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Home My WebLink About8.1 Pacific Chamber Symph Attach 9 RE.CE.IVED ... CITY OF DUBLIN JAN 2 5 2008 CiTY MANAGER'S OFfiCE CITY OF DUBLIN Fiscal Yea, 2008-2009 COMMUNITY GROUP/ORGANIZATION ApPUCATIONFORFuNDS COVER PAGE AGENCY NAME: PACIFIC CHAMBER SYMPHONY PROPOSED PROJECTIPROGRAM NAME: "MUSIC IS FuN" AssEMBLY PROGRAM FOR DUBLIN ELEMENTARY SCHOOLS FuNDING AMOUNT REQUESTED: $12,000 SECTION 2 Page 2 of 18 A77MH~6NI CITY OF DUBLIN Fiscal Yea, 2008-2009 ApPLICATION FOR FUNDS 1. Please select one expense category: 0 Capital X Operating 2. Applicant Information: Organization! Ag Organization! Agency Name Pacific Chamber Symphony Mailing Address Street Address 1155 East 14th Street,. Suite 215 City San Leandro State CA Zip 94577 Lawrence Kohl Music Director/CEO 925-484-9873 Work Phone Lawrence@,PacificChamberSymphony.org Email Board President (if applicable) Work Phone Email Please list the PrimaIy Project Contact Person who woold be able to answer questions about this application and projectIprogrnm during the funding period. Lawrence Kohl Music Director/CEO Contact Person for Project/Program Job Title 925-484-9813 Lawrence@PacificChamberSymphony.org 510-352-3941 Work Phone Email Fax Nonprofit Identifkation No. (required) 94-3105631 City of Dublin Business License No. (required) SECTION 2 Page 3 of18 City of Dublin Fiscal Year 2008-2009 Application fo, Funds 3. Proposed ProjectJProgram Information (Do not describe Organization.) Amount of Funds Requested $ 12,000 (Maximum $25,000 per project.) Proposed ProjectIProgram Name "MUSIC IS FuN" ASSEMBLY PROGRAM FOR DUBLIN Proposed ProjectlProgram Date(s): Start 1/1109 and End 5/30/09 mo. day yr. mo. day yr. Please note: City Council Grant Funds are distributed on a reimbursement basis. If your Agency needs a 1000/0 disbursement at the beginning of the Fiscal Year,.please indicate this below and please provide justification for this need. X Agency is requesting 100% disbursement at the beginning of the Fiscal Year. If selecting this option, please provide justification in the blank space below. o Agency is not requesting 100% disbursement at the beginning of the Fiscal Year. If selecting this option, please provide the frequency that reimbursements will be submitted to the City in the blank space below; e.g., monthly, quarterly, at project completion, etc. The Pacific Chamber Symphony has always had its grants from the City of Dublin given a 100% disbursement at the beginning of the Fiscal Year. PCS operates on a cash accounting system. Grants are typically received upon the award of the grant. This enables PCS to make payments to musicians with grant funds as required during the course of the project. SECTION 2 Page 4 of 18 City of Dublin Fiscal Year 2008-2009 Application fo, Funds a. How would the requested funds be used? · Describe, in detail, the PROPOSED PROJECTIPROGRAM (not the Agency). · BuDeted text is acceptable. · Identify if the proposed project/program is a new service, or extension of an existing one. · An additional page may be added, if needed. Pacific Chamber Symphony Overview of Edu.ca.tiona1 Program. for nementa.1:y Grades Music in school: faci~itating a child's capacity for discovery and mental growth. }> Quintet: perfozmanoe and teacher packet:: basic l1IlZSica~ concepts and bow each insf:r1DDent makes it's unique sounds This program goes beyond a simple exploration of what different instruments look like and the instrumental families they belong to, to an in-depth presentation through accessible classical music, demonstration on how each instrument really achieves it's unique acoustical profile and the exploration of a basic musical concept. Thus over a period of several years the student will lean about what musically makes rhythm, melody, harmony, scales, character of music, texture, etc. This ensemble consists of the five orchestral and band instruments children are most likely to choose: violin, cello, trumpet, clarinet and flute. In various combinations they produce a compelling blend of the individual voices. The members of the ensemble have literally done thousands of concerts for kids and have led assembly organizers in our feedback reviews to give rave accolades. This assembly is supported by a comprehensive educational package that covers music teaching theory, developmental milestones in children's relationship to music, class projects and activities. It also contains the opportunity for each student to create artwork or write a letter describing the concert. This is a proven method reinforcing the meaning and joy of the musical experience. SECTION 2 Page 5 of 17 b. How would the PROPOSED PROJECTIPROGRAM address an unmet community need and improve the quality of life for Dublin residents. Why is this project/program needed? (Additional page may be added, if needed): Music in school.: facilitating a child's capacity for discovery and men tal growth. 1. Music helps the child: . It engages the whole child and stimulates integration of left and right brain; process and goal driven learning. . It facilitates sensory learning and offers opportunities to link learning styles. . It honors individuality and expression. . It establishes a space for reflection in life, in school and in the community. 2. Our program helps the music programs: Best practices: Most theorists agree that music is best learned through recurring sensory experiences that provide both variety and repetition. Next, concepts that categorize elements in music and help students develop awareness (~Ear Training") are introduced. This teaches students to identify musical concepts as they listen. Also, students should be encouraged to develop individual musical opinions and preferences, as a first step to establishing a relationship to music. 3. Curriculum: The following package is designed with respect to the teleological considerations outlined above. Each year the curriculum takes on a specific musical concept with a corresponding musical ensemble. As children learn about the basic concepts of music (rhythm, melody, acoustics and timbre, harmony, form, style, etc.) throughout the elementary grades awareness, understanding and discerning appreciation are developed. c. What documentation!datalrecords SUpport the need for this PROPOSED PROJECfIPROGRAM? Please identify your data sources. (Additional page may be added, if needed.) Our program has been endoISed by the School Board and by the Dublin Partners in Education. Our feedback fonns as well as infonnal comments demonslIate that the program is needed and enjoyed by the students. It has been pointed out that our program gives reachers a common language to talk about music and to do follow-up activities with their students. Enrollment in music progrnms has increased in the school districts where our ensemble has performed. SECTION 2 Page 6 of17 City of Dublin Fiscal Year 2008-2009 Application for Funds d. Specify the PROPOSED PROJECTIPROGRAM population to be served. The program is for elementary school children K - 5 of the Dublin Unified School District Elementary Schools. e. Projects/programs must be evaluated to detennine if they are being carried out efficiently and if project/program goals are being met. Please describe how you plan to monitor your project/program's success and impact. · An additional page may be added, if needed. Pacific Chamber Symphony evaluates the success of our in-school performances from the compiled results of feedback forms to participating teachers and the drawings and letters of the students who are remarkably articulate about their experience. PCS in discussion with the elementary schools seeks to gain a greater understanding of specific needs and preferences. The feedback is then processed by the PCS music director and the professional musicians who make up the ensemble and influences the shaping of future programs. f. Specify numbers of clients served by agency, then by PROPOSED PROJECTIPROGRAM: SECTION 2 Page 7 of 17 ',,,,,- ?_~""~ ~..."~'!I:'''''i'r;;'''"-;,''_'h"''';)''''''''9~~~'~,,,0';~:'o,;;l<-;'_q~_~~*:""'~~_~_~"m<i;kq~_~~_:'l~..Jt'la't:t&'liT"'1'1Jl';''r.li_j. r~III"':_~~,f:".-.;liJlllJ"!i~. ,rr'....~~.iJIIi<n!i~~"I!:.. City of Dublin Fiscal Year 2008-2009 Application /0' Funds s. Financial Information - Operating Budget 3. Expense Budget FY 2008-2009 THIShOJECTI EXPENSE BUDGET OltG.t\NlZA.'fION PROGRAM GRANTREQUES'l Personnel Costs Administration and Musicians $191,000 $14,000 $12,000 Non-PersoDDelCosts Program Services $80,000 $2,000 0 Supporting Services $20,000 $1,000 0 Other (please specify) Other (please specify) TOTAL $276,000 $17,000 $12,000 Further CommentslExplanations (if necessary): SECTION 2 Page 8of17 City of Dublin Fiscal Year 2008-2009 Application 10' Funds b. Revenue Budgd FY 2008-2009 REVENUE BUDGET ORGANIZATION PIlOJECTIPROGRAM CommittedlRestrided Funds f ify source) Non-CommittedJRestrieted Foods ( 01' source) Contributions $166,000 DPIE $500 Contributions Hacienda Child Development. Fund $1,000 Contributions From General ~ . $3,500 ( lnPratmg Contracts and tuition $15,000 Government $53,690 City of Dublin $12,000 Tickets $50,000 TOTAL $284,690 $17,000 Further CommentslExplanations (if necessary): SECTION 2 Page 9 of17 ..' .. City of Dublin FISCtIl Year 1()(J8-1009 Application fo, Funds 6. General Agency Information x Past grant applicants may check this box in lieu of completing item 6 (a-d) if the program/organizational description on file witb the City is correct and current. a. List all years that Organization bas previously received City of Dublin funding (not Community Development Block Grant - CDBG). b. Describe tbe population(s) served by the Organization. c. Describe all the services the Organization currently provides to Dublin residents. · An additional page may be added, ifneeded. d. Has your agency ever previously received funds from the City of Dublin? Jfyes, please specify in what Fiscal Years and the amount received each year. SECTION 2 Page 10 of17 ~ 04~lL C~~...Jo~/' ~\i~k~\1' ~:~ .J :, City of Dublin Fiscal Year 2008-2009 Application for Funds 7. Required Attachments: o Onlv one (1) copy per Aeencv of each of the following is required, even with multiple projects/programs submitted. o Applications without the following documents will not he reviewed for funding. o Please label attachments: A, B, C, etc. XA Names of Governing Board; identify current Board officers. . Current total Organization operating budget, including revenue. Clearly label/identify the program that includes the PROPOSED PROJECTIPROGRAM. XB. x c. Most recent audit report or tax return (if applicable). X D. Resolution, letter or other document providing evidence of Board/Organization approval of application, and date approval was granted. · Board/Organization approval may be pending. X E. Organization's certificate of insurance showing coverage for liability and workers' compensation. X F. Application Verification Declaration Signature Page. Q G. Signed affidavit form from each collaborating agency named in proposed project/program plan (if applicable). X H. Copy of IRS Letter of Determination indicating tax exempt status. SECTION 2 Page 11 of 17 (!:)(-~--" F\ Pacific Chamber Symphony, Board of Trustees ~ elson Mosher, Esq. Chairmain Sheldon Cement. Treasurer Joyce Nevins, Secratary Lawrence Kohl, President Robert Belknap Larry Goldfarb Joel Wienstein Brian Fowler Larrry Thorpe Gil Roeder Board Council Sharon Collins Richard Winefield Sherri Ferris Gary Cohn Pat Kernan Jo Cazenave ~ PACIFIC CHAMBER SYMPHONY PROJECTED STATEMENT OF ACTIVITIES Projected Year Ended June 30. 2008 Total Public support and revenues: Contributions Government grants Contracts and tuition Ticket sales $ 132,500 48,691 27,800 43,000 Total public support and revenues 251,991 Expenses: Program services: Community performances Education and outreach 151,112 56,334 Total program services 207,446 Supporting services: Management and general Fundraising 19,254 16,692 Total supporting service 35,946 Total expenses 243,392 CHANGE IN NET ASSETS 8,599 NET ASSETS, BEGINNING OF YEAR (20,959) NET ASSETS, END OF YEAR $ ( 11, 441 ) Project $3,000 7,000 $10.000 $9,100 $9.100 $450 $450 $900 $10.000 @ PACIFIC CHAMBER SYMPHONY ACCOUNTANTS' REVIEW REPORT and FINANCIAL STATEMENTS For the Years Ended June 30,2007 and 2006 STOREK~ CARLSON & STRUTZ Certified Public Accountants CONTEN'I'~ INDEPENDENT ACCQTJNTANTS' REVIEW REPORT PAGE 1 FINANCIAL STATEMENTS Statements of Financial position Statements of Activities Statements of Functional Expenses Statements of Cash Flows Notes to Financial Statements 2 3-4 5-6 7 8-9 PACIFIC CHAM1U;:R SYMPHONY ~J.mm~QL.~TI~:;; FOR THE YEARS ENDED JUNE 30, 2007 AND 2006 2007 Temporarily Restricted Total 2006 Unrestricted Public support and revenues: Local government grants Ticket sales $ 142,849 $ $ 142,849 $ 219,916 40,691 40,691 46,190 21,586 21,586 23,909 22,225 22,225 7,320 2,700 2,700 2,122 125 125 21 Contributions Contracts and tuition Other income Interest income Special events Net assets released from restrictions: Satisfaction of purpose restrictions Total public support and revenues _~30,176 230,176 299,478 Expenses: Program services: Community performances Education and outreach Total supporting services 144,675 144,675 180,784 26,055 --- 26,055 24,909 ----2-70,730 170,730 205,693 38,767 38,767 44,98:: 18, 640 18,640 36,214 57,407 57,407 81,199 228,137 ~-- 228,137 286,892 2,039 2,039 12,586 (20,959) (20,959) (33,545) $ (18,9~) $ $ (18,920) $ (20,959) Total program services support~ng services: Management and general Fundraising Total expenses CHANGE IN NET ASSETS NET ASSETS, BEGINNING OF YEAR NET ASSETS, END OF YEAR The accompanying notes are an integral part of these financial statements. - 3 - PACl:F:IC CBAHBBR SYMPHONY STATBIIBIft'S OF ACT:IVl:Tl:BS POR T.IIB YBAR BNDBD J'CJNB 30, 2006 unrestricted Public support and revenues: Contributions Local government grants Ticket sales Contracts and tuition Other income Interest income Special events Net assets released from restrictions: Satisfaction of purpose restrictions $ 219,916 46,190 23,909 7,320 2,122 21 50,000 Total public support and revenues 349,478 Expenses: Program services: Community performances Education and outreach 180,784 24,909 Total program services 205,693 Supporting services: Management and general Fundraising 44,985 36,214 Total supporting services 81,199 Total expenses 286,892 CHANGE IN NET ASSETS 62,586 NET ASSETS, BEGINNING OF YEAR (83,545) NET ASSETS, END OF YEAR $ (20,959) 2006 Temporarily Restricted $ (50,000) (50,000) (50,000) 50,000 $ Total $ 219,916 46,190 23,909 7,320 2,122 21 299,478 180,784 24,909 205,693 44,985 36,214 81,199 286,892 12,586 (33,545) $ (20,959) - 4 - The aooompllJ1'y1ng notes are an integral part of these financial stat_ta. Contract: labor - musicians $ Salaries - Music Director Concert production costs Cont.ract labor - other Rent Advertising Postage Professional fees Payroll taxes Printing and publications Heal th insurance Telephone Insurance Other expenses Supplies Interest expense Bank char-ges Travel and confe!:ence Dues and subscriptions Special events License and permits Auto expenses Total expenses before depreciation Depreciation TOTAL EXPENSES Percent of total expenses ~~lLS~ s.TII~.F:!IIic.~~ FOR THE YEARS RNDRDJUNIl: 30 2007 AND 2006 Community Poerfo~! PROcmAK SERV~___~ Total ----~.. 69,416 40,000 25,120 E.ducatiotl ~~~~ 15, fiOO 2,230 8,225 4,413 4,376 1,243 107 144,675 26,055 85,01-6 4.0,000 27,350 8.22-5 ___~"_~!!~..!..~BRVICBS__ Mana.gement and Genera.l ~--- S,717 12,000 5,295 5.583 4,413 4,376 3,196 2,630 .1.243 271 1, 253 1,ll2. 580 311 no 107 170,73D $ 144,675 :;____~""o.~~ i~_.':2.tl~-3{) 11.4% 63.4% 38.278 489 -..----- Fundraisin~ 10,279 3,95-9 4,402 20 Total -- 5,717 12,000 10,279 9,254 5,563 4,402 . 3,196 2,630 1,253 1,112 580 18,640 56,918 489 --- ---~ r=,,,,,.==",;~~~-,,,~ ~~.=-2.!~~~~~","__ 57, 40~L 8.2% 74. B% 17.0* The accompanying notes are an .integral part of these financial. statements. - 5 271 2007 2006 Total Total Expenses Expenses 85,016 92,821 40,000 31,667 27,350 68,837 13,942 44,989 12,000 12,000 10,279 2,051 9,254 2,667 5,583 3,189 4,413 1,973 4,402 7,703 4,376 4,373 3,196 4/396 2,630 ),201 1,524 3,035 1,253 1,740 1,112 212 580 746 311 310 107 20 452 -------- ~~ 227,648 286,403 4H9 4B9 311 310 20 $ __,~28!.2:37 L= 2a6~~ 25.2% ~~~% 100.0% Contract labor - musicians Concert production costs Contract labor - other Salaries - Music Director Rent Printing and publications Telephone Health insurance Insurance Professional fees Other expenses Postage Advertising Payroll taxes Supplies Bank charges License and permits Auto expenses Interest expense Special events Total expenses before depreciation Depreciation TOTAL EXPENSES Percent of total expenses ~QNX. ii:l'~.!lHA1...);W)IOOlJ~s.. PROGRAM SERVICES SUPPORTING SlmVICES 2006 --- Community Educat~on Ha.na.gemen t Tota.l 1?srformances and Outreach Total and General Fundraiaing Total Expenses -- 79,785 13, 036 S 92,821 S $ 92,821 61,364 7,473 68,837 f;,lj,e3"/ 4,400 4,400 16,903 23,686 40,589 44,989 31,667 }l,667 31,667 12,000 12,000 12,000 660 7,043 7,703 7,703 4,396 4,396 4,396 4,373 4f373 4,373 3,201 3,201 3,201 3,189 3,189 3,189 1,622 1,622 400 1,013 1,413- 3,035 944 1,723 2,667 2,667 2,051 2,051 2,U5l 1,973 1,973 1..9TJ 1,042 698 1,740 1,740 746 746 746 452 452 452 351 351- 351 212 212 212 "_._--- ---',--- ~----~ _._---._--~ --- 180,764 24,909 205,693 44,496 36,2~4 80,710 286,403 489 489 489 -"---~---'.'_.~- -""----,..---.-- -,,---~-"-,_._--~-- --"---- ---'---'--- -~- $ 180,784 $ 24,909 ~ ~ 36,214 L- 81, :L99 286,892 63.0% 8.7% 71.7% 15.7% ~% 28.3% 100.0% The accompanying notes are an intaqral part of these financial statements. - 6 - PACIFIC CHAMB.ER SYMPHO:Nx STATEMENTS OF CASH FLOWS FOR THE YEARS ENDED JTINE 3~007 AND 2006 (See Accountants' Review Report) CASH FLOWS FROM OPERATING ACTIVITIES Change in net assets Adjustments to reconcile change in net assets with net cash provided by operating activities: Depreciation and amortization Increase in accrued expenses Net cash to operating activities 2007 2006 $ 2,039 $ 12,586 489 489 1,185 546 3,713 13,62l CASH FLOWS FROM FINANCING ACTIVITIES Payments on advance from board member Advance from board member Payments on credit line Payments on cash advances Proceeds from cash advances Net cash from financing activities NET DECREASE IN CASH CASH AT BEGINNING OF YEAR CASH AT END OF YEAR Supplemental disclosure of cash flow information: Interest paid 1 112 212 The accompanying notes are an integral part of these financial statements. - 7 - ?ACIFIC.CHAM13ER SYMPHON!l tJOTES TO FINANCIAL STATEMENTS FOR THE YEARS ENDED JUNE 30. 2007 AND 2006 (See Accountants' Review Report) NOTE ~ - OPERATIONS AND SIGNIFICANT ACCOUNTING POLICIES (a) The Pacific Chamber Symphony ('the Organization," or "PCS") is a non-profit organizat::Lon incorporated in California in 1989 as the Chamber Orchestra of San Leandro for the purpose at offering quality chamber symphony performances to audiences of the San Francisco Bay Area. In 2002, the Organization changed its name to Pacific Chamber Symphony. Performing at several concert venues and local schools, PCS promotes the appreciation of chamber symphony in the community through its performances and educational outreach programs. The Organization 's revenues are derived principally from contributions, government grants, and ticket sales from its performances. (b) The accompanying financial statements have been prepared on the accrual basis in conformity with u. S. generally accepted accounting principles. Those principles require management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosures of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting periOd. Actual results could differ from such estimates. (c) In accordance with Statement of Financial Accounting Standards (SFAS) No. 117, Financial Scacements of Noc-for~Profic Organizations, Pacific Chamber Symphony reports information regarding its financial position and activities according to three classes of assets: unrestricted net assets, temporarily restricted net assets, and permanently restricted net assets. (d) Pacific Chamber Symphony has also adopted SPAS No. 116, Accounting for Contributions Received and Contribut:ions Made, whereby contributions received are to be recorded as unrestricted, temporarily restricted,or permanently restricted support depending on the existence and/or nature of any donor restrictions. Restricted net assets are reclassified to unrestricted net. assets upon satisfaction of the time or purpose restriction. Unconditional promises to give are recognized as revenue at the time the promise is made by the donor; conditional promises to give are disclosed but not recognized as revenue until the conditions are met. (e) Acquisitions of property and equipment in excess of $1,000 are capitalized. Property and equipment are carried at cost or, if donated, at approximate fair value at the date of donation. Depreciation is computed using the straight-line method with estimated useful lives, from five to seven years. (f) Pacific Chamber Symphony considers all highly liquid investments available for current use with an initial maturity of three months or less to be cash equivalents. (g) Fundraising activities are performed primarily by PCS donors and other volunteers. Special events that are major and/or ongoing are reported as gross proceeds and related expenses in accordance with AICPA's Not:-for-Profit: Organizat:ions and SFAS No. 117, Financial Stat:ements of Not-for-Profit Organizations. Joint costs incurred in fundraising activities are allocated between program and support services in the statement of functional expenses, as required by AICPA's Not-for-Profit Organizations. (h) Pacific Chamber Symphony has obtained tax-exempt status from the Internal Revenue Service under Section 501 (c) (3) of the Internal Revenue Code and from the Franchise Tax Board under Section 23701 (d) of the California Revenue and Tax Code. Accordingly, no provision for federal income tax or California franchise tax has been made. Pacific Chamber Symphony has been classified. as a publicly supported charitable organization, which is not a private foundation under IRS Code Section 509(a). - 8 - ?ACIFIC.CHAMBER SYMPHONY NOTES TO FINANCIAL STATEMENTS - (Continued) FOR THE YEARS ENDED JUNE 30, 2007 AND 2006 (See Accountants' Review Report) NOTE 2 - DONATED SERVICES, MATERIALS AND FACILITIES For the year ended June 30, 2007, Pacific valued at $12,000. The total value of contributions are included in contributions Chamber Symphony received donated otfice rent- $12,000 ($15,000 for 2006) of these in-kind and expenses on the statements of activities. NOTE 3 - ADVANCE FROM KEY EMPLOYEE One of Pacific Chamber Symphony I s key employee has advanced the Organization cash to pay its current obligations, agreeing to take payments without interest as surplus cash becomes available to PCS. NOTE 4 - RELATED PARTY TRANSACTIONS Pacific Chamber Symphony shares a common board of directors with two organizations, Pacific Chamber Symphony Orchestra and Pacific Chamber Orchestra, both of which are nonprofit California corporations. There were no material transactions in 2007 or 2006 between these related parties. - 9 - Paci~j c i a7(JJnJx~r ~~ymph()ny @ Council Members City of Dublin January 22, 2008 Dear City Council, The Board of Trustees of the Pacific Chamber Symphony hereby approves the submission of this grant proposal for a $12,000 one year grant in support of the Pacific Chamber Symphony's "Music is Fun!" assembly program for the Dublin schools. Thank you for your consideration and your support. Nelson Mosher, Chair of the Board of Trustees Pacific Chamber Symphony 1155 East 14th Street Suite 215 San Leandro, CA 94577 p 510.352.3945 F 510.352.3947 114 Sansome street Suite 825 San Francisco, CA 94108 p 415.989.6872 F 415.989.6873 6834 Gartand Court P1easanton, CA 94588 p 925.484.9783 Pac ificCh amberSymphony.org LAWRENCE KOHL Music DIrector & Conductor OP ID DATE (MMJOD1YYYY) PACI-10 11 27 07 THIS CERTIFICATE IS ISSUED AS A MATrER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. ACORD,. CERTIFICATE OF LIABILITY INSURANCE PRODUCER MCDer.mott-Costa Co., Inc. Lie # 0167057 276 Dolores Ave San Leandro CA 94577 Phone:510-351-7460 Fax: 510-357-3230 INSURED INSURERS AFFORDING COVERAGE NAIC' INSURER A: NonProfit.' Zn. Allien.... of CA INSURER B: State COIlIpItD..t1on Zna. Fund INSURER C; INSURER D: INSURER E: pac~fic Chamber Symphogy 1155 East 14th Street *215 San Leandro CA 94577 COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOl'MTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT VWfH RESPECT TO \MilCH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUB.JECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPe OF INSURANCe POLICY NUMBER "J:"~TMMlDiWir DATEIMMJD~ LIMITS GENERAL UABlUTY EACH OCCURRENCE S 1000000 - 11/17/07 11/17/08 UAMI\\,:jC A X COMMERCIAl GENERAL LIABILITY 200700695NPO PREMISES (Ea occ:urence) $ 100000 1 CLAIMS MADE ~ OCCUR MED EXP (Any one person) $ 10000 PERSONAL & ADV INJURY $ 1000000 f--- ~ Liquor Liabili ty GENERAL AGGREGATE S 2000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS.COMP~PAGG S 2000000 I POLICY n ~~8i h" LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT - $ 1000000 A ANY AUTO 200700695NPO 11/17/07 11/17/08 (Ea accicIenl) - ALl OWNED AUTOS BODILY INJURY - S SCHEDULED AUTOS (Per person) - ~ HIRED AUTOS BODILY INJURY $ ~ NON-OWNED AUTOS (Per accident) - PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ==iANYAUTO OTHER THAN EA ACe $ AUTO ONLY: AGG S EXCESSlUMBRElLA UABlUTY EACH OCCURRENCE S :J OCCUR 0 CLAIMS MADE AGGREGATE $ S =i DEDUCTIBLE $ RETENTION S $ WORKERS COMPENSATION AND X rT~N:'Ws I \V~:t B EMPLOYERS' UABIUTY 1600067-07 07/22/07 07/22/08 E.L. EACH ACCIDENT $1000000 ANY PROPRIETORIPARTNERlEXECUTIVE OFFICERlMEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $1000000 II red c1ascribe under S 1000000 S ECIAl PROVISIONS below E.L. DISEASE. POLlCY LIMIT OTHER DESCRIPTION OF OPERAllONS I LOCAllON81 VEHICLES I EXCLUSIONS ADDED BY ENDORseMENT I SPECIAL PROVISIONS Proof of Insurance only. CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPlRAllO DATI! THEREOF, THe ISSUING INSURER WIU. ENDEAVOR TO MAIL 30 * DAYS WRITTEN NOllCE TO THE CERTIFICATE HOLDeR NAMED TO THE LEFT, BUT FAILURE TO DO so SHALL IMPOSE NO OBUGATlON OR UABILlTY OF ANY KIND uPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTH0R2EDREPRESENTA~ CERTIFICATE HOLDER City of Dublin ACORD 25 (2001/08) @ACORDCORPORATION 1988 ~TATE HOME OFFICE COMPENSATION /FURND HERE ARE YOUR NEW RATES FOR THE PERIOD INDICATED. IF YOUR NAME OR ADDRESS SHOULD BE CORRECTED OR IF INSURANCE IS NOT NEEDED FOR NEXT YEAR, PLEASE TELL US. CONTINUOUS POLICY 1600067 -07 SAN FRANCISCO ANNUAL RATING ENDORSEMENT IT IS AGREED THAT THE CLASSIFICATIONS AND RATES PER $100 OF REMUNERATION APPEARING IN THE CONTINUOUS POLICY ISSUED TO THIS EMPLOYER ARE AMENDED AS SHOWN BELOW. PACIFIC CHAMBER SYMPHONY CALIFORNIA 1155 E 14TH ST STE 215 SAN LEANDRO, CALIF 94577 PERIOD 7-22-07 TO 7-22-08 IMPORTANT THIS IS NOT A BILL SEND NO MONEY UNLESS STATEMENT IS ENCLOSED rHE RATING PERIOD BEGINS AND ENDS AT 12:01AM 'ACIFIC STANDARD TIME DEPOSIT PREMIUM MINIMUM PREMIUM PREMIUM ADJUSTMENT PERIOD $749.00 $215.00 SEMI-ANNUAL R NB NAME OF EMPLOYER- PACIFIC CHAMBER SYMPHONY (A NON PROFIT ORGANIZATION) (A NON-PROFIT ORGANIZATION) CODE NO. PRINCIPAL WORK AND RATES EFFECTIVE FROM 07-22-07 TO 07-22-08 PREMIUM BASIS INTERIM BASE BILLING RATE RATE* 9151-1 THEATERS--MUSIC ENSEMBLES--ALL PERFOR- MERS AND DIRECTORS OF PERFORMERS. 40000 2.00 2.00 ********BUREAU NOTE INFORMATION******** FEIN 943105631 TOTAL ESTIMATED ANNUAL PREMIUM $800 City of Dublin . Fiscal Year 2008-2009 €.. '~"" . "."", 'f) , , /1' Application for Funds ApPLICA nON VERIFICA nON I attest that the information contained in this FY 2008-2009 grant application is accurate and that the funds requested will not supplant any other monies secured by the organization. Attached is a resolution, letter, or other document providing evidence that the Board of Directors approved the application as submitted. Successful applicants are required to submit a summary report as soon as possible after submitting the reimbursement request, but not later than August 30,2009. Failure to submit a report will result in ineligibility for future funding. Signatures:/. ~ . ~~ /:::7:;~1~ / L----..~ 7 { I If'J< 1/2""' fi T Date Board President/Chairperson SECTION 2 Page 12 of1? INTERNAL REVENUE SERVICE P. O. BOX 2508 CINCINNATI, OH 45201 ~f /""'"-~'."'''' / I.. \ .\\ l I 1'1 DEPARTMENT OF THE TREASURY --- Date: DEe 292000 Employer Identification Number: 94-31.05631. DLN: 1.7053276055000 Contact Person: JOHN J MCGEE ID# 31.1.69 Contact Telephone NUmber: (877) 829-5500 CLASSICAL PHILHARMONIC OF NORTHERN CALIFORNIA 1155 E 14TH ST 215 SAN LEANDRO, . CA 94577 Addendum Applies: No Dear Applicant: We have considered your application for a group exemption letter recog- nizing your subordinates as exempt from federal income tax under section 501{a) of the Internal Revenue Code as organizations of the type described in section 501. (c) (3) . Our records show'that you were recognized as exempt from federal income tax under section 501 (c) (3) of the Code. Your exemption letter remains in effect. Based on information you supplied, we recognize your subordinates whose names appear on the list you submitted as exempt from federal income tax under section 501 (c) (3) of the Code. Additionally, we have classified the organizations that you operate, supervise, or control, and that are covered by your notification to us, as organizations that are not private foundations because they are organizations of the type described in section 509 (a) of the Code. Donors may deduct contributions' to your subordinates as. provided in section 1.70 of the Code. Bequests, legacies, devises, transfers, or gifts to your subordinates or for their use are deductible for federal estate and gift tax purposes if they meet the applicable provisions of section 2055, 21.06, and 2522 of the Code. Your subordinates whose gross receipts each year are normally more than $25,000 are each required to file Form 990, Return of organization Exempt From Income Tax, by the 15th day of the fifth month after the end of their annual accot.mting period. If you prefer, you may file a group return for those sub- ordinates that authorize you in writing to include them in that return. If you are required to file Form 990 for your own. activities, you must file a separate . return and may not be included. on any group return that you file for your sub- ordinates. The law imposes .a penalty of $20 a day when a return is filed late, t.mless there is reasonable cause for the. delay. However, the ~mum penalty imposed cannot exceed $10,000 or 5 percent. of your gross receipts for the year, whichever is less. For organizations with gross receipts exceeding $1,000,000 in any year, the penalty is $100 per day per return. unless there is reasonable Letter 2419 (DOjCG) -2- CLASSICAL PHILHARMONIC OF NORTHERN cause for the delay_The maximum penalty for an organization with gross receipts exceeding $~, 000,000 shall not exceed $50,000. This penalty may also be charged if a return is not complete, so your subordinates should make sure their retUrns are complete before filing them. Please advise your subordinates that, if they receive a Form 990 package in the mail, they shoul.d file the return even if their gross receipts do not exceed the $25, 000 minimum. If not required to file, a subordinate should simply attach the l~lprovided, check the box in the heading to indicate that its annual gross. receipts are nonnally $25,000 or less and sign the return. This will allow us to update our records to show that the subordinate is not required to file and to delete that subordinate from the list of organizations that will receive Form 990 packages in future years. Your subordinates are required to make their annual information return, Form 990 or Form 990-EZ, available for public inspection for three years after the later of the due date of the return or the date the return is filed. You and your subordinates are also required to make available for public inspection your group exemption application, any supporting documents and this exemption letter. Copies of these documents are also required to be provided to any individual upon written or in person request without charge other than reason- able fees for copying and postage. You may fulfill this requirement by placing these documents on the Internet. Penalties may be imposed for failure to comply with these requirements. Additional infonnation is available in Publication 557, Tax-Exempt Status for Your Organization, or you may call our toll free number shown above_ Your subordinates are not required to file federal. income tax returns unless subject to the tax on unrelated business income under section 511 of the Code. Each organization subject to this tax must file Form. 990-T, Exempt Organization Business Income Tax Retm:n. In this letter we are not determining whether any of your subordinates I present or proposed activities are. unrelated trade or business as defined in section 5J.3 of the Code. Each year, at least 90 days before the end of your annual accounting period., please send the items listed below to the Internal Revenue Service Center at the address shown below. 1. A statement describing any changes during the year in the purposes, character, or method of operation of. your subordinates; 2 - A list showing the names. mailing addresses (including Postal ZIP codes), actual addresses if different. and employer identification numbers of subordinates that, since your previous report: a. Changed names or address; b. Were deleted from your roster; or c. Were added to your roster. 3. For subordinates to be added, attach: a - A statement that the' information on which your present group exemption letter is based applies to the new subordinates; b. A statement that each has given you written authorization to Letter 2419 (DO/CG) -C-/. ;j' ,,fi -3- CLASSICAL PHILHARMONIC OF NORTHERN f. add its name to the roster; A list of those to which the Service previously issued exemption rulings or determination letters; A statement that none of the subordinates is a private foundation as defined in section 509{a} of the Code if the group exemption letter covers organizations described in section 501(c} (3)i The street address of each subordinate whose mailing address is a P.O...BoXi and The information required by Revenue Procedure 75-50, 1975-2 C.B. 587, for each subordinate that is a school claiming exemption under section SOl {c} (3). Also include any other information necessary to establish that. the. schooL.ifLc.omplying wit.ll the_requiremelJ,t;.s of Revenue Ruling 71-447, 1971-2 C.B. 230. This is the .,same information required by Schedule B, Form 1023, Application for Recognition of Exemption Under Section 501(c) (3) of the Internal Revenue Code. c. d. e. 4. If applicable, a statement that your group exemption roster did not change since your previous report. please mail the information requested in this letter to the following address: Internal Revenue Service Ogden UT 84201 Your Group Exemption Number is 3680. Your subordinates are required to include this number on each Form 990, Return of organization Exempt From Income Tax, and Form 990-T, Exempt Organization Business Income Tax Return, that they file. Please advise your subordinates> of this requirement and provide them with the Group Exemption Number. If the heading of this letter indicates that an addendum applies, the enclosed addendum is an integral part of this letter. Because this letter could help reaol ve any questions about the exempt status and foundation status of your subordinates. you should keep it for your records. If you have any questions, please contact the person whose name and telephone number are shown in the heading of this letter. Sincerely yours, ~71t~ Steven T. Miller Director, Exempt Organizations Letter 2419 (DO!CG)