GDBC Entrepreneurship Institute - VM Casello ! r
0 FORWARD CHECK.
CITY OF BOYNTON BEACH
DIRECT PAYMENT REQUISITION
Please issue a check in the amount of $ 1,000.00 .
TO: GBDC ENTREPRENEURSHIP INSTITUTE
3200 S CONGRESS AVE#104
BOYNTON BEACH FL 33462
FOR: Develop social entrepreneurs through training business coaching and technical assistance. Emphasis
is on youth to aid in reducing school drop-out rates and increase leadership skills
Vice Mayor Casello's Community Support Funds Expenditure
Requested By: Janet M. Prainito Date: . September 22, 2015
Approvals:
FUND DEPT_BASIC ELE OBJ AMOUNT
001 1110 511 95 47 1,000.00
Div Head ti _ . •
• 4'R. r.
net M. Prainito
Finance Dept.
Tim Howard
I
City Manager
Lori LaVerriere
1,000.00_
R15-055
EXHIBIT "A"
COMMUNITY SUPPORT FUNDS
REQUEST FORM
Part I - Summary of Request (to be completed by City Clerk)
Date of Request: 9- 8 - 15
Requested by Mayor/Commissioner: 9fPc� MAj, i C$5e 1I o
Amount Requested: $_. 6I 060. 00
Recipient/Payee: GrOc F-nwreneursIt;PIns-nruTE
Description of project, program, or activity to be funded: 501c3 *ha+ clevelop
en+ref rtneurs ru �fclinin� business cOAchi +each. Ft5Si STANce. Ernp&psis i5 on
lowth 40 Aid 'in reclueh 5 &,ol drop-ouT rakes ¶ iner �
eAsE. lrship5Kill5.
Part II - Availability of funds
The annual appropriation of funds available to the requesting Member of the
Commission listed above is $ a, 000
The balance of funds available for the requesting Member of the Commission is
$4,c00 .
Accordingly:
There are funds available as requested
ii There are insufficient funds available as requested
Dated: 9-8 -15-
B S . PiLtii
41, City Clerk
Part III-Eligibility Evaluation
• Public funds will not be used to improve private property unless there is a clear
public need, purpose and benefit
• The recipient/payee provides service within the City
• The public purpose is beneficial to the :nti a •. mu served by such donation
Dated: ' -a - 15 B A •
Req -sting Member of the City Commission
S:\CC\WP\COMMUNITY INVESTMENT FUNDS\Community_Support_Funs_Policy.2015.doc
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Entrepreneurship institute
P:561-894-4510 F 561-894-4501
info@gbdcei.com www.gbdcei.com
3200 S Congress Ave#104 Boynton Beach, 33462
Date: August 25, 2015
To: Vice Mayor Casello
Re: Non Profit Funding Request
Narrative
GBDCEI was formally structured as a 501c3 in August of 2014. Our Mission is the development
of social entrepreneurs through training,business coaching and technical assistance. Emphasis is
placed on young entrepreneurs; to aid in the reduction of school dropout rates and the increase in
leadership skills and job creation. While our formal 501c3 structure dates back only one year; the
work began many years prior. For more than a decade the GBDCEI team has delivered technical
assistance, economic development programs and community outreach programs directly to the
community and as consultants to organizations such as:
• SBA resource provider Florida Women's Business Center,
• The Urban League,
• The United Way,
• Center for Enterprise Opportunity,
• The City of Boynton Beach
We have also created programs and delivered them on behalf of several strategic alliance
partners such as:
t I
• The Boynton Beach CDC,
• The Milagro Center,
• POPS Fort Lauderdale and Belle Glade.
• ArtFusion of Delray
Our youth outreach programs have made great impact on the youth and young adults of South
Florida. The Kid-preneur World, The Business Side of Art(Youth Version), The Summer Youth
Cultural Entrepreneurship and OJT and The Youth Business Plan Competition has served many
teens and young adults statewide. The programs have focused on developing leaders, critical
thinkers, creating jobs and career development.
Growth Plan
GBDC Entrepreneurship Institute is currently planning the launch of Mobile Entrepreneurship &
Leadership Training Program(M.E.L.T.) for current and future entrepreneurs in Florida. This
program addresses the state's need for qualified and skilled talent. M.E.L.T. is a program that
provides technical assistance, educates and trains individuals; looking to starting or grow a
business. The program is also aimed at reducing the high school dropout rate,reduce
unemployment and improve the socio-economic conditions of the communities in which
participants reside.
Allocation of Funding
The funding received will be used to provide scholarships to our winter session of the Kid-
Preneur World. Boynton Beach students ages 10 to 15 will be granted reduced admissions to the
camp. The funds received will abate 50% of the camp cost($150 per week will be reduced to
$75).
The Kid-Preneur Camp Winter 2015- The Kid-Preneur World Winter program includes
intensive action and excitement-packed sessions, where kids create their own small town and act
out professional job duties. Monday morning elections determine the roles of each child for that
week. In a fast-paced, dynamic environment,the kids develop leadership and interpersonal skills
.
while dealing with flooding, earthquakes, and other acts of nature. Resident problems,budget
crises, sending their children to college, opening bank accounts, resolving credit issues and many
other unexpected problems and situations may arise. At Kid-Preneur World, we believe in the
benefits of encouraging experiential learning that engages the whole child. Our participants learn
by exploring, experiencing and addressing real-life situations. They,learn to think, explore and
act! We include money games designed to teach financial lessons, guest speakers and field trips
that show them how a real city works.
Thank you for your kind consideration of this funding request. I have read the program
guidelines and stipulate that we will adhere to the guidelines and requirements.
Respectfully,
Annette Gray
-Executive Director/Fo :-r
CC To: Board Members of GBDC Entrepreneurship Institute
Hubert Macintosh, (Chair And Treasurer) Financial Strategist
Alterraon Phillips,Esq., (Vice Chair)—Legal Oversight
Stephanie Rockwell, (Secretary, Public Relations, Governance Oversight)
Ansel Graham Record, (Governance Oversight)
Rocio Davis,Board Member(Governance Oversight)
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H-,�9. .
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Form W.9 Request for Taxpayer Give Form to the
(Rev.December2014) Identification Number and Certification requester.Do not
Department of the Treasury send to the IRS.
Internal Revenue Service
1ame(as shown on your income tax return).Name is required on this line;do not leave this line plank.
C keg-c 'e.NC.0Ars k�, -k
2 siness name/disregarded entity n e,if different from above
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°- 3 Check appropriate box for federal tax classification;check only one of the following seven boxes: 4 Exemptions(codes apply only to
c certain entities,not individuals;see
° ❑Individual/sole proprietoror ❑ C Corporation ❑ S Corporation ❑ Partnership ❑Trust/estate
y instructions on page 3):
O.a c single-member LLC Exempt payee code(if any)
As r, iiiLimited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=partnership)►
`° 2 Note.For a single-member LLC that is disregarded,do not cheiryck LLC;check the appropriate box in the line above for Exemption from FATCA reporting
H the tax classification of the single-member owner. r` \/�J code(if any)
a` c her(see instructions)► non_ 4 -a U Cs- \C (Applies to accounts maintained outside the U.S.)
'V°-- 5 Address(numbertstreet,and apt.or suite no.) VVV JJl\if !! equester's name and address(optional)
co
6 City,state,and ZIP code J
cu
%) 13Q .,Ak�Y «e \ Pc_ 334 �
7 List acc unt number(s)here(optional)
,Part I Taxpayer Identification Number(TIN)
Enter your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid (Social security number
backup withholding.For individuals,this is generally 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 identification number(EIN).If you do not have a number,see How to get a
TIN on page 3. or
Note.If the account is in more than one name,see the instructions for line 1 and the chart on page 4 for Employer identification number
guidelines on whose number to enter.
i --4_- ( D-14 S 6
Part II 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.citizen or other U.S.person(defined below);and
4.The FATCA code(s)entered on this form(if any)indicating that I am exempt from FATCA reporting is correct.
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 abandon - t of secured property,cance!Jatiorroj debt,contributions to an individual retirement arrangement(IRA),and
generally,payments other than inter- and dividends,you are not required • sign the certification,but you must provide your correct TIN.See the
instructions on page 3.
Sign Signature of / j
Here U.S.person 10. '/(_ •��(/( . /" r Date s. g 1 1
General Instructions •Fir 1098(home mortgage interest),1098-E(student loan interest),1098-T
Section references are to the Internal Revenue Code unless otherwise ted. (torm)1099-C(canceled debt)
Future developments.Information about developments affecting Form (such •Form 1099-A(acquisition or abandonment of secured property)
as legislation enacted after we release it)is at www.irs.gov/fw9.
Use Form W-9 only if you are a U.S.person(including a resident alien),to
Purpose of Form provide your correct TIN.
An individual or entity(Form W-9 requester)who is required to file an information If you do not return Form W-9 to the requester with a TIN,you might be subject
return with the IRS must obtain your correct taxpayer identification number(TIN) to backup withholding.See What is backup withholding?on page 2.
which may be your social security number(SSN),individual taxpayer identification By signing the filled-out form,you:
number(ITIN),adoption taxpayer identification number(ATIN),or employer 1.Certify that the TIN you are giving is correct(or you are waiting for a number
identification number(EIN),to report on an information return the amount paid to to be issued),
you,or other amount reportable on an information return.Examples of information
returns include,but are not limited to,the following: 2.Certify that you are not subject to backup withholding,or
•Form 1099-INT(interest earned or paid) 3.Claim exemption from backup withholding if you are a U.S.exempt payee.If
•Form 1099-DIV(dividends,including those from stocks or mutual funds) applicable,you are also certifying that as a U.S.person,your allocable share of
any partnership income from a U.S.trade or business is not subject to the
•Form 1099-MISC(various types of income,prizes,awards,or gross proceeds) withholding tax on foreign partners'share of effectively connected income,and
•Form 1099-B(stock or mutual fund sales and certain other transactions by 4.Certify that FATCA code(s)entered on this form(if any)indicating that you are
brokers) exempt from the FATCA reporting,is correct.See What is FATCA reporting?on
•Form 1099-S(proceeds from real estate transactions) page 2 for further information.
•Form 1099-K(merchant card and third party network transactions)
Cat.No.10231X Form W-9(Rev.12-2014)
INTERNAL REVENUE SERVICE DEPARTMEivi' OF THE TREASURY
P. 0. BOX 2508
CINCINNATI, OH 45201
Employer Identification Number:
Date: DEC 2 3 2014 47-1296502
DLN:
17053245346024 •
GBDC ENTREPRENEURSHIP INSTITUTE INC Contact Person:
3200 CONGRESS AVE STE 104 LISA M VAN DER SLUYS ID# 95264
BOYNTON BEACH, FL 33426 Contact Telephone Number:
(877) 829-5500
Accounting Period Ending:
December 31
Public Charity Status:
170(b)(1)(A) (vi )
Form 990 Required:
Yes
Effective Date of Exemption:
July 9, 2014
Contribution Deductibility:
Yes
Addendum Applies:
No
Dear Applicant:
We are pleased to inform you that upon review of your application for tax
exempt status we have determined that you are exempt from Federal income tax
under section 501(c)(3) of the Internal Revenue Code. Contributions to you are
deductible under section 170 of the Code. You are also qualified to receive
tax deductible bequests, devises, transfers or gifts under section 2055, 2106
or 2522 of the Code. Because this letter could help resolve any questions
regarding your exempt status, you should keep it in your permanent records.
Organizations exempt under section 501(c)(3) of the Code are further classified
as either public charities or private foundations. We determined that you are
a public charity under the Code section(s) listed in the heading of this
letter.
•
- For important information about your responsibilities as a tax-exempt
organization, go to wNw.irs.gov/charities. Enter "4221-PC" in the search bar
to view Publication 4221-PC, Compliance Guide for 501(c)(3) Public Charities,
which describes your recordkeeping, reporting, and disclosure requirements.
Sincerely,
Director, Exempt Organizations •
Letter 947
•
R15-055
CITY OF BOYNTON BEACH
COMMUNITY SUPPORT FUNDS POLICY
PURPOSE: The purpose of the Community Support Funds (CSF) is to provide a
source of discretionary funding to support projects, programs and activities in the City
which are accessible and beneficial to the citizens of the City. Due to the broad and
diverse nature of programs or projects that may be eligible for funding from the
Community Support Funds, no specific list of eligible projects, programs, or activities is
appropriate.
SCOPE: This policy recognizes that there is a specific line item in the City Commission
portion of the City's annual budget. Each year, in the annual budget adoption process,
the City Commission shall consider an appropriation for Community Support Funds.
The Commission is not required to appropriate Community Support Funds but when it
does, the amount appropriated, if any, shall be available for distribution by the Mayor
and City Commissioners in equal amounts only for qualified programs or projects. By
way of example: If the Commission budgets $10,000, the Mayor and each
Commissioner may request distributions up to $2,000 for the year that the funds are
appropriated:
CRITERIA FOR ELIGIBILITY: Eligibility for funding shall be conditioned on a finding by
the City Commission that:
1. Public funds should not be used to improve private property unless there is a
clear public need, purpose and benefit; and
2. The recipient/payee will use 100% of the funds to provide services within the
City; and
3. The public purpose is beneficial to the entire community served by such donation
and to the City as a whole; and
4. Proper safeguards shall be implemented by the City administration to assure that
the funds will be used for the stated purpose, such as:
a. Prior to receiving any funds, the recipient must complete a W-9 Request for
Taxpayer Identification Number Form in order to be added to the City's
vendor list.
b. Within 60 days of receipt of funds, the recipient must provide the Finance
Director appropriate backup documentation demonstrating the funds were
used for the stated purpose approved by the Commission.
c. Should the recipient fail to submit the appropriate documentation within the
allotted time, the City Commission may deem the recipient ineligible for any
future funding.
The findings of the City Commission as to each of these required elements shall be
inferred from the Commission's approval or disapproval of the requested distribution
without the need for separate findings.
PROCEDURE FOR CONSIDERATION OF EXPENDITURES: The procedures for
expenditures from the Community Support Funds are as follows:
1. The Mayor or any member of the City Commission shall make a request to the
City Clerk for the expenditure of funds. The requesting member of the City
R15-055
Commission must have a written request from the entity seeking funds. The
written request must contain a narrative explanation indicating how the funds will
be used and an affirmative acknowledgement that the requestor understands and
will comply with the above listed conditions for eligibility and use. The written
request will be forwarded to the City Commission along with Exhibit "A" (see Step
2).
2. The City Clerk shall complete a Community Support Fund Request Form (form
attached as Exhibit "A") and confirm the funds are available with the Finance
Director.
3. If the appropriate funds are available the City Clerk will schedule the matter to be
considered by the City Commission at the next scheduled City Commission
meeting under New Business.
4. The City Commission shall act on the request for expenditure by approving or
disapproving the agenda item. A majority vote is required for approval of the
expenditure.
DISCRETIONARY NATURE OF COMMISSION ACTION: The decision of the City
Commission to approve or disapprove a requested distribution of Community
Support Funds is discretionary and is not subject to appeal, review or challenge.