH RD, SUITE D 0151 MURRIETA, CA 92662 ORGANIZATION AND GEOGRAPHIC AREA SERVED Name of Applicant A PLACE FOR ALL PIECES Organization: _ Website: aplaceforallpleces.org Number of Paid Staff: 0 Geographic Area(s) the Organization Serves: Year Founded: 2013 Social Media: FACEBOOK, INSTAGRAM Number of Volunteers: 26+ TEMECULA VALLEY Geographic Area(s) the Proiect/Progrram Serves: TEMECULA VALLEY NOTE: COMMUNITY SERVICE FUNDING GRANT PROGRAM FUNDING MUST BE EXCLUSIVELY USED TO SERVE TEMECULA. Contact Name: IVY KIRSHBERG Title/Position: PRESIDENT Contact Person's Direct Telephone: _714 7241010 Contact Person's Email: Ikimhberg@yahoo.com NONPROFIT STATUS Is this organization incorporated as a nonprofit? Yes F&] Date of Incorporation as a Nonprofit: 21I2r2013 No ❑ IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING Federal Identification Number: 46-2012269 State Identification Number: 3546151 PRINT OUT AND ATTACH TO THIS APPLICATION VERIFICATION FROM FEDERAL (IRS) AND STATE (FTB) AS FOLLOWS: 1. ❑ Attach IRS Deductibility Status using this link: 17ttts_Ilapps.irs.gov/app/eosl 2. ❑ Attach State Entity Status Letter using this link: https://www.ftb.ca.clov/otiliiie/self Serve entity StatGIS letterlindex.asr) 3. ❑ Attach first page only of most recent IRS Form 990 or attach print out of detailed info about your charity found on this State Registry's Search Tool: llti l�rct.[fry:e.covlVBliticali❑nlWctalSe��rrll.a_:1 : '1i.1�:ihry 'r City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 5 of 13 APPLICATION AUTHORIZATION Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over $500 including any business transactions, negotiations, investments, or interests in real property with a Temecula City Council Member during the past 12 months? No © Yes ❑ IF YES, BRIEFLY DESCRIBE: Is a Temecula City Council Member a member of the Board of Directors or an Officer of the organization? No E] Yes ❑ IF YES, PROVIDE COUNCIL MEMBER'S NAME AND TITLE WITHIN THE ORGANIZATION: This Application has been authorized by the organization's: Executive Committee 0 Board of Directors ❑ F Members -at -Large ❑ MISSION STATEMENT OF ORGANIZATION BRIEFLY DESCRIBE THE ORGANIZATION'S MISSION/GOALS AND OBJECTIVES. A Place for All Pieces fosters a community of empowered children and adults. Our goal is to Increase the quality of life for people on the spectrum. By providing opportunities for social motivation, initiations, and peer to peer interaction. FINANCIAL STATEMENTS UPON REQUEST, COPIES OF THE ORGANIZATION'S CURRENT BUDGET/FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT), AND IF AVAILABLE CPA'S AUDIT, MAY BE NEEDED UPON REQUEST TO DEMONSTRATE SOUND FINANCIAL MANAGEMENT. DO NOT SUBMIT NOW. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 6 of 13 FUNDING SOURCES CITY OF TEMECULA—SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM THE CITY FOR ANY PROGRAM? No [K] Yes ❑ IF YES, PROVIDE BELOW. NAME OF PROGRAM/PROJECT MONTH + YEAR NAME OF CITY GRANT AMOUNT FUNDED BY THE CITY GRANT OR SPONSORSHIP FUNDING RECEIVED OR SPONSORSHIP OTHER OUTSIDE SOURCES —SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM ENTITIES (NOT INCLUDING THE CITY) FOR THE SAME PROJECTIPROGRAM IN THIS APPLICATION? No [J Yes ❑ IF YES, PROVIDE INFORMATION IN TABLE BELOW. AMOUNT T MONTH + YEAR i RECEIVED NAME OF ENITY II FUNDING RECEIVED $ 5,000 HAI ADVANCED MATERIALS SPECIALISTS Q@ 12/2021 P W P W City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 7 of 13 GRANT PROJECT/PROGRAM DESCRIPTION IMPORTANT- RECEIPTS/INVOICES IS REQUIRED TO BE SUBMITTED TO THE CITY TO VALIDATE THE ORGANIZATION SPENT GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE PROJECT/PROGRAM AS DESCRIBED HERE 1 DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT. A Place for All Pieces Teen Adult Halloween Event will provide much needed social skills, peer to peer support. Temecula Special Needs families with teens and adults are always In need of programs. This event promotes a positive and safe environment for everyone. With the help of High School volunteers in the Temecula Valley area, special needs families are given the opportunity to enjoy themselves without judgements. They are surrounded by families who are also in need of respite from the daily grind of taking care of someone with special needs. 2 DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED, ALSO, INCLUDE A LIST OF GOODS, EQUIPMEMENT, AND/OR SERVICES THIS ORGANIZATION HAS PURCHASED OR PLANS TO PURCHASE WITH AWARDED FUNDS TO SUPPORT THIS PROGRAM/PROJECT. VENUE: $1600 DECORATIONS: $3500 FOOD: $1500 DJ: $300 3 TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS. Our Halloween stance event Is our biggest event of the year. Temecula Special Needs families and Peer volunteers from Terecula schools have participated in the past. It Is not only geared to benefit tf a special needs families, bUI also the high school peers who have returned yearly to help develop a positive environment for everyone. 3b ESTIMATED NUMBER OF PEOPLE FROM TEMECULA EXPECTED TO BENEFIT I 50-75 FROM THIS PROJECT/PROGRAM: 3c ESTIMATED NUMBER OF VOLUNTEERS INVOLVED IN THIS PROJECT/PROGRAM: 25-50 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 8 of 13 PROJECT/PROGRAM DESCRIPTION CONTINUED 4 SUMMARY STATEMENT- SUMMARIZE ANSWERS 1 - 3 ABOVE IN 50 WORDS OR LESS. ❑ur event focuses on a positive environment. It helps develop social skills for the special needs, while peer volunteers continue to learn compassion and patience. It is the most sought after event of the year, with attendance growing every year. The cost will he around $6,900 this year. 5 IF APPLYING FOR MORE THAN $5,000, PLEASE EXPLAIN HOW THE COVID-19 PANDEMIC AFFECTED THIS NONPROFIT ORGANIZATION'S ABILITY TO SERVE THE TEMECULA COMMUNITY. YOU MAY ALSO INCLUDE INFLATIONARY CONCERNS. 6 IF APPLYING FOR MORE THAN $5,000, EXPLAIN HOW FUNDS HAVE OR WILL: (1) CREATE NEW PROJECT/PROGRAM, (2) EXPAND EXISTING PROJECT/PROGRAM, AND/OR (3) CONTINUE EXISTING PROJECT/PROGRAM. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 9 of 13 PROJECT/PROGRAM BUDGET (do not fill in shaded areas) LINE ITEMS FOR PROJECT/PROGRAM REVENUES J EXPENSES LIST REVENUES/INCOME FOR PROJECT/PROGRAM Amount of money requested from this City of Temecula $ Community Services Grant (Not to exceed $50,000) 6,000 Amount contributed to the Project/Program by the Applicant $ Organization 1,900 Other grants or funding already awarded for Project/Program, if any $ 0 In -Kind match amount or volunteer credit hours estimated amount $ 45 hrs TOTAL REVENUE 1 $ 6,900 LIST OF EXPENSES FOR PROJECT/PROGRAM Tools/Equipment ! $ Facilities/Rent/Insurance $ 1,600 Supplies $ Marketing $ Services $ 300 Food 1,500 $ 3,500 Other Staffing Expense THIS IS INELIGIBLE TO BE FUNDED BY CITY'S GRANT, HOWEVER PLEASE INCLUDE. T $ $ 6,900 TOTAL EXPENSES $ 6,900 TOTAL BUDGET $ City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 10 of 13 PREVIOUS* FISCAL YEAR (FY) 2021-2022 COMPLIANCE REPORT IF YOUR ORGANIZATION WAS NOT AWARDED A COMMUNITY SERVICE FUNDING GRANT IN FY 21122 (LAST YEAR), THEN SKIP THIS PAGE. If your organization was awarded a Community Service Funding Grant in FY 2021-2022 (last year) by the City of Temecula, please submit this information. If your organization was awarded a Community Service Funding Grant in Fiscal Year 2021-2022 by the City of Temecula, all grant funds received must have been expended anytime on or between July 1, 2021, and June 30, 2022. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any future funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent. If the funds were not spent in accordance with the approved/awarded application, the organization will be required to return the amount of funds to the City. To substantiate that Fiscal Year 2021-2022 funds received from the City were spent appropriately, proper back-up documentation including the completed table below with accompanying receipts/invoices, must be submitted to the City on or before due date: September 12, 2022. 1. Fill out table below (make additional copies if needed to explain all expenditures_) 2. Attach copies of receipts/invoices (in the same order as listed in this table.) 3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590 Attn: City Managers Office —CSF EXPENDITURE REPORT due on or before September 12, 2022 Organization: _ Name of Project/Program: FY 2021-2022 Amount of $ CSF Grant Fund Awarded: Month & Year CSF Grant Received from City: Number of Beneficiaries Living in 92590, 92591, 92592 that Directly Benefitted from this Program/Project (approximate number of beneficiaries if you do not have precise number): Name of Company I-cR E on Receipt or Invoice F 7 ¢a 2 1 3 1 Ez Date on ReceiptlInvoice MUST BE ON OR BETWEEN JULY 1, 2021 -JUNE 30, 2022 EXPENDITURE TOTAL Amount Expenditure Description Purpose DESCRIBE THE EXPENDITURE PURPOSE OF EXPENDITURE EXPENDITURE TOTAL MUST BE EQUAL TO (OR GREATER) THAN TOTAL AWARD AMOUNT City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 11 of 13 FISCAL YEAR (FY) 2022-2023 COMPLIANCE REPORT If your organization is awarded a Community Service Funding - REINVESTMENT IN TEMECULA Grant in FY2022-2023 by the City of Temecula, follow these instructions. If your organization is awarded a Community Service Funding Grant - REINVESTMENT IN TEMECULA in FY2022-2023 by the City of Temecula, all grant funds received must be expended anytime on or between March 20, 2020 and June 30, 2024. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent. If the funds are not spent in accordance with the approved/awarded application, the organization may not receive and/or will be required to return said amount of funds to the City. To substantiate that grant funds from the City are spent appropriately, proper back-up documentation including the table below with accompanying receipts/invoices, must be submitted to the City as outlined on this page. 1. Fill out Expenditure Report table below. Make additional copies if needed to explain all expenditures. A. If awarded $5,000. Submit the following Expenditure Report within 60 days after spending $5,000' no later than June 30, 2024, to demonstrate grant funds were spent in accordance with the Application. [If you were awarded less than $5,000, submit Expenditure Report for that amount.) B. If awarded grant funds exceeding $5,000. A) Follow #1.A above first. B) To receive grant funds exceeding $5,000 (between $5K-$50K), submit the following Expenditure Report to be reimbursed for the remaining balance of award to demonstrate funds were spent in accordance with the Application. This report can be submitted in $10,000 increments (but no less than $10,000 unless the remaining grant award funding amount is less than $10K). This report must be submitted to the City no later than June 30, 2024 to receive remaining grant funds. 2. Attach copies of receiptslinvoices (in the same order listed in table below). 3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590, Attn: City Manager's Dept. "CSF-Reinvestment in Temecula" EXPENDITURE REPORT DATED Organization: Name of Project/Program: TOTAL FY 2022-2023 Month & Year FIRST $5,000 check Amount of Grant Fund Awarded: $ was received from City: 1. Is this Expenditure Report is to provide documentation for first $5,000 awarded and received? Yes_ or No (already submitted). 2. My organization has already received $ of the total FY 2022-23 Grant Fund awarded by the City 3. Is this Expenditure Report is submitted to request reimbursement of funds? No or Yes If yes, Amount of Request S_ Number of beneficiaries living in 92590, 92591, 92592 that directly benefitted from this Program/Project (approximate number of beneficiaries if you do not have precise number) _ r d E L " E 4Z 2 3 Name of Company on Receipt or Invoice Date on Expenditure ReceiptlInvoice MUST SUPPORT PROJECT/PROGRAM IN APPLICATION & AWARD LETTER MUST BE ON OR BETWEEN March 20, 2020 - JUNE 30, Amount Description Purpose 2024 EXPENDITURE TOTAL $ EXPENDITURE TOTAL City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 12 of 13 ACKNOWLEDGEMENT/SIGNATURE PAGE The applicant acknowledges and agrees to the following: Recipient is subject to all Community Service Funding Program requirements including submittal deadlines and payment disbursements. Every Community Service Funding application is considered individually and on its own merit. ■ Awards will be given to organizations and activities that directly benefit the residents of Temecula. Funding is not immediately available to the recipient, and requires an award letter signature upon approval. Please allow time for checks to be processed. * The awarding of Community Service Funding does not constitute an automatic annual allocation. ■ The recognition for Community Service Funding should accrue to the City of Temecula. Community Service Funding must be spent as specified on the Application and records may be requested by the City of Temecula to ensure the funds were used appropriately. Community Service Funding grants will not be awarded or announced within the 60 days before an election in which an awarding Council Member is on the ballot. The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. 16 If awarded a Community Service Funding Grant by the City of Temecula last year, then compliance receipts must be submitted on or before this application's due date or this application may be rejected as incomplete. I/we hereby certify the information contained in this Application is true to the best of our knowledge and belief. ORGANIZATION NAME: A PLACE FOR ALL PIECES MAILING ADDRESS: 27890 CLINTON KEITH RD, SUITE D #160 MURRIETA, CA 92662 PRESIDENT / AUTHORIZED OFFICER: _IVY KIRSHBERG PHONE: ( 714 ) 724-1010 EMAIL: lkirshborg@yahoo.com SIGNATURE:, _ DATE: IF DIFFERENT THAN ABOVE, APPICATION PREPARED BY: 8/29/2022 PRESIDENT 1111t VO I"N I)i"N, yrfAP: PRGd I NANV T SUBMIT ORIGINAL APPLICATION BY MONDAY, SEPTEMBER 12, 2022, TO: City of Temecula Community Service Funding Attn: City Manager's Office 41000 MAIN STREET TEMECULA, CA 92590 Questions: Stacey.Brown@TemeculaCA.gov (951) 694-6413 Betsy. Lowrey@TemeculaCA.gov (951) 693-3959 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 13 of 13 INTERNAL REVENUE SERVICE P. O. BOX 2508 CINCINNATI, OR 45201 Date: A PLACE FOR ALL PIECES C/O KURT GRAVES 3118 WILSHIRE BLVD STE D SANTA MONICA, CA 90403 Dear Applicant: DEPARTMENT OF THE TREASURY Employer Identification Number: 46-2012269 DLN: 17053098339043 Contact Person: MR. DAVIS ID# 31636 Contact Telephone Number: (877) 029-5500 Accounting Period Ending: December 31 Public Charity Status: 170 (b) (1) (A) (vi) Form 990 Required: Yes Effective Date of Exemption: February 12, 2013 Contribution Deductibility: Yes Addendum Applies: No 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, Director, Exempt Organizations Letter 947 (DO/CG) STATE OF CALIFORNIA FRANCHISE TAX BOARD F T B PO BOX 942657 SACRAMENTO CA 94257-0540 Entity Status Letter Date: 8/29/2022 ESL ID: 8818358920 Why You Received This Letter According to our records, the following entity information is true and accurate as of the date of this letter. Entity ID: 3546151 Entity Name: A PLACE FOR ALL PIECES 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. 5. The entity was administratively dissolved/cancelled on through the Franchise Tax Board Administrative Dissolution process. Important Information This information does not necessarily reflect the entity's current legal or administrative status with any other agency of the state of California or other governmental agency or body. If the entity's powers, rights, and privileges were suspended or forfeited at any time in the past, or if the entity did business in California at a time when it was not qualified or not registered to do business in California, this information does not reflect the status or voidability of contracts made by the entity in California during the period the entity was suspended or forfeited (R&TC Sections 23304.1, 23304.5, 23305a, 23305.1). The entity certificate of revivor may have a time limitation or may limit the functions the revived entity can perform, or both (R&TC Section 23305b). Connect With Us Web: ftb.ca.gov Phone: 800-852-5711 from 7 a.m. to 5 p-m. weekdays, except state holidays 916-845-6500 from outside the United States California Relay Service: f711 or 800-735-2929 (For persons with hearing or speech impairments) FTB 4263A WEB (REV 12-2019) Q HELPO MENU Home > Tax Exempt Organixdtion Search > A Place For All Pieces < Back to Search Result A Place For All Pieces EIN: 46-2012269 1 Murrieta, CA, United States Form 990-N (e-Postcard) 8 Organizations who have filed a 990-N (e-Postcard) annual electronic notice. Most small organizations that receive less than $50,000 fall into this category. Tax Year 2021 Form 990-N (e-Postcard) Tax Period: 2021 (01/01/2021 - 12/31/2021) EIN: 46-2012269 Legal Name (Doing Business as): A Place For All Pieces Mailing Address: 27890 Clinton Keith Rd Suite D151 Murrieta, CA 92562 United States Principal Officer's Name and Address: Ivy Kirshberg 27890 Clinton Keith Rd Suite D151 M u rri eta, CA 92562 United States Gross receipts not greater than: $50,000 FY 2022/2023 COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA GRANT APPLICATION # 2 AIM FOR GOOD INC. ► W wirl)Vm'lI�FL- ►i111 FISCAL YEAR 2022.2023 COMMUNITY SERVICE FUNDING - REINVESTMENT IN TEMECULA PROGRAM APPLICATION (Please Print or Type) DUE ON OR BEFORE: MONDAY, SEPTEMBER 12, 2022 PROJECT/PROGRAM INFORMATION Amount Requested: $ 50,000 MAXIMUM ALLOWABLE: $50,000 PER ORGANIZATION AIM for Good Project/Program Title: Physical Address of Project/Program: Start Date: 4/20 End Date: indefinite INCLUDE IF DIFFERENT THAN ORGANIZATION'S MAILING ADDRESS If Grant is Awarded, Make Check Payable to: AIM for Good, Inc. Mailing Address: 31493 Rancho Pueblo Rd. #205 Temecula, CA 92592 ORGANIZATION AND GEOGRAPHIC AREA SERVED Name of Applicant AIM for Good, Inc Organization: _ Website: www.AimForGood.org Number of Paid Staff: 0 Year Founded: 2020 Social Media: FB/Instagram Number of Volunteers: 15 Geographic Area(s) the Organization Serves: Temecula Valley Geographic Area(s) the Proiect/Program Serves: Temecula Valley NOTE: COMMUNITY SERVICE FUNDING GRANT PROGRAM FUNDING MUST BE EXCLUSIVELY USED TO SERVE TEMECULA. Contact Name: Mark Anselmo Title/Position: President/Co-Founder Contact Person's Direct Telephone:9519726680 Contact Person's Email: markanselmo®gmail.c Of NONPROFIT STATUS Is this organization incorporated as a nonprofit? Yes Date of Incorporation as a Nonprofit: 4/17/20 No IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING Federal Identification Number: 850914556 State Identification Number: 4584598 PRINTOUT AND ATTACH TO THIS APPLICATION VERIFICATION FROM FEDERAL (IRS) AND STATE (FTS) AS FOLLOWS: 1. ® Attach IRS Deductibility Status using this link: htt :1/a sirs. ov/a Leos/ 2. B Attach State Entity Status Letter using this link: htt s., /www.ftb.ca, ov/online/self serve entitystatus letterlindex.as � {{ � 3. ® Attach first page only of most recent IRS Form 990 or attach print out of detailed infc6W424marity found on this State Registry's Search Tool: htt :1/rct.do .ca. r►111erihcationtWeb/Search.as x?facili =Y CITYMI 'IAGEP'SOFFICE City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 5 of 13 APPLICATION AUTHORIZATION Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over $500 including any business transactions, negotiations, investments, or interests in real property with a Temecula City Council Member during the past 12 months? No❑ Yes ❑ IF YES, BRIEFLY DESCRIBE: Is a Temecula City Council Member a member of the Board of Directors or an Officer of the organization? No N Yes ❑ IF YES, PROVIDE COUNCIL MEMBER'S NAME AND TITLE WITHIN THE ORGANIZATION: This Application has been authorized by the organization's: Executive Committee ❑ Board of Directors IN Members -at -Large ❑ MISSION STATEMENT OF ORGANIZATION I BRIEFLY DESCRIBE THE ORGANIZATION's MISSION/GOALS AND OBJECTIVES. Our goal is to give back to our community wherever the needs may be. Our mission to help local individuals and families in need, local non -profits and to help facilitate events that spread awareness of multiple causes. Our founder originally started a non-profit, Our Nicholas Foundation, in 2004 to help support the local Autism community when their youngest son was diagnosed. Over the years he has seen needs multiply in many areas including cancer, hunger, autism/special needs, family support and more and wanted a solution to help quickly with no delays...thus AIM for good was started. FINANCIAL STATEMENTS UPON REQUEST, COPIES OF THE ORGANIZATION's CURRENT BUDGET/FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT), AND IF AVAILABLE CPA's AUDIT, MAYBE NEEDED UPON REQUEST TO DEMONSTRATE SOUND FINANCIAL MANAGEMENT. DO NOT SUBMIT NOW. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 6 of 13 FUNDING SOURCES CITY OF TEMECULA—SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM THE CITY FOR ANY PROGRAM? No E Yes ❑ IF YES, PROVIDE BELOW. NAME OF PROGRAM/PROJECT MONTH + YEARu NAME OF CITY GRANT AMOUNT FUNDED BY THE CITY GRANTOR SPONSORSHIP FUNDING RECEIVED OR SPONSORSHIP 1- OTHER OUTSIDE SOURCES —SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM ENTITIES (NOT INCLUDING THE CITY) FOR THE SAME PROJECTIPROGRAM IN THIS APPLICATION? NON Yes ❑ IF YES, PROVIDE INFORMATION IN TABLE BELOW, NAME OF ENITY City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 7 of 13 GRANT PROJECT/PROGRAM DESCRIPTION IMPORTANT - RECEIPTSANVOICES IS REQUIRED TO BE SUBMITTED TO THE CITY TO VALIDATE THE ORGANIZATION SPENT GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE PROJECTIPROGRAM AS DESCRIBED HERE E DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT. Simply local individuals, families and non -profits in need ... whether that's financial, public awareness or volunteer support. 2 DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED. ALSO, INCLUDE A LIST OF GOODS, EQUIPMEMENT, AND/OR SERVICES THIS ORGANIZATION HAS PURCHASED OR PLANS TO PURCHASE WITH AWARDED FUNDS TO SUPPORT THIS PROGRAM/PROJECT. Our goal is to find needs and immediate) fill them it's hunger needs this Y g s Fall/Winter with the inflation/recession challenges we face... challenges local non -profits face with decreased donations in a recessionary period... providing video marketing for those in need ... charity events or public community support.. -Autism art camps...we are flexible and will fill the need. We have purchased and will be upgrading video production equipments to promote those in need via online marketing, etc. and will help purchase items as needed locally to help whomever we can. 3 TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS. Our focus is the Temecula Valley. Locally for non -profits we have directly supported Michelle's Place, Community Mission of Hope, Autism & the Arts j Foundation and Jacob's House and plan to expand that further. 3b 3c ESTIMATED FROM THIS PROJECT/PROGRAM: PROGRAM BER OF PEOPLE FROM TEMECULA EXPECTED TO BENEFIT Sky's the limit ESTIMATED NUMBER OF VOLUNTEERS INVOLVED IN THIS PROJECT/PROGRAM 15 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 6 of 13 PROJECT/PROGRAM DESCRIPTION CONTINUED 4 SUMMARY STATEMENT - SUMMARIZE ANSWERS 1 - 3 ABOVE IN 50 WORDS OR LESS. Helping individuals, families and non -profits wherever possible locally. 5 IF APPLYING FOR MORE THAN $5,000, PLEASE EXPLAIN HOW THE COVID-19 PANDEMIC AFFECTED THIS NONPROFIT ORGANIZATION'S ABILITY TO SERVE THE TEMECULA COMMUNITY. YOU MAY ALSO INCLUDE INFLATIONARY CONCERNS. Covid, Inflation and Recession will and does impact all non-profit contributions. We haven't actively fundraised as we didn't want to compete for local dollars as the local non -profits build their strategies going forward... 6 IF APPLYING FOR MORE THAN $5,000, EXPLAIN HOW FUNDS HAVE OR WILL: (1) CREATE NEW PROJECT/PROGRAM, (2) EXPAND EXISTING PROJECT/PROGRAM, AND/OR (3) CONTINUE EXISTING PROJECT/PROGRAM. Our goal is to help whomever we can locally without any red tape ... so this grant would help us kickstart that goal and funnel much needed support via financial, marketing/promoting of needs, direct partnerships and more. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 9 of 13 PROJECT/PROGRAM $UDGET (dQ not fill In shaded prqss) LINE ITEMS FOR PROJECT/PROGRAM ___TREVENUES EXPENSES LIST REVENUES/INCOME FOR PROJECT/PROGRAM Amount of money requested from this City of Temecula $ 50000 Community Services Grant (Not to exceed $S0,000) Amount contributed to the Project/Program by the Applicant $ Organization Other grants or funding already awarded for Project/Program, if any $ 10000 In -Kind match amount or volunteer credit hours estimated amount $ 0 TOTAL REVENUE $ 60000 LIST OF EXPENSES FOR PROJECT/PROGRAM r s/Equipment ities/Rent/Insurance Supplies Marketing Services Food Other Staffing Expense THIS IS INELIGIBLE TO BE FUNDED BY CITY'S GRANT, HOWEVER PLEASE INCLUDE. TOTAL EXPENSES TOTAL BUDGET $60000 $5000 $55000 $60000 $60000 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 10 of 13 PREVIOUS* FISCAL YEAR (FY) 2021-2022 COMPLIANCE REPORT IF YOUR ORGANIZATION WAS NOT AWARDED A COMMUNITY SERVICE FUNDING GRANT IN FY 21/22 (LAST YEAR), THEN SKIP THIS PAGE. If your organization was awarded a Community Service Funding Grant in FY 2021-2022 (last year) by the City of Temecula, please submit this information. If your organization was awarded a Community Service Funding Grant in Fiscal Year 2021-2022 by the City of Temecula, all grant funds received must have been expended anytime on or between July 1, 2021, and June 30, 2022. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any future funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent. If the funds were not spent in accordance with the approvedlawarded application, the organization will be required to return the amount of funds to the City. To substantiate that Fiscal Year 2021-2022 funds received from the City were spent appropriately, proper back-up documentation including the completed table below with accompanying receipts/invoices, must be submitted to the City on or before due date: September 12, 2022. 1. Fill out table below (make additional copies if needed to explain all expenditures.) 2. Attach copies of receipts/invoices (in the same order as listed in this table.) 3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590 Attn: City Manager's Office —CSF EXPENDITURE REPORT due on or before September 12, 2022 AIM for Good Inc AIM for Good Organization: _' Name of Project/Program: FY 2021-2022 Amount of 'N/A CSF Grant Fund Awarded: Month & Year CSF Grant Received from City: Number of Beneficiaries Living in 92590, 92591, 92592 that Directly Benefitted from this ProgramlProject (approximate number of beneficiaries if you do not have precise number): Date on E' E Name of Company Receiptllnvoice iture u on Receipt or Invoice MUST BE ON OR BETWEEN Amount Description Purpose Q z JULY 1, 2021 -,TUNE 30, 2022 DESCRIBE THE EXPENDITURE PURPOSE OF EXPENDITURE 1 R EXPENDITURE TOTAL $ EXPENDITURE TOTAL MUST BE EQUAL TO (OR GREATER) THAN TOTAL AWARD AMOUNT City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 11 of 13 FISCAL YEAR (FY) 2022-2023 COMPLIANCE REPORT If your organization is awarded a Community Service Funding - REINVESTMENT IN TEMECULA Grant in FY2022-2023 by the City of Temecula, follow these instructions. If your organization is awarded a Community Service Funding Grant - REINVESTMENT IN TEMECULA in FY2022-2023 by the City of Temecula, all grant funds received must be expended anytime on or between March 20, 2020 and June 30, 2024. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent. If the funds are not spent in accordance with the approved/awarded application, the organization may not receive andlor will be required to return said amount of funds to the City. To substantiate that grant funds from the City are spent appropriately, proper back-up documentation including the table below with accompanying receipts/invoices, must be submitted to the City as outlined on this page. 1. Fill out Expenditure Report table below. Make additional copies if needed to explain all expenditures. A. If awarded $5,000. Submit the following Expenditure Report within 60 days after spending $5,000 no later than June 30, 2024, to demonstrate grant funds were spent in accordance with the Application. [If you were awarded less than $5,000, submit Expenditure Report for that amount.) B. If awarded grant funds exceeding $5,000. A) Follow #1.A above first. B) To receive grant funds exceeding $5,000 (between $5K-$50K), submit the following Expenditure Report to be reimbursed for the reraining balance of award to demonstrate finds were spent in accordance with the Application. This report can be submitted in $10,000 increments (but no less than $10,000 unless the remaining grant award funding amount is less than $10K). This report must be submitted to the City no later than June 30, 2024 to receive remaining grant funds. 2. Attach copies of receipts/invoices (in the same order listed in table below). 3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590, Attn: City Manager's Dept. "CSF-Reinvestment in Temecula" EXPENDITURE REPORT DATED Organization: AIM for Good, Inc Name of ProjectlProgram: AIM for Good TOTAL FY 2022-2023 Month & Year FIRST $5,000 check Amount of Grant Fund Awarded: $ was received from City: 1. Is this Expenditure Report is to provide documentation for first $6,000 awarded and received? Yes or No (already submitted). 2. My organization has already received $ of the total FY 2022-23 Grant Fund awarded by the City 3. Is this Expenditure Report is submitted to request reimbursement of funds? No or Yes If yes, Amount of Request S Number of beneficiaries living in 92590, 92591, 92592 that directly benefitted from this Program/Project (approximate number of beneficiaries if you do not have precise number) Date on Expenditure E Name of Company Receipt/invoice MUST SUPPORT PROJECT/PROGRAM IN APPLICATION & AWARD LETTER u E on Receipt or Invoice MUST BE ON OR BETWEEN 92 March 20,2020-JUNE30, Amount 1 Descri tion Pur ose a z 2024 p p �_ rs I EXPENDITURE TOTAL $ EXPENDITURE TOTAL City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 12 of 13 ACKNOWLEDGEMENT/SIGNATURE PAGE The applicant acknowledges and agrees to the following: Recipient is subject to all Community Service Funding Program requirements including submittal deadlines and payment disbursements. Every Community Service Funding application is considered individually and on its own merit. Awards will be given to organizations and activities that directly benefit the residents of Temecula. • Funding is not immediately available to the recipient, and requires an award letter signature upon approval. Please allow time for checks to be processed. m The awarding of Community Service Funding does not constitute an automatic annual allocation. The recognition for Community Service Funding should accrue to the City of Temecula. Community Service Funding must be spent as specified on the Application and records may be requested by the City of Temecula to ensure the funds were used appropriately. • Community Service Funding grants will not be awarded or announced within the 60 days before an election in which an awarding Council Member is on the ballot. The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. • If awarded a Community Service Funding Grant by the City of Temecula last year, then compliance receipts must be submitted on or before this application's due date or this application may be rejected as incomplete. I/we hereby certify the information contained in this Application is true to the best of our knowledge and belief. ORGANIZATION NAME: AIM for Good, Inc MAILING ADDRESS: 31493 Rancho Pueblo Rd. #205 Temecula, CA 92592 PHONE: (951 ) 9726680 EMAIL: markanselmo@gmail.com PRESIDENT / AUTHORIZED OFFICER: Mark Anselmo izirdi N�,P1F SIGNATURE: O—A:�, ` — DATE: 09/1 1 /22 IF DIFFERENT THAN ABOVE, APPICATION PREPARED BY: V f-J N f P - - SUBMIT ORIGINAL APPLICATION BY MONDAY, SEPTEMBER 12, 2022, TO: City of Temecula Community Service Funding Attn: City Manager's Office 41000 MAIN STREET TEMECULA, CA 92590 Questions: Stacey. Brown@TemeculaCA.gov (951) 694-6413 Betsy. Lowrey@TemeculaCA.gov (951) 693-3959 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 13 of 13 Department of the Treasury Internal Revenue Service Date: 04/07/2021 Tax Exempt and Government Entities I RS P.O. Box 2508 Employer ID number: Cincinnati, OH 45201 85-0914556 Person to contact: Name: Customer Service ID number: 31954 Telephone: (877) 829-5500 AIM FOR GOOD INC Accounting period ending: 31493 RANCHO PUEBLO ROAD 205 December 31 TEMECU LA, CA 92592 Public charity status: 170(b)(1)(A)(vi) Form 990 1990-EZ / 990-N required: Yes Effective date of exemption: April 17, 2020 Contribution deductibility: Yes Addendum applies: No DLN: 26053414002361 Dear Applicant: We're pleased to tell you we determined you're exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). Donors can deduct contributions they make to you under IRC Section 170. You're also qualified to receive tax deductible bequests, devises, transfers or gifts Linder Section 2055, 2106, or 2522. This letter could help resolve questions on your exempt status. Please keep it for your records. Organizations exempt under IRC Section 501(c)(3) are further classified as either public charities or private foundations. We determined you're a public charity under the IRC Section listed at the top of this letter. If we indicated at the top of this letter that you're required to file Form 990/990-EZ/990-N, our records show you're required to file an annual information return (Form 990 or Form 990-EZ) or electronic notice (Form 990-N, the e-Postcard). If you don't file a required return or notice for three consecutive years, your exempt status will be automatically revoked. If we indicated at the top of this letter that an addendum applies, the enclosed addendum is an integral part of this letter. For important information about your responsibilities as a tax-exempt organization, go to www.irs.gov/charities. Enter "4221-PC" in the search bar to view Publication 4221-PC, Compliance Guide for 501(c)(3) Public Charities, which describes your recordkeeping, reporting, and disclosure requirements. Sincerely, a- - t4t0f� Stephen A. Martin Director, Exempt Organizations Rulings and Agreements Letter 947 (Rev. 2-2020) Catalog Number 35152P STATE OF CALIFORNIA FRANCHISE TAX BOARD F T B PO BOX 942657 SACRAMENTO CA 94257-0540 Entity Status Letter Date: 9/11/2022 ESL ID: 5184525432 Why You Received This Letter According to our records, the following entity information is true and accurate as of the date of this letter Entity ID: 4584598 Entity Name: AIM FOR GOOD, 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 . ❑ 4. We do not have current information about the entity. ❑ 5. The entity was administratively dissolved/cancelled on through the Franchise Tax Board Administrative Dissolution process. Important Information This information does not necessarily reflect the entity's current legal or administrative status with any other agency of the state of California or other governmental agency or body. If the entity's powers, rights, and privileges were suspended or forfeited at any time in the past, or if the entity did business in California at a time when it was not qualified or not registered to do business in California, this information does not reflect the status or voidability of contracts made by the entity in California during the period the entity was suspended or forfeited (R&TC Sections 23304.1, 23304.5, 23305a, 23305.1). The entity certificate of revivor may have a time limitation or may limit the functions the revived entity can perform, or both (R&TC Section 23305b). Connect With Us Web: ftb.ca.gov Phone: 800-852-5711 from 7 a.m. to 5 p.m. weekdays, except state holidays 916-845-6500 from outside the United States California Relay Service: 1711 or 800-735-2929 (For persons with hearing or speech impairments) FTB 4263A WEB (REV 12-2019) Q HELPB MENU Home > Tax Exempt Qrganix ion r h > Aim For Good Inc. 39TR-V'-VTTTR11;MM Aim For Good Inc. EIN: 85-0914556 1 Temecula, CA, United States Other Names Determination Letter o A favorable determination letter is issued by the IRS if an organization meets the requirements for tax-exempt status under the Code section the organization applied. Final Letters Publication 78 Data o Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions. On Publication 78 Data List: Yes Deductibility Code: PC Form 990-N (e-Postcard)-o Organizations who have filed a 990-N (e-Postcard) annual electronic notice. Most small organizations that receive less than $50,000 fall into this category. Tax Year 2021 Form 990-N (e-Postcard) Tax Period: 2021 (01/01/2021 - 12/31/2021) EIN: 95-0914556 Legal Name (Doing Business as): Aim For Good Inc Mailing Address: 31493 Rancho Pueblo Road Suite 205 Temecula, CA 92592 United States Principal Officer's Name and Address: Mark Anselmo 31493 Rancho Pueblo Road Suite 205 Temecula, CA 92592 United States Gross receipts not greater than: $50,000 Organization has terminated: No Website URL: www.AimForGood.org Page Last Reviewed or Updated. 20-November-2020 f* Share $ Print e Home > Tax Exempt Organization Search > Our Nicholas Foundation Inc < $ack to Search R se ults Our Nicholas Foundation Inc EIN: 20-3348800 1 Temecula, CA, United States Auto -Revocation list o HELPO MENU Organizations whose federal tax exempt status was automatically revoked for not filing a Form 990-series return or notice for three consecutive years. Important note: Just because an organization appears on this list, it does not mean the organization is currently revoked, as they may have been reinstated. Posted Date: 08-10-2015 Exemption Type: 501(c)(3) Exemption Reinstatement Date: Revocation Date: 05-15-2015 Revocation Posting Date: 08-10-2015 Page Last Reviewed or Updated; 20-November-2020 F f* Share I Print STATE OF CALIFORNIA FRANCHISE TAX BOARD ('F T B FO BOX 942857 SACRAMENTO CA 94257-0540 Entity Status Letter Date: 9/13/2022 ESL ID: 2107018787 Why You Received This Letter According to our records, the following entity information is true and accurate as of the date of this letter. Entity ID: 2784676 Entity Name: OUR NICHOLAS FOUNDATION, INC. 1. The entity is in good standing with the Franchise Tax Board. 0 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 . 4. We do not have current information about the entity. 5. The entity was administratively dissolved/cancelled on through the Franchise Tax Board Administrative Dissolution process. Important Information This information does not necessarily reflect the entity's current legal or administrative status with any other agency of the state of California or other governmental agency or body. If the entity's powers, rights, and privileges were suspended or forfeited at any time in the past, or if the entity did business in California at a time when it was not qualified or not registered to do business in California, this information does not reflect the status or voidability of contracts made by the entity in California during the period the entity was suspended or forfeited (R&TC Sections 23304.1, 23304.5, 23305a, 23305.1). The entity certificate of revivor may have a time limitation or may limit the functions the revived entity can perform, or both (R&TC Section 23305b). Connect With Us Web: ftb.ca.gov Phone: 800-852-5711 from 7 a.m, to 5 p.m, weekdays, except state holidays 916-845-6500 from outside the United States FY 2022/2023 COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA GRANT APPLICATION # 3 ANIMAL FRIENDS OF THE VALLEYS CITY OF TEMECULA FISCAL YEAR 2022.. 2023 COMMUNITY SERVICE FUNDING.. REINVESTMENT IN TEMECULA PROGRAM APPLICATION (Please Print or Type) DUE ON OR BEFORE: MONDAY, SEPTEMBER 12, 2022 PROJECT/PROGRAM INFORMATION Amount FZ,1ecquqasted: $5o,000 IlvAximum ALLOWABLE: $50,000 PER ORGANIZATION Project/Program Title: Temecula Has Heart for the Animals Start Date: 0710122 End Date: 07/01/24 Physical Address of Project/Program: City of Temecula INCLUDE IF DIFFERENT THAN ORGANIZATION'S MAILING ADDRESS If Grant is Awarded, Make Check Payable to: Animal Friends of the Valleys Mailing Address: 33571 Mission Trail Rd Wildomar, Ca. 92595 Attn: Beth Soltysiak ORGANIZATION AND GEOGRAPHIC AREA SERVED Name of Applicant Organization: Animal Friends of the Valleys Year Founded: 1987 Website: animalfriendsofthevalleys.com Social Media: animaKdendsoffheyalleys Number of Paid Staff: 84 Number of Volunteers: 3752 Geographic Area(s) the Organization Serves: Temecula, Murrieta, Wildomar, Lake Elsinore, Canyon Lake, Menifee and surroundina rural county areas Geographic Area(s) the P.rograrn Serves: Citizens residing in the City of Temecula NOTE: COMMUNITY SERVICE FUNDING GRANT PROGRAM FUNDING MUST BE EXCLUSIVELY USED TO SERVE TEMECULA. Contact Name: Beth Solt sick Title/Position: Director of Development Contact Person's Direct Telephone: 951-805-6239_Contact Person's Email: beth(&Dafv,org City of Temecula Community Service Funding- Reinvestment in Temecula GRANT APPLICATION Page 5 of 13 NONPROFIT STATUS Is this organization incorporated as a nonprofit? Yes O Date of Incorporation as a Nonprofit: 1987____ No O IF NO, THE INELIGIBLE TO RECEIVE CITY FUNDING Federal Identification Number:33-0276892 State Identification Number: 1611141 PRINT OUT AND ATTACH TO THIS APPLICATION VERIFICATION FROM FEDERAL (IRS) AND STATE (FTB) AS FOLLOWS: I. D Attach IRS Deductibility Status using this link: http://apps.irs.gov/app/eos/ 2. D Attach State Entity Status Letter using this link: https://www.ftb.ca,gov/online/self serve entity status letter/i dex.asp 3. D Attach first page only of most recent IRS Form 990 or attach print out of detailed info about your charity found on this State Registry's Search Tool: http://rct.doj.ca,govNerification/Web/Search.aspx?facility=Y City of Temecula Community Service Funding- Reinvestment in Temecula GRANT APPLICATION Page 6 of 13 Self Serve Entity Status Letter Entity Search Result Results displayed below. Entities matching the search criteria Entity ID Entity Name city .-ka.1.4.1 ANIMAL FRIENDS OF THE VALLEYS, INC. WILDOMAR Back Copyright© 2022 State of Callfornia ill Internal Revenue Service P.O. Box 2508 Cincinnati, OH 45201 nn Date: [LIAR IS JU07 ANIMAL FRIENDS OF THE VALLEY INC PO BOX 1143 LAKE ELSINORE, CA 92531-1143 Dear Sir or Madam: Department of the Treasury Person to Contact: Roger Meyer ID# 31-07707 Toll Free Telephone Number: 877-829-5500 Employer Identification Number: 33-0276892 This is in response to your request of January 30, 2007, regarding your tax-exempt status. Our records indicate that a determination letter was issued in December 1988 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 you are not a private Foundation within the meaning of section 509(a) of the Code because you are described in section 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. If you have any questions, please call us at the telephone number shown in the heading of this letter. Sincerely, Cindy estcolt Manager, Exempt Organizations Determinations Form 990 Return of Qrganization Exempt From Income Tax Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) OMB No. 1545-0047 2020 ► Do not enter social security numbers on this form as it may be made public. Open to Public Department of the Treasury Internal Revanuo service ■ Go to www.frs. ovlForrn990 for instructions and the latest Information, Ins colon A For the 2020 calendar ear or tax year be innln 07-01 c Name of aMxalloaNIM L FRIENDS OF THE VALLEYS 2020. and ondln 06-30 2021 INC D Employer Identification number B check if applicable: ❑ Address change qfthut,619sas 33-0276892 ❑ Name change Number and street (or P.O. box if mail Is not delivered to street address) Roemfsulte E Telephone number ❑ In! tat return 33751 MISSION TRAIL 951 674-0618 ❑ Final retumllarminated City or town, state or province, country, and ZIP or foreign postal coda G Gross receipts ❑ Amended return WILDOMAR CA 92595-8430 S 6,486,943 ❑ Application pending F Name and address of principal offlcer: H(al is this a group retum (msuhordinates9 ❑ Yes ❑g No H(b) Are all subordinates Included? ❑ Yes ❑ No 1 Tax-exempt status: 0 501(o)s) 501(n) ( ) aPrl rre. 4947 a 1 or 527 If "No," attach a [!at. See Instructions J ftb$lie: ► WWWW . ANIMALFRIEND�SOFTHEVALiL-IEYS . COM H c ► Group exompWn number K Form ofomanlration- M C u..roticn I r-y 1 Trust I fyAssociation 1 1 other ► f- Year of formation: 1987 1 M State of (apfd domicile: CA Part 1 I Summary_ 1 Briefly describe the organization's mission or mostsignificant activities; DEDICATED TO PROMOTING HUMANE CARE OF ANIMALS THROUGH EDUCATION AND A HUMANE, PRO -ACTIVE ANIMAL SERVICES PROGRAM. COMMITTED TO PREVENTING m c THE SUFFERING OF ANIMALS AND TO ENDING PET OVERPOPULATION 4- 2 Check this box ► ❑ if the organization discontinued its operations or disposed of more than 25% of its net assets. 0 3 Number of voting members of the governing body (Part VI, line 1a) .. , ........ . . .. . .... 3 7 y4 Number of independent voting members of the governing body (Part VI, line 1 b) .... .. ........ . 4 7 5 122 5 Total number of individuals employed in calendar year 2020 (Part V, line 2a) ..... .. .. ..... 5 6 4,959 �-, 6 Total number of volunteers (estimate If necessary) ... . . .. ...... . ....... .. . .... 7a 0 Q 7a Total unrelated business revenue from Part Vlll, column (C), line 12 . ......... .. .. ...... 71lb 33 418 b Net unrelated business taxable income from Form 990-T Part i line 11 Prior Year Current Year 912,088 825,791 8 Contributions and grants (Part VIII, fine 111) . . . . . . ... . .. .. . . . . . . . . 4 , 720 024 9 Program service revenue (Part VIII, line 2g) ... ..... . . . ............ 5,412,806 _ 65,799 58 343 10 Investment income (Part Vlll, column (A), lines 3, 4, and 7d) .... .......... 11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and Ile) . .. . . .. . . . 80,006 124. 116 5,877,917 6,421,136 12 Total revenue - add lines 8 through 11 musts ual Part Vlll, Column (A), line 12 13 Grants and similar amounts paid (Part IX, column (A), lines 1-3) . . .. . . . ...... 208,816 220,137 0 14 Benefits paid to or for members (Part IX, column (A), line 4) . . . . .. . .. .... . 3,481,504 3,602, 602, 564 15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-10) ... .. 16a Professional fundraising fees (Part IX, column (A), line 1 le) .... ..... ..... . 0 a b Total fundraising expenses (Part IX, column (D), line 25) ► 224,282 17 Other expenses (Part IX, column (A), lines 11a-1Id, 11f-24e) .. • • . • • . • • 1 981,930 2,105,589 5,672,250 51928,290 18 Total expenses. Add lines 13-17 (must equal Part IX, column (A), line 25) .. ..... 205,667 492,846 19 Revenue less expenses. Subtract line 18 from line 12 $ Beginning of Current Year 8nd or year 5 598,692 6,453, 827 92 '20 Total assets (PartX, line 16) . . . . . . . . . . . . . . .. . . . .. . . . . .. . . 1m 21 Total liabilities (Part X, line 26) . . .. . .. . ........ . . . .. .. ...... 1,067,599 1,132,842 Aar: 22 Net assets or fund balances. Subtract line 21 from line 20 4 531093 5320 985 111 Sianature Block Under penalties of perjury, I declare [hat I have examined this return, Including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and eompiole: Declaration of preparer (other than officer) Is based on all information of which preparer has any knowledge. TAMMI BOYD 1 05-11-2022 Sign Signature of officer Date Mere TAMMI BOYD, PRESIDENT - Typo or print name and title Print/Type preparees name Preperees signature Date Check R if PTIN Paid KRISTINE M ANDERSON t7-08-2022 sWemployed P00226669 Preparer Firm'sname ► ANDERSON PROFESSIONAL SERVICES Firm'sEIN ► Use Only Flrm'saddress ► 17620 GRAND AVENUE Phone no. Lake Elsinore CA 92530-53914 951-678-2165 May the IRS discuss this return with the prepareir shown above? see Instructions . X Yes No For Paperwork Reduction Act Notice, see the separate instructions. Form 990 (2020) EEA APPLICATION AUTHORIZATION Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over $600 including any business transactions, negotiations, investments, or interests in real property with a Temecula City Council Member during the past 12 months? No X Yes D IF YES, BRIEFLY DESCRIBE: Is a Temecula City Council Member a member of the Board of Directors or an Officer of the organization? No X Yes D IF YES, PROVIDE council MEMBER'S NAME AND TITLE WITHIN THE ORGANIZATION: Maryann Edwards is the current JPA Board member that oversees the Animal Friends of the Valleys Board of Directors. There is a city representative on the JPA Board from each of the & cities we serve. MISSION STATEMENT OF ORGANIZATION I BRIEFLY DESCRIBE THE ORGANIZATION'S MISSION/GOALS AND OBJECTIVES. I Animal Friends of the Valleys is dedicated to promoting humane care of animals through education and proactive animal service programs. We are committed to preventing the suffering of animals and to help end pet overpopulation in the communities we serve. AFV's vision is to be recognized as the leading shelter by providing a safe haven for all animals, while becoming a full -service animal care facility that offers quality and affordable care. Through community education and involvement, AFV will reach our vision to help end pet overpopulation and find a loving and forever home for all adoptable pets in our shelter. FINANCIAL STATEMENTS UPON REQUEST, COPIES OF THE ORGANIZATION'S CURRENT BUDGET/FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT), AND IF AVAILABLE CPA'S AUDIT, MAYBE NEEDED UPON REQUEST TO DEMONSTRATE SOUND FINANCIAL MANAGEMENT. DO NOT SUBMIT NOW. City of Temecula Community Service Funding- Reinvestment in Temecula GRANT APPLICATION Page 7 of 13 FUNDING SOURCES CITY OF TEMECULA-SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM THE CITY FOR ANY PROGRAM? NoD Yes D IF YES, PROVIDE BELOW NAME OF PROGRAM/PROJECT AMOUNT MONTH+ YEAR NAME OF CITY GRANT FUNDED By THE CITY GRANT OR SPONSORSHIP FUND NG RECEIVED OR SPONSORSHIP Community Service Grant Spay. /neuter grant $5000 09/2020 (ISpay/neuter grant 4-ommunity service grant $ $ OTHER OUTSIDE SOURCES -SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM ENTITIES (NOT INCLUDING THE: CITY) FOR THE SAME PROJECT/PROGRAM IN THIS APPLICATION? No YesX IF YES, PROVIDE INFORMATION IN TABLE BELOW, AMOUNT MONTH+YEAR RECEIVED NAME OF ENITY FUNDING RECEIVED $20,000 T (Rachel Ray COVID Relief Grant for all cities D5/2021 $15,000 (Matching grant for all local cities for spay/neuter fees. 07/2021 $$20,00 CDFA Spay/neuter grant 2022-2023 for all six cities 05/2022 City of Temecula Community Service Funding- Reinvestment in Temecula GRANT APPLICATION Page 8 of 13 GRANT PROJECT/PROGRAM DESCRIPTION IMPORTANT- RECEIPTS/INVOICES IS REQUIRED TO BE SUBMITTED TO THE CITY TO VALIDATE THE ORGANIZATION SPENT GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE PROJECT/PROGRAM AS DESCRIBED HERE DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT. • Free Spay/neuter vouchers Days to the citizens of Temecula • Free Pet Micro- chipping day or days 2022-2023 for Temecula Residents • Low cost pet adoptions at various business locations throughout the city of Temecula for Temecula residents only. Must show proof of residency. Expanded senior living visits with trained shelter pets within the city if Temecula • expanded pet education and reading program to school age children at both Temecula City Libraries. • Community Pet Walk within the city of Temecula 2 DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED, ALSO, INCLUDE A LIST OF GOODS, EQUIPMEMENT, AND/OR SERVICES THIS ORGANIZATION HAS PURCHASED OR PLANS TO PURCHASE WITH AWARDED FUNDS TO SUPPORT THIS PROGRAM/PROJECT. The funds from this award will be spent with great regard. Every dollar will be spent helping the animals and the the citizens that reside in Temecula. The Temecula reinvestment Community Service grant will be allocated for Temecula residents only. AFV's low -cast spay/neuter clinic offers pet sterilization for $60-$130 depending on size and sex of Dog. 0n average it costs $So per dog. For cats AFV charges $50-$60 dependent on sex of the cat. For the Temecula spay neuter vouchers we are allocating 25% of the funds to help curb spay/neuter fees for the residents of Temecula. The funds will help cover over 100 spay/neuter surgeries and will help stop on average an extra 570 from roaming the streets or ending up in the shelter. Last year we offered City of Temecula Community Service Funding- Reinvestment in Temecula GRANT APPLICATION Page 9 of 13 3 TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING, EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS. 1FV serves all local cities in southwest Riverside County, with Temecula being the largest with the highest )opulation. Most of all of our events are hosted in the city of Temecula. Every year on February 23 World Spay lay, AFV hosts a Spay/Neuter free voucher day for the residents residing in each city. Last year, we hosted World ;pay Day at Mary S. Roberts Senior Center. Because of funding we had to cap off at 100 free vouchers. With this einvestment grant of $50,000, AFV can help more Temecula citizens alter their pets. Since COVID and the rate of nflation many pet owners are forgoing spay/neutering their pet and have had to relinquish litters of puppies and :ittens to the shelter. This grant will help the citizens of Temecula from unwanted litters and keep the number of trays down in the city. All those applying for a free voucher have to show proof of residency with a current driver tense and utility bill. AFV would also offer free micro -chipping at these events. Currently the average cost to ;pay a dog $100 and $80 to neuter at AFV's low cost spay/neuter clinic. AFV Micro -chips are $20. 85% of all nimals that become lost without a micro -chip will never find their way back home. It costs AFV $628 an hour to are, feed and house over 200 pets at the shelter a day. This funding would dramatically decrease the number of inwanted pet litters in the city of Temecula. Last year alone, from the city of Temecula, AFV took in 218 stray cats, 32 owner relinquished cats of those 172 were adopted, 30 returned to owners, 98 adopted by rescues. Stray emecula dogs were at 246, owner relinquished 334. 255 Temecula dogs were adopted, 176 returned to owners nd 65 were adopted by rescues. Continuing to increase spay/neuter surgeries would decrease these animals ever inding their way into the shelter. This also illustrates the importance of micro -chipping Temecula pets. urrently, AFV hosts many off -site adoption events at various businesses in Temecula to accommodate Temecula tizens from making the drive to Wildomar. Some of these Businesses are Pet Co, Paradise Chevrolet Cadillac, ello Temecula Subaru, Promenade Mall, Mexico Cafe and various other Temecula Businesses. The citizens of Temecula are still dealing with the effects from COVID especially senior citizens living in assisted living homes. AFV would like to increase our foster service animal program to visit the assisted living in Temecula proper. It has proven that animals especially dogs' offsets loneliness, increases mobility, and increases cognitive ability while interacting with a dog or cat. This holds true for the school age children in Temecula. Many children are feeling anxious with the world around them. AFV would like to reinstate Dog Daze reading program at both City of Temecula Libraries. These days would be coordinated with the city of Temecula. Every Wednesday AFV hosts Huey's reading program from 3-4:30 free to school age children. We would like to expand a version of this program to the Temecula Libraries. This program helps children learn the proper way to approach an animal, how to care and feed a pet. It also allows them to read to the animals without peer judgment and increases reading skills and public speaking while have a good time. stly, AFV would like to host a Temecula Pet Walk during both years of the grant funding to bring the community 3b E S T I M AT E D NUMBER OF PEOPLE FROM TEMECULA EXPECTED TO BENEFIT FROM THIS PROJECT/PROGRAM: 3c ESTIMATED NUMBER OF VOLUNTEERS INVOLVED IN THIS PROJECT/PROGRAM: 1400 with all program: I. City of Temecula Community Service Funding- Reinvestment in Temecula GRANT APPLICATION Page 10 of PROJECT/PROGRAM DESCRIPTION CONTINUED 4 SUMMARY STATEMENT- SUMMARIZE ANSWERS 1 —3 ABOVE IN 50 WORDS OR LESS - An ima I Friends of the Valleys has been serving the cities of southwest Riverside County for over 35 years. In current reports from Animal Welfare Association 70% of households have. 1 nr 2 pets residing in the Kamp. It is vital to help those citizens in Temecula that need extra help offsetting the cast of spay/neutering their pet. AFV already offers low cost spay/neuter surgery but with times the way they are many need additional assistance. These programs are greatly needed in the city of Temecula and if awarded will be able to help hundreds of Temecula residents young and old alike. 5 IF APPLYING FOR MORE THAN $5,000, PLEASE EXPLAIN HOW THE COVID-19 PANDEMIC AFFECTED THIS NONPROFIT ORGANIZATION'S ABILITY TO SERVE THE TEMECULA COMMUNITY. YOU MAY ALSO INCLUDE INFLATIONARY CONCERNS. AFV was deemed at) essential business by the Governor of California, That meant we were to remain open to to the public while abiding to all COViD guidelines. Duringthe peak time of COVID we were open by appointment only and had to adhere social distancing and sanitizing protocols. During 2021 until 2022 AFV had to postpone all major community fundraising events. AFV hosts three signature events. Wines for Canines and kitties, FORE the Animals Golf Tournament, and Paws on the Promenade Spooktacular which are all held at venues in Temecula. AFV lost over $170,000 possibly more by not having these events. We are trying to mace -up For lost revenue. AFV had to reduce or suspend the afore mentioned programs we are suggesting in this funding application. During COVID we had many people adopt due to the ability to work remotely, however once people started to go back to work pet intake increased. Now with people forgoing spay/neuter surgeries because of financial hardships we are getting more litters of puppies and kittens than in the past few years. Inflation accompanied with COVID has put a strain on many Temecula residents. The demographists in Temecula vary greatly and AFV would like to accommodate all citizens and their pets. While it helps the citizens in Temecula it also helps AFV reduce the number of animals entering the shelter. AFV currently has an average 241 animals at the shelter looking for loving and forever homes. These are dogs, cats, rabbits, guinea pigs, small farm animals reptiles and various wildlife. Our mission is to find a loving home for all adoptable pets. We are pleased to report we are at the highest adoption rate in our 35 years. 6 IF APPLYING FOR MORE THAN $5,000, EXPLAIN HOW FUNDS HAVE OR WILL: (1) CREATE NEW PROJECTIPROGRAM, (2) EM0EXISTING PROJECTIPROGRAM, _ANDIQR_(a)_C7 TNLE.EXISTING PR- DJEC'.TIRRO RAM 1) The funds from this 2022-2023 reinvestment Grant from the City of Temecula will allow Animal Friends of the Valleys to create a new Pet Walk event for the citizens in Temecula. This will bring in much needed funding to the shelter for other Temecula events while supporting Temecula citizens their pets and local Temecula businesses. It encourages the focus on animal welfare in the city of Temecula while helping Temecula businesses and welcomes community gathering for all ages including pets. Temecula events such as these will help Temecula residents become more aware of the community programs offered at or through AFV. The new reading and pet education program will be offered to all Temecula elementary school children at both Temecula libraries. This will encourage children to learn to love to read while reading to a live pet. Funding from this grant will allow AFV to be able to offer this program a few times a year while offering it free of charge to Temecula families. Reading is fundamental and a fun way to encourae-e children and narents to utill7P TemPrula`s hPautlful libraries. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 9 of 13 2) In the past few years AN had to suspend or eliminate existing programs that help serve the city of Temecula due to lack of funding. Our micro -chipping events had to be suspended due to the lack of funding and social distancing. Micro -chipping is imperative in all domestic pets so they can find their way home. Every July 4th there are hundreds of dogs that run away due to City fireworks in Temecula alone. The ones with micro -chips get reunited 90% faster than those without micro -chips, It is imperative to help those Temecula pets and their owners. I Free Spay/neuter voucher program for the city of Temecula will help all Temecula citizens help offset the cost of ' altering their pet and ending unwanted litters. Many families will forgo the extra cost of altering their pet due to the high cost of living and supporting their children. It is mandatory in Temecula to have your pet licensed and to receive licensing, a pet must be vaccinated and spayed or neutered. With the newly adopted city mandatory spay/neuter laws, this grant is priceless in helping Temecula members afford the cost to spay/neuter their pets. The new ordinance is modeled after a fix -it ticket allowing pet owners that have been citied to come into compliance by spay/neutering their pet to avoid fines. This grant will offset the number of Temecula pets surrendered because of the financial burden on the owners. This will help those owners who cannot afford the cost of surgery and ultimately not be fined. The vouchers are good for dogs, cats, and rabbits. These programs will help deter Temecula residents from relinquishing their pets due to financial hardships. By offsetting these costs, it will help the economy in Temecula as residents will be able to spend more on local groceries, apparel stores, and gas to name a few. AFV is continually exploring new ways to encourage every community member to be responsible pet owners and help reduce pet overpopulation. 3) AFV would also use this funding to expand on existing pet adoption events in the city of Temecula. Currently we have offsite adoptions to help bring shelter pets to the city of Temecula to be adopted by Temecula residents. AN would like to expand on pet adoptions in the city of Temecula at various local businesses. On average at every off -site pet adoption there are over 10 adoptions per event. That is 10 less mouths to feed for AFV. While bringing a new family member into 10 Temecula homes. AFV's goals to help animals find loving homes while reducing the number of animals in the shelter. We would encourage other Temecula businesses to offer adoption events at their location. This helps the animals the shelter and the Temecula business with added marketing and flow of traffic onto their business. There are many new assisted living apartments in the city of Temecula. This population has been affected the most by COVID. Those in assisted living were under strict quarantine guidelines. Even family members could not visit their loved ones even if the senior was ill, This increased anxiety levels and depression among the residents, Many therapists that worked at the assisted living homes were cancelled due to COVID. This ultimately hurt the residences physically and mentally. Before COVID AFV had trained foster pets visit the elderly for companionship and to ease loneliness. Once an animal greeted each resident they would become happier and would interact with the animal which would increase mobility. Seeing the dog would emote past memories of their own pet and cognitively they would remember past experiences. To our delight many of the assisted living homes are pet friendly and the restrictions from COVID are lessening. Pets help the elderly increase memory, widen mobility by throwing a toy and by bending if possible to pet the animal. All pets ease loneliness and depression. These foster pets show unconditional love and affection. This is a must needed service to the elderly of Temecula, City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 10 of ACKNOWLEDGEMENT/SIGNATURE PAGE The applicant acknowledges and agrees to the following: • Recipient is subject to all Community Service Funding Program requirements including submittal deadlines and payment disbursements. Every Community Service Funding application is considered individually and on its own merit. • Awards will be given to organizations and activities that directly benefit the residents of Temecula. • Funding is not immediately available to the recipient, and requires an award letter signature upon approval. Please allow time for checks to be processed. • The awarding of Community Service Funding does not constitute an automatic annual allocation. • The recognition for Community Service Funding should accrue to the City of Temecula, • Community Service Funding must be spent as specified on the Application and records may be requested by the City of Temecula to ensure the funds were used appropriately. • Community Service Funding grants will not be awarded or announced within the 60 days before an election in which an awarding Council Member is on the ballot. The recipient shall provide a full accounting with documentation o the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. If awarded a Community Service Funding Grant by the City of Temecula last year, then compliance receipts must be submitted on or before this application's due date or this aapplication may be rejected as incomplete- 1/we hereby certify the information contained in this Application is true to the best of our knowledge and belief. Animal Friends of the Valleys ORGANIZATION NAME: MAILING ADDRESS: 33751 Mission Trail Rd. Wildomar CA. 92595 PHONE 051) 805.6239 EMAIL: befli(@_afv.org PRESIDENT/ AUTHORIZED OFFICER: ��� SD I`t'vS t & K-'. n TIrLE(11 { SIGNATUR y DATE: 09/10/2022 MONTH, DAY, YEAR IF DIFFERENT THAN ABOVE, APPICATION PREPARED BY: PRINT MAME. TITLE SUBMIT ORIGINAL APPLICATION BY MONDAY, SEPTEMBER 12, 2022, TO: City of Temecula Community Service Funding Attn: City Manager's Office 41000 MAIN STREET TEMECUiA, CA 92590 Questions: Stacey. Brown@TemeculaCA.gov (951) 694-6413 Betsy. Lowrey@TemeculaCA.gov (951) 693-3959 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 13 of 13 elf FY 2022/2023 COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA GRANT APPLICATION # ASSISTANCE LEAGUE OF TEMECULA CITY OF TE1%fCCtlLII FISCAL YEAR 2022.2023 COMMUNITY SERVICE FUNDING M REINVESTMENT IN TEMECULA PROGRAM APPLICATION (Please Print or Type) DUE ON OR BEFORE: MONDAY, SEPTEMBER 12, 2022 PROJECT/PROGRAM INFORMATION Amount Requested: $ bo7 000 Project/Program Title: 5 Points Physical Address of Project/Program: MAXIMUM ALLOWABLE: $50,000 PER ORGANIZATION 3/20/202Q 6/30/2023 Start Date: End Date: INCLUDE IF DIFFERENT THAN ORGANIZATION'S MAILING ADDRESS If Grant is Awarded, Make Check Payable x Assistance League of Temecula Valley Mailing Address: 74120 Via Montezuma i emecula, CA 92590 ORGANIZATION AND GEOGRAPHIC AREA SERVED Name of Applicant Organization: Assistance League of Temecula Valley 1989 9 Year Founded: Website: assistanceleague.org/temecula-valley Number of Paid Staff: None Social Media: Facebook & Instagram Number of Volunteers: 200 Geographic Area(s) the Organization Serves: Temecula Geographic Area(s) the Pro ect/Pro ram Serves: Temecula _ NOTE: COMMUNITY SERVICE FUNDING GRANT PROGRAM FUNDING MUST BE EXCLUSIVELY USED TO SERVE TEMECULA. Contact Name: Diane Sitar Title/Position: Grants Coordinator Contact Person's Direct Telephone: k'951) 526-6771 Contact Person's Email: altemeculaayahoo.com NONPROFIT STATUS Is this organization incorporated as a nonprofit? Yes ® Date of Incorporation as a Nonprofit: 6/15/1989 No ❑ IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING Federal Identification Number: 33-0360419 State Identification Number: 1463456 PRINT OUT AND ATTACH TO THIS APPLICATION VERIFICATION FROM FEDERAL (IRS) AND STATE (FTB) AS FOLLOWS: 1. n Attach IRS Deductibility Status using this link: h :/la sirs, ovla /eos/ 2. M Attach State Entity Status Letter using this link: https:/Iwww.ftb.ca.gov/onfine/self serve entity status ietterlindex.asp. 3. ® Attach first page only of most recent IRS Form 990 or attach print out of detailed info about your charity found on this State Registry's Search Taal: h1p:11rct.doi.ca.gaVNerilica[ionlVllehl5eerch.asnX?FaClllty�Y City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 5 of 13 APPLICATION AUTHORIZATION Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over $500 including any business transactions, negotiations, investments, or interests in real property with a Temecula City Council Member during the past 12 months? No E] Yes ❑ IF YES, BRIEFLY DESCRIBE. i Is a Temecula City Council Member a member of the Board of Directors or an Officer of the organization? No ® Yes ❑ IF YES, PROVIDE COUNCIL MEMBER'S NAME AND TITLE WITHIN THE ORGANIZATION: This Application has been authorized by the organization's: Executive Committee ❑ Board of Directors ® Members -at -Large ❑ MISSION STATEMENT OF ORGANIZATION BRIEFLY DESCRIBE THE ORGANIZATION'S MISSION/GOALS AND OBJECTIVES, Assistance League of Temecula Valley (ALTV) ® is celebrating 34 years of service in Southwest Riverside County, ALTV is an all -volunteer, 501(c)(3) nonprofit organization that transforms lives and strengthens our communities through philanthropic programs in Southwest Riverside County. Member volunteers are dedicated to identifying and serving the needs of Temecula, Murrieta, Menifee, Lake Elsinore, Wildomar and Romoland communities through philanthropic programs developed and administered by our members. FINANCIAL STATEMENTS UPON REQUEST, COPIES OF THE ORGANIZATION'S CURRENT BUDGET/FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT), AND IF AVAILABLE CPA'S AUDIT, MAYBE NEEDED UPON REQUEST TO DEMONSTRATE SOUND FINANCIAL MANAGEMENT. DO NOT SUBMIT NOW. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 6 of 13 FUNDING SOURCES CITY OF TEMECULA—SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM THE CITY FOR ANY PROGRAM? No ❑ Yes ® IF YES, PROVIDE BELOW. NAME OF PROGRAM/PROJECT AMOUNT MONTH + YEAR NAME OF CITY GRANT FUNDED BY THE CITY GRANT OR SPONSORSHIP FUNDING RECEIVED OR SPONSORSHIP Operation Schocl Bell $ 6,sI0 April 2021 CDBG Operation School Bell $ 5,000 December 2020 CSF Operation School Bell $ 7,226 April 2022 CDBC� 5 Points $ 920 July 2022 Council member di •rr n r� CSF Operation School Bell $ .9,491 April 2020 CDBG Operatioii School Bell $ 5,o00 December 2021 CSF $ OTHER OUTSIDE SOURCES —SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM ENTITIES (NOT INCLUDING THE CITY) FOR THE SAME PROJECT/PROGRAM IN THIS APPLICATION? NO ® Yes ❑ IF YES, PROVIDE INFORMATION IN TABLE BELOW. MONTH + YEAR FUNDING RECEIVED City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 7 of 13 GRANT PROJECT/PROGRAM DESCRIPTION IMPORTANT -RECEIPTS/INVOICES IS REQUIRED TO BE SUBMITTED TO THE CITY TO VALIDATE THE ORGANIZATION SPENT GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE PROJECT/PROGRAM AS DESCRIBED HERE 1 DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT. All TV idontlfuos the needs of chilrren rind families in Temecula and develops piulaat;uopic progrrrm.n ro be adrninrstered independently as well vis in parnership with other non-prorits. ALTV's 5 Points Pro ram proVIdes varous basic needs in the area of clothing, food, heaith, literacy and supplies 007N,,iij is provided to iovv to moderate income families, fo-sterihorncicsz3 youth, as weii as emergency lothing to students in need. Food is provided for school prograrns and local food pantries rleaith services provide hygiene kits for foster/horneless and teddy bears to local hospitr.iIs to comfort children in crisis. �Ne al°,3o provide supplies to the schools (such as backpacks) school supplies, fidget (oys, etc) as needed +Nhcn LCAP school counselors identify specific needs. Please see rite attached list for more specific information regarding the service and supplies we have provides and expert to provide in the future 2 DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED. ALSO, INCLUDE A LIST OF GOODS, EQUIPMEMENT, AND/OR SERVICES THIS ORGANIZATION HAS PURCHASED OR PLANS TO PURCHASE WITH AWARDED FUNDS TO SUPPORT THIS PROGRAMMROJECT. Approximately $17,000 of the requested grant funds will reimburse At -TV for a variety of services and supplies that directly benefit those residing in Temecula from March 20, 2020 to the present. We have attached a list of those items to give examples of what we provide and will provide receipts with our Compliance Report. The remaining funds from this $50,000 grant request will be used to fund additional similar services and supplies between now and June 30, 2023. Going forward; it is our intention to purchase supplies from stores and vendors in the City of Temecula whenever possible. ALTV works closely with Temecula middle and high schools to provide supplies for the LCAP program, the special needs preschool program and foster youth as well as elementary school support. In addition, we work closely with Temecula transitional housing and the community pantry. TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING. J EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS. Services provided and supplies purchased directly benefit Temecula residents. Services and supplies were, and will continue to be, distributed to residents through LCAP counselors, Rancho Darnacitas Empowerment Village, foster youth agencies; Community Mission of Hope, Temecula transitional housing, Non Minor Dependents, Temecula Valley Hospital, and Temecula schools for various basic needs. 1 3b ESTIMATED NUMBER OF PEOPLE FROM TEMECULA EXPECTED TO BENEFIT FROM THIS PROJECT/PROGRAM: 2, 3c ESTIMATED NUMBER OF VOLUNTEERS INVOLVED IN THIS PROJECT/PROGRAM: 25 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 8 of 13 PROJECT/PROGRAM DESCRIPTION CONTINUED 4 SUMMARY STATEMENT — SUMMARIZE ANSWERS 1 — 3 ABOVE IN 50 WORDS OR LESS. �rUC(.?eCls r-IYn ti'i= ClUlf1C'M,'i ':R de � �r'.iIC :.� and 7lwanals `that dl cctiy hcdi' C '�� 1 � r' r tit �:h Grr:,n �nr. talili�:s �n Z��grn r,Ulc,.-lar1Cal'??l lrr;rlt fi^iIS g1'a11t In cl`l:diJorl to ncoryle Imn, our Stol;_" `i'v!ll r�kjk'v AL1"/ i0 I1-,o'eas2 filat'?l'�ci S In 7022-2023 til Provide f(l( if; r� eed fl T%f"UlCU �l. All ALTV c`;vF,n1.j8 13 Sri•: � S '�7 I1C9 Qc?]I CC;f;"1"!-'t��ltl?S ,. _?r''1r_ tiir'jLlijil C)Jr;7t"il7[l'.I1�Jlsl(; �?�pgr_11t1a 5 IF APPLYING FOR MORE THAN $5,000, PLEASE EXPLAIN HOW THE COVID-19 PANDEMIC AFFECTED THIS NONPROFIT ORGANIZATION'S ABILITY TO SERVE THE TEMECULA J COMMUNITY. YOU MAY ALSO INCLUDE INFLATIONARY CONCERNS. ALTV has faced several challenges in its operations. When ALTV was forced to close its thrift shop under COVID mandates, it inhibited our ability to generate income from our thrift shop, which is cur primary source of revenue. ALTV has been in recovery mode since that time. We also faced challenges in providing services and distributing materials due to the mandates. ALTV collaborated with local LCAP school counselors, food pantries, and foster/homeless agencies to provide services and materials to the best of our ability during those challenging times. We were successful in our efforts to help the community. Inflation has also significantly increased the cost to operate our philanthropic programs. 6 IF APPLYING FOR MORE THAN $5,000, EXPLAIN HOW FUNDS HAVE OR WILL: (1) CREATE NEW PROJECT/PROGRAM, (2) EXPAND EXISTING PROJECT/PROGRAM, AND/OR (3) CONTINUE EXISTING PROJECT/PROGRAM. Proceeds from this grant will allow ALTV to continue providing basic needs services and materials to children and families of Temecula. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 9 of 13 PROJECT/PROGRAM BUDGET (do not fill in shaded areas) LINE ITEMS FOR PROJECT/PROGRAM REVENUES EXPENSES LIST REVENUES/INCOME FOR PROJECT/PROGRAM Amount of money requested from this City of Temecula $ 50.000 Community Services Grant (Not to exceed $50,000) Amount contributed to the Project/Program by the Applicant $ 316,2` 0 Organization Other grants or funding already awarded for Project/Program, if any I $ In -Kind match amount or volunteer credit hours estimated amount _ $ 10,000 TOTAL REVENUE $ 86,250 LIST OF EXPENSES FOR PROJECT/PROGRAM Tools/Equipment $ Facilities/Rent/Insurance $ Supplies $ 59,250 Marketing $ Services $ Food 1 1 27,000 Other $ Staffing Expense THIS IS INELIGIBLE TO BE FUNDED BY CITY'S GRANT; $ J HOWEVER PLEASE INCLUDE. TOTALEXPENSES $ TOTAL BUDGET $ j $ 86,250 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 10 of 13 Services and supplies provided between Marcie 20 2020 and resent: Christmas presents for Moms and children residing at Rancho Damacitas Empowerment Village * Emergency clothing for a foster child Supplies for the Exceptional Children's Christmas Program in Temecula Christmas presents for Temecula Transitional Housing - Non -Minor Dependents • Household items for Temecula Transitional Housing — Non -Minor Dependents • Backpacks for Community Mission of Hope • Food and hygiene supplies for Community Mission of Hope • Fidget toys & stress balls for Temecula school counselors to distribute as needed • Clothing for students at Temecula Elementary school • Movie tickets for HUGS Foster Family Agency (summer activities for foster youth) • Teddy Bears for Temecula Valley Hospital for children in crisis • Computer tablets for youth residing at Rancho Damacitas Empowerment Village • Student Body cards for foster/homeless youth at Great Oak High School • Famous Footwear gift cards for families residing at Rancho Damacitas Empowerment Village • Mini refrigerator & microwave for Great Oaks High School's ROOTS program (LCAP) ■ Old Navy gift cards for students at Temecula Middle Schools Examples of Support, Supplies and Food to be provided from present to June 30 2023: Support for LCAP Program (Local Control and Accountability Plan) at Temecula schools. • Program addressed the needs of foster/homeless youth, second language learners and youth living in poverty. • All middle and high schools in Temecula have an LCAP counselor on site. Support for all LCAP programs in Temecula schools (3 high schools and 6 middle schools) which provide the following services for foster/homeless youth: * School supplies • Food/healthy snacks ■ Student Body cards • Senior package (valued at $200 each) that include a choice of a yearbook, prom ticket, grad night ticket, etc. * Funds for special classes * Hygiene kits * Computer tablet or other necessary electronics • Emergency clothing * Incentives for learning * Support for extra programs * Stress relievers (fidget toys, stress balls, etc.) for counseling sessions Food voucher for Western Eagle Foundation Support for Temecula Elementary Schools: Food for Vail Elementary's "pantry closet" which is available to families with food insecurity. Other Temecula schools may have a similar program that we would support. Support for Special Needs Preschools. There are 11 Special Education Preschool (PreK) Classrooms in TVUSD, teaching over 200 students at Jackson Elementary and Alamos Elementary: * School supplies • Emergency clothing * Enrichment activities * Books for classroom libraries * Manipulatives for hands-on learning * STEM items (i.e. Magnetic Building Tiles, STEM kits, Butterfly/Ladybug habitats, etc.) • Social Emotional Learning (SEL) supports (i.e. Lakeshore Feelings and Emotions items, pretend play items, cooperative games, etc.) ■ Flexible Seating (floor seats, wobble cushions, balance balls, bean bags, etc.) • Sensory Manipulatives and supports • Gross Motor/Fine Motor equipment or supplies Support for Foster/Homeless Youth: Household items for young adults in Transitional Housing in Temecula through Foster Family Agencies Food vouchers ■ Educational support (special classes or counseling) • Christmas gifts Support for Rancho Damacitas Empowerment Village: • Food vouchers • Christmas gifts for Moms and children • Grocery/gas cards • Special classes or programs as requested by staff Support for Exceptional Children's Christmas Program. This program is designed for special needs children who get a visit with Santa and have activities in which they participate while waiting for their turn to see Santa. ALTV's "Assisteens" auxiliary (7th-12th graders) administer the program: • An appropriate toy or activity for children waiting to speak with Santa • Goodie bag for each child Book for each child Support for Community Mission of Hope: • Backpacks • Food as needed Support for Temecula Valley Hospital: • ALTV provides Teddy Bears on a monthly basis for children receiving care in the hospital ACKNOWLEDGEMENT/SIGNATURE PAGE The applicant acknowledges and agrees to the following: ■ Recipient is subject to all Community Service Funding Program requirements including submittal deadlines and payment disbursements. • Every Community Service Funding application is considered individually and on its own merit. ■ Awards will be given to organizations and activities that directly benefit the residents of Temecula. • Funding is not immediately available to the recipient, and requires an award letter signature upon approval. Please allow time for checks to be processed. The awarding of Community Service Funding does not constitute an automatic annual allocation. ■ The recognition for Community Service Funding should accrue to the City of Temecula. Community Service Funding must be spent as specified on the Application and records may be requested by the City of Temecula to ensure the funds were used appropriately. ■ Community Service Funding grants will not be awarded or announced within the 60 days before an election in which an awarding Council Member is on the ballot. ■ The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. • If awarded a Community Service Funding Grant by the City of Temecula last year, then compliance receipts must be submitted on or before this application's due date or this application may be rejected as incomplete. I/we hereby certify the information contained in this Application is true to the best of our knowledge and belief. ORGANIZATION NAME: Assistance League of Temecula Valley MAILING ADDRESS: 28720 Via Montezuma Temecula, CA 92590 PHONE: (951 ) 111-6771 EMAIL: _;sip -me i1ladVhtu1) coin PRESIDENT/AUTHORIZED OFFICER: Mary Murphy President jllrt � SIGNATURE: ! Ir f '•r ,,? 1 r+. /�' DATE: Au ust 17, 2022 IF DIFFERENT THAN ABOFVE; Diane Sitar APPICATION PREPARED BY: SUBMIT ORIGINAL APPLICATION BY MONDAY, SEPTEMBER 12, 2022, TO: City of Temecula Community Service Funding Attn: City Manager's Office 41000 MAIN STREET TEMECULA, CA 92590 Questions: Stacey. Brown@TemeculaCA.gov (951) 694-6413 Betsy. Lowrey@TemeculaCA.gov (951) 693-3959 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 13 of 13 Q HELP® MENU Home > Tax Exempt Qrganixation Search > Assistance League Of Temecula Valley Assistance League Of Temecula Valley EIN: 33-0360419 1 Temecula, CA, United States Publication 78 Data e Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions. On Publication 78 Data List: Yes Deductibility Code: PC Copies of Returns (990,990-EZ, 990-PF, 990-T) v Electronic copies (images) of Forms 990, 990-EZ, 990-PF or 990-T returns filed with the IRS by charities and non- profits. Tax Year 2020 Form 990 Tax Year 2019 Form 990 Tax Year 2017 Form 990 Tax Year 2016 Form 990 STATE OF CALIFORNIA FRANCHISE TAX BOARD F"GB PO BOX 942857 SACRAMENTO CA 94257-0540 Entity Status Letter Date: 7/29/2022 ESL ID: 4849707501 Why You Received This Letter According to our records, the following entity information is true and accurate as of the date of this letter. Entity ID: 1463456 Entity Name: ASSISTANCE LEAGUE OF TEMECULA VALLEY ❑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. X3. 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. ❑ 5. The entity was administratively dissolved/cancelled on through the Franchise Tax Board Administrative Dissolution process. Important Information • This information does not necessarily reflect the entity's current legal or administrative status with any other agency of the state of California or other governmental agency or body. • If the entity's powers, rights, and privileges were suspended or forfeited at any time in the past, or if the entity did business in California at a time when it was not qualified or not registered to do business in California, this information does not reflect the status or voidability of contracts made by the entity in California during the period the entity was suspended or forfeited (R&TC Sections 23304.1, 23304.5, 23305a, 23305.1). ■ The entity certificate of revivor may have a time limitation or may limit the functions the revived entity can perform, or both (R&TC Section 23305b). Connect With Us Web: ftb.ca.gov Phone: 800-852-5711 from 7 a.m. to 5 p.m. weekdays, except state holidays 916-845-6500 from outside the United States California Relay Service: 711 or 800-735-2929 (For persons with hearing or speech impairments) FTB 4263A WEB (REV 12-2019) efile GRAPHIC print - DO NOT PROCESS I As Filed Data - I DLN: 93493283011090 Q Form 0 Return of Organization Exempt From Income Tax OMB No. 1545-0047 V t►� 2019 Under section 501(c), 627, or 4947(a)(1) of the Internal Revenue Code (except private fou7iii ► Do not enter social security numbers on this form as it may be made public. 0,1—o cent of lbc Tr wnw ► Go to V WIVW, 4aV/al`arnt-r7 for instructions and the latest information. Imemnl Revenue S—ice A For the 2010 catendar vear. or tax Koar beginning 06.01-2,019 and ending 05.31-2020 B Check if applicable: C Name of ugarazaS ten D Employer identification number ASSISTANCE LEAGUE OF TEMECULA VALLEY ❑ Address change ❑ Name change 33-0360419 ❑ Initial - etm n Doing 4ual4tasa as ❑ FinalrMwNlel minnpl ❑ Amended return Numbor and streot (of P.O. box if rnad Is not deliviuvil to street e4rlrey7) Room(suile E Telephone number Q Application p",Iil 28720 VIA MCNIEIUMA (951) 694-8016 CAy or town, State or province, country, and ZIP or fu4ipn pt t," coda TEMECUTA, CA 92590 G Gross receipts$ 1,196,835 F Name and address of prindpal ofiieer: H(a) Is this a group return for 28720 VIA MONTEZUMA subordinates? ❑Yes RNo TEMECULA CA 9259D2510 H(b) Are all subordinates ❑Yes []No included? I Tax-exempt status: 21)O c 501( 3 ❑ 501 c ( ) 4 (insert no,) ❑ 4947(a)(1) or ❑ 527 If "No," attach a list. (see instructions) 3 Website: • www,te+rtecu3avaltey.asylstanealaapue.erp H(c) Group exemption number ► K Form of organization: I] Corporation ❑ Trust ❑ Association ❑ Other ► L Year of formation: 1989 1 M State of legal domicile: CA SUMM,3ry 1 Briefly describe the organization's mission or most significant activities: ASSISTANCE LEAGUE OF TEMECULA VALLEY IS A VOLUNTEER PHILANTHROPIC ORGANIZATION DEDICATED TO SERVING THE NEEDS OF m FAMILIES IN SOUTHWEST RIVERSIDE COUNTY. VOLUNTEERS ARE COMMITTED TO COMMUNITY SERVICE AND SPECIAL PROGRAMS TO HELP LOCAL. CHILDREN AND FAMILIES IN NEED. ti C Q s 0 0 2 Check this box ► ❑ if the organization discontinued its operations or disposed of more than 251/o of Its net asse 9. 4 3 Number of voting members of the governing body (Part VI, line la) . 3 12 y 4 Number of independent voting members of the governing body (Part VI, line lb) . . . . . 4 12 5 Total number of individuals employed in calendar year 2019 (Part V, line 2a) . 5 0 Q 6 Total number of volunteers (estimate if necessary) . . . . 6 220 7a Total unrelated business revenue from Part Vlll, column (C), line 12 . 7a 0 b Net unrelated business taxable income from Form 990-T, line 39 . . . . . 7b Prior Year Current Year 8 Contributions and grants (Part VIII, line 1h) . . . 866,804 759,835 6,970 5,318 9 Program service revenue (Part VIII, line 2g) . . . 284 234 n, SO Investment income (Pert VIII, column (A), lines 3, 4, and 7d ) . 0 11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and Ile) 12 Total revenue —add lines 8 through it (must equal Part VIII, column (A), line 12) 874,058 765,387 13 Grants and similar amounts paid (Part IX, column (A), lines 1-3 ) . . . 413,579 321,838 0 14 Benefits paid to or for members (Pert IX, column (A), line 4) . . . . . 15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-10) 0 0 v' 16a Professional Fundraising fees (Part IX, column (A), line lie) . C. b Total fundraising expenses (Part IX, column (D), line 25) 0169,249 17 Other expenses (Part IX, column (A), lines 11a-11d, Ilf-24e) . . . . 443,295 408,940 18 Total expenses. Add lines 13-17 (must equal Part IX, column (A), line 25) 856,874 730,778 17,164 34,609 19 Revenue less expenses. Subtract line 18 from line 12 . b t IBepinning of Current Year End of Year arc 71 20 Total assets (Part X, line 16) . . . E173,2831 860,753 m 59,534 12,395 a 21 Total liabilities (Part X, line 26) . . . . . . x411. 22 Net assets or fund balances. Subtract line 21 from line 20 813,7491 846,356 HIS Signature f6fatk Ulider penalties of perjury, I declare that I have examined this return, Including Accompanying sehedulos and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer(othgr than officer) is based on all information of which preparer has sign ••• Q10.1o. 5lynature of ofcar Date Here 11 E1 1 19E WilEIL pretxleat Type or print name and title Print/ I ype preparers name Preparer's signature Dare t z, Check El if p00449291 Paid self- Preparer Firrr's name ► LESLIE A DOHERTY CPA APC Firm's EIN ► 20-20B2661 Use Only I Firm's address ► 41680 KALMIA ST STE 115 Phone no- (951) 698-2260 MURRIETA, CA 92562 May the IRS discuss this return with the preparer shown above? (see instructions) . © Yes ❑ No For Paperwork Reduction Act Notice, see the separate instructions. Cat. No, 11282Y Form 990 (2019) FY 2022/2023 COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA GRANT APPLICATION # 5 BIKE TEMECULA VALLEY CORP CITY OF TEMECULA FISCAL YEAR 2022.2023 COMMUNITY SERVICE FUNDING - REINVESTMENT IN TEMECULA PROGRAM APPLICATION (Please Print or Type) DUE ON OR BEFORE: MONDAY, SEPTEMBER 12, 2022 PROJECT/PROGRAM INFORMATION Amount Requested: $ 5,000 MAXIMUM ALLOWABLE: $50,000 PER ORGANIZATION Project/Program Title: Cycle For Hope Start Date: 08/10/22 End Date: I LN03122 Physical Address of Project/Program. 2736 Ynez Road, L-7 #205 Temecula, California 92591 INCLUDE IF DIFFERENT THAN ORGANIZATION'S MAILING ADDRESS If Grant is Awarded, Make Check Payable to: Bike Temecula Valley, Corp. Mailing Address: 31311 Canterbury Court Temecula, Ca. 92591 ORGANIZATION AND GEOGRAPHIC AREA SERVED Name of Applicant Organization: Bike Temecula Vall , Corp. Year Founded: 2021 htt s //www.tvbikecoalition.com/ https://www.facebook.com/biketemeculavalley Website: P = Social Media: roalitinni Number of Paid Staff: Number of Volunteers: 51 Geographic Area(s) the Organization Serves: Primarily Temecula Geographic Area(s) the Project/Program Serves: Primarily Temecula NOTE: COMMUNITY SERVICE FUNDING GRANT PROGRAM FUNDING MUST BE EXCLUSIVELY USED TO SERVE TEMECULA. Contact Name: Gary Oddi Contact Person's Direct Telephone: 951-970-8034 Title/Position: President of the Board of Directors Contact Person's Email: garyoddi@tvbikecoalition.com NONPROFIT STATUS Is this organization incorporated as a nonprofit? Yes x❑ Date of Incorporation as a Nonprofit: June 10, 2021 No ❑ IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING Federal Identification Number: 87-1364605 State Identification Number: 4755644 PRINT OUT AND ATTACH TO THIS APPLICATION VERIFICATION FROM FEDERAL (IRS) AND STATE (FTB) AS FOLLOWS: 1. ❑ Attach IRS Deductibility Status using this link: http://apf)s.irs.gov/a;]p/eos/ 2. ❑ Attach State Entity Status Letter using this link: https://www.ftb.ca.govlonline/self serve entity status letter/index.aso 3. ❑ Attach first page only of most recent IRS Form 990 or attach print out of detailed info about your charity found on this State Registry's Search Tool: h t : /r a , v/V rili anon/Web/Search.aspx?facility=Y City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 5 of 13 APPLICATION AUTHORIZATION j Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over $500 including any business transactions, negotiations, investments, or interests in real property with a Temecula City Council Member during the past 12 months? No 0 Yes ❑ IF YES, BRIEFLY DESCRIBE: Is a Temecula City Council Member a member of the Board of Directors or an Officer of the organization? No ❑x Yes ❑ IF YES, PROVIDE COUNCIL MEMBER'S NAME AND TITLE WITHIN THE ORGANIZATION: This Application has been authorized by the organization's: Executive Committee ❑ Board of Directors ❑x Members -at -Large ❑ MISSION STATEMENT OF ORGANIZATION BRIEFLY DESCRIBE THE ORGANIZATION'S MISSION/GOALS AND OBJECTIVES. -71 Bike Temecula Valley (BTV) Is an engaged Inclusive coalition of cyclists, dedlcated to advocating for a safe, fun, and accessible network of cycling infrastructure and treatments that promote human powered recreation and transportation. We proactively work to assure the safety of the cycling and human powered community. Protecting from auto v cycle collisions and other dangers of the road, through the installation of facilities and treatments. such as protected bike lanes, bike crossings, cycle tracks, class - I bike lanes, at. Also, be a leader in safe riding and driving practices, such as sharing the road, eye contact, hand signals, rolling stops. distracted or impaired driving or riding. Ultimately. develop a vision "0" culture for active transportation. Positively fostering the growth and development of cycling in the region through marketing, fund — raising, educating, and advising. Listen to the community and collectively share their voice regarding cycling to the city, county, and community at large. Make everything we do and advocate for available to all, consciously removing all obstacles. Such as, facilities made available for people with disabiiitias, low-income neighborhoods, et. And trails being reached easily from all neighborhoods and accessible to wheelchairs or mobility scooters, Advancing cycling as a pleasurable pursuit. It Is whatever brings joy to those participating with the coalition [hat is cycling related, for Instance; when your bike or other human powered vehicle brings happiness, including slow sociable riding experiences; endurance endorphin release rides, single track adrenaline eustress runs, pump track skills confidence building laps, nature rides, tow stress facilities use, aesthetically pleasing rides, et Constructively, pragmatically, tenaciously, and In n FINANCIAL STATEMENTS UPON REQUEST, COPIES OF THE ORGANIZATION'S CURRENT BUDGET/FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT), AND IF AVAILABLE CPA'S AUDIT, MAY BE NEEDED UPON REQUEST TO DEMONSTRATE SOUND FINANCIAL MANAGEMENT. DO NOT SUBMIT NOW. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 6 of 13 FUNDING SOURCES CITY OF TEMECULA—SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM THE CITY FOR ANY PROGRAM? No ❑x Yes ❑ IF YES, PROVIDE BELOW. NAME OF PROGRAM/PROJECT AMOUNT MONTH + YEAR NAME OF CITY GRANT FUNDED BY THE CITY GRANT OR SPONSORSHIP FUNDING RECEIVED OR SPONSORSHIP Cycle For Hope Event, Funds submitted $ 900 June, 2022 City Council CS Grant, to Community Mission of Hope (CMOH) not BTV Council Member Stewart $ 2500 City Council CS Grant, Mayor Protem Schwank Cycle For Hope Event, Funds submitted y P June, 2022 to CMOH not BTV BTV is currently requesting funds from City Council CS Grant from all 5 Council Members OounsA-Men*e an application, while one has declined our $ "2500" (Amount applied for. Funding 2022 -23 City Council CS proposal, and 3 have not yet responded. NOT re eiv d1- Grant OTHER OUTSIDE SOURCES —SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM ENTITIES (NOT INCLUDING THE CITY) FOR THE SAME PROJECTIPROGRAM IN THIS APPLICATION? NO X❑ Yes ❑ IF YES, PROVIDE INFORMATION IN TABLE BELOW. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 7 of 13 GRANT PROJECT/PROGRAM DESCRIPTION IMPORTANT - RECEIPTS/INVOICES IS REQUIRED TO BE SUBMITTED TO THE CITY TO VALIDATE THE ORGANIZATION SPENT GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE PROJECT/PROGRAM AS DESCRIBED HERE 1 DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT. Our major event this year will be the "Cycle for Hope" bike rides on October 2. This is a cycling event supported by BTV in collaboration with Community Mission of Hope / Rancho Damacitas. This event includes three rides, 50 - 25 - 15 milers, where participants will be given an opportunity to ride their bicycles through the neighborhoods of Temecula and on the roads of Temecula Valley Wine Country for a great cause_ Though these rides are simply rides, chip timing will be provided so riders can have access to their performance results. The event ultimately is to benefit The Community Mission of Hope / Rancho Damacitas to help end homelessness and hunger In our community. Secondarily BTV is dedicated to supporting events and programs that encourage healthy activities. The Cycle For Hope will demonstrate the benefits of an active community. In an event of this magnitude, volunteers are key to success. The support of volunteers from Temecula brings our community together to promote health, wellness, and a higher quality of life. 12 DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED. ALSO, INCLUDE A LIST OF GOODS, EQUIPMEMENT, AND/OR SERVICES THIS ORGANIZATION HAS PURCHASED OR PLANS TO PURCHASE WITH AWARDED FUNDS TO SUPPORT THIS PROGRAM/PROJECT. If granted the Funding, we would supplement the "Cycle For Hope" event budget. Within this budget we will be purchasing route signage, sign frame holders, volunteer high visibility vests and shirts, participant commemorative shirts, and bike racks, (as designated in the Program/Project Budget sheet provided in this Application). The largest cost from the Budget is support from California Highway Patrol and Temecula Police, Traffic Division for route safety, which is not covered in the CS Grant funding. Yet this extreme expense puts a strain on our budget expenditures, therefore increasing the need to fund the above listed expenditures. �1 3 TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS. The ultimate goal for all proceeds from this event will benefit the Community Mission of Hope and will be allocated to feed the hungry and help the homeless. The proceeds will be directly infused to The Community Mission of Hope's system that helps feed the hungry and support a better life for the homeless. These proceeds will provide direct assistance to those needful populations of Temecula. Residual benefits are: - Bringing community together at a healthy event to benefit our most vulnerable residents. - Including Temecula youth / students in the activity and in the volunteer force for community service. - Educating Temecula about the benefits of cycling. 3b ESTIMATED NUMBER OF PEOPLE FROM TEMECULA EXPECTED TO BENEFIT 500+ FROM THIS PROJECT/PROGRAM: (Base on how many people CMOH can help with the roceeds-froali.jtclp.For Hopei 3c ESTIMATED NUMBER OF VOLUNTEERS INVOLVED IN THIS PROJECT/PROGRAM: 100+ City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 8 of 13 PROJECT/PROGRAM DESCRIPTION CONTINUED 4 SUMMARY STATEMENT — SUMMARIZE ANSWERS 1 — 3 ABOVE IN 50 WORDS OR LESS. Partnering with CMOH, BTV is excited to provide a healthy event for Temecula Residents. Cycle For Hope includes diverse volunteer opportunities, will trumpet Temecula's bicycle routes, and assures all proceeds are channeled to help end homelessness and feed the hungry. 5 IF APPLYING FOR MORE THAN $5,000, PLEASE EXPLAIN HOW THE COVID-19 PANDEMIC AFFECTED THIS NONPROFIT ORGANIZATION'S ABILITY TO SERVE THE TEMECULA COMMUNITY. YOU MAY ALSO INCLUDE INFLATIONARY CONCERNS. 6 IF APPLYING FOR MORE THAN $5,000, EXPLAIN HOW FUNDS HAVE OR WILL: (1) CREATE NEW PROJECT/PROGRAM, (2) EXPAND EXISTING PROJECT/PROGRAM, AND/OR (3) CONTINUE EXISTING PROJECT/PROGRAM. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 9 of 13 PROJECT/PROGRAM BUDGET (do not fill in shaded areas) LINE ITEMS FOR PROJECT/PROGRAM REVENUES LIST REVENUES/INCOME FOR PROJECT/PROGRAM Amount of money requested from this City of Temecula $ Community Services Grant (Not to exceed $50,000) 5,000 Amount contributed to the Project/Program by the Applicant $ Organization 0 Other grants or funding already awarded for Project/Program, if any $ 3400 (2021 - 22 City Council Community Service Grants, Stewart & Schwank allocated to Community Mission of Hope for Cycle For Hn _ In -Kind match amount or volunteer credit hours estimated amount $ 0 TOTAL REVENUE $ 8,400 LIST OF EXPENSES FOR PROJECT/PROGRAM Tools/Equipment Bike Racks, sign holders Facilities/Rent/Insurance Insurance Flyer for City of Temecula & Riverside Count Volunteer high visibility Shirt I Vest, Supplies Course Signage and Markers, radios, Participant Marketing Socalcycling.com, Pierson Print Flyers & Posters Services Registration Service, BikeSignup.com Food Other Staffing Expense THIS IS INELIGIBLE TO BE FUNDED BY CITY'S GRANT; HOWEVER PLEASE INCLUDE. (Temecula PD & CHIP & Gemini Tir TOTAL EXPENSES TOTAL BUDGET $ EXPENSES $ 1000 $ 300 $ 4500 $ 800 $ 1750 250 $ 0 Ing) $17,000 $ 25,600 $ 25,600 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 10 of 13 PREVIOUS* FISCAL YEAR (FY) 2021-2022 COMPLIANCE REPORT IF YOUR ORGANIZATION WAS NOT AWARDED A COMMUNITY SERVICE FUNDING GRANT IN FY 21/22 (LAST YEAR), THEN SKIP THIS PAGE. If your organization was awarded a Community Service Funding Grant in FY 2021-2022 (last year) by the City of Temecula, please submit this information. ` If your organization was awarded a Community Service Funding Grant in Fiscal Year 2021-2022 by the City of Temecula, all grant funds received must have been expended anytime on or between July 1, 2021, and June 30, 2022. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any future funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent. If the funds were not spent in accordance with the approved/awarded application, the organization will be required to return the amount of funds to the City. To substantiate that Fiscal Year 2021-2022 funds received from the City were spent appropriately, proper back-up documentation including the completed table below with accompanying receipts/invoices, must be submitted to the City on or before due date: September 12, 2022. 1. Fill out table below (make additional copies if needed to explain all expenditures.) 2. Attach copies of receipts/invoices (in the same order as listed in this table.) 3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590 Attn: City Manager's Office — CSF EXPENDITURE REPORT due on or before September 12, 2022 Organization: FY 2021-2022 Amount of $ CSF Grant Fund Awarded: Name of Project/Program. Month & Year CSF Grant Received from City: Number of Beneficiaries Living in 92590, 92591, 92592 that Directly Benefitted from this Program/Project (approximate number of beneficiaries if you do not have precise number): - Date on _ Expenditure Name of Company Receipt/Inv, Eon Receipt or Invoice MUST BE ON OR BETWEEN Amount Description Purpose Q = JULY 1, 2021 - JUNE 30, 2022 ` DESCRIBE THE EXPENDITURE PURPOSE OF EXPENDITURE 1 2 3 4 I 5 6 Is EXPENDITURE TOTAL EXPENDITURE TOTAL MUST BE EQUAL TO (OR GREATER) THAN TOTAL AWARD AMOUNT City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 11 of 13 FISCAL YEAR (FY) 2022-2023 COMPLIANCE REPORT If your organization is awarded a Community Service Funding - REINVESTMENT IN TEMECULA Grant in FY2022-2023 by the City of Temecula, follow these Instructions. If your organization is awarded a Community Service Funding Grant - REINVESTMENT IN TEMECULA in FY2022-2023 by the City of Temecula, all grant funds received must be expended anytime on or between March 20, 2020 and June 30, 2024. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any funding. City of Temecula reserves the right to conduct an audit andlor require additional back-up information to substantiate how funds received from the City were spent. If the funds are not spent in accordance with the approved/awarded application, the organization may not receive and/or will be required to return said amount of funds to the City. To substantiate that grant funds from the City are spent appropriately, proper back-up documentation including the table below with accompanying receipts/invoices, must be submitted to the City as outlined on this page. 1. Fill out Expenditure Report table below. Make additional copies if needed to explain all expenditures. A. If awarded $5,000. Submit the following Expenditure Report within 60 days after spending $5,000 no later than June 30, 2024, to demonstrate grant funds were spent in accordance with the Application. [If you were awarded less than $5,000, submit Expenditure Report for that amount.) B. If awarded grant funds exceeding $5,000. A) Follow #1.A above first. B) To receive grant funds exceeding $5,000 (between $5K-$50K), submit the fuilowing Expenditure Report to be reimbursed for the remaining balance of award to demonstrate funds were spent in accordance with the Application. This report can be submitted in $10,000 increments (but no less than $10,000 unless the remaining grant award funding amount Is less than $10K). This report must be submitted to the City no later than June 30, 2024 to receive remaining grant funds. 2. Attach copies of receipts/invoices (in the same order listed in table below). 3. Send to: Organization: City of Temecula, 41000 Main St., Temecula, CA 92590, Attn: City Manager's Dept. "CSF-Reinvestment in Temecula" EXPENDITURE REPORT DATED Name of Project/Program: TOTAL FY 2022-2023 Month & Year FIRST $5,000 check Amount of Grant Fund Awarded: $ was received from City: 1. Is this Expenditure Report Is to provide documentation for first $5,000 awarded and received? Yes_ or No (already submitted). 2. My organization has already received $ of the total FY 2022-23 Grant Fund awarded by tho City 3. Is this Expenditure Report is submitted to request reimbursement of funds? No or Yos If yes, Amount of Request $ Number of beneficiaries living in 92590, 92591, 92592 that directly benefitted from this Program/Project (approximate number of beneficiaries if you do not have precise number) i Date on Expenditure MUST SUPPORT PROJECT/PROGRAM IN APPLICATION & AWARD LETTER E Name of Company Receiptllnvoice on Receipt or Invoice MUST BE ON OR BETWEEN rto E , March 20, 2020-JUNE 30. Amount Description Purpose Q z 2024 EXPENDITURE TOTAL�$ EXPENDITURE TOTAL i City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 12 of 13 ACKNOWLEDGEMENT/SIGNATURE PAGE The applicant acknowledges and agrees to the following: • Recipient is subject to all Community Service Funding Program requirements including submittal deadlines and payment disbursements. ■ Every Community Service Funding application is considered individually and on its own merit. • Awards will be given to organizations and activities that directly benefit the residents of Temecula. • Funding is not immediately available to the recipient, and requires an award letter signature upon approval. Please allow time for checks to be processed. • The awarding of Community Service Funding does not constitute an automatic annual allocation. • The recognition for Community Service Funding should accrue to the City of Temecula. • Community Service Funding must be spent as specified on the Application and records may be requested by the City of Temecula to ensure the funds were used appropriately. ■ Community Service Funding grants will not be awarded or announced within the 60 days before an election in which an awarding Council Member is on the ballot, • The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. • If awarded a Community Service Funding Grant by the City of Temecula last year, then compliance receipts must be submitted on or before this application's due date or this application may be rejected as incomplete- I/we hereby certify the information contained in this Application is true to the best of our knowledge and belief. ORGANIZATION NAME: Bike Temecula Valley, Corp. MAILING ADDRESS: 31311 Canterbury Court Temecula, Ca. 92591 PRESIDENT / AUTHORIZED OFFICER: Gary A. Oddi PHONE;( 951 ) 970-8034 EMAIL: garyoddi@tvbikecoalition.com President, Board of Directors _..} 7 PRINT NAME SIGNATURE: • _ DATE: August 12, 2022 MONTH, DAY, YEAR IF DIFFERENT THAN ABOVE, APPICATION PREPARED BY: PRINT NAME TITLE SUBMIT ORIGINAL APPLICATION BY MONDAY, SEPTEMBER 12, 2022, TO: City of Temecula Community Service Funding Attn: City Manager's Office 41000 MAIN STREET TEMECU LA, CA 92590 Questions. Stacey.Brown@TemeculaCA.gov (951) 694-6413 Betsy. Lowrey@TemeculaCA.gov (951) 693-3959 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 13 of 13 Department of the Treasury Date: Internal Revenue Service 07/19/2022 Tax Exempt and Government Entities Employer ID number. I� P.O. Box 2508 87-1364605 Cincinnati, OH 45201 Person to contact: Name: Customer Service ID number: 31954 Telephone: (877) 829-5500 BIKE TEMECULA VALLEY CORD Accounting period ending: 27636 YNEZ ROAD L-7 205 December 31 TEMECULA, CA 92591 Public charity status: 509(a)(2) Form 9901990-EZ 1990-N required: Yes Effective date of exemption: June 1a-, -2-021' Contribution deductibility: Yes Addendum applies: No DLN: 26053582002322 Dear Applicant: We're pleased to tell you we determined you're exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). Donors can deduct contributions they make to you under IRC Section 170. You're also qualified to receive tax deductible bequests, devises, transfers or gifts under Section 2055, 2106, or 2522. This letter could help resolve questions on your exempt status. Please keep it for your records. Organizations exempt under IRC Section 501(c)(3) are further classified as either public charities or private foundations. We determined you're a public charity under the IRC Section listed at the top of this letter. If we indicated at the top of this letter that you're required to file Form 990/990-EZ/990-N, our records show you're required to file an annual information return (Form 990 or Form 990-EZ) or electronic notice (Form. 990-N, the e-Postcard). If you don't file a required return or notice for three consecutive years, your exempt --status-will -be -automatically-revok If we indicated at the top of this letter that an addendum applies, the enclosed addendum is an integral part of this letter. For important information about your responsibilities as a tax-exempt organization, go to www.irs.gov/charities. Enter "4221-PC" in the search bar to view Publication 4221-PC, Compliance Guide for 501(c)(3) Public Charities, which describes your recordkeeping, reporting, and disclosure requirements. Sincerely, Stephen A. Martin Director, Exempt Organizations Rulings and Agreements Letter 947 (Rev. 2-2020) Catalog Number 35152P r Secretary of State r Certificate of Status 44ppoft Kl I, SHIRLEY N. WEBER, PH.D., California Secretary of State, hereby certify: Entity Name: BIKE TEMECULA VALLEY, CORP. Entity No.: 4755644 Registration Date: 06/10/2021 Entity Type: Nonprofit Corporation - CA - Public Benefit Formed In: CALIFORNIA Status: Active The above referenced entity is active on the Secretary of State's records and is authorized to exercise all its powers, rights and privileges in California. This certificate relates to the status of the entity on the Secretary of State's records as of the date of this certificate and does not reflect documents that are pending review or other events that may impact status. No information is available from this office regarding the financial condition, status of licenses, if any, business activities or practices of the entity. IN WITNESS WHEREOF, I execute this certificate and affix the Great Seal of the State of California this day of June 27, 2022. SHIRLEY N. WEBER, PH.D. Secretary of State Certificate No.: 024913933 To verify the issuance of this Certificate, use the Certificate No, above with the Secretary of State Certification Verification Search available at bizfileOnline.sos.ca.gov. oil Bicycle Coalition Bike Temecula Valle Nbikecoalitionx Cycle For Hope Pro Ride Half Century o"$125 8:OOAM PDT 11:00PM PDT Price increases after September 1, 2022 at 7:59am PDT Sign Up EVENTS Cycle For Hope Intermediate Ride Quarter Century $85 8:30AM PDT 11:00PM PDT Registration ends October 2, 2022 at 8:29am PDT RIDE WEBSITE Additional ride Information can be found at https://www.bikesignup.com/Race/CA/Temecula/CycleForHope. PLACE Community Mission of Hope, 41760 Rider Way Temecula, CA US 92590 DESCRIPTION Cycle For Hope Local Ride 15 Miler $39 9:OOAM PDT 11:OOPM PDT Registration ends October 2, 2022 at 8:59am PDT Cycle For Hope is a cycling event to help end homelessness and hunger in our community. There will be three ride distances, 15, 25, and 50 miles through thf city of Temecula and The Temecula Valley Wine Country. Ride results will be provided by Gemini Timing. A commemorative T-shirt and goodie bag will be provided. The courses will take cyclists through Temecula's finest neighborhoods and trails and the 25 and 50 milers will ride through the beautiful Temecula Valley Wine Country. Post race celebration will be held at Refuge Brewery. RIDE CONTACT INFO If you have any questions about this ride, click the button below. BIKE TEMECULA VALLEY IS A S01C, NON-PROFIT ORGANIZATION. WE THANK OUR COMMUNITY PARTNERS AND WELCOME YOUR CONTRIBUTIONS TO CYCLING IN THE VALLEY. tveducators.org msjc MT. SAN )ACINTO COLLEGE 0 0B 0� �B TEMECULA, CA 11 901 COMMUNITY MISSION OF HOPE RANCHO DAMACITAS CHILDR(=N & FAMILY SIRVIUS FY 2022/2023 COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA GRANT APPLICATION # • 1 BIRTH CHOICE OF TEMECULA CITY OF TEMECUI.A FISCAL YEAR 2022.2023 COMMUNITY SERVICE FUNDING • REINVESTMENT IN TEMECULA PROGRAM APPLICATION (Please Print or Type) DUE ON OR BEFORE: MONDAY, SEPTEMBER 12, 2022 1 PROJECT/PROGRAM INFORMATION Amount Requested: $ 50.000 MAXIMUM ALLOWABLE: $50,000 PER ORGANIZATION Project/Program Title: Client Care Programs Start Date:Ongoing End Date: Ongoing Physical Address of Project/Program: 41750 Winchester Rd. Suite O, Temecula Ca. 92590 INCLUDE IF DIFFERENT THAN ORGANIZATION's MAILING ADDRESS If Grant is Awarded, Make Check Payable to: Birth Choice Centers Mailing Address:1jdge Gate Dr. Suite 220 I ORGANIZATION AND GEOGRAPHIC AREA SERVED Name of Applicant Organization: Birth Choice of Temecula _ Year Founded. _ 1989 Website; www_bifthchoicecenter%grg Social Media: _0-birthchoiceoftemecula Number of Paid Staff: 3 Number of Volunteers: 1.2 Geographic Area(s) the Organization Serves: Temecula Valley/Riverside County Geographic Area(s) the Proiect/Program Serves: Temecula Valle /Riv0!2!jnty NOTE: COMMUNITY SERVICE FUNDING GRANT PROGRAM FUNDING MUST BE EXCLUSIVELY USED TO SERVE TEMECULA. Contact Name: Janette Chun Title/Position: CEO Contact Person's Direct Telephone: 951-234-6140 Contact Person's Email: contact@ bi rthch o ice, center NONPROFIT STATUS Is this organization incorporated as a nonprofit? Yes ® Date of Incorporation as a Nonprofit: 1989 No ❑ IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING Federal Identification Number: 33-0302353 State Identification Number: CI800935 PRINT OUT AND ATTACH TO THIS APPLICATION VERIFICATION FROM FEDERAL (IRS) AND STATE (FTB) AS FOLLOWS: 1. ❑ Attach IRS Deductibility Status using this link: htto://ai3i)s.irs.gQv/82 /eos/ 2. ❑ Attach State Entity Status Letter using this link: https-/Iwww.ftb.ca.gov/online/self serve entity status letter/index.as 3. ❑ Attach first page only of most recent IRS Form 990 or attach print out of detailed info about your charity found on this State Registry's Search Tool: htt :Ilrct.doi.ca. ovNeNficationA(Veb/Search.as x?facilit =Y City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 5 of 13 APPLICATION AUTHORIZATION Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over $500 including any business transactions, negotiations, investments, or interests in real property with a Temecula City Council Member during the past 12 months? No ® Yes ❑ IF YES, BRIEFLY DESCRIBE: Is a Temecula City Council Member a member of the Board of Directors or an Officer of the organization? No ® Yes ❑ IF YES, PROVIDE COUNCIL MEMBER'S NAME AND TITLE WITHIN THE ORGANIZATION: This Application has been authorized by the organization's: Executive Committee ❑ Board of Directors Members -at -Large ❑ MISSION STATEMENT OF ORGANIZATION BRIEFLY DESCRIBE THE ORGANIZATION'S MISSION/GOALS AND OBJECTIVES To support people facing pregnancy, parenting and reproductive health concerns. Birth Choice of Temecula's goal is to allow families a place to go to deal with unplanned pregnancy and parenting concerns. We also want to allow women and men a place to deal with reproductive loss through a support group program. It is our objective to offer education, mentorship and material needs support to families that are struggling with providing for their children and are desiring rentorship and parenting support. We never want a family to feel as if they cannot parent due to lack of goods and services. FINANCIAL STATEMENTS UPON REQUEST, COPIES OF THE ORGANIZATION'S CURRENT BUDGET/FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT), AND IF AVAILABLE CPA'S AUDIT, MAY BE NEEDED UPON REQUEST TO DEMONSTRATE SOUND FINANCIAL MANAGEMENT. DO NOT SUBMIT NOW. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 6 of 13 FUNDING SOURCES CITY OF TEMECULA—SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM THE CITY FOR ANY PROGRAM? No ❑ Yes ❑ IF YES, PROVIDE BELOW. NAME OF PROGRAM/PROJECT AMOUNT MONTH + YEAR NAME OF CITY GRANT FUNDED BY THE CITY GRANT OR SPONSORSHIP FUNDING RECEIVED OR SPONSORSHIP Client Care Program $ 500 June 2021 Council Member Grant Client Care Program i $ 2000 June 2021 Council Member Grant Client Care Program $ 1000 July 2022 Council Member Grant I$ $ OTHER OUTSIDE SOURCES —SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM ENTITIES (NOT INCLUDING THE CITY) FOR THE SAME PROJECT/PROGRAM IN THIS APPLICATION? No ® Yes ❑ IF YES, PROVIDE INFORMATION IN TABLE BELOW AMOUNT MONTH + YEAR RECEIVED NAME OF ENITY FUNDING RECEIVED $ $ I$ $ 1 $ 1 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 7 of 13 GRANT PROJECT/PROGRAM DESCRIPTION IMPORTANT - RECEIPTS/INVOICES IS REQUIRED TO BE SUBMITTED TO THE CITY TO VALIDATE THE ORGANIZATION SPENT GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE PROJECT/PROGRAM AS DESCRIBED HERE 11 DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT. I This funding will go to support our centers programs to include the following: Client Care Program and Fatherhood Program The Client Care and Fatherhood Programs offer pregnancy, parenting and life skills education, one on one mentoring, material assistance, grief and loss support and related services. 2 DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED, ALSO, INCLUDE A LIST OF GOODS, EQUIPMEMENT, AND/OR SERVICES THIS ORGANIZATION HAS PURCHASED OR PLANS TO PURCHASE WITH AWARDED FUNDS TO SUPPORT THIS PROGRAM/PROJECT. For our 2023 Budget Year, our Client Care and Fatherhood Programs will use these funds to purchase the following goods, equipment and services: - Upgraded technology (i.e. computers as ours are 7 years old and need to be updated) - IT professionals to install said computers and monitor them - Goods such as: Hygiene Kits, Diapers, Wipes, Formula, Car Seats, Pak n Plays, Strollers, clothing, gas and food cards and various other parenting needs. - Brochures, paper goods and materials needed for these programs - Update some office furniture (Need a few new chairs) - Offset a portion of building lease (at least 35%) 3 TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS. Our center services around 120 Temecula residents annually. They come for regular monthly visits and enjoy our services at no cost. Many other Temecula residents avail themselves of our pregnancy testing and ultrasound services as well as the services that we are requesting funding for. Being able to have baby items, mentors, courses and upgraded technology will allow them to receive maximum benefit so that Temecula farnilies feel strong so that we can assist with building safe and great communities. I 3b ESTIMATED NUMBER OF PEOPLE FROM TEMECULA EXPECTED TO BENEFIT 120 FROM THIS PROJECT/PROGRAM: 3c ESTIMATED NUMBER OF VOLUNTEERS INVOLVED IN THIS PROJECT/PROGRAM 12 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 8 of 13 PROJECT/PROGRAM DESCRIPTION CONTINUED 4 SUMMARY STATEMENT — SUMMARIZE ANSWERS 1 — 3 ABOVE IN 50 WORDS OR LESS. Birth Choice Centers is a place of help that provides assistance to families who need help to provide for them and their children. Our programs provide them with the goods and services they need. Without such help, they would not be able to build thriving families. 5 IF APPLYING FOR MORE THAN $5,000, PLEASE EXPLAIN HOW THE COVID-19 PANDEMIC AFFECTED THIS NONPROFIT ORGANIZATION'S ABILITY TO SERVE THE TEMECULA COMMUNITY. YOU MAY ALSO INCLUDE INFLATIONARY CONCERNS. he CV-19 Pandemic was an incredible difficulty for us. Previously our center was operating 4 ays a week and we serviced close to 1600 appointments a year. We had 25 volunteers and 5 taff. Once the pandemic hit we went down to 3 staff and 2 volunteers as well as our donations rasticaIly reducing to the paint that we had to shut down 2 days of service each week. he needs of the families did not stop however and with 2 days of service and 3 staff we still ad 1,279 appointments that year, that meant that we had close to 10 appointments every day. was an incredible feat that was only possible because of our great love for our clients and a lot IF prayer. Now we are operating 3 days a week with 3 staff and have 12 volunteers. ;Our clientele continues to grow and the need is incredible, especially during this time of inflation land steep prices. 6 IF APPLYING FOR MORE THAN $5,000, EXPLAIN HOW FUNDS HAVE OR WILL: (1) CREATE NEW PROJECT/PROGRAM, (2) EXPAND EXISTING PROJECT/PROGRAM, AND/OR (3) CONTINUE EXISTING PROJECT/PROGRAM. For our 2023 budget year, it is our intention to expand our existing programs and projects. Our reality is that our programs are expanding without us trying to expand them. This grant will give us the ability to serve all residents without having to decrease supplies to make them last. These last 2 years we provided families with over 15k diapers, around 500 cans of formula and 600 bags of clothing as well as hundreds of other goods We are only in August of 2022 and we are already near bypassing that amount. This grant will allow us to not only upgrade our serious) outdated technologybut also provide for much needed goods for our families as our services are greatly expanding. These funds would also allow us to offset a portion of our building lease up to 35%. If the board wishes that the funds to offset leasing charges should be allocated differently, we would then adjust the apportionment to the boards preference. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 9 of 13 PROJECT/PROGRAM BUDGET (do not fill in shaded areas) LINE ITEMS FOR PROJECT/PROGRAM IiI REVENUES LIST REVENUES/INCOME FOR PROJECT/PROGRAM Amount of money requested from this City of Temecula $ 50,000 Community Services Grant (Not to exceed $50,000) Amount contributed to the Project/Program by the Applicant $120,000 Organization Other grants or funding already awarded for Project/Program, if any $ 2000 EXPENSES In -Kind match amount or volunteer credit hours estimated amount $ 30,000 TOTAL REVENUE $ 202,000 LIST OF EXPENSES FOR PROJECT/PROGRAM Tools/Equipment i — $ 15,000 Facilities/Rent/Insurance 1111 $ 65,000 Supplies $ 40,000 I I 1 Marketing $ 5,500 Services $ 3,500 Food $ 20,000 Other F $ 5,500 Staffing Expense THIS IS INELIGIBLE TO BE FUNDED BY CITY'S GRANT; $ 68 000 HOWEVER PLEASE INCLUDE. TOTAL EXPENSES $ 223,500 TOTAL BUDGET $ $ 200,000 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 10 of 13 PREVIOUS` FISCAL YEAR (FY) 2021-2022 COMPLIANCE REPORT IF YOUR ORGANIZATION WAS NOT AWARDED A COMMUNITY SERVICE FUNDING GRANT IN FY 21/22 (LAST YEAR), THEN SKIP THIS PAGE. If your organization was awarded a Community Service Funding Grant in FY 2021-2022 (last year) by the City of Temecula, please submit this information. If your organization was awarded a Community Service Funding Grant in Fiscal Year 2021-2022 by the City of Temecula, all grant funds received must have been expended anytime on or between July 1, 2021, and June 30, 2022. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any future funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent. If the funds were not spent in accordance with the approved/awarded application, the organization will be required to return the amount of funds to the City. To substantiate that Fiscal Year 2021-2022 funds received from the City were spent appropriately, proper back-up documentation including the completed table below with accompanying receipts/invoices, must be submitted to the City on or before due date: September 12, 2022. 1. Fill out table below (make additional copies if needed to explain all expenditures.) 2. Attach copies of receipts/invoices (in the same order as listed in this table.) 3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590 Attn: City Manager's Office —CSF EXPENDITURE REPORT due on or before September 12, 2022 Organization: Name of Project/Program: FY 2021-2022 Amount of $ CSF Grant Fund Awarded: Month & Year CSF Grant Received from City: Number of Beneficiaries Living in 92590, 92591, 92592 that Directly Benefitted from this Program/Project (approximate number of beneficiaries if you do not have precise number): Date on Expenditure E Name of Company Receipt/invoice .9 on Receipt or Invoice MUST BE ON OR BETWEEN Amount Description Purpose JULY 1, 2021 - JUNE 30. 2022 DESCRIBE THE EXPENDITURE PURPOSE OF EXPENDITURE ¢z 1 2 3 4 5 1A EXPENDITURE TOTAL $ EXPENDITURE TOTAL MUST BE EQUAL TO (OR GREATER) THAN TOTAL AWARD AMOUNT City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 11 of 13 FISCAL YEAR (FY) 2022-2023 COMPLIANCE REPORT If your organization is awarded a Community Service Funding - REINVESTMENT IN TEMECULA Grant' FY2022-2023 by the City of Temecula, follow these instructions. If your organization is awarded a Community Service Funding Grant - REINVESTMENT IN TEMECULA in FY2022-2023 by the City of Temecula, all grant funds received must be expended anytime on or between March 20, 2020 and June 30, 2024. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent. If the funds are not spent in accordance with the approved/awarded application, the organization may not receive and/or will be required to return said amount of funds to the City. To substantiate that grant funds from the City are spent appropriately, proper back-up documentation including the table below with accompanying receipts/invoices, must be submitted to the City as outlined on this page. 1. Fill out Expenditure Report table below. Make additional copies if needed to explain all expenditures. A. If awarded $5,000. Submit the following Expenditure Report within 60 days after spending $5,000 no later than June 30, 2024, to demonstrate grant funds were spent in accordance with the Application. [If you were awarded less than $5,000, submit Expenditure Report for that amount.) B. If awarded grant funds exceeding $5,000. A) Follow #1.A above first. B) To receive grant funds exceeding $5,000 (between $5K-$50K), submit the following Expenditure Report to be reimbursed for the remaining balance of award to demonstrate funds were spent in accordance with the Application. This report can be submitted in $10,000 increments (but no less than $10,000 unless the remaining grant award funding amount is less than $10K). This report must be submitted to the City no later than June 30, 2024 to receive remaining grant funds 2. Attach copies of receipts/invoices (in the same order listed in table below). 3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590, Attn: City Manager's Dept. "CSF-Reinvestment in Temecula" EXPENDITURE REPORT DATED Organization: TOTAL FY 2022-2023 Amount of Grant Fund Awarded: $ Name of Project/Program: Month & Year FIRST $5,000 check was received from City: 1. Is this Expenditure Report is to provide documentation for first $5,000 awarded and received? Yes._ or No (already submitted). 2. My organization has already received $ of the total FY 2022-23 Grant Fund awarded by the City 3. Is this Expenditure Report is submitted to request reimbursement of funds? No or Yes If yes, Amount of Request 5 Number of beneficiaries living in 92590, 92591, 92592 that directly benefitted from this Program/Project (approximate number of beneficiaries if you do not have precise number). Date on tName of Company Receipt/invoice E on Receipt or Invoice MUST BE ON OR BETWEEN :0 3 March 20, 2020 - JUNE 30, Q Z 2024 Expenditure MUST SUPPORT PROJECT/PROGRAM IN APPLICATION & AWARD LETTER Amount I Description Purpose 1 I$ 1 _ 2 $ 3 $ EXPENDITURE TOTAL $ EXPENDITURE TOTAL City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 12 of 13 ACKNOWLEDGEMENT/SIGNATURE PAGE The applicant acknowledges and agrees to the following: ■ Recipient is subject to all Community Service Funding Program requirements including submittal deadlines and payment disbursements. • Every Community Service Funding application is considered individually and on its own merit. • Awards will be given to organizations and activities that directly benefit the residents of Temecula. • Funding is not immediately available to the recipient, and requires an award letter signature upon approval. Please allow time for checks to be processed. • The awarding of Community Service Funding does not constitute an automatic annual allocation. • The recognition for Community Service Funding should accrue to the City of Temecula. • Community Service Funding must be spent as specified on the Application and records may be requested by the City of Temecula to ensure the funds were used appropriately. • Community Service Funding grants will not be awarded or announced within the 60 days before an election in which an awarding Council Member is on the ballot. ■ The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. • If awarded a Community Service Funding Grant by the City of Temecula last year, then compliance receipts must be submitted on or before this application's due date or this application may be rejected as incomplete. I/we hereby certify the information contained in this Application is true to the best of our knowledge and belief. ORGANIZATION NAME: Birth Choice of Temecula MAILING ADDRESS: 1 Ridgegate Dr. Suite 220 Temecula, Ca. 92590 PRESIDENT / AUTHORIZED OFFICER: Janette Chun °RINT NAME SIGNATURE IF DIFFERENTTHAN ABOVE, APPICATION PREPARED BY: PHONE: (951) 240-3006 EMAIL: contact@birthchoice.center CEO TITLE DATE: 9/1 /2022 MON`N, DAY, YEAR PRINrNAiMf TIf E SUBMIT ORIGINAL APPLICATION BY MONDAY, SEPTEMBER 12, 2022, TO: City of Temecula Community Service Funding Attn: City Manager's Office 41000 MAIN STREET TEMECULA, CA 92590 Questions: Stacey.Brown@TemeculaCA.gov (951) 694-6413 Betsy. Lowrey@TemeculaCA.gov (951) 693-3959 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 13 of 13 STATE OF CALIFORNIA FRANCHISE TAX BOARD F T 8 PO BOX 942857 SACRAMENTO CA 94257-0540 Entity Status Letter Date: 8/18/2022 ESL ID: 2469572054 Why You Received This Letter According to our records, the following entity information is true and accurate as of the date of this letter Entity ID: 1800935 Entity Name: BIRTH CHOICE CENTERS, INC. 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. a3. 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. ❑ 5. The entity was administratively dissolved/cancelled on through the Franchise Tax Board Administrative Dissolution process. Important Information This information does not necessarily reflect the entity's current legal or administrative status with any other agency of the state of California or other governmental agency or body. If the entity's powers, rights, and privileges were suspended or forfeited at any time in the past, or if the entity did business in California at a time when it was not qualified or not registered to do business in California, this information does not reflect the status or voidability of contracts made by the entity in California during the period the entity was suspended or forfeited (R&TC Sections 23304.1, 23304.5, 23305a, 23305.1). The entity certificate of revivor may have a time limitation or may limit the functions the revived entity can perform, or both (R&TC Section 23305b). Connect With Us Web: ftb.ca.gov Phone: 800-852-5711 from 7 a.m. to 5 p.m. weekdays, except state holidays 916-845-6500 from outside the United States California Relay Service: 711 or 800-735-2929 (For persons with hearing or speech impairments) FTB 4263A WEB (REV 12-2019) Q HELPB MENU Home > Tax Exempl-ftanIzation Search > Birth Choice Centers Inc. Birth Choice Centers Inc. EIN: 33-0302353 1 Temecula, CA, United States Other Names Publication 78 Data o Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions. On Publication 78 Data List: Yes Deductibility Code: PC Copies of Returns (990, 990-EZ, 990-PF, 990-T) e Electronic copies (images) of Forms 990, 990-EZ, 990-PF or 990-T returns filed with the IRS by charities and non- profits. Tax Year 2019 Form 990 Tax Year 2018 Form 990 Tax Year 2016 Form 990 Form 990 OMB No. 1545-0047 Return of Organization Exempt From Income Tax 2020 -'•tlnder"ctft§01(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) dpor t,to Pu(allc ooparlmont of the Treasury ► Do not enter social security numtters an this form as it may be made public, Inleriler Revenue Service ► Go to wwwdrs.gov1ftrmM tar instructions and the latest Information. Insisectfon A For the 2020 calendar year, or tax year beginning , 2020, and ending , 20 B Check if applicable: C D Employer identification number Address change BIRTH CHOICE CENTERS, INC. 33-0302353 Name change 1 RIDGE GATE DR. #22D E Telephone number Initial return TEMECULA, CA 92590 951-699-9808 Final return/terminated Amended return G Gross receipts $ 822,629. F Name and address of principal officer: JANETTE CHUN H(a) Is This a group return for suboedlnalos? Yes Application pending["SAME No AS C ABOVE H(b) Are all subordinates included? Yes No If "No," attach a list. See instructions Tax-exempt status: }{ 501(c)(3) 501(e) ( )� (insert no.) 4947(a)(1) or 527 J Website: ► WWW. BIRTHCHOICECENTERS . ORG H(c) Group exemption number ► K Form of organizafion: }C Corporation Trust Association Other► L Year of formation; 1989 M State of legal domicile; CA Part I I Summaty 1 Briefly describe the organi2alion's mission or most significant activities -CRISIS PREGNANCY COUNSELING AND v PARENTAL SUPPORT INCLUDING CLOTHES FOOD AND OTHER MEANS, _______ ----- -- —-------------- ----- ___----•-------------_---- c o _�'—----------- 0 2 Check this box ► If the organization discontinued its operations or disposed of more than 25% of its net assets. a 3 Number of voting members of the governing body (Part VI, line 1a) ......................... ......... 3 9 ed 4 Number of independent voting members of the governing body (Part VI, line 1 b) 4 W) .......... ......... r 5 Total number of individuals employed in calendar year 2020 (Part V, line 2a)........................... 5 13 z 6 Total number of volunteers (estimate if necessary) ................................................... 6 30 a 7a Total unrelated business revenue from Part VIII, column (C), line 12.. .. ........ . . . .......... ....... 7a 0. b Net unrelated business taxable income from Form 990-T, Part I, line 11. ............................... I 7b 0. Prior Year Current Year 8 Contributions and grants (Part VIII, line 1 h).......... ...... , ... . � ti•••• •••••••-••••--•- 573 969. 822 629. 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 l le) .............. 12 Total revenue — add lines 8 through 11 (must equal Part VIII, column (A), line 12) -- -. 573 969. 822,629. 13 Grants and similar amounts paid (Part IX, column (A), lines 1-3) .................... 122 028. 75,863. 14 Benefits paid to or for members (Part IX, column (A), line 4)........ . . ........ . . . ... . h 15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-10)...-- 236 845. 169 618. ° 16a Professional fundraising fees (Part IX, column (A), line 11 e) .. . . . . . ........... . . . .. . b Total fundraising expenses (Part IX, column (D), line 25) ► 9 777. "' 17 Other expenses (Part IX, column (A), lines 11a-11d, 11f-24e)........................ 296 443. 297 198. 18 Total expenses. Add lines 13-17 (must equal Part IX, column (A), line 25) . - - - . - - - - . 655,316. 542 679. 19 Revenue less expenses. Subtract line 18 from line 12 ......... .... ............. . —81, 347 . Beginningof Current Year 279 950. End of Year 20 Total assets (Part X, line 16). . . ...... . ......... . ... ... .. ....... , ............ 118,546. 426,675. 21 Total liabilities (Part X, line 26).......... ....... . ........ ......... , , .. Net 17,620. 45,799. 100 926. 380, 876. 22 assets or fund balances. Subtract line 21 from line 20 . - -. .................... Part 11 1 Slgnature Block Under penalties of perjury, I declare that I I+ exantln this Mum, rKl d�lr accompanying stherhdas and slalonlenh, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other I + d 1f , of „filch limparor Nis any hsrowtadpa. Sign signatures ofoilrecr'Rmm► -- ifala Here DOUGLAS MACRAE TREASURER ype or print name and tirlo Print/Type preparer's name Preparer's sir dies Dale CheckX if PTIN Paid DOUGLAS C. MACRAE 1 tP00438711 Preparer Firm's name ► SHAFER & MACRAE CPAS Use Only Firm'saddress ► 43385 BUSINESS PARK DR STE 150 Firm's EIN ► 33-0884861 TEMECULA CA 92590 Phoneno, 951-296-0785 May the IRS discuss this return with the preparer shown above? See instructions- . . .. X Yes No BAA For Paperwork Reduction Act Notice, see the separate instructions- TEEA01011- 01/19/21 Form 990 (2020) FY 2022/2023 COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA GRANT APPLICATION # 7 BNAI CHIAM i A,. I K, k 1 �y `l FISCAL, YEAR {��r 2 - 202233 �+��� �+ �r� �r ` COMMUNITY SERVICE ICE FUNDING - REINVES T �1ii..i7 1 IN , EMEVYI...i"A PROGRAM APPLICATION (Please PrW or Type) DUE ON OR BEFORE: MONDAY, SEPTEMBER 12, 2.022 PROJECT/PROGRAM INFORMATION Amount Requested $ 3 .L .0 k i ti MA)UMUM ALLOWABLE $50,OW PER ORGANIZATION � ' r �Drrin1�f12 �� PrajectlPrngraln Title: >"� [� • tivl V � � �� WI sw bate: End Date: Physical Address of ProjectlProgrsm: V 1Ca 1Y1 P_ A . UYCIQ. L Li INCLUd6 IF DIFFMENT T14AN GrGANIZA us KuL*4G ApcAE`:s If Grant is Awa(dad, Make Check Payable to: Com CLt on B nain ,I Che l Mailing Address: 2 -! ��\Jia 9r1netsc-t ORGANIZATION AND GEOGRAPHIC AREA SERVED Name of Applicant Organization: Q r e G [r JQ Y1 4) hAl l 0"M I (Near Founded: Website: r i �= , l' 1.) I ] a .t7 r1'1 Soaial Media: G lx*r k „� !.. ��4i i m r h can Number of Paid Staff -3 Number of Volurftem _ GeOgraphic Area(s) the Organization Serves: 7crn �wlel , [fly (1" 6A ,}1� � [ (� C lots f °�} I z i 11 b rL)d<— Geograptdc Areas) the Pro' _ Serves: l FrC'� ��1 rt : l�l U� fF1 e t-6A _^ NOTE r-UW--Q?d Y SERVICE FUNDdNG GRANT Pr=PAIA FUNom MUST mELXct_tj.,- U SERVE TEMECULA Contact Persods Dkect Telephone_ U 1 9l b-f 13% Go ntad Per%orf's Emaih bnA i _ 1Q rrl PIONWROFIT STATUS Is this organization incorporated as a nonprofit? Yes Q i]ate of Incorporation as a NonpraFR: o— 1 q l l No ❑ IF NO. THEN INEOWLE TO RErEfVE CITY FUNDIM6 Federal lclentrfication Number: � � � � � St*e Itlerrtification Number: R-5 PRINT PUT ACID ATTACH TO T' IS APPLICATION VERIFICATION FROM FEDERAL (IRS) AND STATE (FTB) AS FOLLQM: 1, 2 Attach IRS Deductibility Status using this link: hft:Agg 22vlas>�e�1 2. Attach State Entity Status Letter using this link: Laos f .o flb sefve eqM status letterlsnclex.3s 3. d Attach fast page only of most recant IRS Form 990 or attach print out of detailed info about your charity Found on this State RegisWs Search Taol: lrrct- ca- NC'�iliG3tidrr/111k+biSf3adPS —Y Cary of Temewla Caren undy ,%Nke Funding - Reinvestment in T(-n-eeu'-a GRANT APPLICATION Page 5 of 13 APPLICATION AUTI#OR1.ZA1'10N Has IRc organization or any menftm of Me Sowd of Direaol-; of the orgw'xation been invoMed wrih any personal bminess Iransadions valued over $6W inducting any business transactions, negotiations, invest nts, or interests in real property with a Temecula City Gourd Member during the P2912 months? Nn ,Yes ❑ LF YES, BRIEFLY OESCR1t3E is a Te cula City Council Member a member VIM Bbitrd of Dftct0r3 Wig Off VA the organization? No Y?S ❑ tF YES, PROME COUNCIL irEMBER'S NAUC AND TITLE VWTHIN THE ORGANIZATION: Tics Applicabon has been authorized by the orgaNzationr'sL;: Executive Committee ❑ Board of Directors Members -at Lame ❑ MISSION STATrINEIE?ff OF ORGANIZATION BRtE=FLY DESCRIBE THE ORCANIZATION'S MISSIONAGOAL S AND OBJECTIVES- V1�f'gCAt;or Vic;+ cWAIr+� i5 \m2 pit( JCAr)dj �,>>1 ° +�- o zn L ,fir 1ti YU� e. C� S tide y � edo 6 +c bjQtrQ a *4 ���hYhillJ �U� CiJ IJ 16ml =f p") /� V, FINANCIAL STATEMENTS iI7C'�!I jiGr! ��7 UPON REQUEST, COPIES OF THE ORGANiZATIOMS CURRENT BUDGETIFINANCLAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT), AND IF AVAILABLE CPA'S AUDIT, MAY BE NEEDED UPON REQUEST TO DE NMSTRATE SOUND FIMANCIAL MANAGEMENT- DO NOT SUBMIT NOW. City & Temccula Cwywnun4y %"vote h-unaln,7 - Ki9ww=Z&M"L Wr I WIMlk14 f-MIAN I /V -r-Uc'^TIC+r+I rey. 0 ..r 10 FUNDING SOURCES CITY OF TEMECULA—SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQ STING) ANY OTHER SOURCES OF FUNDI NO FROM THE CITY FOR ANY PROGRAM? NO 94 Yes ❑ IFYES. PROMDE BELOW, MAW OF PROGRAM/PROJECT FUNDED BY THE CITY GRANT OR SPONSORSHIP AMOUNT MONTIJ + YEAR FUNDING RECEIVED I NAME OF C" GRANT OR 5FON50RSHIP _ I I � OTHER OUTSIDE SOURCES —SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM ENTITIES (NOT INCLUDING THE CITY) FOR TIME-SAMEIN THIS APPLICATION? No [ Yes [] IF YES. PROVIDE INF047MA11ON INTABLE BELOW. AMOUNT RECEIVED NAME Cif EfIf1Y &"TN +YEAR FUNDING RECEIVED M of Temecula Comnturity St11ViCt Funding - Relm+enwt in Temewle CiRANT APPLICATION Page 7 of 13 GRANT PR0,ffCT/PR0GRW DESCREMOY P PORTANT-RECEIPTMMVUfCESISRVOUIREDTOEESUBMITTEDTOTHEMYTOVAUOATETHEORGANIZATIONSPENTGRANT FUNDING AMRDED RY THE CITY TOSUPPORT THE PROXCPPROGRAM AS DESCRIBED HERE 1 DESCRIBE THE PROJECT/PROGRAM TI-iE TEMEGULA GRANT FUNDING WILL SUPPORT. �or�� : on x i ► ► 1 On K5 +d �, aV<:AA e, 7illoeL l ,:� rpjjd07 -.> on -f!� �� E 5 �, r ��� tl��vv� � i c1 C v oit Il dPSk5 �0 I�I� t' k i s u (}eki d i)vr c�nnvI Awl v� v y � �U �I a SSova., S pde r a vi 0 n 2 DESCRIBE HOW THE ORGANISATION WILL SPEND THE GRANT FUNDING, IF AWARDED, ALSO, INCLUDE A LIST OF 00005, EQUPWMENT, ANDIOR SERVICES THIS ORGAN9ZATION HAS PURCHMED OR PLANS TO PURCHASE VIKM AYORDED FUNDS TO SUPPORT THIS PROGRAMIPROJECT. -lo 1'Y? aln;cftn scq il e. PYOJ 1��jC�1r'1�.Y45r Eli►@�j�^G�j }met! aeeP s sckFe- C�00Y. J ,J .�1 Ge the n t- &) 'ry'),lf Cot-�A- -'� � � Imo*, �i � �`� � �,} FS ►'o(2 C� ct�l"�; �OpipIlIxej loci decor fiOr 3 TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAMIPRQIECT IF A~DED CTIY FUNDING_ EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFIT y TEMECULA RESIDENTS. and (-5 �w on l� Sync go�U�. SyL��! i c> K. 4D j5 rj �v j I�V q Ilk�r�c�i ��c��l n"" erl t- � f off a fT 6067i 3D ESTIMATED NUMBER OF PEOPLE FROM TEMECULA EXPECTED TO BENEFIT FRAM THIS PROJECTIPROGRAM 3C ESTIMATED NUMBER OF VOLUNTEERS INVOLVM IN THIS PR0JC-CT"0C-pRAFA 30 , � o City of TamaG:la Camwnly Service Funding - Reinveatnert in Temsada GRANT APPLICATION Page B of 13 PROJECTIPROGRAM DESCRIPTION t'O,'VnA lUED 4 SUMMARY STATEMENT - SUMMARIZE ANSWERS 1- 3 ABOVE IN 50 WORDS OR LESS. here iS o17Ij a Pw CUm fyluk-ri i�„ or voy)*1 510 'ie, d bu I t a S a ,�'/)a I� -rIvrPtv 11Ja(e fri 'J� ' fi t' /�`r�e?CUIC rPSI alb s. 5 IF APPLYING FOR MORE THAN $5,000, PLEASE EXPLAIN HOW THE COVID-19 PANDEMIC AFFECTED THIS NONPROFIT ORGANIZATIOWS ABILITY TO SERVE THE TEMECULA COMMUNITY. YOU MAY ALSO INCLUDE INFLATIONARY CONCERNS. 6 C'c) r�C�Gf��nn p3'Y)'v 'hrrr lo. Pp d C WIr.f U-s sbon 7"'? elderly peopfb yjo-� abkc- �n,? Asp tag Pkit d,( wn a.s incorne, . 3coee, fvOi reopo01f1 C)jy- 1'r� (-5 1 c� " )qa f oTv r f was ' y'ron IF APPLYING FOR MORE THAN $5,000, EXPLAIN HOW FUNDS HAVE OR WILL= (7) NEW PROJECT/PROGRAM, (2) EXPAND EXISTING PROJECTIPROGRAM, AND/OR (3) CONTINUE EXISTING PROJECTIPROGRAM. aS Y r 11C.c� Ianr� j � f �j -c � ro s �n r4 r(a), tie,ors �l ��+� ���'`�!'rS� G�',1�'� le- �jol.)!'� L s) �'lor � �� ��� ' ,Pl or t 5 q �' P Cf uL '' /7e P r r7 Q f0 I A r`'-9 �'j C M� u uy of Temecula Community Service FundMg - Ri .nvestmentin iernrr_ula GRANT APPLICATION Page 9 of 13 PROJK7/PROGRAM BUDGET tdo not fill in shaded areas) LINE rFEMS FOR PRWECT/PROGRAiM — REVENUES D7MEMSFS LIST REVENUES/1NOOME FOR PROJECT/PROGRAM Amount of money requested from this City of Temecula $ Community Senricm Grant (Not to exceed W,000) 3 Amount contributed to the PrVJiect/Progmm by the Applicant $ Organization Other grants or funding already awarded for Project/Program, if any $ - �I In -Kind match amount or volunteer credit hours estimated amount $ TOTAL REVENUE $2 0 Z7iJ LIST OF UPENSES FOR MMECF/PROGRAM Tools/Equipment $ Facilitias/Rentlinsurance Supplies $ 6 Marketing $ Services $ Food V Other Staffing Expense THIS 15 INELIGIBLE TO BE FUNDED BY idM GRANT; HOWEVER PLEASE INCLUDE_ $ TOTAL EXPENSO 4 TOTAL BUDGET $ . $ Kati Cn of Temecula Community Service Fundog • kemveurrerrt in Temecula GRANT APPLICATION Pape 10 of 13 f — ACKNZ OWLEUGEN ENTISIGIIATURE PAGE The applicant acknowledges and agrees to the following: • Recipient is subject to all Community Service Funding Program requirements including submittal deadlines and payment disbursements_ • Every Community Service Funding application is considered individually and on its own merit. Awards will be given bo organizations and activities that directly benefit the residents of Temecula_ • Funding is nolt Imirnediately available to the recipient, and requires an award letter signature upon approval_ Please allow time for checks to be processed_ • The awarding of Community Service Funding does not oonstltube an automatic annual allocation. • The recognition for Community Service funding should accrue by the City of Temecula. • Cornmundty Service Funding must be spent as specified on the Application and records may be requested by the City of Temecula to ensure the funds were used appropriately, • Community Service Funding grants wiH not be awarded or arrvounced within the f;0 days before an election in which an awarding Council Member is on the ballot. • The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. • If awarded a Community Service Funding Grant by the City of Temecula last year, then compliance receipts must be submitted on or before this applicadon's due date or this appliicrtion may be rejected as incomplete. I/we hereby certify the information contained in this Application is true to the best of our knowledge and belief. ORGANIZATION NAME: On&I I DI MAILIK ADDRf:SS: 21.15 1 D c l 'l [,f.Snl PHOf#E: 5I 42-7-7 ,- -73 t1Vri 5( EAMI:bm T chgl M I g1nail, um PRESIDENT / AUTHORIZED OFFICEFL r 1�u-S b' 1(/,(") p' sidew t SIGNATU RL _ j/� 9561{•�",-' DATE-1 +'I IF DIFFERENT THAN ABOVE, APPICATIDIH PREPARED BY: ir'^+!h H A M F SUBMIT ORIGINAL APPLICATION BY MONDAY, SEPTEMBER 12, 2022, TO: City of Temecula Corn m inity Service Funding Attn: City Manager's Mce 41000 MAIN STREET TEMECULA, CA 92590 Questions: Stacey,lBrown@TerrleculaCA.gov (951) 694.6413 B",Lowrey@Temem[aCA.gov (951) 69L�3959 City of Temecula Comnu'ity &errioe Funding , Reinve9brre4t in Tem v::o GRANT APPLICATION Page 13 of 13 STATE OF CALtF40MA ~ FFLW4CWRETAXFXVJD F" B PO BOX % 2957 SACRAMENTO CA 94257A540 Entity Status Letter ESL ID: &M554520 Why You RaONved This LeWr According to our records, the following entity information is true wW a wnde a5 of The dale oflhis letter, ErMy ID_ 0722510 Enft Name: CONGREGATION FINAi C HAIM OF MURRIETA HOT SWfNGS 1. The entity is in good standing wet the FfaWNM Tax hoard_ 2. ThO amity i5 root in good standing with the Franchise Taos Board_ ® 3. The entity is curerdly exempt loom tax under Revenue and Taxation Code (R&TQ Sedion 23701 d- 4- VA do not have ounent Wommlion aboiA The entlty- 5. The entity was administratiwety di5solvedlcxncelled on throuo the FmncWe Tax Board AdndnlstrallNe Dfss,WuWn proem, kepostard informmMon + This infomiatfon does not necessa* refkd ThO cniiiy's current legal or administrative status with any other agency of the stale of California or other governmental agency (w body. • if the erffdy% powers, rights, and pfMbges were suspended or forleRed at any time in the past or if the errllity did business in California at a time when It was not qualffied or not registered to do business in Catfomia, this inforrnxtiori does not rated the status or voidabiiiily of contracts made by The entity in Callfonlia during the perW Tile erlft was suspended or forfeded (R&TC SecbDm 23304.1. Z3304.5, 23305a. 23305-1), The entity Canute of reviver may have a Erne !-amnion or mwy limit fha furKdons the n,,Aved annoy can periomr, or both (RUG Section 233Q5b). Cormert With Us Web, ftkC4Lgmr Phone: 800-852.5711 from 7 d.rrt.1* 5 psm, weekdays, except state holidays Qlf �500 hum outside the United States California Relay Service: 711 or t3-735-2M (For pwsons with hearfirtla or speech i npaimmmrts) F1`13 42MA WED (REY 12-2019) NF-LP8 MENU = ffQ= > Tax pA OTganixation Search > Congregation Snai Chaim Of Murrieta Hot Springs Congregation Bnai Chaim Of Murrieta Hot Springs EIN: 95-30941901 Murrieta, CA, United States Publication 78 Data o organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions. On PubUcatiarr 78 Data List: Yes Deductibility Code: PC Po_qe lost ReWewedor Updated 10-N0vembar-2= � r", Shiro $ Mrrt W Lim, 956 MA DCLAM, I .. . i; -,j . - '. -, I 1 11 1 :f- I Registrant Details (as Wjcim N� (XN(WJXj.NI'I0N BMeU CHAIM OF UUMELA H(Yr SM1sc:3 fRS MM� VAtbe r Tn- Rdigicv; Rcgistry Status: Exempt - Religious Renewal Dw/Exp. Date: NUMLOur; EX(IMWI b..%w. ]Record Tyv.,-, (7hanoty Xtjj.-b-aU?,n Firattift Dow INAC of LA* IU'ft-W4&LEMA7 Mia-ding Address (MY, N-W Z* %ft WRIM CA 425O Corr Fifing I ,,s & espondence 2010 Raffic APP %NoI.%bpd An-nual Renewal Data No AnimeW R&wwal Dam Related R-P-.�!qistratjons & Event Reports No Related Records 6"PaPffo.j0jrA &W31MM VA FY 2022/2023 COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA GRANT APPLICATION # BOY SCOUTS OF AMERICAY CA IE COUNCIL 045 TAHQUITZ DISTRICT CrrYOFTENECULA FISCAL YEAR 2022 - 2023 COMMUNITY SERVICE FUNDING • REINVMWTMENT IN TEMECULA PROGRAM APPLICATION (Pisa so Pant or Type) DUE ON OR BEFORE: MONDAY, SEPTEMBER 129 2022 PROJECT/PROGRAM INFORMATION Amount Requested: $ 50,000.00 MAXIMUM ALLOWABLE: $50.000 PER ORGANIZATION Scouting In Temecula Project/Program Title: Start Date: 9-12-22 End Date: 8-30-24 Physical Address of Project/Program: Same as mailing address INCLUDE IF DIFFERENT THAN ORGANIZATION'S MAILING ADDRESS If Grant is Awarded, Make Check Payable to: Boy Scouts Of America, Tahquitz District Mailing Address: 2351 W. Lugonla Ave. Suite F Redlands, Ca.92374 ORGANIZATION AND GEOGRAPHIC AREA SERVED Name of Applicant Tahqultz District, Boy Scouts of America Organization: Year Founded.. 1910 Website: clecbsa.org Social Media: facebvok.comltahquitz.district Number of Paid Staff: 1 Number of Volunteers: 230 Geographic Area(s) the QLaaakgion Serves: Riverside and San Bernardino Countines Geographic Area(s) the Prolecypr2gram Serves: Temecula NOTE: COMMUNITY SERVICE FUNDING GRANT PROGRAM FUNDING MUST BE EXCLUSIVE v USED TO SERVE TEMECULA. Contact Name: Tim Long Title/Position: District Executive Contact Person's Direct Telephone:951-453-3666 Contact Person's Email: tim.long@scouting.org NONPROFIT STATUS Is this organization incorporated as a nonprofit? Yes Date of Incorporation as a Nonprofit: 1910 No ❑ IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING Federal Identification Number. 95-1744350 State Identification Number. 7689144562 PRINT OUT AND ATTACH TO THIS APPLICATION VERIFICATION FROM FEDERAL (IRS) AND STATE (FTS) AS FOLLOWS: 1. ❑ Attach IRS Deductibility Status using this link: htt :Ila sirs, ovla Leos/ 2. ❑ Attach State Entity Status Letter using this link: htt sLwww.ftb.ca. ov/amine/self serve entit s atus ;etterlindex.as 3. ❑ Attach first page only of most recent IRS Form 990 pr attach print out of detailed info about your charity found on this State Registry's Search Tool: t n .ca. avN�rilica EonMlehlSearch as x7facl I =� City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 5 of 13 APPLICATION AUTHORIZATION Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over $600 including any business transactions, negotlatlons, investments, or interests in real property with a Temecula Cfty Council Member during the past 12 months? No N Yes ❑ IF YES, BRIEFLY DESCRIBE: Is a Temecula City Council Member a member of the Board of Directors or an Officer of the organization? No M Yes ❑ IF YES, PROVIDE COUNCIL MEMBERS NAME AND TITLE WITHIN THE ORGANIZATION: This Application has been authorized by the organization's: Executive Committee 0 Board of Directors ❑ Members -at -Lange ❑ MISSION STATEMENT OF ORGANIZATION BRIEFLY DESCRIBE THE ORGANIZATION'S MISSION/GOALS AND OBJECTIVES. The mission of the Boy Scouts of America is the porepare young people to make ethical and moral choices over their lifetimes by instilling in them the values of the Scout Oath and Law. The goal of Scouting is to encourage the physical, intellectual, social, emotional and spiritual developments of young people so that they take a constructive place in society as responsible citizens, and as members of their local, national and international communities. FINANCIAL STATEMENTS UPON REQUEST, COPIES OF THE ORGANIZATION'S CURRENT BUDGET/FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT), AND IF AVAILABLE CPNS AUDIT, MAY BE NEEDED UPON REQUEST TO DEMONSTRATE SOUND FINANCIAL MANAGEMENT. DO NOT SUBMIT NOW. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 6 of 13 FUNDING SOURCES CITY OF TEMECULA—SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM THE CITY FOR ANY PROGRAM? No ❑ Yes ■ IF YES, PROVIDE BELOW. NAME OF PROGRAM/PROJECT AMOUNT MONTH + YEAR NAME OF CITY GRANT FUNDED BY THE CITY GRANT OR SPONSORSHIP FUNDING RECEIVED OR SPONSORSHIP Day Camp/Outdoor-Adventure -7500 f i $ $ OTHER OUTSIDE SOURCES —SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM ENTITIES (NOT INCLUDING THE CITY) FOR THE SAME PROJECTIPROGRAM IN THIS APPLICATION? No E Yes ❑ IF YES, PROVIDE INFORMATION IN TABLE BELOW. AMOUNT MONTH + YEAR RECEIVED NAME OF ENITY FUNDING RECEIVED G. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 7 of 13 GRANT PROJECT/PROGRAM DESCRIPTION IMPORTANT- RECEIPTS/INVOICES IS REQUIRED TO BE SUBMITTED TO THE CITY TO VALIDATE THE ORGANIZATION SPENT GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE PROJECT/PROGRAM AS DESCRIBED HERE 1 DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT. The Boy Scouts of America is active and looking to grow membership within the timeframe of this grant not only in the number of Temecula residents, but in our international relationships. We are looking to accomplish this by bringing BSA Scouts and/or groups from Temecula's sister city in Japan to Temecula, as we aim to expand out diversity and inclusion goals as an organization. 2 DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED. ALSO, INCLUDE A LIST OF GOODS, EQUIPMEMENT, AND/OR SERVICES THIS ORGANIZATION HAS PURCHASED OR PLANS TO PURCHASE WITH AWARDED FUNDS TO SUPPORT THIS PROGRAM/PROJECT. Boy Scouts of America is looking to help cover the costs of membership for Scouts and their families in Temecula as well as cover the costs of bringing Scouts from our sister city in Japan, to Temecula, to enhance the City's existing relationship. This may include shipping costs for materials sent, covering the cost of food and host family supplies, etc. 3 TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING, EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS. This grant will specifically enable Temecula residents to participate in the Scouting program in a much less -personal finances way. Our goal is to use these funds to cover registration costs for Scouts. Secondarily, this grant will fund the transporation costs and food costs for Scouts from Japan bringing international tourism revenue through site -seeing and local businesses and shops in the city. 3b 3c ESTIMATED NUMBER OF PEOPLE FROM TEMECULA EXPECTED TO BENEFIT FROM THIS PROJECT/PROGRAM: 50-100 ESTIMATED NUMBER OF VOLUNTEERS INVOLVED IN THIS PROJECT/PROGRAM: 30_40 City of Temecula Community Service Funding - Reinvestment In Temecula GRANT APPLICATION Page 8 of 13 PROJECT/PROGRAM DESCRIPTION CONTINUED 4 SUMMARY STATEMENT - SUMMARIZE ANSWERS 1 - 3 ABOVE IN 50 WORDS OR LESS. Boy Scouts of America is looking to increase our membership numbers within the City of Temecula by covering costs associated with joining or remaining in the program. Scouting teaches Temecula residents the value of community and we'd like to expand that internationally through diversity and inclusion to our sister city in Japan. LCOPPLYING FOR MORE THAN $5,000, PLEASE EXPLAIN HOW THE COVID-19 PANDEMIC ECTED THIS NONPROFIT ORGANIZATION'S ABILITY TO SERVE THE TEMECULA MMUNITY. YOU MAY ALSO INCLUDE INFLATIONARY CONCERNS. The COVID-19 pandemic had a significant Impact on our program in Temecula. Boy Scouts saw a double-digit percentage reduction in membership and participation across the board. With the increased costs associated with simply providing for a family, Temecula residents are expressing challenges in covering costs of the program and being able to keep their child in the program that they know makes a positive and tangible difference. 1.9 IF APPLYING FOR MORE THAN $5,000, EXPLAIN HOW FUNDS HAVE OR WILL: (1) CREATE NEW PROJECT/PROGRAM, (2) 9,XPAND EXISTING PROJECT/PROGRAM, AND/OR (3) CONTINUE EXISTING PRO,IECTIPROGRAM. These funds will help the Boy Scouts of America continue and expand out engagement with the residents of Temecula by providing a program that gives back to the community through Eagle Scout projects, and a variety of other community service/impact opportunities. These funds will additionally enable our program to provide Temecula's sister city in Japan the opportunity to visit the city of Temecula, learn more about it and bring international awareness and knowledge of all Temecula has to offer back to Japan. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 9 of 13 PROJECT/PROGRAM BUDGET (do not flll In shaded arem) LINE ITEMS FOR PROJECT/PROGRAM FREVENUES- LIST REVENUES/INCOME FOR PROJECT/PROGRAM Amount of money requested from this City of Temecula $ 50,000 Community Services Grant (Not to exceed $50,000) Amount contributed to the Project/Program by the Applicant $ 4,000.00 Organization Other grants or funding already awarded for Project/Program, if any $ 0 In -Kind match amount or volunteer credit hours estimated amount $ 5,000.00 TOTAL REVENUE $ 59,000 LIST OF EXPENSES FOR PROJECT/PROGRAM Tools/Equipment Facilities/Rent/Insurance Supplies Marketing Services Food Other Staffing Expense EXPENSES $15,000.00 $4,500.00 $5,000.00 $3,000.00 $1,500.00 $5,000.00 $30,000.00 THIS IS INELIGIBLE TO BE FUNDED BY CITY'S GRANT; HOWEVER PLEASE INCLUDE. $20,000.00 TOTAL EXPENSES $84,000.00 TOTAL BUDGET $59,000.00 $84,000.00 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 10 of 13 PREVIOUS* FISCAL YEAR (FY) 2021-+2022 COMPLIANCE REPORT IF YOUR ORGANIZATION WAS NOT AWARDED A COMMUNITY SERVICE FUNDING GRANT IN FY 21122 (LAST YEAR), THEN SKIP THIS PAGE. If your organization was awarded a Community Service Funding Grant in FY 2021-2022 (last year) by the City of Temecula, please submit this information. If your organization was awarded a Carnmunity Service Funding Grant in Fiscal Year 2021-2022 by the City of Temecula, ail grant funds received must have been expended anytime on or between July 1, 2021. and June 30, 2022. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any future funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received Frorn the City were spent If the funds were not spent in accordance with the a p p rovedlawe rd ad application, the 0rgaalzation will be required to retum the amount of funds to the City. To substantiate that Fiscal Year 2021-2022 funds received from the City were spent appropriately, proper hack -up documentation including the completed table below with accompanying receiptslinvoices, most be submitted to the City on or before due date: September 12, 2022. 1. Fill out table below (make additional copies if needed to explain all expenditures.) 2. Attach copies of recetptslinvoices (in the same order as listed in this table.) 3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590 Attn: City Manager's Office - CSF EXPENDITURE REPORT due on or before September 12, 2022 Organization: Tahquitz District, Boy Scouting In Temecula Scouts--Cf-Amer 1.0 —Name of ProJact/Program: FY 2021-2022 Amount of '2500 CSF Grant Fund Awarded: _ Month & Year CSF Grant Received from City: 06/2022 Number of Beneficiaries Living In 92590, 92591, 92592 that Directly Benefftted 50 from this PfogramfProject (approximate number of benanoiaries If you do not have precise number): Name of Company Date on __ Ex nditure on Recelpt or Invoice MUSTBE OIN OR BVETWEEN Amount Description Purpose JULY t, 2021 -DUNE 30, Z022 DESCRIBE THE EXPENDITURE I PURPOSE OF EXPENDITURE z r � - — - T��J>."A3"par� 6r $ c4 S�"+s(r"P�lres 2 A)A-5 P. rho. rh�� �, 2-o-jz $ zap. 64u'w-e« >� 3 6on4-k e Tor zo11. 4 $ AA-4 cea, (S "erde' U C'* Dar e."op. ALT$h{.,r �7uii5WPKf t �iE � eue rrt a c.�.y.•�i e t EXPENDITURE TOTAL $ S�`I 11 26 EXPENDITURE TOTAL MUST BE EQUAL TO OR GREATER) THAN TOTAL AWARD AMOUNT, Cfty of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 11 of 13 M,oftqPTFQd= 0jp 5fo2 6371 Haven Avis Sb 3-213 Randw Cucamonga, CA 91737-OW US (909) NS-7671 www.ThelEJAz THE IMAgEMpORium BILL.TO BOY SCOUTS OF AMERICA California Inland Empire Council 1230 Indian Cl. Redlands, CA 92374 P.MNUMBER SAIM NEP Per Edits Ham pa Cu MMApp" 351 6.0981197 2.140.44T 2M Cab Soaat Day Camp Rod wlBlack toga Prka Youth. 49s. 133m, 105L - Adult: 39st 14m, 71., 4XI CUOM 200 6.7822 1,366.44T 2M Cub Swut Day Camp Kaye" wMa k Logo PdM Ad —A 1183, Mn- 58L. 5ft. 22 2YJ 6 34 4 4xt Dbowwt - - - f-874.22-874.22T 'r & Promotional Discount M- $tD3--I1tp-21 2 s0.7 6 SUBTOTAL 2.622.66 TAX (7.75%) 203.26 TOTAL 2,825.92 AP RDVE J ENTERED ay: DATEG glzZ 7111etox akwebl INVvICE Involos Number, 270541 POW NASD. DIC. W42115 LNM DRIVE WALDO. VO 53093 sev.l..o wr2m -§Fnaws avow rrr/= w mxa awmma 31M oomw OMPNOON 9wn3-ZH* 40610 rnrprnwulArml�► ST7EirQ C1fCW5AC=Aff ostq Paid In-FzU_ 9111 CA INLAND EMPIRE CCUNCIL BSA i Ship CA INLAND EMPIRE COUNCIL BSA To: 58155 [DYLLBROOK OR T4: MOM DOWNS IDYLLW=,CA 92549 531651DYLLBROOKOR IRS M STATES IDYLLWILO. CA 92549 UNITED STATES Trrm: ad aeo Na Your Raftw Ca 3rNp V♦_i ICOM cc blun1bif 'Cud9iRCL11Q nvw. Qaudr lam IN" Aiiwi WMONPFW,IT test TAROEr RW4)CK&gT CALL TO WTUPoe1NFii! m- 911-aw Oirdtr 0i1[ U" 9uanttoc !fitIPrlea TQwPrlcoArlU MD EACH me an OVAD lit SAM in 190A0 2.0 aw we"ty: v^w.naepeehowm.ory Mono: (920) 52"OW Fg7C: (92Q} 627.6t142 Amountsubject to Amount Exempt Subtolal: Sales Tax from Sales Tax IrW610 Discount, Q.W 3.297.0D Total Sales Tax. 3,297.00 ILM 0.00 Taut 3,207.00 nf 9 An t rtim a•an e irefox about"blw Invoice Number: 270542 J u,a.,�r w.yH unSanwvr r+vacf involm Re _ao ' Srdp pea. Pips I NJa= V7/2M enrl0r_ � + cwtlimw ffl ..- Cl> tm W4285 LAKE ONVE awm WALDOr WI 53093 CUa r41ERe OuL ow Shipment Hutn�er 709.790.2m C90.4ACC0UW oA8 Paid 4nft# ti1B CA INLAND EMPIRE COUNCIL BSA S11)p CA INLAND EMPIRE COUNCIL BSA To: 53145 IDYLLSROOK OR TCK MIKE DOWNS IDYLLWIM CA 92549 1095 MONTECITO DR UNITED STATES CORONA, CA 92879 UNITED STATES Temu Ert Doo ko. Your Rtf►nnce 6hlp yiy CRWIT CNID oe i SfIIi�iQ I7s.afrrlollvn far atv LM gimuSI41 t�11tm0a I.4301k1IC9 W41 alto: Ww naep"11"e.org Afflo rd Subject to Amount Exempt Sales Tax from Sales Tax 0,00 219.00 Phone: (02016234040 pw 1920)623-0042 Subtatak Involce Discount; Total Sal" Tac: Total; 219.00 0.00 0.00 210.00 ,f G+rJ 11'1MH 0.49A A 11 Monday, September 12, 2022 at 15.51:14 Pacific Daylight Time Subject: FW: Your BoothPop Order Confirmation (#10057) Date: Monday, September 12, 2022 at 12:34:23 PM Pacific Daylight Time From: Matt Bear To: Tim Long Attachments: Image001.png, image002.png Matt Bear I Scout Executive, CEO BOY SCOUTS OF AMERICA Callfornia Inland Empire Council 2351 W Lugonla Ave. Ste F Redlands, CA 92374 P 909.793.2463 x302 1 C 909.544.9796 - - - - - ��.-a-n-x-x•!1'►s��li=[ez inn•11_it�'L','�Slr:.i•1'[�Ili4!IC=#l'L�l-1:i�3LR�•��� ter »y CAMP RMRRSOM CALWIGHIA INLAND IV•I•N ,DV%Q" i CONFIAENMAUry NOVICE This message is lnten*d to ba 09+4"Od only by UM listod mdPent(a). It may contain Inb7 mtlon that is privileged. conlWandal ondPorexampt from dlsdosum underappircobte law. Any dissemination, dls6fbution or copying of this massege is st►tcflyplroR�ltad withouf nry(lrlpr pam7lSSi0I7. If you 3ltl not the fntarrdad R?C}�ifan� or if yvu tie VB n)COIIRRd Ahls oommunkatxNf In e►ror, please notify me Immediataly byreturn e-may end pennananlly remove the ontinel message and any oopias bum yDarowputor and all back-up systams, From: BoothPop <service@boothpop.com> Sent: Thursday, June 30, 2022 3:28 PM To: Matt Bear <Matt.Bear@scouting.org> Subject: Your BoothPop Order Confirmation (#10057) Thanks for Your Order Your order ID is #10057. A summary of your order is shown below. To view the status of your orders(ick bm• Shipping Address Billing Address Page 2 of 2 Matt Bear John ®ear Callfomia Inland Empire Council, Boy Scouts of America 2033 E BROOKSIDE DR 2351 W Lugoinle Ave. Ste F Ontario, CA, California 91761 Redlands, California 92374 United States United States 9090449796 DON"9796 Your Order Contains... 10114 east Custom Full Color Event Canopy Tents (Add Backwall? No Thanksl, Add sidewalls? No Thanksl. Select Production 7irm Standard Production-7 CAN10F 2 $900.000SD $1,800.00U5D Buslaeas Days, Are Your Files Print -Ready? Yes, I desWed the files myself., Carrying Case Optlons., Black Nylon Beg, Desired In - Hand Date? Jul 15th 2022) Boothpop L CopyraglttD 2017 Boothpop STOP. THINK, CLICK. Subtotal: $1,800.00 USD Shipping: $0.00 USD Tax: $139.50 USD Grand Total: $1.939.50 USD Payment Method: Credit Card Page 2 of 2 ACKNOWLEDGEMENT/SIGNATURE PAGE The applicant acknowledges and agrees to the following: Recipient is subject to all Community Service Funding Program requirements including submittal deadlines and payment disbursements. • Every Community Service Funding application is considered individually and on its own merit. • Awards will be given to organizations and activities that directly benefit the residents of Temecula. • Funding is not immediately available to the recipient, and requires an award letter signature upon approval. Please allow time for checks to be processed. • The awarding of Community Service Funding does not constitute an automatic annual allocation. • The recognition for Community Service Funding should accrue to the City of Temecula. • Community Service Funding must be spent as specified on the Application and records may be requested by the City of Temecula to ensure the funds were used appropriately. • Community Service Funding grants will not be awarded or announced within the 60 days before an election in which an awarding Council Member Is on the ballot. • The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. • If awarded a Community Service Funding Grant by the City of Temecula last year, then compliance receipts must be submitted on or before this application's due date or this application may be rejected as incomplete. i/we hereby certify the information contained in this Application is true to the best of our knowledge and belief. ORGANIZATION NAME: Tahquitz District, Boy Scouts of America MAILING ADDRESS: 2351 W. Lugonla Ave, Ste F Redlands, Ca. 92374 PHONE: 951 1 ` 53-3666 EMAIL: tim.long@scouting.org PRESIDENT AUTHORIZED OFFICER: Tim Long, District Executive SIGNATURE DATE: 09/1 L/LOLL IF DIFFERENT THAN Ail3O APPICATION PREPARED BY: SUBMIT ORIGINAL APPLICATION BY MONDAY, SEPTEMBER 12, 20221 TO: City of Temecula Community Service Funding Attn: City Manager's Office 41000 MAIN STREET TEMECULA, CA 92590 Questions: Stacey. Brown@TemeculaCA.gov (951) 694-6413 i3etsy.L.ovrrey@TelliectilaCA.gov (951) 693-3959 City of Temecula Community Service Funding - Reinvestment In Temecula GRANT APPLICATION Page 13 of 13 ralRs jniern ! Rovohus sprVicv 0264e4 CINCINNATI ON 45999-0038 SOY SCOUTS OF AMERICA STEPHANIE PHILLIPS 1325 W WALNUT HILL LN IRVING TX 75038-3008 In reply refer tot 02 48219434 Jan. 21, 2020 I.TR 4167C 0 22-1576300 000000 00 130010850 BODC s TE OY Scouts of Ameft Callfornle Inland Empire Coundl 045 B5 EIN N 95-1744350 Eerployer identification numbers 22-1976300 Group exemption numbers 1761 Dear Taxpayers This is in response to your request dated Jan. 09. 2020, for Information about your tax-exempt status. Our records indicate we issued a determination letter to you in November 1965, and you're currently exempt under Internal Revenue Code (IRC) Section 501(c)(3). We also recognized the subordinates on the list you submitted as eXearpt frow federal Income tax under IRC Section 501(c)(3). For federal incope tax purposes, donors can deduct contributions they make to you as provided in IRC Section 170. You're also qualified to receive tax deductible bequests, legacies, devises, transfers, or gifts under IRC Sections 2059, 2106 and 2522. Please refer to wtrw.irs.gov/charities for information about filing requirements. Specifically, IRC Section 60331(j) provides that, 11 you don't file a required return Or notice for three consecutive years, Your exempt status will be automatically revoked on the filing due date of the third required return or notice. In addition, each subordinate organization is subject to automatic revocation if it doean+t'file a required return oe Rat'ics for thr•tt' consecutive years. Subordinate organizations can file required°returns or notices individually or as part of a group return. For tax forest instructions, and publications, visit www.irs.gov or call 1-800-TAX-FORM (1-800-829-3676). If you have questions, call 1-877-829-5500 between 8 none and 5 p.m., local time, Monday through Friday (Alaska and Hawaii follow Pacific Time I . STATE OF CALIFORNIA FRANCHISE TAX BOARD FTB PO BOX942857 SACRAMENTO CA 94257-0540 Entity Status Letter Date: 10/12/2022 ESL ID: 1908321967 Why You Received This Letter According to our records, the following entity information is true and accurate as of the date of this letter. Entity ID: 0094468 Entity Name: CALIFORNIA INLAND EMPIRE COUNCIL, INC., BOY SCOUTS OF AMERICA ® 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. a3. 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. 5. The entity was administratively dissolved/cancelled on through the Franchise Tax Board Administrative Dissolution process. Important Information This information does not necessarily reflect the entity's current legal or administrative status with any other agency of the state of California or other governmental agency or body. If the entity's powers, rights, and privileges were suspended or forfeited at any time in the past, or if the entity did business in California at a time when it was not qualified or not registered to do business in California, this information does not reflect the status or voidability of contracts made by the entity in California during the period the entity was suspended or forfeited (R&TC Sections 23304.1, 23304.5, 23305a, 23305.1). The entity certificate of revivor may have a time limitation or may limit the functions the revived entity can perform, or both (R&TC Section 23305b). Connect With Us Web: ftb.ca.gov Phone: 800-852-5711 from 7 a.m. to 5 p.m. weekdays, except state holidays 916-845-6500 from outside the United States 1990 Return of Organization Exempt From Income Tax OMB �No. 1545-0047 Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) / 0, Do not enter social security numbers on this form as it may be made public. .1..101 ruttnent ol'the fl Sll y ► Go to www.1rs.rgov/Farni990, for instructions and the latest information. mind Revenue Sen,icc For the 2019 calendar year, or tax year beginning I heck if applicable: C Name of organization BOY SCOUTS OF AMERICA Address change CALIFORNIA INLAND EMPIRE COUNCIL 045 Name change Initial return Doing business as Final return/terminarxl Amended ietui n Number and street (ur P.O. bux if mall is nc Application pending 1230 INDIANA COURT City or town, state or province, country, and ZIP or REDLANDS, CA 92374 F Name and address of principal MATT MYERS 1230 INDIANA COURT REDLANDS,CA 92374 Tax-exempt status: 0 501(c)(3) ❑ 501(c) ( ) (insert no Website; ► WWW.BSA-CIEC.ORG and endlnn 12-31-2019 street D Employer identification number 95-1744350 E Telephone number (909) 793-2463 G Gross receipts $ 5,2.87,572 H(a) Is this a group return for subordinates? ❑ Yes 0 No H(b) Are all subordinates included? ❑ Yes ❑No ❑ 4947(a)(1) or ❑ 527 If "No," attach a list. (see instructions) H(c) Group exemption number ► :orm of organization: W Corporation ❑ Trust ❑ Association ❑ Other ► L Year of formation: 1972 1 M State of legal domicile: CA 1 Briefly describe the organization's mission or most significant activities: To prepare younQ people to make ethical and moral choices over their lifetimes by iri in them the values of the scout oath and law. 2 Check this box ► ❑ if the organization discontinued its operations or disposed of more than 25% of its net assets. 3 Number of voting members of the governing body (Part VI, line la) . 3 28 4 Number of independent voting members of the governing body (Part Vl, line lb) . 4 27 5 Total number of individuals employed in calendar year 2019 (Part V, line 2a) . 5 51 6 Total number of volunteers (estimate if necessary) 6 7,500 7a Total unrelated business revenue from Part VIII, column (C), line 12 . 7a 0 b Net unrelated business taxable income from Form 990-T, line 39 . 7b Prior Year Current Year 8 Contributions and grants (Part VIII, line lh) . 882,430 1,209,552 9 Program service revenue (Part VIII, line 2g) . 826,140 1,182,412 10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) . 1,151,801 289,333 11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and Ile) 996,616 1,229,474 12 Total revenue —add lines 8 through 11 (must equal Part VIII, column (A), line 12) 3,856,987 3,910,776 13 Grants and similar amounts paid (Part IX, column (A), lines 1-3) 20,776 30,274 14 Benefits paid to or for members (Part IX, column (A), line 4) 0 15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-10) 1,366,133 1,340,520 16a Professional fundraising fees (Part IX, column (A), line Ile) 0 t b Total fundralsing expenses (Part IX, column (D), line 25) ►344,942 17 Other expenses (Part IX, column (A), lines lla-lld, llf-24e) 1,254,888 1,531,487 18 Total expenses. Add lines 13-17 (must equal Part IX, column (A), line 25) 2,641,797 2,902,281 19 Revenue less expenses. Subtract line 18 from line 12 . 1,215,190 1,008,495 N Beginning of Current Year End of Year .v 20 Total assets (PartX, line 16) . . 3,801,789 4,841,080 n g 21 Total liabilities (Part X, line 26) . . 612,414 742,180 22 Net assets or fund balances, Subtract line 21 from line 20 3,189,375 4,098,900 ii M Si nature Block der penalties of perjury, I decla•e that I have examined this return, including accompanying schedules and statements, and to the best of my Dwledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has knowledge. it FY 2022/2023 COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA GRANT APPLICATION # a I BOYS & GIRLS CLUB OF SOUTHWEST COUNTY f 4 kj I K01-11" FISCAL YEAR 2022 - 2023 COMMUNITY SERVICE FUNDING - REINVESTMENT IN TEMECULA PROGRAM APPLICATION (Please Print or Type) DUE ON OR BEFORE: MONDAY, SEPTEMBER 12, 2022 PROJECT/PROGRAM INFORMATION Amount Requested: $ 50,000 MAXIMUM ALLOWABLE: $50,000 PER ORGANIZATION Before & After School Day Camp Project/Program Title: Programs Start Date: 1/1/22 End Date: 6/30/23 Physical Address of Project/Program: 31465 Via Cordoba, Temecula, CA 92592 INCLUDE IF DIFFERENT THAN ORGANIZATION'S MAILING ADDRESS If Grant is Awarded, Make Check Payable to: Boys & Girls Clubs of Southwest County Mailing Address: PO Box 892349 Temecula, CA 92589 ORGANIZATION AND GEOGRAPHIC AREA SERVED Name of Applicant Boys & Girls Club of Organization: Southwest County Website: www.becswc.org Number of Paid Staff: 31 Geographic Area(s) the Organization Serves: Year Founded: 1990 Social Media: @becswc Number of Volunteers, 100 Temecula, Murrieta, Lake Elsinore Geographic Area(s) the Proiect/Program Serves: Temecula NOTE: COMMUNITY SERVICE FUNDING GRANT PROGRAM FUNDING MUST BE EXCLUSIVELY USED TO SERVE TEMECULA. Contact Name: Carly Bennett -Valle Title/Position: CEO/CFO Contact Person's Direct Telephone:951-699-1526 Contact Person's Email: carlyv@becswc.org NONPROFIT STATUS Is this organization incorporated as a nonprofit? Yes Date of Incorporation as a Nonprofit. 1996 No ❑ IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING Federal Identification Number: 33-0475756 State Identification Number: 1671809 PRINT OUT AND ATTACH TO THIS APPLICATION VERIFICATION FROM FEDERAL (IRS) AND STATE (FWIjAg �&i! s: 1. K Attach IRS Deductibility Status using this link: http://apps.irs.aov/anti/eos/ sEp 12 2022 2. 0 Attach State Entity Status Letter using this link: htips://www.ftb.ca.govionline/self serve entity status letter/index.ask C, . nr 1 =n�t_t;'SorrKI. 3. ® Attach first page only of most recent IRS Form 990 or attach print out of detaile�tPfol4your charity found on this State Registry's Search Tool: http://rct.do'.ca.gov/Verification/Web/Search.asox?far.illty=Y City of Temecula Community Service Funding - Reinvestment In Temecula GRANT APPLICATION Page 5 of 13 APPLICATION AUTHORIZATION Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over $500 including any business transactions, negotiations, investments, or interests in real property with a Temocula City Council Member during the past 12 months? No ■Lj` Yes ❑ IF YES, BRIEFLY DESCRIBE: Is a Temecula City Council Member a member of the Board of Directors or an Officer of the organization? No q Yes ❑ IF YES, PROVIDE COUNCIL MEMBER'S NAME AND TITLE WITHIN THE ORGANIZATION: This Application has been authorized by the organization's: Executive Committee ❑ Board of Directors ❑ Members -at -Large ❑ MISSION STATEMENT OF ORGANIZATION BRIEFLY DESCRIBE THE ORGANIZATION'S MISSION/GOALS AND OBJECTIVES. The mission of the Boys & Girls Club of Southwest County is to inspire, enable, and support all youth to realize their full potential as successful, responsible, and impactful members of the community. FINANCIAL STATEMENTS UPON REQUEST, COPIES OF THE ORGANIZATION'S CURRENT BUDGET/FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT), AND IF AVAILABLE CPA'S AUDIT, MAYBE NEEDED UPON REQUEST TO DEMONSTRATE SOUND FINANCIAL MANAGEMENT. DO NOT SUBMIT NOW. City or Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 6 of 13 FUNDING SOURCES CITY OF TEMECULA—SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM THE CITY FOR ANY PROGRAM? No ❑ Yes E IF YES, PROVIDE BELOW. NAME OF PROGRAM/PROJECT AMOUNT MONTH + YEAR NAME OF CITY GRANT FUNDED BY THE CITY GRANT OR SPONSORSHIP �Y FUNDING RECEIVED F OR SPONSORSHIP Before & After School Program $7226 Awarded CDBG 22-23 Great Futures Breakfast $1080 7/2022 CM CSF 21-22 Great Futures Breakfast $1080 7/2022 CM CSF 21-22 Before & After School Program $6969 4/2022 CDBG 21-22 Ultimate STEM $5000 CSF 21-22 CDBG 20-21 CSF 20-21 2/2022 8/2021 4/2021 Before & After School Program $5491 Ultimate STEM $5000 is l OTHER OUTSIDE SOURCES —SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM ENTITIES (NOT INCLUDING THE CITY) FOR THE SAME PROJECT/PROGRAM IN THIS APPLICATION? NO ❑ Yes N IF YES, PROVIDE INFORMATION IN TABLE BELOW. AMOUNT RECEIVED NAME OF ENITY $ 1125 1Walrrlart $ 5000 SCE $ 10000 f TJX Foundation MONTH + YEAR I FUNDING RECEIVED 12/2020 12/2020 1 /2021 $ 1500 $ 20000 $ 3333 $ 3567 lWalmart OJJDP TJX Foundation Nano Bank RCTC 3/2021 12/2021 1/2022 6/2022 $ 18780 Ongoing City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 7 of 13 GRANT PROJECT/PROGRAM DESCRIPTION IMPORTANT- RECEIPTS/INVOICES IS REQUIRED TO BE SUBMITTED TO THE CITY TO VALIDATE THE ORGANIZATION SPENT GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE PROJECT/PROGRAM AS DESCRIBED HERE 1 DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT. Boys & Girls Club of Southwest County (BGCSWC) provides year-round academic support, sports, arts, STEM, career readiness, and leadership programs through our Before & After -School and Day Camp Programs. Our programs consist of high quality integrated academic, behavioral, and social -emotional learning practices that help address issues faced by our youth today. BGCSWC enriches the lives of young people and provides a safe haven in which they can learn and grow. We are committed to ensuring that Club members stay inschool, build healthy relationships, have a strong sense of self, and that they are prepared for adulthood 2 DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED. ALSO, INCLUDE A LIST OF GOODS, EQUIPMEMENT, AND/OR SERVICES THIS ORGANIZATION HAS PURCHASED OR PLANS TO PURCHASE WITH AWARDED FUNDS TO SUPPORT THIS PROGRAM/PROJECT. The BCGSWC will utilize grant funds to support programming efforts for the Before & After School and Day Camp programs for youth ages 6-17. Funds awarded will be used to purchase program and food supplies, equipment (including safety equipment), cover some transportation expenses from transporting youth to/from school, and other necessary expenses (including insurance costs) required to run our high quality, safety focused programs year-round. 3 TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS. Grant funding for our programs will benefit youth members ages 6-17 who are Temecula residents. The grant funding will provide needed supplies, equipment, and other necessary expenses required to run safe, quality Before and After School and Day Camp Programs for Temecula's youth at our Pechanga Great Oak Clubhouse. 3b ESTIMATED NUMBER OF PEOPLE FROM TEMECULA EXPECTED TO BENEFIT $O FROM THIS PROJECT/PROGRAM: 3c ESTIMATED NUMBER OF VOLUNTEERS INVOLVED IN THIS PROJECT/PROGRAM: 5 _J City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 8 of 13 PROJECT/PROGRAM DESCRIPTION CONTINUED 4 SUMMARY STATEMENT - SUMMARIZE ANSWERS 1 - 3 ABOVE IN 50 WORDS OR LESS. BGCSWC will provide Before/After School and Day Camp Programming year-round to youth ages 6-17. Youth will participate in high quality, safety focused youth development programs daily. Funds awarded will be used for supplies, equipment, transportation, food, marketing and other necessary costs required to run these programs. 5 IF APPLYING FOR MORE THAN $5,000, PLEASE EXPLAIN HOW THE COVID-19 PANDEMIC AFFECTED THIS NONPROFIT ORGANIZATION'S ABILITY TO SERVE THE TEMECULA COMMUNITY. YOU MAY ALSO INCLUDE INFLATIONARY CONCERNS. During the pandemic, we temporarily closed 2 of our 3 clubhouses.With the support of our community, we were able to keep our doors open at our Pechanga Great Oak Clubhouse in Temecula. We adjusted and adapted a new Learning Hub Program where youth could come to the Club, use our wiFi and participate in their virtual classes during the day. Our staff assisted each child to make sure they could log in and stayed on task each school day, then helped with homework after class.The organization's annual revenue in 2020 decreased 60% or $900,000 from 2019, and in November of 2020 the Board of Directors made the tough decision to lay-off the President & CEO and Director of Marketing & Special Events to help decrease expenses.We have also faced capacity restrictions due to social distancing practices over the last 2 vears. 6 IF APPLYING FOR MORE THAN $5,000, EXPLAIN HOW FUNDS HAVE OR WILL: (1) CREATE NEW PROJECT/PROGRAM, (2) EXPAND EXISTING PROJECT/PROGRAM, AND/OR (3) CONTINUE EXISTING PROJECT/PROGRAM. Awarded funds will allow BGCSWC to continue existing programming. Our Before & After School and Day Camp Programs are the main umbrella that make up our programming structure. Through both of these programs youth are provided the opportunity to learn and grow in a safe, fun environment with the support of professionally trained mentors. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 9 of 13 PROJECT/PROGRAM BUDGET (do not fill In shaded areas) LINE ITEMS FOR PROJECT/PROGRAM REVENUES LIST REVENUES/INCOME FOR PROJECT/PROGRAM Amount of money requested from this City of Temecula $ 50,000 Community Services Grant (Not to exceed $50,000) Amount contributed to the Project/Program by the Applicant $ 233,630 Organization Other grants or funding already awarded for Project/Program, if any $ 38,900 CDBG; CSF; RCTC; TJX FOUNDATION; UNITED WAY; NANO BANK In -Kind match amount or volunteer credit hours estimated amount $ TOTAL REVENUE $ 322,530 LIST OF EXPENSES FOR PROJECT/PROGRAM Tools/Equipment INCLUDING SAFETY EQUIPMENT Facilities/Rent/Insurance " lI�IV�J!\/�IYVC - VV-Nr-MML LIABILITY/PROPERTYM/ORKERS COMP Supplies INCLUDING PROGRAM Marketing Services Food Other INCLUDING UTILITIES; TRANSPORTATION Staffing Expense THIS IS INELIGIBLE TO BE FUNDED BY CITY'S GRANT; _HOWEVER PLEASE INCLUDE. EXPENSES $8,520 1 $30,180 i1 $11,000 $1, 000 $4, 000 30,000 $237,830 TOTAL EXPENSES $322,530 TOTAL BUDGET $322,530 $322,530 ; City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 10 of 13 ACKNOWLEDGEMENT/SIGNATURE PAGE The applicant acknowledges and agrees to the following: • Recipient is subject to all Community Service Funding Program requirements including submittal deadlines and payment disbursements. • Every Community Service Funding application is considered individually and on its own merit. • Awards will be given to organizations and activities that directly benefit the residents of Temecula. • Funding is not immediately available to the recipient, and requires an award letter signature upon approval. Please allow time for checks to be processed. • The awarding of Community Service Funding does not constitute an automatic annual allocation. • The recognition for Community Service Funding should accrue to the City of Temecula. • Community Service Funding must be spent as specified on the Application and records may be requested by the City of Temecula to ensure the funds were used appropriately. ■ Community Service Funding grants will not be awarded or announced within the 60 days before an election in which an awarding Council Member is on the ballot. • The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. • If awarded a Community Service Funding Grant by the City of Temecula last year, then compliance receipts must be submitted on or before this application's due date or this application may be rejected as incomplete. I/we hereby certify the information contained in this Application is true to the best of our knowledge and belief. ORGANIZATION NAME: Boys & Girls Club of Southwest County MAILING ADDRESS: PO Box 892349 Temecula, CA 92589 PHONE: (951, 699-1526 x109 EMAIL: carlyv@becswc.org PRESIDENT/AUTHORIZED OFFICER: Carly Bennett -Valle PRI,V F L-7 SIGNATURE: jf�7)-_ IF DIFFERENT THAN ABOVE, APPICATION PREPARED BY: DATE: 9/11 /22 CEO/CFO TIM-F !v"ofi l,, No, YFAR rL_ SUBMIT ORIGINAL APPLICATION BY MONDAY, SEPTEMBER 12, 2022, TO: City of Temecula Community Service Funding Attn: City Manager's Office 41000 MAIN STREET TEMECULA, CA 92590 Questions: Stacey.Brown@TemeculaCA.gov (951) 694-6413 Betsy. Lowrey@TemeculaCA.gov (951) 693-3959 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 13 of 13 Q HELPO MENU Home > Tax Exempt 0 ganization Search > Boys & Girls Club Of Southwest County < Back to Search Results Boys & Girls Club Of Southwest County EIN: 33-0475756 1 Murrieta, CA, United States Other Names Publication 78 Data o Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions. On Publication 78 Data List: Yes Deductibility Code: PC Copies of Returns (990, 990-EZ, 990-PF, 990-T) o Electronic copies (images) of Forms 990, 990-EZ, 990-PF or 990-T returns filed with the IRS by charities and non- profits. Tax Year 2019 Form 990 Tax Year 2018 Form 990 Tax Year 2017 Form 990 Tax Year 2016 Form 990 STATE OF CALIFORNIA FRANCHISE TAX BOARD FTB PO BOX 942957 SACRAMENTO CA 94257-0540 Entity Status Letter Date: 9/12/2022 ESL ID: 5296811263 Why You Received This Letter According to our records, the following entity information is true and accurate as of the date of this letter. Entity ID: 1671809 Entity Name: BOYS & GIRLS CLUBS OF SOUTHWEST COUNTY 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. 0 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. ❑ 5. The entity was administratively dissolved/cancelled on through the Franchise Tax Board Administrative Dissolution process. Important Information This information does not necessarily reflect the entity's current legal or administrative status with any other agency of the state of California or other governmental agency or body. If the entity's powers, rights, and privileges were suspended or forfeited at any time in the past, or if the entity did business in California at a time when it was not qualified or not registered to do business in California, this information does not reflect the status or voidability of contracts made by the entity in California during the period the entity was suspended or forfeited (R&TC Sections 23304.1, 23304.5, 23305a, 23305.1). The entity certificate of revivor may have a time limitation or may limit the functions the revived entity can perform, or both (R&TC Section 23305b). Connect With Us Web: ftb.ca.gov Phone 800-852-5711 from 7 a.m. to 5 p.m. weekdays, except state holidays 916-845-6500 from outside the United States California Relay Service: 711 or 800-735-2929 (For persons with hearing or speech impairments) FTB 4263A WEB (REV 12-2019) EXTENDED TO NOVEMBER 15, 2021 Return of Organization Exempt From Income Tax OMB No. 1545-0047 Form 99D Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) 21320 Department of the Treasury ■ Do not enter social security numbers on this form as it may be made public. pen to Pub] lc Ininnal Revenuesevrce Go to www.irs. ov/Form990 for instructions and the latest information. Inspection A For the 2020 calendar year, or tax year beginning and ending 8 chock n C Name of organization D Employer identification number appllrnbfe: ®Gik"e BOYS & GIRLS CLUB OF SOUTHWEST COUNTY []mange Doing business as 3 3- 0 4 7 5 7 5 6 �Initlal rsturn Number and street (or P.O. box if mail is not delivered to street address) Roam/suite E Telephone number Dictum/ 25090 JEFFERSON AVE SUITE A 951-699-1526 termfn- aled City or town, state or province, country, and ZIP or foreign postal code G Grosso, mjo+ T $ 1 , 0 9 8 , 2 4 6 . Amended MURR I ETA CA 9 2 5 6 2 return H(a) Is this a group return Otronlina- F Name and address of principal officer: AMANTE P�,ie1rg P P for subordinates? .,-.., DYes ®No 25090 JEFFERSON AVE STE A, MURRIETA, CA 925 H(b) Are all subordinates included70Yes ONo Tax -axe m t status: W 501(c)(3) Q 501 c) }■ Insert no.) 4947(a)(1) or 527 If "No," attach a list. See instructions J Website, ■ WWW . BGCSWC . ORG H c Group exem Lion number K Form of orolnixation: LX1 Corporation I I Trust I I Association 1 7 other■ I L Year of formation: I QQn M et of Is al domicile: CA 1 Briefly describe the organization's mission or most significant activities: THE MISSION OF THE BOYS & GIRLS to CLUB OF SOUTHWEST COUNTY IS TO INSPIRE, ENABLE, AND SUPPORT ALL 2 Check this box ■ !. 1 if the organization discontinued its operations or disposed of more than 25% of its net assets. 3 Number of voting members of the governing body (Part VI, line 1 a) 3 22 ,e 4 Number of independent voting members of the governing body (Part VI, line 1 b) ,. ,,...., 4 22 5 Total number of individuals employed in calendar year 2020 (Part V, line 2a) 5 6 Total number of volunteers (estimate if necessary) ,.. 6 a7 a Total unrelated business revenue from Part VIII, column (C), line 12 7a 0. b Net unrelated business taxable income from Form 990-T, Part I, line 11................................ .... 7b 0. Prior Year Current Year d 8 Contributions and grants (Part VIII, line 1 h) 686,867. 9 Program service revenue (Part VIII, line 2g) ....773,433. 225 , , 10 Investment income (Part VIII, column (A), lines 3, 4, and 7d) 0. 7 , 5 21 . 15 9 , 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 121 , , , 683,527. 13 Grants and similar amounts paid (Part IX, column (A), lines 1.3) 0. 14 Benefits paid to or for members (Part IX, column (A), line 4) -67 in 15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5.10) 1 , , 9 2 2 . , r 16a Professional fundraising fees (Part IX, column (A), line 11 e) .., _ 0. b Total fundraising expenses (Part IX, column (D), line 25) ■ 16 7 , 3 3 6 . W 17 Other expenses (Part IX, column (A), lines 11 a-11 d, 11 f-24e) 7 18 Total expenses. Add lines 13.17 (must equal Part IX, column (A), line 25) ...... 1,952, --f712,449. 19 Revenue less ex erases. Subtract line 18 from line 12................. ............... ....... .„__.._ -1 3 , $ 2 . — 32 , 9 22 . N Beginning of Current Year End of Year �; R 20 Total assets (Part X, line 16) 2,140,262. Sa Sa 21 Total liabilities (Part X, line 26) 126,060. 2 3 0 7M. 985,2W 22 Net assets or fund balances. Subtract line 21 from line 20 . ..... ...ZP. w. .... 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 olliter) is based on all information of which preparef has any knowledge. —10 Sign Iglu ure o officer Date Here \ STEVE AMANTE, TREASURER ype or print name and title Print/Type preparer's name Preparer's signature a e Check PTIN Paid 3REGORY J. PRUDHOMME , CPA if r ern to ed 0 0 2 3 4 5 2 5 Preparer Firm's name b, PRUDHOMME ASSOCIATES CPAs^ , INC. Firm's EIN Use Only Firm's address ■ 43460 RIDGE PARK DRIVE, SUITE TEMECULA , CA 92590 Phone no. ( 9 51) 6 7 6— 3131 May the IRS discuss this return with the preparer shown above? See instructions X 1 Yes I 7 N, 032001 12-23-20 LHA For Paperwork Reduction Act Notice, see the separate instructions. Form 990 (2020) SEE SCHEDULE 0 FOR ORGANIZATION MISSION STATEMENT CONTINUATION FY 2022/2023 COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA GRANT APPLICATION # 10 CADENZA STRING ORCHESTRA CITY OF TTwMEC[)LA► FISCAL YEAR 2022 - 2023 COMMUNITY SERVICE FUNDING - REINVESTMENT IN TEMECULA PROGRAM APPLICATION (Please Print or Type) DUE ON OR BEFORE: MONDAY, SEPTEMBER 12, 2022 I PROJECT/PROGRAM INFORMATION Amount Requested: $ ,wj al) MAXIMUM ALLOWABLE: $50,000 PER ORGANIZATION Project/Program Title: Y&,An I��iS�Oan el f+� FU14 p Start Date Physical Address of Project) rogram: _a1g1 1011/2012 End Date: 51,3112&'Z fog INCLUDE IF DIFFERENT THAN ORGANIZATION's MAILING If Grant is Awarded, Make Check Payable to: OIJOI ��IrI(k (90 Mailing Address: ORGANIZATION AND GEOGRAPHIC AREA SERVED Name of Applicant rr __ Organization: TTtri ord�Iym Year Founded: 2��g Website A CG YI S7iI r ICY S Social Media: _ f0c_&b&V[<', _hidaCj�Gt1l� Number of Paid Staff:J Number of Volunteers: Geographic Area(s) the Organization Serves: �tlVet ids GUA Geographic Area(s) the Proiect/Program Serves: efil eL(l NOTE: COMMUNITY SERVICE FUNDING GRANT PROGRAM FUNDING MUST BE E_XCL�U$IVELY USED TO SERVE TEMECULA. Contact Name: 1 oZ cQGlI r) Title/Position: Tr' 5( fer 0. Contact Person's Direct Telephone: �`1oWkontact Person's Email: 2-C-CO IiQ4 �• NONPROFIT STATUS Is this organization incorporated as a nonprofit? Yes [Date of Incorporation as a Nonprofit: - A •24a No ❑ IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING Federal Identification Number: 93 �O State Identification Number: _c q tg6Jr0q PRINT OUT AND ATTACH TO THIS APPLICATION VERIFICATION FROM FEDERAL (IRS) AND STATE (FTB) AS FOLLOWS: 1. [Attach IRS Deductibility Status using this link: I7tt ./icif12ti +I-, oovlapL/eos/ 2. Attach State Entity Status Letter using this link: itttfls IIwwW Ill) C&A.'JOV/r,rilinelself serve elitity statLIS letter/index-asp 3. Attach first page only of most recent IRS Form 990 or attach print out of detailed info about your charity found on this State Registry's Search Tool: �7.rtt3 I�rC! dci.ca.croylVerifips;tir:��IW Y�I;r:�rr..l7.aspx?facility=Y City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 5 of 13 APPLICATION AUTHORIZATION Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over $500 including any business transactions, negotiations, inve7Yes[] Is' or interests in real property with a Temecula City Council Member during the past 12 months? IN IF YES, BRIEFLY DESCRIBE: Is a 7Yes ula City Council Member a member of the Board of Directors or an Officer of the organization? No ❑ IF YES, PROVIDE COUNCIL MEMBER'S NAME AND TITLE WITHIN THE ORGANIZATION: This Application has been authorized by the organization's: Executive Committee ❑ Board of Directors ❑ Members -at -Large I MISSION STATEMENT OF ORGANIZATION BRIEFLY DESCRIBE THE ORGANIZATION'S MISSION/GOALS AND OBJECTIVES I 10, rudel lxu�)(d ed-vt0honl arvt f(9 ut1fI h Gall 7 FINANCIAL STATEMENTS UPON REQUEST, COPIES OF THE ORGANIZATION'S CURRENT BUDGET/FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT), AND IF AVAILABLE CPA'S AUDIT, MAY BE NEEDED UPON REQUEST TO DEMONSTRATE SOUND FINANCIAL MANAGEMENT. DO NOT SUBMIT NOW. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 6 of 13 FUNDING SOURCES CITY OF TEMECULA—SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM THE CITY FOR ANY PROGRAM? No /Yes ❑ IF YES, PROVIDE BELOW, NAME OF PROGRAM/PROJECT AMOUNT MONTH + YEAR NAME OF CITY GRANT FUNDED BY THE CITY GRANTOR SPONSORSHIP FUNDING RECEIVED OR SPONSORSHIP 8 OTHER OUTSIDE SOURCES —SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM ENTITIES (NOT INCLUDING THE CITY) FOR THE SAME PROJECTIPROGRAM IN THIS APPLICATION? No ❑ Yes IF YES, PROVIDE INFORMATION IN TABLE BELOW AMOUNT MONTH + YEAR RECEIVED NAME OF ENITY FUNDING RECEIVED $ - )and 6061- hs istrxu City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 7 of 13 GRANT PROJECT/PROGRAM DESCRIPTION IMPORTANT - RECEIPTS/INVOICES IS REQUIRED TO BE SUBMITTED TO THE CITY TO VALIDATE THE ORGANIZATION SPENT GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE PROJECT/PROGRAM AS DESCRIBED HERE 1 DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT 1� /b 4 /rcuc /& /xz* a 100i ►'rru�L far V 7Lh a nrura��i kc 2 DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED. ALSO, INCLUDE A LIST OF GOODS, EQUIPMEMENT, AND/OR SERVICES THIS ORGANIZATION HAS PURCHASED OR PLANS TO PURCHASE WITH AWARDED FUNDS TO SUPPORT THIS PROGRAM/PROJECT. — 1.cC� punt 4Y n� ,,4 y 3 TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS win % U C c • r� �' a, i ��r tea C-#Ip 3b ESTIMATED NUMBER OF PEOPLE FROM TEMECULA EXPECTED TO BENEFIT FROM THIS PROJECT/PROGRAM: 30 3c ESTIMATED NUMBER OF VOLUNTEERS INVOLVED IN THIS PROJECT/PROGRAM: X City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 8 of 13 PROJECT/PROGRAM DESCRIPTION CONTINUED 4 SUMMARY STATEMENT - SUMMARIZE ANSWERS 1 - 3 ABOVE IN 50 WORDS OR LESS. �l (v19all a �t ► 11.a1 f�1 u G V f �1 a I� ,u�E�LI • � tit flan/ &ljW*c/ Gov �$ ' f-eir ��h�c�cPA• l��P�, . /Atp �4-0 OW aakl la�, 49- 6enhaf, 5 IF APPLYING FOR MORE THAN $5,000, PLEASE EXPLAIN HOW THE COVID-19 PANDEMIC AFFECTED THIS NONPROFIT ORGANIZATION'S ABILITY TO SERVE THE TEMECULA COMMUNITY. YOU MAY ALSO INCLUDE INFLATIONARY CONCERNS. IIlCGi '� 0 IF APPLYING FOR MORE THAN $5,000, EXPLAIN HOW FUNDS HAVE OR WILL: (1) CREATE NEW PROJECT/PROGRAM, (2) EXPAND EXISTING PROJECT/PROGRAM, AND/OR (3) CONTINUE EXISTING PROJECT/PROGRAM. W d loam >f f0 AcZ-1nalitc, tex-Aw v kticlvo n r c- City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 9 of 13 PROJECT/PROGRAM BUDGET (do not fill in shaded areas) LINE ITEMS FOR PROJECT/PROGRAM REVENUES EXPENSES LIST REVENUES/INCOME FOR PROJECT/PROGRAM Amount of money requested from this City of Temecula $/a �� Community Services Grant (Not to exceed $50,000) Amount contributed to the Project/Program by the Applicant $ VVD Organization Other grants or funding already awarded for Project/Program, if any $ In -Kind match amount or volunteer credit hours estimated amount $ / ' m TOTAL REVENUE $ /tj� 6VD LIST OF EXPENSES FOR PROJECT/PROGRAM Tools/Equipment $ $ 5� Facilities/Rent/Insurance Supplies $ it 6M Marketing $ /I6M Services $ .150v $ Food Other $ 1i5� Staffing Expense THIS 15 INELIGIBLE TO BE FUNDED BY CITY'S GRANT; $ HOWEVER PLEASE INCLUDE. _ TOTAL EXPENSES TOTAL BUDGET $ City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 10 of 13 i - PREVIOUS* FISCAL YEAR (FY) 2021-2022 COMPLIANCE REPORT *IF YOUR ORGANIZATION WAS NOT AWARDED A COMMUNITY SERVICE FUNDING GRANT IN FY 21/22 (LAST YEAR), THEN SKIP THIS PAGE. If your organization was awarded a Community Service Funding Grant in FY 2021-2022 (last year) by the City of Temecula, please submit this information. If your organization was awarded a Community Service Funding Grant in Fiscal Year 2021-2022 by the City of Temecula, all grant funds received must have been expended anytime on or between July 1, 2021, and June 30, 2022. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any future funding. City of Temecula reserves the right to conduct an audit andlor require additional back-up information to substantiate how funds received from the City were spent. If the funds were not spent in accordance with the approved/awarded application, the organization will be regUired to return the amount of funds to the City. To substantiate that Fiscal Year 2021-2022 funds received from the City were spent appropriately, proper back-up documentation including the completed table below with accompanying receipts/invoices, must be submitted to the City on or before due date: September 12, 2022. 1. Fill out table below (make additional copies if needed to explain all expenditures.) 2. Attach copies of receipts/invoices (in the same order as listed in this table.) 3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590 Attn: City Manager's Office — CSF EXPENDITURE REPORT due on or before September 12, 2022 Organization: FY 2021-2022 Amount of $ CSF Grant Fund Awarded: Name of Project/Program: Month & Year CSF Grant Received from City: Number of Beneficiaries Living in 92690, 92691, 92692 that Directly Benefitted from this Program/Project (approximate number of beneficiaries if you do not have precise number): Date on Expenditure E Name of Company Receipt/invoice Eon Receipt or Invoice MUST BE ON OR BETWEEN Amount Description Purpose a = JULY 1, 2021 - JUNE 30. 2022 DESCRIBE THE EXPENDITURE PURPOSE OF EXPENDITURE i I 2 I 3 4 5 0 EXPENDITURE TOTAL .P EXPENDITURE TOTAL MUST BE EQUAL TO { (OR GREATER) THAN TOTAL AWARD AMOUNT i1 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 11 of 13 FISCAL YEAR (FY) 2022-2023 COMPLIANCE REPORT If your organization is awarded a Community Service Funding - REINVESTMENT IN TEMECULA Grant in FY2022-2023 b the Cit of Temecula, follow these instructions. If your organization is awarded a Community Service Funding Grant - REINVESTMENT IN TEMECULA in FY2022-2023 by the City of Temecula, all grant funds received must be expended anytime on or between March 20, 2020 and June 30, 2024. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent. If the funds are not spent in accordance with the approved/awarded application, the organization may not receive and/or will be required to return said amount of funds to the City. To substantiate that grant funds From the City are spent appropriately, proper back-up documentation including the table below with accompanying receipts/invoices, must be submitted to the City as outlined on this page. 1. Fill out Expenditure Report table below. Make additional copies if needed to explain all expenditures. A. If awarded $6,000. Submit the following Expenditure Report within 60 days after spending $5,000 no later than June 30, 2024, to demonstrate grant funds were spent in accordance with the Application. [If you were awarded less than $5,000, submit Expenditure Report for that amount.) B. If awarded grant funds exceeding $6,000. A) Follow #1,A above first. B) To receive grant funds exceeding $5,000 (between $5K-$50K), submit the following Expenditure Report to be reimbursed for the remaining balance of award to demonstrate funds were spent in accordance with the Application. This report can be submitted in $10,000 increments (but no less than $10,000 unless the remaining grant award funding amount is less than $1 DK). This report must be submitted to the City no later than June 30, 2024 to receive remaining grant funds. 2. Attach copies of receipts/invoices (in the same order listed in table below). 3. Send to Organization: City of Temecula, 41000 Main St., Temecula, CA 92690, Attn: City Manager's Dept. "CSF-Reinvestment in Temecula" EXPENDITURE REPORT DATED Name of Project/Prog TOTAL FY 2022-2023 Month & Year FIRST $5,000 check Amount of Grant Fund Awarded: $. was received from City: 1. Is this Expenditure Report is to provide documentation for first $6,000 awarded and received? Yes_ or No (already submitted). 2. My organization has already received $ of the total FY 2022-23 Grant Fund awarded by the City 3. Is this Expenditure Report is submitted to request reimbursement of funds? No or Yes If yes, Amount of Request $ Number of beneficiaries living in 92690, 92691, 92692 that directly benefitted from this Program/Project (approximate number of beneficiaries if you do not have precise number) E Name of Company az on Receipt or Invoice I 2 3 Date on ReceiptlInvoice MUST BE ON OR BETWEEN March 20, 2020 - JUNE 30. 2024 EXPENDITURE TOTAL Expenditure MUST SUPPORT PROJECTIPROGRAM IN APPLICATION & AWARD LETTER Amount Description Purpose W I EXPENDITURE TOTAL City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 12 of 13 ACKNOWLEDGEMENT/SIGNATURE PAGE The applicant acknowledges and agrees to the following: • Recipient is subject to all Community Service Funding Program requirements including submittal deadlines and payment disbursements. • Every Community Service Funding application is considered individually and on its own merit. • Awards will be given to organizations and activities that directly benefit the residents of Temecula. • Funding is not immediately available to the recipient, and requires an award letter signature upon approval. Please allow time for checks to be processed. • The awarding of Community Service Funding does not constitute an automatic annual allocation. The recognition for Community Service Funding should accrue to the City of Temecula. • Community Service Funding must be spent as specified on the Application and records may be requested by the City of Temecula to ensure the funds were used appropriately. • Community Service Funding grants will not be awarded or announced within the 60 days before an election in which an awarding Council Member is on the ballot, • The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. If awarded a Community Service Funding Grant by the City of Temecula last year, then compliance receipts must be submitted on or before this application's due date or this application may be rejected as incomplete. I/we hereby certify the information contained in this Application is true to the best o^f our knowledge and belief. �j 1 ORGANIZATION NAME: Lalrn1 . Av iJ►G�ii L ISfr MAILING ADDRESS: C'erf 01c mu 7 EMAIL: PRESIDENT / AUTHORIZED OFFICER: PHONE: (&) --c-)400m.3 SIGNATURE: DATE: o IF DIFFERENT THAN ABOVE, APPICATION PREPARED BY: SUBMIT ORIGINAL APPLICATION BY MONDAY, SEPTEMBER 12, 2022, TO: City of Temecula Community Service Funding Attn: City Manager's Office 41000 MAIN STREET TEMECULA, CA 92590 Questions: Stacey. Brown@TemeculaCA.gov (951) 694-6413 Betsy. Lowrey@TemeculaCA.gov (951) 693-3959 I,c&n City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 13 of 13 STATE OF CALIFORNIA FRANCHISE TAX BOARD FTB PO BOX 942857 SACRAMENTO CA 94257-0540 Entity Status Letter Date: 9/7/2022 ESL ID: 1281837848 Why You Received This Letter According to our records, the following entity information is true and accurate as of the date of this letter Entity ID: 4196509 Entity Name: CADENZA STRING ORCHESTRA 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. ❑ 5. The entity was administratively dissolved/cancelled on through the Franchise Tax Board Administrative Dissolution process. Important Information • This information does not necessarily reflect the entity's current legal or administrative status with any other agency of the state of California or other governmental agency or body. • If the entity's powers, rights, and privileges were suspended or forfeited at any time in the past, or if the entity did business in California at a time when it was not qualified or not registered to do business in California, this information does not reflect the status or voidability of contracts made by the entity in California during the period the entity was suspended or forfeited (R&TC Sections 23304.1, 23304.5. 23305a, 23305.1). The entity certificate of revivor may have a time limitation or may limit the functions the revived entity can perform, or both (R&TC Section 23305b). Connect With Us Web: ftb.ca.gov Phone: 800-852-5711 from 7 a m. to 5 p.m. weekdays, except state holidays 916-845-6500 from outside the United States California Relay Service: 711 or 800-735-2929 (For persons with hearing or speech impairments) FTB 4263A WEB (REV 12-2019) INTERNAL REVENUE SERVICE P. O. BOX 2508 CINCINNATI, OH 45201 Date: WAY 2 0 2019 CADENZA STRING ORCHESTRA C/O SANDIWA DEL ROSARIO 31927 CORTE POLLENSA TEMECULA, CA 92592-0000 Dear Applicant: DEPARTMENT O? THE TREASURY' Employer Identification Number: 83-4606030 DLN: 26053530002529 Contact Person: CUSTOMER SERVICE ID# 31954 Contact Telephone Number: (877) 829-5500 Accounting Period Ending: May 31 Public Charity Status: 170(b) (1) (A) (vi) Form 990/990-EZ/990-N Required: Yes Effective Date of Exemption: September 20, 2018 Contribution Deductibility: Yes Addendum Applies: No We're pleased to tell you we determined you're exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). Donors can deduct contributions they make to you under IRC Section 170. You're also qualified to receive tax deductible bequests, devises, transfers or gifts under Section 2055, 2106, or 2522, This letter could help resolve questions on your exempt status. Please keep,it for your records. Organizations exempt under IRC Section 501(c)(3) are further classified as either public charities or private foundations. We determined you're a public Charity under the IRC Section listed at the top of this letter. If we indicated at the top of this letter that you're required to file Form 990/990-EZ/990-N, our records show you're required to file an annual information return (Form 990 or Form 990-EZ) or electronic notice (Form 990-N, the e-Postcard). If you don't file a required return or notice for three consecutive years, your exempt status will be automatically revoked. If we indicated at the top of this letter that an addendum applies, the enclosed addendum is an integral part of this letter. For important information about your responsibilities as a tax-exempt organization, go to www.irs.gov/charities. Enter 114221-PC" in the search bar to view Publication 4221-PC, Compliance Guide for 501(c)(3) Public Charities, which describes your recordkeeping, reporting, and disclosure requirements. Lette-- 947 HOME ABOUT MEDIA CAREERS REGULATIONS RESOURCES PROGRAMS CONTACT Registrant Details Entity type: Corporate Class as registered wlth the Secretary of State or based on founding & reglstratlon documents, Mailing Address Filings & Correspondence Annual Renewal Data Related Registrations & Event Reports The related records shown below depend on the record type being viewed: • Charity Registrations relate to Professional Fundralsing Events which relate to Professional Fundralser Registrations. • Raffle Reglstratlons relate to Raffle Reports. • Click on the RCT Registration No to navigate to the related record. FY 2022/2023 COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA GRANT APPLICATION # 11 CANINE SUPPORT TEAMS INC. CITY OF TE ECUTA FISCAL, YEAR 2022 M 2023 COMMUNITY SERVICE FUNDING M REINVESTMENT IN TEMECULA PROGRAM APPLICATION (Please Print or Type) DUE ON OR BEFORE: MOND", SEPTEMBER 12, 2022 Amount Requested: $ Project/Program Title PROJECT/PROGRAM INFORMATION I 50,000 MAXIMUM ALLOWABLE: $50,000 PER ORGANIZATION PAWZ for Wounded Veterans Program Physical Address of Project/Program: Start Date: 01 1 3 End Date: 12/31/23 INCLUDE IF DIFFERENT THAN ORGANIZATION'S MAILING ADDRESS If Grant is Awarded, Make Check Payable to: Canine Support Teams, Inc. Mailing Address: 24480 Jenny Ln, Murrieta, CA 92562 I ORGANIZATION AND GEOGRAPHIC AREA SERVED I Name of Applicant Organization: Canine Support Teams Inc. Year Founded: 1989 F: @caninesupportteamsl I: @k9supportteams/ Website: caninesu ortteams.or Social Media: Ts QKgSuponrtTeams Number of Paid Staff: Number of Volunteers: 40+ Geographic Area(s) the Organization Serves: Southern California 84%, AZ, CO, HI, ID, NV, OR, TX, and WA Geographic Area(s) the Project/Program Serves: Southern California 87% and HI, NV, OR, TX, WV NOTE: COMMUNITY SERVICE FUNDING GRANT PROGRAM FUNDING MUST BE EXCLUSIVELY USED TO SERVE TEMECULA. Contact Name: Judy Hernandez Title/Position: Client Service/Donor Relations/Admin. Contact Person's Direct Telephone: _951 301-3625 Relations/Administration Contact Person's Email: cstmain@caninesupportteams.org NONPROFIT STATUS Is this organization incorporated as a nonprofit? Yes ® Date of Incorporation as a Nonprofit: 1991 No ❑ IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING Federal Identification Number: 33-0434821 State Identification Number: 1484828 PRINT OUT AND ATTACH TO THIS APPLICATION VERIFICATION FROM FEDERAL (IRS) AND STATE (FTB) AS FOLLOWS: 1. ❑ Attach IRS Deductibility Status using this link: htto://aQps,irs.gov/aPPleos/ 2. ❑ Attach State Entity Status Letter using this link: httos://www.ftb.ca.gov/online/self serve entity status letterlindex.as 3. ❑ Attach first page only of most recent IRS Form 990 or attach print out of detailed info about your charity found on this State Registry's Search Tool: http_1/rct.dQi.ca,aavNedfica$ionM 1Search.aspx?facility=Y City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 5 of 13 APPLICATION AUTHORIZATION Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over $500 including any business transactions, negotiations, investments, or interests in real property with a Temecula City Council Member during the past 12 months? No ® Yes ❑ IF YES, BRIEFLY DESCRIBE: Is a Temecula City Council Member a member of the Board of Directors or fficer of the organization? No® Yes ❑ IF YES, PROVIDE COUNCIL MEMBERS NAME AND TITLE WITHIN THE ORGANIZATION: This Application has been authorized by the organization's: Executive Committee ❑ Board of Directors ® Members -at -Large ❑ MISSION STATEMENT OF ORGANIZATION BRIEFLY DESCRIBE THE ORGANIZATION'S MISSION/GOALS AND OBJECTIVES. Mission: To provide specially trained dogs to persons with disabilities to support their personal, social, and occupational independence. Canine Support Team's (CST) goal is to place 30 dogs annually with individuals who have various disabilities including, but not limited to, multiple sclerosis, cerebral palsy, cystic fibrosis, traumatic brain injury (TBI), spinal cord injury, post -traumatic stress disorder (PTSD), and limited mobility. By delivering expertly trained service dogs, we seek to provide disabled individuals with enhanced mobility, independence, and companionship. CST accomplishes this by individually training each dog to assist with: walking with and beside a wheelchair or walker, retrieving dropped items, turning lights on and off, opening and closing doors, pressing elevator buttons, pulling off socks and sweaters, and barking to alert for help in emergencies, and serving as an ice -breaker in public situations. For eligible veteran clients, CST provides the service dog at no cost to the recipients. FINANCIAL STATEMENTS UPON REQUEST, COPIES OF THE ORGANIZATION'S CURRENT BUDGET/FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT), AND IF AVAILABLE CPA'S AUDIT, MAYBE NEEDED UPON REQUEST TO DEMONSTRATE SOUND FINANCIAL MANAGEMENT, DO NOT SUBMIT NOW. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 6 of 13 FUNDING SOURCES CITY OF TEMECULA—SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM THE CITY FOR ANY PROGRAM? No ❑ Yes X❑ IF YES, PROVIDE BELOW. NAME OF PROGRAM/PROJECT FUNDED BYTHE CITY GRANT OR SPONSORSHIP AMOUNT MONTH + YEAR FUNDING RECEIVED NAME OF CITY GRANT OR SPONSORSHIP PAWZ for Wounded Veterans $ 5,491.75 September 2020 City of Temecula OTHER OUTSIDE SOURCES —SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM ENTITIES (NOT INCLUDING THE CITY) FOR THE SAME PROJECT/PROGRAM IN THIS APPLICATION? NO ❑ Yes R IF YES, PROVIDE INFORMATION IN TABLE BELOW, AMOUNT RECEIVED NAME OF ENITY MONTH + YEAR FUNDING RECEIVED $ 15,000 California Relief Grant Program March 2021 $ 2,800 Fredrick and Lorine Taylor Foundation September 2020 $ 15,000 Mary Jo & Hank Greenberg Animal Welfare Foundation November 2020 $ 10,000 Inland Empire Community Foundation October 2020 $ 5,000 Linda I. Smith Foundation November 2020 $3,500 Sidney Stern Memorial Trust May 2021 $5,000 The Armrod Charitable Foundation May 2021 $ 525,827 Wounded Warriors Service Dog Program (US Treasury) January 2022 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 7 of 13 GRANT PROJECT/PROGRAM DESCRIPTION IMPORTANT- RECEIPTS/INVOICES IS REQUIRED TO BE SUBMITTED TO THE CITY TO VALIDATE THE ORGANIZATION SPENT GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE PROJECT/PROGRAM AS DESCRIBED HERE I DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT. CST launched the PAWZ for Wounded Veterans Program to address the increasing number of men and women who, after serving our country in the United States military, require a service dog (SD). At no cost to the recipients, CST trains service dogs to support disabled veterans who are seeking enhanced mobility, independence, and companionship. Whether their disability is obvious or invisible, CST is committed to helping veterans reclaim their independence. At around 8 weeks, SDs are placed with Volunteer Puppy Raisers (VPR), who work directly with CST trainers to socialize the puppies through outings and experiences (e.g-, navigating restaurants and shopping centers, using public transportation, processing through TSA, handling crowded events, etc.) VPRs participate in CST -led trainings twice per month. At 18 months, dogs enter Advanced Training (AT) with our Inmate Trainers (IT) through our Prison Pup Program. SDs learn the specific tasks necessary to support a disabled client. ITs meet weekly for training sessions with CST's professional trainers. After AT, dogs are matched with disabled veterans and start the t 0-day Team Training at CST's facility. Upon completion, the dog and veteran receive the Assistance Dogs International (ADI) Public Access Certification. For the "working life" of their SDs, clients are encouraged to contact CST for supplemental training and required to complete a CST Veterinary Health Certificate and to recertify with ADI. 2 DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED. ALSO, INCLUDE A LIST OF GOODS, EQUIPMEMENT, AND/OR SERVICES THIS ORGANIZATION HAS PURCHASED OR PLANS TO PURCHASE WITH AWARDED FUNDS TO SUPPORT THIS PROGRAM/PROJECT. The funds provided by this grant will help CST to provide two additional Temecula veterans with a service dog. It costs an estimated $25,000 to prepare a dog for a life of service. The bulk of CST's expenses are related to the physical care and training of our service dogs. The money awarded will pay for the training, training equipment (e.g., leashes, collars, harnesses, vests, and training tools), canine care equipment (e.g., grooming equipment, crates, microchips, housing), dog food, supplies for the advanced training program (e.g., training treats, consumable tools, equipment), kennel supplies (e.g., food dishes, storage containers, specialized cleaning supplies), and veterinary care and prescriptions (e.g., monthly flea, tick, and heartworm pills, general health, and emergency illnesses). 3 TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS. According to the CDC, one in four adults in the U.S. has a disability, including impairments with vision, hearing, mobility, and cognition. These individuals face many challenges, particularly relating to their access to quality jobs, education, and other social functions. Yet, with the assistance of expertly trained service dogs, disabled individuals have been able return to the activities that enrich their lives. For instance, one recent study concluded that "vets with service dogs reported a 22 percent higher rate of life satisfaction, as well as similarly increased rates of mental health, resilience, and ability to participate in social activities." This same study also found that veterans with service dogs "indicated having fewer post -traumatic stress disorder (PTSD) symptoms and lower levels of depression." (rebootcamp.militarytimes.com) The City of Temecula has more than 8,000 veterans, of which more than 6,000 are under the age of 64. With the generous funding from this grant, CST will be able to provide two additional veterans from Temecula with a professionally trained service dog to help support their personal, social, and occupational independence. Furthermore, CST currently has 7 other veteran clients who reside in Temecula, who we will be able to continue to provide supplemental training and re -certify with ADI. 3b ESTIMATED NUMBER OF PEOPLE FROM TEMECULA EXPECTED TO BENEFIT FROM THIS PROJECT/PROGRAM: 1 9 3c ESTIMATED NUMBER OF VOLUNTEERS INVOLVED IN THIS PROJECT/PROGRAM: 1 10 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 8 of 13 PROJECT/PROGRAM DESCRIPTION CONTINUED 4 SUMMARY STATEMENT — SUMMARIZE ANSWERS 1 — 3 ABOVE IN 50 WORDS OR LESS. At no cost to the recipient, CST's PAWZ program trains dogs to support disabled veterans who are seeking enhanced mobility, -independence, -and -companionship. —This -grant will-help-OST-provide-two-Temecula-veterans-with-a service-d costs an estimated $25,000 to prepare a dog for a life of service. 5 IF APPLYING FOR MORE THAN $5,000, PLEASE EXPLAIN HOW THE COVID-19 PANDEMIC AFFECTED THIS NONPROFIT ORGANIZATION'S ABILITY TO SERVE THE TEMECULA COMMUNITY. YOU MAY ALSO INCLUDE INFLATIONARY CONCERNS. Due to California COVID state mandates, which precluded CST from meeting with clients, conducting the prison training program, and holding our Team Training intensives, our number of placements declined for 2020, Beginning in July 2020, we were able to resume training in a limited capacity (1:1 team trainings) and were pleased to place eight dogs with veterans in such a short time. In 2021, ten dogs were placed with veterans. Again, COVID restrictions hampered our ability to conduct much of our advanced training, especially within the prison. Today, we are back to our pre-COVID placement levels with an anticipated 30 dogs being placed with veterans this year. It should be noted, that while we were under COVID restrictions, CST did take a number of steps to ensure the safety and well-being of our clients, pups, and staff. Most notable, CST initiated supplemental, specialized virtual training, including: (1) helping clients with PTSD mitigate symptoms being exacerbated by their isolation using their service dog; (2) offering new methods for navigating stores and for exercising with social distancing; and (3) providing solutions, especially for those suffering from compromised immune systems, for caring for their dog and themselves. 6 IF APPLYING FOR MORE THAN $5,000, EXPLAIN HOW FUNDS HAVE OR WILL: (1) CREATE NEW PROJECT/PROGRAM, (2) EXPAND EXISTING PROJECT/PROGRAM, AND/OR (3) CONTINUE EXISTING PROJECT/PROGRAM. The approximate cost to raise and train a dog for a life of service is $25,000. Over the next year, CST will identify two eligible veterans from within Temecula who would benefit from the partnership of a service dog. With the generous funds provided by the City of Temecula, CST will be able to provide these two individuals with an expertly trained service dog at no cost to the individual. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 9 of 13 PROJECT/PROGRAM BUDGET (do not fill in shaded areas) LINE ITEMS FOR PROJECT/PROGRAM j REVENUES EXPENSES LIST REVENUES/INCOME FOR PROJECT/PROGRAM Amount of money requested from this City of Temecula $50,000 Community Services Grant (Not to exceed $50,000) Amount contributed to the Project/Program by the Applicant Organization Other grants or funding already awarded for Project/Program, if any In -Kind match amount or volunteer credit hours estimated amount $ $ 525,827 $ TOTAL REVENUE $575,827 LIST OF EXPENSES FOR PROJECT/PROGRAM Tools/Equipment Facilities/Rent/Insurance Supplies $ 47,040 $ 57,680 $ 8,080 Marketing $68,800 Services $ 60,320 Food Other $18,690 Staffing Expense THIS IS INELIGIBLE TO BE FUNDED BY CITY'S GRANT; HOWEVER PLEASE INCLUDE. TOTAL EXPENSES TOTAL BUDGET $218,250 $478,940 $ $478,940 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 10 of 13 PREVIOUS` FISCAL YEAR (FY) 2021-2022 COMPLIANCE REPORT IF YOUR ORGANIZATION WAS NOT AWARDED A COMMUNITY SERVICE FUNDING GRANT IN FY 21/22 (LAST YEAR), THEN SKIP THIS PAGE. If your organization was awarded a Community Service Funding Grant in FY 2021-2022 (last year) by the City of Temecula, please submit this information. If your organization was awarded a Community Service Funding Grant in Fiscal Year 2021-2022 by the City of Temecula, all grant funds received must have been expended anytime on or between July 1, 2021, and June 30, 2022. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any future funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to -substantiate how funds received -from the City were Spent: - If the funds were not spent in accordance with the approved/awarded application, the organization will be required to return the amount of funds to the City. To substantiate that Fiscal Year 2021-2022 funds received from the City were spent appropriately, proper back-up documentation including the completed table below with accompanying receipts/invoices, must be submitted to the City on or before due date: September 12, 2022. 1. Fill out table below (make additional copies if needed to explain all expenditures.) 2. Attach copies of receipts/invoices (in the same order as listed in this table.) 3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590 Attn: City Manager's Office — CSF EXPENDITURE REPORT due on or before September 12, 2022 Organization: FY 2021-2022 Amount of $ CSF Grant Fund Awarded: Name of Project/Program: Month & Year CSF Grant Received from City: Number of Beneficiaries Living in 92590, 92591, 92592 that Directly Benefitted from this Program/Project (approximate number of beneficiaries if you do not have precise number): Date on £ Name of Company Receipt/Invoice E on Receipt or Invoice MUST BE ON OR BETWEEN Amount JULY 1, 2021 - JUNE 30, 2022 QZ Lt I 3 4 5 6 EXPENDITURE TOTAL diture Description DESCRIBE THE EXPENDITURE Purpose PURPOSE OF EXPENDITURE EXPENDITURE TOTAL MUST BE EQUAL TO (nR r,RFATFRI THAN TnTAI AWARrI AAAnI IMT City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 11 of 13 FISCAL YEAR (FY) 2022-2023 COMPLIANCE REPORT If your organization is awarded a Community Service Funding - REINVESTMENT IN TEMECULA Grant in FY2022-2023 by the City of Temecula, follow these instructions, If your organization is awarded a Community Service Funding Grant - REINVESTMENT IN TEMECULA in FY2022-2023 by the City of Temecula, all grant funds received must be expended anytime on or between March 20, 2020 and June 30, 2024, In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent. If the funds are not spent in accordance with the approved/awarded application, the organization may not receive and/or will be required to return said amount of funds to the City. To substantiate that grant funds from the City are spent appropriately, proper back-up domimentatinn innliidin0 the tahle below with accompanying receipts/invoices, must be submitted to the City as outlined on this page. 1. Fill out Expenditure Report table below. Make additional copies if needed to explain all expenditures. A. If awarded $5,000. Submit the following Expenditure Report within 60 days after spending $5,000 no later than June 30, 2024, to demonstrate grant funds were spent in accordance with the Application. [If you were awarded less than $5,000, submit Expenditure Report for that amount.) B. If awarded grant funds exceeding $5,000. A) Follow #1.A above first. B) To receive grant funds exceeding $5,000 (between $5K-$50K), submit the following Expenditure Report to be reimbursed for the remaining balance of award to demonstrate funds were spent in accordance with the Application. This report can be submitted in $10,000 increments (but no less than $10,000 unless the remaining grant award funding amount is less than $10K). This report must be submitted to the City no later than June 30, 2024 to receive remaining grant funds. 2. Attach copies of receipts/invoices (in the same order listed in table below). 3. Send to Organization: City of Temecula, 41000 Main St., Temecula, CA 92590, Attn: City Manager's Dept. "CSF-Reinvestment in Temecula" EXPENDITURE REPORT DATED Name of Project/Program- TOTAL FY 2022-2023 Month & Year FIRST $5,000 check Amount of Grant Fund Awarded: $ was received from City: 1. Is this Expenditure Report is to provide documentation for first $5,000 awarded and received? Yes_ or No (already submitted). 2. My organization has already received $ of the total FY 2022-23 Grant Fund awarded by the City 3. Is this Expenditure Report is submitted to request reimbursement of funds? No or Yes If yes, Amount of Request $ Number of beneficiaries living in 92590, 92591, 92592 that directly benefitted from this Program/Project (approximate number of beneficiaries if you do not have precise number] E Name of Company Eon Receipt or Invoice Q Z 2 Date on Receipt/Invoice MUST BE ON OR BETWEEN March 20, 2020 - JUNE 30, 2024 EXPENDITURE TOTAL Expenditure MUST SUPPORT PROJECT/PROGRAM IN APPLICATION & AWARD LETTER Amount I Description I Purpose EXPENDITURE TOTAL City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 12 of 13 ACKNOWLEDGEMENT/SIGNATURE PAGE The applicant acknowledges and agrees to the following: • Recipient is subject to all Community Service Funding Program requirements including submittal deadlines and payment disbursements. • Every Community Service Funding application is considered individually and on its own merit. • Awards will be given to organizations and activities that directly benefit the residents of Temecula. • Funding is not immediately available to the recipient, and requires an award letter signature upon approval, Please allow time for checks to be processed. • The awarding of Community Service Funding does not constitute an automatic annual allocation. • The recognition for Community Service Funding should accrue to the City of Temecula. • Community Service Funding must be spent as specified on the Application and records may be requested by the City of Temecula to ensure the funds were used appropriately. • Community Service Funding grants will not be awarded or announced within the 60 days before an election in which an awarding Council Member is on the ballot. • The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. • If awarded a Community Service Funding Grant by the City of Temecula last year, then compliance receipts must be submitted on or before this application's due date or this application may be rejected as incomplete. I/we hereby certify the information contained in this Application is true to the best of our knowledge and belief. ORGANIZATION NAME: Canine Support Teams, Inc. MAILING ADDRESS: 24480 Jenny Ln, Murrieta, CA 92562 951-301-3625 PHONE: ( ) EMAIL- cstmain@caninesupportteams,org PRESIDENT / AUTHORIZED OFFICER: _ C O- fuk QQQ jAQ,1nQf L _ PRINT NAME TITLE SIGNATURE• PTE: a-x MONTH, DAY, YEAR IF DIFFEREN THAN ABOVE, APPICATION PREPARED BY: Nye 5 -t &figu— PRINT NAME TITLE SUBMIT ORIGINAL APPLICATION BY MONDAY, SEPTEMBER 12, 2022, TO: City of Temecula Community Service Funding Attn: City Manager's Office 41000 MAIN STREET TEMECULA, CA 92590 Questions: Stacey.Brown@TemeculaCA.gov (951) 694-6413 Betsy.Lowrey@TemeculaCA.gov (951) 693-3959 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 13 of 13 Q HELPO MENU Home > Tax Exempt Organiza#ion Search > Canine Support Teams Inc. aI: s I : M Canine Support Teams Inc, E I N: 33-0434821 1 M u rri eta, CA, United States Other Names Publication 78 Data Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions. On Publication 78 Data List: Yes Deductibility Code: PC Copies of Returns (990, 990-EZ, 990-PF, 990-T) o Electronic copies (images) of Forms 990, 990-EZ, 990-PF or 990-T returns filed with the IRS by charities and non- profits. Tax Year 2019 Form 990 Tax Year 2018 Form 990 Tax Year 2017 Form 990 Tax Year 2016 Form 990 Page Last Reviewed or Updated: 20-November-2020 r# Share $ Print STATE OF CALIFORNIA FRANCHISE TAX BOARD PO BOX 942857 SACRAMENTO CA 94257-0540 Entity Status Letter Date: 9/4/2022 ESL ID: 8084017744 Why You Received This Letter 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. X❑ 1. The entity is in good standing with the Franchise Tax Board. El2. The entity is not in good standing with the Franchise Tax Board. X❑ 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. ❑ 5. The entity was administratively dissolved/cancelled on through the Franchise Tax Board Administrative Dissolution process. Important Information This information does not necessarily reflect the entity's current legal or administrative status with any other agency of the state of California or other governmental agency or body. If the entity's powers, rights, and privileges were suspended or forfeited at any time in the past, or if the entity did business in California at a time when it was not qualified or not registered to do business in California, this information does not reflect the status or voidability of contracts made by the entity in California during the period the entity was suspended or forfeited (R&TC Sections 23304.1, 23304.5, 23305a, 23305.1). The entity certificate of revivor may have a time limitation or may limit the functions the revived entity can perform, or both (R&TC Section 23305b). Connect With Us Web: ftb.ca.gov Phone: 800-852-5711 from 7 a.m. to 5 p.m. weekdays, except state holidays 916-845-6500 from outside the United States California Relay Service: 711 or 800-735-2929 (For persons with hearing or speech impairments) FTB 4263A WEB (REV 12-2019) ** PUBLIC DISCLOSURE COPY ** Return of Organization Exempt From Income Tax Form 990 Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) Depart1110- Do not enter social security numbers on this form as it may be made public. tatarnatmenf of U. Bury 110� Go to www.irs.gov/FormOgO for instructions and the latest information. A For the 2020 calendar yanr, or tax year beginning B ctsw* if C Name of organization ,volcabW j IMMW CANINE SUPPORT TEAMS INC. [-6r am*! wu a Doing business as iavun Number and street (or P.O. box if mail Is not delivered to street address) [�],r= P.O. BOX 891767 termin- ated City or town, state or province, country, and ZIP or foreign postal code [�A"""'�°''LN!me ECULA CA 92589-1767 I JI�P II �:k�inito�� and address of principal officer: CAROL ROQUEMORE Pend`' AS C ABOVE Tax-exempt status: 501 e 3 5U 1 c ■ inswt on, 4947 J Website: Ill WWW.CANINESUPPORTTEAMS.ORG K Farm} of or anizallon: LXj Cnrparalion Trust Association El Other 0- Part l I Sui rtmaty and 2020 Open to Public Inspection D Employer identification number 33-0434821 Room/suite E Telephone number 951)-301-3625 G Glosslwolp%s 784 460. H(a) Is this a group return for subordinates? I J Yes X1 No H(b) Are all suhordlnates includod? [::] Yes [::] No r 527 If "No," attach a list. See instructions 19 9 01 M State of local domicile' CA 1 Briefly describe the organization's mission or most significant activities: CANINE SUPPORT TEAMS ( CST) IS A 0 G CALIFORNIA BASED NON—PROFIT ORGANIZATION THAT PROVIDES SPECIALLY c2 Check this box 0 if the organization discontinued its operations or disposed of more than 25% of its net assets. c3 Number of voting members of the governing body (Part VI, line 1 a) g 8 0 4 Number of independent voting members of the governing body (Part VI, line 1 b) 4 6 am-- w 5 Total number of individuals employed in calendar year 2020 (Part V, line 2a) .............. 5 14 14 6 Total number of volunteers (estimate if necessary) ,- a7 a Total unrelated business revenue from Part VIII, column (C), line 12 7a 0. b Not unrelated business taxahle income from Form 990-f Part I line 11 7b 0 . Prior Year Current Year 650,543. 781,283. 0 8 Contributions and grants (Part VII I, line 1 h) m9 Program service revenue (Part VIII, line 2g) 3,602. 2,950. 10 .......... ,_ ._..................................... Investment income (Part VIII, column (A), lines 3 4, and 7d) ,,,,,, „ 752. 227. 11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 1 Oc, and 11 e) ............ 8 641. —5, 334. 12 Total revenue - add lines 8 thr h 11 must equal part Vill column (A). line 121 663, 538. 779,126. 13 Grants and similar amounts paid (Part IX, column (A), lines 1.3) _ . , .--• _ 0. 0. 14 Benefits paid to or for members (Part IX, column (A), line 4) ..-- - . 0. 0. 385,795. 360,815. 15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-10) 2 16a Professional fundraising fees (Part IX, column (A), line 1le) ,.,,, ., „ 0 . 0. n b Total fundraising expenses (Part IX, column (D), line 25) 68 991 . 17 Other expenses (Part IX, column (A), lines 11a-1Id, 1 lf-24e) ------------ -- 304 631. 397,514 . 690 426. 758,329. 18 Total expenses. Add lines 13-17 (Must equal Part IX, column (A), line 25) 19 .--, -. • ., Revenue less expenses. Subtract line 18 from line 12 ............. .. ........... ... ..... .. — 2 6 8 8 8 . 20,797. Beginialno of Current Year End of Year 20 Total assets (Part X, line 16) . _. .... 341,292. 605,226 . 10,000. 253,137 . a 21 Total liabilities (Part X, line 26) .................. .... 22 Not assets or fund balances. Subtract fine 21 from line 20 331,292. 352,089 . rdr4 IN I -agdglakulu 01FJU1i 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 Irue, currect, and complete. Declaration of Rreparar outer than officer is Mae on all information of which prqaftr has any knowledge. Sign Signalum of officer Dare Here CAROL RO UEMORE, VICE PRESIDENT/CEO lype or print narnc and title PrintiType preparer's name Preparer's signature 13aio ec Pl'IN Paid OVEPREET BUTTAR CPA OVEPREET BUTTAR CPI1/10/2]ilm e 01329403 Preparer Firin's name MERCAD I EN , P.C. line's N 2 2 — 3 2 71712 Use Only Firm's address P. 0. BOX 7648 PRINCETON, NJ 08543-7648 1PIwn-!ro.609--689-9700 May the iRS discuss this return with the prepare?, shown above? See irtstnrctions X1 Yes 032001 12-23-20 LHA For Paperwork Reduction Act Notice, see the separate instructions. Form 990 (2020) SEE SCHEDULE 0 FOR ORGANIZATION MISSION STATEMENT CONTINUATION FY 2022/2023 COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA GRANT APPLICATION 12 CAUSE FUR PAWS INC CITY OF TEMECUI[A FISCAL YEAR 2022.2023 COMMUNITY SERVICE FUNDING - REINVESTMENT IN TEMECULA PROGRAM APPLICATION (Please Print or Type) DUE ON OR BEFORE: MONDAY, SEPTEMBER 12, 2022 PROJECT/PROGRAM INFORMATION Amount Requested: $ 10,000 MAXIMUM ALLOWABLE: $50,000 PER ORGANIZATION Cause Fur Paws Helping animals Project/Program Title: with diabetes Start Date: 01 /01 /209�d Date: 12/1 /2022 36522 Via er e Physical Address of Project/Program:Terniecitla r;l 9259 INCLUDE IF DIFFERENT THAN ORGANIZATION'S MAILING ADDRESS If Grant is Awarded, Make Check Payable to: Cause Fur Paws, Inc Mailing Address: 47200 De Portola Temecula, Ca 92592 ORGANIZATION AND GEOGRAPHIC AREA SERVED Name of Applicant Organization: Cause Fur Paws, Inc Website: www.causefurpaws.org Number of Paid Staff: 0 Year Founded: 2011 Social Media: https://Www.facebook.com/causeforpawstemect Number of Volunteers: 3 Geographic Area(s) the Organization Serves: Riverside County Geographic Area(s) the Proiect/Program Serves: Temecula NOTE: COMMUNITY SERVICE FUNDING GRANT PROGRAM FUNDING MUST BE EXCLUSIVELY USED TO SERVE TEMECULA. Contact Name: Valerie Andrews Title/Position: President Contact Person's Direct Telephone: 951 775-7275 Contact Person's Email: vall @causeefurpaws.org NONPROFIT STATUS Is this organization incorporated as a nonprofit? Yes ® Date of Incorporation as a Nonprofit: 2011 No ❑ IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING Federal Identification Number: 27-5415050 State Identification Number: 3354176 PRINT OUT AND ATTACH TO THIS APPLICATION VERIFICATION FROM FEDERAL (IRS) AND STATE (FTB) AS FOLLOWS: 1. ❑ Attach IRS Deductibility Status using this link: http://apps,irs.gov/app/��eos/ 2. ❑ Attach State Entity Status Letter using this link: https://www.ftb.ca.gov/online/self serve entity status letter/index.asD 3. ❑ Attach first page only of most recent IRS Form 990 or attach print out of detailed info about your charity found on this State Registry's Search Tool: httQ//rcl.doi.ca.govfVrificationNVeb/Search.asnx?facility=Y City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 5 of 13 APPLICATION AUTHORIZATION Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over $500 including any business transactions, negotiations, investments, or interests in real property with a Temecula City Council Member during the past 12 months? No ® Yes ❑ IF YES, BRIEFLY DESCRIBE: Is a Temecula City Council Member a member of the Board of Directors or an Officer of the organization? No ® Yes ❑ IF YES, PROVIDE COUNCIL MEMBER'S NAME AND TITLE WITHIN THE ORGANIZATION: This Application has been authorized by the organization's: Executive Committee ® Board of Directors ❑ Members -at -Large ❑ MISSION STATEMENT OF ORGANIZATION BRIEFLY DESCRIBE THE ORGANIZATION'S MISSION/GOALS AND OBJECTIVES. To provide donated funds to veterinarians and animal hospitals that directly benefits the immediate physical well-being of animal diabetes. These funds wili help finance costs for medicine, veterinarian services and hospitalization expenses, due to the effects of diabetes on the animals and/or prevent euthanasia due to inability to meet the costs of medical care. Upon appiication, approval and fund availability, Cause for Paws will disperse funds to pay the bill received from the veterinarian or animal hospital with eligibility criteria met and availability of funds. To provide appropriate referrals for health or behavioral care for Animals with Diabetes. To provide education and to inform the public about Diabetes in animals FINANCIAL STATEMENTS UPON REQUEST, COPIES OF THE ORGANIZATION'S CURRENT BUDGET/FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT), AND IF AVAILABLE CPA'S AUDIT, MAYBE NEEDED UPON REQUEST TO DEMONSTRATE SOUND FINANCIAL MANAGEMENT. DO NOT SUBMIT NOW, City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 6 of 13 I FUNDING SOURCES CITY OF TEMECULA—SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM THE CITY FOR ANY PROGRAM? No ® Yes ❑ IF YES, PROVIDE BELOW. f NAME OF PROGRAM/PROJECT AMOUNT MONTH +YEAR NAME OF CITY GRANT + FUNDED BY THE CITY GRANTOR SPONSORSHIP I FUNDING RECEIVED OR SPONSORSHIP I OTHER OUTSIDE SOURCES —SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM ENTITIES (NOT INCLUDING THE CITY) FOR THE SAME PROJECT/PROGRAM IN THIS APPLICATION? No ® Yes ❑ IF YES, PROVIDE INFORMATION IN TABLE BELOW. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 7 of 13 GRANT PROJECT/PROGRAM DESCRIPTION IMPORTANT - RECEIPTS/INVOICES IS REQUIRED TO BE SUBMITTED TO THE CITY TO VALIDATE THE ORGANIZATION SPENT GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE PROJECT/PROGRAM AS DESCRIBED HERE 1 DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT. Our program is to get the word out by local publications, social media outreach and direct emaili that this organization can help with the costs associated to animal diabetes. They don't need to -euthanize their pets we can help_ We have been helping for over 11 years. -We also hold a fund raiser at Oak Mountain Winery on August 21st to raise money, have a dog carnival for the dogs to enjoy and educate the people about canine diabetes, treatments and funding. 2 DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED. i ALSO, INCLUDE A LIST OF GOODS, EQUIPMEMENT, AND/OR SERVICES THIS ORGANIZATION HAS PURCHASED OR PLANS TO PURCHASE WITH AWARDED FUNDS TO SUPPORT THIS PROGRAM/PROJECT. We will use this money to reach out to all of the local Temecula Veterinarians, animal hospitals,pet stores and animal supply stores to let them know we will help any needy pet owners with the costs of diabetes control to include insulin, needles, glucose testing and test kits as well as precription food as long as the funds last. Helping our local pet owners. 3 TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS. Any animals in Temecula with diabetes will benefit with our support in paying for insulin and need special diets,vet bills and testing. The people will benefit by not only the finaciai support but the community being educated what to look for in their pets and get them help before they get very sick or loose their eyesight. The education will reach the whole community with out outreach 1 in 500 dogs suffer from diabetes. 3b ESTIMATED NUMBER OF PEOPLE FROM TEMECULA EXPECTED TO BENEFIT FROM THIS PROJECT/PROGRAM: 3c ESTIMATED NUMBER OF VOLUNTEERS INVOLVED IN THIS PROJECT/PROGRAM: 114 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 8 of 13 PROJECT/PROGRAM DESCRIPTION CONTINUED 4 SUMMARY STATEMENT — SUMMARIZE ANSWERS 1 — 3 ABOVE IN 50 WORDS OR LESS. It has been our goal to be_able _to_reach more_people to educate them on canine —I diabetes and let them know we are here to help financially with the treatment of their pets. We are also experienced with our own diabetic dog symptoms and treatments and help give comfort and suggestions for everyday care and giving shots to animals. 5 IF APPLYING FOR MORE THAN $5,000, PLEASE EXPLAIN HOW THE COVID-19 PANDEMIC AFFECTED THIS NONPROFIT ORGANIZATION'S ABILITY TO SERVE THE TEMECULA COMMUNITY. YOU MAY ALSO INCLUDE INFLATIONARY CONCERNS. During covid we were not able to do any fundraising ( it is still not easy to raise funds and get donations). The Veterinarian situation is still not good as many retired so people have long waits to get an appointment for their pets. We are able to help in referring vets that specialize in diabetes and eye issues which is common with diabetic dogs. With people having to pay higher prices for everything they don't have the fund it takes for Insulin and needles and therefore are forced to Euthanize their furry friends.That is where we come in and can pay for the services the animals need with your help. 6 IF APPLYING FOR MORE THAN $5,000, EXPLAIN HOW FUNDS HAVE OR WILL: (1) CREATE NEW PROJECT/PROGRAM, (2) EXPAND EXISTING PROJECT/PROGRAM, AND/OR (3) CONTINUE EXISTING PROJECT/PROGRAM. The funds will enable us to continue helping the animals and will give us the money to promote what we do and gain support to continue growing and helping the community, We have been self supporting for over 11 years but we want to reach everyone and not have to turn anyone down for lack of funds. We will have the fund to put together phamphl with information about canine diabetes and distribute to all local animal hospitals, Vet offices, petco etc. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 9 of 13 PROJECT/PROGRAM BUDGET (do not fill in shaded areas) LINE ITEMS FOR PROJECT/PROGRAM REVENUES EXPENSES LIST REVENUES/INCOME FOR PROJECT/PROGRAM Amount of money requested from this City of Temecula $ Community Services Grant(Not to exceed $50�000)- 10, 000 Amount contributed to the Project/Program by the Applicant $ Organization 1500 Other grants or funding already awarded for Project/Program, if any $ I In -Kind match amount or volunteer credit hours estimated amount $ TOTAL REVENUE $ 11500.00 LIST OF EXPENSES FOR PROJECT/PROGRAM Tools/Equipment (- $ Facilities/Rent/Insurance $ 500 Supplies $ 500 Marketing $1500 Services $ Food 1000 $ Other Staffing Expense THIS IS INELIGIBLE TO BE FUNDED BY CITY'S GRANT; $ HOWEVER PLEASE INCLUDE. TOTAL EXPENSES $ 3500.00 TOTAL BUDGET $ $ 3500.00 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 10 of 13 PREVIOUSFISCAL YEAR (FY) 2021-2022 COMPLIANCE REPORT IF YOUR ORGANIZATION WAS NOT AWARDED A COMMUNITY SERVICE FUNDING GRANT IN FY 21/22 (LAST YEAR), THEN SKIP THIS PAGE. If your organization was awarded a Community Service Funding Grant in FY 2021-2022 (last year) by the City of Temecula, please submit this information If your organization was awarded a Community Service Funding Grant in Fiscal Year 2021-2022 by the City of Temecula, all grant funds received must have been expended anytime on or between July 1, 2021, and June 30, 2022. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may -jeopardize any future funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent. If the funds were not spent in accordance with the approved/awarded application, the organization will be required to return the amount of funds to the City To substantiate that Fiscal Year 2021-2022 funds received from the City were spent appropriately, proper back-up documentation including the completed table below with accompanying receipts/invoices, must be submitted to the City on or before due date: September 12, 2022. 1. Fill out table below (make additional copies if needed to explain all expenditures.) 2. Attach copies of receipts/invoices (in the same order as listed in this table.) 3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590 Attn: City Manager's Office — CSF EXPENDITURE REPORT due on or before September 12, 2022 Organization. _ Name of Project/Program: FY 2021-2022 Amount of $ CSF Grant Fund Awarded: Month & Year CSF Grant Received from City: Number of Beneficiaries Living in 92590, 92591, 92592 that Directly Benefitted from this Program/Project (approximate number of beneficiaries if you do not have precise number): E d Date on Expenditure e Name of Company Receipt/invoice Description Purpose Q Y z' on Receipt or Invoice MUST BE ON OR BETWEEN Amount I DESCRIBE THE EXPENDITURE PURPOSE OF EXPENDITURE JULY 1, 2021 - JUNE 30. 2022 5 $ I 6 $ EXPENDITURE TOTAL $ EXPENDITURE TOTAL MUST BE EQUAL TO (OR GREATER) THAN TOTAL AWARD AMOUNT City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 11 of 13 FISCAL YEAR (FY) 2022-2023 COMPLIANCE REPORT If your organization is awarded a Community Service Funding - REINVESTMENT IN TEMECULA Grant in FY2022-2023 by the City of Temecula, follow these instructions. If your organization is awarded a Community Service Funding Grant - REINVESTMENT IN TEMECULA in FY2022-2023 by the City of Temecula, all grant funds received must be expended anytime on or between March 20, 2020 and June 30, 2024. In addition, all grant funds must be substantiated with proper back-up documentation, Failure to provide proper documentation may jeopardize any funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent. If the funds are not spent in accordance with the approved/awarded application, the organization may not receive and/or will be required to return said amount -of -funds-to-the-City-.To-substantiate-that-grant funds-from-the--City-are-spent-appropriatelyi-proper back-up documentation including the table below with accompanying receipts/invoices, must be submitted to the City as outlined on this page. 1. Fill out Expenditure Report table below. Make additional copies if needed to explain all expenditures. A. If awarded $5,000. Submit the following Expenditure Report within 60 days after spending $5,000 no later than June 30, 2024, to demonstrate grant funds were spent in accordance with the Application. [If you were awarded less than $5,000, submit Expenditure Report for that amount.) B. If awarded grant funds exceeding $5,000. A) Follow #1.A above first. B) To receive grant funds exceeding $5,000 (between $5K-$50K), submit the following Expenditure Report to be reimbursed for the remaining balance of award to demonstrate funds were spent in accordance with the Application. This report can be submitted in $10,000 increments (but no less than $10,000 unless the remaining grant award funding amount is less than $10K). This report must be submitted to the City no later than June 30, 2024 to receive remaining grant funds. 2. Attach copies of receipts/invoices (in the same order listed in table below). 3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590, Attn: City Manager's Dept. "CSF-Reinvestment in Temecula" EXPENDITURE REPORT DATED Organization: _ Name of Project/Program:,. , TOTAL FY 2022-2023 Month & Year FIRST $5,000 check Amount of Grant Fund Awarded: $ was received from City: 1. Is this Expenditure Report Is to provide documentation for first $5,000 awarded and received? Yes_ or No (already submitted). 2. My organization has already received $ of the total FY 2022-23 Grant Fund awarded by the City 3. Is this Expenditure Report is submitted to request reimbursement of funds? No or Yes If yes, Amount of Request $ Number of beneficiaries living in 92590, 92691, 92592 that directly benefitted from this Program/Project (approximate number of beneficiaries if you do not have precise number) - a) Date on Expenditure t W Name of Company Receiptlinvoice MUST SUPPORT PROJECT/PROGRAM IN APPLICATION &AWARD LETTER E on Receipt or Invoice MUST BE ON OR BETWEEN Q Z March 20, 2020 - JUNE 30, 2024 Amount Description Purpose 1 011 Ea J -I.. --L$ I EXPENDITURE TOTAL $ EXPENDITURE TOTAL City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 12 of 13 ACKNOWLEDGEMENT/SIGNATURE PAGE The applicant acknowledges and agrees to the following: • Recipient is subject to all Community Service Funding Program requirements including submittal deadlines and payment disbursements. Every Community Service Funding application is considered individually and on its own merit. ■ Awards will be given to organizations and activities that directly benefit the residents of Temecula. • Funding is not immediately available to the recipient, and requires an award letter signature upon approval. Please allow time for checks to be processed. The awarding of Community Service Funding does not constitute an automatic annual allocation. • The recognition for Community Service Funding should accrue to the City of Temecula. • Community Service Funding must be spent as specified on the Application and records may be requested by the City of Temecula to ensure the funds were used appropriately. • Community Service Funding grants will not be awarded or announced within the 60 days before an election in which an awarding Council Member is on the ballot, • The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. • If awarded a Community Service Funding Grant by the City of Temecula last year, then compliance receipts must be submitted on or before this application's due date or this application may be rejected as incomplete. I/we hereby certify the information contained in this Application is true to the best of our knowledge and belief. ORGANIZATION NAME:.l12�� MAILING ADDRESS: t PHONE: EMAIL PRESIDENT / AUTHORIZED OFFICER:11`r.T['t�%�, PRINT NAME SIGNATURE: )J41t�Q. IF DIFFERENTTHAN ABOVE, APPICATION PREPARED BY: DATE: 7 1:;�.I q Q,— SUBMIT ORIGINAL APPLICATION BY MONDAY, SEPTEMBER 12, 2022, TO: City of Temecula Community Service Funding Attn: City Manager's Office 41000 MAIN STREET TEMECULA, CA 92590 Questions: Stacey.Brown@TemeculaCA.gov (951) 694-6413 Betsy. Lowrey@TemeculaCA.gov (951) 693-3959 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 13 of 13 STATE OF CALIFORNIA Tpp FRANCHISE TAX BOARD FIR PO BOX 942857 SACRAMENTO CA 94257-0540 Entity Status Letter Date: 7/2/2022 ESL ID: 2469901519 Why You Received This Letter According to our records, the following entity information is true and accurate as of the date of this letter. Entity ID: 3354176 Entity Name: CAUSE FUR PAWS, 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. 5. The entity was administratively dissolved/cancelled on through the Franchise Tax Board Administrative Dissolution process. Important Information This information does not necessarily reflect the entity's current legal or administrative status with any other agency of the state of California or other governmental agency or body. If the entity's powers, rights, and privileges were suspended or forfeited at any time in the past, or if the entity did business in California at a time when it was not qualified or not registered to do business in California, this information does not reflect the status or voidability of contracts made by the entity in California during the period the entity was suspended or forfeited (R&TC Sections 23304.1, 23304.5, 23305a, 23305.1). The entity certificate of revivor may have a time limitation or may limit the functions the revived entity can perform, or both (R&TC Section 23305b). Connect With Us Web: ftb.ca.gov Phone: 800-852-5711 from 7 a.m. to 5 p.m. weekdays, except state holidays 916-845-6500 from outside the United States California Relay Service: 711 or 800-735-2929 (For persons with hearing or speech impairments) FTB 4263A WEB (REV 12-2019) INTERNAL REVENUE SERVICE P. O. BOX 2508 CINCINNATI, OH 45201 Date: QEPZ52o11 CAUSE FUR PAWS INC -- C-/O-VALERI-EANDREWS 47200 DE PORTOLA TEMECULA, CA 92592 Dear Applicant: DEPARTMENT OF THE TREASURY Employer Identification Number: 27-5415050 DLN: 17053227305011 Contact Person: YVONNE-LIGGET-T ID9 31296 Contact Telephone Number: (877) 829-5500 Accounting Period Ending: December 31 Public Charity Status: 509 (a) (2) Form 990 Required: Yes Effective Date of Exemption: January 25, 2011 Contribution Deductibility: Yes Addendum Applies: No 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, Lois G. Lerner Director, Exempt Organizations Letter 947 (DO/CG) W 2021 - 990-N (e-Postcard) ACCEPTANCE LETTER Form 990-N (e-Postcard) Online Filing Congratulations! Your 2021 tax return has been accepted by the IRS. Thank you for preparing your exempt tax return, IRS Form 990-N, with ExpressTaxExempt. Your return information is listed below and we hope you had a pleasant experience e-filing with ExpressTaxExempt. FORM INFORMATION TAX YEAR: 2021 IRS SUBMISSION ID: 32101820220322000136 TAXPAYER INFORMATION NAME: Cause Fur PAws Inc DBA NAME: Cause Fur Paws ADDRESS: 47200 De Portola Rd STATE/COUNTRY: California PHONE: (951) 767-2116 RETURN ID: 4B00032229517-4 E-FILE TIME STAMP: 2/1/2022 2:03:58 PM TAX ID: 27-5415050 CITY: Temecula ZIP: 92592 EMAIL: vandrews@oakmountainwinery.com PLEASE PRINT A COPY OF THIS LETTER FOR YOUR RECORDS Thank you again for your business. If you have any questions or need any assistance, please contact our customer support via live online chat, email at support@expresstaxexempt.com, or by phone at 704-839-2321. We're here to help! Sincerely, ExpressTaxExempt Support Team (704)839-2321 support@expresstaxexempt.com Span Enterprises • (704) 839-2321 • 2685 Celanese Road Suite 103 • Rock Hill, SC - 29732 Rie-gustrant Details Organization Name: CAUSE FUR PAWS, INC. IRS FEIN: 275415050 Entity Type: Public Benefit SOS/FTB Corporate/Organization Number: 3354176 Registry Status: Delinquent Renewal Due/Exp. Date: 5/15/2018 RCI' Registration Number: CT0251190 Issue Date: 7/17/2017 Record Type: Charity Registration Effective Date: 7/17/2017 Date of Last Renewal: DBA: Ma hog Address Strect: 47200 DE PORTOLA Street Line 2: City, State Zip: TEMECULA CA 92592 F;4rVi v gs & Corriespond ence , sing Reports Letter Missing Reports Letter Incom Incomplete RRF-I Letter Founding Documents Founding Documents ConCrttifltign of Registration j,,etter Confirmation of Registration Letter Form RRF-1 2020 s —tDs I ir 1-Q uency Letter Ist Delinquency Letter ,Founding Document Click on Document Type at the Icfl to open PDF 2-].J FarM REE-1 Click on DOCrlmCnt Type at the left to open PDF 2016 E4rir1 RELI Click on Document Type at the left to open PDF 2M Form RU-11 Click on Document Type at the left to open PDF 2414 ForM RRF=1 Click on Document Type at the left to open PDF 2012 Form RRF-1 Click on Document Type at the left to open PDF 12011 Form RRF-I Click on Document Type at the left to open PDF +1 ' . mL a s: R e ' -,e w a 1`a D "„ a Status of Filing: Accepted Accounting Period Begin Date: 1 /l,/201 1 Accounting Period End Date: 12/3 1 "201 I Filing Received Date: 8;21/20I7 Form RRF-1 RejectAneomplete Reason: Form CT-TR-I Reject/Incomplete Reason: IRS Form 990 Reject/Incomplete Reason: Notes From Registry Staff; !status of Filing: � Accepted Accounting Period Begin Date: l'1/2012 Accounting Period End Date: 12/31/2012 Filing Received Date: 3/21"2017 Form RRF-1 Reject/Incomplete Reason; Form CT-TR-I Reject/Incomplete Reaso IRS Form 990 Reject/lneomplete Reasoi Notes From Registry Staff: Status of Filing: Accounting Period Begin Date: Accounting Period End Date: Filing Received Date: Form RRF-1 Reject/Incomplete Reason: Form CT-TR-I Reject/Incomplete Reasc IRS form 990 Reject/Incomplete Reasoi Notes From Registry Staff: Status of Filing: Accounting Period Begin Date. - Accounting Period End Date: Filing Received Date: Form RRF-1 RejectAncomplete Reason: Form CT-TR-1 Reject/Incomplete Reasn IRS Form 990 RejectAncomplete Reaso► Notes From Registry Staff: Status of Filing: Accounting Period Begin Date: Accounting Period End Date. - Filing Received Date: Form RRF-1 Reject/Incomplete Reason: Form CT-TR-I Reject/Incomplete Reaso IRS Form 990 Reject/Incomplete Reason Notes From Registry Staff: Status of Filing: Accounting Period Begin Date: Accounting Period End Date: Filing Received Date: Form RRF-1 Reject/fneomplete Reason: Form CT-TR-I Reject/Incomplete Reaso IRS Form 990 Reject/Incomplete Reason Notes From Registry Staff: Status of Filing: Accounting Period Begin Date: Accounting Period End Date: Filing Received Date: Form RRF-I Reject/Incomplete Reason: Form CT TR-1 Reject/Incomplete Reasoi IRS Form 990 RejecOncomplete Reason Notes From Registry Staff: Status of Filing: Accounting Period Begin Date: Accounting Period End Date: Filing Received Date: Form RRF-1 Reject/Incomplete Reason: Form CT-TR-I Reject/Incomplete Reaso► IRS Form 990 Reject/Incomplete Reason; Notes From Registry Staff: Status of Filing: Accounting Period Begin Date: Accounting Period End Date: Filing Received Date: Form RRF-I Reject/Incomplete Reason: Form CT-"rR-1 Reject/Incomplete Reasor IRS Form 990 Reject/Incomplete Reason: Notes From Registry Staff: Status of Filing: Incomplete Accounting Period Begin Date: 1 /1 /2020 Accounting Period End Date: 12/3 1;20)0 Filing Received Date. 8; l8i"2021 Form RRF-I Reject/Incomplete Reason: Form CT TR-I RejecOncomplete Reason: IRS Form 991) Reject/Incomplete Reason: Notes From Registry Staff: Related Registrations & Even ept �. No Related Records FY 2022/2023 COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA GRANT APPLICATION # 13 CULTIVATING INCLUSION INC. CITY OF TEMECULA FISCAL YEAR 2022.2023 COMMUNITY SERVICE FUNDING - REINVESTMENT IN TEMECULA PROGRAM APPLICATION (Please Print or Type) DUE ON OR BEFORE: MONDAY, SEPTEMBER 12, 2022 PROJECT/PROGRAM INFORMATION Amount Requested: $ 7,500.00 Project/Program Title: cultivating Inclusion Inc. MAXIMUM ALLOWABLE: $50,000 PER ORGANIZATION Start Date: 02-02-2015 End Date: ongoing Physical Address of Project/Program 39775 Alta Murrieta Dr., Murrieta, CA 92563 - "no mail should be sent to physical address. INCLUDE IF DIFFERENT THAN ORGANIZATION'S MAILING ADDRESS If Grant is Awarded, Make Check Payable to: Cultivating Inclusion Go Mary Ann Tams •• Mailing Address: 31430 Loma Linda Rd., Temecula, CA 92592-1604 **all correspondence needs to go to this address, ORGANIZATION AND GEOGRAPHIC AREA SERVED Name of Applicant Organization: Cultivating Inclusion Inc. Website: http:11www.cultivatingindusionfarm.com Number of Paid Staff. zero Year Founded: 2015 Social Media: Facebook, Instagram Number of Volunteers: 15 to 20 Geographic Area(s) the Organization Serves: southwest Riverside County Geographic Area(s) the Proiect/Program Serves: Southwest Riverside county NOTE: COMMUNITY SERVICE FUNDING GRANT PROGRAM FUNDING MUST BE EXCLUSIVELY USED TO SERVE TEMECULA. Contact Name: Mary Ann Tams Title/Position: Garden Director Contact Person's Direct Telephone: 951-296-7756 Contact Person's Email: Cultivatinginclusion2@yahoo.aom NONPROFIT STATUS Is this organization incorporated as a nonprofit? Yes ® Date of Incorporation as a Nonprofit: 06-26.2018 No ❑ IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING Federal Identification Number: e2-06o9510 State Identification Number: =� "7 �3 PRINT OUT AND ATTACH TO THIS APPLICATION VERIFICATION FROM FEDERAL (IRS) AND STATE (FTEl) AS FOLLOWS: 1. XAttach IRS Deductibility Status using this link: littp:ltclpl)s.irs.gov/app/co 1 2. l)�Attach State Entity Status Letter using this link: htt s:1/ A.ftb.ca.gov/onfine/seif serve entity status lettedindex.as 3. J9 Attach first page only of most recent IRS Form 990 # attach print out of detailed info about your charity found on this State Registry's Search Tool: ht ://rc .do'.ca. ovNeriri do /W 1 rc s x?f ilit =Y City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 5 of 13 APPLICATION AUTHORIZATION Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over $500 including any business transactions, negotiations, investments, or interests in real property with a Temecula City Council Member during the past 12 months? No ® Yes ❑ IF YES, BRIEFLY DESCRIBE: Is a Temecula City Council Member a member of the Board of Directors or an Officer of the organization? No �Z Yes ❑ IF YES, PROVIDE COUNCIL MEMBER'S NAME AND TITLE WITHIN THE ORGANIZATION: This Application has been authorized by the organization's: Executive Committee ❑ Board of Directors Members -at -Large ❑ MISSION STATEMENT OF ORGANIZATION BRIEFLY DESCRIBE THE ORGANIZATION'S MISSION/GOALS AND OBJECTIVES. Cultivating Inclusion is a one of a kind project that provides vocational training opportunities for youth and adults with special needs throughout our valley. We provide a job site location for day programs, two of which, Care -Rite Vocational Services and TMI Vocational Services are located in the City of Temecula. We work side by side with special needs adults as they learn how to prepare, plant, nurture and ultimately harvest produce. The feeling of satisfaction and accomplisment is palatable upon their faces- Not only do our special needs adult visitors learn the rudiments of gardening, they know that the produce they have cared for goes to local food banks. We have been able to bring nearly 1,200 Ibs of citurss and produce to St. Vincent de Paul (St. Catherine's Catholic Church chapter) and Western Eagle Foundation this year alone Together we learn to work as a team and socialize with a bit of fun in between through snacks, games and crafts. All of the above is brought together by a wonderful group of volunteers who believe that our special needs adults involved in Cultivating Inclusion are a necessary and vital part of our community. FINANCIAL STATEMENTS UPON REQUEST, COPIES OF THE ORGANIZATION'S CURRENT BUDGET/FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT), AND IF AVAILABLE CPA'S AUDIT, MAY BE NEEDED UPON REQUEST TO DEMONSTRATE SOUND FINANCIAL MANAGEMENT. DO NOT SUBMIT NOW. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 6 of 13 FUNDING SOURCES CITY OF TEMECULA—SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM THE CITY FOR ANY PROGRAM? No kZ Yes ❑ IF YES, PROVIDE BELOW. NAME OF PROGRAM/PROJECT FUNDED BY THE CITY GRANT OR SPONSORSHIP City of Temecula AMOUNT t MONTH + YEAR FUNDING RECEIVED 01-2022 NAME OF CITY GRANT OR SPONSORSHIP $ 5,000.00 $ Community Sery Reinvesting in Temecula Grant $ $ i $ $ $ OTHER OUTSIDE SOURCES —SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM ENTITIES (NOT INCLUDING THE CITY) FOR THE SAME PROJECTIPROGRAM IN THIS APPLICATION? No ❑ Yes ❑ IF YES, PROVIDE INFORMATION IN TABLE BELOW AMOUNT MONTH + YEAR NAME OF ENITY RECEIVED FUNDING RECEIVED Heritgae Hills Event Ctr. $ 1,000.00 01-2020 $ Inland Empire Community 9-2020 660.00 Foundation $ 5,000.00 Lendistry - State of CA Grant Coalition - California Relief Program 02-2021 $ 1,420,00 Rodgers Seed Money 01-2021 $ 3,500.00 Vines Christian Fellowship 03-2021 $ 1,450.00 Network for Good 06-2022 Q 300.00 Vines Christian Fellowship 06-2022 06-2022 $ 217.00 The Habit - Fundraiser percentage of sales City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 7 of 13 GRANT PROJECT/PROGRAM DESCRIPTION IMPORTANT - RECEIPTS/INVOICES IS REQUIRED TO BE SUBMITTED TO THE CITY TO VALIDATE THE ORGANIZATION SPENT GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE PROJECT/PROGRAM AS DESCRIBED HERE 1 DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT. The Cultivating Inclusion farm is spedficatly designed for special needs adults. We literally give our special needs adult visitors the tools to care for and nurture produce In a community garden setting. We welcome adults who are part of State of California licensed day programs and students in the Adult Transition Programs in Temecula Valley USD. Together we harvest a variety of produce which in turn is donated to local food banks, i.e. St Vincent de Paul, Western Eagle Foundation and Community Mission of Hope. In this positive outdoor environment our patient volunteers work side by side with our farmhands, and when we take a break together, socializing skills are honed and enjoyed. The unique combination of co-workers is real and friendships are formed, united in a great cause to provide fresh produce to our neighbors in need- 2 DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED. ALSO, INCLUDE A LIST OF GOODS, EQUIPMEMENT, AND/OR SERVICES THIS ORGANIZATION HAS PURCHASED OR PLANS TO PURCHASE WITH AWARDED FUNDS TO SUPPORT THIS PROGRAM/PROJECT. Keeping our landscape clear of weeds and vermin is of primary concern. Because when both of these pests are present our produce is threatened and the beauty is blighted on the property. As this is very vital, keeping our farm neat and healthy, we require both weed abatement and pest control services. In addition, we supply our special needs adults with water, healthy Snacks, arcs and crafts, copy services for different information and adult coloring books, For promotional purposes funds are spent on flyers for events, business and post cards, Not to mention signage so that our garden is one that can be located easily. We recently had a theft of our previous heavy aluminum sign at the farm which was a $700.00 purchase. The tools and replacements that are required of gardening is also one in which monies are spent. Along with the buying starter plants, shrubs and trees to shade our garden and provide beauty. Soils of all variety to enrich our indigenous soil are required and this too is an expense. All in all —any resources received will be put to goad use and will very much help our farm grow 3 TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS. Temecula residents who attend either a day program like Care Rite, TMI or ATP programs in TVUSD benefit from the Cultivating Inclusion farm experience Once our special needs adults walk through our garden gate they are greeted with a smile and hello. This is sometimes not always the case when they enter locations, but at the farm all are welcome and appreciated by their presence. We become friends and co-workers, bringing life to our soil and harvesting the produce, it is a sense of accomplishment that is palpable and necessary feeling for everyone to experience. 3b ESTIMATED NUMBER OF PEOPLE FROM THIS PROJECT PROGRAM FROM TEMECULA EXPECTED TO BENEFIT I 350 3c ESTIMATED NUMBER OF VOLUNTEERS INVOLVED IN THIS PROJECT/PROGRAM: I 15to20 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 8 of 13 PROJECT/PROGRAM DESCRIPTION CONTINUED 4 SUMMARY STATEMENT - SUMMARIZE ANSWERS 1 - 3 ABOVE IN 50 WORDS OR LESS. We are a community garden set up to teach our special needs adults about growing produce. Fresh produce that we in turn donate to fellow neighbors in need of fresh food who welcome afresh alternative In this growing process we we show our special needs adults they have purpose- 5 IF APPLYING FOR MORE THAN $5,000, PLEASE EXPLAIN HOW THE COVID-19 PANDEMIC AFFECTED THIS NONPROFIT ORGANIZATIONS ABILITY TO SERVE THE TEMECULA COMMUNITY. YOU MAY ALSO INCLUDE INFLATIONARY CONCERNS. Covid 19 specifically affected our non profit due to the fact that our adults in both day programs and ATP classes with TVUSD were not meeting in person. Therefore, like the rest of the word, they had to resort to communicating with those outside of their home via zoom. In 2020, though the Cultivating Inclusion farm was being maintained we were not being visited by our special needs communities because of the restrictions. When w321 came around, we greeted sporadically special needs adults whose day programs limited to being open three days a week. We would also host special events around holidays, wherein folks picked out pumpkins, made pine cone ornaments and valentines with sunflower seeds. In June of 2021, we were able once again to greet our day programs and we were thrilled to have them back we had missed them and our mission of working together to grow produce for our neighbors in need. Since the pandemic is ongo�nq even now, I notice that plants, delivery or soils, seeds and snacks that we provide have all increased in price, More often than not, nur dear volunteers will donate snacks and craft supplies to an effort to decrease having Cultivating Inclusion funds used for this reason- 6 IF APPLYING FOR MORE THAN $5,000, EXPLAIN HOW FUNDS HAVE OR WILL: (1) CREATE NEW PROJECT/PROGRAM, (2) EXPAND EXISTING PROJECT/PROGRAM, AND/OR (3) CONTINUE EXISTING PROJECT/PROGRAM. In addition to promotional items, supplies and general repairs, we would like to make the Cultivating inclusion farm accessible for those special needs adults who have mobility issues. It has been suggested that perhaps our center lane of the farm, meaning from front fence to the back fence a strip of concrete to enable all of our special needs adults can have a garder,.ng experience_ Lasl ye It we had a girt named Jessica who was part of an ATP program had an electric track chair but she became mire in some weller soil and we almost could not get her out, And Jessica really loved coming to the farm so she did return but we were more diligent about where she could travel to avoid getting stuck again. This request for mobility has come from leachers and parents of special needs adults. I could not in good conscience omit this need as being very important. For this above reason Cultivating Inclusion is asking for the additional $2,500.00 for the sole purpose of providing a centenualk for all our special needs adults. As in 2021 we requested $5,000.00 and happily gratefully received it in January 2022, but this year we are requesting the additional monies for the above purpose.. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 9 of 13 PROJECT/PROGRAM BUDGET (do not fill in shaded areas) LINE ITEMS FOR PROJECT/PROGRAM REVENUES EXPENSES LIST REVENUES/INCOME FOR PROJECT/PROGRAM Amount of money requested from this City of Temecula $ 7.500,00 Community Services Grant (Not to exceed $50,000) Amount contributed to the Project/Program by the Applicant $ 6.000.00 Organization -- Other grants or funding already awarded for Project/Program, if any $ 3.500.00 In -Kind match amount or volunteer credit hours estimated amount $ TOTAL REVENUE $ 16,00000 LIST OF EXPENSES FOR PROJECT/PROGRAM Tools/Equipment $ 300.00 Facilities/Rent/Insurance" $ 834,00 Supplies $ 700,00 Marketing $ 1,500.00 Services $ 0. Food $1,e66.00 Other Accessibility $ 2,500M $ 0 Staffing Expense THIS IS INELIGIBLE TO BE FUNDED BY CITY'S GRANT; HOWEVER PLEASE INCLUDE. $ $7,500.00 TOTAL EXPENSES TOTAL BUDGET $ $ 5,000.00 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 10 of 13 PREVIOUS* FISCAL YEAR (FY) 2021-2022 COMPLIANCE REPORT IF YOUR ORGANIZATION WAS NOT AWARDED A COMMUNITY SERVICE FUNDING GRANT IN FY 21/22 (LAST YEAR), THEN SKIP THIS PAGE. If your organization was awarded a Community Service Funding Grant in FY 2021-2022 (last year) by the City of Temecula, please submit this information. I If your organization was awarded a Community Service Funding Grant in Fiscal Year 2021-2022 by the City of Temecula, all grant funds received must have been expended anytime on or between July 1, 2021, and June 30, 2022. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any future funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent. If the funds were not spent in accordance with the approved/awarded application, the organization will be required to return the amount of funds to the City. To substantiate that Fiscal Year 2021-2022 funds received from the City were spent appropriately, proper back-up documentation including the completed table below with accompanying receipts/invoices, must be submitted to the City on or before due date: September 12, 2022. 1. Fill out table below (make additional copies if needed to explain all expenditures.) 2. Attach copies of receipts/invoices (in the same order as listed in this table.) 3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590 Attn: City Manager's Office — CSF EXPENDITURE REPORT due on or before September 12, 2022 Organization: — Cultivating Inclusion Inc. Name of Project/Program; Cultivating Inclusion FY 2021-2022 Amount of $ CSF Grant Fund Awarded: $5,000.00 Month & Year CSF Grant Received from City: 01-2022 Number of Beneficiaries Living In 92590, 92591, 92592 that Directly Benefitted from this Program/Project (approximate number of beneficiaries if you do not 1,200 have precise number): Previously submltled and approved before see attached confirmation dated 08-27-202Y. E Date on _ Expenditure Name of Company Receipt/Invotce Description Purpose on Receipt or Invoice MUST BE ON OR BETWEEN Amount DESCRIBE THE EXPENDITURE PURPOSE OF EXPENDITURE JULY 1, 2021 - JUNE 30, 2022 1 $ 2 $ 3 $ EXPENDITURE TOTAL MUST BE EQUAL TO EXPENDITURE TOTAL $ (OR GREATER) THAN TOTAL AWARD AMOUNT. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 11 of 13 FISCAL YEAR (FY) 2021-2022 COMPLIANCE REPORT If your organization is awarded a Community Service Funding Grant in FY 2021.2022 by the City of Temecula, then this information is not due until Monday, September 12, 2022 If your organization is awarded a Community Service Funding Grant in Fiscal Year 2021-2022 by the City of Temecula, all grant funds received must be expended anytime on or between July 1, 2021, and June 30, 2022. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any future funding_ City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent. If the funds are not spent in accordance with the approved purpose stated on the Application,4be organization will be required to refund the amount of Funds. To substantiate that Fiscal Year 2021-2022 funds received from the City were spent appropriately, proper back -tap documentation including the table below with accompanying receipts/invoices, must be submitted to the City on or before due date: Monday, September 12, 2022_ EXPENDITURE REPORT due on or before Monday, September 12, 2022 1. Provide the number of beneficiaries living in 92590, 92591 and 92592 that directly benefitted 1200 From this program (approximate number of beneficiaries if you don't have a precise number): 2. Fill out this table (include additional copies if needed to explain all expenditures) 3, Attach Receipts/Invoices (in the same order as listed In this table) 4. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590, Attn: City Manager's Office - CSF Organization: Cultivating Inclusion Inc. Amount of Grant Fund Awarded: $ 5,000.00 Name of Company E on Receipt/invoice az'I 1 Home Depot I 2 Home Depot 3 Date (Mo/DayNr) on Receipt/lnvoice Must be dated on or between July 1, 2021 - June 30, 2022 11 /09/21 01 /26/22 Home Depot 02/15/22 Amount of Expenditure $ 38.44 $ 52.20 4 Home Depot 103/14/22 J $ 17.36 Louie's Nursery10/13/21 1 $ 77.94 Louie's Nursery 11 /09/21 ' $277.50 7 Louie's Nursery� 02/ �/22 EXPENDITURE TOTAL Note: Expenditure Total must be equal to (or greater than) the "Amount of Grant Fund Awarded" (above) provided by the City $ 39.98 Name of Project/Program: Cultivating Inclusion Inc. Month + Year Grant Received from City: 01 /2022 Describe... Explain ... (1) what the expenditure was I how the expenditure (2) purpose of the expenditure specifically benefitted Temecula residents MUST support Project/Program If namesladdresses of Temecula description on Application + Award Letter beneficiaries are available, Alensu attach. -- 1 cu foot citrus fertilizer "use Keeping our grove thriving cols lertifizer specTcauy to enrich sail in our grove. for food banks and clients rosemary, lettuce, cabbage starter plants Winter crops for food banks~ to ensure a winter crop and cllsnte learn io nurture plants steer manure for winter crop plants, Winter crops for food banks amending soil is key to productivity and clients learn the rare of veg. Petunia easy way plant 4 pack To make our farm pretty for to beautify the garden. clients and visitors Native blackberry bushes, for spring crop of berries for clients to harvest. 8 yards of organic planting mix soil to ensure the health of soil for prodrloe. 2 Flats of sirawherry plants so that a sweet treat is available for food banks. $ `;4� 9:"I / p i1 of 3 To ensure a variety of produce Is given to food hanks. Needed to keep our crop healthy for food banks/clients Healthy options for clients to harvest for food bank needy. City of Temecula Community Service Funding Grant APPLICATION Page 6 of 7 FISCAL YEAR (FY) 2021-2022 COMPLIANCE REPORT If your organization is awarded a Community Service Funding Grant in FY 2021-2022 by the City of Temecula, then this information is not due until Monday, September 12, 2022 If your organization is awarded a Community Service Funding Grant in Fiscal Year 2021-2022 by the City of Temecula, all grant funds received must be expended anytime on or between July 1, 2021, and June 30, 2022. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any future funding. City of Temecula reserves the right to conduct an audit and/oi require additional back-up information to substantiate how funds received from the City were spent. If the funds are not spent in accordance with the approved purpose stated on the Application,.the organization will be required to refund the amount of funds, To substantiate that Fiscal Year 2021-2022 funds received from the City were spent appropriately, proper back-up documentation including the table below with accompanying receipts/invoices, must be submitted to the City on or before due date: Monday, September 12, 2022. EXPENDITURE REPORT due on or before Monday, September 12, 2022 1. Provide the number of beneficiaries living in 92590, 92591 and 92592 that directly benefitted 1200 from this program (approximate number of beneficiaries if you don't have a precise number): _ 2. Fill out this table (include additional copies if needed to explain all expenditures) 3. Attach Receipts/Invoices (in the same order as listed in this table) 4. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590, Attn: City Manager's Office - CSF Organization: Cultivating Inclusion Inc. Amount of Grant Fund Awarded: $ 5,000.00 Date (MolDaylYr) Name of Company E Recelpt/lnvoice on Receiptlinvoice Amount .Ion u E 2 Must be dated on or between July 1, 2021 - of Expenditure p Z June 30, 2022 2 Orozco Gen Maint. 1 08/30/2021 $ 385.00 3 Orozco Gen Maint. 09/28/202 1 $ 385.00 4 LOrozco Gen Maint. I O/26/202 5 Orozco Gen Maint. 1 1 /30/202 1 $ 385.00 6 Orozco Gen Maint. 1 2/28/2021 1 $ 385.00 7 Orozco Gen Maint. 0 1 /31 /2022 1 $ 385.00 Name of Project/Program: Cultivating Inclusion Inc. Month + Year Grant Received from city: 01 /2022 Describe... Explain ... (1) what the expenditure was how the expenditure 1 (2) purpose of the expenditure specifically benefitted Temecula residents MUST support Project/Program If namesladdresses of Temecula description on Application + Award Lefterl beneficiaries are available, i Initial cost of weed clean up in order M ry TC4C�eililtt foLqur for our farm to be neat in appearance. clients and visitors in appearance. Keeping our farm clean so that it is neat More accessible for our and accessible for our visitors and clients. clianw and Wallora in appearance, Keeping our farm clean so that is neat and More accessible for our accessible for our visitors and clients. clients and visitors. Repair and replacement of Produce to nurture for clients irrigation drip system to keep farm green. and food for food banks. Keeping our farm free of weeds so that I More accessible and easy it has a neat and pleasant appearance. for clients to harvest produce. Keeping our farm free of weeds so that More accessible and easy it has a neat and pleasant appeafance, for clients to harvest produce. Keeping our farm free of weeds so,het More accessible and easy It has a neat and pleasant appearance. for clients to harvest produce. EXPENDITURE TOTAL Note: Expenditure Total must be equal to $ 2:7,0e'00 f pg 2 (or greater than) the "Amount of Grant Fund of 3 Awarded" (above) provided by the City City of Temecula Community Service Funding Grant APPLICATION Page 6 of 7 FISCAL YEAR (FY) 021-2022 COMP41ANCE REPORT If your organization is awarded a Community Service Funding Grant In FY 2021r2022 by the City of Temecula, then this Information Is not due until Mdnday, September 12, 2022 If your organization Is awarded a Community Service Funding Grant in Fiscal Year 2021-2022 by the City of Temecula, --all-grant-funds reoelved-must-be-expended-anytkne-on-or-between-July-1 2021-and-Jung-30,-2022- In addition, - all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any future funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up Information to substantiate how funds reoetved from the City were spent. t% If the funds are not spent in accordance with the approved purpose staled on the Application, the organization will be required to refund the amount of funds. To substantiate that Fiscal Year 2021-2022 funds received from the City were spent appropriately, proper back-up documentation including the table below with accompanying recelpts/invoices, must be submitted to the City on or before due date: Monday, September 12, 2022. EXPENDITURE REPORT due on or before Monday, September 12, 2022 1 1. Provide the number of beneficiaries living in 92590, 92591 and 92592 that directly, benefitted from this program (approximate number of beneficiaries if you don't have a precise number): IQLOO 2. Fill out this table (include additional copies if needed to explain all expenditures) 3. Attach Receiptslinm voices (in the sae order as listed in this table) 4. Send to: City of Temecula, 41000 Main St, Temecula, CA 92590, Attn: City Managers Office - CSF Organization: Cultivating InCIUSIOn Inc. Name of ProjecWrogram:L,f1;Lh&.t3:7ulCIUS! Amount of Grant Fund Awarded: $ Month + Year Grant Received from City.() � -- Data (Mo/DayNt) Name of Company on Recelpt/lnvolcs on Recelptllnvolce Must be dated on or $ between July 1. 2021 - June 30, 2022 "IN 7 .0401H 3-1S-; Describe... Explain ... Amount Of Expenditure (1) what the expenditure was (2) purpose of the expenditure MUST MUST support Project Program description on Application + Award Lettet how the expenditure specifically benefitted residents M namecfaddnasas of Temecula beneAdarlss art available. $ -- �� 3 • Ham, cfo�i Frr drs ^40.n "P -, -I" kw �_ ,.rc- ni A naw a* fdr wivt Prro- EXPENDITURE TOTAL ` �O. (� Note, Ex nditure roiai must be equal$ 4 to (or greater than) the-AarlqurIf of Grant Fund I Awarded' (above) provided by the City r W CJfr.-0tls ait"ndC tbwd tom- l) le, . City of Temecula Community Service Funding Grant APPLICATION Page 6 of 7 FISCAL YEAR (FY) 2021-2022 COMPLIANCE REPORT If your organization is awarded a Community Service Funding Grant in FY 2021-2022 by the City of Temecula, then this information is not due until Monday, September 12, 2022 If your organization is awarded a Community Service Funding Grant in Fiscal Year 2021-2022 by the City of Temecula, all grant funds received must be expended anytime on or between July 1, 2021, and June 30, 2022. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may -jeopardize -any -future -funding.. City -of Temecula -reserves-the-right to -conduct an -aud it -and/or require -additional back-up information to substantiate how funds received from the City were spent. If the funds are not spent in accordance with the approved purpose stated on the Application4he organization will be required to refund the amount of funds. To substantiate that Fiscal Year 2021-2022 funds received from the City were spent appropriately, proper back-up documentation including the table below with accompanying receipts/invoices, must be submitted to the City on or before due date: Monday, September 12, 2022. EXPENDITURE REPORT due on or before Monday, September 12, 2022 1. Provide the number of benefioieries living in 92590, 92591 and 92592 that directly benefitted 1200 from this program (approximate number of beneficiaries if you don't have a precise number): 2. Fill out this table (include additional copies if needed to explain all expenditures) 3. Attach Receipts/Invoices (in the same order as listed in this table) 4. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590, Attn: City Manager's Office - CSF Organization: Cultivating Inclusion Inc. Amount of Grant Fund Awarded: $ 5,000.00 Name of Company E on Receipt/lnvoice t� u E az' 1 Orozco Gen Maint Date (Mo/DayNr) on Receiptlinvoice Amount Must be dated on or between July 1, 2021 - of Expenditure June 30, 2022 03/01 /2022 $ 385.00 r[uUUI rr rCSL- TlujI AZ - 3 Rodent Pest Tech 0911 gI2021 1� $ 230.00 4 Rodent Pest Tech 11 /19/2021 $ 230.00 5 Rodent Pest Tech f 12/20/2091 $ 230.00 6 Rodent Pest Tech 102/19/2022 $ 230.00 7 Rodent Pest Tech 1 03/22/2022* $ 230.00 Name of Project/Program: Cultivating Inclusion Inc. Month + Year Grant Received from City: 01 /2022 Describe... (1) what the expenditure was (2) purpose of the expenditure MUST support Project/Program description on Appilcation + Award Let Keeping our farm free of weeds so thal it has a neat accessible appearance. Rid the farm of vermin and pests to ensure a safe environment, Rid the faun of vermin and pests to ensure a safe environment. Rid the farm of vermin and pests to ensure a safe environment. Rid the farm of vermin and pests _ to ensure a safe environment. Rid the farm of vermin and pests to ensure a safe environment. Rid the farm of vermin and pests to ensure a safe environment. EXPENDITURE TOTAL 'pd on 3/1112022 Note: Expenditure Total must be equal to $ 111,8109 3 of 3 (or greater than) the "Amount of Grant Fund Total $54t4rW for 3 pgs Awarded" (above) provided by the City a 19 City of Temecula Community Service Funding Grant APPLICATION Explain ... how the expenditure specifically benefitted Temecula residents If namesladdresses or Temecula beneficiaries are available, please attach. Helps keep our farm safe for visitors and more food for food banks, clients and more food for food hanks. Helps keep our farm safe for clients and more food for food banks. Helps keep our farm safe for clients and more food for food banks. Helps keep our farm safe for 4*ntn oral morn rood for frxxl banks, Helps keep our farm safe for clients end more food for food banks. Helps keep our farm safe for clients end more food for food bunks, Page 6 of 7 FISCAL YEAR (FY) 2022-2023 COMPLIANCE REPORT If your organization is awarded a Community Service Funding - REINVESTMENT IN TEMECULA Grant in FY2022-2023 by the City of Temecula, follow these instructions. If your organization is awarded a Community Service Funding Grant - REINVESTMENT IN TEMECULA in FY2022-2023 by the City of Temecula, all grant funds received must be expended anytime on or between March 20, 2020 and June 30, 2024. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent. If the Funds are not spent in accordance with the approved/awarded application, the organization may not receive and/or will be required to return said amount of funds to the City. To substantiate that grant funds from the City are spent appropriately, proper back-up documentation including the table below with accompanying receipts/invoices, must be submitted to the City as outlined on this page. I. Fill out Expenditure Report table below. Make additional copies if needed to explain all expenditures. A. If awarded $5,000. Submit the following Expenditure Report within 60 days after spending $5,000 no later than June 30, 2024, to demonstrate grant funds were spent in accordance with the Application. [If you were awarded less than $5,000, submit Expenditure Report for that amount.) B. If awarded grant funds exceeding $5,000. A) Follow #1.A above first. B) To receive grant funds exceeding $5,000 (between $5K-$50K), submit the following Expenditure Report to be reimbursed for the remaining balance Of award to demonstrate funds were spent in accordance with the Application. This report can be submitted in $10,000 increments (but no less than $10,000 unless the remaining grant award funding amount is less than $10K). This report must be submitted to the City no later than June 30, 2024 to receive remaining grant funds. 2. Attach copies of receipts/invoices (in the same order listed in table below). 3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590, Attn: City Manager's Dept. "CSF-Reinvestment in Temecula" EXPENDITURE REPORT DATED Organization:- Cultivating Inclusion Inc. Name of Project/Program: Cultivating Inclusion Inc. TOTAL FY 2022-2023 Month & Year FIRST $5,000 check Amount of Grant Fund Awarded: 5_ was received from City: _ 1. Is this Expenditure Report is to provide documentation for first $5,004 awarded and racelved? Yes or No (already submitted). 2. My organization has already received $ of the total FY 2022-23 Grant Fund awarded by the City 3. Is this Expenditure Report is submitted to request reimbursement of funds? No or Yes If yes, Amount of Request $ Number of beneficiaries living in 92590, 92591, 92592 that directly benefitted from this Program/Project (approximate number of beneficiaries if you do not have precise number) m l Date on Expenditure E t Name of Company Receipt/invoice MUST SUPPORT PROJECT/PROGRAM IN APPLICATION &AWARD LETTER o E on Receipt or Invoice MUST BE ON OR BETWEEN a z' 1 Merch 20, 2020-JUNE 30, Amount Description Purpose 2024 2 $ 3 $ EXPENDITURE TOTAL $ EXPENDITURE TOTAL City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 12 of 13 ACKNOWLEDGEMENT/SIGNATURE PAGE The applicant acknowledges and agrees to the following: • Recipient is subject to all Community Service Funding Program requirements including submittal deadlines and payment disbursements. • Every Community Service Funding application is considered individually and on its own merit. • Awards will be given to organizations and activities that directly benefit the residents of Temecula. • Funding is not immediately available to the recipient, and requires an award letter signature upon approval. Please allow time for checks to be processed. • The awarding of Community Service Funding does not constitute an automatic annual allocation. • The recognition for Community Service Funding should accrue to the City of Temecula. ■ Community Service Funding must be spent as specified on the Application and records may be requested by the City of Temecula to ensure the funds were used appropriately. • Community Service Funding grants will not be awarded or announced within the 60 days before an election in which an awarding Council Member is on the ballot. The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. If awarded a Community Service Funding Grant by the City of Temecula last year, then compliance receipts must be submitted on or before this application's due date or this application may be rejected as incomplete. I/we hereby certify the information contained in this Application is true to the best of our knowledge and belief. ORGANIZATION NAME: Cultivating Inclusion Inc. MAILING ADDRESS: Cultivating Inclusion c/o Mary Ann Tams 951 296-7756 31430 Loma Linda Rd., PHONE: (_) Temecula, CA 92592-1604 Cultivatinginclusion2@yahoo.com EMAIL: M PRESIDENT /AUTHORIZED OFFICER: Mary Ann Tams, Garden Director A �� ,1 �� ,� PRINF NAIME 11`LE I Y I l�t�i' y t �I f. v T-� August 2, 2022 SIGNATURE: DATE: IF DIFFERENT THAN ABOVE, APPICATION PREPARED BY: PRINT NAME MONTH, DAY. VIA! SUBMIT ORIGINAL APPLICATION BY MONDAY, SEPTEMBER 12, 2022, TO: City of Temecula Community Service Funding Attn: City Manager's Office 41000 MAIN STREET TEMECULA, CA 92590 Questions: Stacey.Brown@TemeculaCA.gov (951) 694-6413 Betsy.Lowrey@TemeculaCA.gov (951) 693-3959 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 13 of 13 INTERNAL REVENUE SERVICE P. O. BOX 2508 CINCINNATI, OH 45201 Date- J U 2 6 2018 CULTIVATING INCLUSION INC 39901 ALPINE UNION DR UNIT C __MURRIETA,CA 92563-0000 Dear Applicant: DEPARTMENT OF THE TREASURY Employer Identification Number: 82-4809510 DLN: 26053569009448 Contact Person: CUSTOMER SERVICE ID# 31954 Contact Telephone Number: (877) 829-5500 Accounting Period Ending: December 31 Public Charity Status: 509 (a) (2) Form 990/990-EZ/990-N Required: Yes Effective Date of Exemption: March 9, 2018 Contribution Deductibility: Yes Addendum Applies: No we're Pleased to tell you we determined you're exempt from federal income tax under Internal Revenue Code (IRC) Section.501(c)(3). Donors can deduct contributions they make to you under IRC'Section 170. You're also qualified to receive tax deductible bequests, devises, transfers or gifts under Section 2055, 2106, or 2522. This letter could help resolve questions on your exempt status. Please keep it for your records. Organizations exempt under IRC Section 501(c)(3) are further classified as either public charities or private foundations. We determined you're a public charity under the IRC Section listed at the top of this letter. If we indicated at the top of this letter that you're required to file Form 990/990-EZ/990-N, our records show you're required to file an annual information return (FOrM 990 or Form 990-EZ) or electronic notice (Form 990-N, the e-Postcard). If you don't file a required return or notice for three consecutive years, your exempt status will be automatically revoked. If we indicated at the top of this letter that an addendum applies, the enclosed addendum is an integral part of this letter. For important information about your responsibilities as a tax-exempt organization, go to www.irs.gov/charities. Enter 114221-PC" in the search bar to view Publication 4221-PC, Compliance Guide for 501(c)(3) Public Charities, which describes your recordkeeping, reporting, and disclosure requirements. Letter 947 -z- CULTIVATING INCLUSION INC Sincerely, Director, Exempt Organizations Rulings and Agreements Letter 947 STATE OF CALIFORNIA FRANCHISE TAX BOARD F T B t PO BOX 942857 SACRAMENTO CA 94257-0540 Entity Status Letter Date: 7/31 /2022 ESL ID: 3166835146 Why You Received This Letter According to our records, the following entity information is true and accurate as of the date of this letter. Entity ID: 4127453 Entity Name: CULTIVATING INCLUSION 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. X❑ 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. 5. The entity was administratively dissolved/cancelled on through the Franchise Tax Board Administrative Dissolution process. Important Information This information does not necessarily reflect the entity's current legal or administrative status with any other agency of the state of California or other governmental agency or body. • If the entity's powers, rights, and privileges were suspended or forfeited at any time in the past, or if the entity did business in California at a time when it was not qualified or not registered to do business in California, this information does not reflect the status or voidability of contracts made by the entity in California during the period the entity was suspended or forfeited (R&TC Sections 23304.1, 23304.5, 23305a, 23305.1). • The entity certificate of revivor may have a time limitation or may limit the functions the revived entity can perform, or both (R&TC Section 23305b). Connect With Us Web: ftb.ca.gov Phone: 800-852-5711 from 7 a.m. to 5 p.m, weekdays, except state holidays 916-845-6500 from outside the United States California Relay Service: 711 or 800-735-2929 (For persons with hearing or speech impairments) FTB 4263A WEB (REV 12-2019) Q HELPS] MENU Home > Tax Exempt( rganixation Search > Cultivating Inclusion Inc. < Back to 5earcUesults Cultivating Inclusion Inc. EIN: 82-4809510 1 Temecula, CA, United States Other Names Determination Letter e A favorable determination letter is issued by the IRS if an organization meets the requirements for tax-exempt status under the Code section the organization applied. Final Letters Publication 78 Data o Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions. On Publication 78 Data List: Yes Deductibility Code: PC Form 990-N (e-Postcard) a Organizations who have filed a 990-N (e-Postcard) annual electronic notice. Most small organizations that receive less than $50,000 fall into this category. Tax Year 2021 Form 990-N (e-Postcard) Tax Period: 2021 (01/01/2021 - 12/31/2021) EIN: 82-4809510 Legal Name (Doing Business as): Cultivating Inclusion Inc Mailing Address: 31430 Loma Linda Road Temecula, CA 92592 United States Principal Officer's Name and Address: Mary A Tams 31430 Loma Linda Road Temecula, CA 92592 United States Gross receipts not greater than: $50,000 Organization has terminated: No Website URL: http://www.cultivatinginclusionfarm.com Tax Year 2020 Form 990-N (e-Postcard) Tax Year 2019 Form 990-N (e-Postcard) Tax Year 2018 Form 990-N (e-Postcard) Po Lost Reviewed or Updated: 20-November-2020 r* Share Print L. 0'e C � i.-i! 4. . zif Organization Name; CUr1:11VATING INCLUSION INC., IRS FEIN: 824809510 Entity Type: Public F3ci,etit SOS/FTB Corporate/Organization Number: 4127453 Registry Status: Current Renewal Due/Exp. Date: 5/ 15/2023 RCT Registration Number: CT026-1665 Issue Date: 10/14/20t9 R"ortl Iype: Charily Re-isuation Effective Date: 10/14/2019 Date of Last Renewal: 6/6/2022 DBA: Mailing Address 'Street; 31430 LOMA LINDA RD Street Line 2: City, State zip: ITNIECULA CA 92592 ("f--47Q Confirm ltljon LiLjjggi tt' tl n Click on Document I')�pe at the Icft to open PDF 1' un g D� 117] Cl1lS —� ���-�-- Click on Documcnl Type ai the left lu open I't)1- � - Form CT-TR-i 2021 CT-550 Fornl f IBC' _1,_.1ticoIllplete 2018 Form RRf-1 2019-An1INI I "")I -Ill CT-TR-1 2020 I prat RRf I 2020 wjLR Fit - L 2021 Renewal Fill 1L 2020 _� ~ it Status of Filing: ;accepted Accounting Period Begin Dale: Ut/201 n Accounting Period End Date: i2 1/2018 Filing Received Dale: 10,29/2o19 Form R11117-1 Reject/Incomplete Reason: Form CT-TR-1 Reject/Incomplete Reason: IRS Form 991) Reject/Incomplete Reason: Hates From Registry Staff: Status of Filing: E-•Accepted Accounting Period Begin Date: 1/1/20[9 Accounling Period End Date: 12;:31/2019 Filing Received Date: 1 /2T2020 Form RRF-1 Reject/Incomplete Reason: Form C F-TR-1 Reject/Incomplete Reason; IFUR Form 990 Reject/Incomplete Reason: Notes From Registry Staff: Status of Filing: Accepted Accounting Period Begin Date: 7,11/2019 Accounting Period End Date: 7/1/2020 Filing Received Date. 7/27,2020 Form RRF-I Reject/Incomplete Reason: Form CT-TR-1 Reject/[ncomplete Reason: IRS Form 990 Reject/Incomplete Reason: Notes From Registry Staff: Status of Filing: Accepted Accounting Period Begin Date: 1/1/2020 Accounting Period End Date: 12/3 P2020 Filing Received Date: I I.M12021 Form RRF-I Reject/Incomplete Reason: Resubmission/Correction Accepted Form CT-TRA RejectAncomplete Reason: Resubmission/Correction Accepted IRS Form 990 Reject/[ncomplete Reason: Notes From Registry Staff: Status of Filing: Accounting Period Begin hate: Accounting Period land Dale: Filing Received Date: Form RRF-1 Reject/incomplete Reason: Form CT-TR-I Reject/Incomplete Reason: IRS Form 990 Reject/Incomplete Reason: Notes From Registry Staff: Accepted 1 /1 /2021 12/ 3 1 /2021 5/27/2022 Res ubinission/Correction Accepted ReSUbmissiwL/CwTectlon Accepted No Related Records FY 2022/2023 COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA GRANT APPLICATION # 14 DORLAND MOUNTAIN ARTS COLONY INC. CITY OF TEMECUI.A FISCAL YEAR 2022 - 2023 COMMUNITY SERVICE FUNDING - REINVESTMENT IN TEMECULA PROGRAM APPLICATION (Please Print or Type) DUE ON OR BEFORE: MONDAY, SEPTEMBER 12, 2022 I PROJECT/PROGRAM INFORMATION Amount Requested: $ MAXIMUM ALLOWABLE: $50,000 PER ORGANIZATION Project/Program Title: Art for Temecula Start Date: 1/1/2023 End Date: 12/31/2023 Physical Address of Project/Program: Dorland Mountain Arts 36701 Highway 79 Temecula CA 92592 INCLUDE IF DIFFERENT THAN ORGANIZATION's MAILING ADDRESS If Grant is Awarded, Make Check Payable Dorland Mountain Arts to: Mailing Address: PO Box 6 Temecula CA 92593 ORGANIZATION AND GEOGRAPHIC AREA SERVED Name of Applicant Organization: Dorland Mountain Arts Year Founded: 1979_ Website: m Social Media: Number of Paid Staff: 2 Number of Volunteers: 95 Geographic Area(s) the Organization Serves: Temecula valley Geographic Area(s) the Project/Program Serves: Temecula Valley NOTE: COMMUNITY SERVICE FUNDING GRANT PROGRAM FUNDING MUST BE EXCLUSIVELY USED TO SERVE TEMECULA. Contact Name: Janice Cipriani- Willis Title/Position: Executive Director Contact Person's Direct Telephone: 951-302-3837 Contact Person's Email: info@dodorlandartscolony.org NONPROFIT STATUS Is this organization incorporated as a nonprofit? Yes ® Date of Incorporation as a Nonprofit: 1984 No ❑ IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING Federal Identification Number: 95-3786125 State Identification Number: PRINT OUT AND ATTACH TO THIS APPLICATION VERIFICATION FROM FEDERAL (IRS) AND STATE (FTB) AS FOLLOWS: 1. ❑ Attach IRS Deductibility Status using this.link: http://ar)os.irs.clovlapo%osl 2. ❑ Attach State Entity Status Letter using this link: htt s:!/www.ftb.ca, ov/online/self serve entity status letter/index-as 3. ❑ Attach first page only of most recent IRS Form 990 or attach print out of detailed info about your charity found on this State Registry's Search Tool: httta:Ilrct.doi.ca.govNerification/Web/Search.apx?facih'fy=Y City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 5 of 13 APPLICATION AUTHORIZATION Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over $500 including any business transactions, negotiations, investments, or interests in real property with a Temecula City Council Member during the past 12 months? No 0 Yes ❑ IF YES, BRIEFLY DESCRIBE: Is a Temecula City Council Member a member of the Board of Directors or an Officer of the organization? No x❑ Yes ❑ IF YES, PROVIDE COUNCIL MEMBER'S NAME AND TITLE WITHIN THE ORGANIZATION: This Application has been authorized by the organization's: Executive Committee ❑ Board of Directors Members -at -Large ❑ MISSION STATEMENT OF ORGANIZATION BRIEFLY DESCRIBE THE ORGANIZATION'S MISSION/GOALS AND OBJECTIVES. voflana s mission Is io provloe a unique, Inclusive WorKing retreat Tor visual artists, Writers, and musicians inspiring creativity in a secluded natural setting. Dorland serves the regional community with arts events, educational and healing workshops and projects for children and adults. In conjunction with The Nature Conservancy, Dorland is mandated to protect the ecology of the undeveloped portion of its 300 acres. As such, Dorland staff and volunteers maintain trails and a small lake on the property, and make every effort to identify and preserve indigenous flora and fauna, and remove non -indigenous species. On May 3, 2004, the Eagle Mountain fire destroyed every single one of Dorland's structures. Convening immediately after the fire, the Board of Directors, devoted past resident artists, and individual supporters moved forward to rebuild. A licensed arborist guided the project, delicately removing fire -damaged trees to preserve the remaining indigenous oaks and surrounding native plants. Importantly, the Board of Directors used this loss as an opportunity to begin more sustainable building and construction practices. Since 2014, Dorland has added four more cottages, a Community Arts Center, ADA compliance (including two ADA parking spaces) and a pavilion and deck for community events. The now -thriving Associate Artists Program benefits Dorland's local and regional artists by providing artists, writers, musicians and supporters of the arts with essential space to meet, discuss: create, plan and impiement activities that support Dorland FINANCIAL STATEMENTS UPON REQUEST, COPIES OF THE ORGANIZATION'S CURRENT BUDGET/FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT), AND IF AVAILABLE CPA'S AUDIT, MAY BE NEEDED UPON REQUEST TO DEMONSTRATE SOUND FINANCIAL MANAGEMENT. DO NOT SUBMIT NOW. I City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 6 of 13 FUNDING SOURCES CITY OF TEMECULA—SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM THE CITY FOR ANY PROGRAM? No Z Yes ❑ IF YES, PROVIDE BELOW. NAME OF PROGRAM/PROJECT AMOUNT MONTH +YEAR NAME OF CITY GRANT FUNDED BY THE CITY GRANTOR SPONSORSHIP FUNDING RECEIVED OR SPONSORSHIP OTHER OUTSIDE SOURCES —SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM ENTITIES (NOT INCLUDING THE CITY) FOR THE SAME PROJECTIPROGRAM IN THIS APPLICATION? No Q Yes ❑ IF YES, PROVIDE INFORMATION IN TABLE BELOW AMOUNT MONTH + YEAR RECEIVED NAME OF ENITY FUNDING RECEIVED City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 7 of 13 GRANT PROJECT/PROGRAM DESCRIPTION IMPORTANT - RECEIPTS/INVOICES IS REQUIRED TO BE SUBMITTED TO THE CITY TO VALIDATE THE ORGANIZATION SPENT GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE PROJECT/PROGRAM AS DESCRIBED HERE 1 DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT. the Associate Artist Program serves our local area of Temecula Valley. The program is run soley by volunteers. 550 local members participate in the program by organizing public activities that support Dorland, the regional arts community, and each other Dorland.'s cultural events in the Temecula Valjey attract an. average of 1615 attendees/ year, promoting the arts in our region. In conjunction with the City of Temecula, Dorland supports local artists with exhibits at the Merc Gallery, the Temecula Valley Museum, an online gallery and other local venues. The recent addition of Dorland's Community Arts Studio building with its outdoor Pavilion further gives Dorland the opportunity to provide expanded public arts events, exhibits, and educational and healing workshops for community children, youth, and adults. Programs that directly serve Temecula Valley residents: ASSOCIATE ARTISTS PROGRAM: Coffee on the Deck - Discussions about art, sharing, demos and critiques. 2 x per month COMMUNITY ARTS CENTER. 6 Art Exhibits per year open for public viewing and receptions WORKSHOPS: Sunday Scribblers - Free. This is a writing workshop and critique focusing on poetry and prose every Sunday. It includes guest speakers. Table Manners Theater - Free. Open to the public to participate in reading original and new plays and screenplays 6x per year 2 DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED. ALSO, INCLUDE A LIST OF GOODS, EQUIPMEMENT, AND/OR SERVICES THIS ORGANIZATION HAS PURCHASED OR PLANS TO PURCHASE WITH AWARDED FUNDS TO SUPPORT THIS PROGRAM/PROJECT. Funding will support the operation of the Community Art where Dorland runs its community programs. Grant support would enhance the amenities by funding the installation of a utility sink and new flooring. New Flooring Art in the Community Studio/Gallery -$1500 Utility Sink Art in Studio/Gallery -$500 Facilities/Rent/Insurance for Community Studio/Gallery - $1,839 Supplies - $430 Marketing - $289 TOTAL- $4558 3 TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS. Dorland hosts many events open to Temecula residents in The Community Arts Center located on our beautiful mountain campus. This three room building, deck and pavilion area allows us a space to invite local residents to participate in programs, workshops and special projects. The main room of this building provides a gathering place for workshops, programs and meetings. In addition, there is a library room and studio used for programs and available for special projects. Tge deck and covered pavilion provide outdoor space for community meetings, workshops and programs. Dorland Mountain Arts strives to provide a safe and welcoming space for the community to come together, learn about new ideas and skills and meet other creative folks. By offering free and very low cost programs to Temecula residents we are providing an opportunity for creative exchange, learning and sharing. Having a quality space with varied amenities enhances the experience for Temecula residents and allows for more programs in the future. 3b ESTIMATED NUMBER OF PEOPLE FROM TEMECULA EXPECTED TO BENEFIT 800-1000 FROM THIS PROJECT/PROGRAM: 3c ESTIMATED NUMBER OF VOLUNTEERS INVOLVED IN THIS PROJECT/PROGRAM: 1 10 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 8 of 13 PROJECT/PROGRAM DESCRIPTION CONTINUED 4 SUMMARY STATEMENT — SUMMARIZE ANSWERS 1 — 3 ABOVE IN 50 WORDS OR LESS. Dorland Mountain Arts is committed to providing quality programs and experiences to the Temecula community. —Upgrading our program space will -help us continue to provide creative sharing and learning opportunities. The Community Art Center is vital to our mission and indispensable in offering a quality experience to the residents of Temecula Valley. 5 IF APPLYING FOR MORE THAN $5,000, PLEASE EXPLAIN HOW THE COVID-19 PANDEMIC AFFECTED THIS NONPROFIT ORGANIZATION'S ABILITY TO SERVE THE TEMECULA COMMUNITY. YOU MAY ALSO INCLUDE INFLATIONARY CONCERNS. I_ 6 IF APPLYING FOR MORE THAN $5,000, EXPLAIN HOW FUNDS HAVE OR WILL: (1) CREATE NEW PROJECT/PROGRAM, (2) EXPAND EXISTING PROJECT/PROGRAM, AND/OR (3) CONTINUE EXISTING PROJECT/PROGRAM- City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 9 of 13 PROJECT/PROGRAM BUDGET (do not fill in shaded areas) LINE ITEMS FOR PROJECT/PROGRAM REVENUES EXPENSES LIST REVENUES/INCOME FOR PROJECT/PROGRAM Amount of money requested from this City of Temecula $ Community Services Grant (Not to exceed $50,000) 4,558 Amount contributed to the Project/Program by the Applicant $ Organization 5,500 Other grants or funding already awarded for Project/Program, if any $ In -Kind match amount or volunteer credit hours estimated amount $ 7,704 TOTAL REVENUE $ 17,762 LIST OF EXPENSES FOR PROJECT/PROGRAM Tools/Equipment $ Facilities/Rent/Insurance $ 1,839 Supplies $ 430 Marketing $ 289 Services $ 2,000 Food Other flooring and sink $ 2,000 Staffing Expense THIS IS INELIGIBLE TO BE FUNDED BY CITY'S GRANT, - HOWEVER PLEASE INCLUDE. $ 3,500 TOTALEXPENSES $ TOTAL BUDGET J $ 17,762 1 $ 10,058 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 10 of 13 PREVIOUS* FISCAL YEAR (FY) 2021-2022 COMPLIANCE REPORT IF YOUR ORGANIZATION WAS NOT AWARDED A COMMUNITY SERVICE FUNDING GRANT IN FY 21122 (LAST YEAR), THEN SKIP THIS PAGE. If your organization was awarded a Community Service Funding Grant in FY 2021-2022 (last year) by the City of Temecula, please submit this information. If your organization was awarded a Community Service Funding Grant in Fiscal Year 2021-2022 by the City of Temecula, all grant funds received must have been expended anytime on or between July 1, 2021, and June 30, 2022. In addition, ail grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any future funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent If the funds were not spent in accordance with the approved/awarded application, the organization will be required to return the amount of funds to the City. To substantiate that Fiscal Year 2021-2022 funds received from the City were spent appropriately, proper back-up documentation including the completed table below with accompanying receipts/invoices, must be submitted to the City on or before due date: September 12, 2022. 1 _ Fill out table below (make additional copies if needed to explain all expenditures.) 2. Attach copies of receipts/invoices (in the same order as listed in this table.) 3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590 Attn: City Manager's Office — CSF EXPENDITURE REPORT due on or before September 12, 2022 Organization: Name of Project/Program: FY 2021-2022 Amount of $ CSF Grant Fund Awarded: Month & Year CSF Grant Received from City: Number of Beneficiaries Living in 92590, 92591, 92592 that Directly Benefitted from this Program/Project (approximate number of beneficiaries if you do not have precise number): Date on Expenditure E Name of Company 2 Receipt/Invoice M on Receipt or Invoice MUST BE ON OR BETWEEN Amount Description Purpose a3 JULY 1, 2021 - JUNE 30, 2022 DESCRIBE THE EXPENDITURE PURPOSE OF EXPENDITURE 1 $ 2 3 4 5 $ 6 $ EXPENDITURE TOTAL $ EXPENDITURE TOTAL MUST BE EQUAL TO (OR GREATER) THAN TOTAL AWARD AMOUNT City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 11 of 13 FISCAL YEAR (FY) 2022-2023 COMPLIANCE REPORT If your organization is awarded a Community Service Funding - REINVESTMENT IN TEMECULA Grant in FY2022-2023 by the City of Temecula, follow these instructions. If your organization is awarded a Community Service Funding Grant - REINVESTMENT IN TEMECULA in FY2022-2023 by the City of Temecula, all grant funds received must be expended anytime on or between March 20, 2020 and June 30, 2024. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent. If the funds are not spent in accordance with the approved/awarded application, the organization may not receive and/or will be required to return said -amount-of-funds-to-the-City To -substantiate -that -grant -funds -from -the -City -are -spent -appropriately, proper -.pro documentation including the table below with accompanying receipts/invoices, must be submitted to the City as outlined on this page. 1. Fill out Expenditure Report table below. Make additional copies if needed to explain all expenditures. A. If awarded $5,000. Submit the following Expenditure Report within 60 days after spending $5,000 no later than June 30, 2024, to demonstrate grant funds were spent in accordance with the Application. [If you were awarded less than $5,000, submit Expenditure Report for that amount.) B. If awarded grant funds exceeding $5,000. A) Follow #1.A above first. B) To receive grant funds exceeding $5,000 (between $5K-$50K), submit the following Expenditure Report to be reimbursed for the remaining balance of award to demonstrate funds were spent in accordance with the Application. This report can be submitted in $10,000 increments (but no less than $10,000 unless the remaining grant award funding amount is less than $10K). This report must be submitted to the City no later than June 30, 2024 to receive remaining grant funds. 2. Attach copies of receipts/invoices (in the same order listed in table below). 3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590, Attn: City Manager's Dept. "CSF-Reinvestment in Temecula" EXPENDITURE REPORT DATED Organization: Name of Project/Program: TOTAL FY 2022-2023 Month & Year FIRST $5,000 check Amount of Grant Fund Awarded: $ was received from City: 1. Is this Expenditure Report is to provide documentation for first $5,000 awarded and received? Yes_ or No (already submitted). 2. My organization has already received $ of the total FY 2022-23 Grant Fund awarded by the City 3. Is this Expenditure Report is submitted to request reimbursement of funds? No or Yes If yes, Amount of Request $ Number of beneficiaries living in 92590, 92591, 92692 that directly benefitted from this Program/Project (approximate number of beneficiaries if you do not have precise number)_ E Name of Company E on Receipt or Invoice Q Z 1 2 3 Date on Expenditure Receipt/Invoice MUST SUPPORT PROJECT/PROGRAM IN APPLICATION & AWARD LETTER MUST BE ON OR BETWEEN March 20, 2020 - JUNE 30, Amount Description Purpose 2024 Q W R EXPENDITURE TOTAL $ EXPENDITURE TOTAL City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 12 of 13 ACKNOWLEDGEMENT/SIGNATURE PAGE The applicant acknowledges and agrees to the following: • Recipient is subject to all Community Service Funding Program requirements including submittal deadlines and payment disbursements. • Every Community Service Funding application is considered individually and on its own merit. • Awards will be given to organizations and activities that directly benefit the residents of Temecula. • Funding is not immediately available to the recipient, and requires an award letter signature upon approval. Please allow time for checks to be processed. • The awarding of Community Service Funding does not constitute an automatic annual allocation. • The recognition for Community Service Funding should accrue to the City of Temecula. • Community Service Funding must be spent as specified on the Application and records may be requested by the City of Temecula to ensure the funds were used appropriately. Community Service Funding grants will not be awarded or announced within the 60 days before an election in which an awarding Council Member is on the ballot. The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. ■ If awarded a Community Service Funding Grant by the City of Temecula last year, then compliance receipts must be submitted on or before this application's due date or this application may be rejected as incomplete. I/we hereby certify the information contained in this Application is true to the best of our knowledge and belief. ORGANIZATION NAME: Dorland Main Arts MAILING ADDRESS: PO Box 6 Temecula CA 92593 PHONE:( 951 ) 302-3837 EMAIL: infoRDorlandArts.org PRESIDENT / AUTHORIZED OFFICER: 4 Nawsha Narrisnin _ SIGNATURE: r�U - r DATE: 9/10/2022 IF DIFFERENT THAN ABOVE, APPICATION PREPARED BY: SUBMIT ORIGINAL APPLICATION BY MONDAY, SEPTEMBER 12, 2022, TO: City of Temecula Community Service Funding Attn: City Manager's Office 41000 MAIN STREET TEMECULA, CA 92590 Questions: Stacey. Brown@TemeculaCA.gov (951) 694-6413 Betsy. Lowrey@TemeculaCA.gov (951) 693-3959 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 13 of 13 !nternal Revenue Service District Director DORLAND 4OUNTAIN ARTS COLONY, INC. Da te: NOV 0 1 1984 Dorland N,cuntain Colony, Inc. 36701 Highway 79 Temecula, CA 92390 Dear Applicant: DepartrnehL Jr the TreasL,,, y Our Letter Dated: December 29, 1982 Person to Contact M. Tomback Contact Telephone Number. t 213 ) 688-488 5 This modifies our letter of the above date in which we stated that you would be treated as an organization which is not a private foundation until the expiration of your advance ruling period. 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 Internal Revenue Code, because you are an`organization of the type described in section Sn�(all1�* Your exempt status under section 501(c)(3) of the code is still in effect. Grantors and contributors may rely on this determination until the Internal Revenue Service publishes notice to the contrary. However, a grantor or a 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 that resulted in your loss of section 504!T1f�,L* _ status, or acquired knowledge that the Internal Revenue Service had given potice that you would be removed from classification as a section 509laR W organization. Because this letter could help resolve any questions about your private foundation status, please keep it in your permanent records. If you have any questions, please contact the person whose name and telephone number are shown above. Sincerely iotlrn. District Directar 'axed 170(b)(1)(A)(vi) P.O. Sox 2350, Los Angeles, Calif. 90053 Letter 1o50 (00) (7-771 STATE OF CALIFORNIA FRANCHISE TAX BOARD F T B PO BOX 942857 SACRAMENTO CA 94257-0540 Entity Status Letter Date: 9/12/2022 ESL ID: 7857079728 Why You Received This Letter According to our records, the following entity information is true and accurate as of the date of this letter. Entity ID: 1104809 Entity Name: DORLAND MOUNTAIN ARTS COLONY 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. 0 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. ❑ 5. The entity was administratively dissolved/cancelled on through the Franchise Tax Board Administrative Dissolution process. Important Information This information does not necessarily reflect the entity's current legal or administrative status with any other agency of the state of California or other governmental agency or body. If the entity's powers, rights, and privileges were suspended or forfeited at any time in the past, or if the entity did business in California at a time when it was not qualified or not registered to do business in California, this information does not reflect the status or voidability of contracts made by the entity in California during the period the entity was suspended or forfeited (R&TC Sections 23304.1, 23304.5, 23305a, 23305.1). The entity certificate of revivor may have a time limitation or may limit the functions the revived entity can perform, or both (R&TC Section 23305b). Connect With Us Web: ftb.ca.gov Phone: 800-852-5711 from 7 a.m. to 5 p.m. weekdays, except state holidays 916-845-6500 from outside the United States s�!i �• California Secretary of State Electronic Certified Copy I, SHIRLEY N. WEBER, Ph.D., Secretary of State of the State of California, hereby certify that the attached transcript of 2 pages is a full, true and correct copy of the original record in the custody of the California Secretary of State's office. IN WITNESS WHEREOF, I execute this certificate and affix the Great Seal of the State of California on this day of January 15, 2022 SHIRLEY N. WEBER, Ph.D. Secretary of State Verification Number: P82RJ34 Entity (File) Number: C1104809 To verify the issuance of this Certificate, use the Verification Number above with the Secretary of State Electronic Verification Search available at bizfile. sos. ca. gov rn' California Secretary of State MINN Electronic Filing Secretary of State r State of California Corporation - Statement of Information Entity Name: DORLAND MOUNTAIN ARTS COLONY, INC. Entity (File) Number: File Date: Entity Type: Jurisdiction: Document ID: Detailed Filing Information 1. Entity Name: 2. Business Addresses: a. Street Address of Principal Office in California: b. Mailing Address: 3. Officers: a. Chief Executive Officer: C1104809 01 /13/2022 Corporation CALIFORNIA H110480 DORLAND MOUNTAIN ARTS COLONY, INC. 36701 Highway 79 South Temecula, California 92592 United States of America PO Box 6 Temecula, California 92593 United States of America Curtis Horton 1869 Pasadena Glen Rd Pasadena, California 91107 United States of America b. Secretary: Noreen Ring 1935 Vista Del Norte Fallbrook, California 92028 United States of America Use bizMe.sos.ca.gov for online filings, searches, business records, and resources. v M N 00 a (D oo E� LP Z C a) O N U � CY N >o 0 M N " � N M o U � E a N a� UD 0 00 IT 0 C N E rJ O W t�.r,n Ile r� California Secretary of State Electronic Filing Officers (Cont'd): C. Chief Financial Officer: 4. Agent for Service of Process: Natasha HdIIISUn 24 Almy St Newport, Rhode Island 02840 United States of America Curtis Horton 1869 Pasadena Glen Rd Pasadena, California 91107 United States of America By signing this document, I certify that the information is true and correct and that I am authorized by California law to sign. Electronic Signature: Janice Cipriani Use bizfile.sos.ca.gov for online filings, searches, business records, and resources. 0 0 Nr 0 2 C N E 7 U O r1W Form 990 OMn No, 1545-0047 Return of Organization Exempt From Income Tax 2020 Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) DapfuImool of Iho Tnlin ry ► Do not enter social security numbers on this form as it may be made public. Open to Public Intmnat Revenue Service ► Go to wwwJrs. ov1Form990for instructions and the latest information. Inspection A For the 2020 calendar year, or tax year beginning .2020. and ending 20 B Check if applicable: C Employer identification number ,Address change DORLAND MOUNTAIN ARTS COLONY 95-3786125 Name change P.O. BOX 6 E Telephone number Inliiai�e ;rn TEMECULA, CA 92593-0006 - 951 : 302-3 337 Final returNtermir'aled bb Amended return, G Cross recmials Y Appheation pendiny F Name and address of principal off,cer: WO'Is�Mis a group return for subordinate Tax-exempt status: J Website: ► W K Form of organization: SAME AS C ABOVE 501(cy3) 501(c) ( )� (Insertno.) )ORLANDARTSCOLONY,ORG Corporation I I Trust I I Ass or: ialion Other H(b) Are all subordinates mcruded? If ' No, , attach a list_ Sea. insuuctions Grcup exemption number 142 830. Yet: No Y<F No I Year or formation: 1982 I M Slate of legal domicile: CA Part l I 5ummaill 1 Briefly describe the organization's mission or most significant actnrilies:THE MISSION OF DORLAND MOUNTAIN ARTS_ COL_ONY__IS TO PROVIAE A jQVETWORK_ING AN_D_PE_RFORMANCE_R_E_TR_EAT�FOSTERING --_'_---_ _ r A COMMUNITY CONNECTION TO_THE_CREATIVE PROCESS IN A SECLUDED_ _CR_E_ATI_V_ITY_, _All] _ _ __- 0 2 _NA_T_U_RA_L__SE_T_TING_._____-_-_--__________-_-_-_-__--__--_-_--_--____--_-__--_----_ Check this box ► f if the organization discontinued its operations or disposed of more than 25% of its net assets. — _ --- ta 3 Number of voting members of the governing body (Part VI, line la). ..... 3 7 °a N 4 Number of independent voting members of the governing body (Part VI, line lb) - - - q 5 Total number of individuals employed in calendar year 2020 (Part V. line 2a). -. 5 2 6 Total number of volunteers (estimate if necessary). - 3 a 7a Total unrelated business revenue from Part VIII, column (C), line 12 7a a. b Net unrelated business taxable income from Form 990-T, Part I, line 11 ..... 7b 0, Prior Year Current Year 8 Contributions and grants (Part VIII, line lh)......... .... 174 803. 57,364. 9 Program service revenue (Part VIII, line 2g) .. 79,267. 74,586. 10 Investment income (Part VIII, column (A), lines 3, 4, and M) 1,450. 642. cc 11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9C. I0f:..an _dilie] 13,066. 10,238. 12 Total revenue -- add Imes 8 through 11 (must equal Part Vlll- co mn (A), line 12) 268, 586. 142, 830. 13 Grants and similar amounts paid (Part IX, column (A), lines 1-3).. - - . 14 Benefits paid to or for members (Part IX, column (A), line 4) .... .. . w 15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-10) 21, 669, 25,993. 16a Professional fundraising fees (Part IX, column (A), line Ile) wb Total Fundraising expenses (Part IX, column i line 25) ► 1,662. 17 Other expenses (Part IX, column (A), lines IIa-lid, 11f-24e)-- .. ..- ... 18 Total expenses. Add lines 13-17 (must equal Part )X, column (A), line 25) 19 Revenue less expenses. Subtract line 18 from line 12 86 561. 105 170. 108 230. 131 163. 160 356. 11 667. 88 4" 0p 1LL 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 903, 212. 920 211. 11,158.1 16,490. 892,054.1 903 721. Part If Signature Bloc urvfw penalties of poqury, I drrefare that I have eaamufed the return, mcludufy all:4v"anying scheduies and sialemerC, and to Bee best of my knnwledge and belief, it is free, cerrect, and complete. Declaration of preparl (other than officer) is based on all Womil W whMil prepare, has any knuMedge. t� Sign - arrgrwreraa11.oreCer vase Here CURTIS HORTON PRESIDENT. Yt7u or print narne and hl e Printilype preparers came Nreparcr's signature Dale Checx Lj If PT•N Paid LESLIE A. DOHERTY CPA LESLIE A. DOHERTY CPA self-employed P00449291 Preparer Firm snarne ► LESLIE A DOHERTY CPA APC Use Only nm'saddress ► 41880 KALMIA ST STE 115 FinnsEIN► 20-2082661 MURRIETA, CA 92562 Phoncno. (951) 698-2260 May the IRS discuss this return with the preparer shown above? See instructions JXYes No I For Paperwork Reduction Act Notice, see the separate instructions. rF=ALlo1L o!nnra' Form 990 (2020) FY 2022/2023 COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA GRANT APPLICATION # 1!5 FINE ARTS THEATER NETWORK CPI`Y OF TEM.IOCULA. FISCAL. YEAR 2022.2023 COMMUNITY SERVICE FUNDING - REINVEST'MENT IN TEMECULA PROGRAM APPLICATION (Please Print or Type) DUE ON OR BEF"ORE:-MONDAY-, SEPT-EMBER 12, 2022--- PROJECT/PROGRAM INFORMATION ) Amount Requested: $ 50,000.00 _ MAXIMUM ALLOWABLE: $50,000 PER ORGANIZATION Pump up the Volume Project/Program Title. _ Start Date: 12/1122 End Date: 5/31 /23 Physical Address of Project/Program: 42051 Main Street, Temecula CA 92590 INCLUDE IF DIFFERENT THAN ORGANIZATION'S MAILING ADDRESS If Grant is Awarded, Make Check Payable to: Fine Arts Network Mailing Address: 41391 Kalmia St #200 Murrieta, CA 92562 ORGANIZATION AND GEOGRAPHIC AREA SERVED Name of Applicant Fine Arts Network Theater Organization: _ Company Year Founded: 1994 Website: www.fantheater.com Number of Paid Staff: 3 (part time) Social Media: FB, Instagram Number of Volunteers: 100's annually Geographic Area(s) the Organization Serves: SW Riverside County, Temecula Valley Geographic Area(s) the Project/Program Serves: Old Town Temecula Community Theater NOTE: COMMUNITY SERVICE FUNDING GRANT PROGRAM FUNDING MUST BE EXCLUSIVELY USED TO SERVE TEMECULA. Contact Name- Beverly Stephenson Title/Position: founder/director Contact Person's Direct Telephone:951-314-2401 Contact Person's Email: faerietalewriter@gmail, NONPROFIT STATUS Is this organization incorporated as a nonprofit? Yes E Date of Incorporation as a Nonprofit: 10/7/94 No ❑ IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING Federal Identification Number: 33-0624570 State Identification Number: 1872912 PRINT OUT AND ATTACH TO THIS APPLICATION VERIFICATION FROM FEDERAL (IRS) AND STATE (FTB) AS FOLLOWS: 1. N Attach IRS Deductibility Status using this link: httpJ/al)ps.irs.gov/apeleros/ 2. K Attach State Entity Status Letter using this link: https://www.ftb,ca.g-Q-v/online/self serve enfty status letter/index.as 3. N Attach first page only of most recent IRS Form 990 or attach print out of detailed info about your charity found on this State Registry's Search Tool: littn�//rct.do'.ca. ❑v/VerificatiordWeb/`Search.as x?facilll =Y City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 5 of 13 APPLICATION AUTHORIZATION Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over $500 including any business transactions, negotiations, investments, or interests in real property with a Temecula City Council Member during the past 12 months? No Q_Yes -❑_IF_YES,-BRIEFLY_ DESCRIBE: — Is a Temecula City Council Member a member of the Board of Directors or an Officer of the organization? No pj Yes ❑ IF YES, PROVIDE COUNCIL MEMBER'S NAME AND TITLE WITHIN THE ORGANIZATION: This Application has been authorized by the organizations: Executive Committee ❑ Board of Directors M Members -at -Large ❑ MISSION STATEMENT OF ORGANIZATION BRIEFLY DESCRIBE THE ORGANIZATION'S MISSION/GOALS AND OBJECTIVES. To build the self-esteem of all individuals through broad based, hands-on exposure in the performing arts. To channel the creativity of young and old in a positive and artistic direction. To utilize the sucess and self-esteem attained through participation as a preventative measure against negative peer pressure and anti -social behaviors. To involve the community, from youths to seniors in the sharing of their talents both on stage and off as leaders and mentors. To provide instruction in all genres of performing arts and stagecraft. To produce and perform quality local productions for the benefit of the participants and the spectators. FINANCIAL STATEMENTS UPON REQUEST, COPIES OF THE ORGANIZATION's CURRENT BUDGET/FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT), AND IF AVAILABLE CPA'S AUDIT, MAYBE NEEDED UPON REQUEST TO DEMONSTRATE SOUND FINANCIAL MANAGEMENT. DO NOT SUBMIT NOW. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 6 of 13 FUNDING SOURCES CITY OF TEMECULA—SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM THE CITY FOR ANY PROGRAM? No ❑ Yes M IF YES, PROVIDE BELOW NAME OF PROGRAM/PROJECT MONTH + YEAR NAME OF CITY GRANT FUNDED BY THE CITY GRANT OR SPONSORSHIP FUNDING RECEIVED OR SPONSORSHIP Theater LIVE after Covid $2500 October 2020 Community Servic $ $ $ $ OTHER OUTSIDE SOURCES —SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM ENTITIES (NOT INCLUDING THE CITY) FOR THE SAME PROJECT/PROGRAM IN THIS APPLICATION? No ■ Yes ❑ IF YES, PROVIDE INFORMATION IN TABLE BELOW AMOUNT MONTH + YEAR NAME OF ENITY RECEIVED _ _ FUNDING RECEIVED City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 7 of 13 GRANT PROJECTIPROGRAM DESCRIPTION IMPORTANT - RECEIPTS/INVOICES IS REQUIRED TO BE SUBMITTED TO THE CITY TO VALIDATE THE ORGANIZATION SPENT GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE PROJECT/PROGRAM AS DESCRIBED HERE 1 DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT. When the Old Town Theater _opened, The —Theater _Foundation -provided 36 wireless mic units. We, (Theater -foundation, Fine Arts Network, TVP) the resident companies have refurbished these mics multiple times over the past 17 years. We, now, only have 10 working units. We, Fine Arts Network, proposes to purchase an additional 24 units so we once again have enough mics to stage full musicals, concerts and plays. The program specifically is to keep the OTTCT at the cutting edge of performance venues by providing a quality visual and sound experience. The program would free us from the burden of renting mics from amide-aaencies.-at_a_heftv price while maintainina a auality sound experience. 2 DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED. ALSO, INCLUDE A LIST OF GOODS, EQUIPMEMENT, AND/OR SERVICES THIS ORGANIZATION HAS PURCHASED OR PLANS TO PURCHASE WITH AWARDED FUNDS TO SUPPORT THIS PROGRAM/PROJECT. The grant will provide for the purchase of 24 body mic kits which includes the elements, battery pack, transmitter and case to house all 24 units. (see attached) 3 TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS, The Old Town Temecula Community Theater (OTTCT) has been praised as a "jewel box" of a theater. From its inception we have provided great sound. That element is in danger of disappearing due to the 17 year old and nearly obsolete equipment we have refurbished on several occasions. Local residents comprise over 50% of our audience. Temecula residents are proud to boast of the fine theater we have. If the sound quality is poor, the entire experience of live theater is undermined and becomes a negative experience for all. When first conceived, great attention was paid to the acoustics of the theater. After all the time and money spent on building and creating a fine reputation, we desire to maintain the 3b ESTIMATED NUMBER OF PEOPLE FROM TEMECULA EXPECTED TO BENEFIT 1 O,000+ annua FROM THIS PROJECT/PROGRAM: 3c ESTIMATED NUMBER OF VOLUNTEERS INVOLVED IN THIS PROJECT/PROGRAM: I200+ City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 8 of 13 PROJECT/PROGRAM DESCRIPTION CON71NUED 4 SUMMARY STATEMENT - SUMMARIZE ANSWERS 1 - 3 ABOVE IN 50 WORDS OR LESS. -Pump up the Volume will maintain quality sound and quality theatrical experience at the OTTCT by purchasing new state of the art equipment. 5 IF APPLYING FOR MORE THAN $5,000, PLEASE EXPLAIN HOW THE COVID-19 PANDEMIC AFFECTED THIS NONPROFIT ORGANIZATION'S ABILITY TO SERVE THE TEMECULA COMMUNITY. YOU MAY ALSO INCLUDE INFLATIONARY CONCERNS. The pandemic stripped us of our reserves and any ability we might have had to purchase this equipment directly. At the most recent board meeting we were earmarking funds to purchase new mic units over the next 3 years. We hoped to purchase 5-10 units (based on costs) immediately. Based on the estimate we just received, we would be hard pressed to afford 5 units currently ourselves. It would then take us 5 years in order to build to a full rack of 24 mics, hoping that we would not lose all of the older 10 units before we could replace them. The pandemic has created a situation, where we feel we are at ground zero, starting all over again building audiences, networking with performers and training our young theatrical enthusiasts. 6 IF APPLYING FOR MORE THAN $5,000, EXPLAIN HOW FUNDS HAVE OR WILL: (1) CREATE NEW PROJECT/PROGRAM, (2) EXPAND EXISTING PROJECT/PROGRAM, AND/OR (3) CONTINUE EXISTING PROJECT/PROGRAM. The above mentioned funds will complement and ultimately replace seriously dated equipment that verges on being obsolete. It will allow new and existing programs/productions to maintain the high caliber of sound come to be expected of performances at OTTCT. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 9 of 13 PROJECT/PROGRAM BUDGET (do not fill in shaded areas) LINE ITEMS FOR PROJECT/PROGRAM REVENUES EXPENSES LIST REVENUES/INCOME FOR PROJECT/PROGRAM Amount of money requested from -this City of Temecula $ 50,000 Community Services Grant (Not to exceed $50,000) Amount contributed to the Project/Program by the Applicant $ 17,000 I Organization Other grants or funding already awarded for Project/Program, if any In -Kind match amount or volunteer credit hours estimated amount $ TOTAL REVENUE $ 67,000 LIST OF EXPENSES FOR PROJECT/PROGRAM 24 body mics with elements, casing, Tools/Equipment transmitters etc. see attached $ 67,000 Facilities/Rent/Insurance $ Supplies $ Marketing $ Services $ Food $ Other $ Staffing Expense THIS IS INELIGIBLE TO BE FUNDED BY CITY'S GRANT; $ HOWEVER PLEASE INCLUDE. TOTAL EXPENSES $ TOTAL BUDGET $67,000 $67,000 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 10 of 13 FISCAL YEAR (FY) 2020-2021 COMPLIANCE REPORT If your organization is awarded a Community Service Funding Grant in FY 2020-2021 by the City of Temecula, then this information is not due until September 13, 2021 If your organization is awarded a Community Service Funding Grant in Fiscal Year 2020-2021 by the City of Temecula, all grant funds received must be expended anytime on or between July 1, 2020, and June 30, 2021. In addition, —all=grant=funds=must=be=substantiated-Mth-proper-back=up=dseumentation: Failure-to=provid"roper=docum-e-ntatl6n may jeopardize any future funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent. If the funds are not spent in accordance with the approved purpose stated on the Application, the organization will be required to refund the amount of funds. To substantiate that Fiscal Year 2020-2021 funds received from the City were spent appropriately, proper back-up documentation including the table below with accompanying receipts/invoices, must be submitted to the City on or before due date: September 13, 2021. EXPENDITURE REPORT due on or before September 13, 2021 1. Provide the number of beneficiaries living in 92590, 92591 and 92592 that directly benefitted 4,000 locals from this program (approximate number of beneficiaries if you don't have a precise number): annually 2. Fill out this table (include additional copies if needed to explain all expenditures) 3. Attach Receipts/Invoices (in the same order as listed in this table) 4. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590, Attn: City Manager's Office - CSF Organization: Fine Arts Network Theater Co. Amount of Grant Fund Awarded: $ 2500.00 Theater LIVE Name of Project/Program: after Covid Month + Year Grant Received from City: DEC 2020 Date (Mo/Day/Yr) Describe... Explain ... Name of Company on Receipt/invoice Amount (1) what the expenditure was how the expenditure E - on Receipt/Invoice of (2) purpose of the expenditure specifically benefitted E Must be dated on or between July 1, 2020 - Expenditure MUST support Project/Prcgram description on Application + Award Letter Temecula residents Q z June 30, 2021 1 It benefitted residents Collection Made By City: /1/2020 - 9/30/2020 $ 300.00 1. Social Media by keeping them 10/1/2020-12/31/20 0 S �00.90 2. To keep FAN alive and formed of social informed opportunities that were Brittany relevant during closure. To safe and available. It _ Campbell promote Go Fund Me and provided and outlet for fundraising efforts during safe gathering and 1/1/2021- 3/31/2021 UU $ 300. closure on Social Media provided hope andcomfort through artistic 4/1/2024 - 6/30/2021 $ 300.0o presentations 2 Got Print.com January 13, 2021 1. Season program $2,427.94 2. To provide advertising and promotion materials EXPENDITURE TOTAL 3627.94 Note: Expenditure Total must be equal to (or greater than) the "Amount of Grant Fund Awarded" (above) provided by the City. City of Temecula Community Service Funding Grant In anticipation of opening we prepared a advertising style magazine piece to provide information about the City, the Theater and upcoming shows and what to FY 2021/2022 PREVIOUS* FISCAL YEAR (FY) 2021-2022 COMPLIANCE REPORT IF YOUR ORGANIZATION WAS NOT AWARDED A COMMUNITY SERVICE FUNDING GRANT IN FY 21122 (LAST YEAR), THEN SKIP THIS PAGE. If your organization was awarded a Community Service Funding Grant in FY 2021-2022 (last year) by the City of Temecula, please submit this information. If your organization was awarded a Community Service Funding Grant in Fiscal Year 2021-2022 by the City of Temecula, all grant funds received must have been expended anytime on or between July 1, 2021, and June 30, 2022. In addition, all grant funds must be substantiated with RLo er back -Up documentation. Failure to provide proper documentation may jeopardize any future funding. City oiTem'ecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent. If the funds were not spent in accordance with the approved/awarded application, the organization will be required to return the amount of funds to the City. To substantiate that Fiscal Year 2021-2022 funds received from the City were spent appropriately, proper back-up documentation including the completed table below with accompanying receipts/invoices, must be submitted to the City on or before due date: September 12, 2022. 1. Fill out table below (make additional copies if needed to explain all expenditures.) 2. Attach copies of receipts/invoices (in the same order as listed in this table.) 3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590 Attn: City Manager's Office— CSF JEXPENDITURE REPORT due on or before September 12, 2022 Fine Arts Network Theater Pump up the Volume Organization: Name of Project/Program: Omvanv 91 FY 2021-2022 Amount of $ CSF Grant Fund Awarded: '�' Month & Year CSF Grant Received from City: October 2020 I Number of Beneficiaries Living in 92590, 92591, 92592 that Directly Benefitted from this Program/Project (approximate number of beneficiaries if you do not have precise number): Date on E Name of Company Receipt/invoice E on Receipt or Invoice MUST BE ON OR BETWEEN QZ JULY 1, 2021 - JUNE 30, 2022 2 3 4 5 6 —.I-- I EXPENDITURE TOTAL _ Expenditure Amount Description Purpose DESCRIBE THE EXPENDITURE I PURPOSE OF EXPENDITURE EXPENDITURE TOTAL MUST BE EQUAL TO (OR GREATER) THAN TOTAL AWARD AMOUNT City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 11 of 13 FISCAL YEAR (FY) 2022-2023 COMPLIANCE REPORT If your organization is awarded a Community Service Funding - REINVESTMENT IN TEMECULA Grant in FY2022-2023 by the City of Temecula, follow these instructions. If your organization is awarded a Community Service Funding Grant - REINVESTMENT IN TEMECULA in FY2022-2023 by the City of Temecula, all grant funds received must be expended anytime on or between March 20, 2020 and June 30, 2024. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent. If the funds are not spent in - - accordance with the approved/awarded applicaticn, thee organization may not -receive and/or will -be -required -to -return -said amount -of -funds -to -the -City. To- substantiate--that-grant-funds from-the-City--are-spent--appropriately, proper -back-up documentation including the table below with accompanying receipts/invoices, must be submitted to the City as outlined on this page. 1. Fill out Expenditure Report table below. Make additional copies if needed to explain all expenditures. A. If awarded $5,000. Submit the following Expenditure Report within 60 days after spending $5,000 no later than June 30, 2024, to demonstrate grant funds were spent in accordance with the Application. [If you were awarded less than $5,000, submit Expenditure Report for that amount.) B. If awarded grant funds exceeding $5,000. A) Follow #1,A above first, B) To receive grant funds exceeding $5,000 (between $5K-$50K), submit the following Expenditure Report to be reimbursed for the remaining balance of award to demonstrate funds were spent in accordance with the Application. This report can be submitted in $10,000 increments (but no less than $10,000 unless the remaining grant award funding amount is less than $10K). This report must be submitted to the City no later than June 30, 2024 to receive remaining grant funds. 2. Attach copies of receipts/invoices (in the same order listed in table below). 3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590, Attn: City Manager's Dept. "CSF-Reinvestment in Temecula" EXPENDITURE REPORT DATED Organization: Fine Arts Network Theater Name of Project/Program: Pump up the Volume Company p TOTAL FY 2022-2023 Month & Year FIRST $5,000 check Amount of Grant Fund Awarded: _ _ was received from City: . 1. Is this Expenditure Report is to provide documentation for first $5,000 awarded and received? Yes_ or No (already submitted). 2. My organization has already received $ of the total FY 2022-23 Grant Fund awarded by the City 3. Is this Expenditure Report is submitted to request reimbursement of funds? No or Yes If yes, Amount of Request $ Number of beneficiaries living in 92590, 92591, 92592 that directly benefitted from this Program/Project (approximate number of beneficiaries if you do not have precise number) E Name of Company Eon Receipt or Invoice 4Z Date on Receipt/Invoice MUST BE ON OR BETWEEN March 20. 2020 - JUNE 30, 2024 Expenditure MUST SUPPORT PROJECT/PROGRAM IN APPLICATION & AWARD LETTER Amount Description Purpose I 3 EXPENDITURE TOTAL $ EXPENDITURE TOTAL City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 12 of 13 ACKNOWLEDGEMENT/SIGNATURE PAGE The applicant acknowledges and agrees to the following: Recipient is subject to all Community Service Funding Program requirements including submittal deadlines and payment disbursements. • Every Community Service Funding application is considered individually and on its own merit. ■ Awards will be given to organizations an__d activities that__directly_benefit the reWents_of Temecula. • Funding is not immediately available to the recipient, and requires an award letter signature upon approval. Please allow time for checks to be processed. • The awarding of Community Service Funding does not constitute an automatic annual allocation. • The recognition for Community Service Funding should accrue to the City of Temecula. • Community Service Funding must be spent as specified on the Application and records may be requested by the City of Temecula to ensure the funds were used appropriately. 7 Community Service Funding grants will not be awarded or announced within the 60 days before an election in which an awarding Council Member is on the ballot. C The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. • If awarded a Community Service Funding Grant by the City of Temecula last year, then compliance receipts must be submitted on or before this application's due date or this application may be rejected as incomplete. I/we hereby certify the information contained in this Application is true to the best of our knowledge and belief. ORGANIZATION NAME: Fine Arts Network Theater Company MAILING ADDRESS: 41391 Kalmia St.#200 Murrieta, CA 92562 PRESIDENT/ AUTHORIZED OFFICER: Joe Arreola PHONE: (951 )314-2401 EMAIL: fantheaterco@gmail.com President SIGNATURE: LJrG _ _ DATE: "/9/22 MONIT'H, DAY. YEAR IFDIFFERENT THAN AB ",Beverly Stephenson founder/director APPICATION PREPARED BY: I T ; . "'. SUBMIT ORIGINAL APPLICATION BY MONDAY, SEPTEMBER 12, 2022, TO: City of Temecula Community Service Funding Attn: City Manager's Office 41000 MAIN STREET TEMECULA, CA 92590 Questions. Stacey. Brown@TemeculaCA.gov (951) 694-6413 Betsy. Lowrey@TemeculaCA,gov (951) 693-3959 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 13 of 13 STATE OF CALIFORNIA �jj FRANCHISE TAX BOARD FTB PO BOX 942857 SACRAMENTO CA 94257-0540 Entity Status Letter Date: 9/12/2022 ESL ID: 5629859781 Why You Received This Letter According to our records, the following entity information is true and accurate as of the date of this letter. Entity ID: 1872912 Entity Name: FINE ARTS NETWORK 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. 5. The entity was administratively dissolved/cancelled on through the Franchise Tax Board Administrative Dissolution process. Important Information This information does not necessarily reflect the entity's current legal or administrative status with any other agency of the state of California or other governmental agency or body. If the entity's powers, rights, and privileges were suspended or forfeited at any time in the past, or if the entity did business in California at a time when it was not qualified or not registered to do business in California, this information does not reflect the status or voidability of contracts made by the entity in California during the period the entity was suspended or forfeited (R&TC Sections 23304.1, 23304.5, 23305a, 23305.1). The entity certificate of revivor may have a time limitation or may limit the functions the revived entity can perform, or both (R&TC Section 23305b). Connect With Us Web: ftb.ca.gov Phone: 800-852-5711 from 7 a.m. to 5 p.m. weekdays, except state holidays 916-845-6500 from outside the United States California Relay Service: 711 or 800-735-2929 (For persons with hearing or speech impairments) Q HELPB MENU Home > Tax Exempt Organization Search > Fine Arts Network < Back to Search Results Fine -Arts- Network EIN: 33-0624570 1 Murrieta, CA, United States Publication 78 Data o Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions. On Publication 78 Data List: Yes Deductibility Code: PC Copies of Returns (990, 990-EZ, 990-PF, 990-T) o Electronic copies (images) of Forms 990, 990-EZ, 990-PF or 990-T returns filed with the IRS by charities and non- profits. Tax Year 2019 Form 990 Tax Year 2018 Form 990 Tax Year 2017 Form 990 Tax Year 2016 Form 990EZ Tax Year 2015 Form 990EZ INTERNAL REVENUE SERVICE DISTRICT DIRECTOR 2 CUPANIA CIRCLE MONTEREY PARK, CA 91755-7406 Date: OCT FINE ARTS NETWORK C/O-VIRGINIA K. COSTILQYT 28410 FRONT STREET, SUITE 104 TEMECULA, CA 92590 Dear Applicant: DEPARTMENT OF THE TREASURY Employer Identification Number: 33-0624570 Case Number: 954230016 Contact Person: TERRY IZUMI Contact Telephone Number: (714) 826-1448 Accounting Period Ending: December 31 Foundation Status Classification: 509 (a) (2) Advance Ruling Period Begins: July 27, 1994 Advance Ruling Period Ends: Dec. 31, 1998 Addendum Applies: No Based on information you 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). 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 expect to be a publicly supported organization described in section 509(a)(2). Accordingly, during an advance ruling period you will be treated as a publicly supported organization, and not as a private foundation. This advance ruling period begins and ends on the dates shown above, Within 90 days after the end of your advance ruling period, you must send us the information needed to determine whether you have met the require- ments of the applicable support test during the advance ruling period. If you establish that you have been a publicly supported organization, we will classi- fy you as a section 509(a)(1) or $09(a)(2) argani.zation 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, we will classify you as a private foundation for future periods. Also, if we classify you as a private foundation, we will treat you as a private foundation from your beginning date for purposes of section 507(d) and 4940, Grantors and contributors may rely on our determination that you are not a private foundation until 90 days after the end of your advance ruling period. If you send us the required information within the 90 days, grantors and contributors may continue to rely on the advance determination until we make a final determination of your foundation status. If we publish a notice in the Internal Revenue Bulletin stating that we Letter 1045 (DO/CG) 2020�- O.Insa6 Public - - 2020, and ending Y0 D Emp ►.3d,st, rlau - h TS it ir4E—. lcyrr flltnl' isaSan nCM -1r =INS AnMr�t�. 33jC624570 25125 MADISON A1,1E. STE A MURRIETA, CA-925 5 2_ 951-314-2401 T SAME AS C ABOVE i1':� :'may ell{f}^ J --I website, - HTTP : //;4Wd , FANTHEATER . CCN / I Yff rla 1 h1 rA 1 l3tretty e- F-tre Ih orGani2atiCn's rr..s;; ^ :r mcs; g;yrlt'I[3nt a,:trvll;es TO m ,BRN�CALY : ATR-d_C_AL QTETMELA-VA1fY,PC6CTOS k!i_3> 7,7 d",ty:� 3 P4-, tCer at vc' s� r, er�.t,._rs ;1 , t.!5��5e �# —I'S ,h �- k7tb 4 h.-'•C '( ��te�,`r�c`1 [-�....... . r 3� ;eat ';'`.?;'. ,F. `�' ,rag 2a).7a Iv l� .r/.9?at..,•'b`et }le a •r -s :afar;; -e o m B �.::.ft;t•t,_, r� 3r:� �r_3.:,;i'ar+ . (?x <. S~ Q 11 .fl Oar, •:� v.,, ,�� ��fl I 1�. I I. :b��( .N' - ,4 1 12 Tota1 re,ier e - add i.res 8 rh ; _irr. ;' if Est equal R t; rf C,hnrs ;,fir ;�; e Ir 13 GranSr` Il3r s a td , Y �r'',(i l.f 1#.S �3i^. 4-•�•. ,Y :CItn't r? 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'r �rw' ; xL'Y^7 �hR�71. 'S J'u 1t 'a�:s a^9 _ :Yr ^, _ j •,� I •• . d t re�',n [t rr cr7 wt5 :Itds U, 3,0 Sign — Here 5TEPHANIE BEALS '; N ur: •Slr vW pre — TF' ASL'Rc #[. _i rtCr 1 t Paid LESLIE A. DCHERTY, CPA, LESLIE A. Do Paid ' ,r.-�;.j9,, EPOC�14492Q,j Preparer Firm's:a:nt w LESLIE A DJHERTY &COMPANY. PC Use Only F wi'ii 41880 KAI.KA ST STE 170 - 2 .-F082551 Mi7RRIETA. CA 92562 698-2260 4y the tFtS 3iszuzs this rtft,rr ro�th tt:e preparer st-own .FCve? Sae ir.dlruf•t00r.s No 3AA For Paperwork Reduction Act Notice, see tha separate Instructions. ~ ,._ Prior Year Current Year -' �746. 22,159. i5$,552. g 13p 4. - -.i19� 011. �.. _ 2G1 li5.I 114r612. 2M 115.1 114 612. -30. 947.:. 4, 689. Bagtnning of Current Year End of Year 1E,212. 36,D.J r 38,3QL. Star Way Systems Corporation Quote P. 0. Box 1357 Murrieta, CA 92564 9/8/2022 Phone # 951-678-5680 • ' " ' &0) ' Fax # 951-678-8052 19592 Fine Arts Network Beverly Stephenson 41391 Kalmia St Ste 200 Murrieta, CA 92562 Omnidirectional Condenser Miniature-Lavalier Mic-Black Shure WL93 30 95.00 80.00 2,400.00 Quad Digital Wireless Receiver with internal power Shure 6 9,034. 5,646.2 33,877.50 supply, 1 /2 Wave Antenna and Rack Mounting hardware ULXD4Q=-G50 Digital Wireless Bodypack Transmitter with Miniature 4-pin Shure ULXD1=-G5 1 24 794. 496.25 11,910.00 Connector Five -way active antenna and power distribution system. Shure UA845UWB 2 1,474. 921.25 1,842.50 Switchable frequency ranges: 147-216 MHz, 470-960 MHz, 1240-1260 MHz, 1492-1525 MHz, 1785-1805 MHz Passive Directional Antenna (470-952 MHz) Shure PA805SWB 2 373.0 261.25 522.50 includes 10' BNC/BNC Cable Rechargeable Battery Shure SB900B 48 126.00 100.0c 4,800.00 Rack Battery Charger Shure SBRC-US 4 835.00 621.25 2,485.00 Black Label 16-space Amp Rack with Wheels Odyssey 2 799.95 592.19 1,184.38 FZAR16WBL Utility Rack Drawer 3RU 5.25in Middle Atlantic 4 242.00 153.12- 612.50 UD3 3RU Snake Cable 12-channel XLR male to XLR female, 19 Sescom 2 189.4S 173.69 347.38 12XLM-12XLF-10 Labor - Rack Build 1,500.0 1,500.00 Estimated shipping 600.00 600.00 OPTIONAL UPGRADE: (30) Omnidirectional Earset Headworn Microphone, cocoa - Shure MX153C/0-TQG $226.25 each x 30 = $6,787.50 plus tax, if applicable NOTE: Prices are valid for 15 days from date of quote. Deposit of 50% is required to bind this quote. Once order is placed (ie. deposit is received), estimated delivery is 6 months due to supply chain issues. Sales Tax 8.75% 5,248.40 Total $67,330.16 To accept this quote, please sign, date and return: Prepared by CS Full Compass Systems, Ltd 9770 Silicon Prairie Parkway MADISON, WI 53593 608-831-7330 Fax:608-831-6330 Bill to: Fine Arts Network 41391 Kalmia St Ste 200 MURRIETA HOT Si'RINGS, CA 92562 Ship to: Fine Arts Network 41391 Kalmia St Ste 200 MURRIETA HOT SPRINGS, CA 92562 Quotation Confirmation # Page Date Sales order Purchase order # Ordered by _Salesperson Payment Customer account FOB Expiration date a SOC4836238-3 1of2 9/12/2022 SOC4836238 Dave Cradler Credit Card CUC2601395 FOBO 10/27/2022 Qty Extended Mfg Item number Description ordered Unit Ship via Unit jerice price Fin SHU MX153T/0-TQG Mic, Headworn Omni Cond. Tan 30 EA Bestway $224.12 $6723.60 https://www.fullcompass.com/prod/205081 SHU ULXD4Q-G50 Quad Digital Receiver 6 EA Bestway $5088.45 $30530.70 https://www.fullcompass.com/prod/215817 SHU ULXD1-G50 Transmitter, Bodypack 24 EA Bestway $491.58 $11797.92 https://www.fullcompass.com/prod/205101 SHU UA845UW-B Antenna/PowerDistSy 2 EA Bestway $917.28 $1834.56 https://www.fullcompass.com/prod/518501 SHU PA805SWB Antenna Wide Band 2 EA Bestway $272.42 $544.84 https-://www.fullcompass.com/prod/125440 SHU SB900B Lithium -Ion Rechargeable Battery 48 EA Bestway $101.92 $4892.16 https://www.fullcompass.com/prod/602392 SHU SBRCUS Axient Digital Rackmount 8-Bay 4 EA Bestway $613.72 $2454.88 Charging Station https://www.fullCOMpa5S.com/prod/530000 ODY FZAR16WBL Case,16sp w/Wheels,BlackLabel 2 EA Bestway $533.49 $1066.98 https-//www.fullcompass.com/prod/230379 MID UD3 3 Space Rack Drawer 4 EA Bestway $142.56 $570.24 https://www.fullcompass.com/prod/020422 PRO MT12XFXM-10 Snake 12chl XLRF-XLRM loft 2 EA Bestway $114.66 $229.32 Sales subtotal amount: $60645.20 Promotional discount: $0.00 Shipping & handling: $375.24 Net amount: $61020.44 Sales tax: $5306.46 Total: $66326.90 FY 2022/2023 COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA GRANT APPLICATION # 16 FIRST TEE INLAND EMPIRE AKA BRIGHTON HILL ACADEMY SPORTS AND LEARNING CENTER CITY OF TEMECUTA FISCAL YEAR 2022 - 2023 COMMUNITY SERVICE FUNDING - REINVESTMENT IN TEMECULA PROGRAM APPLICATION (Please Print or Type) DUE ON OR BEFORE: MONDAY, SEPTEMBER 12, 2022 I PROJECT/PROGRAM INFORMATION I Amount Requested: $ 50,000 MAXIMUM ALLOWABLE: $50,000 PER ORGANIZATION Project/Program Title: First Tee IE Life Skills Experience ClassesStart Date: 9/1/2022 End Date: Ongoing Physical Address of Project/Program: INCLUDE IF DIFFERENT THAN ORGANIZATION's MAILING ADDRESS If Grant is Awarded, Make Check Payable to: First Tee — Inland Empire Mailing Address: 215 N. D Street, Suite 304 San Bernardino, CA 92401 I ORGANIZATION AND GEOGRAPHIC AREA SERVED I Name of Applicant Brighton Hill Academy SLC dba First Tee — Inland Empire Organization: Year Founded: g014 I Irs esln aTr�rre Website: %vww.firstteeiniandempir_e_,org Social Media: FB—firsttee-inlande►r+pire Number of Paid Staff: 4 Number of Volunteers: 35 Geographic Area(s) the Organization Serves: Raypyside and San Be[Dard no county Geographic Area(s) the Proiect/Program Serves Temecula Valley NOTE: COMMUNITY SERVICE FUNDING GRANT PROGRAM FUNDING MUST BE EXCLUSIVELY USED TO SERVE TEMECULA. Contact Name: Pamela Tyler Title/Position: Executive Director Contact Person's Direct Telephone: 909,297.6262 _ Contact Person's Email: pamelatyler@thefirstteeinlandempire.org NONPROFIT STATUS Is this organization incorporated as a nonprofit? Yes ® Date of Incorporation as a Nonprofit: 2014 No ❑ IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING Federal Identification Number: 46-4933764 State Identification Number: 3671608 PRINT OUT AND ATTACH TO THIS APPLICATION VERIFICATION FROM FEDERAL (IRS) AND STATE (FTB) AS FOLLOWS: 1. ® Attach IRS Deductibility Status using this link: http-://aPI)s.irs.gov/app/eos/ 2. ® Attach State Entity Status Letter using this link: https://www.ftb.ca.gov/online/self serve entity status letter/index.as 3. ® Attach first page only of most recent IRS Form 990 or attach print out of detailed info about your charity found on this State Registry's Search Tool: httr):/Iret.doi.ca..govNerification/Web/Search.asnx?faciiity=Y City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 5 of 13 C APPLICATION AUTHORIZATION Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over $500 including any business transactions, negotiations, investments, or interests in real property with a Temecula City Council Member during the past 12 months? No ® Yes ❑ IF YES, BRIEFLY DESCRIBE: Is a Temecula City Council Member a member of the Board of Directors or an Officer of the organization? No ® Yes ❑ IF YES, PROVIDE COUNCIL MEMBER'S NAME AND TITLE WITHIN THE ORGANIZATION: This Application has been authorized by the organization's: Executive Committee [N Board of Directors ❑ Members -at -Large ❑ MISSION STATEMENT OF ORGANIZATION BRIEFLY DESCRIBE THE ORGANIZATION'S MISSION/GOALS AND OBJECTIVES. To impact the lives of young people by providing educational programs that build character, instill live -enhancing values and promote healthy choices through the game of golf. Create a safe introduction to golf for Temecula Youth via three delivery channels: Green golf courses, Community Programs partnering with other Youth Organizations, and School Programs introducing the program via PE Classes in the Temecula Unified School District teaching youth CORE Values, life skills, and how to succeed in their communities. Participants ages 5-18 progress through the program, deepening their understanding of life skills and golf development. The integrated approach helps youth build confidence and resilience while on the course, at home and in school. The goal is to Build Game Changers who are committed to: Pursuing Goals, Growing through Challenge, Collaborating with others, Building Positive Self -Identity and Using Good Judgment. FINANCIAL STATEMENTS UPON REQUEST, COPIES OF THE ORGANIZATION'S CURRENT BUDGET/FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT), AND IF AVAILABLE CPA'S AUDIT, MAY BE NEEDED UPON REQUEST TO DEMONSTRATE SOUND FINANCIAL MANAGEMENT. DO NOT SUBMIT NOW. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 6 of 13 FUNDING SOURCES CITY OF TEMECULA—SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM THE CITY FOR ANY PROGRAM? No ❑ Yes ® IF YES, PROVIDE BELOW. NAME OF PROGRAM/PROJECT AMOUNT MONTH + YEAR NAME OF CITY GRANT FUNDED BY THE CITY GRANT OR SPONSORSHIP FUNDING RECEIVED OR SPONSORSHIP I First Tee Inland Empire Jr Golf Program $ 2000 -May 2021 CMO-MR First Tee Inland Empire Jr Golf Program $ 1000 May 2021 CMO-J Stewart First Tee Inland Empire Jr Golf Program $ 1000 May 2021 CMO- ME First Tee Inland Empire Jr Golf Program $ 2500 July 2021 CMO- Schwank $ $ $ I I OTHER OUTSIDE SOURCES —SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM ENTITIES (NOT INCLUDING THE CITY) FOR THE SAME PROJECT/PROGRAM IN THIS APPLICATION? No ❑ Yes DKI IF YES, PROVIDE INFORMATION IN TABLE BELOW. AMOUNT RECEIVED NAME OF ENITY J Michael or J Kathleen Smith (Quarterly) Tom Pernice, Jr. Charities, Inc. 20,000.00 MONTH + YEAR FUNDING RECEIVED $ $ 75,000 $ 20,000 $ 10,000 $ 99,910 67, 848 $ 5,826 $ 25,000 2020 12-2020 2020 Toyota -Corporate Corporate Contributions Government Grants Business Contributions Charles Schwab Matching Funds Grant 2021 2021 2021 2022 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 7 of 13 GRANT PROJECT/PROGRAM DESCRIPTION IMPORTANT- RECEIPTS/INVOICES IS REQUIRED TO BE SUBMITTED TO THE CITY TO VALIDATE THE ORGANIZATION SPENT GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE PROJECT/PROGRAM AS DESCRIBED HERE 1 1 DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT. 1 First Tee — Inland Empire (FTIE) is a youth character development educational program teaching youth NINE CORE Values and NINE Healthy habits while learning to play golf. Youth learn life skills on how to better -communicate -with -family, —in school--and-how-to succeed -in tlTeir-future endeavors: -Supporting children ages 5-18 in the City of Temecula in the First Tee IE Junior Golf Program. The goal is to reach youth through After -School Program opportunities on local Golf Courses, School PE Programs and Community Programs through the City of Temecula Parks. 2 DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED ALSO, INCLUDE A LIST OF GOODS, EQUIPMEMENT, AND/OR SERVICES THIS ORGANIZATION HAS PURCHASED OR PLANS TO PURCHASE WITH AWARDED FUNDS TO SUPPORT THIS PROGRAM/PROJECT. The grant funding will be utilized to expand FTIE programs in City of Temecula. This funding will allow FTIE to purchase curriculum, supplies for programs, hats, shirts, and other items needed to run the programs. It will help offset insurance, service costs and snacks. Additional Coaches will be needed which require Background Checks, training, and additional Program Expenses. 3 TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS. FTIE exists to enable kids to build strength of character that empowers them through a lifetime of new challenges. Temecula's youth in our programs are: more confident in school, and active community members. A progressive curriculum that focuses on social and emotional learning objectives through activities that are developmentally appropriate, designed to meet kids where they are. FTIE is building Game Changers who can change and enrich a community. The outcome of being in First Tee programs are good citizens, better people, more confident youth with a higher self-esteem that helps heal their generation and community. This helps reduce juvenile delinquency, gang affiliation, and crime for the community. Stats show 98% graduate High School and 84% go onto College. FTIE is focused on diversity, equity and inclusion of all youth no matter their ethnicity or socioeconomic status. It provides an equal playing field for under -served kids who normally would not be able to afford playing golf. Scholarships are offered. No child is turned away. 3b ESTIMATED NUMBER OF PEOPLE FROM TEMECULA EXPECTED TO BENEFIT 650 FROM THIS PROJECT/PROGRAM: 3c ESTIMATED NUMBER OF VOLUNTEERS INVOLVED IN THIS PROJECT/PROGRAM 35 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 8 of 13 PROJECT/PROGRAM DESCRIPTION CONTINUED 4 SUMMARY STATEMENT — SUMMARIZE ANSWERS 1 — 3 ABOVE IN 50 WORDS OR LESS. By seamlessly integrating the game of golf with a life skills curriculum, FTIE creates learning --experiences that -build -inner strength, self=confidence,and resilience that -kids -carry to- — everything they do. FTIE offers after school programs at Golf Courses, Parks and Schools for eight weeks, four times a year and summer camps. We could not expand our program access to these youth programs without generous contributions from the City of Temecula! 5 IF APPLYING FOR MORE THAN $5,000, PLEASE EXPLAIN HOW THE COVID-19 PANDEMIC AFFECTED THIS NONPROFIT ORGANIZATION'S ABILITY TO SERVE THE TEMECULA COMMUNITY. YOU MAY ALSO INCLUDE INFLATIONARY CONCERNS. FTIE lost 60% of committed funds during Covid-19 Pandemic. This resulted in reduced staff and reduced programming to the community. Increased costs during this inflationary period has driven up the cost for employees, program supplies, vendor and transportation costs, higher golf course fees, all materials affecting each area of the operation have increased. In an effort to help First Tee Chapters rebound from Covid and inflationary concerns, Charles Schwab is offering Matching Grant funds if the Chapter receives 50% more donations than the year before, FTIE will receive $32,500 in 2023. IF APPLYING FOR MORE THAN $5,000, EXPLAIN HOW FUNDS HAVE OR WILL: (1) CREATE NEW PROJECT/PROGRAM, (2) EXPAND EXISTING PROJECT/PROGRAM, AND/OR (3) CONTINUE EXISTING PROJECT/PROGRAM- If approved, funds will expand and continue existing programming in more Temecula Parks, Schools, Golf Courses, Charter Schools and other Youth Organizations . OBJECTIVES: • Growing Participant base by 50%, increasing Girls participation by 15%, and BIPOC by 25% • Growing Coach base by 50% to reach 650 more participants while increasing diversity of staff/coach/volunteers to six more under -served, underrepresented program locations • Increasing after -school programming locations by 35% to help students reach their full potential as productive, caring, and responsible citizens City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 9 of 13 PROJECT/PROGRAM BUDGET (do not fill in shaded areas) LINE ITEMS FOR PROJECT/PROGRAM REVENUES i EXPENSES LIST REVENUES/INCOME FOR PROJECT/PROGRAM Amount of money requested from this City of Temecula ' $ 50,000 � Community Services Grant -(Not to exceed-$50;000) � — Amount contributed to the Project/Program by the Applicant $ 105,000 I Organization Other grants or funding already awarded for Project/Program, if any $ 35,000 in-Kinci maTrn Amount nr vniiintppr rrpriit hmirc pctimntpri mmniint TOTAL REVENUE 1 $ 215,000 LIST OF EXPENSES FOR PROJECT/PROGRAM Tools/Equipment Facilities/Rent/Insurance Supplies Marketing Services I _ _ Food Other Staffing Expense THIS IS INELIGIBLE TO BE FUNDED BY CITY'S GRANT; HOWEVER PLEASE INCLUDE. TOTAL EXPENSES TOTAL BUDGET j $ 215,000 $ 2000 $ 2000 $ 1500 $ 10,000 1,500 $ 33,000 $ 165,000 $ I $ 215,000 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 10 of 13 PREVIOUS` FISCAL YEAR (FY) 2021-2022 COMPLIANCE REPORT IF YOUR ORGANIZATION WAS NOT AWARDED A COMMUNITY SERVICE FUNDING GRANT IN FY 21/22 (LAST YEAR), THEN SKIP THIS PAGE. If your organization was awarded a Community Service Funding Grant in FY 2021-2022 (last year) by the City of Temecula, please submit this information. If your organization was awarded a Community Service Funding Grant in Fiscal Year 2021-2022 by the City of Temecula, all grant funds received must have been expended anytime on or between July 1, 2021, and June 30, 2022. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any future funding.- City of -Temecula -reserves -the -right to conduct - an- audit -and/or-require -add itional-back=up information to substantiate how funds received from the City were spent. If the funds were not spent in accordance with the approved/awarded application, the organization will be required to return the amount of funds to the City. To substantiate that Fiscal Year 2021-2022 funds received from the City were spent appropriately, proper back-up documentation including the completed table below with accompanying receipts/invoices, must be submitted to the City on or before due date: September 12, 2022, 1. Fill out table below (make additional copies if needed to explain all expenditures.) 2. Attach copies of receipts/invoices (in the same order as listed in this table.) 3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590 Attn: City Manager's Office —CSF EXPENDITURE REPORT due on or before September 12, 2022 Organization: FY 2021-2022 Amount of $ CSF Grant Fund Awarded: Name of Project/Program: Month & Year CSF Grant Received from City: Number of Beneficiaries Living in 92590, 92591, 92592 that Directly Benefitted from this Program/Project (approximate number of beneficiaries if you do not have precise number): EName of Company Eon Receipt or Invoice 4Z' 2 3 4 5 6 Date on Receipt/Invoice MUST BE ON OR BETWEEN JULY 1, 2021 - JUNE 30, 2022 EXPENDITURE TOTAL Amount Expenditure Description DESCRIBE THE EXPENDITURE EAh-LNUI I UKt I U I AL IVIUJ I bt tUUAL I U (OR GREATER) THAN TOTAL AWARD AMOUNT Purpose PURPOSE OF EXPENDITURE City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 11 of 13 FISCAL YEAR (FY) 2022-2023 COMPLIANCE REPORT If your organization is awarded a Community Service Funding - REINVESTMENT IN TEMECULA Grant in FY2022-2023 by the City of Temecula, follow these instructions. If your organization is awarded a Community Service Funding Grant - REINVESTMENT IN TEMECULA in FY2022-2023 by the City of Temecula, all grant funds received must be expended anytime on or between March 20, 2020 and June 30, 2024. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent. If the funds are not spent in accordance with the approved/awarded application, the organization may not receive and/or will be required to return said amount of funds to the City To substantiate that grant funds from the City are spent appropriately, proper back-up documentation including the table below with accompanying receipts/invoices, must be submitted to the City as outlined on this page. 1. Fill out Expenditure Report table below. Make additional copies if needed to explain all expenditures. A. If awarded $5,000. Submit the following Expenditure Report within 60 days after spending $5,000 no later than June 30, 2024, to demonstrate grant funds were spent in accordance with the Application. [If you were awarded less than $5,000, submit Expenditure Report for that amount ) B. If awarded grant funds exceeding $5,000. A) Follow #1.A above first B) To receive grant funds exceeding $5,000 (between $5K-$50K), submit the following Expenditure Report to be reimbursed for the remaining balance of award to demonstrate funds were spent in accordance with the Application. This report can be submitted in $10,000 increments (but no less than $10,000 unless the remaining grant award funding amount is less than $10K). This report must be submitted to the City no later than June 30, 2024 to receive remaining grant funds. 2. Attach copies of receipts/invoices (in the same order listed in table below). 3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590, Attn: City Manager's Dept. "CSF-Reinvestment in Temecula" EXPENDITURE REPORT DATED Organization: I TOTAL FY 2022-2023 Amount of Grant Fund Awarded: $ Name of Project/Program: Month & Year FIRST $5,000 check was received from City: 1. Is this Expenditure Report is to provide documentation for first $5,000 awarded and received? Yes_ or No (already submitted). 2. My organization has already received $ of the total FY 2022-23 Grant Fund awarded by the City 3. Is this Expenditure Report is submitted to request reimbursement of funds? No or Yes If yes, Amount of Request $ Number of beneficiaries living in 92590, 92591, 92592 that directly benefitted from this Program/Project (approximate number of beneficiaries if you do not have precise number) V Date on Expenditure 0 Name of Company Receipt/Invoice MUST SUPPORT PROJECT/PROGRAM IN APPLICATION & AWARD LETTER u E on Receipt or Invoice' MUST BE ON OR BETWEEN Z _ March 20, 2020 - JUNE 30, Amount Description Purpose E-1 EXPENDITURE TOTAL $ EXPENDITURE TOTAL City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 12 of 13 ACKNOWLEDGEMENT/SIGNATURE PAGE The applicant acknowledges and agrees to the following: • Recipient is subject to all Community Service Funding Program requirements including submittal deadlines and payment disbursements. • Every Community Service Funding application is considered individually and on its own merit. ■ Awards will be given to organizations and activities that directly benefit the residents of Temecula. • Funding is not immediately available to the recipient, and requires an award letter signature upon approval. Please -allow -time -for -checks -to -be processed. • The awarding of Community Service Funding does not constitute an automatic annual allocation. • The recognition for Community Service Funding should accrue to the City of Temecula. • Community Service Funding must be spent as specified on the Application and records may be requested by the City of Temecula to ensure the funds were used appropriately. • Community Service Funding grants will not be awarded or announced within the 60 days before an election in which an awarding Council Member is on the ballot. The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. • If awarded a Community Service Funding Grant by the City of Temecula last year, then compliance receipts must be submitted on or before this application's due date or this application may be rejected as incomplete. I/we hereby certify the information contained in this Application is true to the best of our knowledge and belief. ORGANIZATION NAME: Brighton Hill Academy SLC dba First Tee —Inland Empire MAILING ADDRESS: 215 N. D Sreet San Bernardino, CA 92401 PRESIDENT / AUTHORIZED OFFICER: Pamela Tyler aRINJ Nnrnr SIGNATURE: IF DIFFERENT THAN ABOVE, APPICATION PREPARED BY: PHONE: (909 ) 297-6262 EMAIL: pamelatyler@thefirstteeiniandempire.org Co -Founder, Executive Director DATE: 8-18-2022 rA0N 1 1. —AV (-AP TrFi-F_ SUBMIT ORIGINAL APPLICATION BY MONDAY, SEPTEMBER 12, 2022, TO: City of Temecula Community Service Funding Attn: City Manager's Office 41000 MAIN STREET TEMECULA, CA 92590 Questions: Stacey.Brown@TemeculaCA.gov (951) 694-6413 Betsy. Lowrey@TemeculaCA.gov (951) 693-3959 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 13 of 13 INTERNAL REVENUE SERVICE P. 0. BOX 2508 CINCINNATI, OH 45201 Date: 1 A N 28 2015 BRIGHTON HILL ACADEMY SPORTS AND LEARNING CENTER C/O MELODY FISCHETTI 3560 RAWLEY 5T CORONA, CA- 92882 Dear Applicant: DEPARTMENT OF THE TREASURY Employer Identification Number: 46-4933764 DLN: 17053301366004 Contact Person: FAITH E CUMMINS ID# 31534 Contact Telephone Number: (877) 829-5500 Accounting Period Ending: December 31 Public Charity Status: 170(b)(1)(A)(vi) Ford"990-Requ1red:J�"-�" Yes Effective Date of Exemption: April 30, 2014 Contribution Deductibility: Yes Addendum Applies: No 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. For important information about your responsibilities as a tax-exempt organization, go to wow.irs.gov/charities. Enter "4221-PC" in the search bar to view Publication 4221-PC, Compliance Guide for 501(c)(3) Public Charities, which describes your recordkeeping, reporting, and disclosure requirements. Sincerely, Director, Exempt Organizations Letter 947 STATE OF CALIFORNIA FRANCHISE TAX BOARD FTB PO BOX 942857 SACRAMENTO CA 94257-0540 Entity Status Letter Date: 8/25/2022 ESL ID: 8861241572 Why You Received This Letter According to our records, the following entity information is true and accurate as of the date of this letter Entity ID: 3671608 Entity Name: BRIGHTON HILL ACADEMY SPORTS AND LEARNING CENTER ❑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. ❑X 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. ❑ 5. The entity was administratively dissolved/cancelled on through the Franchise Tax Board Administrative Dissolution process. Important Information This information does not necessarily reflect the entity's current legal or administrative status with any other agency of the state of California or other governmental agency or body. If the entity's powers, rights, and privileges were suspended or forfeited at any time in the past, or if the entity did business in California at a time when it was not qualified or not registered to do business in California, this information does not reflect the status or voidability of contracts made by the entity in California during the period the entity was suspended or forfeited (R&TC Sections 23304.1, 23304.5, 23305a, 23305.1). The entity certificate of revivor may have a time limitation or may limit the functions the revived entity can perform, or both (R&TC Section 23305b). Connect With Us Web: ftb.ca.gov Phone: 800-852-5711 from 7 a.m. to 5 p.m. weekdays, except state holidays 916-845-6500 from outside the United States California Relay Service: 711 or 800-735-2929 (For persons with hearing or speech impairments) FTB 4263A WEB (REV 12-2019) 990 -Return-oUOrganization-Exempt From -Income Tax OM13,NQ._1545.0047— .,- Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) 2021 =.r—mot of the Treasury No Do not enter social security numbers on this form as it may be made public, a AFV_a� P.-venue Service ► Go to www.irs.gov/Form990 for instructions and the latest information. x. =or the 2021 calendar year, or tax year beginning , 2021, and ending, 20 e it applicable: o Name of organization BRIGHTON HILL ACADEMY, SPORTS AND LEARNING CENTER D Employer identification number .-esschange DW22 business as THE FIRST TEE OF INLAND EMPIRE 46-4933764 .A.,re change Number and street (or P.O. box if mail is not delivered to street address) Room/suite E Telephone number s alraturn 215 NORTH D STREET 309 909) 297-62G2 =: ar rewrWtorminated City or town, state or province, country, and ZIP or foreign postal code k. b-,dadr©Sum SAN BERNARDINO, CA 92401 1 G Gross receipts $ _335r 669. _ AM. Mllon par4rig F Name and address of principal officer: H(a) Is this a group return for subordinates? [3 Yes © No JT VISBAL 215 NORTH D STREET ST. 304 SAN BERNARDINO CA 92401 H(b) Are all subordinates Included? ❑ Yes ❑ No --. exempt status: X❑ 501(c)(3) [] 501(e) ( ) -4 (Inien no.) ❑ 4947(a)(1) or ❑ 527 If "No," attach a list. See instructions. H(c] Group exemption number ► ► www. firstteein1andem ire. o rig A. of otganizalion: ©corporation ❑ Trust ❑ Association ❑ Other ► L Year of formation: 2 014 1 M State of legal domicile: CA Surnmaq , 1 - Briefly describe the organization's mission or most significant activities: EMPOWER YOUTH WITH TUTORIAL, ED_U_CATI.ONAL_ S SPORTS PROGRAMS WHICH INSTILL PERSONAL G QWT.l�1__PROVIDE LIFE PRINCIPLES - - - ---------------------------------------- _ ,a 2 C 3 4 AND STFZENGHTHEN CHARACTER VIA THE FIRST TEE LIFE SKILLS Check this box ► ❑ if the organization discontinued its operations or disposed of Number of voting members of the governing body (Part VI, line 1 a) . Number of independent voting members of the governing body (Part VI, line 1 b) . _w w_ _ __---------------------------- more than 25% of Its net assets. 3 . . . 4 - 15 15 5 Total number of individuals employed in calendar year 2021 (Part V, line 2a) 5 9 ' 6 Total number of volunteers (estimate if necessary) , . . . . . . , , . . . . . 6 25 7a Total unrelated business revenue from Part VIII column C line 12 b Net unrelated business taxable income from Form 990-T, Part I, line 11 7b 0. Prior Year Current Your _ Contributions and grants (Part VIII, line 1h) , . . . . . , . . . . . 116 665. 286 355. = G Program service revenue (Part VIII, line 2g) . . , . . , , , - • 30 810. 49 314. Investment income (Part VIII, column (A), lines 3, 4, and 7d) . . . . . . 3 • U, - 1 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11 e) . ':2 Total revenue —add lines 8 through 11 must equal Part VIII, column , Iine 12 14' 4 7 8 . 335,669. 13 Grants and similar amounts paid (Part IX, column (A), lines 1-3) , , . , , 14 Benefits paid to or for members (Part IX, column (A), line 4) . . . , . . :5 Salarles, other compensation, employee benefits (Part IX, column (A), lines 5-10) 202 810 . 134 798. 299. '6a Professional fundraising fees (Part IX, column (A), line 11e) . . . , . , r b Total fundraising expenses (Part IX, column (D), line 25) ► __25 _691. 105 414. 131, 128. Other expenses (Part IX, column (A), lines 11a-11d, 11f-24e) . , . . . 'o Total expenses. Add lines 13-17 (must equal Part IX, column (A), line 25) 308 224 . 266 225, 19 Revenue less expenses, Subtract line 18 from line 12 -160 7 4 6. 69 4 4 4 . " = Beginning of Current Year Fnd of Year -_ 1 20 1_ 21 ' 22 Total assets (Part X, line 16) • , , , , , , , , , , , , , , , Total liabilities (Part X, line 26) , . . . . , . . , . . . . Net assets or fund balances. Subtract line 21 from line 20 63,022. 67 105. 225 391. 201 092 - -162 369. -133. 987. Signature Block =anaties 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 and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge. 09 2022 Signature of officer Date �rl c'ere JT VISSA& CHAIRMAN EMERITUS Type or print name and title FY 2022/2023 COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA GRANT APPLICATION # 17 FRED FINCH YOUTH CENTER CARES INC. CITY OF TEMECUI[A FISCAL YEAR 2022.2023 COMMUNITY SERVICE FUNDING - REINVESTMENT IN TEMECULA PROGRAM APPLICATION (Please Print or Type) DUE ON OR BEFORE: MONDAY, SEPTEMBER 12, 2022 PROJECT/PROGRAM INFORMATION I Amount Requested: $ 3,960.00 MAXIMUM ALLOWABLE Temecula BEST Program Project/Program Title: Equipment and Materials Start Date: Physical Address of Project/Program $50,000 PER ORGANIZATION End Date: 27555 Ynez Road, Suite 406 Temecula, CA 92591 INCLUDE IF DIFFERENT THAN ORGANIZATION'S MAILING ADDRESS If Grant is Awarded, Make Check Payable to: Fred Finch CARES, Inc. Mailing Address: 8787 Complex Drive, Suite 300 San Diego, CA 92123 I ORGANIZATION AND GEOGRAPHIC AREA SERVED Name of Applicant Fred Finch CARES, Inc. Organization: Website: fredfinch.rg/cares Number of Paid Staff: 132 Year Founded: 2017 Number of Volunteers: 5 Geographic Area(s) the Organization Serves: southern California Geographic Area(s) the Project/Program Serves: Temecula NOTE: COMMUNITY SERVICE FUNDING GRANT PROGRAM FUNDING MUST BE EXCLUSIVELY USED TO SERVE TEMECULA. Contact Name: Clay Myers -Bowman Title/Position: Development Officer Contact Person's Direct Telephone: (619) 972-1985 Contact Person's Email: claymyersbowman@fre NONPROFIT STATUS Is this organization incorporated as a nonprofit? Yes 0 Date of Incorporation as a Nonprofit: No ❑ IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING Federal Identification Number: 81-4243450 State Identification Number: _3956277 PRINT OUT AND ATTACH TO THIS APPLICATION VERIFICATION FROM FEDERAL (IRS) AND STATE (FTB) AS FOLLOWS: 1. ❑ Attach IRS Deductibility Status using this link: htt ://a s.irs. ov/a /eos/ 2. ❑ Attach State Entity Status Letter using this link: httos:/Iwww.ftb.ca.gov/online/self serve entity status letter/index.aslo 3. ❑ Attach first page only of most recent IRS Form 990 or attach print out of detailed info about your charity found on this State Registry's Search Tool: http://rct.doo.ca.g2v/Veri[ic3tiDn/Web/Search.asQx?facility,=Y City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 5 of 13 APPLICATION AUTHORIZATION Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over $500 including any business transactions, negotiations, investments, or interests in real property with a Temecula City Council Member during the past 12 months? No U Yes ❑ IF YES, BRIEFLY DESCRIBE: Is a Temecula City Council Member a member of the Board of Directors or an Officer of the organization? No A Yes ❑ IF YES, PROVIDE COUNCIL MEMBER'S NAME AND TITLE WITHIN THE ORGANIZATION: This Application has been authorized by the organization's: Executive Committee [] Board of Directors ❑ Members -at -Large ❑ MISSION STATEMENT OF ORGANIZATION BRIEFLY DESCRIBE THE ORGANIZATION'S MISSION/GOALS AND OBJECTIVES. The purpose of Fred Finch CARES is to set the standard for thorough developmental assessment and supportive services to children and families impacted by developmental disabilities, mental health concerns, and significant trauma and loss, in San Diego County and across Southern California. Our staff is diverse, compassionate, committed, and innovative. All our services respond to the needs of our local communities. At Fred Finch CARES, we are committed to having a workforce that is reflective of diversity as well as representative of the cultural and linguistic needs of those we serve. Children are empowered to foster self-reliance and independence, build, and improve healthy relationships, teach self-awareness, and increase their coping skills and self-esteem. Caregivers learn the skills to manage difficult situations, assess, and meet their child's needs. By providing an array of individualized, trauma -informed, and culturally responsive interventions that build upon each participant's strengths, we ensure strong positive outcomes. FINANCIAL STATEMENTS UPON REQUEST, COPIES OF THE ORGANIZATION'S CURRENT BUDGET/FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT), AND IF AVAILABLE CPA'S AUDIT, MAY BE NEEDED UPON REQUEST TO DEMONSTRATE SOUND FINANCIAL MANAGEMENT. DO NOT SUBMIT NOW. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 6 of 13 FUNDING SOURCES CITY OF TEMECULA-SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM THE CITY FOR ANY PROGRAM? No N Yes ❑ IF YES, PROVIDE BELOW. NAME OF PROGRAM/PROJECT gMOUNT MONTH + YEAR NAME OF CITY GRANT FUNDED BY THE CITY GRANT OR SPONSORSHIP FUNDING RECEIVED OR SPONSORSHIP OTHER OUTSIDE SOURCES —SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM ENTITIES (NOT INCLUDING THE CITY) FOR THE SAME PROJECTIPROGRAM IN THIS APPLICATION? NO ■ Yes ❑ IF YES, PROVIDE INFORMATION IN TABLE BELOW. AMOUNT MONTH + YEAR RECEIVED NAME OF ENITY FUNDING RECEIVED City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 7 of 13 GRANT PROJECT/PROGRAM DESCRIPTION IMPORTANT- RECEIPTS/INVOICES IS REQUIRED TO BE SUBMITTED TO THE CITY TO VALIDATE THE ORGANIZATION SPENT GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE PROJECT/PROGRAM AS DESCRIBED HERE 1 DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT Fred Finch CARES has developed the Behavior Education and Skills Training (BEST--)-program-in-order-to-bridge-the-behavioral-health- workforce -gap -while meeting the growing need for behavioral health workforce in communities of high need, including Temecula where we currently operate several social service and 'behavioral health programs for children, youth and families. Fred Finch CARES seeks support to implement a Bilingual BEST program to help build a behavioral health workforce in Temecula. 2 DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED. ALSO, INCLUDE A LIST OF GOODS, EQUIPMEMENT, AND/OR SERVICES THIS ORGANIZATION HAS PURCHASED OR PLANS TO PURCHASE WITH AWARDED FUNDS TO SUPPORT THIS PROGRAM/PROJECT. The BEST program will provide 10 participants with a paid training experience that will enhance their knowledge and skills in serving children, youth, and families with developmental disabilities; learn the basics of Applied Behavior Analysis, and medical and mental health terminology, while preparing them for job opportunities within our organization. Each successful graduate of the program who transitions into an entry-level position will be equipped to serve up to 10 bilingual (Spanish/English) and/or monolingual Spanish speaking children, youth, or families. This arantfu.nd n.c wFll Su = material.-andeaaicment_Gosts for _the tra.in.ino. 3 TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS. The BEST program was developed out of the need for Registered Behavioral Technicians to work with children, youth and their families impacted by developmental disabilities. We are seeking to train qualified bilingual providers in the Temecula area who can deliver high quality services across a variety of sectors. By providing participants the training and skills that can be utilized across different treatment settings, we can ensure that the same quality of service is implemented to meet the growing needs of the community. 3b ESTIMATED NUMBER OF PEOPLE FROM TEMECULA EXPECTED TO BENEFIT FROM THIS PROJECT/PROGRAM: 11 0 3c ESTIMATED NUMBER OF VOLUNTEERS INVOLVED IN THIS PROJECT/PROGRAM: 0 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 8 of 13 C PROJECT/PROGRAM DESCRIPTION CONTINUED 4 SUMMARY STATEMENT - SUMMARIZE ANSWERS 1 - 3 ABOVE IN 50 WORDS OR LESS. In response to a dire need for cultural and linguistic diversity in -mental health care, Fred Finch CARES seeks funding to support a bilingual Behavior Education and Skills Training program in order to meet the growing need for behavioral health workers in Temecula. 5 IF APPLYING FOR MORE THAN $5,000, PLEASE EXPLAIN HOW THE COVID-19 PANDEMIC AFFECTED THIS NONPROFIT ORGANIZATION'S ABILITY TO SERVE THE TEMECULA COMMUNITY. YOU MAY ALSO INCLUDE INFLATIONARY CONCERNS. 6 IF APPLYING FOR MORE THAN $5,000, EXPLAIN HOW FUNDS HAVE OR WILL: (1) CREATE NEW PROJECT/PROGRAM, (2) EXPAND EXISTING PROJECT/PROGRAM, AND/OR (3) CONTINUE EXISTING PROJECT/PROGRAM. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 9 of 13 PROJECT/PROGRAM BUDGET (do not fill in shaded areas) LINE ITEMS FOR PROJECT/PROGRAM REVENUES EXPENSES LIST REVENUES/INCOME FOR PROJECT/PROGRAM Amount of money requested from this City of Temecula $ 3,960.00 Community Services Grant (Not to exceed $50,000) Amount contributed to the Project/Program by the Applicant $ Organization Other grants or funding already awarded for Project/Program, if any $ In -Kind match amount or volunteer credit hours estimated amount $ TOTAL REVENUE $ LIST OF EXPENSES FOR PROJECT/PROGRAM Tools/Equipment Facilities/Rent/Insurance Supplies Marketing Services Food (requested funding) Other Participant Stipends; Contractors Staffing Expense THIS IS INELIGIBLE TO BE FUNDED BY CITY'S GRANT; HOWEVER PLEASE INCLUDE. TOTAL EXPENSES TOTAL BUDGET $ I? $2396.00 $3960.00 $5000.00 $6526.39 $17,882.39 $17,882.39 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 10 of 13 PREVIOUS` FISCAL YEAR (FY) 2021-2022 COMPLIANCE REPORT IF YOUR ORGANIZATION WAS NOT AWARDED A COMMUNITY SERVICE FUNDING GRANT IN FY 21122 (LAST YEAR), THEN SKIP THIS PAGE. If your organization was awarded a Community Service Funding Grant in FY 2021-2022 I (last year) by the City of Temecula, please submit this information. If your organization was awarded a Community Service Funding Grant in Fiscal Year 2021-2022 by the City of Temecula, all grant funds received must have been expended anytime on or between July 1, 2021, and June 30, 2022. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any future funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent. If the funds were not spent in accordance with the approved/awarded application, the organization will be required to return the amount of funds to the City. To substantiate that Fiscal Year 2021-2022 funds received from the City were spent appropriately, proper back-up documentation including the completed table below with accompanying receipts/invoices, must be submitted to the City on or before due date: September 12, 2022. 1. Fill out table below (make additional copies if needed to explain all expenditures.) 2. Attach copies of receipts/invoices (in the same order as listed in this table.) 3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590 Attn: City Manager's Office — CSF EXPENDITURE REPORT due on or before September 12, 2022 Organization: Fred Finch CARES, Inc. Name of Project/Program: Temecula BEST Program Equipment and Materials FY 2021-2022 Amount of $ CSF Grant Fund Awarded: Month & Year CSF Grant Received from City: Number of Beneficiaries Living in 92590, 92591, 92592 that Directly Benefitted from this Program/Project (approximate number of beneficiaries if you do not have precise number): EName of Company E on Receipt or Invoice <Z 1 2 3 4 5 6 Date on ReceiptlInvoice MUST BE ON OR BETWEEN JULY 1, 2021 - JUNE 30, 2022 Expend itu re -- Amount Description Purpose DESCRIBE THE EXPENDITURE PURPOSE OF EXPENDITURE EXPENDITURE TOTAL EXPENDITURE TOTAL MUST BE EQUAL TO (OR GREATER) THAN TOTAL AWARD AMOUNT City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 11 of 13 FISCAL YEAR (FY) 2022-2023 COMPLIANCE REPORT If your organization is awarded a Community Service Funding - REINVESTMENT IN TEMECULA Grant in FY2022-2023 by the City of Temecula, follow these instructions. If your organization is awarded a Community Service Funding Grant - REINVESTMENT IN TEMECULA in FY2022-2023 by the City of Temecula, all grant funds received must be expended anytime on or between March 20, 2020 and June 30, 2024. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent. If the funds are not spent in accordance with the approved/awarded application, the organization may not receive and/or will be required to return said amuuld ur runds to the City. To substantiate that grant funds from the City are spent appropriately, proper back-up documentation including the table below with accompanying receipts/invoices, must be submitted to the City as outlined on this page. 1. Fill out Expenditure Report table below. Make additional copies if needed to explain all expenditures. A. If awarded $5,000. Submit the following Expenditure Report within 60 days after spending $5,000 no later than June 30, 2024, to demonstrate grant funds were spent in accordance with the Application. [If you were awarded less than $5,000, submit Expenditure Report for that amount.) B. If awarded grant funds exceeding $5,000. A) Follow #1.A above first. B) To receive grant funds exceeding $5,000 (between $5K-$50K), submit the following Expenditure Report to be reimbursed for the remaining balance of award to demonstrate funds were spent in accordance with the Application. This report can be submitted in $10,000 increments (but no less than $10,000 unless the remaining grant award funding amount is less than $1OK). This report must be submitted to the City no later than June 30, 2024 to receive remaining grant funds. 2. Attach copies of receipts/invoices (in the same order listed in table below). 3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590, Attn: City Manager's Dept. "CSF-Reinvestment in Temecula" EXPENDITURE REPORT DATED Organization: Fred Finch CARES, Inc. Name of Project/Program: Temecula BEST Program Equipment and Matertats TOTAL FY 2022-2023 Month & Year FIRST $6,000 check Amount of Grant Fund Awarded: $ was received from City: _ I. Is this Expenditure Report is to provide documentation for first $5,000 awarded and received? Yes__ or No (already submitted). 2. My organization has already received $ of the total FY 2022.23 Grant Fund awarded by the City 3. Is this Expenditure Report is submitted to request reimbursement of funds? No or Yes If yes, Amount of Request $ Number of beneficiaries living in 92590, 92591, 92692 that directly benefitted from this Program/Project (approximate number of beneficiaries if you do not have precise number) -Z-- --I- - Date on tm Name of Company Receiptllnvoice u E on Receipt or Invoice MUST BE ON OR BETWEEN A 2 March 20, 2020 - JUNE 30, a z 2024 2 Expenditure MUST SUPPORT PROJECT/PROGRAM IN APPLICATION & AWARD LETTER Amount I Description I EXPENDITURE TOTAL $ EXPENDITURE TOTAL Purpose City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 12 of 13 ACKNOWLEDGEMENT/SIGNATURE PAGE The applicant acknowledges and agrees to the following: • Recipient is subject to all Community Service Funding Program requirements including submittal deadlines and payment disbursements. • Every Community Service Funding application is considered individually and on its own merit. • Awards will be given to organizations and activities that directly benefit the residents of Temecula. —Funding-is-not immediately available_ to -the -recipient, and requires an -award letter signature upon -approval. -- Please allow time for checks to be processed. The awarding of Community Service Funding does not constitute an automatic annual allocation. • The recognition for Community Service Funding should accrue to the City of Temecula. Community Service Funding must be spent as specified on the Application and records may be requested by the City of Temecula to ensure the funds were used appropriately. • Community Service Funding grants will not be awarded or announced within the 60 days before an election in which an awarding Council Member is on the ballot. The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. • If awarded a Community Service Funding Grant by the City of Temecula last year, then compliance receipts must be submitted on or before this application's due date or this application may be rejected as incomplete. I/we hereby certify the information contained in this Application is true to the best of our knowledge and belief. ORGANIZATION NAME: Fred Finch CARES, Inc. 8787 Complex Drive, Suite 300 MAILING ADDRESS: _ PHONE: ( ) San Diego, CA 92123 EMAIL: PRESIDENT/ AUTHORIZED OFFICER: Julie Henderson, Director of Development SIGNATURE: DATE: 09/12/22 IF DIFFERENT THAN ABOVE, Alexander Grant Writer APPICATION PREPARED BY: SUBMIT ORIGINAL APPLICATION BY MONDAY, SEPTEMBER 12, 2022, TO: City of Temecula Community Service Funding Attn: City Manager's Office 41000 MAIN STREET TEMECULA, CA 92590 Questions: Stacey.Brown@TemeculaCA.gov (951) 694-6413 Betsy. Lowrey@TemeculaCA.gov (951) 693-3959 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 13 of 13 I��DCparhueut el'[he Trresury 1 IntFrnni Revrnue Srnlre P.O. Box 2508 In reply refer to: 0248364843 Cincinnati OH 65201 Dec. 05, 2017 LTR 4168C 0 B1-4243450 090000 00 00005054 BODC: TE FRED FINCH YOUTH CENTER CARTS INC TOM AL.EXANDER 3800 COOLIDGE AVE }` OAKLAND CA 94602 011299 Employer ID Number: 81-4243450 Form 990 required: Yes Dear Taxpayer: This is in response to your request dated Nov. 24, 2017, regarding Your tax-exempt status. We issued you a determination letter in August 2017, recognizing you as tax-exempt under Internal Revenue Code CIRC) Section 501(c) (3). Our records also indicate you're not a private foundation as defined under IRC Section 509(a) because you're described in IRC Sections 509(a)(1) and 170(b)(1)(A)(vi). Donors can deduct contributions they make to you as provided in IRC Section 170. You're also qualified to receive tax deductible bequests, legacies, devises, transfers, or gifts under IRC Sections 2055, 2106, and 2522. In the heading of this letter, we indicated whether you must file an annual information return. If a return is required, you must file Form 990, 990-EZ, 990-N, or 990-PF by the 15th day of the fifth month after the end of your annual accounting period. IRC Section 6033(j) provides that, if you don't file a required annual information return or notice for three consecutive years, your exempt status will be automatically revoked on the filing due date of the third required return or notice. For tax forms, instructions, and publications, visit www.irs.gov or call 1-800-TAX-FORM (1-800-829-3676). If you have questions, call 1-877-829-5500 between 8 a.m. and 5 p.m., local time, Monday through Friday (Alaska and Hawaii follow Pacific Time). FRED FINCH YOUTH CENTER CARES INC X TOM ALEXANDER 3800 COOLIDGE AVE OAKLAND CA 94602 0248364843 Dec. 05, 2017 LTR 4168C 0 81-4243450 000000 00 0000505S Sincerely yours, Kim A. Billups, Operations Manager Accounts Management Operations 1 STATE OF CALIFORNIA p FRANCHISE TAX BOARD F T W PO BOX 942857 SACRAMENTO CA 94257-0540 Entity Status Letter Date: 9/12/2022 ESL ID: 6921971578 Why You Received This Letter According to our records, the following entity information is true and accurate as of the date of this letter Entity ID: 3956277 Entity Name: FRED FINCH YOUTH CENTER CARES, INC. ❑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. ❑X 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. ❑ 5. The entity was administratively dissolved/cancelled on through the Franchise Tax Board Administrative Dissolution process. Important Information This information does not necessarily reflect the entity's current legal or administrative status with any other agency of the state of California or other governmental agency or body. If the entity's powers, rights, and privileges were suspended or forfeited at any time in the past, or if the entity did business in California at a time when it was not qualified or not registered to do business in California, this information does not reflect the status or voidability of contracts made by the entity in California during the period the entity was suspended or forfeited (R&TC Sections 23304.1, 23304.5, 23305a, 23305.1). The entity certificate of revivor may have a time limitation or may limit the functions the revived entity can perform, or both (R&TC Section 23305b). Connect With Us Web: ftb.ca.gov Phone: 800-852-5711 from 7 a.m. to 5 p.m. weekdays, except state holidays 916-845-6500 from outside the United States California Relay Service: 711 or 800-735-2929 (For persons with hearing or speech impairments) FTB 4263A WEB (REV 12-2019) PUBLIC DISCLOSURE COPY PLEASE FILE IN A SAFE PLACE ARMAN I NO "P 12657 Alcosta Blvd., Suite 500 San Ramon, CA 94583 ph 925.790.2600 fx 925.790.2601 ** PUBLIC DISCLOSURE COPY ** Return of Organization Exempt From Income Tax D'°I` NU,150-W`r Farm 990 Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) (Rev. January 2020) Oepar[ment of the Treasury Do not enter social security numbers on this form as it may made public. Open to Public 2019 Inl,rnal geyenun Wr Lo Go to www,.irs.gov/Form99O for Instructions and the latest Information. Inspection A For the 2019 calendar year, or tax ar beginning JUL 1, 2019 and endinn JUN 30, 2020 B CN,.klt C Name of organization .ppflr bta =Atld%W1104 FRED FINCH YOUTH CENTER CARES INC. n Of4amn dwloe Doing business as Number and street (or P.O. box if mail Is not delivered to street address) 3800 COOLIDGE AVENUE tarmm- .tad City or town, state or province, country, and ZIP or foreign postal code =olwn1tle� tOAKLAND, CA 94602 ph Di F Name and address of principal officer: ED HSU prardfnn SAME AS C ABOVE Tax exam t status. S 501 c 3 501 c insert rm. 4947 i J Website: HTTPS://WWW.FREDFINCH.ORG/CARES/ K Farm of arpanizalion; .0 Corporation 0 Trust n Association F-1 Other D Employer identification number 81-4243450 Room/suite E Telephone number 510-462-2244 G 0ormm"opl-s 2,891.868, H(a) Is this a group return for subordinates? „ ,-. [Yes Q No H(b) Are all subardlneles included? [� Yes El No lr 521 If "No," attach a list. (see instructions) 2016 CA 1 Briefly describe the organization's mission Or most significant activities: FRED FINCH YOUTH CENTER CARES INC. ("CARES") WAS FORMED IN NOVEMBER 2016 (CONTINUED ON SCHEDULE O) 2 Check this box if the organization discontinued its operations or disposed of more than 25% of its net assets. 0 3 Number of voting members of the governing body (Part VI, line 1 a) 3 4 0 4 Number of independent voting members of the governing body (Part VI, line 1 b) 4 3 Od d 5 Total number of individuals employed in calendar year 2019 (Part V, line 2a) 5 132 M1 6 Total number of volunteers (estimate if necessary) 8 3 Q7 a Total unrelated business revenue from Part VIII, column (C), line 12 7a 0. b Net unrelated business taxable income from Form 9907line 39 7b 0. Prior Year Current Year 1.140.649. 1, 386 832. ry 8 Contributions and grants (Part VIII, line 1h) c 9 Program service revenue (Part VIII, line 2g) 959, 817. 1,505,036. 10 Investment income (Part VIII, column (A), lines 3, 4, and 7d) , , _ 0. 0. 11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 633. G. 12 Total revenue - add lines 8 through 11 must equal Part VIII, column A fine 17 2,101.099, 2 891 868. 13 Grants and similar amounts paid (Part IX, column (A), lines 1.3) 0. 0. 14 Benefits paid to or for members (Part IX, column (A), line 4) 0. 0. 1,660,619. 2. 412 , 929. w? er 15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-10) _ - 0. 0. 16a Professional fundraising fees (Part IX, column (A), line 11 e) -, - _ _ b Total fundraisingexpenses p (Part IX, column (D), line 25) lop, 0. 739 327. 983, 296. 17 Other expenses (Part IX, column (A), lines 11a-11d, 11f-24e) , 2,394,946. 3.396, 225. 18 Total expenses. Add lines 13.17 (must equal Part IX, column (A), line 25) -293 , 847. -504 357. 19 Revenue less expenses. Subtract fine 18 from line 12 MC Bapinifinn of Caffeat Year End of Your 1 , 112 4D 2. 801 849. 20 TOtaI assets (Part X, line 16) 21 Total liabilities (Part X, line 26} 21972,233. 3,166,037. 2- 22 Net assets or fund balances. Sublract line 21 from line 20 .............. ........ . ....... -1, 859, 831. -2. 364, 188. r-Wr. n I Vrar,GLu,G UlVVd Under penalties of perjury, I declare that I have examined this return, including accompanying schedulds and statements, and to the best of my knowledge and belief, it is if correct, and complete. Declaration of preparer Jolliet man officer) is based on all information of which orDvafer has any knowledgu. Sign I Signaturc of officer Date Here I ED HSU. CFO Type or print name and title Print/Type preparer's name Preparer's signature Date Chif e6 0 PTIN Paid IATTHEW PETROSKI TTHEW PETROSKI lo5113/21 sell-emplo eA �00853132 Preparer Firm'sname ill, ARMANINO LLP Flrm'SElN 94-6214841 Use Only Firm's address 12657 ALCOSTA BLVD, STE. 500 SAN RAMON, CA 94583-4600 Pitone no,925-790-2600 May the IRS discuss this return with the preparer shown above? tqeq instructions R Yas No 932001 01-20-20 LHA For Paperwork Reduction Act Notice, see the separate instructions. Form 990 (2019) SEE SCHEDULE 0 FOR ORGANIZATION MISSION STATEMENT CONTINUATION FY 2022/2023 COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA GRANT APPLICATION # GOOD SAMARITAN FOOD PANTRY CI'I`Y OF'IWIVI ECULA FISCAL YEAR 2022.2023 COMMUNITY SERVICE FUNDING - REINVESTMENT IN TEMECULA PROGRAM APPLICATION (Please Print or Type) DUE ON OR BEFORE: MONDAY, SEPTEMBER 12, 2022 PROJECT/PROGRAM INFORMATION Amount Requested: $ 50,000 MAXIMUM ALLOWABLE: $50,000 PER ORGANIZATION Project/Program Title: Temecula Hunger Relief Program Start Date: 8/1/22 End Date: 8/1/23 Physical Address of Project/Program: INCLUDE IF DIFFERENT THAN ORGANIZATION'S MAILING ADDRESS If Grant is Awarded, Make Check Payable to: Good Samaritan Community Food Pantry Mailing Address: 32127 Camino Rabago, Temecula CA 92592 ORGANIZATION AND GEOGRAPHIC AREA SERVED Name of Applicant Organization: Good Samaritan Community Food Pantry Year Founded: 2019 Website: https://goodsamaritancommunity.oM Social Media: https://www.facebook.com/Good- Samaritan-Community-Food-Pantry-111174284381679 Number of Paid Staff: 0 Number of Volunteers: 12 Geographic Area(s) the Or action Serves: Temecula Residents Geographic Area(s) the Proiect/Program Serves: Exclusively used for Temecula residents NOTE: COMMUNITY SERVICE FUNDING GRANT PROGRAM FUNDING MUST BE EXCLUSIVELY USED TO SERVE TEMECULA. Contact Name: Teri Sue Parker Title/Position: Founder Contact Person's Direct Telephone: 951-415-5731,_Contact Person's Email: terisuecate@hotmail.com_ NONPROFIT STATUS Is this organization incorporated as a nonprofit? Yes X Date of Incorporation as a Nonprofit: 8/5/2020_ No ❑ IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING Federal Identification Number: 85-3139441 State Identification Number: 4636074 PRINT OUT AND ATTACH TO THIS APPLICATION VERIFICATION FROM FEDERAL (IRS) AND STATE (FTB) AS FOLLOWS: 1. ❑ Attach IRS Deductibility Status using this link: htt ://a s.irs. ov/a /eos/ 2. ❑ Attach State Entity Status Letter using this link: htti2s://www.ftb.ca.gov/online/self serve entity status letter/index.asp 3. ❑ Attach first page only of most recent IRS Form 990 or attach print out of detailed info about your charity found on this State Registry's Search Tool: httt)://rct.doj.ca.gov/VerificationiWeb/Search.aspx?facility_=Y City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 5 of 13 APPLICATION AUTHORIZATION Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over $500 including any business transactions, negotiations, investments, or interests in real property with a Temecula City Council Member during the past 12 months? No IK] Yes []IF YES, BRIEFLY DESCRIBE: Is a Temecula City Council Member a member of the Board of Directors or an Officer of the organization? Nog] Yes ❑ IF YES, PROVIDE COUNCIL MEMBER'S NAME AND TITLE WITHIN THE ORGANIZATION_ This Application has been authorized by the organization's: Executive Committee ❑ Board of Directors Members -at -Large ❑ MISSION STATEMENT OF ORGANIZATION BRIEFLY DESCRIBE THE ORGANIZATION'S MISSION/GOALS AND OBJECTIVES. Our goal here at Good Samaritan is to provide and deliver healthy, fresh, food and essentials for Temecula residents, their families, and pets in a safe and courteous way. Our goal is to lift up as many residents as possible who are in need and help them get back on their feet by taking some of the pressure of food insecurity. Delivering food and essentials they need gives them hope, strength, nourishment, and essential items for themselves, their families and their pets. For the elderly and disabled we want to give them peace of mind they will not have to choose between food or medications or keeping their pets, and other essential living expenses they have. We focus on Isolated seniors, veterans, cancer patients, disabled, foster families, and families at risk. Providing fresh and healthy nourishment can and will help these residents get back on their feet quicker and feel supported by their community. FINANCIAL STATEMENTS UPON REQUEST, COPIES OF THE ORGANIZATION'S CURRENT BUDGET/FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT), AND IF AVAILABLE CPA'S AUDIT, MAY BE NEEDED UPON REQUEST TO DEMONSTRATE SOUND FINANCIAL MANAGEMENT. DO NOT SUBMIT NOW, City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 6 of 13 FUNDING SOURCES CITY OF TEMECULA—SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM THE CITY FOR ANY PROGRAM? No ® Yes ❑ IF YES, PROVIDE BELOW. NAME OF PROGRAM/PROJECT AMOUNT MONTH +YEAR NAME OF CITY GRANT FUNDED BY THE CITY GRANT OR SPONSORSHIP FUNDING RECEIVED OR SPONSORSHIP $ 1 f OTHER OUTSIDE SOURCES —SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM ENTITIES (NOT INCLUDING THE CITY) FOR THE SAME PROJECTIPROGRAM IN THIS APPLICATION? NO ❑ Yes g] IF YES, PROVIDE INFORMATION IN TABLE BELOW. AMOUNT MONTH + YEAR NAME OF ENITY RECEIVED FUNDING RECEIVED $ 1 ,000 Morongo Casino 3/2020 $ Chick-fil-A — They are awarding grants if we get one 12/2022 $ City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 7 of 13 GRANT PROJECT/PROGRAM DESCRIPTION ' IMPORTANT- RECEIPTS/INVOICES IS REQUIRED TO BE SUBMITTED TO THE CITY TO VALIDATE THE ORGANIZATION SPENT GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE PROJECT/PROGRAM AS DESCRIBED HERE 1 DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT. This grant would support our Hunger Relief Program for Temecula. Temecula residents who are experiencing food insecurity. 2 DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED. ALSO, INCLUDE A LIST OF GOODS, EQUIPMEMENT, AND/OR SERVICES THIS ORGANIZATION HAS PURCHASED OR PLANS TO PURCHASE WITH AWARDED FUNDS TO SUPPORT THIS PROGRAM/PROJECT. Healthy food to prepare breakfast, lunch, dinner, pet food, essential items and household goods, paper products and cleaning supplies for their homes. This grant would allow us to purchase food that we currently do not get enough of from the community. It is important that the weekly food bags have all of the essential items from all the major food groups and not just canned goods. We deliver meat, grains, dairy, fresh fruits, vegetables and per food that allows them to prepare their meals for their family and pets. 3 TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS. Good Samaritan Community Food Pantry is a local grassroots food pantry. We drop off exclusively to Temecula residents in need directly to their doorstep weekly and biweekly. This allows Temecula residents to stay in their homes. and keep their pets with them. We have found that many of the residents do not have reliable transportation, so delivering food and essentials directly to them has taken some of the burden from their shoulders. 3b ESTIMATED NUMBER OF PEOPLE FROM TEMECULA EXPECTED TO BENEFIT 1000 FROM THIS PROJECT/PROGRAM: [3_c ESTIMATED NUMBER OF VOLUNTEERS INVOLVED IN THIS PROJECT/PROGRAM: 15+ City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 8 of 13 PROJECT/PROGRAM DESCRIPTION CONTINULI) The funding from this grant will replenish the essential healthy food and essential items for the residents here in Temecula and their pets by providing Good Samaritan the resources to purchase the food locally and other essential items the homes need. By focusing on specific areas in Temecula we can provide residents with special dietary needs and restrictions for some, food prices have doubled and the food we drop off weekly or Bi-weekly has to be replenished and replaced. i 5 IF APPLYING FOR MORE THAN $5,000, PLEASE EXPLAIN HOW THE COVID-19 PANDEMIC AFFECTED THIS NONPROFIT ORGANIZATION'S ABILITY TO SERVE THE TEMECULA COMMUNITY. YOU MAY ALSO INCLUDE INFLATIONARY CONCERNS. We depended 100% on donations of food and essentials from the residents locally, at the beginning we were able to keep adding residents in need due to the amount of food and essentials and pet food that was being dropped off to us. But now with food prices doubling and gas prices so high the donations of food and essentials and pet food has come to almost a complete halt. Inflation has devastated so many homes as well as food pantries since many people can only feed themselves and their families and can no longer afford to donate. We also deliver 99% of the food directly to the needy, so the gas prices for volunteers has become a big challenge for our drivers. We were serving residents that could not leave their home, shut ins and residents with high risk factors we had to deliver safely and many have diet restrictions and health issues. The number of residents in need now is staggering. We serve so many with health issues that going out and buying healthy food to help keep them healthy is a luxury, some that we serve had not had fresh produce for months and some were afraid of who handled their food as to not get infected with the virus. Our number of shut-in's has increased and our number of family's has tripled over the last year as the cost of food has made it very hard to keep the fridges and freezers and shelves stocked. 6 IF APPLYING FOR MORE THAN $5,000, EXPLAIN HOW FUNDS HAVE OR WILL: (1) CREATE NEW PROJECT/PROGRAM, (2) EXPAND EXISTING PROJECT/PROGRAM, AND/OR (3) CONTINUE EXISTING PROJECT/PROGRAM. The funds from this grant would allow us to create new ways to add more residents in need and families with special needs. This grant would allow Good Samaritan to continue what we are doing daily - filling the food bags full of healthy foods, essentials, and pet food. We can continue "Adopt A Family" "Adopt A Senior" programs during the Holiday's which has brought so much joy to those who need it. We can continue to provide fresh, healthy, safe food so those in need so they can prepare good meals for breakfast, lunch, and dinner. It will also help us to keep providing paper goods and cleaning supplies, so they can keep germs from spreading and their homes safe and clean. We will be able to continue providing those with special dietary needs. It allows us to keep bringing pet foods and supplies, so they don't have to surrender their beloved pets to a shelter because they can no longer feed them. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 9 of 13 PROJECT/PROGRAM BUDGET (do not fill in shaded areas) LINE ITEMS FOR PROJECT/PROGRAM REVENUES LIST REVENUES/INCOME FOR PROJECT/PROGRAM Amount of money requested from this City of Temecula $50,000 Community Services Grant (Not to exceed $50,000) EXPENSES Amount contributed to the Project/Program by the $1500 Applicant Organization - Estimated donations through out donate button on website for project Other grants or funding already awarded for Project/Program, if any $0 In -Kind match amount or volunteer credit hours estimated amount $85,000 as **OUR IN -KIND donations come in as dropped off food and supplies by donated food the community which has decreased substantially. Guesstimate for 2022 or essentials NOT CASH TOTAL REVENUE $51,500 LIST OF EXPENSES FOR PROJECT/PROGRAM Tools/Equipment $ Facilities/Rent/Insurance — Electric/Gas $6500.00 Supplies — Baggies/Wrapping/Bags/Flyers/Boxes $2500.00 Marketing $ Services $ Food and Essentials $41,000 Other $ Staffing Expense THIS IS INELIGIBLE TO BE FUNDED BY CITY'S GRANT, $0 HOWEVER PLEASE INCLUDE. TOTAL EXPENSES $ TOTAL BUDGET $50,000 $50,000 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 10 of 13 PREVIOUS* FISCAL YEAR (FY) 2021-2022 COMPLIANCE REPORT IF YOUR ORGANIZATION WAS NOT AWARDED A COMMUNITY SERVICE FUNDING GRANT IN FY 21/22 (LAST YEAR), THEN SKIP THIS PAGE. If your organization was awarded a Community Service Funding Grant in FY 2021-2022 (last year) by the City of Temecula, please submit this information. If your organization was awarded a Community Service Funding Grant in Fiscal Year 2021-2022 by the City of Temecula, all grant funds received must have been expended anytime on or between July 1, 2021, and June 30, 2022. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any future funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent. If the funds were not spent in accordance with the approved/awarded application, the organization will be required to return the amount of funds to the City. To substantiate that Fiscal Year 2021-2022 funds received from the City were spent appropriately, proper back-up documentation including the completed table below with accompanying receipts/invoices, must be submitted to the City on or before due date: September 12, 2022. 1. Fill out table below (make additional copies if needed to explain all expenditures.) 2. Attach copies of receipts/invoices (in the same order as listed in this table.) 3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590 Attn: City Manager's Office — CSF EXPENDITURE REPORT due on or before September 12, 2022 Organization: FY 2021-2022 Amount of $ CSF Grant Fund Awarded: Name of Project/Program: Month & Year CSF Grant Received from City: Number of Beneficiaries Living in 92590, 92591, 92592 that Directly Benefitted from this Program/Project (approximate number of beneficiaries if you do not have precise number): 4 Name of Company RecDate on eipt/Invoice on Receipt or Invoice MUST BE ON OR BETWEEN Amount JULY 1, 2021 - JUNE 30, 202-2 Z Q 2 3 4 5 6 EXPENDITURE TOTAL Expenditure_ Description Purpose DESCRIBE THE EXPENDITURE PURPOSE OF EXPENDITURE EXPENDITURE TOTAL MUST BE EQUAL TO (OR GREATER) THAN TOTAL AWARD AMOUNT. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 11 of 13 ACKNOWLEDGEMENT/SIGNATURE PAGE _ 1 The applicant acknowledges and agrees to the following: Recipient is subject to all Community Service Funding Program requirements including submittal deadlines and payment disbursements. Every Community Service Funding application is considered individually and on its own merit. • Awards will be given to organizations and activities that directly benefit the residents of Temecula. Funding is not immediately available to the recipient, and requires an award letter signature upon approval. Please allow_time_ for checks - to -be -processed.-. The awarding of Community Service Funding does not constitute an automatic annual allocation. The recognition for Community Service Funding should accrue to the City of Temecula. • Community Service Funding must be spent as specified on the Application and records may be requested by the City of Temecula to ensure the funds were used appropriately. • Community Service Funding grants will not be awarded or announced within the 60 days before an election in which an awarding Council Member is on the ballot. ■ The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. ® If awarded a Community Service Funding Grant by the City of Temecula last year, then compliance receipts must be submitted on or before this application's due date or this application may be rejected as incomplete. I/we hereby certify the information contained in this Application is true to the best of our knowledge and belief. ORGANIZATION NAME: Good Samaritan Community Food Pantry MAILING ADDRESS: 21227 Camino Rabago Temecula CA 92592 PHONE: 951-415-5731 EMAIL: terisuecate@hotmail.com PRESIDENT / AUTHOOFF R. Teri S e Parker Founder SIGNATURE: _ : =f ;� L OLI` l r�� Q DATE: All IF DIFFERENTTHAN ABOVE, APPICATION PREPARED BY: ` G� I Jul C3r1� SUBMIT ORIGINAL APPLICATION BY MONDAY, SEPTEMBER 12, 2022, TO: City of Temecula Community Service Funding Attn: City Manager's Office 41000 MAIN STREET TEMECULA, CA 92590 Questions: Stacey.Brown@TemeculaCA.gov (951) 694-6413 Betsy. Lowrey@TemeculaCA.gov (951) 693-3959 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 13 of 13 104 STATE OF CALIFORNIA FRANCHISE TAX BOARD PO BOX 94285757 SACRAMENTO CA 94257-0540 Entity Status Letter Date: 8/7/2022 ESL ID:7074774595 Why You Received This Letter According to our records, the following entity information is true and accurate as of the date of this letter Entity ID: 4636074 Entity Name: GOOD SAMARITAN COMMUNITY FOOD PANTRY INC ❑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, 3. The entity is currently exempt from tax under Revenue and Taxation Code (R&TC) Section 23701 . 4, We do not have current information about the entity, 5. The entity was administratively dissolved/cancelled on through the Franchise Tax Board Administrative Dissolution process. Important Information • This information does not necessarily reflect the entity's current legal or administrative status with any other agency of the state of California or other governmental agency or body. • If the entity's powers, rights, and privileges were suspended or forfeited at any time in the past, or if the entity did business in California at a time when it was not qualified or not registered to do business in California, this information does not reflect the status or voidability of contracts made by the entity in California during the period the entity was suspended or forfeited (R&TC Sections 23304.1, 23304,5, 23305a, 23305.1). • The entity certificate of revivor may have a time limitation or may limit the functions the revived entity can perform, or both (R&TC Section 23305b). Connect With Us Web: ftb.ca.gov Phone: 800-852-5711 from 7 a.m. to 5 p.m. weekdays, except state holidays 916-845-6500 from outside the United States California Relay Service: 711 or 800-735-2929 (For persons with hearing or speech impairments) FTB 4263A WEB (REV 12-2019) FY 2022/2023 COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA GRANT APPLICATION # 19 GREEN ACRES INTERACTIVE THERAPY INC. CITY OF TEMECUI[A FISCAL YEAR 2022 - 2023 COMMUNITY SERVICE FUNDING - REINVESTMENT IN TEMECULA PROGRAM APPLICATION (Please Print or Type) DUE ON OR BEFORE: MONDAY, SEPTEMBER 12, 2022 I PROJECT/PROGRAM INFORMATION Amount Requested: $ 50,000 Project/Program Title: Walk, Ride, Run for Gait MAXIMUM ALLOWABLE: $50,000 PER ORGANIZATION Start Date: 5/1/23 End Date: 6/30/23 Physical Address of ProjectlProgram: 35750 De Portola Road Temecula. Ca. 92592 INCLUDE IF DIFFERENT THAN ORGANIZATION'S MAILING ADDRESS If Grant is Awarded, Make check Payable to: Green Acres Interactive Therapy Mailing Address: 35750 De Portola Road Temecula. CA 92592 ORGANIZATION AND GEOGRAPHIC AREA SERVED Name of Applicant Green Acres Interactive Organization: Therapy Website: Gaitprogram.org Number of Paid Staff., 9 Year Founded: 2014 Social Media: FT, Twitter Number of Volunteers: 20 Geographic Area(s) the Organization Serves: Temeucla Geographic Area(s) the Project/Program Serves: Temecula NOTE: COMMUNITY SERVICE FUNDING GRANT PROGRAM FUNDING MUST BE EXCLUSIVELY USED TO SERVE TEMECULA. Contact Name: Margaret Rich Title/Position: Founder Contact Person's Direct Telephone: 909-240-4500 Contact Person's Email: info@gairprogram.org NONPROFIT STATUS Is this organization incorporated as a nonprofit? Yes Date of Incorporation as a Nonprofit: 2014 No ❑ IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING Federal Identification Number: 46-4355227 State Identification Number: 3547698 PRINT OUT AND ATTACH TO THIS APPLICATION VERIFICATION FROM FEDERAL (IRS) AND STATE (FTB) AS FOLLOWS: 1. ❑ Attach IRS Deductibility Status using this link: http://aRps.irs.gov/aop/east 2. ❑ Attach State Entity Status Letter using this link: Mps://www.ftb.ca.gov/online/self serve entity status lefterlindexasip 3. ❑ Attach first page only of most recent IRS Form 990 or attach print out of detailed info about your charity found on this State Registry's Search Tool: http:lfrct.do}.ca.cLovlVerification/Web/Search.aspx?faci€ily=Y City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 5 of 13 APPLICATION AUTHORIZATION Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over $500 including any business transactions, negotiations, investments, or interests in real property with a Temecula City Council Member during the past 12 months? No [AJ Yes ❑ IF YES, BRIEFLY DESCRIBE: Is a Temecula City Council Member a member of the Board of Directors or an Officer of the organization? No 41 Yes ❑ IF YES, PROVIDE COUNCIL MEMBER'S NAME AND TITLE WITHIN THE ORGANIZATION: This Application has been authorized by the organization's: Executive Committee ❑ Board of Directors 0 Members -at -Large ❑ MISSION STATEMENT OF ORGANIZATION BRIEFLY DESCRIBE THE ORGANIZATION'S MISSION/GOALS AND OBJECTIVES. To enrich lives by providing physical and emotional therapy through horse interaction. FINANCIAL STATEMENTS UPON REQUEST, COPIES OF THE ORGANIZATION'S CURRENT BUDGET/FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT), AND IF AVAILABLE CPA'S AUDIT, MAY BE NEEDED UPON REQUEST TO DEMONSTRATE SOUND FINANCIAL MANAGEMENT. DO NOT SUBMIT NOW. 1 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 6 of 13 FUNDING SOURCES CITY OF TEMECULA—SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM THE CITY FOR ANY PROGRAM? No ❑ Yes ❑ IF YES, PROVIDE BELOW. NAME OF PROGRAM/PROJECT MONTH + YEAR NAME OF CITY GRANT AMOUNT -FUNDED_BY-THE-CITY-GRANT-OR-SPONSORSHIP-- -FUNDING-RECEIVED— OR3PONSORSHIP-- E i $ OTHER OUTSIDE SOURCES —SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM ENTITIES (NOT INCLUDING THE CITY) FOR THE SAME PROJECTIPROGRAM IN THIS APPLICATION? No ❑ Yes ❑ IF YES, PROVIDE INFORMATION IN TABLE BELOW. AMOUNT MONTH + YEAR RECEIVED NAME OF ENITY FUNDING RECEIVED $ $5,000 Staples 8/22 $ City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 7 of 13 GRANT PROJECT/PROGRAM DESCRIPTION IMPORTANT- RECEIPTS/INVOICES IS REQUIRED TO BE SUBMITTED TO THE CITY TO VALIDATE THE ORGANIZATION SPENT GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE PROJECT/PROGRAM AS DESCRIBED HERE 1 DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT. To celebrate the growth of Gait and to keep t6he therapeutic riding accessible to the community of Temecula. We invite the community to join us for Walk, Ride, Run for Gait, a fun reason to get outdoors and raise awareness. This was a virtual program because of Covid but now we would like it to be a City of Temecula event. 2 DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED. ALSO, INCLUDE A LIST OF GOODS, EQUIPMEMENT, AND/OR SERVICES THIS ORGANIZATION HAS PURCHASED OR PLANS TO PURCHASE WITH AWARDED FUNDS TO SUPPORT THIS PROGRAM/PROJECT Funds will be used to pay for the boarding, care and feeding of the horses inbolved in the program. Funds ill be used to provide safety equipment (helmets, Gloves and any other tack) as needed to keep participants safe. Funds will be used to clear the trail that will be used for the participants. Funs will be used to provide water, snacks and T-shirts for the participants. S 3 TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS. With the funding we can open up the ranch to the Temecula residents to get involved with the program that night not have the financial funds available to participate in the program. There isn't another facility in Temecula that handles special needs, PTSD for Veterans and other public servants, and helping families that are in need of group therapy because of adoption or group home facilities. 3b ESTIMATED NUMBER OF PEOPLE FROM TEMECULA EXPECTED TO BENEFIT FROM THIS PROJECT/PROGRAM: 3c ESTIMATED NUMBER OF VOLUNTEERS INVOLVED IN THIS PROJECT/PROGRAM: 50 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 8 of 13 PROJECT/PROGRAM DESCRIPTION CONTINUED 4 SUMMARY STATEMENT - SUMMARIZE ANSWERS 1 - 3 ABOVE IN 50 WORDS OR LESS. This- program -is -to -raise -awareness -for -the -City -of Temecula-about-itis-therapeutic- program and provide a facility to help families in need of therapy that is interactive with animals and be outdoors. 5 IF APPLYING FOR MORE THAN $5,000, PLEASE EXPLAIN HOW THE COVID-19 PANDEMIC AFFECTED THIS NONPROFIT ORGANIZATION'S ABILITY TO SERVE THE TEMECULA COMMUNITY. YOU MAY ALSO INCLUDE INFLATIONARY CONCERNS. During Covid we had to shut down our facility and lay off employees and we could not secure volunteers even when we opened up the doors. We have to use extensive funds to make the environment safe by purchasing products to clean helmets and reins and tack. We have also had to deal with the rising costs of fuel, horse feed and vet care and food and have not raised our prices as to keep it affordable for the community. 6 IF APPLYING FOR MORE THAN $5,000, EXPLAIN HOW FUNDS HAVE OR WILL: (1) CREATE NEW PROJECT/PROGRAM, (2) EXPAND EXISTING PROJECT/PROGRAM, AND/OR (3) CONTINUE EXISTING PROJECT/PROGRAM. The additional funds will help expand out program from virtual to a physical event that the city of Temecula can participate in. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 9 of 13 PROJECT/PROGRAM BUDGET (do not fill In shaded areas) LINE ITEMS FOR PROJECT/PROGRAM REVENUES I EXPENSES LIST REVENUES/INCOME FOR PROJECT/PROGRAM Amount of money -requested -from -this -City of Temecula— - -$ 50,000 Community Services Grant (Not to exceed $50,000) Amount contributed to the Project/Program by the Applicant $ Organization Other grants or funding already awarded for Project/Program, if any $ 5,000 In -Kind match amount or volunteer credit hours estimated amount $ TOTAL REVENUE $ 55,000 LIST OF EXPENSES FOR PROJECT/PROGRAM Tools/Equipment Facilities/Rent/Insurance Supplies Marketing Services Food Other Staffing Expense THIS IS INELIGIBLE TO BE FUNDED BY CITY'S GRANT; HOWEVER PLEASE INCLUDE. $10,000 f $15,000 $ 5,000 $ 2, 500 $4.200 S $10,000 TOTAL EXPENSES $ 511700. TOTAL BUDGET $ 1$50,000 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 10 of 13 PREVIOUS* FISCAL YEAR (FY) 2021-2022 COMPLIANCE REPORT IF YOUR ORGANIZATION WAS NOT AWARDED A COMMUNITY SERVICE FUNDING GRANT IN FY 21122 (LAST YEAR), THEN SKIP THIS PAGE. If your organization was awarded a Community Service Funding Grant in FY 2021-2022 (last year) by the City of Temecula, please submit this information. If your organization was awarded a Community Service Funding Grant in Fiscal Year 2021-2022 by the City of Temecula, all grant funds received must have been expended anytime on or between July 1, 2021, and June 30, 2022. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any future funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent. If the funds were not spent in accordance with the approved/awarded application, the organization will be required to return the amount of funds to the City. To substantiate that Fiscal Year 2021-2022 funds received from the City were spent appropriately, proper back-up documentation including the completed table below with accompanying receipts/invoices, must be submitted to the City on or before due date: September 12, 2022. 1. Fill out table below (make additional copies if needed to explain all expenditures.) 2. Attach copies of receipts/invoices (in the same order as listed in this table.) 3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590 Attn: City Manager's Office — CSF EXPENDITURE REPORT due on or before September 12, 2022 Organization: Green Acres Interactive Name of Project/Program: Walk, Ride, Run for Gait Therapy FY 2021-2022 Amount of $ CSF Grant Fund Awarded: Month & Year CSF Grant Received from City: Number of Beneficiaries Living in 92590, 92591, 92592 that Directly Benefitted from this Program/Project (approximate number of beneficiaries if you do not have precise number): El Name of Company Eon Receipt or Invoice aZ Date on Receipt/Invoice MUST BE ON OR BETWEEN Amount JULY 1, 2021 - JUNE 30, 2022 Expenditure I Description Purpose DESCRIBE THE EXPENDITURE I PURPOSE OF EXPENDITURE txF'tNUI 1 UKt I U I AL P (OR GREATER) THAN TOTAL AWARD AMOUNT City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 11 of 13 FISCAL YEAR (FY) 2022-2023 COMPLIANCE REPORT If your organization is awarded a Community Service Funding - REINVESTMENT IN TEMECULA Grant in FY2022-2023 by the City of Temecula, follow these instructions. If your organization is awarded a Community Service Funding Grant - REINVESTMENT IN TEMECULA in FY2022-2023 by the City of Temecula, all grant funds received must be expended anytime on or between March 20, 2020 and June 30, 2024. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any funding. City of Temecula reserves the right to conduct an audit andror require additional back-up information to substantiate how funds received from the City were spent. If the funds are not spent in accordance with the _approved/awarded_application,_the_organization_may_not receive -and/or will be -required -to -return -said - amount of funds to the City. To substantiate that grant funds from the City are spent appropriately, proper back-up documentation including the table below with accompanying receipts/invoices, must be submitted to the City as outlined on this page. 1. Fill out Expenditure Report table below. Make additional copies if needed to explain all expenditures. A. If awarded $5,000. Submit the following Expenditure Report within 60 days after spending $5,000 no later than June 30, 2024, to demonstrate grant funds were spent in accordance with the Application. (If you were awarded less than $5,000, submit Expenditure Report for that amount.) B. If awarded grant funds exceeding $5,000. A) Follow #1.A above first. B) To receive grant funds exceeding $5,000 (between $51<4501K), submit the following Expenditure Report to be reimbursed for the remaining balance of award to demonstrate funds were spent in accordance with the Application. This report can be submitted in $10,000 increments (but no less than $10,000 unless the remaining grant award funding amount is less than $10K). This report must be submitted to the City no later than June 30, 2024 to receive remaining grant funds. 2. Attach copies of receipts/invoices (in the same order listed in table below). 3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590, Attn: City Manager's Dept. "CSF-Reinvestment in Temecula" EXPENDITURE REPORT DATED_ Organization: Green Acres Interactive Name of Project/Program: Walk, Ride, Run for Gait Therapy TOTAL FY 2022-2023 Month & Year FIRST $5,000 check Amount of Grant Fund Awarded: $ was received from City: 1. Is this Expenditure Report is to provide documentation for first $5,000 awarded and received? Yes_ or No (already submitted). 2. My organization has already received $ of the total FY 2022-23 Grant Fund awarded by the City 3. Is this Expenditure Report is submitted to request reimbursement of funds? No or Yes If yes, Amount of Request $ Number of beneficiaries living in 92690, 92691, 92692 that directly benefitted from this Program/Project (approximate number of beneficiaries if you do not have precise number) Date on rm Name of Company Receiptlinvoice u E �on Receipt or Invoice MUST BE ON OR BETWEEN US March 20. 2020 - JUNE 30, a z 1 2024 2 Expenditure MUST SUPPORT PROJECT/PROGRAM IN APPLICATION & AWARD LETTER Amount J Description I Purpose EXPENDITURE TOTAL $ EXPENDITURE TOTAL City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 12 of 13 ACKNOWLEDGEMENT/SIGNATURE PAGE The applicant acknowledges and agrees to the following: ■ Recipient is subject to all Community Service Funding Program requirements including submittal deadlines and payment disbursements. • Every Community Service Funding application is considered individually and on its own merit. • Awards will be given to organizations and activities that directly benefit the residents of Temecula. -• Funding -is -not immediately -available -to the -recipient,, and requires -an -award letter signature -upon approval. - Please allow time for checks to be processed. • The awarding of Community Service Funding does not constitute an automatic annual allocation. • The recognition for Community Service Funding should accrue to the City of Temecula. • Community Service Funding must be spent as specified on the Application and records may be requested by the City of Temecula to ensure the funds were used appropriately. • Community Service Funding grants will not be awarded or announced within the 60 days before an election in which an awarding Council Member is on the ballot. • The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. • If awarded a Community Service Funding Grant by the City of Temecula last year, then compliance receipts must be submitted on or before this application's due date or this application may be rejected as incomplete. I/we hereby certify the information contained in this Application is true to the best of our knowledge and belief. ORGANIZATION NAME: Green Acres Interactive Therapy MAILING ADDRESS: 35750 De Portola Rd Temecula, CA 92592 PHONE: ( 90') 240-4500 EMAIL: info@gaitprogram.org PRESIDENT/AUTHORIZED OFFICER: Margaret Rich, Founder DR, INT NAIV; tiT[ r SIGNATURE: -btar aret Rich DATE: 9/12/2022 IF DIFFERENTTHAN ABOVE, APPICATION PREPARED BY: SUBMIT ORIGINAL APPLICATION BY MONDAY, SEPTEMBER 12, 2022, TO: City of Temecula Community Service Funding Attn: City Manager's Office 41000 MAIN STREET TEMECULA, CA 92590 Questions: Stacey. Brown@TemeculaCA.gov (951) 694-6413 Betsy. Lowrey@TemeculaCA.gov (951) 693-3959 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 13 of 13 GREEN ACRES INTERACTIVE THERAPY, INC. (3547698)- Request Certificate Initial Filing Date 02/01/2013 Status Active Standing - SOS Good Standing - FTB Good Standing - Agent Good Standing - VCFCF Good Formed In CALIFORNIA Entity Type Nonprofit Corporation - CA - Public Benefit Principal Address 35750 DE PORTOLA ROAD TEMECULA, CA 92592 Mailing Address 35750 DE PORTOLA ROAD TEMECULA, CA 92592 Statement of Info 02/28/2023 Due Date Agent Individual 2810395 MARGARET RICH 35750 DE PORTOLA RD TEMECULA, CA 92592 Entity Information Initial Status Entity Type Formed In Agent Filing Date GREEN ACRES Nonprofit INTERACTIVE Corporation - MARGARET THERAPY, INC, 02/O1/2013 Active CA - Public CALIFORNIA RICH (3547698) Benefit INTERNAL REVENUE SERVICE P. O. BOX 2508 CINCINNATI, OH 45201 Date : q U G 18 2014 GREEN ACRES INTERACTIVE THERAPY, INC> C/O SELINA STEELE PO BOX 890339 TEMECULA, CA 92589-0339 Dear Applicant: DEPARTMENT OF THE TREASURY Employer Identification Number: 46-4355227 DLN: 17053167363024 Contact Person: CUSTOMER SERVICE ID# 31954 Contact Telephone Number: (877) 829-5500 Accounting Period Ending: February' 28 Public Charity status: 170 (b) (1) (A) (vi) Form 990 Required: Yes Effective Date of Exemption: February 1, 2013 Contribution Deductibility: Yes Addendum Applies: No 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 0£ 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. For important information about your responsibilities as a tax-exempt organization, go to www.irs.gov/charities. Enter 914221-PC" in the search bar to view Publication 4221-PC, Compliance Guide for 501(c)(3) Public Charities, which describes your recordkeeping, reporting, and disclosure requirements. Letter 947 Short Form OMB No. 154e-0047 Form 990-EI Return of Organization Exempt From Income Tax 2020 Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) ► Do not enter social security numbers on this form, as it may be made public. puparnnont of the treasury M Internal nevonue Service 0-Go to www.irs.gov/Form990EZ for instructions and the latest information. A For the 2020 calendar year, or tax year beginning Ma r 2020, and ending Feb 22 2021 B check it applicable: C Name of Organization D Employer identification number ❑ Address change GREEN ACRES INTERACTIVE 'THERAPY INC 46-4355227 ❑ Name change Number and street (or P.O. box if mail is not delivered to street address) oom swte E Talophone number ❑ initialren,rn 35-750 DE PORTOLA 9513022384 Find roturn/terminated Amended return City or town, state or province, country, and ZIP or foreign postal code F Group Exemption Applicallan pending TEMECULA, CA 92592 Number ► G Accounting Method: 0 Cash ❑ Accrual' Other (specify) ► H Check ► ❑X if the organization is not Website: ► N/A required to attach Schedule B J TiLK-exempt status (check orgy one) -- ® 5olicje ❑Set a nsart no. ❑ 4947 1 or 11527 (Form 990, 990-EZ, or 990-PF). K Form of organization: © Corporation ❑ Trust Association ❑ Other L Add lines 5b, 5c, and 7b to line 9 to determine grass receipts, If gross receipts are $200,000 or more, or if total assets (Part II, column (B)) are $500,000 or more, file Form 990 instead of Form 990-EZ . . . . . . . . . . ► $ 13, , 1 r, . Revenue, Expenses, and Changes in Net Assets or Fund Balances (see the instructions for Part 1) Check if the gr anixation used Schedule O to respond to anyguestion in this Part ! . IJ 1 Contributions, gifts, grants, and similar amounts received . . . . . . . . . . . . . 1 !2 993 2 Program service revenue including government fees and contracts . . . , . . . , . 2 3 Membership dues and assessments . . . . . . . . . . . . . . . . , 3 4 Investment income . . . . . . . . . . . . . . . . . . . , , , 4 5a Gross amount from sale of assets other than inventory . , , . IJR-1-- b Less: cost or other basis and sales expenses . , , . . . . . 5b c Gain or (loss) from sale of assets other than inventory (subtract line 5b from line 5a) 5c 6 Gaming and fundraising events: a Gross income from gaming (attach Schedule G if greater than $15,000) . . . . . . . . . , . . c 6a b Gross income from fundralsing events (not including $ of contributions cc from fundraising events reported on line 1) (attach Schedule G if the sum of such gross income and contributlons exceeds $15,000) . 6b 1 845. c Less: direct expenses from gaming and fundraising events . . , ec 5 854 . d Net income or (loss) from gaming and fundraising events (add lines 6a and 6b and subtract line 6c) . . . . . . . . . . . . . . . . . . . . . . . . 6d —4, 009 7a Gross sales of inventory, less. returns and allowances 7a b Less: cost of goods sold . . . . . . . . . . . . . 70 c Gross profit or (loss) from sales of inventory (subtract line 7b from line 7a) . . . . 7c 8 Other revenue (describe in Schedule O) , . , . . . . . . . SP-E, Line 8 Stmt. . 8 1.8 _ 1 3 . 9 Total revenue. Add lines 1, 2, 3, 4, 5c, 6d'. 7c, and 8 . ► 9 12 8 312 . 10 Grants and similar amounts paid (fist in Schedule O) . . . . . . . . . . . . . . 10 11 Benefits paid to or for members; . . . . . . . . . . . . . . . . . . . 11 v 12 Salaries, other compensation, and employee benefits . . . . . . . . . . . . . . 12 f3 0 7 5 . c 13 Professional fees and other payments to Independent contractors . . . . . . . . . . 13 2 100. X14 Occupancy, rent, utilities, and maintenance 14 42 703. w 15 Printing, publications, postage, and shipping , . . . . . . . . . . 15 2,071 . 16 Other expenses (describe in Schedule O) . . . . . . . . . see. Line 16. stmt 16 60 849. 17 Total expenses. Add lines 10 through 16 . ► 17 1 195, 798.. rn 18 Excess or (deficit) for the year (subtract line 17 from line 9) . . . . . . . . . . . . 18 —6, 7, 186. 19 Net assets or fund balances at beginning of year (from line 27, column (A)) (must agree with 4 end -of -year figure reported on prior year's return) . . . . . . . . . . . . . . I19 6 f, 06 5. Z20 Other changes in net assets or fund balances (explain in Schedule 0) . . . . . . . . . 20 21 Net assets or fund balances at end of year. Combine lines 18 through 20 . 1'-21 579 . For Paperwork Reduction Act Notice, see the separate instructions. BAA REV 09/08/21 PRO Form 990-EZ (2020) r • r. 1 a - „ _ ::,;; . it • „ �: ' y- , `r ' ;�, • ;•� , tip•; ts'r''vFt.: In o b o > LID to p >. 0 ° U H a O 4p W u G. Fx Cd w w op m r Qr Fx M. �+ v U a+ tl O ►- W 0 O � a+ '� a Z M O F u 0 ?_ W y b 3 ¢� ul y w [ IL LV 1 � N a a, a v Q 2 p LL u 'd . z 3 n, Vf V) ° w Z O v o ea ajo Z , V) in a � o a ° °- a. y 3 O y ° g _ ebo b a z 3 J °' r o � o, a 0 oo a O O " IL 0 + O o 0 i •� v to aa� H v .5 F- Im W IL 0 LO F- u7 O U 0. z 0 CA �p Cd b 4 bb ,, a v v 3 v aIA 4j 4 L o b°D bA y b y LL1 oo lzLL a IA ❑ �,., ti � �', � .� � v .moo k N 0 M 2 ƒ 7 � \ tg k § § k � § 3 t «,. •�_ // tj\'a \\)ƒ\ }\ �Z) &22) § �o . $lu _ �kE ¥\(2 ° �9 - � _ m 7 _ _ o rz ; ( ) LUa / $'2 ƒ } 2 \ \ /} §) � k\ kƒ g& 3 UA O 0 F- w Y U H m _Z X ,F- V O LL W 0 Y J Q 3 a F- 0 a 0 a F- a O a O LL Z 0 J a l7 0 a 0 w EL 1- a cD a 0 LL Z Ln rn a x Rancho California Arabian Horse Association Presents at 61V.111 A['>'iIA RAH111 35750 De Portola Road in Temecula 11 10rses 101 Apru -v_ _- PDA TRIO 16 A FREE EVENT THAT IS OPEN TO THE PUBLIC Parking$5 clonjat.ionn* per car inch-mles I FREE � a fle ticke—t, *donation to benefit r,A1T Thnr,-4nn!rtl^ Rir4iri(s PI-ograirj and Temecula Valley Rural Lifestyles CELEBRATING THE AMAZING WORLD OF ALL THINGS MOR60 The beauty of the horse transcends all labels and preferences. Behind every horse person lies the child that simply fell in love with a horse. # DEMONSTRATIONS # VENDORS 0 CLUBS FOOD * RAFFLE PONY RIDES I& PETTING ZOO* HAY RIDES Any questions contact Heather - heather@greenacresranchinc.com (951) 302-6045 FY 2022/2023 COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA GRANT APPLICATION # 20 HABITAT FOR HUMANITY INLAND VALLEY INC. CITY OF TEMECULA. FISCAL YEAR 2022 - 2023 COMMUNITY SERVICE FUNDING M REINVESTMENT IN TEMECULA PROGRAM APPLICATION (Please Print or Type) DUE ON OR BEFORE: MOND", SEPTEMBER 12, 2022 PROJECT/PROGRAM INFORMATION Amount Requested: $ 44,094 MAXIMUM ALLOWABLE: $50,000 PER ORGANIZATION Temecula Real Estate and Project/Program Title: nf,,r Start Date: 10.1.22 End Date: 6.30.23 Physical Address of Project/Program: 41615 Winchester Rd Ste 214,Temecula CA 92590 INCLUDE IF DIFFERENT THAN ORGANIZATION'S MAILING ADDRESS If Grant is Awarded, Make Check Payable to: Habitat for Humanity Inland Valley Mailing Address: 27475 Ynez Road #390 Temecula, CA 92591 ORGANIZATION AND GEOGRAPHIC AREA SERVED Name of Applicant Habitat for Humanity Inland Organization: Valley Year Founded: 1991 Website: habitativ.org Number of Paid Staff. 42 Social Media: facebook.com/HabitatIV/ Number of Volunteers: 1,266 Geographic Area(s) the Organization Serves: Southwest Riverside County Geographic Area(s) the Project/Program Serves: Temecula NOTE: COMMUNITY SERVICE FUNDING GRANT PROGRAM FUNDING MUST BE EXCLUSIVELY USED TO SERVE TEMECULA. Contact Name: Mary Stein Title/Position: Associate Director Contact Person's Direct Telephone: 951-296-3362 Contact Person's Email: mary!Rhabitativ.org NONPROFIT STATUS Is this organization incorporated as a nonprofit? Yes Date of Incorporation as a Nonprofit: 2/21/91 No ❑ IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING Federal Identification Number: 33-0461804 State Identification Number: C1681922 PRINT OUT AND ATTACH TO THIS APPLICATION VERIFICATION FROM FEDERAL (IRS) AND STATE (FTB) AS FOLLOWS: 1. ■❑ Attach IRS Deductibility Status using this link: http:/Iapl2s.irs.gov/ap.p/eosl 2. ❑■ Attach State Entity Status Letter using this link: https://www.ftb.ca.gov/onfine/self serve entity_status lettertindex.as 3. >]■ Attach first page only of most recent IRS Form 990 or attach printout of detailed info about your charity found on this State Registry's Search Tool: hit ://rcLdo -ca. oy/Vedfication/WebiS t rch.as x?faciiit =Y City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 5 of 13 APPLICATION AUTHORIZATION Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over $500 including any business transactions, negotiations, investments, or interests in real property with a Temecula City Council Member during the past 12 months? No Yes ❑ IF YES, BRIEFLY DESCRIBE: Is a Temecula City Council Member a member of the Board of Directors or an Officer of the organization? No If Yes ❑ IF YES, PROVIDE COUNCIL MEMBER'S NAME AND TITLE WITHIN THE ORGANIZATION: This Application has been authorized by the organization's: Executive Committee ® Board of Directors ❑ Members -at -Large ❑ MISSION STATEMENT OF ORGANIZATION BRIEFLY DESCRIBE THE ORGANIZATION'S MISSION/GOALS AND OBJECTIVES. The mission of Habitat for Humanity Inland Valley, in partnership with God, is to facilitate the dream of homeownership as well as improve the living conditions for those in the community. FINANCIAL STATEMENTS UPON REQUEST, COPIES OF THE ORGANIZATION'S CURRENT BUDGET/FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT), AND IF AVAILABLE CPA'S AUDIT, MAYBE NEEDED UPON REQUEST TO DEMONSTRATE SOUND FINANCIAL MANAGEMENT. DO NOT SUBMIT NOW. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 6 of 13 FUNDING SOURCES CITY OF TEMECULA—SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM THE CITY FOR ANY PROGRAM? No ❑ Yes E IF YES, PROVIDE BELOW. NAME OF PROGRAM/PROJECT AMOUNT MONTH + YEAR NAME OF CITY GRANT FUNDED BY THE CITY GRANT OR SPONSORSHIP FUNDING RECEIVED OR SPONSORSHIP Critical Home Repair Program $ 50,000 20/21 � CDBG Critical Home Repair Program $ 52,662.71� 21/22 A Brush with Kindness $5,000 21/22 Critical Home Repair Program $49,724 122/23 CDBG ICSF CDBG Temecula Home Repair Program $ 500,000 22/24 Covid19 Reinvest I$ - I$ OTHER OUTSIDE SOURCES —SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM ENTITIES (NOT INCLUDING THE CITY) FOR THE SAME PROJECT/PROGRAM IN THIS APPLICATION? NO E Yes ❑ IF YES, PROVIDE INFORMATION IN TABLE BELOW. f----. r -- - - City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 7 of 13 GRANT PROJECT/PROGRAM DESCRIPTION IMPORTANT - RECEIPTS/INVOICES IS REQUIRED TO BE SUBMITTED TO THE CITY TO VALIDATE THE ORGANIZATION SPENT GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE PROJECT/PROGRAM AS DESCRIBED HERE 1 DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT. The Temecula Real Estate and Education Center will provide resources, training and -home buyer counseling servicesto-help Temecula residents with affordable homeownership. Homebuyer orientations, resource fairs, financial literacy and Healthy Homes workshops will provide educational support to empower residents towards homeownership and preserving home affordability. 1:1 home buyer counseling will guide qualified clients through the complicated affordable home buying process with licensed real estate support and advocacy while also utilizing other available collaborative resources like downpayment assistance. 2 DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED ALSO, INCLUDE A LIST OF GOODS, EQUIPMEMENT, AND/OR SERVICES THIS ORGANIZATION HAS PURCHASED OR PLANS TO PURCHASE WITH AWARDED FUNDS TO SUPPORT THIS PROGRAM/PROJECT Habitat IV will spend the grant funding on launching and supporting the Temecula Real Estate and Education Center. Funds will be spent on facility costs to house the Center, including expenses related to securing space including rent, utilities, liability insurance, etc. Funds will also be spent on classroom supplies and materials for the workshops, including tables and chairs, minor improvements like shelving and partitions for the educational space, and marketing materials and signage for the Center and resource fairs. 3 TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS. This program will be provided to Temecula residents at the Real Estate and Education Center in Temecula and at community events or sites throughout the City. While any resident is welcome to attend and participate, we expect that most will be low -to -moderate income residents working towards affordable homeownership and struggling to navigate the complicated affordable home buying process, such as layering multiple sources of assistance towards their purchase. 3b 3c ESTIMATED NUMBER OF PEOPLE FROM TEMECULA EXPECTED TO BENEFIT 371 FROM THIS PROJECT/PROGRAM: ESTIMATED NUMBER OF VOLUNTEERS INVOLVED IN THIS PROJECT/PROGRAM: cJ City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 8 of 13 PROJECT/PROGRAM DESCRIPTION CONTINUED 14 SUMMARY STATEMENT - SUMMARIZE ANSWERS 1 - 3 ABOVE IN 50 WORDS OR LESS. The Temecula Real Estate and Education Center will provide home -buyer orientations, resource fairs, financial literacy and Healthy Homes workshops, and counseling to empower residents towards home affordability. 1:1 counseling will guide participants through the complicated affordable home buying process with licensed real-estate support while utilizing collaborative resources like down -payment assistance. 5 IF APPLYING FOR MORE THAN $5,000, PLEASE EXPLAIN HOW THE COVID-19 PANDEMIC AFFECTED THIS NONPROFIT ORGANIZATION'S ABILITY TO SERVE THE TEMECULA COMMUNITY. YOU MAY ALSO INCLUDE INFLATIONARY CONCERNS. COVID-19 impacted our ReStores, which provide a substantial source of revenue used to support and launch programs. The pandemic and historic inflation also significantly impacted the rising cost of housing, driving affordable homeownership even farther away for many residents. I The launch of the Temecula Real Estate and Education Center is part of a broader affordable homeownership solution as we collaborate with other agencies and advocate for residents by combining resources, along with Habitat IV support, to impact the affordable homeownership crisis. 6 IF APPLYING FOR MORE THAN $5,000, EXPLAIN HOW FUNDS HAVE OR WILL: (1) CREATE NEW PROJECT/PROGRAM, (2) EXPAND EXISTING PROJECT/PROGRAM, AND/OR (3) CONTINUE EXISTING PROJECT/PROGRAM. 1) This funding would launch the Temecula Real Estate and Education Center by providing funds for facilities along with classroom materials, supplies, and marketing/signage. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 9 of 13 PROJECT/PROGRAM BUDGET (do not fill in shaded areas) LINE ITEMS FOR PROJECT/PROGRAM REVENUES EXPENSES LIST REVENUES/INCOME FOR PROJECT/PROGRAM Amount of money requested from this City of Temecula $ 44,094 Community Services Grant (Not to exceed $50,000) Amount contributed to the Project/Program by the Applicant $ Organization Other grants or funding already awarded for Project/Program, if any In -Kind match amount or volunteer credit hours estimated amount $ TOTAL REVENUE $ 44,094 LIST OF EXPENSES FOR PROJECT/PROGRAM Tools/Equipment $ Facilities/Rent/insurance Facility expenses: Rent, insurance, utilities, ! $ 28 944 landscaping, shelvin 1 arlitions, _POA dues, etc r Supplies Classroom materials and supplies including $ 7 650 printed materials , Marketing Signage and marketing materials $ 7,500 Services I $ Food Other Staffing Expense THIS IS INELIGIBLE TO BE FUNDED BY CITY'S GRANT, HOWEVER PLEASE INCLUDE. TOTAL EXPENSES TOTAL BUDGET $44,094 $44,094 $44,094 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 10 of 13 PREVIOUS* FISCAL YEAR (FY) 2021-2022 COMPLIANCE REPORT xIF YOUR ORGANIZATION WAS NOT AWARDED A COMMUNITY SERVICE FUNDING GRANT IN FY 21122 (LAST YEAR), THEN SKIP THIS PAGE. If your organization was awarded a Community Service Funding Grant in FY 2021-2022 (last year) by the City of Temecula, please submit this information. If your organization was awarded a Community Service Funding Grant in Fiscal Year 2021-2022 by the City of Temecula, all grant funds received must have been expended anytime on or between July 1, 2021, and June 30, 2022. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper rinnumRntatipn may jeopardize any future funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent. If the funds were not spent in accordance with the approved/awarded application, the organization will be required to return the amount of funds to the City. To substantiate that Fiscal Year 2021-2022 funds received from the City were spent appropriately, proper back-up documentation including the completed table below with accompanying receipts/invoices, must be submitted to the City on or before due date: September 12, 2022. 1. Fill out table below (make additional copies if needed to explain all expenditures.) 2. Attach copies of receipts/invoices (in the same order as listed in this table.) 3., Send to: City of Temecula, 41000 Main St., Temecula, CA 92590 Attn: City Manager's Office — CSF EXPENDITURE REPORT due on or before September 12, 2022 Organization: Habitat for Humanity Name of Project/Program: A Brush with Kindness f ani d Vai ev FY 2021-2022 Amount of $ CSF Grant Fund Awarded: 5000 Month & Year CSF Grant Received from City: 2021-2022 Number of Beneficiaries Living in 92590, 92591, 92592 that Directly Benefitted 31 from this Program/Project (approximate number of beneficiaries If you do not have precise number): E Name of Company Eon Receipt or Invoice Q Z Seaeftached 1 spreadsheet 2 1 3 I 4 5 6 Date on ReceiptlInvoice Amount MUST BE ON OR BETWEEN JULY 1, 2021 - JUNE 30, 2022 FIN Description I Purpose DESCRIBE THE EXPENDITURE PURPOSE OF EXPENDITURE EXPENDITURE TOTAL $S (Q 5 EXPENDITURE TOTAL MUST BE EQUAL TO (OR GREATER) THAN TOTAL AWARD AMOUNT. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 11 of 13 FISCAL YEAR (FY) 2022-2023 COMPLIANCE REPORT If your organization is awarded a Community Service Funding - REINVESTMENT IN TEMECULA Grant in FY2022.2023 by the City of Temecula, follow these instructions. If your organization is awarded a Community Service Funding Grant - REINVESTMENT IN TEMECULA in FY2022-2023 by the City of Temecula, all grant funds received must be expended anytime on or between March 20, 2020 and June 30, 2024. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent. If the funds are not spent in accordance with the approved/awarded application, the organization may not receive andlor will be required to return said amount of fundc to the City. To substantiate that grant funds from thu City me, spent appropriately, proper back-up documentation including the table below with accompanying receipts/invoices, must be submitted to the City as outlined on this page. 1. Fill out Expenditure Report table below. Make additional copies if needed to explain all expenditures. A. If awarded $5,000. Submit the following Expenditure Report within 60 days after spending $5,000 no later than June 30, 2024, to demonstrate grant funds were spent in accordance with the Application. [If you were awarded less than $5,000, submit Expenditure Report for that amount.) B. If awarded grant funds exceeding $5,000. A) Follow #1.A above first. B) To receive grant funds exceeding $5,000 (between $5K-$50K), submit the following Expenditure Report to be reimbursed for the remaining balance of award to demonstrate funds were spent in accordance with the Application. This report can be submitted in $10,000 increments (but no less than $10,000 unless the remaining grant award funding amount is less than $10K). This report must be submitted to the City no later than June 30, 2024 to receive remaining grant funds. 2. Attach copies of receipts/invoices (in the same order listed in table below). 3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590, Attn: City Manager's Dept. "CSF-Reinvestment in Temecula" EXPENDITURE REPORT DATED Organization: Habitat for Humanity Name of Project/Program: Temecula Real Estate and Inland Vallev Education Center TOTAL FY 2022-2023 Month & Year FIRST $5,000 check Amount of Grant Fund Awarded: $ was received from City: 1. Is this Expenditure Report Is to provide documentation for first $5,000 awarded and received? Yes_ or No (already submitted). 2. My organization has already received $,_ of the total FY 2022-23 Grant Fund awarded by the City 3. Is this Expenditure Report Is submitted to request reimbursement of funds? No or Yes If yes, Amount of Request $ Number of beneficiaries living in 92590, 92591, 92592 that directly benefitted from this Program/Project (approximate number of beneficiaries if you do not have precise number) Date on Expenditure t MUST SUPPORT PROJECT/PROGRAM IN APPLICATION &AWARD LETTER Name of Company Receipt/invoice a E on Receipt or Invoice MUST BE ON OR BETWEEN a= March 20, 2020 - JUNE 30, Amount Description Purpose Z 2024 2 3 EXPENDITURE TOTAL $ EXPENDITURE TOTAL City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 12 of 13 ACKNOWLEDGEMENT/SIGNATURE PAGE The applicant acknowledges and agrees to the following: • Recipient is subject to all Community Service Funding Program requirements including submittal deadlines and payment disbursements. • Every Community Service Funding application is considered individually and on its own merit. • Awards will be given to organizations and activities that directly benefit the residents of Temecula. • Funding is not immediately available to the recipient, and requires an award letter signature upon approval. Please allow time for checks to be processed. • The awarding of Community Service Funding does not constitute an automatic annual allocation. • The recognition for Community Service Funding should accrue to the City of Temecula. • Community Service Funding must be spent as specified on the Application and records may be requested by the City of Temecula to ensure the funds were used appropriately. ■ Community Service Funding grants will not be awarded or announced within the 60 days before an election in which an awarding Council Member is on the ballot. • The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. • If awarded a Community Service Funding Grant by the City of Temecula last year, then compliance receipts must be submitted on or before this application's due date or this application may be rejected as incomplete. I/we hereby certify the information contained in this Application is true to the best of our knowledge and belief. ORGANIZATION NAME: Habitat for Humanity Inland Valley MAILING ADDRESS: 27475 Ynez Rd #390 Temecula, CA 92591 PRESIDENT/ AUTHORIZED OFFICER: Tammy Marine, SIGNATURE: PHONE: ( 951 ) 296-3362 EMAIL: mary@habitativ.org Executive Director DATE: 9/9/22 RI'll ON11i2:, i 1's1, IF DIFFERENT THAN ABOVE, Mary Stein, Associate Director APPICATION PREPARED BY: P:�iN 111AT11_ I'i. 1 SUBMIT ORIGINAL APPLICATION BY MONDAY, SEPTEMBER 12, 2022, TO: City of Temecula Community Service Funding Attn: City Manager's Office 41000 MAIN STREET TEMECULA, CA 92590 Questions: Stacey.Brown@TemeculaCA.gov (951) 694-6413 Betsy. Lowrey@TemeculaCA.gov (951) 693-3959 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 13 of 13 Habitat for Humanity® September 29, 2015 Inland Valley HFH 27475 Ynez Rd #390 Temecula, CA 92591-4612 RE: 501(c)(3) Letter for Inland Valley HFH, Partner ID# 1101-5322 Dear Affiliate Leader: Help build it! This letter will confirm that Inland Valley HFH, with employer identification number 33- 0461804, is considered a subordinate under the group tax exemption umbrella of Habitat for Humanity International, Inc. ("HFHI") under Section 501(c)(3) of the Internal Revenue Code. The group exemption number assigned to HFHI by the IRS is 8545. This number may be provided to prospective donors, foundations and other grant organizations as they request it and is required on certain IRS forms. Enclosed is a copy of the determination letter dated March 9, 2015, provided by the IRS as evidence of HFHI's tax exempt status as well as its group exemption. The determination letter, together with this letter, confirms Inland Valley HFH's subordinate status and provides evidence of its tax exempt status under Section 501(c)(3) of the Code. In partnership, Beverly Huffman Director, US/Canadian Support Services Center Habitat for Humanity International 877-434-4435 USSupp artCenter 1Tabitat.or • habitat.org !Habitat. We build - Enclosure INTERNATIONAL HEADQUARTERS: 121 Habitat St., Americus, GA 31709-3498 USA www,habitat.org (229) 924-6935 toll free (800) 422-4828 h } jl i j(�� 3 POIF11 ineut of the I'FLniumy � ��f jj lnfvirol Rovonue tirrvlce In reply refer to: 4077550277 OGDEN UT 84201-0029 Mar. 09, 2015 LTR 4167C 0 91-1914868 000000 00 00040704 BODC: TE HABITAT FOR HUMANITY INTERNATIONAL INC HABITAT FOR HUMANITY INTRNL PARENT n V. EDWARD K QUIBELL - CFO/SR VP 121 HABITAT ST AMERICUS GA 31709-3423 052913 Employer Identification Number: 91-1914868 Group Exemption Number: 8545 Person to Contact: Ms Benjamin Toll Free Telephone Number: 1-877-829-5500 Dear Taxpayer: This is in response to your Jan. 20, 2015, request for information about your tax-exempt status. Our records indicate that you were issued a determination letter in January 1987, and that you are currently exempt under section 501(c)(3) of the Internal Revenue Code. Based on the information supplied, we recognized the subordinates named on the list you submitted as exempt from Federal incnme tax under section 501(c)(3) of the Code. 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. If you have any questions, please call us at the telephone number shown in the heading of this letter. Sincerely yours, Tamera Ripperda Director, Exempt Organizations IRS GI-OLIp Exemption FAQs The IRS refers to "central" or "parent" organizations, as well as "subordinate" organizations? What does these terms mean? An organization that has been granted a 501(c)(3) group exemptinn by the IRS is referred to as the central or parent organization. The central organization generally supervises many affiliates or chapters, called subordinate organizations. The subordinate organizations have similar structures, purposes, missions and activities. ❖ In Habitat's case, HFHI is the central organization and each Affiliate is a subordinate organization. What is the reason for group exemptions vs individual exemptions? Group exemptions are an administrative convenience for both the IRS and organizations with many affiliated organizations. Subordinates in a group exemption do not have to file, and the IRS does not have to process, separate applications for exemption. Instead, the IRS allows the central organization to include its subordinate organizations under its tax exempt "umbrella." ❖ Group exemptions are more convenient because only one central organization (HFHI) needs to be checked for tax exempt status. Who determines if a subordinate organization may be included under the central organizations' group exemption? The central organization, not the IRS, determines who is exempt under its 501(c)(3) umbrella. The IRS does not approve or deny a subordinate's inclusion on HFHI's roster of exempt subordinates. It is solely at the discretion of the central organization holding the 501(c)(3) designation as long as the subordinate is similar in mission, purpose, structure and activities. The IRS leaves it up to the central organization to police its own list of subordinate entities and to report any changes. Failure to monitor the list in accordance with the rules set forth by the IRS may result in the central organization having its 501(c)(3) status revoked. •D, HFHI is the final determiner of whether Affiliates are on its group exempt list. The IRS will not issue a letter with regard to an individual Affiliate. How does a donor verify that an organization is included as a subordinate in a group exemption ruling? The central organization which holds the group exemption (rather than the IRS) determines which organizations are included as subordinates under its grnilp exemption umbrella. Therefore, a donor should verify that an organization is a subordinate eligible to receive tax deductible donations by requesting a copy of a letter provided by the central organization to the subordinate confirming the subordinate entity's inclusion on its roster of exempt subordinates. This letter, coupled with a copy of the central organizations 501(c)(3) determination letter provides adequate proof of the entity's tax exempt status. ❖ Affiliate should provide donors a copy of the confirmation letter (with the HFHI IRS determination letter attached) that HFHI provides to each Affiliate on an annual basis. ❖ Donors should be told that the IRS determination letter will not reference the Affiliate by name. How do donors verify that contributions are deductible with respect to a subordinate organization in a section 501(c)(3) group exemption ruling? Many donors are accustomed to consulting the IRS database known as EOS Select Check to confirm that donations to a specific organization are tax deductible. This works well for organizations that have an individual tax exemption; however, it creates a bit of confusion when it comes to organizations with a group tax exemption status. The EOS Select Check database does NOT list all subordinate entities. It lists the central organization because the central organization is the entity that applied for, and was granted, a 501(c)(3) designation. Many times donors become alarmed when they do not see the individual Affiliate listed in the database. It is important to explain to your donor that providing HFHI's group exemption number (GEN) along with a confirmation letter from HFHI, as the central organization, is sufficient proof of the subordinate entity's tax exempt status. Donors may rely upon central organization verification with respect to deductibility of contributions to subordinates covered in a section 501(c)(3) group exemption ruling. ❖ Explain to your donors early the procedure so that they will not be surprised when the Affiliate is not referenced on the EOS database. Employer Identification Number (EIN) vs Group Exemption Number (GEN) The Employer Identification Number (EIN) is a nine -digit number that is unique to each business and generally appears in the following format: XX-XXXXXXX. Its role for a business is similar to that of the Social Security number for an individual. The number includes information about which state the corporation is registered in. This unique identification number is assigned to a business entity so that they can easily be identified by the Internal Revenue Service. The EIN is also known as a Federal Identification Number (FIN) or Tax ID. This number is apart and separate from a company's group exemption number (GEN). The EIN identifies the specific organization. The GEN identifies the entity's further designation as a tax exempt organization. The GEN number is a number assigned by the IRS which identifies the central organization who was granted the group exemption. The GEN number is a 4 digit number that should be supplied to donors when they make a donation. This number allows the donor to make a tax deduction based on the donation to the tax exempt entity. • HFHI's GEN is 8545. This should be given to your donors. • Do not use HFHI's EIN in your Affiliate's tax return and other documents. This will cause the IRS to confuse your Affiliate with HFHI (including accidentally holding you responsible HFHI's payroll taxes, misreporting on Form 990, etc.) ❖ HFHI's GEN is 8545. This should be given to your donors. :• Do not use HFHI's EIN in your Affiliate's tax return and other documents. This will cause the IRS to confuse your Affiliate with HFHI (including accidentally holding you responsible HFHI's payroll taxes, misreporting on Form 990, etc.) STATE OF CALIFORNIA FRANCHISE TAX BOARD Fop� BOA 94257 SA SACRAMENTO CA 94257-0540 Entity Status Letter Date: 7/14/2022 ESL ID: 8461025921 Why You Received This Letter According to our records, the following entity information is true and accurate as of the date of this letter. Entity ID: 1681922 Entity Name: HABITAT FOR HUMANITY INLAND VALLEY, INC. 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. 0 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. ❑ 5. The entity was administratively dissolved/cancelled on through the Franchise Tax Board Administrative Dissolution process. Important Information • This information does not necessarily reflect the entity's current legal or administrative status with any other agency of the state of California or other governmental agency or body. • If the entity's powers, rights, and privileges were suspended or forfeited at any time in the past, or if the entity did business in California at a time when it was not qualified or not registered to do business in California, this information does not reflect the status or voidability of contracts made by the entity in California during the period the entity was suspended or forfeited (R&TC Sections 23304.1, 23304.5, 23305a, 23305.1). • The entity certificate of revivor may have a time limitation or may limit the functions the revived entity can perform, or both (R&TC Section 23305b). Connect With Us Web: ftb.ca.gov Phone: 800-852-5711 from 7 a.m. to 5 p.m. weekdays, except state holidays 916-845-6500 from outside the United States California Relay Service: 711 or 800-735-2929 (For persons with hearing or speech impairments) FTB 4263A WEB (REV 12-2019) State of California 06__� Office of the Department of Justice Attorney General HOME ABOUT MEDIA CAREERS REGULATIONS RESOURCES PROGRAMS CONTACT Registrant Details Entity type: CorporaLe Class as registered �AiiLh the Secretary of State or based on 1`01-inding & registration do Organization Name: HABITAT FOR HUMANITY INLAND VALLEY, INC. IRS FEIN: 330461804 Entity Type: Public Benefit SOS/FTB Corporate/Organization Number: 1681922 Registry Status: Current Renewal Due/Exp. Date: 11/15/2022 RCT Registration Number: 081196 Issue Date: 6/30/2006 Record Type: Charity Registration Effective Date: 6/30/2006 Date of Last Renewal: DBA: r • Address Street: 41615 WINCHESTER RD #214 Street Line 2: City, State Zip: TEMECULA CA 92590 Filings & Correspondence S:_ 550 2010 CT-550 2010 BEL-LM R R E -_ L 2011 RRF-1 2012 IRS Farm 920 2012 2010 RRF-I 2011 RRF-1 2012 RRF-I 2012 IRS Form 990 IRS Form 990 2010 F0A&gDoeuments RRE-1 2009 � 2010 IRS Form 990 Founding Documents 2009 RRF-1 IRS -Form 22QM BREA- 1RSFnrm 990 200$ � M Form 920 2007 2009 IRS Form 990 2008 RRF-1 2008 IRS Form 990 2007 RRF-1 2007 IRS Form 990 RRF-1 2006 2006 RRF-1 IRS Form 990 2006 2006 IRS Form 990 ERE-1 20D5 2005 RRF-1 IRS Form 990 2005 2005 IRS Form 990 RRF-1 2004 2004 RRF-1 RRF-1 2003 2003 RRF-1 IRS Form 990 2003 2003 IRS Form 990 BELL= 2002 RRF-1 IRS Fonn 990 2002 2002 IRS Form 990 RRF- I�0 2000 RRF-I t D uency Notice 1st Delinquency Notice I;&OWgl Filing 2017 Renewal Filing 2020 RRF- 120 l 3 2013 RRF-1 IRS Form 990 20 l3 2013 IRS Form 990 ERE --I 20 l 1 2011 RRF-1 - — IRS Form 990 2Q1.1 2011 IRS Form 990 RRE L2M 2014 RRF-i IRS_ Form 99 2a i a 2014 IRS Form 990 20 ! 5 IZR A 2015 RRF-1 2015 lR,S, Egan 290 2015 IRS Form 990 - 2016 Form RRF-1 2016 IRS Eolm .990 Series 2016 IRS Fonn 990 Series Renewal Filing 2018 Renewal Filing 2019 IRS Form 990 S r-LCS 2021 AnnualData Status of Filing: Accepted Accounting Period Begin Date: 7/l/2009 Accounting Period End Date: 6/30/2010 Filing Received Date: 9/17/2012 Form RRF-1 Reject/Incomplete Reason: Form CT TR-1 Reject/Incomplete Reason: IRS Form 990 Reject/Incomplete Reason: Notts From Registry Staff: Status of Filing: Accepted Accounting Period Begin Date: 7/1/2010 Accounting Period End Date: 6/30/2011 Filing Received Date: 7/16/2012 Form RRF-1 Reject/incomplete Reason: Form CT TR-1 Reject/Incomplete Reason: IRS Form 990 Reject/incomplete Reason: Notes From Registry Staff: Status of Filing: Accepted Accounting Period Begin Date: 7/1/2011 Accounting Period End Date: 6/30/2012 Filing Received Date: 11/19/2012 Form RRF-1 Reject/Incomplete Reason: Form CT TR-1 Reject/Incomplete Reason: IRS Form 990 Reject/Incomplete Reason: Notes From Registry Staff: Status of Filing: Accepted Accounting Period Begin Date: 7/1/2012 Accounting Period End Date: 6/30/2013 Filing Received Date: 2/20/2014 Form RRF-1 Reject/incomplete Reason: Form CT-TR-I Rejectlincomplete Reason: IRS Form 990 Reject/Incomplete Reason: Notes From Registry Staff: Statris of Filing: Accepted Accounting Period Begin Date: 7/1/2013 Accounting Period End Date: 6/30/2014 Filing Received Date: 12/23/2014 Form RRF-I Reject/Incomplete Reason: Form CT-TR-I Reject/Incomplete Reason: IRS Form 990 Reject/Incomplete Reason: (Votes From Registry Staff: Status of Filing: Accounting Period Begin Date: Accounting Period End Date: Filing Received Date: Form RRF-1 Reject/incomplete Reason: Foi m CT-TR-1 Reject/Incomplete Reason: IRS Form 990 Reject/Incomplete Reason: Notes From Registry Staff: Status of Filing: Accounting Period Begin Date: Accounting Period End Date: Filing Received Date: Form RRF-i Reject/Incomplete Reason: Form C'T-TR-I Reject/lncomplete Rcason: IRS Form 990 Reject/Incomplete Reason: Notes From Registry Staff: Status of Filing: Accounting Period Begin Date: Accounting Period End Date: Filing Received Date: Form RRF-1 Reject/Incomplete Reason: Form CT-TR-I RejectAncomplete Reason: IRS Form 990 Reject/Incomplete Reason: Notes From Registry Staff: Status of Filing: Accounting Period Begin Date: Accountine Period End Date: Received Date: Form RRF-1 Reject/Incomplete Reason: Form CT-TR-1 Reject/Incomplete Reason: IRS Form 990 Reject/Incomplete Reason: Notes From Registry Staff: Status of Filing: Accounting Period Begin Date: Accounting Period End Date: Filln2 Received Date: (Form RRF-1 Reject/Incomplete Reason: Form CT-TR-I Reject/Incomplete Reason: IRS Form 990 Reject/incomplete Reason: Notes From Registry Staff: Status of Filing: Accounting Period Begin Date: Accounting Period End,Date: Filing Received Date: Form RRF-1 Reject/Incomplete Reason: Furor CT TR-I Reject/Incomplete Reason: IRS Form 990 Rejectlincomplete Reason: Notes From Registry Staff: .Status of Filing: Accounting Period Begin Date: Accounting Period End Date: Filing Received Date: Form RRF-t Reject/Incomplete Reason: Form CT-TR-I Reject/Incomplete Reason: IRS Form 990 Reject/Incomplete Reason: Notes From Registry Staff: Prereq Type: Registrant: Registration No: Date Established: Prereq Type: Registrant: Registration No: Date Established: Proroquisito Relationship: Charily BEYOND DIRECT MARKETING LLC I;D01!]E93 Registration Type: Fundraising Event Registration Status: Complete 1/23/2014 Association Date: 1/1/2014 Expiration Date: 12/31/2014 Prerequisite Relationship: Charity BEYOND DIRECT MARKETING LLC F0022149 Registration Type: Fundraising Event Registration Status: 1/20/2015 Association Date: 1/1/2015 Expiration Date: Complete 12/31/2015 Return of Organization Exempt From Income Tax ro- A Form990 Under section 501(c), 527, or 4947(aH1) of the Internal Revenue Code (except private foundations) Qnparlment of Ina iroeALey _Do _ not enter social security numbers on this form as itmay be made public. For the 2020 Calendar year, or tax year baglnnIn 9 JUL 1 2020 and ending JN 30, 2021 B Check If C Name of organization D Employer identification number applicable: HABITAT FOR HUMANITY Inge INLAND VALLEY INC. Name change Doing business as * * — * * * 18 0 4 Initial return Number and street (or P.O. box if mail is not delivered to street address) Room/suite E Telephone number Final 41615 WINCHESTER RD #214 951-296-3362 return/ termin- ated City or town, state or province, country, and ZIP or foreign postal code G Gross receipts $ 4Z572,741 retturnded TEME CULA CA 92590 H(a) Is this a group return tb�eca F Name and address of officer. TAMARA MARINE principal for subordinates? Yes [XI No pending SAME AS `+ ABOVE H(b) Are an subordinates included? Yes NO I Tax. exem Rit status: W 501 c 3 5o1 c ■ ]n5ert no. 4447 a 1 or 527 If "No," attach a list. See instructions J Web site: 10, WWW . HABITAT IV . ORG I H c Grou2 exemption number K Form of or anization; Corporation Trust Association Other ■ t_ Year of formation: 19 9 21 M Stain of leoal domicile, CA 1 1 Briefly describe the organization's mission or most significant activities: THE MISSION OF HAB I TAT FOR HUMANITY INLAND VALLEY INC. IN PARTNERSHIP WITH GOD IS TO c 2 Check this box if the organization discontinued its operations or disposed of more than 25% of its net assets. '0 3 Number of voting members of the governing body (Part VI, line 1 a) ...--................................................. 3 15 0 4 Number of independent voting members of the governing body (Part VI, line 1 b) ...... a 15 5 5 4 5 Total number of individuals employed in calendar year 2020 (Part V, line 2a) .........................................• 6 7 Total number of volunteers (estimate if necessary) ....................... .................................... Total 6 725 7a 0. a unrelated business revenue from Part VIII, column (C), line 12 ................ ...... ............................... b Net unrelated business taxable income from Form 9901Part I line 11 _ 7b 0. Prior Year Current Year y 6 Contributions and grants (Part VIII, line 1 h) „ „ --- ..-,-, . 331,397. 118,129. v 9 Program service revenue Part Vlll, line 2 „„ ( 9) ........... 1,074,355. 523,207. d 10 Investment income (Part VIII, column (A), lines 3, 4, and 7d) 799. 778. ......„--,,,,-,- 11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) --..... 2 71 b 698. 3 2 61 1 255 , 12 Total revenue - add Imes 8 t h roug h 11 irrivst eq ual Part VI 11, column A fine 12 4,123,249. 13 Grants and similar amounts paid (Part IX, column (A), lines 1-3) ........................... 0. 0. 14 Benefits paid to or for members (Part IX, column (A), line 4) 0. 0. 15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-10) 16a Professional fundraising fees (Part IX, column (A)line 11 e .............. b Total fundraising expenses (Part IX, column (D), line 25) ► 85,418. 17 Other expenses (Part IX, column (A), lines 11s-11d, 11f-24e) ._ .................... 18 Total expenses. Add lines 13-17 (must equal Part IX, column (A), line 25) .,... ... ,- 19 Revenue less expenses, Subtract line 16 from line 12 ........ - ... o. 20 Total assets (Part X, line 16) ..................... 21 Total liabilities (Part X, line 26) ---, ............. 22 Not assels or fund balances. Subtract line 21 1 571,254. 1 6914 805. Q a 2,521,583. 2,378,37z. 4,092,837. 4 073 176. 30 412. Beginning of Currant Year 430 193. End of Year 3,769,205. 3,491,798. 1,676,224-1 9681624 2,092,981. 2,523,174. 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 preparor other than officer is based art all information of which preparer has an knowlod e. Sign I Signature of officer CLIENTS COPY Date Here TAMAR.A MARINE, EXECUTIVE DIRECTOR Type or print name and title Print/Type preparer's name Prepare Date Check PflN Paid )ANIEL P. SCHREIBER 189202 Preparer Firm's name JGD & ASSOCIATES LLF Firm's EIN * * * * * 2551 Use Only Firm's addressila. 9191 TOWNE CENTRE DRIVE 0340 SAN DIEGO CA 92122-1274 Phonena.858-587-1000 May the IRS discuss this return with tho Rreparer shown above? See Instructions Yes No . ........................... ... 092001 12-23-20 LHA For Paperwork Reduction Act Notice, see the separate instructions. Form 990 (2020) SEE SCHEDULE 0 FOR ORGANIZATION MISSION STATEMENT CONTINUATION FY 2022/2023 COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA GRANT APPLICATION # 21 HIS LITTLE FEET INC. CITY OF TEMECULA FISCAL YEAR 2022.2023 COMMUNITY SERVICE FUNDING - REINVESTMENT IN TEMECULA PROGRAM APPLICATION (Please Print or Type) DUE ON OR BEFORE: MONDAY, SEPTEMBER 12, 2022 PROJECT/PROGRAM INFORMATION Amount Requested: $ - 04 600 . MAXIMUM ALLOWABLE: $50,000 PER ORGANIZATION Project/Program Title: Q� �1�C ��� Start Date: End Date: (7 3 L 23 Physical Address of Project/Program: -�-«� �6-()et "C�M��� �l C� 9 zsg2 INCLUDE IF DIFFERENT THAN ORGANIZATI`ON's MAILING ADDRESS If Grant is Awarded, Make Check Payable to: s t l )c - Mailing Address: 344,5, r chC I On ORGANIZATION AND GEOGRAPHIC AREA SERVED Name of Applicant I j Organization: l5 l 1 r�� Year Founded: 1 _ Website: V4 V��S L��[ Social Media: [r\C-4 Number of Paid Staff: S Number of Volunteers: Geographic Area(s) the Organization Serves: V L a 1\ I}U�1�11°.S Geographic Area(s) the Project/Program Serves: %Q v; do- co-� NOTE: COMMUNITY SERVICE F�U`DI�G GRANT PROGRAM FUNDING MUST BE EXCLUSIVELY USED TO SE VE TEEMECULA. Contact Name:� A� t jltin�j o\ Title/Position:XG(I • Contact Person's Direct Telephone: V" (�ontact Person's Email: l5 mQi•`.�„ NONPROFIT STATUS Is this organization incorporated as a nonprofit? YesKDate of incorporation as a Nonprofit: 20 NO ❑ IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING Federal Identification Number: l -3 1 611W State Identification Number: PRINT OUT AND ATTACH TO THIS APPLICATION VERIFICATION FROM FEDERAL (IRS) AND STATE (FTB) AS FOLLOWS: 1. ❑ Attach IRS Deductibility Status using this link: http://apps.irs.gov/apl /eos/ 2. ❑ Attach State Entity Status Letter using this link: htti)s://www.ftb.ca,gov/online/self serve entity status letter/index.as 3. ❑ Attach first page only of most recent IRS Form 990 or attach print out of detailed info about your charity found on this State Registry's Search Tool htip://rct.doi.ca.clovNerificationlWeblSearch.aspx?facility=Y APPLICATION AUTHORIZATION Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over $500 including any business transactions, negotiations, investments, or interests in real property with a Temecula City Council Member during the past 12 months? No M Yes ❑ IF YES, BRIEFLY DESCRIBE: Is a Temecula City Council Member a member of the Board of Directors or an Officer of the organization? No X Yes ❑ IF YES, PROVIDE COUNCIL MEMBER'S NAME AND TITLE WITHIN THE ORGANIZATION: This Application has been authorized by the organization's: Executive Committee ❑ Board of Directors Members -at -Large ❑ MISSION STATEMENT OF ORGANIZATION BRIEFLY DESCRIBE THE ORGANIZATION'S MISSION/GOALS AND OBJECTIVES. rAP NCA ` e� a��., o v Vo f �� 4e -�.� sto t It I��Qc`a , a��- aid���� c� C Q-[ s. ll s ii W r7 5 S �. Z � j �'�� � � � �C � OU� of SU �1es w VA qn� s oa �s / A�° i ►n� and �s Q� , Soo D W*ac D FINANCIAL STATEMENTS UPON REQUEST, COPIES OF THE ORGANIZATION'S CURRENT BUDGET/FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT), AND IF AVAILABLE CPA'S AUDIT, MAYBE NEEDED 9MN§TKATt %@UNP FINAN9IAL M/ANAQlKMENT•. ID® NOT SUBMIT NOW-, FUNDING SOURCES CITY OF TEMECULA—SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM THE CITY FOR ANY PROGRAM? No 2rY@5 ❑ IF YES, PROVIDE BELOW. NAME OF PROGRAM/PROJECT AMOUNT MONTH + YEAR NAME OF CITY GRANT FUNDED BY THE CITY GRANT OR SPONSORSHIP FUNDING RECEIVED OR SPONSORSHIP OTHER OUTSIDE SOURCES —SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM ENTITIES (NOT INCLUDING THE CITY) FOR THE SAME PROJECT/PROGRAM IN THIS APPLICATION? NO ❑ Yes IF YES, PROVIDE INFORMATION IN TABLE BELOW. AMOUNT MONTH + YEAR RECEIVED NAME OF ENITY FUNDING RECEIVED $ , 000 GRANT PROJECT/PROGRAM DESCRIPTION IMPORTANT - RECEIPTS/INVOICES IS REQUIRED TO BE SUBMITTED TO THE CITY TO VALIDATE THE ORGANIZATION SPENT GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE PROJECT/PROGRAM AS DESCRIBED HERE 1 DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT. h vm go bt ul Cr\ c +r r 2 DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF A ALSO, INCLUDE A LIST OF GOODS, EQUIPMEMENT, AND/OR SERVICES THIS ORGANIZATION HAS PURCHASED OR PLANS TO PURCHASE WITH AWARDED FUNDS TO SUPPORT THIS PROGRAM/PROJECT. elr `` 5�� C PS � � Ok�s ��� ki �0 � 1 " too �0i��iS/C�i��c �r Gns�S - ow 3D0- -0g, a-�� , sa s �S - r G�► 1�,rec� .� 3 TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING, EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS. ��,�•s �ar� S -���sQ o�� �(e CGN � GoMMU ..�_�..1awl.i �s Ce�kloh� vt�dQr aae �-F i �oU`�.•'o�i�r �8 \\NA 0 �U� r %aA�Ms� M4 NIDe-/ 3b ESTIMATED NUMBER OF PEOPLE FROM TEMECULA EXPECTED TO BENEFIT FROM THIS PROJECT/PROGRAM: CJ 3c ESTIMATED NUMBER OF VOLUNTEERS INVOLVED IN THIS PROJECT/PROGRAM: 3r� PROJECT/PROGRAM DESCRIPTION CONTINUED 4 SUMMARY STATEMENT - SUMMARIZE ANSWERS 1 - 3 ABOVE IN 50 WORDS OR LESS. cmss Le„Wkt�� V� �A\ iO�f�Un �n 2D�3� aliSl` S alno,- 1 h Q [,F to 4 EM L �1q 2?knce, il Ins C`e ^ jh-� �0 awl o of h s 5 IF APPLYING FOR MORE THAN $5,000, PLEASE EXPLAIN HOW THE COVID-19 PANDEMIC AFFECTED THIS NONPROFIT ORGANIZATION'S ABILITY TO SERVE THE TEMECULA COMMUNITY. YOU MAY ALSO INCLUDE INFLATIONARY CONCERNS. Q -A' �e t1 Q ovr 0� o� S p,� v OW �G.`Q- o� s ha es �v4 Q�h air �s 6 IF APPLYING FOR MORE THAN $5,000, EXPLAIN HOW FUNDS HAVE OR WILL: (1) CREATE NEW PROJECT/PROGRAM, (2) EXPAND EXISTING PROJECT/PROGRAM, AND/OR (3) CONTINUE EXISTING PROJECT/PROGRAM. PROJECT/PROGRAM BUDGET (do not fill in shaded areas) LINE ITEMS FOR PROJECT/PROGRAM REVENUES LIST REVENUES/INCOME FOR PROJECT/PROGRAM Amount of money requested from this City of Temecula $01000 Community Services Grant (Not to exceed <rn nn0) Amount contributed to the Project/Program by the Applicant Organization Other grants or funding already awarded for Project/Program, if any $ I—) I0b0 In -Kind match amount or volunteer credit hours estimated amount $ N /A TOTAL REVENUE $1(,006 LIST OF EXPENSES FOR PROJECT/PROGRAM EXPENSES Tools/Equipment $ Facilities/Rent/Insurance $ D i Supplies $ 1G1� '(Cl Z Marketing $ 3 00 Services $ Foody Other �v� ����� $ 2-1,1 3 3 Staffing Expense THIS IS INELIGIBLE TO BE FUNDED BY CITY'S GRANT; $ Zt(- b HOWEVER PLEASE INCLUDE. TOTAL EXPENSES TOTAL BUDGET $ /`:1.. _.r :- /-O A PIT A 001 1/' A T1/1P 1 0--- 4 n -4: 413 PREVIOUS* FISCAL YEAR (FY) 2021-2022 COMPLIANCE REPORT IF YOUR ORGANIZATION WAS NOT AWARDED A COMMUNITY SERVICE FUNDING GRANT IN FY 21122 (LAST YEAR), THEN SKIP THIS PAGE. If your organization was awarded a Community Service Funding Grant in FY 2021-2022 (last year) by the City of Temecula, please submit this information. If your organization was awarded a Community Service Funding Grant in Fiscal Year 2021-2022 by the City of Temecula, all grant funds received must have been expended anytime on or between July 1, 2021, and June 30, 2022. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any future funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent. If the funds were not spent in accordance with the approved/awarded application, the organization will be required to return the amount of funds to the City. To substantiate that Fiscal Year 2021-2022 funds received from the City were spent appropriately, proper back-up documentation including the completed table below with accompanying receipts/invoices, must be submitted to the City on or before due date: September 12, 2022. 1. Fill out table below (make additional copies if needed to explain all expenditures.) 2. Attach copies of receipts/invoices (in the same order as listed in this table.) 3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590 Attn: City Manager's Office —CSF I Organization: EXPE FY 2021-2022 Amount of $ CSF Grant Fund Awarded: REPORT due on or before September 12, 2022 Name of Project/Program: Month & Year CSF Grant Received from City: Number of Beneficiaries Living in 92590, 92591, 92592 that Directly Benefitted from this Program/Project (approximate number of beneficiaries if you do not have precise number): qEw Date onExpenditure Name of Company Receipt/Invoice Description I Purpose Receipt or Invoice MUST BE ON OR BETWEEN Amount DESCRIBE THE EXPENDITURE I PURPOSE OF EXPENDITURE JULY 1. 2021 - JUNE 30. 2022 1 $ 2 $ 3 $ 4 $ 5 $ 6 $ EXPENDITURE TOTAL MUST BE EQUAL TO EXPENDITURE TOTAL (OR GREATER) THAN TOTAL AWARD AMOUNT. Tn.........1.. / MAKIT AMMI 1/"ATI/1k1 0nnn 4A nF �7 FISCAL YEAR (FY) 2022-2023 COMPLIANCE REPORT If your organization is awarded a Community Service Funding - REINVESTMENT IN TEMECULA Grant in FY2022-2023 by the City of Temecula, follow these instructions. If your organization is awarded a Community Service Funding Grant - REINVESTMENT IN TEMECULA in FY2022-2023 by the City of Temecula, all grant funds received must be expended anytime on or between March 20, 2020 and June 30, 2024. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent. If the funds are not spent in accordance with the approved/awarded application, the organization may not receive and/or will be required to return said amount of funds to the City. To substantiate that grant funds from the City are spent appropriately, proper back-up documentation including the table below with accompanying receipts/invoices, must be submitted to the City as outlined on this page. 1. Fill out Expenditure Report table below. Make additional copies if needed to explain all expenditures. A. If awarded $5,000. Submit the following Expenditure Report within 60 days after spending $5,000 no later than June 30, 2024, to demonstrate grant funds were spent in accordance with the Application. [If you were awarded less than $5,000, submit Expenditure Report for that amount.) B. If awarded grant funds exceeding $5,000. A) Follow #1.A above first. B) To receive grant funds exceeding $5,000 (between $5K-$50K), submit the following Expenditure Report to be reimbursed for the remaining balance of award to demonstrate funds were spent in accordance with the Application. This report can be submitted in $10,000 increments (but no less than $10,000 unless the remaining grant award funding amount is less than $10K). This report must be submitted to the City no later than June 30, 2024 to receive remaining grant funds. 2. Attach copies of receipts/invoices (in the same order listed in table below). 3. Send to: I Organization:_ City of Temecula, 41000 Main St., Temecula, CA 92590, Attn: City Manager's Dept. "CSF-Reinvestment in Temecula" EXPENDITURE REPORT DATED Name of Project/Program: TOTAL FY 2022-2023 Month & Year FIRST $5,000 check Amount of Grant Fund Awarded: $ was received from City: 1. Is this Expenditure Report is to provide documentation for first $5,000 awarded and received? Yes_ or No (already submitted). 2. My organization has already received $ of the total FY 2022-23 Grant Fund awarded by the City 3. Is this Expenditure Report is submitted to request reimbursement of funds? No or Yes If yes, Amount of Request $ Number of beneficiaries living in 92590, 92591, 92592 that directly benefitted from this Program/Project (approximate number of beneficiaries if you do not have precise number) v Date on r Name of Company Receipt/Invoice E on Receipt oir Invoice MUST BE ON OR BETWEEN Q Z March 20, 2020 - JUNE 30, 2 3 1 Expenditure MUST SUPPORT PROJECT/PROGRAM IN APPLICATION & AWARD LETTER EXPENDITURE TOTAL $ Amount Description EXPENDITURE TOTAL !_4....F If.... A:-,- 0..;........I..,.....4 ;.. T,....., .., ,1.. !?OAAIT AOOI 1f%ATIP1k1 0--- 4n ..F 47 L ACKNOWLEDGEMENT/SIGNATURE PAGE The applicant acknowledges and agrees to the following: • Recipient is subject to all Community Service Funding Program requirements including submittal deadlines and payment disbursements. ■ Every Community Service Funding application is considered individually and on its own merit. ■ Awards will be given to organizations and activities that directly benefit the residents of Temecula. • Funding is not immediately available to the recipient, and requires an award letter signature upon approval. Please allow time for checks to be processed. • The awarding of Community Service Funding does not constitute an automatic annual allocation. The recognition for Community Service Funding should accrue to the City of Temecula. s Community Service Funding must be spent as specified on the Application and records may be requested by the City of Temecula to ensure the funds were used appropriately. Community Service Funding grants will not be awarded or announced within the 60 days before an election in which an awarding Council Member is on the ballot. The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. ■ If awarded a Community Service Funding Grant by the City of Temecula last year, then compliance receipts must be submitted on or before this application's due date or this application may be rejected as incomplete. I/we hereby certify the information contained in this Application is true to the best of our knowledge and belief. ORGANIZATION NAME: MAILING ADDRESS: -i� S V �� �Ae 1;-Q • PHONE: 6L2,) 4-7 - 03 10 ON e" � ,�0V EMAIL: 1�1.5`1\ `C�Q� � qm%\ •Coflh PRESIDENT / AUTHORIZED OFFICER: ��'� WOO-- CX� � � D o(^t Ck),(- T I ` SIGNATURE: K' _ DATE: US Lo l L1' `1-)N 7 ! I, DAY, YEAR IF DIFFERENT THAN ABOVE, APPICATION PREPARED BY: t,A- SUBMIT ORIGINAL APPLICATION BY MONDAY, SEPTEMBER 12, 2022, TO: City of Temecula Community Service Funding Attn: City Manager's Office 41000 MAIN STREET TEMECULA, CA 92590 Questions: Stacey.Brown@TemeculaCA.gov (951) 694-6413 Betsy.Lowrey@TemeculaCA.gov (951) 693-3959 11:4.. C.....4:.... i.. !'MAKIT A001 1/"ATI/1A1 0...... 47 -4! 412 ea f)4- Stoic of California wFranchise Tax Board PO Box 1286 Rancho Cordova CA 95741-1286 HIS LITTLE FEET, INC. PO BOX 11572 SANTA ANA CA 92711 Regarding: Organization's Name: CCN: Purpose: R&TC Section: Form of Organization: Accounting Period Ending: Tax -Exempt Status Effective: Tax -Exempt Status HIS LITTLE FEET, INC. 3776899 Charitable 23701d Incorporated 07/31 04/13/2015 Date: 02.11.16 Case: 30820600701287076 Case Unit: 30820600701287080 In reply refer to: 760:GRW:F120 Exempt Acknowledgement Letter 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) Section 23701 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. 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 12-2014) Exempt Applfcatfon\Correspondence \LTR 001-EAL .,INTERNAL REVENUE SERVICE P. O. BOX 2508 CINCINNATI, OH 45201 Date -DEC 14 2015 HIS LITTLE FEET INC C/O BRIAN MCDONALD 7755 CENTER AVE STE 1100 HUNTINGTON BEACH, CA 92647 Dear Applicant: DEPARTMENT OF THE TREASURY Employer Identification Number: 47-3769966 DLN: 17053308318025 Contact Person: MICHELLE A GLUTZ ID# 31213 Contact Telephone Number: (877) 829-5500 Accounting Period Ending: December 31 Public Charity Status: 170 (b) (1) (A) (vi) Form 990/99o-EZ/990-N Required: Yes Effective Date of Exemption: April 13, 2015 Contribution Deductibility: Yes Addendum Applies: No We're pleased to tell you we determined you're exempt from federal income tax under Internal Revenue Code (IRC) Section 501(C)(3). Donors can deduct contributions they make to you under IRC Section i70. You're also qualified to receive tax deductible bequests, devises, transfers or gifts under Section 2055, 2106, or 2522. This letter could help resolve questions on your exempt status. Please keep it for your records. Organizations exempt under IRC Section 501(c)(3) are further classified as either public charities or private foundations. We determined you're a public charity under the IRC Section listed at the top of this letter. If we indicated at the top of this letter that you're required to file Form 990/990—Ezt99V- -our-records show you're required to file an annual - - information return (Form 990 or Form 990-EZ) or electronic notice (Form 990-N, the e-Postcard). If you don't file a required return or notice for three consecutive years, your exempt status will be automatically revoked. If we indicated at the top of this letter that an addendum applies, the enclosed addendum is an integral part of this letter. For important information about your responsibilities as a tax-exempt organization, go to www.irs.gov/charities. Enter "4221-PC" in the search bar to view Publication 4221-PC, Compliance Guide for 501(c)(3) Public Charities, which describes your recordkeeping, reporting, and disclosure requirements. Letter 947 Form 990 Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) Department of the Treasury ► Do not enter social security numbers on this form as it may he made public, Internal Revenue'Servtoe ► Go to www-frs.gev1Form990 for instructions and the latest information. A For the 2021 calendar year, or tax year beginning B Check if applicable: Address change HIS LITTLE FEET INC Name change 3445 STUDEBAKER ROAD nitial rebim LONG BEACH, CA 90808 Final return/tennmeled Amended rehrn AppnCaFron perdrng F Name and address of principal officer: Same As C Above Tax-ezewpt status: N 501(e)(3) Ll 501(c) (insert no,) J Website: ► WWW.HISLITFEET.ORG K Form oferganization 1XI C01p01aNG11 Ll Trusf 11 Association Other, art Summate 0Po1e No. 1545.0047 2021, and ending 20 D Employer identification number 47-3769966 _ Telephone number 562 397-0370 G Gross re qft $ 202 I Is IhiS a group return for5ubptdmales? Yes HIM Are ali subordinates included? Yes If "Nc," attach a list. See instructions, 4947(a)(1) or 527 X(c) Group exemption number ► L Year o` forruabon: M state of legal domicile: CA No No 1 Briii de_sc_ribe_tile_orga_nizatio_Ws fission or_most signsttrani a_rllvltle_s:T_0_P_R_OV_I_D_E_A_S_SI_S_T_AN_C_E_T_O NEED----------------..__-________------------------_----__----__ _CH_ILDR_E_N_Z_N___ --------------------------------------------------------------- cE 2 __ _______________ ____ _ ____ __ ___ _ Check this box ► If the organization discontinued its operations or disposed of more than 25°% of its net assets. � — — — — — f — — 3 Number of voting members of the governing body (Part VI-, line 1 a) . , ... . .. 3 7 °d N 4 Number of independent voting members of the governing body (Part VI, line 1 b)... ........ . ..... 4 5 Total number of individuals employed in calendar year 2021 (Part V, line 2a) .. ..... . .. , ... 5 0 6 Total number of volunteers (estimate if necessary), • , • , .... ....... 6 0 a 7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 142. b Net unrelated business taxable Income from Form 990-T, Part I, line 11 .. ..... 7b 0 , Prior Year Current Year 8 Contributions and grants (Part VIII, line 1h) 146 640. 201 F 924. m 9 Program service revenue (Part VIII, line 2g) 142 10 Investment income (Part VIII, column (A), lines 3, 4, and 7d) 11 Other revenue (Part VII'i, column (A), lines 5, 6d, 8c, 9c, 10c, and 11 e).......... 12 Total revenue — add lines 8 through 11 (must equal Part VIII, column (A), line 12) 146,640. 202,065. 13 Grants and similar amounts paid (Part IX, column (A), lines 1.3). ... ....... , 83 950. 14 Benefits paid to or for members (Part IX, column (A), line 4) ....................... 15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-10) ,.- • . 24 713. 43 114. H 16a Professional fundraising fees (Part IX, column (A), line Ile) .. . ........ —.,. ... 657. C b Total fundraising expenses (Part IX, column i line 25) ^i— 4,409. 31,155. 17 Other expenses (Part IX, column (A), lines 1la-lId, 1If-24e)- 18 Total expenses. Add lines 13-17 (must equal Part IX, column (A), line 25).. .... 25,370. 158 222, 19 Revenue less expBRses, Subtract line 18from line 12....................... . ..... 121 270. 43 844. Beginning of Current Year End of Year 20 Total assets (Part X, line 16). ...... ..-.... ................ 96 878. 140 722. 21 Total liabilities (Part X, line 26) - — ... , .. ," 0. 07 p i 22 Net assets or fund balances. Subtract line 21 from line 20............... .... ..... 96 878. 140 722 , rarz ii I za nature 13loctt L4kWr penalties of pepury, I declare that i have exampled this return, rnckidIng accorrvanying schedules and stal9ttgRfs, and to the best of my knowledge and belief, it is true, correct, and rpnpllete, Declaration of prepare., (other than officer) 6 bused on all lnlormatiin of WIWI preparer has any knowtgdyb- Sign IsIcnaingoreulcef pale Here ` HALI WOLF President TyrW or prnl n:irrve Aml lrlle Print/Type preparer's name Preparer's signature Date Check Lj it I PTIN Paid Tanya R Lansin E.A. Tana R Lansing,E.A. 5 04/22 selhernployed P0I219573 Preparer Furmsname ' LENNING & CO., INC. Use Only Firm'saddress ► 13924 Seal Beach Blvd Ste C Firm'sEIN ► 20-2141302 Seal Beach CA 90740 Phonenp 562 594-9729 May the IRS discuss this return with the preparer shown above? See instructions.... . JXJ Yes I I No BAA For Paperwork Reduction Act Notice, see the separate instructions. TEEA01011 09/22121 Form 990 (2021) FY 2022/2023 COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA GRANT APPLICATION # HOSPICE OF THE VALLEYS CITY OF TEMECULA FISCAL YEAR 2022.2023 COMMUNITY SERVICE FUNDING - REINVESTMENT IN TEMECULA PROGRAM APPLICATION (Please Print or Type) DUE ON OR BEFORE: MONDAY, SEPTEMBER 12, 2022 j PROJECT/PROGRAM INFORMATION Amount Requested: $ 50,000 Project/Program Title: Senior Assistance Program MAXIMUM ALLOWABLE: $50,000 PER ORGANIZATION Physical Address of Project/Program: Same as below Start Date: 3/20/20 End Date: 6/30/24 INCLUDE IF DIFFERENT THAN ORGANIZATION'S MAILING ADDRESS If Grant is Awarded, Make Check Payable to: Hospice of the Valleys Mailing Address; 25240 Hancock Ave. Ste 120 Murrieta, CA 92562 ORGANIZATION AND GEOGRAPHIC AREA SERVED Name of Applicant Organization: Hospice of the Valleys Year Founded: 1982 htt s //hos lce mlps:/twww.facebook.som/HospiceoflheValleys Website: P P ofthevalleys.org/ Social Media: hUps:+ANww.+nslasram.commosplreofthevalleyssd Number of Paid Staff: 58 Number of Volunteers: 40 Geographic Area(s) the Organization Serves: Southwest Riverside County Geographic Area(s) the Pro"ect/Pro ram Serves: Temecula NOTE: COMMUNITY SERVICE FUNDING GRANT PROGRAM FUNDING MUST BE EXCLUSIVELY USED TO SERVE TEMECULA. Contact Name: Melanie House Contact Person's Direct Telephone: 951-972-2189 Title/Position: Development Coordinator Contact Person's Email: mhouse@hovsc.org NONPROFIT STATUS Is this organization incorporated as a nonprofit? Yes Date of Incorporation as a Nonprofit: June 29,1983 No ❑ IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING Federal Identification Number: 95-3846314 State Identification Number: 1131444 PRINT OUT AND ATTACH TO THIS APPLICATION VERIFICATION FROM FEDERAL (IRS) AND STATE (FTB) AS FOLLOWS: 1. N Attach IRS Deductibility Status using this link: htti)://aps.irs.gov/agp/eos/, 2_ x❑ Attach State Entity Status Letter using this link: hftps.*I/www.ftb.ca.gov/online/self serve_gntity status letter/index.as 3. x❑ Attach first page only of most recent IRS Form 990 or attach print out of detailed info about your charity found on this State Registry's Search Tool: hitp.i/rct.doi.ca.gov/VerificationfWeb/Search.aSpx?facilitv=Y City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 5 of 13 APPLICATION AUTHORIZATION Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over $500 including any business transactions, negotiations, investments, or interests in real property with a Temecula City Council Member during the past 12 months? No ® Yes ❑ IF YES, BRIEFLY DESCRIBE: Is a Temecula City Council Member a member of the Board of Directors or an Officer of the organization? No ❑x Yes ❑ IF YES, PROVIDE COUNCIL MEMBER'S NAME AND TITLE WITHIN THE ORGANIZATION: This Application has been authorized by the organization's: Executive Committee ❑ Board of Directors x❑ Members -at -Large ❑ MISSION STATEMENT OF ORGANIZATION BRIEFLY DESCRIBE THE ORGANIZATION'S MISSION/GOALS AND OBJECTIVES - Hospice of the Valleys Mission is: We foster reverence for life, relief of suffering, and compassion in loss for the terminally ill residents and their families in the communities we serve. Our Vision is:To be a recognized leader of excellence in comprehensive end -of -life care, Hospice of the Valleys began in early 1982 by two sisters in Sun City, California who recognized the need for specialized end -of -life care for people in their community. In order to make this care available, these sisters received hospice training as volunteers and began going door-to-door raising money on their patients' behalf. After years as a volunteer -run organization, Hospice of the Valleys eventually became a full -service, nonprofit 501(c)(3) organization. Today, Hospice of the Valleys employs a team of experienced clinicians and administrative professionals, and continues to have a group of dedicated volunteers who touch the lives of our patients each and every day. After 40 years of caring for hospice patients living in Southwest Riverside County and Fallbrook, Hospice of the Valleys remains committed to the mission of its founders by providing loving hospice care to all who need it, regardless of their ability to pay. FINANCIAL STATEMENTS UPON REQUEST, COPIES OF THE ORGANIZATION'S CURRENT BUDGET/FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT), AND IF AVAILABLE CPA'S AUDIT, MAYBE NEEDED UPON REQUEST TO DEMONSTRATE SOUND FINANCIAL MANAGEMENT. DO NOT SUBMIT NOW. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 6 of 13 FUNDING SOURCES CITY OF TEMECULA—SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM THE CITY FOR ANY PROGRAM? No ❑ Yes N IF YES, PROVIDE BELOW. NAME OF PROGRAM/PROJECT AMOUNT MONTH +YEAR NAME OF CITY GRANT FUNDED BY THE CITY GRANT OR SPONSORSHIP FUNDING RECEIVED OR SPONSORSHIP Senior Assistance Program Senior Assistance Program $ 5,000 January 2021 Community Service Funding jary 2022 Community Service Funding I OTHER OUTSIDE SOURCES —SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM ENTITIES (NOT INCLUDING THE CITY) FOR THE SAME PROJECTIPROGRAM IN THIS APPLICATION? No ❑ Yes ❑x IF YES, PROVIDE INFORMATION IN TABLE BELOW. AMOUNT MONTH + YEAR RECEIVED NAME OF ENITY FUNDING RECEIVED $ 5,491 CDBG Temecula May 2021 (FY 20-21) $ 7,226 CDBG Temecula Funds not yet received _ (FY 22-23) $ City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 7 of 13 GRANT PROJECT/PROGRAM DESCRIPTION IMPORTANT- RECEIPTS/INVOICES IS REQUIRED TO BE SUBMITTED TO THE CITY TO VALIDATE THE ORGANIZATION SPENT GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE PROJECT/PROGRAM AS DESCRIBED HERE 1 DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT, The Senior Assistance Program provides compassionate hospice care to terminally ill patients and support to their families. The Program pays for the direct cost of hospice care for senior citizens and the severely disabled. Direct hospice care includes, but is not limited to, personal visits by physicians, nurses, home health aides, social workers, and spiritual care advisors; the provision of durable medical equipment, medical supplies, medication delivery, and bereavement support services. Our services are extended to our patients and their families while the patient is living and up to at least 13 months after death. After the patient passes, caregivers receive bereavement support that includes phone calls and/ or personal visits by a bereavement counselor or chaplain, access to grief support groups, bereavement books and mailings, as well as memorial services of remembrance twice per year, Hospice of the Valleys does not believe in adding to the burden of patients or their families by asking for reimbursements or co - pays that are not covered by insurance. For example, Medicare does not cover a $5.00 co -pay for each medication that each of our patients are prescribed; however, Hospice of the Valleys takes care of that cost and does not pass the co -pay on to our oatients. During times when end of life is imminent, we do not want our patients and their families to incur yet another expense. Dur goal is to ensure no one is turned away or provided with limited hospice care simply due to their inability to pay. 2 DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED ALSO, INCLUDE A LIST OF GOODS, EQUIPMEMENT, AND/OR SERVICES THIS ORGANIZATION HAS PURCHASED OR PLANS TO PURCHASE WITH AWARDED FUNDS TO SUPPORT THIS PROGRAM/PROJECT. For every patient on our service. Hospice of the Valleys makes numerous visits to the the patient and their family, to wherever they call home. From nurses, to home health aides; doctors, to social workers; and even spiritual care and bereavement staff we see patients many times a week to care for them as they near the end of their lives. These visits are all hours of the day and night, as well as on weekends and holidays. Funds will be used towards patient care and costs not covered by Medicare or other insurances. This includes, but is not limited to, provisions such as medication delivery services, incontinence supplies, overbed tables, medication co -pays, and mobile shower equipment, just to name a few. We estimate that we will serve approximately 240 patients in Temecula from March 20, 2020 through June 30, 2024 (already served 125 from 3/20/20 to 8/15122) for a total of $20,285 54 spent from 3/20/20 to 8/15/22 and we can project that we will double that by June 30, 2024 ($40,571.08). These items keep our patients comfortable; alleviate the burden to their caregivers; and help with added expenses that families shouldn't have to amass at the end of their loved one's lives. Additionally, our Hospice Hearts have become an invaluable gift we offer to our patients' families and caregivers. When separated, the tiny inner heart can be placed with the loved one who has died as a reminder of their unbroken connection to those who remain behind. Numerous families who have received the hospice hearts have told us how meaningful they are and how they would be treasured. Hospice Hearts are $6 per and we offer an unlimited amount to families when their loved one has passed. 3 TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS We serve approximately 350 patients a year in Southwest Riverside County, and since year 2000, 15% of our patients reside in Temecula. When looking at our patient count, since March 20, 2020, we have served 120 Temecula patients (residents as of 8/15/22) and can estimate that at least one of these patient's family members or friends also benefited from our services (as many of the provisions we provide ease the burden for the caregiver). We can also estimate that our services in the City of Temecula, will double the 120 patients number through June 30, 2024, for a total of 240 patients that we are including in this grant. The patients we serve are presumed low -moderate income persons based on the fact that they are either severely disabled adults and/ or senior citizens (age 62 and above). Our patients have been diagnosed with a terminal illness and have 6 months or less to live, as certified by a physician. While we expect to serve approximately 240 total patients residing in the City of Temecula (from March 20, 2020 through June 30 2024), the scope of our service extends beyond the patient. Our hospice team also assists each patient's caregiver as they journey through the dying process. Our interdisciplinary team is available to assist caregivers in making difficult end -of -life decisions and help families navigate the many issues surrounding death. Once the patient dies, Hospice of the Valleys provides comprehensive bereavement support and education to families/ caregivers, extending the number of individuals we serve 3b ESTIMATED NUMBER OF PEOPLE FROM TEMECULA EXPECTED TO BENEFIT I 240 FROM THIS PROJECT/PROGRAM: 3c ESTIMATED NUMBER OF VOLUNTEERS INVOLVED IN THIS PROJECT/PROGRAM: 1 20 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 8 of 13 PROJECT/PROGRAM DESCRIPTION L CONTINUED 4 SUMMARY STATEMENT — SUMMARIZE ANSWERS 1 — 3 ABOVE IN 50 WORDS OR LESS The Senior Assistance Program provides compassionate hospice care to the terminally ill patients of Temecula and to support to their families. During times when end of life is imminent, we ensure no one is turned away or provided with limited hospice care simply due to their inability to pay. 5 IF APPLYING FOR MORE THAN $5,000, PLEASE EXPLAIN HOW THE COVID-19 PANDEMIC AFFECTED THIS NONPROFIT ORGANIZATION'S ABILITY TO SERVE THE TEMECULA COMMUNITY. YOU MAY ALSO INCLUDE INFLATIONARY CONCERNS. The COVID-19 pandemic affected Hospice of the Valleys and in turn, serving the Temecula community, in a number of ways which are listed below: • The pandemic forced people to remain in their homes and not frequent their doctor's office. As a result the number of patients that were admitted was down considerably; lowering our census and funding. • Patients also were coming on to service later than usual as a result of not visiting their doctor; again causing a deficit to our per day funding/insurance reimbursements. • Some patients did not want staff in the home for fear of transmission so giving care brought many new challenges. • Our doctors were only allowed to do tele-visits as opposed to in person care. • Volunteers were not allowed to visit patients which put a further strain on caregivers and patients alike. • Staffing shortages as a result of illness and burnout. • Increased costs in terms of PPE (Personal Protective Equipment) as staff had to be protected to work at facilities or patient homes. • Staff who are not vaccinated needed and continue need to be tested each week at a cost to us. • Significant labor expenses in regards to COVID training, tracking, contact tracing, reporting. • Certain items, gloves for example, were in short supply and cost more than ever before. 6 IF APPLYING FOR MORE THAN $5,000, EXPLAIN HOW FUNDS HAVE OR WILL: (1) CREATE NEW PROJECT/PROGRAM, (2) EXPAND EXISTING PROJECT/PROGRAM, AND/OR (3) CONTINUE EXISTING PROJECT/PROGRAM- The U.S. Census Bureau (American Community Survey) estimates Temecula's population to be approximately 110,846 as of 2021, with over 10.5% being 65 years and older. While Hospice of the Valleys provides care to all hospice patients regardless of age, the majority of our patients are senior citizens. Hospice of the Valleys currently cares for approximately 350 patients per year, with 15% of those patients residing in Temecula. As this group of 11,639 senior citizens in the City continues to age, there will likely be a greater need for hospice services in the grant service area. In order to meet this anticipated demand, Hospice of the Valleys will continue to raise funds through grants, donations, fundraisers, community support, and our planned giving program. The work we do with our Senior Assistance Program has been existing since our founding 40 years ago and will be indefinitely ongoing City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 9 of 13 PROJECT/PROGRAM BUDGET (do not fill in shaded areas) LINE ITEMS FOR PROJECT/PROGRAM REVENUES EXPENSES LIST REVENUES/INCOME FOR PROJECT/PROGRAM $ 50,000 Amount of money requested from this City of Temecula Community Services Grant (Not to exceed $50,000) Amount contributed to the Project/Program by the Applicant $ 3,326,212 Organization Other grants or funding already awarded for Project/Program, if any $12,717 In -Kind match amount or volunteer credit hours estimated amount $ 49,837 TOTAL REVENUE $ 3,438,766 LIST OF EXPENSES FOR PROJECT/PROGRAM Tools/Equipment I $626,298 Facilities/Rent/Insurance $151,571 Sup p lies :overbed tables, full -electric beds, incontinence supplies, and medication co -pays 3/20/20-6/30/24 $ 40,571.08 $ 33,493 $156,828 $53,146 Marketing Services Mileage exp for patient visits Other Hospice Hearts: 240 patients x 10 hearts/family x $6.00 each $ 14,400.00 Staffing Expense THIS IS INELIGIBLE TO BE FUNDED BY CITY'S GRANT; HOWEVER PLEASE INCLUDE. $ 2,681,346 $3,757,653.08 TOTAL EXPENSES $ TOTAL BUDGET $ (318,887.08) City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 10 of 13 ACKNOWLEDGEMENT/SIGNATURE PAGE The applicant acknowledges and agrees to the following: • Recipient is subject to all Community Service Funding Program requirements including submittal deadlines and payment disbursements. • Every Community Service Funding application is considered individually and on its own merit. • Awards will be given to organizations and activities that directly benefit the residents of Temecula. • Funding is not immediately available to the recipient, and requires an award letter signature upon approval. Please allow time for checks to be processed. • The awarding of Community Service Funding does not constitute an automatic annual allocation. • The recognition for Community Service Funding should accrue to the City of Temecula. • Community Service Funding must be spent as specified on the Application and records may be requested by the City of Temecula to ensure the funds were used appropriately. • Community Service Funding grants will not be awarded or announced within the 60 days before an election in which an awarding Council Member is on the ballot. • The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. • If awarded a Community Service Funding Grant by the City of Temecula last year, then compliance receipts must be submitted on or before this application's due date or this application may be rejected as incomplete. I/we hereby certify the information contained in this Application is true to the best of our knowledge and belief. ORGANIZATION NAME: Hospice of the Valleys_ MAILING ADDRESS: 25240 Hancock Ave. Ste. 120 PHONE: (951) 200-7800 Murrieta. CA 92562 _ _ EMAIL: _omathias@hovsc.or _ PRESIDENT / AUTHORIZED OFFICER: _Paul Mathias CFO SIGNATURE: /01uw to IF DIFFERENT THAN ABOVE, APPICATION PREPARED BY: Melanie House Nr DATE: September 9, 2022 Development Coordinator SUBMIT ORIGINAL APPLICATION BY MONDAY, SEPTEMBER 12, 2022, TO: City of Temecula Community Service Funding Attn: City Manager's Office 41000 MAIN STREET TEMECULA, CA 92590 Questions. Stacey.Brown@TemeculaCA.gov (951) 694-6413 Betsy. Lowrey@TemeculaCA.gov (951) 693-3959 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 13 of 13 STATE OF CALIFORNIA TAX BOARD BPO Q!)FRANCHISE BOX 942857 SACRAMENTO CA 94257-0540 Entity Status Letter Date: 7/14/2022 ESL ID: 8598323706 Why You Received This Letter According to our records, the following entity information is true and accurate as of the date of this letter. Entity ID: 1131444 Entity Name: HOSPICE OF THE VALLEYS SC 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. ❑ 5. The entity was administratively dissolved/cancelled on through the Franchise Tax Board Administrative Dissolution process. Important Information ■ This information does not necessarily reflect the entity's current legal or administrative status with any other agency of the state of California or other governmental agency or body. • If the entity's powers, rights, and privileges were suspended or forfeited at any time in the past, or if the entity did business in California at a time when it was not qualified or not registered to do business in California, this information does not reflect the status or voidability of contracts made by the entity in California during the period the entity was suspended or forfeited (R&TC Sections 23304.1, 23304.5, 23305a, 23305.1). • The entity certificate of revivor may have a time limitation or may limit the functions the revived entity can perform, or both (R&TC Section 23305b). Connect With Us Web: ftb.ca.gov Phone: 800-852-5711 from 7 a.m. to 5 p.m, weekdays, except state holidays 916-845-6500 from outside the United States California Relay Service: 711 or 800-735-2929 (For persons with hearing or speech impairments) FTB 4263A WEB (REV 12-2D19) Q HELPB MENU Home > Tax Exemganization Search > Hospice Of The Valleys Sc < Bla&to Search Results Hospice Of The Valleys Sc EIN: 95-3846314 1 Murrieta, CA, United States Other Names Publication 78 Data e Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions. On Publication 78 Data List: Yes Deductibility Code: PC Copies of Returns (990, 990-EZ, 990-PF, 990-T) o Electronic copies (images) of Forms 990, 990-EZ, 990-PF or 990-T returns filed with the IRS by charities and non- profits, Tax Year 2019 Form 990 Tax Year 2018 Form 990 Tax Year 2017 Form 990 Tax Year 2016 Form 990 Tax Year 2015 Form 990 Page Last Reviewed or Updated. 20-November-2020 P► Share $ Print Form 990 Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) uepfrrr MIt of Ihq TrNrxury ► Do not enter social security numbers on this form as it may be made public. InlMeo rRevenue S40 rta ► Go to wwjJrs.AfovIFormB 0 for Instructions and the latest information. OMG No, 1545-0347 Open to Public Inspecllan H ror me zuzu cafenoar year, or tax yenr beginning 2020, and ending , 20 B Checx if applicable; C D gmptoyH Identification numher Addfesschange HOSPICE OF THE VALLEYS SC, INC. 95-3846314 Name, change 25240 HANCOCK AVE, STE 120 E Telephone number Initial return MURRIETA, CA 92562 951-200-7800 Final relurn/terminated Amended rclurn G Gross mc,l.pU $ 6 297 143. Application pending F Name and address of principal officer: LYNET E CVAR MfA) Ix INh a group return for nowaolmesi Yes No Same As C Above Ill l Are all subo,drnates included? Yes tic If'No.' attach a list See inslruclions I Tax-exempt status: X 501(C}{3) 501W (iourt no.) 4947(a)(1) or 527 J Webslte: ► Hllr W.1joSpICEOPTHEVALLEYS.ORG Mil Group exemption number ► K Form of organizalicn: {;prpfpalilHl Trust Association Other"` L Year of lorrnalion: 1983 1 M state of legal domicile: CA r nrerjrry aescnee Inc organlzatfon-s nusslon or roost signiCCant activilies:(�e foster reverence _f_or__1_ifeJ_relief of-----ngs-----m---In in loss for the_ter_Mi_na.1�i11 residents -.and -their families in the communities we serve,_ E- - -- - - - - - -- - - -----_--------- c 2 Check This box ► if the organization discontinued its operations or disposed of more than 25% of its net assets, -------.---------e-------_-_-_._---------- . - - - 0 3 Number of voting members of the governing body (Part VI, line la)... ... 3 9 e'a 4 Number of independent voting members of the governing body (Part Vl, line lb),....... , , , 4 ayi A 5 Total number of individuals employed in calendar year 2020 (Part V, line 2a). -5 64 6 Total number of volunteers (estimate if necessary) ... _ .. . .... . ......... . .... 6 -52 a 7a Total unrelated business revenue from Part VIII, column (C), line 12 ................ . . ... 7a 0. b Net unrelated business taxable income from Form 990-T, Part 1, line I ... 7b 0 . Prior Year Current Year 8 Contributions and grants (Part Vill, line Ih)........... _ 66,351, 531 200_ 9 Program service revenue (Part VIII, line 2g), .. . 5, 861 297. 5 704 345. 10 Investment income (Part VIII, column (A), lines 3, 4, an dj 14,323, 16,311. 11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9 , I 1 107 795. 42 952. 12 Total revenue - add lines 8 through 1 I (must equal P , co Nnur (A), line 12) 6 049 766. 6 2 4 808. 13 Grants and similar amounts paid (Part IX, column (A), lines 1.3). 14 Benefits paid to or for members (Part IX, column (A), line 4) ... .. . . 15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-10)..... 3_ 857, 048: 4 306 846. 16a Professional fundraising fees (Part IX, column (A), line l le),.. . . b Total Fundraising expenses (Part IX, column (D), line 25) ► 113, 477. 17 Other expenses (Part IX, column (A), lines Ila-1 ld, 11f-24e). 1 783 463. 1 875 r 6I7. 18 Total expenses. Add lines 13-17 (must equal Part IX, column (A), line 25) _y1 .t 5 640,511, ,� 6 182 463. 19 Revenue less expenses, Subtract line 18 from line 12 . , . , , . • • • • • , , . , . • • • , _40 9, 255 . BeAnof Current Year 112 345. End of Year 6 20 Total assets (Part X, line 16) ...... 2 820 982. 2,899,195. 21 Total liabilities (Part X, line 26).... . 363 380. 320 322, 22 Net assets or fund balances. Subtract line 21 front line 20. 2,457,602. 2 57a .863. Part ff Signature Block penalties of perjury, I declare Ihet I nave examined This returnincluding accptrlpanymg schedules and slatornents, and to line besl of my knowledge and belief, it is true, correcl, Declaration of preyarer (other Ihan nl6i 0 Is based on all information of o i preparer has any knowledge, and l now Cernplele. Sign r 5rrralwaorallkrrr —nai4 — Here LYNETTE CVAR CA0/CF0 Tpa -, "nnnf nnmo Ww Irulu Prinlrrype preparer's name Proparel'e signature male Check PTIN Paid Paul J Ka ark, CPA Paul J Ka mark CPA eu-empleyj d P01873961 Preparer FwW, nanr.= ► NIGRO & NIGRO PC _ Use Only F,.,,,; adLfe„ ► 25220 Hancock Ave Ste 400 Furrrs FIN � 30•-0636241 _ MURRIETA, CA 925624 Phow-lo. (951) 698-8783 May the IRS discuss this return with the preparer shown above? See instructions., IXI Yes I T—No BAA For Paperwork Reduction Act Notice, see the separate Instructions. TEen01011- 0111901 Form 990 (2020) FY 2022/2023 COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA GRANT APPLICATION # 23 INLAND VALLEY SYMPHONY AKA TEMECULA VALLEY SYMPNONY CITY OF TEMCULA FISCAL YEAR 2022 - 2023 COMMUNITY SERVICE FUNDING - REINVESTMENT IN TEMECULA PROGRAM APPLICAMON (Please Print or Type) DUE ON OR BEFORE: MONDAY, SEPTEMBER 12, 2022 PROJECT/PROGRAM INFORMATION Amount Requested: $ S* 0 0 O MAXIMUM ALLOWABLE: $50,000 PER ORGANIZATION Project/Program Title: n � E ASO rJ Of 14 0 P e Start Date: of. I End Date: 70.23 Physical Address of Project/Program: Tfrx¢eAt dj$1I 1 SsS AMCL& VIr+� ��, '��rrirr,+ �• INCLUDE IF DIFFERENT THAN ORGANIZATIONS MAILING ADDRESS Cat u 9L If Grant is Awarded, Make Check Payable to: xN C- w b IA ON �qpkW, TW e Mailing Address: ORGANIZATION AND GEOGRAPHIC AREA SERVED Name of Applicant v AM e' Organization: a Year Founded: q Q R Website: WWLV-'rEFAF-CI.LA fA11 M Iw. •O�Social Media: w�• IFACEAoOK.CQ rmBcuAA- Number of Paid Staff: '� oZ- Number of Volunteers: Geographic Area(s) the Organization Serves: 11 fA E Geographic Area(s) the Prolect/Program Serves: T M r,0 UAA \101 iq NOTE: COMMUNITY SERVICE FUNDING GRANT PROGRAM FUNDING MUST BE EXCLUSIVELY US D TO SERVE TEMECULA. Contact Name: QLQ KA To 0 5 Title/Position: C �W-rrVC IDIAEGTOA Contact Person's Direct Telephone: SI g• 271 — Contact Person's Email: GJ4AIA Too S 09ai 0 Gon,414. Parr NONPROFIT STATUS Is this organization incorporated as a nonprofit? Yes ® Date of Incorporation as a Nonprofit: -I• U - 77 No ❑ IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING Federal Identification Number: 15002000 State Identification Number: a 0 r PRINT OUT AND ATTACH TO THIS APPLICATION VERIFICATION FROM FEDERAL (IRS) AND STATE (FTB) AS FOLLOWS: 1. ❑ Attach IRS Deductibility Status using this link: hItpA/appsjrs.Aov1app1eos1 2. ❑ Attach State Entity Status Letter using this link: httl5-9'-:1/www.ft.c . ov n Ine e f serve entity status letter/inde?x.as 3. ❑ Attach first page only of most recent IRS Form 990 or attach print out of detailed info about your charity found on this State Registry's Search Tool: htt ://rct.do .ca. avN dfica ion eb/Sears s 0f ilt -Y City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 5 of 13 4 APPLICATION AUTHORIZATION Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over $500 including any business transactions, negotiations Investments, or interests in real property with a Temecula City Council Member during the past 12 months? No Yes ❑ IF YES, BRIEFLY DESCRIBE: Is a Temecula City Council Member a member of the Board of Directors or an Officer of the organization? No � Yes ❑ IF YES, PROVIDE COUNCIL MEMBER'S NAME AND TITLE WITHIN THE ORGANIZATION: This Application has been authorized by the organization's: Executive Committee V\] Board of Directors ❑ Members -at -Large ❑ MISSION STATEMENT OF ORGANIZATION BRIEFLY DESCRIBE THE ORGANIZATION'S MISSION/GOALS AND OBJECTIVES, MISSION STATEMENT Temecula Valley Symphony aspires to provide quality, innovative, and compelling music programming and serves as a leader of the arlS in our community, through an organization that provides the support necessary for these efforts, in an atmosphere that is fun, positive, and supportive. MISSION STATEMENT The purpose of Temecula Valley Youth Symphony is to enrich the lives of student musicians with outstanding educational and performance opportunities for all levels, in a nurturing and challenging environment without discrimination. Working together with parents, private and school music instructors, TVYS will provide the finest possible training with rehearsal and performance opportunities to enable the students to develop, share and Further enrich their lives through the power of music. TVYS believes that music is proven to enhance student performance in all academic areas. FINANCIAL STATEMENTS UPON REQUEST, COPIES OF THE ORGANIZATION'S CURRENT BUDGET/FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT), AND IF AVAILABLE CPA'S AUDIT, MAY BE NEEDED UPON REQUEST TO DEMONSTRATE SOUND FINANCIAL MANAGEMENT. DO NOT SUBMIT NOW. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 6 of 13 FMDMG SOURCES CITY OF TEMECULA—SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM THE CITY FOR ANY PROGRAM? No ❑ Yes P9 IF YES, PROVIDE BELOW, -' "LiF% vv101wM 0UUKGES—SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM ENTITIES (NOT INCLUDING THE CITY) FOR THE SAME PRDIIECT OO IN THIS APPLICATION? NO Yes IF YES, PROVIDE INFORMATION IN TABLE BELOW. City of Temecula Community Service Funding - Reinvestment In Temecula GRANT APPLICATION Page 7 of 13 GRANT PROJECT/PROGRAM DESCRIPTION IMPORTANT- RECEIPTS/INVOICES IS REQUIRED TO BE SUBMITTED TO THE CITY TO VALIDATE THE ORGANIZATION SPENT GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE PROJECT/PROGRAM AS DESCRIBED HERE 1 DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT. Ft ev +z�t�.5 Grant funds will support "SEASON OF HOPE" and allow us to invite Is of school children and senior citizens to our concerts with FREE ADMISSION. Monies will be used for marketing and outreach materials to spread throughout the community. Payment will be made to various musicians for participating in the program and demonstrating their instruments. Printed materials distributed at concerts will contain educational information about the composer, the style of music, and the instruments featured on the concert. i 2 DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED. ALSO. INCLUDE A LIST OF GOODS, EQUIPMEMENT. AND/OR SERVICES THIS ORGANIZATION HAS �— PURCHASED OR PLANS TO PURCHASE WITH AWARDED FUNDS TO SUPPORT THIS PROGRAM/PROJECT. Compensate musicians for performances, website improvements, increase marketing to promote higher visibility and recognition in the community. TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS. Two large concerts will be held at Temecula Valley High School with outreach to local students, music studios, and school band programs. Dv outreach through the Temecula Valley UttiHed school district. Special concert invitations will be distributed at places like the Mary Phillips Senior Center, and various senior housing communities in Temecula, offering FREE Tickets to the concerts. Free tickets will also be distributed to the Boys and Girls Club and other local charities. 3b ESTIMATED NUMBER OF PEOPLE FROM TEMECULA EXPECTED TO BENEFIT FROM THIS PROJECT/PROGRAM: 3c ESTIMATED NUMBER OF VOLUNTEERS INVOLVED IN THIS PROJECT/PROGRAM: City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION 1056 50 Page 8 of 13 PROJECT/PROGRAM DESCRIPTION CONTINUED 4 SUMMARY STATEMENT — SUMMARIZE ANSWERS 1 — 3 ABOVE IN 50 WORDS OR LESS. SEASON OF HOPE will focus on providing FREE concert tickets to hundreds of local Temecula residents (focusing on the elderly population), and local students and their families. Concerts will include some music selections composed by minority or female composers and will include educational elements in the presentation of materials and/or the music performance itself. 5 IF APPLYING FOR MORE THAN $5,000, PLEASE EXPLAIN HOW THE COVID-19 PANDEMIC AFFECTED THIS NONPROFIT ORGANIZATION'S ABILITY TO SERVE THE TEMECULA COMMUNITY. YOU MAY ALSO INCLUDE INFLATIONARY CONCERNS. Due to lockdowns, we had to cancel 6 concerts and were unable to schedule further concerts until Covid-19 restrictions were lifted. Consequently we not only lost performance revenues but also most of our sources of donations. Were it not for a couple of pandemic related relief grants received from the State and Riverside County, we would have been forced to close down our organization completely. Due to lack of funds we were unable to resume full concert scheduling for both the last and the upcoming season. Inflationary pressures have increased most of our basic general operating expenses as well as the cost of musicians because of higher cost of living, especially gas prices. 6 IF APPLYING FOR MORE THAN $5,000, EXPLAIN HOW FUNDS HAVE OR WILL: (1) CREATE NEW PROJECT/PROGRAM, (2) EXPAND EXISTING PROJECT/PROGRAM, AND/OR (3) CONTINUE EXISTING PROJECT/PROGRAM. One of our goals for our 2022-2023 Season is to offer FREE CONCERTS to Temecula Valley Uuiflic School District's students and families to educate them about symphonic music which is proven to improve the mental health of students. We will use grant funds for marketing and outreach throughout the community to also offer free tickets for the elderly and senior citizens in the Temecula Valley. As part of our educational program we also host a young artist concerto competition and will select winners to perform at our April 22, 2023 concert with the Symphony. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 9 of 13 PROJECT/PROGRAM BUDGET (do not fill in shaded areas) I - -LINE ITEMS FOR PROJECT/PROGRAM REVENUES jEXPENSES LIST REVENUES/INCOME FOR PROJECT/PROGRAM Amount of money requested from this City of Temecula $ 50 000 Community Services Grant (Not to exceed $50,000) Amount contributed to the Project/Program by the Applicant $ Organization 19,333 Other grants or funding already awarded for Project/Program, if any $ 3,000 In -Kind match amount or volunteer credit hours estimated amount $ 38,500 — _ TOTAL REVENUE $ 110 833 LIST OF EXPENSES FOR PROJECT/PROGRAM Tools/Equipment a $ 0 Facilities/Rent/Insurance $ 9,275 Supplies $ - — 2,090 Marketing I $ 16,133 Services $ 50,560 ~ Food - — I 1,000 Other $ 14,495 Staffing Expense THIS IS INELIGIBLE TO BE FUNDED BY CITY'S GRANT; f HOWEVER PLEASE INCLUDE, $ 17,280 TOTAL EXPENSES TOTAL BUDGET' $ 110,833 $ 110,833 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 10 of 13 ACIK7. O WLEDGEWNTISIGNATURE PAGE The applicant acknowledges and agrees to the following: • Recipient Is subject to aft COrnmunityServlce Funding Program requirements inciudingsubmittal deadlines and payment disbursements. • Every Community .Service Funding application is considered individually and on its own merit. • Awards will be given to organizations and activities that directly benefit the residents of Temecula. • Funding is not immediately available to the recipient, and requires an award letter signature upon approval. Please allow time for checks to be processed. ■ The awarding of Community Service Funding does not constitute an automatic annual allocation. ■ The recognition for Community Service Funding.should accrue to the City of Temecula. • Commurlfty Service Funding must be spent as specified on the Application and records may be requested by the City of Temecula to ensure the funds were .used apprOpriately. F Community Service Fund€nggrants will not be awarded or announced within the 60 days before an election In which an awarding Council Member is on the ballot. • The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. • If awarded a Community Service Funding Grant by the City of Temecula last year, then compliance receipts must be submitted on or before this application's due date or this application may be rejected as Incomplete. Vwe hereby certify the information contained in this Application is true to the .best of our knowledge and belief. ORGANIZATION NAME: Inland Valley Symphony, Inc. dba Temecula Valley Symphony MAILING ADDRESS: PO Bay. &17 Temecula, CA 92593 PHONE: ( 9511333-4945 (Alwia) or 818-?31-09314,A�na) - EMAIL,• W&najoos a) a�Lcnna PRESIDENT / AUTHORIZED OFFICER: MAIA CANTIRELL TREASU..RFR y -Pl ;rNr NA F TITLE SIGNATURE: DATE: Q� �[)�� IF DIFFERENT TH MQNT}I, DAY, YEAR A�AI30VF, APPICATION PREPARED BY:. ALANA 100S - EXECUTWE DIRECTOR PRINT NAME TITLE SUBMIT ORIGINAL APPLICATION BY MQNDAY, SEPTEMBER 12, 2022, TO: City of Temecula Community Service Funding Attn., City Manager's Office 41000 MAIN STREET TEMECULA, CA 92590 Questions: Stacey.Brown@Temecul,-)CA.gov (951) 694-6413 Betsy.Lowrey@TerneculaCA.gov (951) 6W-3959 C€ty of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 13 of 13 Q HELP® MENU E Home > Tax ExemQrganization Search > Inland Valley Symphony Inland Valley Symphony EIN: 33-0862000 1 Temecula, CA, United States Publication 78 Data e Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions. On Publication 78 Data List: Yes Deductibility Code: PC Copies of Returns (990, 990-EZ, 990-13F, 990-T) e Electronic copies (images) of Forms 990, 990-EZ, 990-PF or 990-T returns filed with the IRS by charities and non- profits. Tax Year 2020 Form 990EZ Tax Year 2019 Form 990 Tax Year 2018 Form 990EZ Tax Year 2017 Form 990EZ Tax Year 2016 Form 990EZ STATE OF CALIFORNIA rry� FRANCHISE TAX BOARD f r F• 1 S PO BOX 942857 SACRAMENTO CA 94257-0540 Entity Status Letter Date: 9/9/2022 ESL ID: 5729240826 Why You Received This Letter According to our records, the following entity information is true and accurate as of the date of this letter. Entity ID: 2045812 Entity Name: INLAND VALLEY SYMPHONY 0 I. The entity is in good standing with the Franchise Tax Board, ❑ 2. The entity is not in good standing with the Franchise Tax Board. X3. 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. ❑ 5. The entity was administratively dissolved/cancelled on through the Franchise Tax Board Administrative Dissolution process. Important Information This information does not necessarily reflect the entity's current legal or administrative status with any other agency of the state of California or other governmental agency or body. If the entity's powers, rights, and privileges were suspended or forfeited at any time in the past, or if the entity did business in California al a time when it was not qualified or not registered to do business in California, this information does not reflect the status or voidabllity of contracts made by the Entity in California during the period the entity was suspended or forfeited (R&TC Sections 23304.1, 23304.5, 23305a, 23305.1). The entity certificate of revivor may have a time limitation or may limit the functions the revived entity can perform, or both (R&TC Section 23305b). Connect With Us Web: ftb.ca.gov Phone: 800-862-5711 from 7 a.ni. to 5 p.m. weekdays, except state holidays 916-845-6500 from outsisie tlu United States California Relay Service: 711 or 800-735-2929 (For persons with hearing or speech impairments) FTB 4263A WEB (REV 12-2019) HOME ABOJI- MEDIA CA R --: E R EGC -AT I 0Nf--; RES0 R S PROGRAMS CUDNT/1U, Registrant Detail Entry ype Cot por;; e Class u5 registered with the secc2Lai v of e. or based ran fol,r6ng 60CL11 Organization Name: INLAND VALLEY SYMPHONY IRS FEIN: —3.10862000 Entity Type; Public Benefit SOS/FfB Corporate/Organization Number: 2045812 Registry Status: Current Renewal Due/Exp. Date: 11/15/2022 W.-I'Registration Number: CT0162898 Issue Date: 7/19/2010 Record rfy . pe: Charity Registration Effective Date: 7/19/2010 Date of Last Reneivak 11/18/2021 DBA: MaHing Address Street: PO BOX 637 Street Line 2., City, State Zip: 'I'EMECULA CA 92593 Filings & Correspondence UWiW=y—ULUaUQ,11 Delinquency 1st Notice ondi g—DAmmenta Uarm 990--EZ 412 M1 L-1-= RKE-11 IQL6 IME-1 2009 &ULZJ�() I Form 9901? Lk 7M) LRE- L 2 QL1 IRUIDGNTP-9 21L L. L" RS ul t,1 ()9() Z(L Return Check Letter Founding Documents 2012 RRLF-I 2012 IRS Form 990-EZ 2004 RR F- 1. 2005 RRF-1 2006 RRF-1 2007 RRF-1 2009 RRF-1 2010 IRS Fonm 990-EZ 2008 RRF-1 2011 RRF-I 2011 IRS Foirn 990-F7 2009 IRS Form 990 2008 IRS Form 990-EZ Confirmation ol'Registration First Notice to Register Secolld Notice to Register 2021 2018 2019 2020 2013 RRF-1 2013 IRS Form 990-1 Z 2015 RRF-1 1 ' -Z 2015 IRS Fonn 990-E.Z ?415 rm-���'1"��w 2015 IRS Forrn 940-F1 2016 RRF-1 �'.511T17 RAF-1 2017 IS { =92017 Annual; Renewal Data Status of filing: Accepted Accounting Period Begin Date: 7/1/2009 Accounting Period End Date: 6/30/2010 Filing Received Date: 12/1/2010 Furin RRF-1 Reject/Incomplete Reason: Form CT-TR-1 Reject/Incomplete Reason: IRS Form 990 Reject/Incomplete Reason; Notes From Registry Staff; Status of Filing; Accounting Period Begin Date: Accounting Period End Date: Filing; Received Date: Form RRF-1 Reject/Incomplete Reason: Form CT-TR-I Reject/Incomplete Reason: IRS Form 990 Rejecl/Incomplete Reason: Notes From Registry Staff: Status of Filing: Accounting Period Begin Date: Accounting Period End Date: Filing Received Date: Form RRF-1 Reject/incomplete Reason: 1, arm CT-TR-1 Reject/Incomplete Reason: IRS Form 990 Reject/Incomplete Reason; Notes from Registry Staff: Status of Filing: Accounting Period Begin Date: Accounting Period Fnd Date: Filing Received Date; Form RRF-1 Reject/Incomplete Reason: Form CT-TR-1 Reject/Incomplete Reason: IRS Form 990 Reject/Incomplete Reason: Notes From Registry Staff. - Status of Filing: Accounting Period Begin Date: Accounting Period End Date: Filing Received Date: Form RRF-1 Reject/Incomplete Reason: Form C'r-'i'R-I Reject/Incomplete Reason. - IRS Form 990 Reject/Incomplete Reason: Notes From Registry Staff; Status of Filing: - Accounting. Period Begin Date: Accounting Period End Dates Filing Received Date: Accepted 7/ 1 /2010 6/30/201 1 11/17/2011 Accepted 7/ 1 /201 1 6/3 0/2012 10/31 /2012 Accepted 7/1/2012 6/30/2013 11/1K2013 Accepted 7/1/2013 6/30/2014 2/9./20 Li Accepted 7/ 1/2014 0./3 0/2015 1!5/2016 Form RRF-1 Reject/Incomplete Reason: Form CT-TR-1 Reject/Incomplete Reason: IRS Form 990 Reject/lncomplete Reason: Motes From Registry Staff: Status of Filing: Accounting Period Begin Date: Accounting Period End Date: Filing Received Date: Form RRF-t RejectAncomplete Reason: Form CT-TR-I Reject/incomplete Reason: IRS Form 990 Reject/Incomplete Reason: ]Votes From Registry Staff: Status of Filing: Accounting Period Begin Date: Accounting Period End Date: Filing Received Date: Forst RRF-1 Reject/Incomplete Reason: Forst CT-TR-I Reject/incomplete Reason: IRS Form 990 Reject/Incomplete Reason: Notes From Registry Staff: Accepted 7/1/2015 6/30/2016 11 /18/2016 Accepted 7/1/2016 6/30/2017 11/16/2017 Status of Filing: TAccepted Accounting Period Begin Date: 7/1/2017 Accounting Period End Date: 6/30/2018 Filing Received Dale: 11/20/2018 Form RRF-1 Reject/Incomplete Reason: Form CT-TR-1 Reject/Incomplete Reason: IRS Form 990 RejectAncomplete Reason: Nalm From Registry itnff! Status of Filing: Accounting Period Begin Date: Accounting Period End Date: Filing Received Date: Form RRF-1 Reject/Incomplete Reason: Form CC TR-1 Reject/Incomplete Reason: IRS Form 990 Reject/incomplete Reason: Notes From Registry Staff. - Status of Filing: Accounting Period Begin Date: Accounting Period End Date: Filing Received Date- Forin RRF-1 Reject/Incomplete Reason: Form CT-TR-1 Reject/Incomplete Reason., IRS Form 990 Reject/Incomplete Reason: Notes From Registry Staff: Sialux of Filing: Accounting Period Begin Date: Accounting Period End Date: Filing Received Date: Form RRF-1 Reject/lncomplete Reason: Form CT-TR-I Reject/Incomplete Reason: IRS Form 990 Reiect/Incomplete Reason: Votes From Registry Staff: Accepted 7/ U2018 6/30/2019 11/12/2019 r+"Up *u 7/1/2019 6/30/2020 5/10/2021 Accepted 7/ 1 / 2020 6/3 N2021 10/20/2021 04 Nay}/~�1 5£•, I I(7W r,HOU r MECIA CAREERS REGU! ATOMS RE OUROES PROCRWOS 1ONTAC:T Cack on the Organization tYlemn- for details about the registration Or report record, The maximum number of records shown per page Is 5t7. If there are multiple pageq of th, reaulu, the c{ickable page numheis, wilt be d,splavud at tha bottom, If rots get trio many results or do not Sind ttte aryartlzation fur wttfGt you arts searchmQ, rfFrk the 'Sears button and Change the search cdterfa. it Is lft+st to search oy something that I as unique to the Olganiaatlan as Ogsibie sues as State Charity Registratlori Number. FCIN, � Corporate Number, ur an ilnuSual porLium Of their name. TO See pli regI$tratmn and report records aSWoated with an'IN"Metron. avoid "archmg by State Charity Reoistra Number as that Is regard-speciflc. 9earcit►L in I ORGANIZATION MADE RECORD TYPE REGISTRY STATUS RCT NUMBER FEI liC17 CharityF�egtstration-- — _,C.urret}t 330$62000tiEME[ 2020 FEDERAL EXEMPT ORGANIZATION TAX SUMMARY (EZ) PAGE 1 INLAND VALLEY SYMPHONY 3R-0862ann FORM 990-EZ REVENUE 2020 2019 DIFF CONTRIBUTIONS, GIFTS, AND GRANTS....... PROGRAM SERVICE REVENUE 40,196 98,769 -58,573 ..................... INVESTMENT INCOME....... 12,973 , 1 83, 744 -70, 771 ........ . ........... 1 0 TOTAL REVENUE., ....... . ....... ...... .... 53,170 182,514 -129, 344 EXPENSES PROFESSIONAL FEES/PYMT TO CONTRACTORS PRINTING, PUBLICATIONS, AND POSTAGE....... 36,683 119,218 -82,535 OTHER EXPENSES. .... .... I ......... -.......... 441 18,521 250 48,445 191 -29, 924 TOTAL EXPENSES ....................................... 55,645 167,913 -112, 268 NET ASSETS OR FUND BALANCES EXCESS OR (DEFICIT) FOR THE YEAR... NET ASSETS/FUND SAL. AT BFG. OF YEAR.... -2, 475 35,235 14,601 20,409 -17, 076 14,826 OTHER CHANGES IN NET ASSETS/FUND BAL.. 1 225 -224 NET ASSETS/FUND BAL. AT END OF YEAR ... 32,761 35,235 -2,474 coy. Registry of Charitable Trusts P.O. Box 903447 Sacramento, CA 94203-4470 Telephone: (916) 445-2021 WEBSITE ADDRESS: ht1 Wa4j.ca.uov1charitiesl c7V/6 z eo?8 INITIAL REGISTRATION FORM STATE OF CALIFORNIA OFFICE OF THE ATTORNEY GENERAL REGISTRY OF CHARITABLE TRUSTS (Government Code Sections 12580-12599.7) Pursuant to Section 12585, registration is required of every trustee subject to the Supervision of Trustees'and__ Fundraisers for Charitable Purposes Act within thirty days after receipt of assets (cash or other forms of property) for the charitable purposes for which organized. Every charitable (public benefit) corporation, association and trustee holding assets for charitable purposes or doing business in the State of California must register with the Attorney General, except those exempted by California Government Code section 12583. Corporations that are organized primarily as a hospital, a school, or a religions organization are exempted by Section 12583. Name of Organization: Inland Valley Symphony, Inc. Yin:. -- --- - T:.: y,,, uumci r�): „ Official Mailing Address for Organization: Address: 4035 Kenosha Ave. city: San Diego State: CA ZIP Code: 92117 Organization's telephone number: (858)270-4521 Organization's e-mail address: info@iniandvalleysymphony,org Organization's fax number: N/A organization's website: In(andValleySymph6ny.Org All organizations rr►ust'apl�ly Car a F ,. erali rrip3ciye d(„�-,M,iMatlan[Nu bat 'ti brganizatloris'thaf;Haire a` rou 3 ek tons riile'oinucl'returns 't�"'' :.,..,.ls......I—- S. I P a Federal Employer Identification Number (FEIN): Group Exemption FEIN (if applicable): 33-0862000 x�yk?..• '" llfl Caifiarnia'corpora tlons air�cl fpreigit�.fir corpor7.7 -f the �umpo �cr. UnincorrAtecl o'{rjanlzaiion5 3re_AZ91i cl m California tax.exesnEitin,i .' : ;l��h [Corporate or Organization Number: C2045812_ Attorney JUN a 1 2010 Ch:1mof ie ffusto CT-1 REGISTRATION FORM (6/2007) Names and addresses of ALL trustees or directors and officers (attach a list If necessary): Name Alana Joos Position President Address 3359 Savannah Way city Palm Springs state CA ZIP Code 92262 Name Douglas Bast Position Vice President Address 29670 Cottonwood Cove Dr. city Menifee state CA ZIP code 92584 Name Emily Miller Position Secretary Address 30207 Silver Ridge Ct. city Temecula state CA ZIP Code 92591 Name Linda Daugherty Position Treasurer Address 27041 Rock Bluff Ave. city Temecula state CA ZIP Code 92591 Name Sharon Rollinson Position: Coordinator Address 4035 Kenosha Ave. city San Diego Describe the primary activity of the organization. (A Copy or the material submitted with the application for federal or state tax exemption will normally provide this Information-} If the organization is based ouIsIdc California, comment fully on the extent of activities In California and how the California activities relate to total activities. In addition, list all funds, property, and other assets held or expected to be held In California. indicate whether you are monitored In your home state, and I so, by wham. Attach additional sheets If necessary, The specific purpose of Inland Valley Symphony is to provide orchestral experience for all age groups, to train younger musicians, to create an interest in musical careers by performing In schools and in public concerts and to improve the cultural experiences available to all citizens in the Inland Valley clgl;mports annualfj Been.days Jitvr'the: or',etotai �isseYs'are'a wehsiter at htlp llac If assets (funds, property, etc.) have been received, enter the date first received Date assets first received: July 1999 What annual accounting period has the organization adopted? Fiscal Year Ending June 30 Calendar Year CT-1 REGISTRATION FORM (6I2007) Attach your founding documents as follows: A) QQLPRERILPEL5 - Furnish a copy of the articles of incorporation and all amendments and current bylaws, if Incorporated outside California, enter the date the corporation qualifled through the California secretary of State's Office to conduct activities In California. B) Associatlons - Furnish a copy of the instrument creating the organization (bylaws, constitution, and/or articles of association). C) Trusts - Furnish a copy of the trust Instrument or will and decree of final distribution. D) Trustees for char table ur oses - Furnish a statement describing your operations and charitable purpose. Has the organization applied for or been granted IRS tax exempt status Yes E) No 0 Date of application for Federal tax exemption: Jilly 26, 1999 Date of exemption letter: July 2000 3 Exempt under Internal Revenue Code section 501(c) If known, are contributions to the organization tax deductible? Yes EJ No p (IRS Attach a cop y of the Application for Recognition of Exemption IRS Form 1023) and the determination letter issued by the IRS, Does your organization contract with or otherwise engage the services Of any commercial fundraiser for charitable purposes, fundralsing counsel, or commercial coventurer? If yes, provide the name(s), address(es), and telephone number(s) of the provider(s): Commercial Fundraiser Fundraising Counsel E Commercial Coventurer Name -- Address city State ZIP Code Telephone Number Commercial Fundraiser Fundraising Counsel Commercial Coventurer Name Address City State ZIP Code Telephone Number Commercial Fundraiser ❑ Fundralsing Counsel [ Commercial Coventurer Name Address City State ZIP Code Telephone Number I declare under penalty of perjury that I have examined this registration form, Including accompanying documents, and to the best of my knowledge and belief, the form and a�p9 cumenl are true, correct, and complete. Title Date CT-1 REGISTRATION FORM (6/2007) FY 2022/2023 COMMUNITY SERVICE FUNDING REINVESTMENT IN TEMECULA GRANT APPLICATION # 24 INTERNATIONAL CHRISTIAN ADOPTIONS CITY OF TEMECUL& FISCAL YEAR 2022.2023 COMMUNITY SERVICE FUNDING - REINVESTMENT IN TEMECULA PROGRAM APPLICATION (Please Print or Type) DUE ON OR BEFORE: MONDAY, SEPTEMBER 12, 2022 Amount Requested: $ Project/Program Title: PROJECT/PROGRAM INFORMATION 18,160 MAXIMUM ALLOWABLE: $50,000 PER ORGANIZATION Community Counseling Start Date: 9/12/2022 End Date: 5/3012023 Physical Address of Project/Program: INCLUDE IF DIFFERENT THAN ORGANIZATION'S MAILING ADDRESS If Grant is Awarded, Make Check Payable to: ICA Mailing Address: 41745 Rider Way, Suite 2 Temecula, CA 92590 ORGANIZATION AND GEOGRAPHIC AREA SERVED Name of Applicant Organization: International Christian Adoptions (ICA) Year Founded: 1990 Website: 4achild.org Number of Paid Staff.. 53 Social Media: @4achild on Instagram and Facebook Number of Volunteers: 0 Geographic Area(s) the Organization Serves: State of California and North Carolina Geographic Area(s) the Project/Program Serves: Temecula Valley Residents NOTE: COMMUNITY SERVICE FUNDING GRANT PROGRAM FUNDING MUST BE EXCLUSIVELY USED TO SERVE TEMECULA. Contact Name: Charlotte Paulsen Title/Position: Executive Director Contact Person's Direct Telephone: (951) 704-4354 Contact Person's Email: chadottep@4achild.org NONPROFIT STATUS Is this organization incorporated as a nonprofit? Yes 0 Date of Incorporation as a Nonprofit: 1990 No ❑ IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING Federal Identification Number: 33-0412343 State Identification Number: 33-0412343 PRINT OUT AND ATTACH TO THIS APPLICATION VERIFICATION FROM FEDERAL (IRS) AND STATE (FTB) AS FOLLOWS: 1. ❑ Attach IRS Deductibility Status using this link: http://apps.irs.govta2pleosl 2. ❑ Attach State Entity Status Letter using this link: RECEWED httr)s:lfwww.ftb.co.00v/online/self serve entity status letter/index.as 7�t 3. El Attach first page only of most recent IRS Form 990 or attach print out of dejLppd i gb your charity found on this State Registry's Search Tool: http:llrct.doi.ca.gov/VedficatlonNVebl a rc s ?� x faclillv�Y City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 5 of 13 APPLICATION AUTHORIZATION Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over $500 including any business transactions, negotiations, Investments, or interests in real property with a Temecula City Council Member during the past 12 months? No K Yes ❑ IF YES, BRIEFLY DESCRIBE: Is a Temecula City Council Member a member of the Board of Directors or an Officer of the organization? No ❑■ Yes ❑ IF YES, PROVIDE COUNCIL MEMBER'S NAME AND TITLE WITHIN THE ORGANIZATION: This Application has been authorized by the organization's: Executive Committee ❑ Board of Directors [j Members -at -Large ❑ MISSION STATEMENT OF ORGANIZATION BRIEFLY DESCI " See Attachec FINANCIAL STATEMENTS UPON REQUEST, COPIES OF THE ORGANIZATION'S CURRENT BUDGET/FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT), AND IF AVAILABLE CPA'S AUDIT, MAYBE NEEDED UPON REQUEST TO DEMONSTRATE SOUND FINANCIAL MANAGEMENT, DO NOT SUBMIT NOW. City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Pane R of 13 FUNDING SOURCES CITY OF TEMECULA—SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM THE CITY FOR ANY PROGRAM? No ❑ Yes 0 IF YES, PROVIDE BELOW. NAME OF PROGRAM/PROJECT AMOUNT MONTH + YEAR NAME OF CITY GRANT FUNDED BY THE CITY GRANT OR SPONSORSHIP FUNDING RECEIVED OR SPONSORSHIP Sunridge Community Church $ 410g0 September 2022 - May 2023 Community Counseling Donation $ $ OTHER OUTSIDE SOURCES —SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM ENTITIES (NOT INCLUDING THE CITY) FOR THE SAME PROJECTIPROGRAM IN THIS APPLICATION? NO ❑ Yes [ j IF YES, PROVIDE INFORMATION IN TABLE BELOW. AMOUNT MONTH + YEAR NAME OF ENITY RECEIVED FUNDING RECEIVED $ q55 U SCRI FY Jul 22 - Jun 23 $ J351 201) U RM Reimbursement Contract 1 FY Jul 22 - Jun 23 ' $ 2-2, / S,2 County Riverside Foster Services FY Jul 22 - Jun 23 $ C�), a#p PAARP Services FY Jul 22 - Jun 23 $ io, 03,q Heartland HS - PRS Contract FY Jul 22 - Jun 23 $ USCCB-US Conf. Catholic Bishops FY Jul 22 - Jun 23 $ City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 7 of 13 GRANT PROJECT/PROGRAM DESCRIPTION IMPORTANT - RECEIPTS/INVOICES IS REQUIRED TO BE SUBMITTED TO THE CITY TO VALIDATE THE ORGANIZATION SPENT GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE PROJECT/PROGRAM AS DESCRIBED HERE F— ------- — --- --- 1 DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT. * See Attached Form 12 DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED. ALSO, INCLUDE A LIST OF GOODS, EQUIPMEMENT, AND/OR SERVICES THIS ORGANIZATION HAS PURCHASED OR PLANS TO PURCHASE WITH AWARDED FUNDS TO SUPPORT THIS PROGRAM/PROJECT. * See Attached Form — - - - - 3 TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS. * See Attached Form — — — i 3b ESTIMATED NUMBER OF PEOPLE FROM TEMECULA EXPECTED TO BENEFIT FROM THIS PROJECT/PROGRAM: 50 Children & Families 3c ESTIMATED NUMBER OF VOLUNTEERS INVOLVED IN THIS PROJECT/PROGRAM: 10 City of Temecula Community Service Fundinq - Reinvestment in Temecula GRANT APPI Ir.ATlnti D.— A -f 1 a PROJECT/PROGRAM DESCRIPTION C'ON77NUED 4 SUMMARY STATEMENT — SUMMARIZE ANSWERS 1 — 3 ABOVE IN 50 WORDS OR LESS. * See Attached Form 5 IF APPLYING FOR MORE THAN $5,000, PLEASE EXPLAIN HOW THE COVID-19 PANDEMIC AFFECTED THIS NONPROFIT ORGANIZATION'S ABILITY TO SERVE THE TEMECULA COMMUNITY. YOU MAY ALSO INCLUDE INFLATIONARY CONCERNS. " See Attached Form 6 IF APPLYING FOR MORE THAN $5,000, EXPLAIN HOW FUNDS HAVE OR WILL: (1) CREATE NEW PROJECT/PROGRAM, (2) EXPAND EXISTING PROJECT/PROGRAM, AND/OR (3) CONTINUE EXISTING PROJECT/PROGRAM. " See Attached Form City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 9 of 13 International Christian Adoptions City of Terneculo Community Service Funding Reinvestment in Temeculo Grant Program Policy Applicotion 01).12-22 Mission Statement of Organization: International Christian Adoptions (ICA) believes in the sanctity of life in that all children born and unborn are valued and uniquely made. Our overriding mission is to offer children hope in the love and compassion of Jesus Christ; hope for basic needs; hope for an education and bright future; and hope for a home in a family they can call their own. The mission is fulfilled through adoption, foster care, humanitarian aid, counseling and support. In addition, the following is our Covenant: • To promote and secure the emotional, spiritual and physical welfare of children who have been victimized, abandoned or persecuted; found in the streets, war zones, government run institutions, refugee camps or family homes. To actively engage in providing immigration and refugee resettlement services to those fleeing persecution, war, oppression and poverty. To provide an environment of peaceful and humanitarian exchange to foreign students and those who go abroad. • To offer an environment where hard working artisans can be paid a fair wage and a given the dignity of self-determination through fair trade. • To provide opportunities for orphans to experience culture ad sense of family with camps to America and in their country. • To widen the horizons of Americans by sending them to foreign countries to experience differing cultures through a myriad of work projects, camps and activities. • Maintain a Haque compliant licensed child placement agency under a different name in accordance with the laws of the State of California in order to provide temporal foster care and adoptive placement. • Maintain several programs to enhance ICA's mission which is not limited to but includes immigration and refugee resettlement services; foreign student exchange program; fair trade; cultural camps; mission programs and tours, and other social service programs. 1.Describe the project/program the Temecula grant funding will support: The Child Trauma and Learning Center at ICA provides mental health and counseling services and support to children, youth and families. Our counseling office in Temecula services all surrounding areas including residents of the City of Temecula. We specialize in serving diverse populations: foster and adoption backgrounds, trauma, childhood, adolescent and family issues, anxiety, depression, addiction, trafficking victims, refugee and immigrant youth, under 18 years of age. Additional services include parent support, case management, educational support/advocacy, etc. It is our desire for children and youth who are struggling with mental and behavioral health concerns, trauma, and grief, can receive the support and services they need in order to attain a well-balanced independent lifestyle, despite any financial hardship. For this reason, one of the goals of the Child Trauma and Learning Center at ICA is help any member in need of services despite lack of financial means. It is our goal to continue to provide financial assistance through scholarships and financial aid for all support services, including but not limited to: provide trauma -informed, person -centered, comprehensive case management services, facilitating timely access to vital services they need to stabilize and re-establish their ability to live independently. These comprehensive services include, but are not limited to, receiving emergency assistance, housing, safety planning, basic needs, health, legal, education, employment, language support. pg 1 of 5 international Christion Adoptions City of Terneculo Community Service Funding Reinvestment in Temecula Gront Program Policy Application 0.9.12.22 Most of our counseling clients/families are referred through Riverside County for Foster Care and two other sources of our programs funded by California Department of Social Services for which our counselors provide services: The Unaccompanied Refugee Minor (URM) Foster Care Program, helps children or youth who have been separated from their families due to war, conflict, natural disaster or abuse by caregivers who were meant to protect them. These situations create upheaval in their lives forcing them to flee from countries to the United States. ICA's counseling services help to ensure children are placed into safe and secure homes. ICA social workers conduct home visits and ongoing case management services. The central purpose of the Trafficking Victim Assistance Program (TVAP) program is to help foreign national survivors of human trafficking achieve HHS certification and provide trauma -informed, person -centered, comprehensive case management services, facilitating timely access to vital services they need to stabilize and re-establish their ability to live independently. These comprehensive services include, but are not limited to, receiving emergency assistance, housing, safety planning, basic needs, health, legal, education, employment, language, and assistance in accessing HHS Certification 2. Describe how the organization will spend the grant funding, if awarded: (Also, include a list of goods, equipment, and/or services this organization has purchased or plans to purchase with awarded funds to support the program/project) 1. A primary goal of the Child Trauma and Learning Center at ICA is to offer counseling services despite a client's inability to pay. It is our goal to continue to provide financial assistance through scholarships and financial aid for all support services. While the Trauma Center program budget carries approximately 4% of the agency's $4.5M budget, the Trauma Center relies on funding from our other state and grant programs to support its professional services. Currently, the program budget receives $216,166 in revenues to cover $240,392 in expenses. Direct Counseling income from clients is projected at $38,643 yet direct cost of counseling services is $61,769. ICA would like to request a grant to A grant fund from the City of Temecula in the amount of $18,164 to partner with ICA in providing for 80 sessions (8 client/family units at an average of 10 sessions per client/family unit). (See next page for FY22-23 Program Budget detail). Iig, � '.,f `. Internotionol Christian Adoptions Community Service Funding Reinvestment in Temecula INTERNATIONAL CHRISTIAN ADOPTIONS 4000 - Contribution Revenues 4100 • Contracts for Services (4% E)asting Contracts) Grant Proposal - City of Temecula 4109 • USCRI 4111 • State of CA- URM Reimbursable Contract 4112 • CountyRiverside Foster Services 4113 • PAARP Services 4114 • Heartland HS-PRS Contract 4115 • USCCB-US Conf.Catholic Bishops Total 4100 • Contracts for Services 4200 • Program Service Fees 4220 • Counseling Income 4222 Psychological Evaluation 4223 Counseling Discount 4220 Counseling Income - Other Total 4220 • Counseling Income Total Income Grants Summaryof Expenses Counseling Services Program Tools & Equipment Facilities, Rent& Insurance Supplies Marketing Services Food Other Personnel Total Expenses NET Income/Loss City of Temecula Grant Program Policy Application 09.12.22 FY22-23 Budget 4,080 455 135,200 22,182 2,240 10,032 3,514 173,623 2,200 (8,938) 45.381 �t:tZ:tIKE 216,346 11,149 12,083 1,282 331 56,269 1,200 12,617 inn Alli 195,262 Grant Request 18,164 (18.164) 21,084 $ 18,164 3: Explain how the grant funding specifically benefits Temecula Residents: (Temecula residents must benefit from this program/project if awarded city funding) The Child Trauma and Learning Center at ICA offers counseling services to the residents of the City of Temecula despite a resident's inability to pay. Partnership with the City of Temecula would provide a continued and reliable source of financial assistance through scholarships and financial aid. Last year our counselors served 86 clients and 865 sessions. This is an average of 10 sessions per family at a unit cost of $278, yet ICA charged on average only $55 per session. Most clients/families cannot afford to pay so we offer financial assistance. International Christian Adoptions City of Temecula Community Service Funding Reinvestment in Temecula Grant Program Policy Application 09,12.22 ICA would like to ask the City of Temecula to consider sponsoring eight families at an average of 10 sessions. The program cost is $18,164.00, Proiection based on FY21-22Service Records Number of Clients/Family N u m be r of Sessi ons Unit Per Unit Cost 86 $ 2,270 865 $ Average Number of Sessions per Client/Family 10 Grant Request: t 8) Families @ ( 10) Sessions Aver 8 226 2,270.49 18,163.91 Due to the nature of the clients we serve, there is a high level of confidentiality so families in Temecula who are currently struggling with the lack of mental and behavioral health services and who are suffering from economic hardship would still be able to receive counseling services. The City of Temecula would play a vital role in sustaining a healthier community by providing social services to families and children through counseling services on how to maintain positive mental health techniques, implement coping skills, reducing the current trauma in society, and joining in the need for healing. Our agency could be an additional resource to the City. 4: Summary Statement — Summarize answers 1-3 above in 50 words or less ICA is not only an ada2tion aeency. Child Trauma and Learning Center provides mental health counseling services support to families in Temecula Valley. We specialize in foster care, adoptions, trauma, childhood, adolescent and family issues, anxiety, depression, addiction, human trafficking victims, refugee and immigrant youth under 18 years of age. S. If applying for more than $5,000, please explain how the COVID-19 Pandemic affected this nonprofit organization's ability to serve the Temecula Community. You may also include inflationary concerns. The Child Trauma and Learning Center at ICA offers counseling services to the residents of the City of Temecula despite a resident's inability to pay. During the Covid-19 Pandemic, when business was forced to shut down, families struggled not only economically, but also to keep their children active and engaged. Families in Temecula saw a rise in depression and anxiety while their youth were struggling with mental and behavioral health dysfunctions. Now that our city is moving back to a sense of normal business operations, many families cannot afford counseling services. Many are struggling to find gainful employment. Yet the youth continue to internalize the effects of the shutdown as children and youth were forced into isolation and education was moved to distance learning. Today, there are many who continue to struggle to get back to sense of normalcy. The Trauma Center saw a decrease of in-house counseling services during the shutdown of March 16, 2020 and thereafter. Not having the ability to see children in -person at the office, which is the most beneficial course of therapy for most children, created a backlog of services. Our counseling team was able to pivot our company completely on-line for Teletherapy services. However, the retention of clients dropped significantly due to many of our clients who fall under the age of 10, or who suffer from ADD/ADHD had struggles focusing for therapy on a computer screen for any length of time. There were also those clients who did not have the means to a confidential and safe space to conduct therapy, or those children and youth who did not have access to an electronic device and/orinternet. International Christian Adoptions City of Temecula Community Service Funding Reinvestment in Temecula Grant Program Policy Application 09,12.22 6. If applying for more than $5,000, explain how funds have or will- (1) CREATE new Project/Program (2) EXPAND existing Project/Program AND/OR (3) CONTINUE existing Project/Program 2. A primary goal of the Child Trauma and Learning Center at ICA is to offer counseling services despite a client's inability to pay or inability to attend in-house sessions. It is our goal to continue to provide services through financial aid. ICA's Program Budget for FY22-23 provides for Direct Counseling income from clients at $38,643 and direct cost of counseling services is projected at $61,769. ICA would like to request a grant to A grant fund from the City of Temecula in the amount of $28,164 to partner with ICA in providing for 80 sessions (8 client/family units at an average of 10 sessions per client/family unit). In the hopes of receiving grant funding from the City of Temecula, and in order to continue providing existing services, ICA has expanded it program budget to include the following: 3. Purchase of 4 iPad Pros for client use at a total of $3,600. The cost of $900 per Wad is a small cost compared to the loss of services for the family members who could not afford an electronic devise and were not able to receive consistent services during times when access to in -office services was not available. Because the Covid variants continue to grow, this method of continuity of services will help serve our client's needs in desperate times. Alternatively, for a family who may not have the transportation means to attend in-house services, this may keep our counselors connected with a needy family. 4. A grant fund from the City of Temecula in the amount of $18,164 providing for 80 sessions (8 client/family units at an average of 10 sessions per client/family unit). Inflationary cost estimates all already factored into FY22-23 program budget for all our program needs including, but not limited to, office rent utilities, program and therapy supplies. p of PROJECT/PROGRAM BUDGET (do not fill in shaded areas) LINE ITEMS FOR PROJECT/PROGRAM REVENUES LIST REVENUES/INCOME FOR PROJECT/PROGRAM Amount of money requested from this City of Temecula $18,164 Community Services Grant (Not to exceed $50,000) Amount contributed to the Project/Program by the Applicant $ Organization 212,264 Other grants or funding already awarded for Project/Program, if any 4,080 In -Kind match amount or volunteer credit hours estimated amount $0 TOTAL REVENUE $234,510 LIST OF EXPENSES FOR PROJECT/PROGRAM Tools/Equipment Facilities/Rent/Insurance Supplies Marketing Services Food —Other I Staffing Expense THIS IS INELIGIBLE TO BE FUNDED BY CITY'S GRANT, HOWEVER PLEASE INCLUDE. TOTAL EXPENSES TOTAL BUDGET $234,510 EXPENSES $11,149 $121083 $1,282 $331 s56,269 17200 $6,987 $105,961 $195,262 $195,262 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 10 of 13 [==-- ACKNOWLEDGEMENT/SIGNATURE PAGE The applicant acknowledges and agrees to the following: • Recipient is subject to all Community Service Funding Program requirements including submittal deadlines and payment disbursements. • Every Community Service Funding application is considered individually and on its own merit. • Awards will be given to organizations and activities that directly benefit the residents of Temecula. ■ Funding is not immediately available to the recipient, and requires an award letter signature upon approval. Please allow time for checks to be processed. • The awarding of Community Service Funding does not constitute an automatic annual allocation. • The recognition for Community Service Funding should accrue to the City of Temecula. ■ Community Service Funding must be spent as specified on the Application and records may be requested by the City of Temecula to ensure the funds were used appropriately, • Community Service Funding grants will not be awarded or announced within the 60 days before an election in which an awarding Council Member is on the ballot. • The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. • If awarded a Community Service Funding Grant by the City of Temecula last year, then compliance receipts must be submitted on or before this application's due date or this application may be rejected as incomplete. I/we hereby certify the information contained in this Application is true to the best of our knowledge and belief. ORGANIZATION NAME: International Christian Adoptions (ICA) MAILING ADDRESS: 41745 Rider Way, Suite 2 Temecula, CA 92590 PHONE: (951 695-3336 EMAIL: charlottep@4achild.org PRESIDENT/AUTH RlzEDOFFICER: C arlot Paulsen WI IN17INTA SIGNATURE: IF DIFFERENTTHAN ABOVE, Jennifer Mitchell APPICATION PREPARED BY: Executive Director 'IT�E DATE: 09/12/2022 MONTH, DAY, YEM Office Manager of Child Trauma & Learning Center SUBMIT ORIGINAL APPLICATION BY MONDAY, SEPTEMBER 12, 2022, TO: City of Temecula Community Service Funding Attn: City Manager's Office 41000 MAIN STREET TEMECULA, CA 92590 Questions: Stacey,Brown@TemeculaCA.gov (951) 694-6413 Betsy. Lowrey@TemecuiaCA.gov (951) 693-3959 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 13 of 13 Q HELPB MENU Home > Tax Exempt Organization Search > International Christian Adoptions International Christian Adoptions EIN: 33-0412343 1 Temecula, CA, United States Other Names Publication 78 Data o Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions. On Publication 78 Data List: Yes Deductibility Code: GROUP Copies of Returns (990, 990-EZ, 990-PF, 990-T) o Electronic copies (images) of Forms 990, 990-EZ, 990-PF or 990-T returns filed with the IRS by charities and non- profits. Tax Year 2020 Form 990 Tax Year 2019 Form 990 Tax Year 2018 Form 990 Tax Year 2016 Form 990 STATE OF CALIFORNIA FRANCHISE TAX BOARD nTB POCRBOX 942857 SAAMENTO CA 94257-0540 Entity Status Letter Date: 9/8/2022 ESL ID: 5733937788 Why You Received This Letter According to our records, the following entity information is true and accurate as of the date of this letter. Entity ID: 1664688 Entity Name: INTERNATIONAL CHRISTIAN ADOPTIONS ❑X 1. The entity is in good standing with the Franchise Tax Board. EJ 2. The entity is not in good standing with the Franchise Tax Board. ❑X 3. The entity is currently exempt from tax under Revenue and Taxation Code (R&TC) Section 23701 d EJ 4. We do not have current information about the entity. ❑ 5. The entity was administratively dissolved/cancelled on through the Franchise Tax Board Administrative Dissolution process. Important Information This information does not necessarily reflect the entity's current legal or administrative status with any other agency of the state of California or other governmental agency or body. If the entity's powers, rights, and privileges were suspended or forfeited at any time in the past, or if the entity did business in California at a time when it was not qualified or not registered to do business in California, this information does not reflect the status or voidability of contracts made by the entity in California during the period the entity was suspended or forfeited (R&TC Sections 23304.1, 23304.5, 23305a, 23305.1). The entity certificate of revivor may have a time limitation or may limit the functions the revived entity can perform, or both (R&TC Section 23305b). Connect With Us Web: ftb.ca.gov Phone: 800-852-5711 from 7 a.m. to 5 p.m. weekdays, except state holidays 916-845-6500 from outside the United States California Relay Service: 711 or 800-735-2929 (For persons with hearing or speech impairments) FTB 4263A WEB (REV 12-2019) Form 990 OMB No 1545-0047 2020 Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) Oppeen to Pubfre lnspecton "apatbnent of the Treasi,ry ► Do not enter social security rt imbers an this form as it may be made public. tnitrmnl rLevenue Service ► Go to wHrv.irs.govIl'oraifor instructions and the latest information. A For the 2020 calendar year, or tax year beginning 7/01 2020, and ending 6/30 .202021 B Check if applicable: c D Employer Identification number Address change INTERNATIONAL CHRISTIAN ADOPTIONS 33-0412343 Name change INSTITUTE FOR CHILDRENS AID E Telephone number Initial return 41745 RIDER WAY #2 951) 695-3336 TEMECULA, CA 92590 I anal relurn/leimiratcd Amondea return G Gross-e"ipcti $ 4, 228, 400. Lj Application pending F Name and address of principal officer: CHARLOTTE PAULSEN K(a) is this a group return for subarnglnTcs� Yes x No Same As C Above HIM Are all subordinates included Yes Do I Tax-exempt status: If "No;" attach a list- See instructions K 501(c)(3) 501(1) ( )� (insert flo,) 4947(ax1) or 527 J Website: ► WWW. 4ACHILD.ORG tr(c) Group eiinmphon number ► 6068 K Form of organization 7X Coiperation I I Trust I I Assocalion Ll Other ► L Year of formaton: 1990 lift stale of low, domicile: CA Part I I Summary 1 Brie Illy describe the organi zati o n's mission or most significant activities -TO OFFER CHILDREN HOPE IN THE LOVE AND COMPASSION OF�JESUS CHRIST nk BASIC NEEDSL FOR AN AND BRIGHT U _EDUCATION _ AND HeOPF FAR A HOME IN A FAMILY THEY CAN CALF, THEIR OWN. THIS I5 FEILFILLED ccFUTURE,_ _TH_R_0_UG_H_ CARES HLUI fANITARIAN CD_UNSE_L_ING AND SUPPORT - - -_ -_ -- - - - - 0 _ADa_PTIa_Nt _F'tiSTER _AID_ 2 Check this box ► if the organization discontinued its operations or disposed of more than 25%-of its net assets._ _ _ 0 3 Number of voting members of the governing body (Part VI, line la)....... 3 7 ee 4 Number of independent voting :members of the governing body (Part VI, line ib) 4 w 5 Total number of individuals employed in calendar year 2020 (Part V, line 2a) .. 5 C9 ? ;_ 6 Total number of volunteers (estimate if necessary) 6 a 7a Total unrelated business revenue from Part VIII, column (C), line 12 7a 0, b Net unrelated business taxable income from Form 990-T, Part I, line 11 7b Q, Prior Year Current Year d 8 Contributions and grants (Part VIII, line IF) 3 851 399. 3 787 276. 9 Program service revenue (Part VIII, line 2g). 134 438. 110 300_ m10 Investment income (Part VIII, column (A), lines 3, 4, and 7d) 267 cc 11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 1 le) 2,236. 326 345. 12 Total revenue - add lines 8 through 1 1 (must equal Part VIII, column: (A), line l2) 3, 988, 073. 4,224,188. 13 Grants and similar amounts paid (Part IX, column (A), lines 1-3) 19 049. 14 Benefits paid to or for members (Part IX, column (A), line 4) .. a 15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-10) 2, 013 061. 2 r 0320 581. 16a Professional fundraising fees (Part IX, column (A), line Ile) b Total fundraising expenses (Part IX, column (D), line 25) ► uFL 1,365, 589. 1, 564, 992, 17 Other expenses (Part IX, column (A), lines 1 la-11d, l if-24e) 18 Total expenses. Add lines 13-17 (must equal Part IX, column (A), line 25) 3,397, 699, 3 597 573. 19 Revenue less expenses, Subtract line 18 from line 12 590 374, 626 615. 8 Beginning of Current Year End of Year 2,582, 687. 2,947,255. m 20 Total assets (Part X, line 16) - 21 Total liabilities (Part X, line 26) .. 513 049. 251 002 . 2 069 638, 2 696 253. zLL 22 Net assets or fund balances. Subtract line 21 from line 20 ran 11 1 as nature C31UGR :1ndcrpar47lbm of parjoy. I declare that thave eKam i.ned tf+ o tn. including xc pany1n9 Schedules and stolements, and to the Des of my knowledge and 'belief, it is bile, correct, and compfeto rliecfArat on of prap8tpir (glhar han ef!pci) is "4 oe II lnrarmnnan of QWn rimparri tins my kr•awlydq� Sign Here '4Jignalffne or officer 1 v-r+---- ..- — — CHARLOTTE PAULSEN Data Executive Director ype or print name and tit e, Paid PrimType preparer's name William A Harris III Preparer's signature William A Harris III Date Check U a Self-en,ploynn IP00614689 PTIN Preparer Use Only Firm's name ' ELITE FINANCIAL SOLUTIONS firm'=_address ' 301 E FOOTHILL BLVD., STE. 201 ARCADIA, CA 91006 Firm'sFIN ► 20-8044652 Phone no 626 Z56-1400 May the IRS discuss th s return with the preoarer shown above? See instructions JXJ Yes I I No BAA For Paperwork Reduction Act Notice, see the separate instructions. TEEAOl01L 01n9121 Form 990 (2020) EXECUTIVE SUMMARY International Christian Adoptions institute for Children's Aid (ICA) is not just an adoption agency. The institute began in 1990 as a non-profit 501(c)(3) corporation with its principal office in Temecula, CA. The institute consists of two major divisions: International Christian Adoptions and the Institute for Children's Aid (ICA) which is inclusive of the Chill ,rrauma Esc Learning Center, We stand on Biblical principles in all we do, lending hospitality and sanctuary to all who are in need. We are a voice For those who cannot speak for themselves, believing that all life is sacred. Our staff is multi-lingual, multi -ethnic and professionally trained to assist in various capacities. This mission of protecting, supporting, and assisting the most vulnerable within our. community is fulfilled at ICA through adoption, foster cart, humanitarian aid, counseling and support. Mission Statement International Christian Adoptions (ICA) believes in the sanctity of life in that all children born and unborn are valued and uniquely made. Our overriding mission is to offer children hope in the love and compassion of jesus Christ; hope for basic needs; hope for an education and bright Future; and hope for a home Ina family they can call their own. The mission is fulfilled through adoption, foster care, humanitarian aid, counseling and support. Our Covenant a To promote and secure the emotional, spiritual and physical welfare of children who have been victimized, abandoned or persecuted; found in the streets, war zones, government run institutions, refugee camps or family homes. • To actively engage in providing immigration and refugee resettlement services to those fleeing persecution, war, oppression and poverty. ■ To provide an environment of peaceful and humanitarian exchange to foreign students and those who go abroad. To offer an environment where harts working artisans can be paid a fair wage and e given the dignity of .self-determination through Fair trade. • To provide opportunities for orphans to experience culture ad sense of family with camps to America and in their country. ■ To widen the horizons of Americans by sending theirs to foreign countries to experience differing cultures through a myriad of work projects, camps and activities. • Maintain a Haque compliant licensed child placement agency under a different name in accordance with the laws of the State of California in order to provide temporal foster care and adoptive placement. Maintain several programs to enhance ICA's mission which is not limited to but includes immigration and refugee resettlement services; foreign student exchange program; fair rralLIC; cultural camps; mission programs and tours,and other social service programs. ICA is a well -established organization that me:cts the standards and qualification of many accreditations such as Accreditation of Rehabilitation Facilities (CARF), Intercountry Adoption Accreditation and Maintenance Entity. Inc. (IAAME), United States Agency of International ❑evelopment (USAID), National Council for Adoption (NCFA) and Evangelical Child and Family Agency (ECFA). In addition, ICA is a Full -service fosterrcare and adoption agency for International and Domestic Adoptions, as well as multi -County Domestic Foster Care and Refugee Foster Care programs. ICA also operates a Jubilee Exchange Fair -Trade Store in efforts to educate the commun i ty of the benefits and impact of purchasi ng fair-trade items both locally and world-wide. Our beautiful hand. -crafted fair-trade items can be found in our office or at various educational events. (Farmers Markets, conferences, pop -ups) DEMOGRAPHICS AND COVID PANDEMIC ICA has seen a rise in mental and behavioral dysregulation since the onset of the COVID-19 pandemic with escalated emotional and psychological traumas for children, youth and families in the community. According to a U.S. Census Bureau report, the number of people experiencing acute anxiety, depression and dysregulation are up 42'yo in the US (Leonhardt, 2021). As COVID- 19 protocols loosen, more families are seeking counseling services for their children. This is being reflected at ICA as the average monthly services provided have risen by 38% during the first quarter of 2022 in comparison to that of 2021, The Narional Alliance on Mental Health (NAM[) (2020) reported that 16% of adolescents (ages 12.17) experienced a major depressive episode (MDE), while 33% of young adults (ages 18-25) experienced a mental illness during the COV [D-19 pandemic. Further, 20%of young people report that the pandemic had a significant negative impact on their mental health. As a society, we must recognize that ouryouth have experienced unique circumstances during the pandemic:, including isolation, transition to virtual learning and drastic changes to routine that severely impacted the mental health of youth and young adults. The impact on children and youth has been significant, and the need far support and care is imperative (NAMI, 2020). Another 2021 study on the mental health of U.S. high school students during the pandemic, conducted by the Centers for Disease Control and Prevention (CDC), showed how impactful the pandemic was on the mental health of high school youth. This study indicated that 37% of students reported they experienced poor mental health during the COVID-19 pandemic, and 44% reported they persistently felt sad or hopeless during the past year (CDC, 2022). The Office of Population Affairs quoted in a Mental Health for Adolescents article, "Globally, the prevalence of youth experiencing clinically elevated anxiety symptoms - roughly 1 in 5 - nearly doubled during the first year of the COVID-19 pandemic", (OPA)(n.d.) (Racine, McArthur, Cooke) (2021). ICA serves people from diverse backgrounds, including many who have experienced trauma or come from the child welfare system. Half of all youth in foster care have a diagnosable mental health disorder (OPA, md.) (Youth.Gov, 2018). Children who are living in foster care have a substantially greater risk of experiencing mental health disorders, especially those connected with traumatic stress, such as abuse and neglect (OPA, n.d.) (Youth.Gov, 2018). In addition, 21% Of youth ages 6 to 17 who live in poverty have mental health disorders (OPA, n.d.) (Lipari, Hedden, Blau, Rubenstein) (2016). It is estimates! that 49.5% of adolescents have dealt with a mental health disorder at one point in their lives (OPA, n.d.). As a non-profit, [CA seeks to offer low -cast, high duality services to our clients. However, many families who have a great need for services find even these low-cost services a hardship. PARTNERSHIP Institute For Children's Aid (ICA) Child Trauma & Learning Center would like to partner with the City of Temecula in Fulfilling the mission of serving vulnerable populations within the Temecula Valley. ICA is requesting the City of Ternecula's consideration for a financial grant. The Institute for C:hildren's Aid Child Trauma & Learning Center serves the community by providing therapeutic support to children, adolescent youth and families. We specialize in serving diverse populations; Faster and adoption backgrounds, trauma, childhood, adolescent and family issues, anxiety, depression, addiction, trafficking victims, refugee and imrnigrant youth, ranging From 0- 18 years of age. Additional services include parent support, case management, educational support/advocacy, etc. It is our desire for children, youth and families who are struggling; with mental and behavioral health concerns, trauma, and grief, can receive the support and services they need, despite any financial hardships a family may face. PROGRAM COSTS In California, the average cost of an hour-long traditional therapeutic session ranges from $65 to $250 for those without insurance (Leonhardt, 2021). As a non-profit 501(c)(3) and as a service to our community, [CA's Child Trauma & Learning Center desires to be as affordable as possible. The fee charged to our clients for an hour of therapy at ICA is $55 per session. But FY22-23 Program Budget estimates costs her session are $278. The center offers services well under market value and has utilized previously awarded financial donations as scholarships to families who are suffering from economic hardship, sometimes on a sliding scale depending on the scholarship awarded or level of need. Our therapists see the need For and importance of conducting services in office and in person, especially for our young clients who struggle to sit still or focus thmugh an hour-long telehealth session. However, for those clients who prefer, we continue to offer telehealth sessions as an option. The comfort of our clients is always a top priority when offering options for therapeutic care. Our therapists also offer 24/7 on -call support to our clients and families. With the addition of grant funds, the ICA Child Trauma & Learning Center would have the ability to continue offering scholarship services to families impacted by financial hardships including individual therapy, group therapy, family clinics, parental skills training, life skills training, educational support services, or case management. A financial grant would provide support to families who are unable to cover the weekly or bi-weekly services. This is especially important when considering high risk clients, those with self -harm concerns, and/or suicidal ideation. The program cost for a standard individual therapeutic session is $278. A client/Family unit will be serviced. at an average of 10 sessions valued at $2,270. Therefore, a grant of $18,1.64 would provide financial assistance for 100 sessions or 8 families at 10 individual therapeutic sessions to clients who have a financial need, and at no cost to the client. THE NEED FOR SERVICES IN OUR COMMUNITY ICA continues to see the clients despite lack of ability to pay for service. This meets with the California hoard of Behavioral Sciences. ethical standards, until mental and/or behavioral issues resolve, accepting whatever financial compensation the client was able to afford. For example, in one particular circumstance, we accepted $10 per therapeutic session from a previous client who was experiencing a financial hardship. As part of a larger agency, the ICA Child Trauma & Learning Center can operate at little to no over -head costs allowing for continual treatment for clients. Overall, the grant funds would allow the Child Trauma & Learning Center to have a lasting positive impact, promoting mental health and healing by increasing the amount of services that: are offered to the families and children with financial hardships that are suffering in our community. There is a high need For therapeutic services for children and youth in the Temecula Valley, many offices are overflowing and have had to place prospective clients on wait lists to be seen, sometimes those clients must wait a full-12 weeks before seeing a clinician. At ICA, we do everything we can to see clients within 1 week from the day they initially call the office. After the past almost three years dealing with a world-wide pandemic, our youth need to be able to receive the help they and their families need. With the addition of grant funds, ICA would also have the possibility to hire another clinician to meet those needs within our community. Last year (FY) UNN-JUL22), ou r pwgram serviced 86 client/family emits: (59) from the Temecula Valley area, (12-Domestic and Foster care families referred from Riverside County and (5) International adoption families. Services to residents in the Temecula Valley area were 82% of our total counseling services. The Child Trauma &x Learning Center provides a comfortable office with trait ma -in formed staff, including licensed clinicians and supervised associates. The clinicians have access to any of our five therapy rooms and many therapeutic tools. Each therapy roam is equipped with a variety of warm and welcoming decor, lighting and activities to meet the specific needs of each client. For example, some clients who have experienced trauma and/or have a specific diagnosis/disability, may have sensitivities to fluorescent lighting requiring a warmer light environment, or may require therapy to take place in an open spars, Each of ICA's therapy rooms were intentionally designed for children with adverse bacl(grounds in mint!. The Child Trauma & Learning Center is equipped with various tools: arts and crafts, board games, hooks and toys, along with many sensory tools like sand/bean buckets, sand tables, blanlcers, stuffed animals and weighted therapy blankets designed to help with sensory processing. The staff at ICA create tailored treatment plans to best suit each client and their needs. Our clinicians value their clients input and strive to create a sense of empowerment and investment from the client's ixrspective. The clinicians take a holistic approach tocach client's case, in order to hest serve their needs, The: client is paired with theclinician that would have the best approach and potentially strongest therapeutic relationship with the client. By doing this, the greatest outcome for therapeutic success for the client can be achieved. To make this achievable, ICA's C:hilcl Trauma &r Learning Centcrnnakes available multiple options for scheduling to allow families to receive the support they need. Adhering, to COVID-19 CDC Guidelines, ICA offers services through telchealth, in -person and in -home therapeutic services (when therapeutically appropriate). Understanding our client's hesitancy regarding COVID-19, ICA provides options, to make each client feel comfortable with their therapeutic experience Therapeutically, we use a combination of the following to provide the most effective approach to healing for each client: evidenced --based modalities including Trauma Focused Cognitive Behavioral Therapy (TF-C BT), Cognitive Behavioral Therapy .(C13T), Dialectical Behavioral Therapy (DBT), SOlution-Focused, narrative Therapy, Trust Based Relational Interventions (TBRi), and evidenced -based techniques (such as Guided Imagery, Mindfulness, Play Therapy, Art Therapy, deep breathing, etc.). After determining the best modality for each client, our clinicians will provide tailored treatment places with adapted techniques suited for each client and decide with the client and fain the hest option for success. An individualized plan will be developed for cacti client to determine the best course of healing. In order to maintain growth and sustained progress, our clinicians will frequently re-evaluate the plan for each client. Due to the Child Trauma &z Learning Center being part of a larger organization with many different programs, the center can thrive without touch overhead costs, allowing fees for services to remain low For clients. This allows For a long-term presence of therapeutic services being available to the community. With the acid itionaI grant funds from the City of -f emecula, the Child rratima &r Learning Center would he equipped to provide support and services to more children and famiIics who are currently struggling with the lacl< of mental and behavioral health services. Through this, we can have a greater impact to reach and sustain our community by teaching the families and children how to maintain positive mental health techniques, implement coping skills, reducing the current trauma in society, and joining in the need for healing. Thank you for your consideration in partnering with ICA in support of our children and families in need. The support is appreciated and will aid in the healing, empowerment and growth for the children that we serve in our local community. ft 0 , �.. r I AIL d. 3�I Aw• i 2021 ANNUAL REPORT �.�MINSTITUTE FOR CHILDREN'S AID,(dba �11 OJ 2 2 104 =1 WOTOUN 9 ro -v XF Headquarters Branch Office Branch Office Pi 41 /1800 Mal Lin Lutl-lot King 4-5 der Way P2 6248 Birdcage St. P�:Irkwy 20'1 I ern E-.Nc u I a, C59 A 92.0 Citrus Heights. CA 95610 1--)urharyla, NC 77707 'Ca IAA E 7�j C'Ir� kP44 2021 Annual Report OUR MISSION International Christian Adoptions (ICA) began in 1990 as a non-profit 501(c)(3) corporation with its principal office in Temecula, CA. ICA consist of two major divisions; International Christian Adoptions and the Institute for Children's Aid. We stand on Biblical principles in all we do lending hospitality and sanctuary to all who are in need. We are a voice for those who cannot speak for themselves believing that all life is sacred. Whoever you are, and whatever your need as a family, we are here to help you. ICA is dedicated in helping children and their families around the world and in the United States. Our staff are multi- lingual, multi -ethnic and professionally trained to assist in various capacities. ICA believes in the sanctity of life in that all children born and unborn are valued and uniquely made. Our overriding mission is to offer children: • HOPE in the love and compassion of Jesus Christ • HOPE for basic needs • HOPE for an education and bright future • HOPE for a home in a family they can call their own. This mission is fulfilled through adoption, foster care, humanitarian aid, counseling and support. 2 ` 2021 Annual Report OUR SERVICES 3 Everything we do is for the children. We have comprised a set of comprehensive services and programs to provide children with loving and safe homes. We work closely with the parents and forever families to ensure an environment where the child can continue to grow and become their best self. Contact our caring and professional staff to learn more. Adoption Services r As a licensed, non-profit adoption agency, ICA provides compassionate and caring services to the adoptive triad (birth parents, adoptive parents and children). Foster Family Services Providing loving support and comfort to abused and neglected children through mentoring programs, reunification services and respite care. Humanitarian Aid Providing relief services to foreign and domestic orphanages and to the children in domestic residential facilities. This relief includes goods delivered, foreign exchange programs, transitional homes and micro business support. Child Trauma & Learning Center up Qualified, well -trained Christian professionals provide counseling services and support groups to birth parents, adopted children, adoptive parents, foster children and foster parents. Family Training We provide ongoing support to the adoptive family and the children they are parenting, both before and after placement. These classes prepare the adoptive and foster families for the special emotional and developmental challenges that they can expect when raising children who have been in institutional care. a 2021 Annual Report 4 Children's Peace Exhibit Institute for Children's Aid presents the first registered museum of its kind to Southern California's Temecula Valley. The Children's Peace Exhibit offers an interactive journey for children and adults of all ages, where they travel through the complexity of contemporary issues affecting children on a global scale. Children and Adults start theirjourney with their own exhibit passport and work through 14 exhibits tackling problems that many children face such as abuse, child slavery, child labor, war, refugees, homelessness, hunger, education and others. Each exhibit is designed to equip and inspire its visitors to learn the facts, identify the problems and become an important advocate for change. The Children's Peace Exhibit is an experience all in itself with the purpose of educating othe