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Home My WebLink AboutItem #11 November 2005 Community Merits Award Grant Cycle AGENDA ITEM COVER SHEET Meeting Date: January 17, 2006 Item # II Contact Name: Contact Number: Tonya Elliott 407 -905-3100 ext. 1061 Reviewed By: Department Director: ~t:' City Manager: _ --=-- Background Summary: The Community Merit Awards (CMA) Board met on Wednesday, December 21, 2005 to discuss the ten applications received during the November 2005 grant application cycle. There is $10,000 budgeted for the CMA's in FY 2006. The amount requested by the organizations is $5,000, which leaves a remaining $5,000 for the 2nd cycle in April of 2006. The Community Merit Review Board is recommending funding all ten organizations at the maximum grant amount of $500. Issue: Should the Mayor and Commissioners approve the funding recommendations made by the Community Merit Award Review Board? Recommendations: Staff respectfully requests that the Mayor and City Commission approve the Community Merit Award Board's recommendation to fund the ten organizations mentioned above for a total of $5,000. There is a total of $10,000 in the account set aside for Community Merit Awards each fiscal year. This leaves a remainder of $5000 for the second grant cycle in April 2006. Attachments: Copies of the Grant Application Financial Impact: Funds budgeted at $10,000, which equates to $5000 for each grant cycle. Type of Item: D Public Hearing D Ordinance First Reading D Ordinance First Reading D Resolution [8J Commission Approval D Discussion & Direction For Clerk's Deaf Use: [8J Consent Agenda D Public Hearing D Regular Agenda D Original Document/Contract Attached for Execution by City Clerk D Original Document/Contract Held by Department for Execution Reviewed by City Attorney Reviewed by Finance Dept. Reviewed by ( ) IZI N/A IZI N/A o N/A .\\.l~lY_Qr S-,-SQQtLY and~g:!:ift Commissioner~ D~lli1Y. HO'Y.~lLQjstrict 1 Scott Anderson. District 2 Rustv Johnson. District 3 Nancv J. Parker. District 4 City Manager Robert Frank STAFF REPORT TO: The Honorable Mayor and City Commissioners FROM: Tonya Elliott, Multimedia/Community Events Manager DATE: January 9, 2006 RE: November 2006 Community Merit Awards Grant Cycle ISSUE Should the Mayor and Commissioners approve the funding recommendations made by the Community Merit Award Review Board? BACKGROUNDIDISCUSSION The Community Merit Awards (CMA) Board met on Wednesday, December 21, 2005 to discuss the ten applications received during the November 2005 grant application cycle. There is $10,000 budgeted for the CMA's in FY 2006. The amount requested by the organizations is $5,000, which leaves a remaining $5,000 for the 2nd cycle in April of 2006. The Community Merit Review Board is recommending funding all ten organizations at the maximum grant amount of$500. The CMA Board approved recommending the following funding allotments to the City Commission for approval: Ocoee H.S. Baseball Team American Le ion,Post 63 Alzheimer Resource Center Inc Bo Scout Troo 198 Ocoee H.S. Winter Guard Ocoee Human Relations Diversit Board Parent, T eacher,Student Assn STA.R.S. of West Oran e Ocoee H.S. Girls Softball Team 11/23/2005 Dian Hoo er 11/28/2005 Eric Entrekin 11/30/2005James Flemin Sr 11/30/2005 Nanc S uillacioti 11/30/2005 Ed Roberts 11/30/2005 Carrie Cox 11/30/2005 Mar Ellen Murra 11/30/2005 Delores Lomberk 11/29/2005 Chesta M Hembrooke 12/9/2005 Sue North 407-877-5027 407-252-6754 407 -656-3838 407-843-1910 407 -489-2979 407 -905-3000 407-905-0116 407-721-2180 407 -292-3559 407 -905-4127 Total $500 $500 $500 $500 $500 $500 $500 $500 $500 $500 $5,000 RECOMMENDATION Staff respectfully requests that the Mayor and City Commission approve the Community Merit Award Board's recommendation to fund the ten organizations mentioned above for a total of $5,000. There is a total of $1 0,000 in the account set aside for Community Merit Awards each fiscal year. This leaves a remainder of $5000 for the second grant cycle in April 2006. " Q.~ \S-o, 1'1 Funding Cycle: November 2005 For more information, please call the Community Relations Department at (407) 905-3109 or e-mail telliott@cLocoee.f1.us. When completing this application, use only the space provided. The only attachment should be the formal organizational support documentation (minutes or letter). Please remember to comDlete a City of Ocoee vendor form or we will not be able to issue a check. Applicants may apply for any amount up to $500. ~~~~.....~...~~~~~~.~....~.~.~~~ Citv of Ocoee Communitv Merit Awards Prol!ram Application Nameoforganlzation:!-/v1A t t!f.l'(i~;Z'llp{J51 {;--g tJ;n~/z."'ClAtoJ /...~i i'6~V Address of Organization: cl71 [d, f'/ (),J f .5f.) W \' rJ 1<';t. C,,4 J?-j~jJJ J Ft.. Contact person for this application: j LA v'\" to? 5 PI ~ vYl ." iu"'cl 5 UZ-J (The contact member must be a member of the organization.) Daytime ph.one numb.:r E-mail address: 1J~1'r\ i ~3lfJJfled pl-:/,c. ~a fY\.- If tJ7-b.5"(P,~ gt.."'> >J 6~L.2 orj-2"!I "It II~ tJ.e11 What are you seeking grant money for? What specifically will the money be used for? S~Jt,&>o I (YI.e d /4/l. f?P 7 ,t. /J-,... A rJ J B by 5 s/Jlj1e. /t&;"'~ m ' What d?!)ar amount are you requesting? (The maximum grant award is $500.) 'If> !J tJ u Is your organi~ation getting fu.n ding f~om any other, so.urce far this specific project? f3/J~ R, ,.J.f*"-6/ P.::..::.d 5V)/~s dVIIl.I'IV"l f/1J;.j.f. s-/. C!.I o€f,'~. D/)vJ 1A..t/eH'\JS A.~~ OU~S, . '" V){ha~is your arfJanization's pri'!'ary funding source? 8-1 d &1. f e: jJftft/....s ..J D v L5 . . How In}'r;h JJ:5mey dae.s your organizpti~n receive from this source each year? Dvo4?!:, ,./.J a/. (/'0 I gldi/ (2~ ML~\~'1f(JO t DD ) !VJ I\H,,-'ht. ,.,>~/o bv,O~ What pther sources of revenue does your organization have? . .food .s-l.lIe~ )jJ~'ll Yp(L~,f iJ At. What is your annual budget fbr this year? il; t't.;> 0 Last year7' 12/ b 0 () Li~t the fundraisers your organization holds? Plit-A. 5 (,lJ f2,S 'l"hlh-':; y c;?#~, gJ~ 12v~v').-L~, YI:1IlJ. s'VJ./es) Gfl;,.~,,(t"5~.r:-s (!:sf (>"'P S./-l/;vf<:., How many members does your organization have? How many live in Ocoee? . 11~ How many clients daes your organization serve? W es~f b~tA,u le c..~?>...; ,v--ft V e/~(lAj1I5 /jo How many live in Ocoee? 1f ~"?D (oao p.ep(liZ l/~ /k{J...rJ-yv C"j. v p,;.J r l>..t' I t!.1tl1Tl1 ~'v e (! Page 2 - Community Merit Awards Application - November 200~'Cycle Has your organization applied for a grant from the City before? yreS If so, when and what did you apply for? . . $. IIi/ply 5'1N'hc1~ fe(!,e-~ .fP/I...'1'Odnjj/IJi,/€sfeJ 'It/:J./?(} IIV O(!;'.;\ea-t.1-it.. Were you successful and, if so, how much money did you receive? Does your organization volunteer In the Ocoee community? If yes, what volunteer activities do you participate in? Y e ~ . Oc 6 ~,6L f' 0 i ,,~<2. .12- I:J j(~ I K (). l..U Y1-y {' ~IIK Or? u~ ~/) ~Jet-" '.;; fI),)y: 111 GJ'" &<J.))K.trnVbL '/4- How many yearly volunteer hours does your organization contrjpute to the community and how are those hours trac or documented? g t .#=~ ?, ~" ~ b.,~~- " W ' (:7 Please Iiitrthfl;specific .accomp sh!TI~ntsy..ol.Jf organization ha~ achie.y1/,.in the past, j 24 months: .~:r#- ~ ~ .../-"Z ..&/~,?ttJ ~ 1.1J4~ tJ-W'CJ7 /IJ~" iJ,"!d..,<' , t; ;'/4,.,h, ..f {h ,odd Is! 5c./woC{ 5Tvde.A-9 "$c.~tJ{ ~~ 4- C' .t!-~-/-';'..r:-c..tPl-G s lease include any other pertineht in1ormation about your orgamzatlon or this specific grant request that you feel would help the City in making its decision: Please attach documentation (meeting minutes or letter) to verify that your organization supports this application. &w'~ /1 ~ #1~ ~Do{f 4- ;7f?.-L.;.,b~ ~~D5 fi!!J 1~~d-~iJ7J' j)~ rf it1 D Ai ~ l,,~ &~me"j,lfV ltlVf)Nc..! Su--ffO (t~t' 0" ((I - I. N\i N of<' S "i,1f",d. /71]/ /' O~!/ [ toAgd /118&tr"/:1'j J. G () Y 5 51 J.:l f~ 1-1' 5 f ~.t AJJ~,,, J Ii' ,'I { De/e.; o/-e5 .;2 6 6:5 3. Se-hoc.L ('ned/3.-}~~.t2ec.lri~vt '-:,~-/- .11.11- ;200:.'-( -2<:;Jt)G'~'chbQl Y</) (L~ For Staff Use Only Date Application Received Was Application Received Complete? 1fnot, D~te Application Returned HIJGH T. GREGORY AMERICAN LEGION POST 63 271 WEST PLANT STREET WINTER GARDEN, li'L 34787 407-656-6361 BOYS STATE 2005 DECEMBER 9, 2004 DELEGATES TO BOYS STATE 2005 [2 Spaces allocated and paid for in advance] Daniel Payne'" 709 Sunburst Cove Lane, Winter Garden, F~ 34787 '" Tel.407-877-6088 Peter Chase Eveleth '" 2560 Tall Maple Loop, Oeoee, F~ 34761-7620>1< Tel 407-877- 8152 STIAND-BYDELEGATE TO BOY STATE 2005 [I space paid for, but not allocate to Post 63 until Jan. 16,2005] Jesse James Dillon >I< 1000 Portmar Way, Winter Garden, F1 34787 '" Tel. 407-656-9125 ALTERNATE DELEGATES TO BOY STATE 2005 (No spaces allocated or paid for; Individuals can apply WiUl Post 19,286. 53 or others for au opeu space. Individual will become Post 63 delegate if primary delegate can not participate] Travis James Bermett >/< 9019 Lake Mabel Drive, Orlando, F132836-8804 '" Tel 407-876- 5449 Steven Andrew Crudele tic 1232 Castlep01t Road, Winter Garden, Fl34787 tic Tel 407- 656-0101. [Post 109 Delegate to Boys State 2005][Brother, Age 11, Ryan Tyler] All five boys will attend Boys State @ FSU in June 2005. 4REEDOM FOREVER, . ~J~~~ '- PROGRAM CHAIRMAN HUGH T. 'GREGORY AMERICAN LEGION POST # 63 217 WEST PLANT STREET HISTORIC WINTER GARIJEN, FLORIDA 34787 TELEPHONE # 407-656-6361 School Medals Presentations for 2005 1. FRIDA Y~ APRIL 22, 2005 @ 1900 Hours: West Orange High School AFJROTC [2] medals; Recipients are Cadet Daniel Payne for American Legion Scholastic Excellence and Cadet Michael Megnley for Military Excellence. Presenter was Post 63 Commander E. George Engelhardt IV. Photogra.phs by Adjutant James Fleming SR 2. MONDAY, MAY, 16~ 2005 @ 1900 Hours in Sanctuary: Foundation Academy's 81h Grade Class Presentation: M/W - Jacob Romoser;.F/W - April Fleming; M!.Hl.\.1- Corey Graham; F/HM: - Liz Bwrow. CONTACT: Judy Rosenbaum @ 407-656- 3677. Medals & Certificates Presented by Adjutant James Fleming. 3. WENDESDA Y, MAY 18, 2005 @ 1000 Hours in Sanctuary: Foundation Academy 5th Grade Class Presentation: M/W - John Hani~on; F/W - Amber Saunders; M!.Hl.\.1- Ryan Bradley; F/Hl\.1- Samantha Hanison. CONTACT: Angel Whitehead @ 407- 656-3677. Medals & Certificates Presented by Adjutant Jim Fleming. 4. FRIDA Y, MAY 20, 2005 @ 0830 Hours in Zellwood Elementary Media Center; 5th . Grade Class recipients are: M/W - Marc Shollenberger; FIW - Karen Guzman; M/HM- Anthony Carter: FIHM: - Aspen Cater. CONTACT: Ms. Michele Edenfield @ 407-884-2258 x2268. Medals & Certificates by Adjutant Jim Fleming. 5. TUESDAY, MAY 24,205 @ 1800 Hours in Auditorium: Lakeview Middle School [1200 East Bay Street W.G.] Bib Grade Class. Recipients are MIW - Kristopher Alvarez; F/W - Alexa Gordon; M/HM - Bobby Gammill; F/Htv1- Samantha Luke. CONTACT: Jim Weis or Robert Ryner @407-877-5010. Medals & Certificates Presented by Adjutant Jim Fleming. 6. THURDA Y, MAY 26, 2005 @ 0830 Hours in Old Auditorium: Dillard Street Elementary 5th Grade Class recipients are: M/W - Cole Songer; F/W - Kelly Morgan; MIHM - Spenser Nampon; F/HM: - Madelyn Bedolla. CONTACT: Kelly Price @ 407-884-2258 x2268. Medals & Certificates Presented by Adjutant Jim Fleming. 7. TIIURDA Y, MAY 26, 2005 @ 0900 Hours in Cafeteria: Lake Whitney Elementary 5th Grade Class recipients are: M/W - Christian Ireland; FIW - Elizabeth Shirley; M/HN - Daniel Greene; F/HM - NatalIa Schneider. CONTACT: Michells Kantor @ 407-877~8888 x 445. Medals & Cel1ificates Presented by Historian LaVor Jolm lVIiles. 8. FRIDAY,MAY 27,2005 @ 0930 Hours in Cafeteria@ Tildenville Elementary 5111 Grade Class recipients are:.MIW - Alberto Cruz; F/W - Meghan Phillips;.N.VI-IM- Garrett Rochell; FIHM ft Michelle Trevino. CONTACT: Becky Milk @ 407-877- 5054 x 450. Medals & Certificates presented by Commander George Engelhardt. 9. FRIDA Y. MAY 27, 2005 @ 0900 HOURS in Cafeteria: Maxey Elementary School 5th Grade recipients are: M/W - Christopher Latclunan; F/W - Markisha Tillman; MfHIvI- Gan'ett Peterson; FIHM - Tymeu:is Chatman. CONTACT: Ms. Belinda Davis @ 407-877-5020; Medals & Cel1ificates Presented by Henry Dudley and Adjutant Jim. Fleming. 10. THURSDAY, JUNE 2, 2005 @ 1800 hours in Room 101, Windermere Preparatory School 5th Grade Recipients are:.MIW - Jake Heninger; F/W - Caitlin Han1{ins; M/HIv( - Alex Hall; FIHlVI - Courtney Sisko. CONTACT: Debra Santostefano @ 407-905-7737. Medals & Certificates Presented by Adjutant Jim Fleming. 11. THURSDAY, JUNE 2, 2005 @ 1930 hours in Room 101, Windelmere PreparatOlY School 8th Grade Recipients are: M/W - Peter Larson; F/W - Deena Magdy; MIHM - Kevin Zeck~er; FIHM - Gabrieile Muelle. CONTACT: Debra Santotefano @ 407-905-7737. Medals & Certificates Presented by Adjutant Jim Fleming. Sunday, May 22, 2005 DO NOT FORGET TIIE TWO PHOTOGRAPHS, ONE FOR IllS TORIAN AND ONE FOR W. O. Tl1\1ES. TO: Ms. Pa1ricia Masciantoni, OCPS ;~~ FROM: James Fleming SR, American Legion Post 6~"'I The total students in each zip code who received an award from the post 63 for year 2003-2004 & 2004-2005. TIlan!C You. L- 2. SAIvlP :MEDALS & CERTIFICATES: Seven Elementary [5th Grade] and Four Middle {8th Grade}classes are participating in year 2006. The cost is approximately $250.00. 3. YEAR 2005 POST 63's FUTURE EVENTS:[a 1 Post 63 Halloween Haunted House on October 28,29,30,31,2005, Friday to Monday. [b] Veteran's Day Ceremony and possible downtown parade to Veteran's Mem01ia1 Park. Everyone who can carry and American Flag properly can enter and participate. [c] Veteran of the Month Ceremony, Saturday on September 10, 2005. FINANCE OFFICER: Thursday, September 8,2005 1. Veteran's Money Market Account has a balance of $2567.10 2. Veteran's Emergency Relief Account has a balance of $1,600.46 3. General Fund has a balance of $1,666.92 4. Bingo Account has a balance of $1969.14. 5. Canteen Account If< Cindy is Manager I~ has a balance of$13.79 Post member Ray Johnson $300.00 check was void.and retiuned to Cdr. Check was written on General account and not on Veteran's relief account. Motion by John Miles, 2nd by Rachel Newborg, not' to assist Ray Johnson at this time due to excessive consumption of alcoholic drinks. mSTORIAN: 1. Status reports on Historic Building Plaque. James Fleming to contact Steve Loomis is concerning plaque donation. CHAPLAIN: 1. Julian Revels, Room 412 of Health Central Park. Call him at 407-296-1600. 2. Hemy Taynor, Room 513 of Health Central Park, call him at 407-296-1600. 3. Claude Blakeney, Suite 110, Heritage by Lake, Hwy 46, Sanford, fl. 4. Ralph Ray Johnson has cancer is undergoing treatment and need fmancial assistance, no inslU"ance and V A is slow. 5. Comrade Laud, age 80, had heart surgeon doing well. 60 Years in AL. POST SERVICE OFFICER REPORT: Given by 1 st Vice Commander. SGT. - AT - ARMS: Vacant Position D. UNFINISHED BUSINESS: 1. Requested a Retreat & Repair letter fl.-om Tenninix prior to paying next year's Drywood Termite Service Agreement cif $250.00. Did Not receive letter, do 2. Winter Garden's Halloween Party will be on Monday, October 31,2005 in Historic Downtown Winter Garden. Post 63 Haunted House will be open from October 28 through October 31, 2005. Post can not be rented from October 24 through November 4, 2005. ,I I,' ~ ~~C(.) Fl,Inding Cycle: November 2005 For more information, please call the Community Relations Department at (407) 905-3109 or e-mail te/liott@cLocoee.fI.us. . When completing this application, use only. the space provided. The only attachment should be the formal organizational support documentation (minutes or letter). Please remember to complete a Citv of Ocoee vendor form or we will not be able to issue ~ check: . . Applicants may apply for any amount up to $500. ................................ City of Ocoee Community Merit Awards Prol!ram Application Name of Organization: Alzheimer Resource Center, Inc. Address of Organization: 1400 N. Semoran Blvd., Suite A, Orlando, FL 32807 Contact person for this application: Nancy Squillac~oti, Executive Director (The contact member must be a member of the organization.) Daytime phone number: 407-843-1910 E-mail address: Nancy@alzheimerresourcl center.org What are you seeking grant money for? What specifically will the monfW be used for? ARC would use funding to help conduct a free Support Group once a month at Summerville Assisted LivIng In Ocoee.'These groups enable careg1vers/fam~lY members Of those sutterlng rrorn &Lzheimer's d~sease ~o sna:-e expe~lenc7s, ideas and . coping stL clt~g 1~::l. F';llld::l wuu.lJ 'cover . cl pULtlull uf fd~ll~tdtuL l~~::l, LLdv~l[uL ::l~rv1~e dcllverJahd program What dollar amount are you requesting? (The maximum grant award is $500.) $ 500 s upp lie e Is your organization getting funding from any other source for this specific project? NO What is your organization's primary funding source? Foundations and Cha,ri ties . . ( 1m.:. tilll t~d WdY) How much money does your organization receive from this source each year? 53% of revenues What other sources of revenue does your organization have? Individuals, Civic/ Service Organizations, Program Fees, Fund-raislng events, ~rain Bank <<esearcn ~ontract, ~roauct ~aLes. What is your annual budget for this year? $ 494, 102 Last year? $ 470 , 573 'Listthefundraisersyourorganization'holds? "Breakfast of Champions" (fund raising breakfast), Annual Parrothead Party 0:. Page 2 - Community Merit Awards Application - November 2004 Cycle * Not Applicable. ARC is not a * membership organ~zation. How many five In How many members does your organization have? Dcoee? * , How many clients does your organization serve? Dcoee? 58. '1 , 100 How many live in Has your organization applied for a grant from the City before? If so, when and what did you apply for? No Were you successful and, if so, how much money did you receive? N/A Does your organization volunteer in the Dcoee community? If yes, what volunteer activities do you participate in? SUDDort Groul;>s, Health Fairs, Information/ Referral, Educational Counselinq (throuqh Alzheimer Resource Center) One of the members of our staff yolunteers throuah the Healina the Children program. How many yearly volunteer hours does your organization contribute to the community andhowarethosehourstrackedordocumented? 415 Volunteer hours per year; ARC tracks them through a volunteer log and data base Please list the specific accomplishments your organization has achieved in the past 24 months: 98% of care ivers reported that because of ARC's services they have increased their understandIng of the d sease; 84 reported that they are more comfortable in theIr care~glving role; and Y6% Indicated Increased awareness Of communIty resources to aSSIst their ~amllY. . . Please include any other pertinent information about your organization or this specific grant request that you feel would help the City in making its decision: Please attach documentation (meeting minutes or letter) to verify that your organization supports this application. For Staff Use Only Date Application Received Was Application Received Complete? If not, Date Application Returned ~'\ Form W-g Request for Taxpayer Identification Number 'and Certification Give form to the requester. Do not send to the IRS. (Rev. January 2005) Department of the Treasury In1ernal Revenue ServIce CIi Name (as shown on your Income tax return) & Alzheimer Resource IU a. Business name, If different from above c o Gl ! ~~ ~~ 'C .5 D.Cl !E Cl ~ Orlando FL 32807 ~ List account number(s) here (optlonaQ C/) Center, D Indlvlduall Check appropriate box: Sole proprietor Address (number, street, and apt. or suite no.) 1400 N. Semoran Blvd., City, state, and ZIP code tiC] Corporation Suite A Inc. D Partnership D Other ~ D Exempt from backup withholding Requester's name and address (optional) Enter your TIN In the appropriate box. The TIN provided must match the name given on Line 1 to avoid backup withholding. For individuals, this Is your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identlflcatlonrlUmber (EIN). If you do not have a number, see How to get a nN on page 3. Note. If the account Is In more than one name, see the chait on page 4 for guIdelines ori whose number to enter. I Social security number I I + I + I or Certification Under penalties of pe~ury, I certify that: 1. The number shown on this form is my correct taxpayer Identification number (or I am waiting for a number to be issued to me), and 2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all Interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and 3. I am a U.S. person (including a U.S. resident alien). Certiflcetion Instructions. You must cross out Item 2 above If you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all Interest and dividends on your tax return. For real eSlata transactions, Item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an Individual retirement arrangement (IRA), and generally, ayments other than Interest and dividends, you are not required to sign the Certification. but you must provide your correct TIN. (See t tructlo 0 page 4.) Sign Here Purpose of Form A person who is required to f' ea in ormation return with the IRS, must obtain your correc t ayer identification number (TIN) to report, for example, income paid to you, real estate transactions. mortgage Interest you paid, acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an IRA. U.S. person. Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN to the person requesting It (the requester) and. when applicable, to: 1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued), 2. Certify that you are not subject to backup withholding, or 3. Claim exemption from backup withholding if you are a U.S. exempt payee; Note. If a requester gives you a form other than Form W-9 to request your TIN, you must use the requester's form if it is substantially similar to this Form W-9, For federal tax purposes you are considered a person if you are: . An individual who is a citizen or resident of the United States, . A partnership, corporation, company. or association created or organized in the United States or under the laws of the United States, or Date ~ . Any estate (other than a foreign estate) or trust. See Regulations sections 301.7701-6(a) and 7(a) for additional Information. Foreign person. If you are a'foreign person, do not use Form W-9. . Instead, use the appropriate Form W-B (see Publication 515, Withholding of Tax on Nonresident Aliens and Foreign Entities). Nonresident alien who becomes a resident alien. Generally, only a nonresident alien individual may use the terms of a tax treaty to reduce or eliminate U.S. tax on certain types of income. However, most tax treaties contain a provision known as a "saving clause." Exceptions specified In the saving clause may permit an exemption from tax to continue for certain types of income even after the recipient has otherwise become a U.S. resident alien for tax purposes. If you are a U.S. resident alien who is relying on an exception contained in the saving clause of a tax treaty to claim an exemption from U.S. tax on certain types of income, you must attach a statement to Form W-9 that specifies the following five items: 1. The treaty country. Generally, this must be the same treaty under which you claimed exemption from tax as a nonresident alien. 2. The treaty article addressing the income. 3. The article number (or location) In the tax treaty that contains the saving clause and its exceptions. Cat. No. 10231X Form W-9 (Rev. 1-2005) .', Mavor S. Scott Vandergrift center of Good L . <).~e !~~~ Commissioners Gary Hood, District 1 Scott Anderson, District 2 Rusty Johnson, District 3 Nancy J. Parker, District 4 City Manager Robert Frank VENDOR/BID LIST APPLICATION The City of Ocoee requires the following infonnation for our vendorlbid list. Please complete the following vendor application in its entirety, along with the attached W-9 form. Return to the Finance Department to ensure placement on our vendorlbid list or to the requesting department to ensure placement of a pending order. Note: It Is the vendor's responsibility to keep your account current with the City, please notify the City of ony subsequent changes to the information furnished below. Your company is subject to removal from the City's active vendorlbid list if the City does not utilize your company's services within three (3) years. Center, Inc. Name of Business Alzheimer Resource Phone# 407-843-1910 Address 1400 N. Semoran Blvd., Fax# 4U/-jtll-4155 Sui te i\ E-Mail Nancy@alzheimerresourcenter.org Orlando, FL 32807 Remit to Address (ifdiflerent) Same As Above Contact Nancy Squi!1::1Eacioti, Executive Director City of Ocoee Occupation License # (Required only for Vendors located within Ocoee City Limits) N/A 'City ofOcoee Registration # (Required only for Construction Vendors that will be applying for a permit) N/A Do you accept Purchase Orders? ~r No Do you accept VISAa!> cards? Yes or @---If yes, what is your Merchant Category Code (MCC Code)? (This code is assigned by your Visa@ Processing Company) Are you a member of Demands tar by Onvia@? Yes or No What City Department will be utilizing your Commodities/Services (if known) Not Known C d'ti' dJ S . P 'dd Counseling, Support Groups, Education ommo 1 es an or ervICes rOVl e . and other caregiver-focused services for families/caregivers of those with Alzheimer's disease Note: The City of Ocoee utilizes Demandstar by Onvla@ for automatic bid and quote notifications. Membership Is not required to register as.o vendor with the City ofOcoee. Nor Is it a requirement to bid on commodities and services for the City. However, membership is a requirement to receive bid and/or quote solicitations from the City. We encourage you to learn more about the Demandstar service by calling toll-free 1-800-331-5537, or visiting www.demandstar.com/suDDller. There is a fee for this service. Please visit the City's BidNendor page at www.ci.ocoee.n.us for more information. Thank you for your interest in doing business with the City of Ocoee. Updated' November 2004 City of Ocoee. 150 N Lakeshore Drive' Ocoee, Florida 34761 phone: (407) 905-3100' fax: (407) 656-8504' www.ci.ocoee.fl.us { f II Alzheimer Resource Center, Inc. 1400 N. SemoranBlvd. Suite A Orlando, FL 32807 (407) 843-1910 (800) 330-1910 Fax: (407) 381-4155 www.AlzhelmerResourceCentcr.orll . Board of Directors Off/cet's Leslio ElIls, Ph.D. Pruldll1ll Jim Salvago VI., Prllltllnt Doniso Cullon 8,.,.,lary Directors Luis G. Allen, MD Joy Block Tanya Burns, LUTCF Pat Galloway Botsy McKeeby, RN John VonLangen Staff Nancy Squillacloti &oculi.. Dlnc/or Susan Bush, MA Gerontology. CVT FIl71lIIy S.M.II ComuIlanI Jerry Hamilton Family 8'",/.11 Sup,_ Leslie Koonce OffICI Man.,,,. Jennifer Purdy CommuI1lcatlonJ/ D1td /t>oclDl 8..01. COOl'dina/or Martha Purdy, LCSW,ACSW Brolo BankSp,c/aJ/a1 Ron St. John llIfol'mollDll D1td Rrftrrol Sp"loUaI November 15, 2005 Mr. Robert Frank, City Manager CITY OF OCOEE 150 N. Lakeshore Drive Ocoee, FL 34761 Dear Mr. Frank: We appreciate the opportunity to submit this request for support from the City of Ocoee. The mission of Alzheimer Resource Center is to strive to lighten the burden and improve the quality of life for families devastated by Alzheimer's disease through counseling, support services, research and hope. We would value a partnership with the City of Ocoee in helping us meet the needs of the often forgotten victim of Alzheimer's disease - the caregiver. Our request is for a $500 grant to be used to help fund a monthly Support Group for caregivers which is held at Summerville Assisted Living in Ocoee. Alzheimer's is an insidious disease that ravages not only the patient, but also the entire family and communities of friends. We know that families can more successfully navigate their journey with the help of our Support Groups and other programs. We thank the. City of Ocoee for considering our funding request. With your help we can continue to provide II a lifeline for the family today, and hope for the families of tomorrow" for those with loved ones suffering from this devastating disease. Please feel free to contact meat 407=8437 1910 shaul you need any further information. 11-1 6-05P01 : 37 RCVD A member ogenoy of A life line for the family today. Hopejor thefamiZll of tomorrow. ....ot,__w" Q~ '000 Funding Cycle: November 2005 For more information, please call the Community Relations Department at (407) 905-3109 or e-mail telliott@cLocoee.f1.us. When completing this application, use only the space provided. The only attachment should be the formal organizational support documentation (minutes or letter). Please remember to complete a City of Ocoee vendor form or we will not be able to issue a check. Applicants may apply for any amount up to $500. ................................ Citv of Ocoee Communitv Merit Awards Prol!ram Application Name OfOrganlzation:~'I DC''')u.:t 1roo p jq'( Address of Organization: f.o . 601- '1'') i.J CJ (' 0 eR.. f t., 3 LJ ') v I Contact person for this ap~lication: ~OOD J-e t1dQ...... f c9 ~ob.QrI-.s- (The contact member must pe a member of th'B organization.) Daytime phone number E-mail address: . . 40')'/o'SlP' &8 ~ LID') .Ljyq ':d-:9 ")Cj '.(A~-(( 0 13[: i.. 7$ @) YAHoo .(om What are you seelfrng grant money for? What specifically will the money' be used for? -(0 .5ej!)~ boys to SlAi'Y\('rqlr CCAIV\P +~a..k C~" {)(..~. o..flfo'rJ... ro ~tJ, What dollar amount are you requesting? (The maximum grant award Is $500.) We c)., (e.. l^ e q, v'--'~.:> 1- {~ 4t> 600 o~ Is your organlzatii:Jn gettinrr funding from any other source for this specific project? fVO How many clients does your organization serve? j ~ bot-') What is your organization's primary fundinfJ source? ~'^^,\ (',....\~.. ^5 ~_c,...r Wf:\~h, y6. oJ S",' tll Pop e'or t'\ 5....1.e.'!); Co.",Jy b",,... s*'\1..R.~. (Y\i!to:' I How much moneY/does your organization receive from this source each year? Ra Ll-lo,I t ^() -C)- . What other .s~urces of revenue does your organization have? ~ V\ ('\ J Ro.. \ ~ ~ .. !'\~_ What is your annual budget fOM-his year? J SID 0 0 ~ Last year? / 3 J 000 0 ~ Li~t t~~~ug!j[aisers y~UJo~f8.alnizatlon ~olld~~OOo~ t. .~'1.1Do on C,...rWq,shQ~, Yc..("(J'-~o.......D.Sl, rY\.e'l"\ t\T{Cva.. IJ'\() '.... How many members does your organization have? How many live in Ocoee? 11.0 Do '15., 0 \\iv.lh' J ~bv1S 10 P)V\/-b~ How many live In Ocoee? j_ 14. /!) AJ 1-\/ rs Page 2 - Community Merit Awards Application - November 2004 Cycle Has your organization applied for a grant from the City before? (Va If so, when and what did you apply for? Were you successful and, if so, how much money did you receive? -e.... Does your organization volunteer in the Ocoee community? If yes, what volunteer activities ~o you part!cip.ate In? Ye,S I "'-:: "0115 c..llA.b .( IAr~Y.5h.O"~j 1I"l/o"'tJ~<..V\~/o..\...~rk ~o LA. .t 11\c. [0 r fo (."i'(Y go cvl fZo..c. /L.;S C\.+ .sf",,-....k ,,, k.D. I c.l.f' c\" \ f\ ~ tAp a.~,.... 10.. ~J V.Qott!J::i How many y~rly voluntee/hours does your organization contribute to the community H(.(f"iCli'll. and how are those hours tracked or documented? !loo", 0 v... r-s. -r~o~ c:\h 1 Ar't}t..r Ot j a.. 0 iZI\+.o(\S .fi...J vH. htd p_ o.....J (J,.f'< 0...... r") rQ CC1'e~. Please list the specific accomplishments your organization has achieved In the past 24 months: rIA 1'\ J f.a...,\',>~ $<1, DCc Of!. 1-0 Se r\ J bO'l5 '/'0 .$ ~(Wo.Mf r C'eI ""f'. " .!) boy 5" v.:>1v,'Q. ?/A II p~ ieJ po!" C\+~~ heys p~ 1 J.. ~OD~f"C'" o~l 0+ ill I OO<lr' f" 1}4 /'0 \If Please include any other pertinent Information about your organization or this specific Cd grant request that you feel would help the City in making Its decision: 1~ocp It:ff I'::>.fht 6(J.e~+ boy.sc.tJ,,,,l-r~cp 1'" OCOQli!.. \..0 ;+^ ~J f:3ie Sc.o,^~s$O FaR, Please attach documentation (meeting minutes or letter) to verity that your organization supports this application. -t" r r",^" <& t-. S. oS Boy s, o.J lro,)p 1'1 \( b.> (~d [v. (l ~ C6Mm I hu. /Y) Q VII\. ~I" ~o f\o OJ" by d " J'"e. SC-lf/)o,t ~'.rh. _ IJ . J_ C L r C r 0 I .) I'phovti 0 r'J f ) \ "\., 01" ) (0 ee. C ,...... .. I + c:. o M IM"\ 1'1 rY'Lt r, A J. iAJ !..llo.r(ll.j f'"'p /, , P I (c.'. ,(I,.,. ~l'd~ ci. hL,~KJ~~ (~ Lf (X') . 8') 7 "0.)79 pf For Staff Use Only Date Application Received Was Application Received Complete? If not, Date Application Returned 1//8~ I~~~ , ! 3;L(s//h g m~, BOYSCOUT TROOP 198 Community Service Hours Sat. Oct. 8 Turkey shoot @West Orange Girls club 8 boys 2 leaders 8.30 am. -4 pm. Fri-Sat. Oct 21..22 Fri. 6 Pm. Working Halloween pa-rty @ park All boys 5pm. -9.30 pm. Sat. Working Turkey shoot @ West Orange Girls club 8 boys 2 leaders 8.30 am. -4 pm. I Sat. Nov. 5th. Turkey shoot West Orange Girls Club 8 boys 2 leaders 8.30 am. -4 pm. .5 COlA~';' d ~or (.~CJc9 ~ fc ~ - uf. :;2-I.Qc.. (,~f'$ - ~ ~y5' 73~ ~ J\}OoN . Nov. 12th Turkey shoot @ West Orange Girls club 8 boys 2 leaders 8.30 am. -4 pm. Dec. 10th Turkey shoot @ West Orange Girls club 8 boys 2 leaders 8.30 am. -4 pm. . Doc",..!- r ~ t'~)) . b boy S i L-t boy5 ~ A""" ~ 5pi'Y\ Sc\.+, <1 A IY' - :;) P /YI. ..5 '^ 1"\ . L~\hd OLA-+- C o()5e,55toA S~eo.MJ 0.. Y\.J. G-AS C';" r: II to be. ~\~(.1 OI..+- , &\c ..e.~ ' c....l .R (,u'\ Ilj..r P 0\ i ^ {-. I{ J. roJ b q-t L-, {rf'I.S t..lv..b t-- o.^ , ~O bOis, 3~.e!i-l'd5 rJ-gJPplY\ A. 11 LA ,\t.Urs . / JJ; u7ltJL .../ , 1~~ ....,- I' ;/., I.""" 1. I ('L QIJ ~ LJ/~" r< --t,J../I1 //)orf<. City Managgr Robert Frank Commissioners Gary Hood, District 1 Scott Andel'son, District 2 Rusty Johnson, District 3 Nancy J. Parker, District 4 MaYill' S. Scott Vandergrift VENDOR/BID LIST APPLICATION The City of Ocoee requires the following information for our vendorlbid llst. Please complete the following vendor application in its entirety, along with the attached W-9 form. Return to the Finance Department to ensure placement on our vendor/bid list or to the requesting department to ensure placement of a pending order. Note: It is the vendor's responsibility to keep your account current with the City, please notify the City of any subsequent changes to the information furnished below. Your company is subject to removal from the City's active vendor/bid list if the City does not utilize your company's services within three (3) years. Name of Business &').} 5c (;> ,./I"J ~- 0'000 I Crx Address V --V . B 0) '? 11.) . 0(0 eJL H .3> (('] u I cO .,.,. Remit to Address (if different) I Contact f q City of Ocoee Occupation License # (Required only for Vendors located within Ocoee City Limits) ~. l,0 " ~ l ~ ~G?\,( t ^J- I r"\ Lu. '1 . 0-:> \' t~ Y\ It 0 r M...c>\.t t' (),,\ 0."\ b"lck. oJI j' t ~-:M2 J f{ 0 b.e tr.ts City of Ocoee Registration # (Required only for Construction Vendors that will be applying for a permit) Do you accept Purchase Orders? Yes or No Do you accept VISA@ cards? Yes or No ---If yes, what is your Merchant Category Code (MCC Code)? (This code is assigned by your Visa@Processing Company) Are you a member of Demands tar by Onvia@? Yes or No What City Department will be utilizing your Commodities/Services (ifknown) Commodities and/or Services Provided Note: The City of Ocoee utilizes Demandstar by Onvia@ for automatic bid and quote notifications. Membership is not required to register as a vendor with the City of Ocoee. Nor is it a requirement to bid on commodities and services for the City. However, membership is a requirement to receive bid and/or quote solicitations from the City. We encourage you to learn more about the Demandstar service by calling toll-free 1-800-331-5537, or visiting WW\Y.QW.l!!!illstllr.com/supJ!li~.r. There is a fee for this service. Please visit the City's BidNendor page at lVW:l:V.C.i.o~Q~~~n!!!.s. for more information. Thank you for your interest in doing business with the City of Ocoee. . City of Oeoee . 150 N Lakeshore Drive. Oeoee, Florida 34761 phone: (407) 905-3100. fax: (407) 656-8504. www.eLocoee.f1.us Form W-9 (Rev. 1-2005) Page 2 4. The type and amount of Income that qualifies for the exemption from tax. 5. Sufficient facts to justify the exemption from tax under the terms of the treaty article. Example. Article 20 of the U.S.-China Income tax treaty allows an exemption from tax for scholarship Income received by a Chinese student temporarily present In the United States. Under U.S. law, this student will become a resident alien for tax purposes If his or her stay In the United States exceeds 5 calendar years. However, paragraph 2 of the first Protocol to the U.S.-China treaty (dated April 3D, 1984) allows the provisions of Article 20 to continue to apply even after the Chinese student becomes a resident alien of the United States. A Chinese student who qualifies for this exception (under paragraph 2 of the first protoco~ and Is relying on this exception to claim an exemption from tax on his or her scholarship or fellowship Income would attach to Form W-9 a statement that Includes the Information described above to support that exemption. If you are a nonresident alien or a foreign entity not subject to backup withholding, give the requester the appropriate completed Form W-8. What Is backup withholding? Persons making certain payments to you must under certain conditions withhold and pay to the IRS 28% of such payments (after December 31, 2002). This Is called "backup withholding." Payments that may be subject to backup withholding Include Interest, dividends, broker and barter exchange transactions, rents, royalties, nonemployee pay, and certain payments from fishing boat operators. Real estate transactions are not subject to backup withholding. You will not be subject to backup withholding on payments you receive If you give the requester your correct TIN, make the proper certifications, and report all your taxable Interest and dividends on your tax return. Payments you receive will be subject to backup withholding if: 1. You do not furnish your TIN to the requester, or 2. You do not certify your TIN when required (see the Part II Instructions on page 4 for details), or 3. The IRS tells the requester that you furnished an Incorrect TIN, or 4. The IRS tells you that you are subject to backup withholding because you did not report all your interest and dividends on your tax return (for reportable interest and dividends only), or 5. You do not certify to the requester that you are not subject to backup withholding under 4 above (for reportable Interest and dividend accounts opened after 1983 only). Certain payees and payments are exempt from backup withholding. See the Instructions below and the separate Instructions for the Requester of Form W-9. Penalties Failure to furnish TIN. If you fall to furnish your correct TIN to a requester, you are subject to a penalty of $50 for each such failure unless your failure Is due to reasonable cause and not to willful neglect. Civil penalty for false Information with respect to withholding. If you make a false statement with no reasonable basis that results In no backup withholding, you are subject to a $500 penalty. Criminal penalty for falsifying Information. Willfully falsifying certifications or affirmations may subject you to criminal penalties Including fines and/or Imprisonment. Misuse of TINs. If the requester discloses or uses TINs In violation of federal law, the requester may be subject to civil and criminal penalties. Specific Instructions Name If you are an Individual, you must generally enter the name shown on your social security card. However, if you have changed your last name, for Instance, due to marriage without Informing the Social Security Administration of the name change, enter your first name, the last name shown on your social security card, and your new last name. If the account Is In Joint names, list first, and then circle, the name of the person or entity whose number you entered In Part I of the form. Sole proprietor. Enter your individual name as shown on your social security card on the "Name" line. You may enter your business, trade, or "doing business as (DBA)" name on the "Business name" line. Limited liability company (LLC). If you are a single-member LLC (Including a foreign LLC with a domestic owner) that is disregarded as an entity separate from Its owner under Treasury regulations section 301.7701-3, enter the owner's name on the "Name" line. Enter the LLC's name on the "Business name" line. Check the appropriate box for your filing status (sole proprietor, corporation, etc.), then check the box for "Other" and enter "LLC" In the space provided. Other entities. Enter your business name as shown on required Federal tax documents on the "Name" line. This name should match the name shown on the charter or other legal document creating the entity. You may enter any business, trade, or DBA name on the "Business name" line. Note. You are requested to check the appropriate box for your status (Individual/sole proprietor, corporation, etc.). Exempt From Backup Withholding If you are exempt, enter your name as described above and check the appropriate box for your status, then check the "~xempt from backup withholding" box In the line following the business name, sign and date the form. Generally, Individuals (Including sole proprietors) are not exempt from backup withholding. Corporations are exempt from backup withholding for certain payments, such as Interest and dividends. Note. If you are exempt from backup withholding, you should stili complete this form to avoid possible erroneous backup withholding. Exempt payees. Backup withholding Is not required on any payments made to the following payees: 1. An organization exempt from tax under section 501 (a), any IRA, or a custodial account under section 403(b)(7) if the account satisfies the requirements of section 401(n(2), 2. The United States or any of Its agencies or instrumentalities, 3. A state, the District of Columbia, a possession of the United States, or any of their political subdivisions or Instrumentalities, 4. A foreign govemment or any of Its political subdivisions, agencies, or Instrumentalities, or 5. An International organization or any of Its agencies or Instrumentalities. Other payees that may be exempt from backup withholding include: 6. A corporation, Form W-9 (Rev. 1-2005) 7. A foreign central bank of Issue, 8. A dealer In securities or commodities required to register In the United States, the District of Columbia, or a possession of the United States, 9. A futures commission merchant registered with the Commodity Futures Trading Commission, 10. A real estate Investment trust, 11. An entity registered at all times during the tax year under the Investment Company Act of 1940, 12. A common trust fund operated by a bank under section 584(a), 13. A financial Institution, 14. A middleman known in the investment community as a nominee or custodian, or \ 15. A trust exempt from tax under section 664 or described In section 4947. The chart below shows types of payments that may be exempt from backup withholding. The chart applies to the exempt recipients listed above, 1 through 15. IF the payment 18 for, . . THEN the payment is exempt for.. . Interest and dividend payments All exempt recipients except for 9 Broker transactions Exempt recipients 1 through 13. Also, a person registered under the Investment Advisers Act of 1940 who regularly acts as a broker Barter exchange transactions and patronage dividends Exempt recipients 1 through 5 Payments over $600 required to be reported and direct sales over $5,000 1 Generally, exempt recipients 1 through 7' 'See Form 1099-MISC, Miscellaneous Income, and ~s Instructions. 'However, the following payments made to a corporation (Including gross proceeds paid to an ettomey under section 6045(1), even If the attorney Is a corporation) and reportable on Form 109B-MISe are not exempt from backup w~hholdlng: medical and health care payments, attorneys' fees; and payments for services paid by a Federal executive agency. Page 3 Part I. Taxpayer Identification Number (TIN) Enter your TIN In the approprIate box. If you are a resident alien and you do not have ana are not eligible to get an SSN, your TIN is your IRS Individual taxpayer Identification number (ITIN). Enter It In the social security number box. If you do not have an ITIN, see How to get a TIN below. If you are a sole proprietor and you have an EIN, you may enter either your SSN or EIN. However, the IRS prefers that you use your SSN. If you are a single-owner LLC that Is disregarded as an entity separate from Its owner (see Limited liability company (LLC) on page 2), enter your SSN (or EIN, If you have one). If the LLC Is a corporation, partnership, etc., enter the entity's EIN. Note. See the chart on page 4 for further clarification of name and TIN combinations. How to get a TIN. If you do not have a TIN, apply for one Immediately. To apply for an SSN, get Form SS-5, Application for a Social Security Card, from your local Social Security Administration office or get this form online at www.socla/security.govlonline/ss-5.pdf. You may also get this form by calling 1-800-772-1213. Use Form W-7, Application for IRS Individual Taxpayer Identification Number, to apply for an ITIN, or Form 8S-4, Application for Employer Identification Number, to apply for an EIN. You can apply for an EIN online by accessing the IRS webslte at www./rs.govlbus/nesses/ and clicking on Employer ID Numbers under Related Topics. You can get Forms W-7 and S8-4 from the IRS by visiting www.lrs.gov or by calling 1-800- TAX-FORM (1-800-829-3676). If you are asked to complete Form W-9 but do not have a TIN, write "Applied For" In the space for the TIN, sign and date the form, and give It to the requester. For Interest and dividend payments, and certain payments made with respect to readily tradable Instruments, generally you will have 60 days to get a TIN and give It to the requester before you are subject to backup Withholding on payments. The 60-day rule does not apply to other types of payments. You will be subject to backup withholding on all such payments until you provide your TIN to the requester. Note. Writing "Applied For" means that you have already applied for a TIN or that you Intend to apply for one soon. CautIon: A disregarded domestic entity that has a foreign owner must use the appropriate Form W-8. ./ Form W-9 (Rev, 1-2005) Pege 4 Part II. Certification To establish to the withholding agent that you are a U.S. person, or resident alien, sign Form W-9. You may be requested to sign by the withholding agent even If Items 1, 4, and 5 below Indicate otherwise. For a joint account, only the person whose TIN Is shown In Part I should sign (when required). Exempt recipients, see Exempt From Backup Withholding on page 2. Signature requirements. Complete the certification as indicated In 1 through 5 below. 1. Interest, dividend, and barter exchange accounts opened before 1984 and broker accounts considered active during 1983. You must give your correct TIN, but you do not have to sign the certification. 2. Interest, dividend, broker, and barter exchange accounts opened after 1983 and broker accounts considered Inactive during 1983. You must sign the certification or backup withholding will apply. If you are subject to backup withholding and you are merely providing your correct TIN to the requester, you must cross out Item 2 In the certification before signing the form. 3. Real estate transactions. You must sign the certification. You may cross out Item 2 of the certification. 4. Other payments. You must give your correct TIN, but you do not have to sign the certification unless you have been notified that you have previously given an Incorrect TIN. "Other payments" Include payments made in the course of the requester's trade or business for rents, royalties, goods (other than bills for merchandise), medical and health care services (Including payments to corporations), payments to a nonemployee for services, payments to certain fishing boat crew members and fishermen, and gross proceeds paid to attorneys (Including. payments to corporations). 5. Mortgage Interest paid by you, scquisltlon or abandonment of secured property, cancellation of debt, qualified tuition program payments (under section 529), IRA, Coverdell ESA, Archer MSA or HSA contributions or distributions, and pension distributions. You must give your correct TIN, but you do not have to sign the certification. What Nam~ and Number To Give the .Requester For this tyoe of "ccount: 1. Individual 2. Two or more Individuals Oolnt account) 3. Custodian account of a minor (Uniform Gift to Minors Act) 4. a. The usual revocable savings trust (grantor Is also trustee) b. So-called trust account that Is not a legal or valid trust under state law 5. Sole proprietorship or single-owner LLC For this type of "ccount: 6. Sole proprietorship or single-owner LLC 7. A valid trust, estate. or pension trust 8. Corporate or LLC electing corporate status on Form 8832 9. Association, club, religious, charitable, educational, or other tax-exempt organization 10. Partnership or multi-member LLC 11. A broker or registered nominee 12. Account with the Department of Agriculture In the name of a public ,entity (such as a state or local government. school district. or prison) that receives agricultural program payments Glv" name "nd SSN of: The individual The actual owner of the account or, If combined funds, the first Individual on the account 1 The minor · The grantor-trustee 1 The actual owner 1 The owner 3 Give n"me and EIN of: The owner 3 Legal entity 4 The corporation The organization The partnership The broker or nominee The public entity 1 List first and circle the name of the parson whoee number you furnish. If only one person on a Joint account has an SSN, that person's number must ba furnished. . Circle the minor's name and furnish the minor's SSN. 'You must show your Individual neme and you may also enter your business or "DBA" name on the second name line. You may use either your SSN or EIN (If you have one). If you "re a sole proprietor, IRS encourages you to use your SSN. . List first and circle the name cf the I"gal trust, estate, or pension trust. (Do not furnish the TIN of the personal repreaentatlve or trustee unless the legal entfty nsalf Is not deslgneted In the e.ccoun1 title.) Note. If no name Is circled when more than one name Is listed, the number will be considered to be that of the first name listed. Privacy Act Notice Section 6109 of the Intemal Revenue Code requires you to provide your correct TIN to persons who must file Information returns with the IRS to report Interest, dividends, and certain other Income paid to you, mortgage Interest you paid, the acqulsitlon or abandonment of secured property, cancellation of debt, or contributions you made to an IRA, or Archer MSA or HSA. The IRS uses the numbers for Identification purposes and to help verify the accuracy of your tax return. The IRS may also provide this information to the Department of Justice for civil and criminal litigation, and to cities, states, and the District of Columbia to carry out their tax laws. We may also disclose this Information to other countries under a tax treaty, to federal and state agencies to enforce federal nontax crlrnlnallaws, or to federal law enforcement and Intelligence agencies to combat terrorism. . You must provide your TIN whether or not you are required to file a tax return. Payers must generally withhold 28% of taxable Interest. dividend, and certain other payments to a payee who does not give a TIN to a payer. Certain penalties may also apply. ctppr ~ 'Sav 'j) . /~ 11/.;l3/oj- /0, 'sCJ4/J! Funding Cycle: November 2005 . For more information, please call the Community Relations Department at (407) 905-3109 or a-mail telliott@cLocoee.f1.us. When completing this application, use only the space provided. The only , attachment should be the formal organizational support documentation (minutes or letter). Please remember to complete a City of Ocoee vendor form or we will not be able to Issue a check. Applicants may apply for any amount up to $500. City of Ocoee Community Merit Awards Program Application Name of Organization: Ocoee Elementarv Literacv Committee Address of Organization: 400 South Lakewood Avenue Ocoee. Florida 34761 Contact person for this application: (The contact member must be a member of the organization.) Dian HooDer CRT . Daytime phone number: (407) 877-5027 ext: 224 E-mail address: hooDerd@ocDs.net What are you seeking grant money for? What specifically will the money be used for? . Materials for our students to integrate technology and literacy by publishing hard cover books. This district has purchased the site license for the software and training. Our media and technology specialists will instruct students to write stories, poetry, autobiographies, journals, field trip memory books, legacy books, photo journals, etc. through our existing word processing and power point programs. We need money to cover the initial purchase of the covers, binding papers and strips. What dollar amount are you requesting? (The maximum grant award is $500.) $500.00 Is your organization getting funding from any other source for this spec/flc project? The district is Drovidino funds for the site license, software and staff trainina. What is your organization's primary funding source? Grants How much money does your organization receive from this source each year? None for this project, however we have received various grants for other projects, such as summer school. ' What other sources of revenue does your organization have? None What Is your annual budget for this year?$O.OO Last year? $0.00 List the fundra/sers your organization holds? Scholastic Book Fair- to purchase Librarv books. This will turn into a fundraiser for the Durchase of future bookswill be Daid for throuah the sale of the books the children make. Page 2 - Community Merit Awards Application - November 2004 Cycle For Staff Use Only Date Application Received Was Application Received Complete? Ifnot, Date Application Returned How many members doss your organization have? 11.How many live in Ocoee? Z How many clients does your organization serve? 675 How many live In Ocoee? 675 Has your organization applied for a grant from the City before? Y~s If so, when and what did you apply for? November 2003 -books for Literacy Breakfast. November 2004- Citizenship DVD's for the Media Center. April 2005- summer literacy proaram. Were you successful and, if so, how much money did you receive? Yes. $500.00 Does your organization volunteer In the Ocoee community? Yes If yes, what volunteer activities do you participate In? Founder's Day. Boy Scouts. Book Clubs. before and after school tutorina. clean-up club. Junior Achievement. . Read to Succeed. Teach-In. monthly Info-breakfasts How many yearly volunteer hours does your organization contribute to the community 150,000 and how are those hours tracked or documented? computer sign in Please list the specific accomplishments your organization has achieved in the past 24 months: We were awarded an "A" for the 4th consecutive year and made Annual Yearly Progress in each of our subgroups. Our students test scores continue to improve in all areas. Please include any other pertinent information about your organization or this specific grant request that you feel would help the City in making its decision: This Year. in addition to readina and math. we werereauired to submit a writina plan (attached) to our district administrator. As part of that plan. we have aaoal for students to publish work. . These materials will enable us to meet this writina a6al. Please attach documentation (meeting minutes or letter) to verify that your organization supports this application. ~ o. o c .co! UQ. flJO') ~.5 ca:: ... ... ;~ SeD 0)0 -0 WN I m:g 00 UN o ~ r:: o en r:: ..c: o ~ co '1i) ..c: en c; CL '(j C .1: Q. "C G) .c .!a Q. E o t,) t,) <C ~ ::J: ~ o ~ "tl l ~ ,~ ::: ] f j 1 E: -a ~ ~ ~ ~ ~ ~ i S! ~ .8 ~ ~ ~ ~ ~ ~ ~ ~.~ a ~ f ~ ~ ~ .~ ~ 't;S ~ l ~ .s ~ ~",~~a ~ ~ ~~!i~~ ~ ~G-~t:S.~ .[:2 ~ :::t:S~t:o.s !.l 1'1 .9 tl f..t ~ ~ '1:: e ~~O~~ ~ ~ l?l ~ Ii.,.... III fl.;~~~~ ~ ~ uuO.....:-Ei~:-Ei .: 0 Q.... ~ ~ ~ ~ f..t~f..t !3 ....::"::..,~ ~ ~~~ -; N c<i 1~ 1:: "C = II "0 E-< . ~ ,~+l BI~ ~oo 8 ~~ i 1t ~ .g~ & !il f II ii.1 ~ .. ~! ~ ~ <51 .~ i "i 8 ! ~ ! ti ~ 8 ~. ~ .~ ~ l .1 ~ b ~ ~ .a ~ -; t'i .S:! ~ ~ 't u ~ 2 a 't;S l:l .~ 2 f i t\., ~ ~ ~ ,g a 2 r)J .p 00 - ~ 'ij ..() e ~ ~ ~ '0 ~ !.l I ~ ..... 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"'~~"'4ij.f::!3 ~~~ g~.!l~~'~~ ~ '- 'll ~ 0 ~ ~ U .~ ~ ... ~ ~ ~..;: .~ G 'll '1S '" QQS ~~Q(..:;~~';5 ~ j ~ ....; c c ~ "",- ... ~ ~ 8 ~ .'E- c:s ti .~ ~ ~ :~ .f:: ... "-itt'i ;...; "-i tt'i ~ tIj ~ ~ 13 ~ t ~ ~ leU oS .6- "l:l \l,o ~ ~ l I~I ~ 51 ti E:; ~~~ ~ ~~s ~ \l,o~ ~ ~ .~ ~~E: ~ ~ ~-5\l,o :~ 'll] ~ i 1J ~ ~ ~ ~~ ~ '!::, -G>~~.~.S~ ~ ~ ~i1:~ ij .~ ~ ~ ~ ~ (3 'S ~ ~ij~~'ts>li: ~ ~e.' ~ ... ~ ~ ~ ~ .~ ~ ~ _~ 6 ~ ~lI..,~.~tI.,lI ~ ~ ~~~~~~ i ~ ~ E: o ~ 'll .1:: ~ ....; r-.i ...;~....; .~ G IE .~ .51 ~ ~ ~ .1]1j '~1 gj~ 4) ~ . 44 ~. ~ t~:~ ~ i~]Jfa p~ ~ .]~ O'~ jl1Jf] i H~~;8 ,Q ~j:f :t=' .g.~ 1 ~ tj u> 8 8 ~~E1;8 ~ t:7' .s ~ . rJl rJl rJl ~~ U u !E !E u ~ 5 4) ~E1 ~ j j ~g. '5'0 j:4 j:4 lI.l t "'el Literacy Meeting Notes 11/21/05 Present: Isabel Chipungu-Media Specialist Dian Hooper-CRT Sandra Conner-Kindergarten teacher Bonnie Stanley-I st grade teacher Kathy Hennesman-3rd grade teacher Madonna Scime-4th grade teacher Richard Godsell-Sth grade teacher Christine Payne- Reading Specialist Tammy Lundman- Technology Specialist I. We discussed PCA T writing rubric literacy breakfast. Each grade level is in the process of developing a student rubric to assist students with writing goals. The purpose of the January breakfast will be to explain rubrics to parents. · Each grade level will give a short presentation of grade level specific rubrics · We will present in grade level order to demonstrate the scaffolding of skills from one grade level to another. . Grades 3-4 will have the same rubric, so teachers will further demonstrate how the rubric score is used to develop learning goals for future writing. 2. Tammy Lundman requested funds to provide the multi-media with publishing materials for Create-a-book. Mrs. Hooper reported that no funds were available to purchase those materials and suggested we write a grant request to the City of Ocoee to provide the Literacy Committee with $500.00 to make those purchases. '::' :;',:,,\:>~,.'< :~;.:: '>, -, "':-';"',\:.':':::~ .',' .::.'",.:,:; i..':;,'~~i\:'.;.'/:',:::_;: :. :-,: :: -':;~ .',:~:"> ",':" , . ~;. ":.{ ". 'g\'~r,:o"'.c' ~ss.''"''\b:~>''..':''',:; , h~~};_ ;""~. .,.!~,.,. ,~'r"',,;/;/,/',''''',:i .-" "-'3.~:'; .;!;::':,:t:::~ ::/:.':?::'..' ";:':::""::~:,P;:':i ..: . ,,":1i~~~~~':c~;, · :;~t,::;:'1;)::~; if"::,';< . "'.'" ,':',':: . " "', '" ;. ;; ~;' ,:". ,,),).".'.J~Y:::,.- .':';",' " . . '. .... . 'tof!:miderrtS~ boobtoclrculafe ~.:;;};':;rL""'S~Wrtl1t10s"bv1'he_e or ge"re .".:...",;~~:"Yo~~g;,Auttaors ,.. ..' ,.. . '?'ijf~iri~:~:'~~Ps'1ea/ Jodk 8Ig"I"9, Press Coverage l~&;(tW$Jd/llI!ll~d':~Af:MNfI~ 4'd,t..A 1... dr. ~ ,.,l' .";;:,.fuq!~.,, ,,',:"';':"0 . "....',.(,..J''..IIIAMQ ~.rn..... , W WllUT grrv . ;',L.':.'.:i":':ij!l~'i.:~;jrli:'t:': .., ,.." .. "." ;; ..... . '. ....(~.~kb~sai~;.. $hjppirig"tH~ndllrg . {S.p~ktWli ~"":. ~"",$SI TOTAL .. ..~..:* . : ... ... .. UnrOR .. . PUBLISHING Funding Cycle: November 2005 ~f. ~ ~. <& 00 " For more .information, please call the Community Relations Department at (407) 905-3109 or e-mail telliott@ci.ocoee.f1.us. ' When completing this application, use only the space provided. The only attachment should be the formal organizational support documentation (minutes or I~tter). Please remember to comolete a Citv of Ocoee vendor form or we will not be able to issue a check. Applicants may apply for any amount up to $500. ................................ Citv of Ocoee Communitv Merit Awards Pro!!ram Application Name of Organization: 0 eoee 1-h3 h . 'SchDO )J2D se b:Lu.. 'T e.a....rY'\ Address of Organization: J q ~ 5 ()r DO 0 CA.o.t u....'l Po lOrd" Rx..K kttJ~ee. Contact person for this application: EYre fp.-in:.... ~- J-.tt? () ~ Cnoch (The contact member must be a member of the organization.) Daytime phone number: L.j01- J 5 ~ .~~ '75 Y_ E-mail address:~e.ILe4).Ocf<;.ne..t What are you seeking grant money for? What specifically will the money be used for? ~$1?Ocl~ -SO/, ~~~ ~':~r::1;:;r~ What dollar amount are you requesting? (The maximum grant award is $500.) $ Sac. co Is your organization getting funding from any other sourc~ for this specific project? fU) I ~ {Li"\,.L Vt...Q:t::. What is your organization's primary funding source? +" clh~ How much money does your organization receive from this source each year? ti a... . lUW 5eJLO What other sources of revenue does your organization have? (Lo.,1A a ;bnvL os ti. \ro.lLL-~LW Jt..6.Y . What is your annual budget for this year? no ~tj:lh N.IA.J Last year? List the fundraisers your organization holds? ~ .-/o..t...u\..,(1lLvY10 AX-. ......Lk~t ~VVl(.. ~ ('I1A'''-- IAJfl...l:l-h. D I r. leu I gq ~ /)i;:S- fiIPJ cf' /..5- /Jit( Page 2 - Community Merit Awards Application - November 2001 Cycle 35 pic.Ll;jtALI How many members does your organization have? 7 (./)Qcfu.>!1->- How many live in Ocoee? a...Ll '6A.+tlLvn toO<'lO How many clients does your organization serve? tJw k.. How many live in Ocoee? tOc)t5Jo C.orYlmI.UL~"J Has your organization applied for a grant from the City before? M If so, when and what did you apply for? Were you successful and, if so, how much money did you receive? (l J Cl..J Does your organization volunteer in the Ocoee community? If yes, what volunteer activities do you participate in? V ~.h uJ"().JV2., fA .sclLO.-CLf1 orhvlruA.ol- ~lAJu-~ ~..l'I.LLi'UL How many yearly volunteer hours does your organization contribute to the community and how are those hours tracked or. do~umented? ~ h..ouA..fi. a 7::1) ~ cu /.u...uLk.. )( '1 c'OQ.cJu..o..-. E{ a.. fY\...UUfV\.Lu-n ~ '10 ~ . Please list the specific accomplishments your organization has achieved in the past 24 months: ~d ~ ~ M lL. ~ s~ IJJ.I. _ (to IULt'J An I .l.L if;;;f~. :~k::O:~'~~~~1 T?~' r,t1::) % OUJfLl --U'L (} ^ {i~'p cXf' _~. rvlP t . Please include any other pertinent information about your organization or this specific grant request that you feel would help the City in making its decision: . ,0.0 '-/0 . . For Staff Use Only Date Application Received Was Application Received Complete? .. Ifnot, Date Application Returned NDU-18-2005 11:05A FROM:DCOEE HIGH SCHOOL Form W-9 (Rev. January 2003) Departmont 01 tho TIIlIl"''Y Inletne! Revenuo Service ...; NlIma '" [ Buslnass nama. II different Irom above g tl fa J City. slele. and ZIP cOda 31 List IICCllunt number(s) hera (opIIDlla~ VI 40?g053099 TD:94076546720 P.Ul Request for Taxpayer Identification Number and Certification OCOEE HIGH SCHOOL OCOEE, FL 34761 O IndlvlduaV Cheek approprtate boxl Solll proprIetor Addrass (number. street, end IIPL or Bulle no,) o Corporation IN Give form to the requester. Do not sBnd to the IRS. o Pertnershlp ~Olher ~ -~~~.~l..... O Exempl from backup wtltlholdlng Requester's nama and address (Optional) Enter your TIN In the appropriate box. For Individuals, this Is your soclel security number (SSN), Howovor, for a resident allen, sole proprietor, or dlsregerded emity, see tho Part I instructions on page 3. For other enlllles, It Is your employer Identlficetlon nLllTlbar (EIN). If you do not have a number. see How to get a TIN on page 3. Noto: If the account Is In more than one name, see eM cllart on pagEl 4 ror gUIClel/nEls on whose numlJer to enter, Certification Under penalties of perjury, I certIfy that: 1. The number shown on this form Is my correct taxpayer Identincatlon number (or lam waiting for a number to be Issued to me), and 2. I am not subject 10 backup withholding because: (a) I am exompt rrom backup wlthholdlng, or (b) I have not been notlned by the Internal Revenue Service (IRS) that I am subject to backup wfthholdlng 8S a result of a failure to report all Interest or divIdends. or (e) the IRS has notified me that I am no longer suQlectto backup withholding. and 3. lam a U.S. person Oncludlng a U.S. resIdent alien). Certification Instrucllons. You must cross out Item 2 above If you have bean notified by the IRS that you are currently subject to backup withholdIng because you have failed to raport alllnterost and diVidendS on your tax return. For reel estate transeCtlons, Item 2 does not apply. Formortgage Interest paid. acquisition or abandonment of secured property. cancellation of debt, contributiOns to an Individual retirement arrangement (IRA), and generally. payments other than Interest and divIdends, you are not requIred to sign the Certification. but you must provide your correct TIN, (See the Instructions on page 4,) Sign Here Datil ~ I) - I ~ - 0 oS Purpose of Form A person who Is required to me an Information return wIth the IRS, must obtain your correct taxpayer Identification number (TIN) to report, for example, Income paid to you. real estate .transactlons. mortgage Interest you paid, acquisItion or abandonment of secured property. cancellation of debt, or contributIons you made to an IRA. U.S. person. Use Form W-9 only If you are a U.S. person Qncludfng a resident alien), to provide your correct TIN to the person requesting It (the requester) and. when applicable, to: 1. Certify that the TIN you ere giving Is correct (or you arB waIting for a number to be Issued), 2. Certify that you are not subject to backup Withholding. or 3. Claim exemption from backup withholding If you are a U.S. exempt peyee. Note: If B requester gives you 8 form other than Form W.9 to request your TfN, you must use tho requester's (orm " It Is substantially similar to this Form W.9. Foreign person. If you are a foreign person, use the approprIate Form W.O (see Pub. 515, Withholding of Tax on Nonresident Aliens and ForeIgn Entitles). Cat. No. 10231X Nonresident alien who becomes a resIdent alien. Generally, only a nonresident alien Individual may use the terms of a taX treaty to reduce or eliminate U.S. tax on certain types of Income. However, most taX treaties contaIn a provision known as II .sevlng clause." ExceptIons specified In the saving clause may permit an exemption from tax to continue for certain types of Income even efter the recipient has otherwise become a U,S. resident alien for talC purposes. If you are a U.S. resident alien who Is relying an an exception contained In the savIng clause of a tax treaty to claim an exemptIon from U.S. tax on certain types of income, you must attach a statement that specltles the follOWing five Items: 1. The treaty country. Generally, this must be the same treaty under which you claimed exemption from tax as a nonresident alien. 2. The treaty artlcle addressing the Income. 3. The arUcle number (or location) In the tax treaty that contains the saving clause and Its exceptions. 4. The type and amount or Income that qualifIes for me exemption from tax. 5. Sufficient facts to Justify the exemption from tax under the terms of the treaty article. J Form W.& (Rev. 1-2003) Ocoee High School Athletic Booster Meeting October 11, 2005 1. Disney Golf Tournament discussed. We still need 5 volunteers to work on Friday October 21 st and Saturday October 22nd. Please call Donnie 407-948-0804 if you are able to help out with these days. Baseball parents/coaches have been the only sport to step up and help out with this golf tournament. Only a few coaches have signed up to work but only on Saturday and Sunday. Some coaches would like to work other days if they can get out of school on Thursday or Friday. Bill Chambers will check with Mike Armbruster on how to split up the money between each sport and the general athletic fund. 2. Thursday, October 13,2005 Channel 13 will feature Ocoee High School Football as the game ofthe week. 3. Tonight the cheerleaders are at Sun State Ford for a special fundraiser with K92. The school with the most supporters there will get $750.00. 4. The baseball team has been working on field preparation. Last week the team put down 8 or 9 pallets of sod. Thank you to all of those who helped. 5. Officers for the Athletic Boosters are as follows: President-Pat Buckles Vice President-David Simpson Treasurer-Barbara Simpson Secretary-Kim Hendrixson Karen Flannigan will be in charge of the Diamond girls (yes, we need a new name). During the nominations Scott Tidmus nominated David Simpson as Pr;sident and 2nd by Joe Stinnett. David said he would rather not accept this position. Scott amended his nomination of David and nominated Pat Buckles (which he graciously accepted) and nominated David Simpson as Vice President the rest is history. 6. We need to think of some ways to run the concession stand at the basketball games. Mr. McFarland spoke on how the band does it. But at the basketball games there is "NO FOOD IN THE GYM". Winter concession will be for basketball and soccer, for both junior varsity and varsity. Mr. McFarland said to call Papa Johns,' tell them you are from Ocoee High School and they will sell you a pizza for $ 6.00 and then sell it for $1.50 a slice. 7. Need someone with a CDL license to drive the activity bus. It pays $20.00 an hour. 8. We need copies of the bylaws at the next meeting. 9. Suggestion to sell t-shirts at the home games. We have 2 different types $15.00 and $20.00. We also have hats for $12.00 and license plates for $6.00. Laura Keller has them and Bill Chambers wanted to have some in his office to sell. 10. Meeting Tuesday October 18th, 2005 at 700 pm to discuss the last minute details of the golf tournament. 11. Discussed doing the Community Merit Award Grant for the baseball team. Everyone was in agreement to do.it. Kim Hendrixson will take care of getting this done and turning it in before the deadline. ~~ ~&oo Funding Cycle: November 2005 , For more information, please call the Community Relations Department at (407) 905-3109 or e-mail telliott@ci.ocoee.f1.us. When completing this application, use only the space provided. The only attachment should be the formal organizational support documentation (minutes or letter). Please remember to comolete a Citv of Ocoee vendor form or we will not be able to issue a check. Applicants may apply for any amount up to $500. ................................ Citv of Ocoee Communitv Merit Awards Prol!ram Aoolication Name of Organization: .OCO€e t-k'Sh ScAm I w u11er ~(d. , +- ~ ~ &~ fL :,l()l.,( Address of Organization: I Cfz) (}C.o<e Cr()LU "" Po, ~ .i-u.r \";"''1' Contact person for this application: Co-rrl:e . &;)( (The contact member must be B member of the organization.) tJ 7 ~ /1_ /1" rl,..., c 1'<1"'1. +(.u,S Daytime phone numberlD 'iVS 3tcO . E-mail address: L-V"'v~ I[;v<-f':>' What. are you seeking grant money for? What specifically will the money b~ used for? W\lI\t:e.r 6=-~~ i<;.. ,ct. ColV\ p~+t-\'loh bqs~J iV1c:l~(H' ..plG\.i +eG..U"r t-~+ CoI1r-J1r2+(lJ. lt~o.""S.t o{-h:.r SC~(':> Ii'\. +~..r ~hIC+ 'f11-cMy IS. <<u,J .{Or ~e~s. &:,r. e.ow..p~'{..li-U'"'I "pl"'OpS tos.{.u.....e, ..ft,:t.1\.~po.'~tt~i '" What dbllar amount are you requesting? (The maximum grant award Is $500.) Vf S'oo. C).Q. Is your organization getting fu'!ding fr~m flny other source for. thl..S specifir; project? 'Pa.re,,+s 0& '€eu..t-.. W\tl.{€.,... ~/J ~{vd4""-t c:ltY'e rej~l1/1Slh/-e ,ft,r fll&e f!-t>e. What is your organizatIon's primary funding source? S-+v...d.e Y\ + ~ \ 1"'\ WI VI ~ r G-u..CI. yJ How much money does your organization receive from this source each year? l}a.r ,-'S What other sources of revenue does your organization have? s.j..u.J-e/ft-lsj Pa Y~I/l'1s What is your annual budget for this year? 3svCj2 'fer Last year? pi skdett-/. List the fundraisers your organization holds? How many members does your organization have? is How many live in Ocoee? /0 How many clients does your organization serve? fZ1 . How many live in Ocoee? ~ , <. Page 2 - Community Merit Awards Application - November 2004 Cycle Has your organization applied for a grant from the City before? /t/O If so, when and what did you apply for? tV I A Were you successful and, if so, how much money did you receive? .D oes your orga. nizatlon. vOlunteer~in the Ocoee community? If yes, weat voll.(nteer ~tivities dO;.sU participate in? :ID .s:,..., e s+u..J",~'\.-ti f\..O..- f 0 u;- Q.T <k:UM~r.> { ~n:t~ t Wf.t (~f'-+ c(.e.v.. T' . How many year, y volunteer hours does your organizatlol} contripyte to the community and ho_w are those hours tracked or documented? ijo../r l-es ( _ ;:: lfs ~r J.to So.. t C\. -\- ~~~ poll'\. t (f 4 scA:,~ I A.a.) 0,;111 he e" Ofl e" oS; lite I(, 4<-lG' OG:., Please list the specific accomplishments your organization has achieved in the past 24 months: See ct..kv'e. . Please include any other pertinent information about your organization or this specific grant request that you feel would help the City in making its decision: Please attach documentation (meeting minutes or letter) to verify that your organization supports this applic~fion. ..,'b' NP (1- I ~ 'Proj yd."'" u..l-\-kevj t--. \'+5 lI" oIv\.>>-kf} I I T ~t.( Js se~ &Y1'~ \<1 ence I d ed(~~ ct~c:l +€a.Uo\ wcrk.(!'acA. m(J(,+1~t' . IS res/O/1.j( ~/e ..fu. ;"'6:'-4.&I.,=: WI,.., u'\'-\.o..\ '" 4- l..,JU \- a.. pA . a JltJ a.. i-~"'- 6 ,~\ \ P f"a.e. +-tc: ~ w ~ k I he I u de I ' "-"" (~ _ t"'l'" . -+ \ ,_ I C;+ 2nJk.ts t.ll.u-ee~ a.Io\.d ew-V'a $C'I...J.lM"_.._? -::J/VlCe ( 50 +~ year cPvr bG~e If.s. ~V\Js (Aye.- l.J,)k~ +k~ S~dRWIs Q.avt J?uil\ ~ VCus< v r pD..reot~ pO-i- ~ f~^\.\ r /1 '.-~o.,~ For Staff Use Only Date Application Received I t/ ~~s;- Was Application Received Complete? lfnot, Date Application Returned - <"-~ .. '1~ '/ () I}t.... "1Y1. (J.L,~ , I, Form W-g Request for Taxpayer Identification Number and Certification Give form to the requester. Do not send to the IRS. (Rev. January 2005) Department of the Treasury Inlemal Revenue SBIVlce e\i Ql !e' a. c: o Gl In C $~ :~ 'c .E 0..(,) !E al a.. VI Gl Ql VI NAme (as shown on your Income tax return) U~ , (i S::,+o()l...- Business name, If different from above Prs. A O Indlvldual/ Check epproprlate box: Sole proprietor o Corporation D Partnership &110 Exempt from backup Other ~ u_____h_________ withholding Requester's name and address (optional) Iq~S-(nuD0;;~' ae;r;Jo~~e ~O IN rr City, state, and code OC~a: '-' ~ i' '7 (, ) List account number(s) here (optlonaQ Taxpayer Identification Number IN Enter your TIN In the appropriate box. The TIN provided must match the name given on Line 1 to avoid backup withholding. For Individuals, thIs Is your social security number (SSN). However, for a resident allen, sole proprietor, or disregarded entity, see the Part I Instructions on page 3. For other entities, It Is your employer Identification number (EIN). If you do not have a number, see How to get a TIN on page 3. Note. If the account /s.ln more than one name, see the chart on page 4 for gu/dellnes on whose number to enter. Certification Under penalties of perjury, I certify that: 1. The number shown on this form Is my correct taxpayer Identification number (or I am waiting for a number to be Issued to me), and 2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all Interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholdIng, and 3. I am a U.S. person (IncludIng a U.S. resident alien). CertIfication Instructions. You must cross out Item 2 above If you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all Interest and dividends on your tax return. For real estate transactIons, Item 2 does not apply. For mortgage Interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an Individual retirement arrange"lent (IRA), and generally, payments other than Interest and dividends, you are not required to sign the Certification, but you must provide your correct TIN. (See the Instructions on page 4.) Sign Here Purpose of Form A person who is required to file an Information return with the IRS, must obtain your correct taxpayer identification number (TIN) to report, for example, income paid to ypu, real estate transactions, mortg~ge interest you paid, acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an IRA. U.S. person. Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN to the person requesting it (the requester) and, when applicable, to: 1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued), 2. Certify that you are not subject to backup withholding, or 3. Claim exemption from backup withholding if you are a U.S. exempt payee. Note. If a requester gives you a form other than Form W-9 to request your TIN, you must use the requester's form if it is substantially similar to this Form W-9. For federal tax purposes you are considered a person if you are: · An individual who is a citizen or resident of the United States, · A partnership, corporation, company, or association created or organized in the United States or under the laws of the United. States, or truly number I + I or' IJ Data ~ tl ~(}/()r · Any estate (other than a foreign estate) or trust. See RegUlations sections 301.7701-6(a) and 7(a) for additional . information. . Foreign person. If you are a foreign person, do not !:Jse Form W-9. InstEiad, use'the appropriate Form W-8 (see Publication 515; Withholding of Tax on Nonresident Aliens and Foreign Entitles). Nonresident alien who becomes a resident alien. Generally, only a nonresident alien individual may use the terms of a tax treaty to reduce or eliminate U.S. tax on certain types of income. However, most tax treaties contain a provision known'as a "saving clause." Exceptions specified in the saving clause may permit an exemption from tax to continue for certain types of income even after the recipient has otherwise become a U.S. resident alien for tax purposes. If you are a U.S. resident alien who is relying on an exception contained in the saVing clause of a tax treaty to claim an exemption from U.S. tax on certain types of Income, you must attach a statement to Form W-9 that specifies the following five items: . 1. The treaty country. Generally, this must be the same trElaty under which you claimed exemption from tax as a nonresident alien. 2. The treaty article addressing the income. 3. The article number (or location) in the tax treaty that contains the saving clause and its exceptions. Cat. No. 10231X Fonn W-9 (Rev. 1-2005) ~ ~s~ L' Funding Cycle: November 2005 For more information, please call the Community Relations Department at (407) 905-3109 or e-mail telliott@cLocoee.f1.us. When completing this application,'use only the space provided. The only attachment should be the formal organizational support documentation (minutes or letter). Please remember to comolete a City of Ocoee vendor form or we will not be able to issue a check. Applicants may apply for any amount up to $500. ................................ Citv of Ocoee Communitv Merit Awards Protfram Application Name of Organization: Qf1Jo 0 '~ ~ l:LA OJ\ ~"brbaJ..L ~ Address of Organization: Jqa5 ()r1Jl)Ji f!Aru LH'I ~ ~tXUJ, OCnLL Contact person for this application: ~ '-1\()IG(:i\. -J.,.Je a ci {.-O~ (' 11 (The contact member must be a member of the organization.) Daytime phone number: ~Ol qOS" Lj I~{ E-mail address: f'i)f-H" S ~ (0 OC{D. {)Lt ~~~~~~~~ ~CA.Q:k... . What dollar amount are you requesting? (The maximum grant award is $500.) $ 500 .00 Is your organization getting funding from any other source for this specific project? ~.o . ~~ (1.Jt~ Mrt:., . . . What is your organization's primary funding source? ~, l nd.J\~ ' How much money does your organization receive from this sourc~h !lJ~ What other sources of revenue does your organization have? ~.LcuLs 4 1/~..u..M. n D.Jl-<LJ What is your annual budget for this year? ~ Last year? ~ List the fundraisf!rs your o,rganization holds? IOO~~ cJ.. Page 2 - Community Merit Awards Application - November 2004 Cycle How many me~bers does your organization have? ~~ How many live in Ocoee? qqolo ()CO.t/L.-Iolo ~ +-VOILU How many clients does your orgamzation serve? wlwlL How many live in Ocoee? CJ:1"7o O:ooD-ld7o ~ ~ Has your organization applied for a grant from the City before? NO If so, when and what did you apply for? Were you successful and, if so, how much money did you receive? () IOJ Does your organization volunteer in the Ocoee community? If yes, what volunteer activitie.~ po ~ou participate in? V ~ W~ r.. 'V'1w.o1.- Q L:b lJ' hi.D €f {I.DnL.YYll..uu:hj ~ YLU-i' u . . How many yearly volunteer hours does your organization contribute to the community and how are those hours tracked or documented?oJ. ~ ~~Q., ~ "4 wa. c:J'\.J.A- C4- (\.... (YLU\..L#'YU.UY) ~ fa o.+- tL . Please list the specific accomplishments your organization has achieved in the past 24 mon~s: ' Please include any other pertinent information about your organization or this specific; grant request that you feel would help the City in making its decision: --10 ~ fU.L For Staff Use Only Date Application Received Was Application Received Complete? Ifnot, Date Application Returned NOlI-18~:.:"dS 11;12I5M FROM:l"Y.OEEHrr-l SCHOOL ".3790S3~9g TO: 9.'076546 720 P.l....1 Form W-9 (RDY. January lClO:lI 0.,.._, 01 "'. T'..."') Inlll,* ....._ SlIrril:. N N""o t Ii tl I f CIty. '111111, Mllll/' c..a;- ~ List lICCOUIll numbelfa, he,,;. ..'ptlOncle Request for Taxpayer Ider,tlflcatlon Number and Certlflcatfon JGIVa form to the roqUil5fer, DO' not Stot'lCl to the fRS. - . . OCOEE HIGH SCHOOl. - tU5 Q(Ofifi CROWN PGlHrPfCv. IJusInasfi 111m". W dlr'81~,'1 rroll,tooYii OCOEE, FL. 3475t -- r IndMdullI C"eck IIpprOf)f1llv 1lO~. '-.: Sole P'oprI~,CI Address (IIUmbllr, 51reel. :~~t.lItO ne- I o Pannomlllp ~ Orn.... .~';-~."'I..:IE :'~I~ Ilar:ktJp Requ..I....s """In and IdClt_ (4pIIo/lot" o Ct>rp(ln,1otI -- Ta. iietlde!\!/Ilc:aUOfl Number (TIN) ------- " ~.. Enter yo~r TIN In tile appropriate bOll. F'Jr IndividualS, this Is YOI.lr SOcIal 5eCunty number rsSN). HowDvor, for II re.l.n, alien. 1I01e prgprlelor, or dl.reSDnllIG IfI1IIY, ...the P.rt 11".\nlcllons on j)tge 3. For olher entities. It Is YOlD l?mployer Icl.rtlllcltion number (EIN). Ir you do not haye a number, see How '0 get . nN CIIl PI9& 3. Nota, "chit IIccounr '$ (n more IMIl OM /'I/lIM. ~df) Ihe 00."1 on pag. . fOf fJUlr:JeI",es on whose fIlImQIN to ftfl/IH. Ibn..I. c.njn~8tlon Under penalllss of plfjury. I certIfy \/lIJt: 1. The nuntbllf Show" on tl1l!l form I. my clWTlld taxpllyer I(lOnlfllcalJon I\Llmber (or I em walling for II llUlnbet \0 be Issued to lOci, Ind 2. I am not SUQ/ecllo ber.kup withholding twlCause: (e) I am tllarnpl from backup wlthholdlng. 01 (bf 111...., 1I~1 been 00.11I00 tIy 1118 Inlemlll Revenue Servtc", (IRSllhBt , am subject to blCl!up w1t/'tholdlng as . result of II rallur& 10 report all Intare.sl or dlvlc.lllncls. or (a) the IRS has flOllftlld 1011 that' em no longltl' subJecl to bllCk~p Wllhholding. .nd 3. lam a U.S. pel1Ol1/1nctudlng . U.S. reskflnllllil"'. Cettlfla.t1011lnIVuctllll'ls. You must cross out Item 2 above If ytiV ha\<e be... nOlined by the IRS that YOu 8/'8 currently sucJeCI to baCkup wIlHloldlng tlel:ause )'OU lIavll falletf to !'epon all Interest anCl eMellnCls on your 181l rOlum. For re.' &Slllte tl'llnsae:Uons. item Z C10es 001 apply For morttJag8 Inler., paid. K:tISIIJOn or abandonment of secured PI'OPllfty. csncollallOl'l of debt. COntributions to an Indlvitluel rellrel'lll!nt IIlTangemerlt (IRA). IlIlCl genar . plIyrTl1nts othBt' than Interest end dlvldlllldll. ~cu are not reqtAred 10 slgn lhe ClIrtIIIceUllIl. 001 you muSl proVIde your COrTeet TIN. (See 'nslructlcfl$ en pegl ..) . - --- SIgn Here Purpose of Form A person who Is requIred to me 1In Irtormatlon return wIth the IRS. must obtain your correct [aApaytli Identification numbar (TIN) to report, ror example, Income paid to you. re81 eSltlte transactions, mortgage Intares! you PlJld. acquisItion or absndonment of 5ccumd property. canceMetkm of debt, Or contributions you made to an IRA. u.s. person. Ulle Form W.8 only II YOlIars 8 U.S. person (IncludIng Q rGsldent aile,,), to provIde your correct 1'1"J to the person requesting It (fhe requester) and, when applicable. 10' 1. CertIfy that the TIN you areglvtng Is correct (or you arB welting for e number to bll Issued), a. CorUfy !hilI you 31a not sUl:!ject to bilckup withholdIng. or 3. Clelm exemption from backup withholding If you are 8 U.S. exempt payee. Note: If 8 requsstwr gives you II form olller than Form W-9 to feqlJestyour TIN, YOll must use th9 request"'s form If;t;$ ,Ub$/Mtl.,1y slmll.r fa tN. Form W-g. Fo....lgn P6f'SCln. If you are a foreign person, use tM approprlat. Form w-e (see Pub. 515, WIthhOldIng of Tox on Nonresident Aliens and Fer41gn Entities). U:'_tl~ nUmb.., W '-L1J f I or ~O,... IcIlIIlllrlulJan RIllnbo'-~ 5 '1+'101010 171!..lLL ::=- .-------- ~---- (.~J.Q.r_:) 0.18. /). / ~. ~ ~oS NonresIdent alien who become. a resIdent ellen. Generally. only a nonresident 81len Individual rTlIiy use the terms of /lISX treaty to reduce or aUmlnatll U.S. tllX on certain types of Income. Howaver. most tall Ifeatls!. cont.'n II provIsion known 8S II "36vln9 clause." Exceptions spilclrled In the saving clause may permit an allemptlon f"Dm tflX to continI>> for cartslrl types of Income ltlltineflllr the raclplant has othttrwlslt t:Jecome l\ U. S. reSld."t .1I"nfor tall purposes. If you are a U.S. resident .811&n who Is relying on an exception contained In the saving clause 01 e ~ax trellty to claim an Ollilmption from U.S. tall on cenaln typllS of In"Olllo. you mUll Quach a statemllflt that :lpecllles the fOllawlng flllo Items: 1. The treaty country. Ganerafly, thIs; mllllt be Ihe same treely under whtch YOu claimed exemptIOn from tax as 8 nonresident alien. 2. The Ir..ty article addressing tha Income. 3. Tne 8Jtlcltt number (or locatlonlln the tell treaty that contsrns the saYing clause and Its exceptions. 4. The type Dnd amount of Income that qualmes lor tilE- exemption from tllll. 5. Sumelenl facts to Justify the 8lttlmpllon from tex under ttle terms of tha ueety artiCle. c.,. 1'10. HU)ll1 Fllfm w.e (Rov. 1-20031 Ocoee High School Athletic Booster Meeting October 11, 2005 1. Disney Golf Toumament discussed. We still need 5 volunteers to work on Friday October 21st and Saturday October 22nd. Please call Donnie 407-948-0804 if you are able to help out with these days. . Baseball parents/coaches have been the only sport to step up and help out with this golf tournament. Only a few coaches have signed up to work but only on Saturday and Sunday. Some coaches would like to work other days if they can get out of school on Thursday or Friday. Bill Chambers will check with Mike Armbruster on how to split up the money between each sport and the general athletic fund. 2. Thursday, October 13,2005 Channel 13 will feature Ocoee High School Football as the game of the week. 3. Tonight the cheerleaders are at Sun State Ford for a special fundraiser with K92. The school with the most supporters there will get $750.00. 4. The baseball team has been working on field preparation. Last week the team put down 8 or 9 pallets of sod. Thank you to all of those who helped. 5. Officers for the Athletic Boosters are as follows: President-Pat Buckles Vice President-David Simpson Treasurer-Barbara Simpson Secretary-Kim Hendrixson Karen Flannigan will be in charge of the Diamond girls (yes, we need a new name). During the nominations Scott Tidmus nominated David Simpson as President and 2nd by Joe Stinnett. David said he would rather not accept this position. Scott amended his . nomination of David and nominated Pat Buckles (which he graciously accepted) and nominated David Simpson as Vice President the rest is history. 6. We need to think of some ways to run the concession stand at the basketball games. Mr. McFarland spoke on how the band does it. But at the basketball games there is "NO FOOD IN THE GYM". Winter concession will be for basketball and soccer, for both junior varsity and varsity. Mr. McFarland said to call Papa Johns, tell them you are from Ocoee High School and they will sell you a pizza for $ 6.00 and then sell it for $1.50 a slice. 7. Need someone with a CDL license to drive the activity bus. It pays $20.00 an hour. 8. We need copies of the bylaws at the next meeting. 9. Suggestion to sell t-shirts at the home games. We have 2 different types $15.00 and $20.00. We also have hats for $12.00 and license plates for $6.00. Laura Keller has them and Bill Chambers wanted to have some in his office to sell. 10. Meeting Tuesday October 18th, 2005 at 700 pm to discuss the last minute details of the golf tournament. 11. Discussed doing the Community Merit Award Grant for the baseball team and the girls softball team. Everyone was in agreement to do it. Kim Hendrixson will take care of getting this done and turning it in before the deadline. '" '\ S 00 Funding Cycle: November 2005 For more information, please call the Community Relations Department at (407) 905-3109 or e-mail telliott@cLocoee.fl.us. When completing this application, use only the space provided. The only attachment should be the formal organizational support documentation (minutes or letter). Please remember to como/ete a City of Ocoee vendor form or we will not be able to issue a check. Applicants may apply for any amount up to $500. ................................ City of Oooee Community Merit Awards Prof!ram Application Name of Organization: Occ>ee Human Relations Diversity Board Address of Organization: 150 N. Lakeshore Drive Ocoee, FL 34761 Contact person for this application: Mary Ellen Murray (The contact member must be a member of the organization.) Daytime phone number: 407':"905-0116 E-mail address:maryellenmurray2@aol.com What are you seeking grant money for? What specifically will the money be used for? .J2.lAtreach programs and communi ty events. to prolllOt~. ,di versi ty . Printed promotjonal materials, guest speakers, board education, provide scholarships (savinGS bonds) to participants in educational competitions and refreshments at events. What dollar amount are you requesting? (The maximum grant award is $500.) $ 500.00 Is your organization getting funding from any other source for this specific project? No What is your organization's primary funding source? Donations How much money does your organization receive from this source each year? N/A What other sources of revenue does your organization have? N/A Estimated What is your annual budget for this year? Goal $5,000.00 Last year? N/A List the fundraisers your organization holds? New board: in planning stage of fundraiser "\ R~ 100;, r~,.. ".. Page 2 - Community Merit Awards Application - November 2004 Cycle How many members. does your organization have? 15 Dcoee? 15 How many clients does your organization serve? 30,000 Dcoee? 30,000 How many live in How many live in Has your organization applied for a grant from the City before? No If so, when and what did you apply for? Nt A Were you successful and, if so, how much money did you receive? N/A Does your organization volunteer in the Dcoee community? If yes, what volunteer activities do you particIpate in? Black History Month Essay Contest, OrisiRisi Folklore presentation, Foundation of L1ght Moaque; National Night Out, Red Ribbon Week Walk, Founders Day Festival, Historic Negro Cemetery Memor,ial, ongoing' "News To You" column titled The Changing Faces;.of Ocoee. How many yearly volunteer hours does your organization contribute to the community and how are those hours tracked or c!ocumented? 999. hours tracked by actual member participation at meetingsl,.and events: . Please list the specific accomplishments your, organization has achieved in the past 24 mon'ths: Iriip.:J,emenl:.ea:::out:.,stracegicPlan,. logo and brochure.Hlia excellent participation in Black History Month Essay Contest and ptesentation~ Have regular column in Ocoee's "News To You". Partnering with other City Advisory Boards and City Departments. Raising awareness on our city's growing diverse population. Instrumental in extending Founders Day Festival activities to Sunday-and coordinating the entertainment. . Please include any other pertinent informijtion about your organization or this specific gr(Jnt reque.st that you feel would help the CiW in making its decision: Please see attached'BROB' brochure~.itemized list. Of. Volunteer hours, photoqraphs, newspaper articles and "i 'I'he, Ch!illging Faces' of Ceoee" column in Oeoee's News To You. Please attach documentation (meeting minutes or letter) to verify that your organization supports this application. For Staff Use Oniy Date Application Received Was Application Received Complete? Ifnot, Date Application Returned HUMAN RELATIONS / DIVERSITY BOARD 2005 Actual Volunteer Hours through November 28, 2005 EVENT HOURS HRDB Meetings Black History Month Essay Contest Orisi-Risi Folklore National Conference on Leadership Diversity Foundation of Lights Mosque Visit National Night Out OCPS Migrant Education "My Community" Event Founders Day Committee Meetings Founders Day Festival Red Ribbon Week Walk Away from Drugs Historic Negro Cemetery Memorial Service Ocoee Rotary Club 360 144 30 24 6 22 5 64 192 6 144 ----2 Total Volunteer Hours 999 Nov 28 05 04:50p Cit~ Clerk Dept 4076565725 p.l MINUTES OF HUMAN RELATIONS/DIVERSITY BOARD REGULAR MEETING HELD AUGUST 4, 2005 CALL TO ORDER Chairperson Lopez-Anderson calleci the meeting to order at 7:05 p.m. in the Commission Chambers Conference Room of City Hall, 150 North Lakeshore Drive. Member Dabbs led in prayer and led the Pledge of Allegiance to the Flag. The clerk called the roll and declared a quorum present. PRESENT: Chairperson Lopez~Anderson, Vice-Chair Phillip Lee Fatt, Members Arzola, Dabbs, Dillard, Karen Lee Fatt, Fleming, Garland, Murray, John Phillips, Kitsy Phillips, Rodriguez and Vereen. Also present were Ex-Officio Mayor Vandergrift, and Administrative Assistant ill Aycock. ABSENT: Members Booth (unexcused) and Davidson (excused). Staff Liaison Grimms was also absent. GUESTS: :--:rone NEW BUSINESS Approva.l ofMinute!l of July 7, 2005 Member Garl.flIJd. seconded bv Member Dillard. moved to ar:mTOve the Minutes of Julv 7, 2005, Mmion carried J2~O. Discussion re: Founder's Day Report & Citizen Survey Chairperson Lopez-Anderson said tbat she and Vice-Chainnan Phillip Lee Fatt were present at the last Founder's Day Committee meeting on July 21st, and met the new Parks & .Recreation Director Vito Petrone. She said that it was confmned in writing that the HRDB's activities on Founder's Day would take place on Sunday from 1 :00-5:00 p.m. and a stage would be available. Chairperson Lopez-Anderson stated the need for the board to work on the three church groups that would be participating with Klassique that day and asked Member Dillard to give an update regarding STAR94, Member Dillard said that STAR94 would participate at Founder's Day on Sunday, which means tbe station's gospel host would attend. She said the only issue is that the station normally pays the'ir talent to petfonn on the weekend and the cmit for two '(2) hours is $200. Before the next meeting, she plans to get with the new director to go over the issue and ask him to participate free of charge, Chairperson Lopez-Anderson envisioned the Reverend begtnning the events on Sunday and turning it over to Member Pbillip Lee F'att, keeping things continuous. Member Dillard said that if they could convince the Reverend to be there on Sunday, then their service would be free. Member Vareen said that he attends church with Rev. Bobby Lions and win talk to him on behalf of the board. Chairperson Lopez-Anderson reminded the board that their fund balance was only $750. Vice-Chairman Lee Fatt said it was good that we had three (3) main acts planned due to the allotted time frame. He said the event begimling at 1:00 p,m. would allow each group 1.5 2 hours 30 minutes each and then Klassique in the order as follows: . Living Waters Church - Urban style . St. PauPs Presbyterian Church - Contemporary style . His Clml'ah New Frontiers Ministries - Caribbean Nov 28 05 04:50p Cit.~ Clerk Dept. 4076565725 p.2 Minutes for Human Relations/Diversity Board August 4, 2005 . Klassique He added that the event will be mostly musical to excite the audience; however, will intertWine \\lith Psalm 24: 1. Member Dabbs stated he spoke to Chairperson Lope,,~Al1derson regarding having local choirs join in the event in order to broaden their horizons even more. Discussion ensued regarding the time crunch at Founder's Day; however, members agreed that tbe idea was well w01th researching for future events. Member Murray arrived at 7.'20 p.m. Member Fleming announced he had made arrangements to have tbe Blood Bank present on Founder's Day, but he was not sure ifit would.be better to have them on Saturday or Sunday. The board decided that whenever they could attend would be great. Chairperson Lopez-Anderson said that Gary Lewis and the Playboys were scheduled to perfonn Friday night, Sawyer Brown is scheduled for Saturday night with Craig Morgan and Jason Alvin, and Klassique will perform on Sunday. Member Dillard added that she had the pictures of Klassique necessary to print posters along with a bio. Chairperson Lopez-Anderson said they would not be putting together a big poster; however, they would do one for Sunday's activities that they would discuss later. Chairperson Lopez-Anderson reviewed the citizen survey that was previously brought before the board. She said the survey had been approved by the Founder's Day Committee and it would cost about $750 to provide the 11,000 copies needed, yet another option would be to post the survey on the City's website. The following options regarding the citizell swvey were discussed: . Passing out and collecting the survey during Founder's Day . Posting the survey on the website before Founder's Day . Posting the survey on tbe website after Founder's Day . Handing out the survey in front of local businesses and in the mall Member Lester. seconded by .Member Garland. moved to post lhe'sunJev on the CiN's website for two weeks after Founder's Dav. Motion carried J 3~O. Recap on Strategic Plan - Vision Chairperson Lopez-Anderson read an email received from Dr. Valerie King that she had sent after reviewing tbe board's draft: strategic plan. She said that Dr. Valerie King suggested adding assessment and evaluation to the plan in measurement. Discussion ensued and many measurements and goa)6 were .set such as: quarterly newsletters, one annual meeting in each HOA district, deadlines to seek grants, etc. A final draft of the strategic plan will be passed out at the next HRDB meeting. Vice-Chair Lee Fatt, seconded bv 1~[emher Dabbs, mOiled to adopt the 2005 Stratef-tc Plan with zhe chanrzes discussed. Motton carried 13-0. Page 2 of 4 Mev 28 05 04:51p Citl:l Cl@rk De,,'t 4076585725 p.3 Minures for Human Relations/Diversity Board August 4. 2005 ChaIrperson Lopez-Anderson said that she received three (3) drafts of the board's ,,\sion and they were read aloud. The board discussed the three drafts and, from tbem, created a fourth and final draft as follows: Our vision for Ocoee is to create a commlmity where; . all citizens are treated with respect and personal dignity, ., personal and professional opportunities abound, . there is a unified effon: among citizens, churches, civic organizations, government leaders, and businesses to achieve all of the above. Chairperson Lopez-Anderson agreed to type up the new vision and email it to all members of: the board. Member Dorcas. seconded l?v Member Karen Lee Fait. moved to acceCJt dratl fbur (4) as the vision of the .f!uman Relations/Diversity Board. Motion carried 13-0. Review Brochure Member Kelley-Rodriguez offered to give professional di versity photos that she has to the board to use in their brochure. Chairperson Lopez-Anderson passed out sample logos that were generously created for free by Alarie Design Associates. The board reviewed the samples and decided whicnlogo would be put on the front of their brochure. Further discussion ensued on the subject of rearranging sections oithe sample brochure in order to create the final draft. It was decided that the chosen HRDB logo would appear at the top ofthe front and 1.he City of Ocoee logo belowthat. The headings inside the brochure would be highlighted in blue, rather than green. The left c.olumn inside would stay the same as the draft. The middle column would list the vision, the mission statement, and the meeting times. The third column. would list the responsibilities. The back of the brochure would have the same left column as the draft and the middle colunm would include the section of questions, comments, a.nd suggestions. Member Gar/and. secc)Jldf:d by "'[ember FlemlnIl. moved to acc!tTJ& the brochure with the changes disl'ussed. Motion carried /3-0. Community Grant ChairperwD Lopez-Anderson said the City's grant cycle begins on November 1$1 and there are two (2) grants: Community Merit Award and the Neighborhood Matching Grant Program. She suggested the board establish a subcommittee to focus on the grani.s and communicate with the City Connnission about budgeting money for the various City boards. Mayor Vandergrift asked if the board members thOllght it would be fair to ask the City to match dollar for dollar as opposed to volunteer man-hoUlS. All agreed that would be great. Chairperson Lope7...Anderllon said that as soon as the changes to tbe brochure are made Rhe will send it to the members. The board's liaison would then place it on the City Commission meeting agenda at the end of September for the Commission's blessing. Each Commissioner would receive a copy of the brochure, strategic plan, and the flyer of Sunday activities. Page 3 of 4 Nov 28 05 04z52p Citl:j Clerk Dept 4076565725 p.'" Minutes for Human Relations/Diversity Board August 4,2005 Cbairperson Lopez-Anderson said the Community Grant application must be completed, submitted, and complied with and she would like a subcommittee to do ail of this. The following members volunteered to fonn a grant subcommittee: Chairperson Lopez-Anderson, Members Dabbs, Fleming, Garland, Kelley- Rodriguez, and Murray. Chairperson Lopez-Anderson sa.id there were grants for both $500 and $2500 and reminded the subcommittee members that they had to keep minutes at their meetings as well. OTHER BUSINESS Set Items for September Agenda Chairperson Lopez-Anderson said she would not be present at the meeting in Sept~mber and Vice- Chainnan Lee Fatt wOl!ld cha.ir the meeting. A. Acceptance and Approval of Human Relations/Diversity Board Minutes of August 4, 2005. B. Founder's Day Report C. Review Final Draft Brochure D. Review Final Draft of Strategic Plan E. Community Grants Update Chairperson Lopez-Anderson announced that next month was Hispanic Heritage Month. She spoke with a lady named Lilly Carrasquillo, who is an artist originally from Puerto Rico and offered to do a demonstration of her art. Ms. Carrasquillo could do a "make and take" with the kids where the children can make a project and take it with them. The website for LiHy Carrasquillo is Y'WJ1..folkvine.org and she asked that members visit the site by clicking on her name and then each individual sun ray. Chairperson Lopez-Anderson said that Ms. Carrasquillo could come out on a holiday or a weekend and would only request travel costs. Chairperson Lopez-Anderson suggested having Ms. Carrasquillo come out to the Community Center In September sometime on a Saturday, possibly the 17th or the 24th. She agreed to contact LilJy Carrasquillo and win infonn the board of her availability. QUESTiONS/COMMENTS none ADJ'OURNMENT The meeting adjourned at 8:55 p.m. Page 4 of 4 Nov 2805 04:53p Cit~ Cl@rk Dept 4076565725 p.5 MINlJTES OF HUMAN RELATIONSIDIVERSITY BOARD REGULAR MEETING HELD SEPTEMBER 1, 2005 CALL TO ORDER Vice Chair Phillip Lee Fatt called the meeting to order at 7:03 p.m. in the Commission Chambers Conference Room of City Hall, 150 North Lakeshore Drive. Member Vereen led in prayer and led the Pledge of Allegiance to the Flag. The clerk caned the roll and declared a quorum present PRESENT: Vice Chair Phillip Lee Fatt, Members Arzola, Davidson, Dillard, Karen Lee Fatt, Fleming, Garland, Mun'ay, Rodriguez and Vereen. Also present was Records Specialist Sibbitt. ABSENT: Chairperson Lopez-Anderson (excused), Members Booth (excused), Dabbs (excused), and John and Kitsy Phillip (unexcused). Staff Liaison Grimms was also absent. GUESTS: None NE W BUSINESS The newest member to the board, Sandra Davidsot:l briefly introduced herself. She has 10 years of Human Resources background and currently works with the Orange County Government. . Approval of M.inutes of August 4, 2005 Member Garland. second,ed by Member Dillard, moved to G1iprove the Minutes of August 4. 200.5, with (:orrections on the bottom first vage which read: "... wmtldal/ow each flroutJ 1.5-2 hours eaqh ... " but should read <t... would allow each group 30 minutes each and then Kiassique....". Corrections were also addressed 011 the tOD of page two which read: "His church-Caribbean" but should have regtJ "New Frontiers MinisTries-Caribbean" and the additlon orEhe gram) Klassique which was omitted from the lls/. Motion carried unanimouslv. Discussion re: Founder's Day Report Vice Chair Phillip Lee Fatt read the flyer that was provided bye-mail to all board members ahead of time for review and comment. :Member Fleming stated he received information and spoke with someone regarding having the blood mobile pr~ent. Vice Chair Phillip Lee Fatt stated he would like to see if they could get permission to put out a table for the churches to. sell their CD's if they have any. Member Dillard stated they would have to look into that since all the vendors have to pay for their space and that may pose as an issue. Vice Chair Phillip Lee Fatt stated he has noticed in the Dcoee News to You on the first page middle paragraph that the times are wrong because they show the Sunday event starting at 11 a.m. He further stated Martha, Dorcas, and himselfwent before the Founder's Day Board and spoke with them about the times for their Sunday event. Member Dillard stated she had sent the corrected Sunday event to the Parks and Recreation Department. Members inquired when the next News to You would come out. Member Murr.y stated they are printed quarterly. She further stated regarding the flyer as a resident from district three sbe would not know where Starke Lake is located. It was the consensus of the board to include the wording "Behind City Hall" OIl the flyer so that it reads: Nov 28 05 04:54p Cit~ Cle....k Dept 40765B5?25 p.6 Minutes for Human Rel11tionslDi\.crsity Board 'september l, 2005 Sunday, October I 6,2005 1:00p.m. - 5:00p.m. on tbe shores of Starke Lake Behind City Hall Downtown Ocoee ~'I1en,ber Dillard. secollded bv Member Murrav. moved to include th~ wordinf "Behind City Hall" to the O>-,'e1' so that it would read: on' the shores of Starke Lake. Behind City Hall. Downtown Ocoee. Motion s;arTied 9-1 with Member Flem;ne olJDosln!!. Regarding the misprint in the News ~o You, Records Specialist Slbbitt stated the board could ask the Ci~' to advertise the correct infonnation for the Sunday event on OGTV and the web page. Member Vereen inquired if they could put something with the water bills. Records Specialist Sibbitt stated they would have to pay to put it in with the water bill because it was asked before when they wanted to do the survey and they were told it would cost. Member Dillard stated the websit.e for Founder's Day b.as several mistakes and she was told by the Founder's Day board that they would have to pay to make corrections to the web page. The board had never been told there was a charge to make changes. She further stated Martha Lopez-Anderson did volunteer to make corrections to the web page for the Founder's Day board and has not heard back from the Parks and Recreation Department yet. Member Dillard further discussed her frustration with the Founder's Day process. Vice Chair PhilIip Lee Fattstated he would get with Tonya Elliott to :fino out what her procedures are to making changes to the News to You. He further stated there would be no 11:00 a.m. non-denominational churc.h service as stated in the News to You. Member Murray inquired as to what time they would have to be at Starke Lake to set up for Sunday's Founder's Day event. Vice Chair Phillip Lee Fart stated they could meet about 12:30 p.m. to set-up. A brief discussion ensued regarding the misprint of the times on the News to Yau and Founder's Day Entertainment. Review Final Draft of Brochure Member Rodriguez stated on the brochure where it says '.About Us" there is a paragraph that states "... who represent the diversity of the community including race, sex., age, religion, disability, se>':llaJ orientation a11d ethnic group." She further stated she feels there should be a period after oommunity and the rest of that sentence should be deleted since the board did not agree on that wording. Member Morray stated she thought that wording was taken from our by-laws. Records Specialist Sibbftt stated Member Murray was correct the wording was taken from the by-laws. Member Rodriquez inquired if the wording". . .including sex~ age, religion. _." bad to stay in the brochure. Records Specialist SibbJtt stated the wording". " including sex, age, religion..." did not have to stay in the brochure but she did want the board to know that Chairperson Lopez-Anderson got her infonnation on the board from tbe by-laws. Member Dillard stated on the brochure under "Vision" she felt there should be a semicolon after dignity, a semicolon and the word "and" after abound, and a period after the word above. Records Specialist Page 2 of4 Nov 28 05 04:55p Citi:! Clel"k Dept 4076565725 p.7 Minutes for Human RelationsfDiversity Board September I, 2005 Sib bitt stated on the back of the brochure under "HRDB Members") staff liaison member Tom GrimmlJ needs to be removed because he has put in his resignation since he is reJocating to California. Member Dillard, seconded bv J!1ember Garland moved to accerJt the Human Relations/Diversity Board brochure with the chanfles stated and discussed. Motion carried unanimouslv. Revjew Final Draft of Strategic Plan Vice Chair Phillip Lee Fatt read each objective on the strategic plan and asked for input from the board. Members made several grammati.cal changes to the strategip plan. Members also replaced the word population on item two under strategy with the words ethnic group to read: "Research and identify what ~ ethnic groups are not represented and identify leaders from these groups." Under strategy for Educated and Responsive Government they alllO made changes as follows: 1) Act as a liaison between the . Gity-City ofOcoee and the community on diverse issues, 2) Sarveyeu-treaea Outreach surveys to find. oot evaluate the needs of the community. Lastly under goalsfobjectives for Diverse Participation they made the following changes: Expand representation and participation of diverse populations on City boards and in community life. Member Katen Lee Fait, seconded by Member Rodrifluez moved to acce"(Jt the chanfles to the Strategic flail as stated and discussed. Motion carrted unanimouslv. Community Grants Update Vice Chair Phillip Lee }'att read an eumaU from the Chair stating that she has had several conversations about grants and it was advised that some if nct all grants require the organization to have a 501 C 3 status. Members inquired if the board would be considered under the City's tax-exempt status. Member Fleming srated there should be a way to get grandfathered in if the City has one. He further explained how the American Legion has a SOl C 19 status. Members reviewed the application for the City of Oc.oee's,MVP Awards for $2500.00. It was decided that the Grant Committee Members would look into the grant applications and follow-up with the board. Member Rodriquez stated she proposes that the board wait unti] next year to work on the Hispanic Heritage Month because they really need to focus on Founder's Day to make a good impression this year. Member Fleming had a list of gmnts and briefly went over the Bellsouth Foundation and the Edith Bush Charity Foundation. He further stated he got his list off of'the Internet. kfemher Rodr;quet. seconded bv Member Davidsoll. moved to have the Hisoanic Hert/aue Month event in 2006. ].1otion carried unanimouWi... OTHER BUSINESS Set Items for October Agenda A. Acceptance and Approval of Human RelationslDivdI'sity Board Minutes of October 6,2005. B. Pounder's Day C. Grant(s) Followooup QUESTIONS/COMMENTS Page 3 \.If 4 Nov 28 05 04:57p Cit.~ CierI<. Dept. 4076565725 p.8 Minutes for Human RelationslDiversity Board September 1, 2005 Member Murray inquired if there was anyone interested in taking the next News to You article because she took a job which will keep ht,"I' busy until December. AD.JOUR.~NT The meeting adjourned at 8:25 p,m. .' '). ~ ' ttf/ ~I ;" . L': I tfA .I14,v......... . r ~..!v"v :Melanie Sihbitt, ~Rf:lcords Specialist -""---......-.. . .- \,. . . .. '. ...--., I . " 1~ ....... 'K . ........,. . '~/'7 ~ .~..~:r"'~'''''''' ,.:.- .-:,-\ M \~. Phillip Lee Fatt, Vice Chair "'-'~...' , I '-' \:.-- Page 4 of 4 A Special Presentation Hosted by the City of Ocoee & the Ocoee Human Relations/Diversity Board To Celebrate Black History Month For more information, please contact the City of Ocoee's Community Relations Department at" (407) 905-3109 wotimes.com I filf'~'~" News Front Page Top Stories Sports Business Obituaries Legals Editorial Social Entertainment Schools Golf Archives Community Winter Garden Ocoee Windermere Dr. Phillips Oakland MetroWest Gotha Services About Us Subscribe Place a Classified Ad Submit Letter Guestbook C1asslfleds Search Archives r.~"~-~' ,Gall Gogie r-'~-'.'-'-- .~ol J Aerial Tour .~ "yl1tr1Oi' Order reprint8 horel .. ~ . iIW..!J.J' fJ ........ . . t -~.. ..'. . .-;:J.....~.. ... Community: Ocoee African folklore performance in Ocoee Members of the city ofOcoee's Human Relations/Diversity Board congratulate Don and Tutu Harrell of the OrisiRisi African Folklore performing arts group after their presentation of African life, culture and music last week at Deeper Life Assembly on A.D. Mims Road. This performance was part of the city's celebration of Black History Month. Shown (l-r) are Martha Lopez-Anderson (board chairman), Don Harrell, Dorcas Dillard, Phillip Lee Fatt, Frann Kelley Rodriguez, Karen Lee Fatt, Carmen Azola, Tutu Harrell and MaryEllen Murray. O~~ '. ,J THE WEST ORANGE TIMES 720 S. Dillard St. - Winter Garden, Florida 34787 httn.1 /mnt1mp.~ .C'.om/Artlcle~/2005/03/08/communitv/ocoee/orisi. txt ~ Page 10f1 SUb5 TII .. .-10..1 , ~ 4/7/2005 C"l l(ll- 4-l Ql gfa 0 ~ Cl ~~ ....... 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E lZl .~ 0 ~n !a kJ !a ~ S s ! 0 .. ;:g ~-E .8 ~ :a J:l ~ 8 ~ 'pa .s8 ~ ~ ~ ~ ~ '1:l 0 ~~ ~ ~ ~ ...... ~~ ~ ~ 0 ~ ~ :a~ ~ 0 g ~ .~ .~ ~ 0 ~ ::> ~ .~~ ~a ~] CIJ U ~. ~ i ."" 0 '> ~ u 0 1~ u s ~ ~ 0 0 0 ~ g. ~ 0 ~ ...... ~~ ~Ci ~ .S ~ 8 u .. ~ .~ ~ 0 ~ ...:l HRDB Partners with the Ocoee Police Department for National Night Out. ~UG 2 2005 wotimes.com I rw 86F _ forec4ISt". News Front Page Top Stories Sports Business Obituaries Legals Editorial Social Entertainment Schools Golf Photo Gallery Archives Community Winter Garden Ocoee Windermere Dr. Phillips Oakland MetroWest Gotha Services About Us Subscribe Place a Classified Ad Submit Letter Guestbook Classlfieds Search Archives r- . ..GO!I Coogle I - G~ Aerial Tour News: Top Stories Ocoee to celebrate National Night Out Aug. 2 . o"~.,. .." .'1/ . <~";(Pjii-",\. .'l .~~:J" ... The Ocoee Police Department will host a National Night Out celebration with lots of activities for fiunilies at Palm Drive Park from 6-8 p.m. this Tuesday, Aug. 2. The Rotary Club of Ocoee has pledged to give out 100 free bicycle helmets for safety and books to help promote literacy, and the Ocoee Police Explorer Post 2909 will have a dmg-prevention display and conduct child fingeIprinting for the parents' records. The Ocoee Fire Department will put on a puppet show and have trucks on display for children to explore. Wal-Mart is donating a portion of the food and providing volunteers, and the McDonald's located on West Colonial Drive in the Town Square Shopping Plaza will donate Happy Meal toys for the play-till-you-win games. Pepsi is partnering with the police department to supply soft drinks. There will be free rides in a real police car for children 5 and older, and OPD will also be supplying food ito be prepared by Local Fire Union 3623. The Ocoee Human Diversity Board will give out free National Night Out balloons, and Ocoee residents have donated the use of their large bounce houses. Several churches have also agreed to come and assist the Ocoee Volunteers in Police Services in staffing the event The police are encouraging neighborhoods to have their own National Night Out celebration, joining forces with thousands of communities nationwide for this 22nd Annual National Night Out, a crime- and drog-prevention event sponsored by the National Association of Town Watch. Hyou would like the Ocoee Police to visit your neighborhood's National Night Out event or assist in coordinating a flashlight walk, call Sgt. Stephen McCosker at 407-905-3160, Ext. 3055. Print fhis story Email t/1is story THE WEST ORANGE TIMES 720 S. Dillard St. -Winter Garden, Florida 34787 httn.llurmur urnnmP'Q ~nm/Rrtic1eR/2005/07 /2R/news/ton stories/news06. txt Page 1 of 1 Sub. ill .......... . 7/28/2005 /iI'!Il\'~""""F''''''''''''<'''.'O''''-'.(;'" '~ ... .,~.,-,..... ",";-" "'r:";"'_'" ". '-'" :..' .,. .J :,'1 /1' .~.~, :~ ~_;.., _.;\J':r':~."..' - . . . . . . - . . . '. .....'"...""".~~.""~....-,..,.'-\.;:','...'.',::, A big crowd turned out for the Oct. 22 Red Ribbon Week walk sponsored by the Ocoee Police Department. Red Ribbon walk draws 150 participants Traditionally, the last weckof Oc- tober is designated as Red Ribbon Week tllroughDut the United States. ~n keeping with tbis program, the SChools in Ocoee participate ina week of events designed to promote drug- free living. This year, in addition to a poster (:ontest sponsored by the RDtary Club of Ocoee, the OCDee Police Depart- ment recently sponsored its fu'st Red Ribbon Week half-mile walk, entitled "The Walk Away from Drugs." The walk drew approximately 150 participants, including more then 70 studentS.from various schools, as well as their parehts and siblings. Each student signed the "1 Pledge TD BeDrug-Free" banner that will be dis- played iit Ocoee Middle SchoDI, be- Cl\use t!jat schoD] bad the llIDst par- ticipants. The first fifth-grade student from each OCDee elementary BchDOl tD ar- rive at the event earned the honor of can:ying Dl!rin, The b.A.R.E. lion, during the wll1k. p~~~~~~~:f.:t;~~o~: . . .:..4'" R~Y' . ,l7P~e,~q!1~~~~,::., <gep~~J:l,9/i9,E! qfficerThgmas M\i;Ol'jey anctDorcas Dillard,.a member' ,1!<?" ..H Jy :B,o@. . . ,.1) lIlII ., . Orl~i~C?i':lee'. t1umanRelatlons Olverslty Board. were both Involved In 'Bo ...e ollseandlil",al... y ~~8~~S ana lh'E) af'ltltdrug walk. . "';iter dCloated by the Dcoee Middle PTA. fuadcjition, the Ocoee Police De- partment condu~ted Ii chance draw- ing for items embosSed with the drug- free pledge, and Mayor Scott Van- dergrift, who presented a proc1ama- 'i'J f. j;' I ::;. ~.. :'};~li," ;-.,; ,".,..-, Hall dc;ciliring Oct. 23-30 as Red Rib- bon W~ek at the last City Commis- sion meeting, spoke about the impor- fance Df choosing to be drug.free. Also on hand to speak to the stu- dents abDut healthy lifestyles were.!)r. 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E=:~' S oop. ~ ~~} I:lS Cia :.j ~ ~ ,~~ .fi.~ I j~ ~ i ; llJ~ ~: ~ ~ 1 I ~ I ~ I.. I ~. 1 Ilfill~l~}] ~tri Ii ~l';-i ~'1 l8~] ~~'ls Jll .. . ;~ .;( I" ~.. 1.) ~li jt '~jt Ul J oJ :11 11 'Hl ~ 8 ~ ~! .~ ~ ~.g] ~ ..~..'... B ' Ij i .1.1 .. ;! l!fl:a ~;i: J;8>! 0...:.:.:.,., .If ~ . ~i' , ~ 8 S~ '..~ fa ~ P<~ ~ f ~ l .! ~ 1 ~ S1"i 1.. ~.. J.. .Ui'i..1 ~. { - ~ , C - l ' ~ f ~ ~ " I ~ ~d V). ..i..;'.j.,.;'..; .... @. JE...iN........!........~ j ...! f.. ~:); ~. .,.0 '!.8 ~ S , ~" '6 . .!l 6 . Oi!' :.. . "8 a . :I . q:]:I ,~ ~ ~ ~ 1 o " ffl In ~ ~ ~ ~ ~ ~ '0 ~d~qi'~ .j8. af~~~ ~ ~S~~~~E5~ ~pP~ ,s~ Funding Cycle: November 2005 For more information, please call the Community Relations Department at (407) 905-3109 or e-mail telliott@cLocoee.f1.us. When completing this application, use only the space provided. The only attachment should be the formal organizational support documentation (minutes or letter). Please remember to comD/ete a Citv of Ocase vendor form or we will not be able to issue a check. Applicants may apply for any amount up to $500. ................................ Citv of Ocoee Communill' Merit Awards Prol!ram ADDlication Name of Organization: Pa.rt.Y'\-t I T~'r-e.'(" t Sh~.c\e.frt h~oc.;Oo--\:\O'f\ (~I\) Address of Organization: Oc.oe.e... \.\'~h ~~oo \ Contact person for this application: '"DJ~ Lovv-be.r \\ (The contact member must be a member of the organization.) Daytime phone number: 401 "la) -;;)..\ 80 d. \o~r'k @ (,Jot u.~-\-. cd+. nit E-mail address: What are you seeking grant money for? What specifically will the money be used for? ~~';..~~1 ~~ ~;~~~ ;-hPt'-",~~~.~~~~:; <:- . V'\a\- ~"t... 0... i\\A.~l.. . What dollar amount are you requesting? (The maximum grant award is $5~O.) $ 500 Is your organization 'getting funding from any other source. for this specific project? No What is your organization's primary funding source? ~a.ro..\.Si~ How much money does your organization receive from this source each year? t 4CTU'O' 50 for What other sources of revenue does your organization have? -Ala ~L . ., What is your annual budget for this year? tt~ 161m Last year? tJtA List the fundraisers your organization holds? SoJ~ cJ;.; ~oo, \~o Me..rchmcli~ o.~ 0... ~o..de.+y I dinf'e:r ~'now. . Page 2 - Community Merit Awards Application - November 2004 Cycle How many members does your organization have? :2. ~L..\ How many live in Ocoee? ~-,.f. How many clients does your organization serve?'5000 ghule.nts How many live in Ocoee? ~L- Has your organization applied for a grant from the City before? No If so, when and what did you apply for? ~/A Were you successful and, if so, how much money did you receive? -11JA Does your organization volunteer in the Ocoee community? If yes, what volunteer activities do you participate in? ' \ n tt.. ~ ~ c.:. ~ comm\.\.t\i 0 t.t"I t. f'i i d f,: ;t ~tt:t ~ ~~ ni :t~ e:tiC. e..'IIt.n+S i e..tc: How many yearly volunteer hours does your organization contribute to the community . and how are those hours tracked or documented? Wt. ho..vr.. nc7\- +mr-Ked +he.. r.ou. rS. 1diJre. e.1Je.ry ~l ~e.nti Q.. co..lI \~ ~e.. ~r 'IollIJ\\cerS. MtMbe.~ cJ....,o...'P 'Show wp o\v WOr~. Please list the specific accomplishments your organization has achieved in the past 24 months: We.. o..re.. 0.... \?ro..~ r\~W ?TSA. OI.lY'" (rAin 3'aJ is +0 f1INl & ~oo \ f)lJ..~c.,. Please include any other pertinent information about your organization or this specific grant reuest that you feel would help the City'in making its decision: Stnce.. h ~~oo\ 0.; ro t 1 nv.rS . h ~I u: roJ rrone..~ ~ ho.."~ 0.. m....~t.. or of"\: not +0. nD.'Jt.. 0.. nu..\~. Wl~ 0Itt.r" ?loco ~ti'\"\!;..M'\J. ~f1>.c.""\ry~ we... ~\ ~t it i~ c.ri\.\~\ ;'0 'h0l.vt. lk nu.rst.. OV\ ClA.n"IplIS.. -to -\e'Nl to o.cL\Ae.ilt~1 \~ (J.Y'\d. tll AtS?~Y'\"E.e. me.!;co...t~oiL' Please attach documentation (meeting minutes or letter) to verify that your organization supports this application. For Staff Use Only Date Application Received / 1/:5 {J / {).S f ./ Was Application Received Complete? If not, Date Application Returned ~ ~-J//] ~ c:2 .:/;? 1/1.1 <:'~ 1> /(;,~1,"<"" Ocoee High School PTSA Ocoee High School Media Center September 12, 2005 The Dcoee High School PTSA held its regular monthly meeting on Monday, September 12, 2005, at the Dcoee High School Media Center, in Ocoee, FL. Billy Flanigan, President, called the meeting to order. Introductions were made of those present, with a total of 30 people attending. The minutes from the last meeting were read and approved. The Treasurer's Report was reviewed and accepted as presented. The PTSA currently has a balance of $3,711.32. Delores Lomberk gave an update on tlie Membership Committee. There are currently 261 members in the Ocoee PTSA. The Principal's Report was given by Mike Armbruster. The following items were mentioned: 1. Ocoee High School has 3,019 students enrolled, with 9 of those students being enrolled as a result of Hurricane Katrina. 2. A new Assistant Principal has been named for Harvard, Teena Moore-Jenkins. 3. As the result of a. "significant event" which took place on campus, 22 students were suspended. One student was removed permanently and 14 students were removed for at least 45 days. To help alleviate the potential for future problems, the number of students at the lunch period was downsized. 4. Homecoming week is September 19-23, 2005, with special activities planned for each day. Crowning of the new King and Queen will be prior to Friday night's football game, and the Homecoming Dance will be Saturday, September 23, 2005 at the Hard Rock Hotel. 5. Progress reports went home on September 8, 2005. Ocoee High School PTSA September 12, 2005 Page Two 6. The grading policywas explained, where every student will earn at least a 50% on homework and tests, which still constitutes a failing grade. Tnis policy was met with some opposition. 7. To check your student's grades, please log in to K12 Planet. Parents may pick up their password at the attendance office. 8. Open House is scheduled for September 20, from 6:00 p.m. - 8:00 p.m. 9. At present, the gasoline supply Is sufficient to enable buses to continue operating for evening activities. Committee / Club Reports were given as follows: 1. The Disney Golf Tournament is scheduled for October 20 - 23, 2005. Volunteers are needed to work with the Sports Boosters Club" as this has the potential to be a large fundraising activity. 2. The Drama Club will give an encore performance of "With Their Eyes". This presentation will be held September 17 at 7:00 p.m. 3. The Renaissance Club remains active, with one of their objectives being to recognize' student achievement. Old Business: The First Knight for Nurses fundra/ser is scheduled for October 1. This will be an evening of dinner and show, with proceeds going toward the School Nurse Program. After some discussion, it was agreed that tickets should sell for $20.00 each. Dan Daly will be coordinating food and decorations for the evening, while Billy Flanigan is in charge of entertainment. Ocoee High School PTSA September 12, 2005 Page Three New Business: The PTSA National Convention is scheduled for November 10. Any officers who could attend this convention would certainly benefit. The monthly newsletter is now being prepared, and will be emailed soon. Email addresses still need to be collected and added to the email group to ensure as large an audience as possible. If anyone would like to assist with the preparation of this newsletter, please contact Dona Dickerson. The next PTSA meeting will be held on Monday, October 3,2005, at 6:00 p.m. in the School Media Center. There being no further business, Laura Keller made a motion to adjourn, and Delores Lomberk seconded the motion. Respectfully submitted, this 27th day of September, 2005. c4~PL.~ Dona M. Dickerson Reporting Secretary 11/28/2005 07:13 4075784399 Form W-g KELLER PAGE 01 Request for Taxpayer Identification Number and Certification Gi' ~ fotm to 'he rer Jester. Do no. sa d to the IRS. ~ <Il [ l: o 4I~ g~ ~~ ~.fi t U1 <Il (jj D Individual! Check approprlata box; SOIIl prQprletor iq~~mOC;;a:d aCibu~~,) P6 J N City, $ll,lte. ~nd ZIP cod OeO "54-, ~) L1sl accol)nt 1'\1.11 ber(l1) here (optlona~ o Corporation Tax ayer Identification Number (TIN) SA o Pllrtnsrahlp ~ OlhGr ~ .mmm........ ~ ~,h~I~~m backup Requester's name and sddress I ptlonsl) Enter your TIN In the appropriate box. The TIN provided must match the name given on Line 1 to avoid backup wltt1holdlng. For IndividualS, this Is your soolal seourIty number (SSN). However, for a realdel"lt alien. sole proprietor, or disregarded entity. see the Part Ilnstruct,lons on page 3, For other entities, It Is your employer Identification number (E;IN). If yol,l OQ nQt have a number, see How to get a TIN on page 3. Note. If the Ilooount itl in mort!! /h/1l1 ont!! namt!!, tlt!!e the chart on page 4 for gulda/ines on whcse nl,lmoer to (Jl1ter, Certification Undt!!r penalties of perjury, I certify that: 1. The nUmber t!!hown on this form is my correct ta>\payer Identlfloatlon number (or I am waiting for a number to be Issued te; ne), and 2, I am not subJeot to backup withholding becausa: (a) I am ext!!h1pt from baokup withholding, or (b) I have not baen notified y the Intema! Revenue Serviee (IRS) that r am $ubjl;lQt to baokup withholding as a result of a failura to report rail Interest or dividends, or )) tha IRS has notified me that I am no longer subject to baokup withhololng, and 3. I am a U.S. per!lon (Including a U.S, resident alien). Certification Instruotlons. You must cross out Item 2 above If you have been notified by tha IRS that you are currently subJeot withholding beoause you have failed to report aI/Interest and dlvldand, on your tax return. For'real estate transaotlons, Item:1 For rnQrtgl!ge Interest paid, acquisItIon or abandonment of seoured property, oanoel/atlon of debt, contributions to en rndivfou arrangement (1M). t!!M generally. payments other than Interest and dlvJdenos, you are not requIred to aign the Certification, bl provide your oorrect TIN. (Se9 the instructlonl;! 01'1 page 4.) Sign Here u...... Purpose of Form A person who Is requIred to fife an Information return wIth the IRS, must obtain your oorrect taxpayer identlfloation number {TIN) to report, for example. Income paid to you. real estate transactions, mortgage Interest you paid, aoquisition or abandonment of s0cured property, oanoellatlan of debt. Or contributions you made to an IRA. U.S. pE!rson. USe Form W-9 only if you are a U.S. person (Including a resident alien), to provIde your oorrect TIN to the person requesting it (111(;) requester) and. when applloable, to: 1. Certify that the TIN you artil giving Is oorrect (or you are waiting for a number to be Issued), 2. Certify that you are not subJeot to backup withholding. w . 3. Claim exemption frombacklip withholding if you are a U.S. exempt payee. Note. If a requester gives you a form other than Form W-9 to request your TIN, you must IJse the requester's form if it Is substantially similar to thIs Form W-9. ' For federal tax purposes you are considered a person if you are: · An Individual who Is a oitizen or resident of the United Sta.tes, · A partnership, corporation. company, or associatIon oreated or organized In the United States or under the laws of the United States, or I l baokup loes not apply. retIrement you multi: Date ~ /I Z?/ os" · Any estate (other than a foreign estate) Or ust. See Regulations sections 301.7701 -6(a) and 7(8) lr additional Information. . Foreign person. If you arB a foreign person, io not use Form W-9. Instlilad. I,Ise the appropriate Forn W-8 (sse Publication 615, Withholding of Tax On Nonn Mdent Aliens and Foreign Entities). Nonresident alien who becomes a reslden slien. Generally, only a nonresident alien individual nay use the terms of a tax treaty to reduce or eliminate L S. tax on certain types of income. However; most tax' eatles contain a provision known S$ a "saving olause." Exoep ons specified In the saving olause may permit an exemptlc from tax to continue for certain tYpes of inoome even aft r the recipient has otherwise become a U.S. resIdent aliEln f r tax purposes. If you are a U.S. resIdent alren who Is rely! ;J on an e~oeptlon contained in the saving clause of I tax treaty to cla.lm an exemption from U,S. tax On certain Ipes of Inoome, you must attach a statement to Form W-g th t specIfies the following fIVe Items: 1, The treaty oountry. Generally, thIs must e the same treaty under which you olalmed exemption ftl " tax as a nonresident alien. 2. The treaty article addressing ths Inoome 3. The artlole number (or looatlon) In the ta treaty that contains the saving clause and Its exception! Cat. No. 10231X Form 1 '.9 (Rev. 102005) I 1: ~'v tooa Funding Cycle: November 2005 For more information, please call the Community Relations Department at (407) 905-3109 or e-mail telliott@ci.ocoee.f1.us. When completing this application, use only the space provided. The only attachment should be the formal organizational support documentation (minutes or letter). Please remember to complete a City of Ocoee vendor form or we will not be able to issue a check. Applicants may apply for any amount up to $500. + + + + + + + + + + -+ + + + + + + + + + + + City of Ocoee Community Merit Awards Program Application Name of Organization: ST.A.R.8. of West Orange, a ministry of 81. Pauls Presbyterian Church Address of Organization: 9600 West Colonial Drive. Ocoee FL 34761-6900 Contact person for this application: Chesta M. Hembrooke (The contact member must be a member of the organization.) Daytime phone number: 407-292-3559 E-mail address:8TAR8-of-West-Orange@cfl.rr.com What are you seeking grant money for? What specifically will the money be used for? Grant money will be used to help provide basic school supplies and backpacks for children of economically challenged families attending public schools in West Orange County. With the addition of middle and high school students this past year. we need additional items specific to the upper grade students. (ie: calculators. graph paper. 3-ring binders. etc.) What dollar amount are you requesting? (The maximum grant award is $500.) $ 500 Is your organization getting funding from any other source for this specific project? There are no specific organizations that provide funding for S.T.A.R.S. What is your organization's primary funding source? donations .How much money does your organization receive from this source each year? $12,000--$26.500 What other sources of revenue does your organization have? We receive financial & in-kind donations from businesses. churches. civic organizations. corporations and individuals._ What is your annual budget for this year? $125.000 Last year? _$57.000 List the fundraisers your organization holds? We participate in Festival of Giving at West Oaks Mall each year and sell tickets for a drawing with a hand qUilted quilt as the prize. Page 2 . Community Merit Awards Application. November 2005 Cycle How many members does your organization have? St. Pauls--596: S.T.A.R.S.--52 How many live in Ocoee? St. Pauls--116: S.T.A.R.S.--15 How many clients does your organization serve? 8046 children How many live in Ocoee? '1700 (estimated) Has your organization applied for a grant from the City before? yes If so, when and what did you apply for? Community Merit Awards in 2003. 2004. 2005_ Were you successful and, if so, how much money did you receive? $500 in 2003. $500 in 2004, , $250 in April. 2005. Does your organization volunteer in the Ocoee community? If yes, what volunteer activities do you participate in? Yes. both S.T.A.R.S. & St. Pauls Presbyterian Church volunteer in the community. An example of what St. Pauls does is food drives. fundraisers & serving food for the West Orange Christian Service Center. Food For Families program & more. How many yearly volunteer hours does your organization contribute to the community and how are those hours tracked or documented? In 2003. over 568 hours. 2004-over 732, and 2005-over 800 hours on just the backpack project. Volunteers are registered on sigo-in sheets & tallied. S.T.A.R.S. aiso involves residents from the. greater West Orange County area. Please list the specific accomplishments your organization has achieved in the past 24 months: . In July/August. 2005 the S.T.A.R.S. program offered 8046 sets of supplies (including 50 for the West Orange Christian Service Center and 104 for Hurricane Katrina evacuee children) along with 7736 backpacks. This was accomplished through community involvement. including a partnership with Disney VoluntEARS. We increased our distribution focus from 13 elementary schools in 2004 to include 26 elementary. 3 middle and 2high schools in 2005. This grant will help us continue and enhance this support of our local children. Please include any other pertinent information about your organization or this specific grant request that you feel would help the City in making its decision: Middle and High School students are often forgotten when individuals and . organizations think about helping "children" in need. The peer pressure. alone. intensifies as children enter middle and high school. This grant will help us provide for not only the younger students, but allow us to continue assisting the high school students and increase our assistance to our middle school students that was initiated as a pilot program in 2005. Please attach documentation (meeting minutes or letter) to verify that your organization supports this application. For Staff Use Only Date Application Received / ! 1/1 Y05- Was Application Received Complete? ' If not, Date Application Returned ,.----;) -v"Vl. . d/.11 /t~/ . ST.PAULS PRESBYTERIAN CHURCH West Highway 50 at the Eastlf!lest Expressway (407) 293-3696 ' Bryan C. Stamper, Ph.D. Pastor November 29, 2005 City of Ocoee , , Community Merit Award Program CommLinity Relations 150 North Lakeshore Drive Ocoee FL 34761 Dear Merit Awards Re.view Board, This letter is to verify that st. Paul~,Pre~byterian Church supports S. r.AR.S. of .. . ", . , West Orange, a cooperative partnership to secure funding to provide back-to-school : - ,-' .\, .' supplies fO~ichlldren atten~irg twenty-thre.eelel1J'entElI"y, thre,e mJddle and two high schools in WestOrange'CountY. . ' . . , Should you have need offurthefinformstioh, pleasefeel freeto:contact me or ProjecfC6ordinatoi, Chesta Hembrooke. Thank you for your consideratiorlof ourap'plication. Sincerely, 11-r t j~ 'Bryan 9. Stamper, Ph.~. Pastor, St. Pauls Presbyterian Church 9600 West Colonial Drive, Ocoee, Florida 34761