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HomeMy WebLinkAboutAttch 2b Chabot-Las Positas.,~ iv ITY OF UBLIN COMMUNITY GROVP/O~RGANIZATIONAL -~ ,. ; ~ ~,~ ,. ~ ,~ = ~~ ~ ~- ~~Y~~^ F IiJNDING RE~;QUESTr~,~,~`~ ~ ~.. ~-t. ~, ~ , ' ~r _~ ,! f,~r ~ ~i 1' j'~ '; ~, }.,~ ,~ ~ , ~ ..,=f ~ 4 ~ ~,`~APPLICAT-ION PAC~KE~,T`r ~;`~ ,, ;~~ ~~:~ . ~ ~ ~, ~,~ ,; ~~;, ~'~ f ~=- ~=,=_-- = `~-:; _,~~~. r~ '';ti ~, 'ti,,~ ~ ` , ~` ~~ } `, , ` > r _ °~,~ ~ l ~ , - -~ ''.~'~,. `• w, ~*` f,~'~f _ ~ ` ''`'ti .~~ ~r , ~ ~ ~,-' ~' Fiscal .Yea~r 2010='2011 ~~`~. ~~~ .~. r ~ ~ ~ ~ ~~,, a~r [ ~~ ~'~' ~~~ i ; , ~ '~ ~~ , r . ,,~~ ,~ 1~~,,t ~ ~~,, ~',• f,,~.,r I ~ ~~, '~ ~ '~ . ~ ~ ~ ~ t4 1 ~F' i'~ ~,, ,_ '1 ~, f's ~~'~°--.._ ~ 1 ~I ~ ~ ~~ l I ~.?~ ~ ~ ,f _ ~lyt ~~ ~ ) ~ ~ ~ ~~ ~ ~'' ~~- ;,r' ~l I~ _~ I ~ '~ ~44 ~ i ,' i~ ~ ~ ~~ ~~ ~~ ~ ~ ~~+ ~ ~ ~ ~~ ~'i'~-i ' ~`'i 'i ' t ~ ,r ' 1 i( r i-~ 7 ~ t' _ t~l 7'i ~ ' t ; ~ _ i li ~ r~ ~ ( j I~ i~~ d~W~ ~`~.~ti ~°~.~ ( ~ ~_ ~,r f~" ~~~_'4, SF -~ ~ ~ i ~I ~ f 1 1 ~i F ~~ ~.~~~'~ ~~' ~-,. ~~ ~ ~ ~ 1 .+' ,,'~ y~ `+, ~~~ I ~ ~~ ~~ 1 I ~i i~ ~ I i~ i~ '-~~ t~l I ~~ !1 r i~~ ~ ,~ ~ ~ i ~ `~~ .~``~ ~' ~``~,, ~~~~ I a ~~~ L_, ~I ~' .-~ ~ t .° .~~ (' ~ _~:~E y ~ ~ ~' -~ `~ ~~ ` ~ ~ l-. I ~~ r ~~^; ``~ ~ ~ jl ~ ~ ~~ ~ ~ ~ ~ ~~~~ r~ ,~ ,a .~,° _ _ ~ ~'t ~~~'~II` '! ~, I --~(~~ I~ f~ y~I. ,~ ~ ; I ` ~ I... .~ ~~:J I ~'~:•-,,_.i '~ ~ ~l4 ':II )~ i ~ I ~ ~_~ ':J~` 'i ~,,~~ Y --'-~ _' ~ I Y~``-~' ~ ~I ~ ~~ ~l i ; ~~`.~'~ I ~~ , -- ~ f ~~ I~,~ _ .~ ~ , ~,- ~ , . ~ ~ I I 1 I ~V ~( ~'4' ~ r,~~ I I `.~``. ,. °`'"`c4 r r r~ 'ii~l j (l ~;_'~ r 1( I r ~ ( ~ : ~ 1 I ! I ~ 1 ~ ~`~,~ .r ,' ~ } ~ ~ .. ~ ''~ ~il ~ i I ~ ~ ~. ~ ~ ~ 4 ~ ~; ~< ,,~' lr ~ ; r.~ `'.., ,, , , ' `, ~1 ~' ~~ ~ ~d ~i 1 ~i ~1 ~I - --' ,~" ~---'~ i`'~ ~ ~ti . _..._~" ,~~1 ~~~ i .~ r ~ ~~ f ~ ! ~ t ~ L~i ~ tf ~ ~ "~' F _ 1s2=~1 4-0 9P03: 07~~`RCV~D ' ~' t ~i i ,~ ~`t. ~`~r I {` r *~ , , ~, ~ ~ _ . ~_ ~ f~ r , r ,,' ~, '.i ~!. ~ ~ ~L ~~~4 i ~ y "'r ~'~ _ r t y'~f ~ ~ a~ J~~ ~i ~ ~ ~~S 4 ~ 1 -~ ` -~ ,r ~ ~, f ~~ r ~I J ;,, ~ ti ,, ti4 '~,~ 4~ ~,;,~ ~; `~ _ ~~, _ ~~ ~' ~'~ ~~ a' ~' r' ; r` , .. ,~ _ 4 t. ', ` ti. _ . 3 ,r' .. ~ ~ ~,' r,' ' , ,' 'ti ~ ~ ~~` 4~ ~'~r~ ~ ,~'`~ ,~ ''~~ `~~ '' f ~.~- ~~~1~ 5 ~4 h ~ y. ~ .4~ ~ ~y {f' r`~ ~~f ~ A~~'` :i ` . ..^ `-y `S~ /' ~~rr y ,F .r ~ \l , 4' ''~ ~. ~' ~ ''1 ~ ~.~ Y F ~•F r- 4 ~h~,-, s ,,- .-~ _ ,..r~,~. ~ .~ . . '~~ ~ ~' ~ ~' .r .r ~ r,. ~.~:: `~.,,_ _. +'~rr: i r ~ ! ~ ''- ~ -~ .' ~~ ~, ~ ~'~ ^~ ~ ' ~ ^ '"'~~ ~ }~S l l~ ~,`-,~ i ,r 1 -~ ~_ _ ~~ ~ .. ~ . ''~ ~. ~ ~ I S-L. -- __ . . . = "` `;~ ` , ! ~~ - I, 'Jr ~ ~ ~ 4` ~, ~ Ji r.a ~` ~ .... ' , ~.,i.' ~S ~ f .1 ' k" ''h.`' :~ .=~' ~ ' ~Y I ~-' 7 r ~, r""-~. -. l ~'I~ 1i :i'`~~-, `"~' f ~''''~'"_ ~~ ~ ~~ ~'~,~ ~~ 1 J ~I ~~~~~ ~ `~ 7 ~~ )~ ~~~ ''`~.~1 ~ ~-}F,~^ ~. _ ~_ , ~ f 1 t ~~ f 1 ~ 1 ~ ~:' :~~ `',~ ~.~„r ,~~__,'i ~~ f ~ ~ l i ~ ~~~ w d.,- _ ' ( ~ ~ ~ I .~ ~ - ~ ~-r"r ~`'~_ -~-_ ;~ t S ~~ ,r,:` ~ ~~ - '`ti `~. - - - Section 2: Application for Community Group/Organizational Funding SECTION 2 ~~~ ~~~~T Page 1 of 19 Z~~ I~ a~ CITY OF DUBLIN Fiscal Year 2010-2011 __- -- ;~ .-_ _` ~ _~- _ r._ _ ` C OMMUNITY~ G1ZO~UP/ORG: F.'` '`I It~~ f I I(~ ''I' ~ ~~ ~.~AP,PLICATION FOR iF~ r. ~ h'~ '. a `,, r''.~'' , ,,,'~ ~t ~, ~ ,. ,~~ ~ `~,~ ~w ~ r.~r~ ~____~~ ~. ,,,~. ~ ~ ~ r~' ` C OVER 'P~AGE ? Y,r~' r 4 _...~ l ~ i ~ ~f ~''~` ~ ~ . ~ - ,{ ~~ ~ ~ ~"~`' r~,,~`~ f ~ ~ i ~~~ ~ ~`~ ''~t'``~ ~ ~ ~4~. ~ ,,, ~;d~ ~ ,,~ ~. _ ~ ~~~. i ~ ' ~ ,~`~'~ r ~ ~~ ~ ~ , ~,~ ~~ i ~ -~ ' r ~'~~ ~~~ i'-7 }~r`~ ~~ E~ ~''` ~''-~,` ` -~ 'r~ ,~' ~' ~ ~ ~~ i f t ~r ~~~' ~~`~~' ~ ~ ~~- ~ ~ --, ~.rJ~ -~ ~-u ~~I i r i ( t ~~ ~ ~ ' ~'' ' ~ ~,t~ i i ~ r r!, r.=.,~ '~, F ~ I j ~~ ~ ~~ ~ ~~ '~~ _ '~ l ~' ~`~ ~ ~ ~,~ f`. AGENC~Y~'~NAIVIE : c~~iaBOT iAs`~P,~osiTas Go~uN~ n I ~ , ~ i~ ~ '~ ~' !r`J ~( i ''. ' l___; IX ~'' ~' ~ I tr ~i ; i,`` .~` ~ TRI-VALLEYvQNE-STOP CAREER G] ~, ~ ~ , - ; ~ =,~,~~ )! ,~ !~ r, a a j ~~ L~ ~ ~ -~ ~~ ~ _ __ _ ~F L.--_ '~1 TION ti ~DS Y,-~~. ~~ rF ~~ f ,, -~.,~~~ ' ;`~ ~~~,; f • , ~. ~ .~ ~ ` ~~, i ~, ~ r ~ ~1 ~ . ~;~~ ~ ~ ~ ' , ~~ ~ ~~ ~~ ~ ~`~: '~;~. '~ ~ !r:f ,,~, ~~.~` ~'i~~~ ~~ ~ ~ ~ ,~4~ i -, '~~~ ~~r~tif ~~'~ ~~ ~~ ~~~ ~', ~~~~ ! ~ ~~~ t I i i I ~y 'yt ?~ ~t ~~ `i ~~ ~~ ~~~i ,,~ `~.., i', , ~, ~ ~ ~, ; f LEGE'DISTRICT/ `" ~ I i ~'• ~ ~~ r .-; JTER ~] ~''~ ~~ ~ ~ ~'_l~ ~ I ~ ~i ~~ ~ ~~~ .,, , ~~ ~ {~ ~ ~~ ,; ,, ~ ~ ` j ! ~,~~``~~ ~ ~"~~. ~ - - ; `_ 1 ~ - ~ ~ ~ ~ ~ ~ i i~, '1 I :~ ,~'" ^ ~ J~ ~ ~ '~ ' I ~ _~ i~~ ' _ I r" i ~ ' ~ ,t'~ i i i i ~ ~; i ~ ! i i, ' ! ~~ ~i ~~ ~~ ~ `~`,~, ~~ ,,~ ~ ~ `~-~. ~~ ir, ~ ~ ~ , i ~ ~ i PROPOSED PROJECT/PROGRAM~~N~A~1VIE-:r,.,.{f ?~~' ' ;' ' ~` ,' ~'.,, I ~. "~ ~~ !' ~L !~ ~~ ~I. ~ ._ = r . , ;~ ' -.... e. ~J ~ J iI J 'I ~~ f , ~ ~ ~ ~ . . ~ ~Ir ~ I I •1~ L i 1 L~i~~ a r ~ ~~ ~ CITY OF DUBLIN=EMPLOYMENT AND TRAININ,G SERVICES ~~`'~ ~{ ~ ,;r~ ~' , F ~ !` ~' ~ ~a 5 ti ~ i ~ , ~ ii ~ `~ ~ ~ 4 '~.~ ~ ,, '' 1L. 1 ~, ~` ,~ ~ y ~~ ~~ r ~~ .,'r ~ ~ ~ ,~ ~ ~ 4 ~ 1 4 `~~ ~ ~ .,, r `' ~, fi ''t , `~ ~ ~ ~. ``z ~ `~~ ,r',~ ~ r , ~ i ~' `~'S 4i~ '., `.~ ~l~e, ``~ ~_ ~ }f i ' , ' f~ ~ 'f ~IIt,'( , ~~ ~ 4 ', 4i. ., , ~ 5~.-~ -~ ti.~ { ~ '}``~ ~~' ~/ ~ , f t`. +~~ f ~~ '~, ``.~'~r`' '+. ~ ~ ~ ~:;r ~'~-f~ ,` ; ` ~.I r ~ .4 . . /'. ~ FUNDING AMOU~NT~-REQUESTED: $15.,0oo~`{r4 ''~~~-~~ ~~ ~'f '~ i r'' ~ ~ _ -- _ _ , ~,~ ~ ti 4 f '*``~ ~ r' -~ ~ ~ ~' . _ _. ~-- . .r...- _ ~ ,'' ~~ . ~y ir ~ y , , ~ ` I ~,1 ^'_ r ~ ~ 4 '~ ~ . ti,~,.~ "'`'~ : ~ 7: ~ ~~ ~ ~ .~--` ~'1 ,- ^'i•t ~ -~, --~..~1~ '* •:,~ ~ "~ -~~ f i~ ~( ~ f `~ i I ~ i r~' ,,,~~ ~ { ~ ~~ ~~~ ~~ I ~ h!~~~i n`s ~ ~ ~,~ i "~..~. .~;-~_ ~~. ~ ~ ~ I ~U ~ !~ ~ 1 w ~~' ~, r~ ~~ -~^A=~ s J~ I~ 4,. ~~ ~] i'~~` _ s~-~'`~~ _ ~--,` _~, '~'-_` } - SECTION Z Page 2 of 19 ~ iv CITY OF DUBLIN Fiscal Year 2010-2011 APPLICATION~=FOR FUNDS ~:~~~ + -~_ -~ iV, ~ ~ `~- ~~ ~= - . ,. r;-~ ~ ~~ ~ ~ ~ >> > ~ '~ `~ ~ ~ ~ .~ ~ `~ 5 ~ ~ ~ ~~ i ~ ,~ r S ~ ~. ~~. i. Please select~one,Cexpense category i~ i0 C,apital,;~' XsOperating s• _ =' J i' r ?' F~.~ 1~ ..4 ~_~ _ _ ~~ ~ i ~ '~: ., +~'' 1~~ ~~'`~ ~1,1 ' ~ _ . - _ ., !, f T r '. . ,r, ~ --- '~-_=.~ ;~ r ~ ~ ,~~4 'rt,~,, 2. Applican't~`vInformation: ~`~~. ^~~~.i '~= 'f . ~'s' .~ .'~ .,'r '4,~ d'' .,'-.r ~:' ;• ~ `~.~'`5, '- ~`_'-y ~,. .' ,~ if~'~~~ ~.,'J ,,'-,~" ~ y . ~ ~ ~ F f ~' Orgamzation/Agenc,y~Name Chabot,-rLas,Po'sita's rC'ommunity,College ;~' ~~ ~` Tri,Valley One=Stop~Career''~Center ~ ~ , -, , ~r+-., ~~,f ~ a ~ ~L. ~ ~ 4 ' t A.'~` ', :~`` r r i f ~ ~~ ~1 ~ ^'~ ; .i r~. ~ - ~ ~ i~ ~~ ~~ ~~ ~~ r~ f~jr ~~ ~~``sy~~,~ ~ ~ ~I ( ~ ~'~1 .~'`~ ~~ Mai'ling Address~ 5020 Franklin Drive, Plea~ ~ ~~ ~~ ~~~~ ~~ ~ ~ ~, ~ i _ i ! 'r 'J~ ~ ~ ``~;. ~'~, `2 ~ `,, Str~eet~Address,~~5020.Franklin~~Drive-- - -- ~` ~ ~ ~='1 I~ I ~ ~ °~ ` ~-"~-~~ '.'f ! i ~ ~ j il I~ ~ i' ~_ ~ ~ City Pleasanton '`~ Stat~te CA Zip 94y' ~ ~ _ , ~i f~ ~~I ~ y~ ~' ff j ( ~`^ ~~ ~ i ~ 1 ~~l ~ ~~ ~ ~ li ~~ ~~~~~ ~'' ~ ~~ ~ _, ,~- DeR' nn ' P 11 d Ph D'~ ~,-~~ 8 ~. ; ,?';.'r,~ ( ~ . , .t ~.~ r` ~~~,r~ ~;,' ~F ~~L~~~u~ ~~ ~'`'' _ ____~ i ~ ~~. ~''~. - --~ `` ~ '~ ~ ~-- . ! ~ ~ ~ i ~ :4~, _._~.~._~ ~~ ~ ~~ - .5' ,f •,•4. 'y~~~-~ _'f~ 7'~ io ~ e ,o ar , __ _ `~~~-~~~-~.,., 1 I F 1 1. . ! I I I. ~ ~ y t ~~, 'Presidentt~~;~,. ~ ~' ~~`-=~. Work Phone ' ~ ,, ~, ~ ~ ~. ,t ~~, ``'~~ ~ ~ ~ i ~i ~ ~ lr ~ `ti _. ~' _ ~ ;Dr. H~al~_G. Gin 'ti ~`~`-~ ~. -~~ rr `, t, `, ~' 4 y t 4~ •,,~ __._ Y_ ^~ .~'''~,~` , Board Presiderit (if~appl'icable) ~`` WorkPhoner , -r~' :: ' 4 ~ : .~_ ,.,.,~ ~,. ,~~ ~ ~"t If you wisl%to;contact a-mern~ber of the Board`o.f Tr'ustees or the Chancell~ ~t'~,`4. ~~"~~ ~1; `~~-._ ~'~. ~ r.~.'`~ a,.,, 1~~~,~' Bailey, Executive Assistant~to t~he~Chancellor: -(92~5) 485-5~207 ~'=~4ti ~ ~ ~. ~, i . ~ ~ r_. ~4 ~, t ~: Please list the PrimarytiPro~ect Contact Person wlio=would~be alile to answer~questions al r r proj ect/program during theti fundi'ng ~period'. ~ ~`~ , ~ ~ ' T= ~, z `~l ~ `~`' '~S'-~; T ~ti '~~~ s'' ~'r f ~~1 ~t'F ~,-ti i ~ i John Alves ~, i ~ 4i ~ ~~4 ,}r ', ~f ~~ r~ Director') ~ ', ~~---~')``~~,`~-.`~`~ ~J `s ' ` 7 _ J-r--~=- ~ti; ;~ , ~ ( ` Contact Person for Project/Program: _ s__ ~- Job_Title`~ ~~' -- (925, 485-5266 Work Phone jalvesn,clpccd.arg ~ ~T (925) 485-5273 Email Federal Tax Identification No. (required) 94-167063 City of Dublin Business License No. (required~ 10043 Fax {~_. ,~ ,. ~; ~, , ~ ~ ~ ~. ii -`~~ > > ~i l `I ~I ~ t ~ ~ ± 1 t t ~ I~ '~ '?~ ~~ 1 ~ 'I ~ i I ~i t ~ t ~ ~t ~~~ ~ I~I t_~ ~~ I ) if~j~i '-;,'' ~~ h` r~~( i ,~ _ ~ ~i i~ ~~ '~ ~ _ ,'f ;I I I I ~r ~, ~~ ? ~~ ~ ; ( ~ I~ ~ a , _j ~ ,~ .I _~, ;, r ~ ~' ,J ~' f , ~ ,~ ,~ ; ~srt f ~, .~` ~'~ Bev application and SECTION 2 Page 3 of 19 L° P ~A City of Dublin Fiscal Year 2010-2011 Application for Funds 3. Proposed Project/Program-In-for-mation_(po not describe organization.) ,t- --7 ~~J,'~ i_ _'_ ^ Y i Ir ~.~',~ ...}a ~~~ ~' i' ~ 3 =~*~-. Amount of Funds Req~uested $ 1~5,,000 `' i~~ ~a ~ ,i ~~ ;1~; ~`~ ,~'~;~-, , ~~` . !! `,. ~, ~, ~ ~ .~~ ~ ~ i ,+r ,!~ ~ .,. 'a~... r (Maximum $25,0~00 per pro~`ect.) '~`_ ~"~ ~ ~ _ _ ~~ ,~~ ~~~ ~~ ~~;~ ~ : ~,.ti '~~, ., ~,y~ ~ ``~ _ ~ .,:~'`~-; ~`` - ~;~` ~ ~' ~;;~ .~"~';.~ ,~ ~,~~ ~~,,~; ,"~ ~ ~-~ ~ ~'~ =~ . ~ ~ ~'f~s` ~,.f~ ~ ~~, ProposedP o~ect%Program~Name: ;~-~` `"~'~ ~: '~`_~, ~~~,~ ` ~';~'`~~y ~ ti f ~ j~'_~.~ ~; Citv of D,ublin Employment and Train'in~~Services-~ '~1 ~~ ~~;~,,~''~~=rff ~~r '~ t'; L ~' < I I ,rrr ~ ~ Fs ~y,v, `4ti. ~' . -1~ { {{t -I L ~ ~~ ~` ` . ,l '%J` ' ~~I t'~ ~y . /R ~!(' f ~ 1 ~ ~~rl .._-. r ~Y~ ~ ~f ~, ~__ ~ I ~4 ~~ I~l Propose`d P-.rojectGProgram Date(s):' Start _~07/O1/20"10.~'~ arid End 06/340/2011--, i;~~,~~'~~ ' ~ ~ k' ' ~~~ ~ ~ -~ ~ ~ ~ = ~ 1~ t~ I ~ 1-' '~ -_:~_,~.~ I__' ~.."_ ' i~ ~~~`- rl, l t~ i~', i i i( ~~ ~ ~ i ~~ ~` ~~ ,r'. _~~, ~~I ~ 1T10~. C~ay ~yT:'~ `~ffiO. C~ay', ~,~!T!i `, 'i ~ `i ~ ~ ~ ~ ~ ~ ~ j~ ~ `~ ' 'ti ~,, ~ ,,r`~~~'',~ ``~ ~i~~ ~ ~ i i ~ i ~ i ~~ i ; t ,i '~ ~ I ~ i ! : I ~ i_~ i ~~ r rr`~ J, ~. I ''`~ ,,~` ~'`w ~'~ ~~! ~~_~ i ~ . ~ ~ ~,,r'' ~•' t~ ''~,~ E. ~ i ~ i ~ . _ I - Y`` I ~ r ~y ' ~ f ~- `~~ I !. ~~ ' ~''f-~.iS ~~ r''~ p~~ ~ _~~ ~ _ _ ~ ~._. . I. ~~~`-~.. . `'. ~ I~',~~I~ ~'~i i~ Please note: ~ Cityr'Council~ ~ i ~ needs ai 100% dis~ `~_:- ~ ~ `below and provide ^ Agency~iis re`questing 1 ' ~~ ~~, If selecting this op ~ ~, ~, ~, , << ~~ ~, ~ ~; X Agenc`y'is'~n`ot~requestin ',' ; ' ~ `~, '~ ~', ~, '~`!, y ~Please nrovide the Grant Funds-ar-e-distnbuted on a re ursement~at-the beginning'of the Fi~ justification fo~~his need . ~ . ~ )0% disbursement at the begimm~g~ `4,~~ _.~".~ ~,`~,,~~ I, ~ ~ ' tion, please provide justification iri~1 ~ 100% disbursement at the be~inni asis. ~If your Age i cy << ~e indicate`~thrs_ ~ ~~~~ ~.~r~ _r~~ ~ I ; f the Fisca~l`Year. ~~~~ ~~ ~~ i ~~~~~ ~ ti_ ~ i ;~` , ~ t J; ,' ~i nianic space of the Fisca l'o'vu ~~ ~ J~ ~' I~ ~~ ~1 ear., ~ ~ ' ~ ~ , , , ~'' r~ .f ,' ~ ,'~ te~City in,',the '' ,~ ,~ r `, ,f' ~`` ~'` 1~~ ' ~ ~ ,~ f ~ ~ ~~ ., ,,~. , 'requency that reiiiibursements will' be submi e. monthl ~'` uarferl 'at;~ ject com letie g•~ Y~ q. Y~ p ~ P ~ ~, =~: : - ~= ,.. ~ ~- ' ,., ~~ ~-ti.,. ~. , .l'~'`~ ~.' ~t. ~ i~-z, ~ ` J ._.~'-```~-''.~, ~ ~~~C~',~ z... We respectfully request the funds~be_dispersed-morithly. _~~ ~- ~ ~ ~ ,, -- ;' " ' ;~ -, ~ 5 ~ I ~,,' ~ _. . - ._ __ ~ = ti ~~', , ~~ 34, ~r 4,, ''~`` ~ -~,. ' ~, ~ -_ _ ~ ~, ~~,, ~,,, 4~, s,.; '+'`ti a ;~~ ~ ( ~~ ~~ ~ I ; .~'--'~ .~l ~~~` ~ ~ ~,, ~• i i , ,.~ ` ~,.,,; ,, ~z-~ ~.~ ~ r ' ~~ ~~ ! ~ ~-'~ ~~ i~ _'~~ ` ~ Et ~~ ~i' .` ~ -~`.. i -' ~ f ~1 ~ f r~ ~ 1~ ~ lLy f' ~ ~tl~ ~ r`~ i ~ '~'` '-,_.~~ c` _J! I ~ ~ ~ - '~- ~' --1-'"r =.,-,= ~,f , ~ ~ I, 4 ~ , ~ , _ j~ ,-~ __ - ~ ~, ~y__ _~ . , - SECTION 2 Page 4 of 19 eu ~r ai City of Dublin Fiscal Year 2010-2011 Application for Funds a. How would the requested funds be used? ^ Describe, in detail, the PROPOSED-P.-ROJECT/PROGRAM (not the Agency). ^ Bulleted text is acceptable , ; ~ i, ~1 ~ f- ~-= . ~ ^ Identify if therproposed pro~ec~ ;program.is a riewjs~~ervice;~or extension of an eX1StlTlgrOlle, ~`~ ~~~~ :'~' ~ ~, 1~ ~ ~ ~' " ~r~~r` ,~''_~'~~''.,',` ^ An additional,page may be-aclde.d; if_need'ed ' X ,';'~ ~~t' ; ':~ ~; `~ ~ '`~- .r ~ G, "~ ~ _ ~ _ °s' ~ ~,,~ `' ~i '` ti : ~~~-•` k ~,~,`~,~ _ ~,~ ~ ~ ~ .~ f ~~, ~ Please ,r r',~ ~.: ~'t ~~ j ~~ ~~ ~ I~ .fr~ J ~~ 1 l i { 1~`. b. i i' ~' Hqw ;wou' '~i ~~,~; `'r. ~' ~ ~^,~need~ and ~ L ( ~ ~ , needed?~ (. I ~ ~.._., 4 ~ f ~~~~ I ' I I I' l ~.i ~Pleaserrefe ~ i to ~ i--{ !I ~~ ~ ~ ~ ~ ~ ~~ '~i i ~I ~~ ~~ l~ fi '1~~ ~ t f~ i ~} t~~ ~~i 1, ~i i, ii 7 ~ ~t ~'~ i~ ~~ , ~ 1 4 ~, ~ 11~ ~ ' ~i ~ y ~~ `~`~ '~ ~ ~, , 'ti ' `~ ' ` ~ ~ ~. c. What doc~ the ~ ~ jf il Q ~ ~-:,,~ -.~ ,.'`~ J- ~ ~~,~~~~ ~, j ~~ 1 ~~ ~~~ { ~ '+ `i ~'~ `- .v , k ~.~ _y} ~. ~ _ ~~ i ~ ~.4 ~~:~ ; ~ `~±_~?-.~ r ~1~ ,-~-4 ~;~ r~`,,;: ~ ~:~r' : ~~'~ '~~ _ ~~ ~ ~ ~ . r ~4 4. ,,~f' .. ~ r i h ~~. ''~~ ~ j ~~41,~r~` .=F~ f ~ ~'~ ~ '',,, }''~s~' `~'°=f'~ ~ `4,, .,~ ~`~~ h5 'VJL~,L~rxv i L~ l:~l~/YKVITKAlVl aaaress an ur _ . ~ ~ ,~ ~uality of~life for Dublin iesidents. ~'~Why is this~ ~ t ~'4. ~,. I I f 1.,~.~ ~'~ '~, `'~. ~ge'maybe~-ad~decl,_ifErieeded)~ -~~ ~ ~'~ ~_ __~ ~._ ._ ~ ~~ ~ . _ __ " ~i ~~r-,~' f ;; ~- J - - ~ - -! _ i ~+ l a { _. _ _. ~ 1~, ~ i'~_-~~ '~ ___ ___ - ~~-;~ ~x ~ r'J . ~~~r~ - - ~ ^I ~, l ,r i ~ `~. ,~ ,r ~L ;'' ,r I I ~'~t, ~...,y. ~` ~.. ~ z` ~r~ rr~ ," i ~ ~',~ ~,' ~.- - z/• ~ i~i ~_ ,~ ,~-2 _ ,y ~ ~'' ~ ~` ` ~' i r c,~.~~' ~_^ r, i 4 ~~, ~~ r ~., ~~ ~~ ~f ~' ~~ ~, ~, ~ ty - .ta/records,s~upport the need for this PROPOSE~] r,,. ~' ,~~,'.r` VI? Please identify your~data sources. ~(Additio~ ,_ ~. `` ~ ~. ~r ~- ~ ; addeC~; lf needeCl ) ~'` ~ _ ~' ~. ~ ~ 1.;. -~~ ,.<- `~, ~ti:~ ~ ~ ~ ~ ~ ' _~ _ -~ _ ~ ~ ti ~r -~ti __ `~; ~~, i ( ~ ~ ~I -'~'~ ~~ ~ ~i ~ `'S ~ ~ '~~' ~',;~'~~'~t ~ "~~ C J- ; _ - _ - ~; ~' ~. `'~ '~ ~ f ~ ' s~ - ~~ -~, ~t ~11k ~,~ i`„ ,~.~, '°,. ~ ~ 1" ~ : L ~~ i +~ - r f ' P10aSe T0f0P t0 1tt3CI1TT10rit~1 ! ~~ ~ ~ ~~'', rr~' ~ ~ ~ ~~ i i ~ ~, + '~' ~';~~' f ~ ~~f,~'~ titilE ~ ,r ,7. ~-. 4~ ~ i~ a ~ '',~ . ti_ ~J F ,~n j ~~ (~b ~ ~ ~ ~ ~~ L,- 1 i~ `J ~,'=` ~ i { ~ a L z ~- =v~ .~r ~ ;. ',-i:.:`__ ~'' 's j {, 4 af ~`~-=,y ~:~ =.,-- ~ ~._._ _~'~` - SECTION 2 Page 5 of 19 ~~ l i Y ~ ~ ~ ~ ~ ~ l~ 1 ~ ~~l -i ~ l ~ l met, community ; , , „ ~p'roj ect/pro ~gram t ' `" ~I' r`'~ i~ i ~ ~ ( ~,`ti~.f ~ ~ rr ,_ ~. ,~,, rl li ~If ~~_.< < r ~ ~ ~ ' 'I. )J~f ' ~ j ~ .r ' ~ ~ a~~~ t~~ I~ ~~ ~ )~ ~~ ~~(~ , ~~ ~ i r ~ i~~ ~~ i j i~ ~~ .~I ' .~ ~' ~ r~ ~` ~' r 1 `~.~~ ~~,~,~~ , ` f ~'i ~, , ~ ~ ,i , ~ ~,~ p ,~,r~',, ~,",~, ~ lal~pag'e may be s 1 L v an City of Dublin Fiscal Year 2010-2011 Application for Funds d. Specify the PRO Please refer to attachment I. r~'f ~,t' ~~~',-,~ ~'~~ ~tyi ~'-° ,,~ ' ~'` ~ ~'4 , s~X- f` .r_~ r.r , ~,,'`a. . = ?'' , ~ ,r.` ~ ~ ~ ~~ ~. ~4, ~ ~'~~ `- ._ _ ~~ ~f __._- r,r ~~'~` r~ -+','~ e. ~!4r ,~Projects/p.rograms mus ~ i ~ i ~~' i' r',~ _ ~i~ ,' arid~`if p"roject/program- ~ ~ ~ ! i~ ~ ~your~proj'ect/program's J ~ ~r I I ^:`~ ^ ~ =An additio ~ ~ 14 ~~ „ ~ r' ~~7 i i I, ~r ~ I~ '~ ~ ~ ~r ~ jPlease~refer;to att~ ~~ i ~-; I"i 1 j ~, ~ i~ ~~ I ~, I i~!,f ~ ~ ~~ ~ 1 ~ ~~ ~~ ~ ~t I~ i I i ~ fi ~l~ ~~ ~, ~4, ~ ~ '~ ~, 4 ' ~ '~ ~ ~ ~ -, ~~, ~~~i 1 ~~ t ~ [ ~:~i ~ 'ry ti ~ ~ ' 4 ~' ~~ ~ l ~ -~ ~i ~~ ~ 4,~ ,,, ,4 , y ,~~~ 4, ~ ~ 'ti4 4, ti~ ~ ~ti ~,~ ~ , f. Specify'numb~ PROJECT/Pi 1~~, PROJECTIPROGRAlVI=population to be served. -- , r- e - U' 1 i ~,- s~` 1.,' , ,~ . ~ ; '~;~, ,_- ^"~-l i ~ ~~ ( i `~ ) I ~ "ti }, { i ~ ~ ~ j a ~ F~=, ~,. ! i ~~ ~ r.' r` ;~' ~=~,:,~`;";~ ~,4 ~~f _~ ~,~ i ~ _~r'~, f +~` ~~ ` ~~1 '~,`~. , E, ~ ~ ~;f~f, ~~4I .,~'~ ~ ~ ;~ ~~:~ . ~r~-~ ~-;~ ~ -~,.~ ~~ ='~`~~''~'f`~~ -~``+~ ~~ '~. ~'' ~' ,r= ~.~ ,~' ~~ ~~~ ~ '~, :~~,~'~~ F '~` ~'~ .~' '~ ~ r' ,.~~ ~d i~r •~ : ` ; . J , r ~ ti 5 ~ 'r i Yf f,--. ,'''r o- . ~ ~ ~ L J ~~ .i '~ ' . .'~ ti ' ~r~% { ~` ~ ~`~. , y~ ~1 z ti , ~,,f' ~ ~~ ~,c~- - - C', ~ J~ ~~ I ~~,; ~ . r~ , f.- .x'k ~,1 deter`rriine~if tliey_are being carried-out'~efficiently ~ -, -- ~ ~,.:~ : - =~ ~.5 ~ ~ ~ ~ , ~ ~ x , , i ~ i. i et. PleaseFde~scr-ibe,h~w~you pl'~an'to, moriitor~i ~act. ~,~,~ ~ ~ ~f ~'~ ~ ~L.~ ' ~' i i y ~ -. ~ ~'~ ~ ~~- ~ I f ~needed: - ~rv'` ~ ~, ~~~ 5~ ~ ~hw ~ ~ GF ,, ~ ; ,.r ~ t , ~,: ~- ~ i t i~'~-~ ~) ~ ~~ '~~1~ ~~ _ ____ .._ __--~ ~_~ ~ ~ ( 1 4_ r ~ ~ i _ i .r''~ , I I I I~ ~ - ~' ~ ~i i [ !7 ~ ~; I ~I ~- ~ ent I. ~ ~~ ~ ~ 4 "~ ~~_.~ ~~.~ - ,F y ~,~-_ . ~ -~ ,,~ ,f L_ ~~ `` " '( ~ ~ 1 ~ r~ ~I ~`'~. ~''~~ 1 ~' ~~ ~f ,' ,' ~ ,~ ~'~f ~ I ', ± i ~~ ~~~~~ ~ ~. ~ ~~ ~~~~ ~~ .~ 1~ ~~ a1 ~'~ l~t ,. f ~ ( ~~` ~' ~5 ~ ~ i ~ 4 ~~ C ~, ~l ~ ~ ~" ~ ~ ~^ ~ ._._._ ~f" f ~ r~ -'_.~'~{ ry ~ ~ ~~ F j t ` L ` nts served ~by ageney, then by l VI' := ,~' ~' I ,., , , , ~,; . ~~ ~~ ~ r J . ~ ~ r.' ~( f f~ t)' f~ ~'t~ ,~` ~' ~ ~ i , r ~' t ~ r ~f J r~ t ~~' r~ ; r ~f ~ ~ ~ ( .J~~~f ~l f j ~' ,~. f'' r~( . ~f c ~'~ r ~'r t ~ , ~r ~~' ~r~ .OP.OSED ~~.'' ,r ~'Fr ~' ~~ ~ ~ ~,='~; f'' ~- ~: : ~ ~ ~ 4 ~ F ~, ~i r '~' Y 4 12` t~~`4`~ ~ '~ ,~ ~ ~`t ~~' ii ~, j ~ ~ ~ "~ - .- ~' _ ''~ ~ ' G 1 ti~ i • r 1 ~ , ~- ~ ~"-~~ ~~:, > w A enc Partici ant Information ,.__ ~-,,, ~ ,~ ; Y -~ ~ r' I ! ', 1 I 'i ; _ ~ ,.~. - - Total Number of Participants:Served by~Agericy (if applieable) -_ _ _.-_^~ __ /0l/09 -12/03/09 6,553 Total Number of Dublin Residents Served by Agency (if applicable) 7/0l/09 -12/03/09 853 Pro'ecdPro ram Partici ant Information Total Proposed Participants Served by this Project/Program 10,000 Total Number of Dublin Residents Served by this Project 1,300 SECTION 2 Page 6 of 19 v City of Dublin Fiscal Year 2010-2011 Application for Funds 5. Financial Information-~- Operating-Budget~e ~ ,,I _- v _ (_~7 C ~ ' _ 1 a. Expense Budget ~- ,; _,;,_,,_ ,--,; ~ ~ ~~,; ,} ' Sy,4-ti ~ , ~; ~, ~ i ~ ~ ~ ,~ r.~ ~~ 'r~ I ~~ E ~ i ~ ; I ~ ~ ;i~ i ~ ~~',.~ ~'.:f' .sc. I ~` e ~( i.~ ~` f . FY 2010-2011 - EXPENSE BUDGET ORGANIZATION _ THIS PROJECT/ PROGRAM GRANT REQUEST Personnel Costs _ Em lo ee Salaries &'Benefits p y., r ~. ~ .~~~ ~ p .~ - ~ i .340~~~~i~ ,~~''~ '._ . 12~~~~" ~;~r ~' ~ s*r'~ ~'12~0~~ Non-Personnel Costs - - . . , Services~ ~'~ ,r~- & Supphes . ~ ~ 60~ ~15 ~` ~ ~ ' '~ ~ ~ ~ ,F .~ ~ ,~~ 3 000 ~~~, , , , ~ ~'~ ', - 3~,;000 ~ ~ ' ~ i~ ~' ,'~ ,!' ; ` ,,~ ,,' ;~' ,;~~Capital Costs ~ ~ ~,~ ``~.6E;0,00 j~(,,~~'~ ~~ ;;' `~,,_ ',~,, , ~, ~, '~~ ', ', '~~ ~ ~ Ser,vices~'to Diibl'in Residents"~~ ~ ; , ~ ~ ;~ - ~,15 ~ 000 ~ ~,~'' `,,. > ,,~ 1~5 000 '~' > ti ~ '~ 'i ~` ~ ~~ '~ `~' ~ ~ ,~ ' Otlier (plea`se'specifyj '~ ~, ~. ~ ~ ~ ~-.~I ~ ~ ~~'`~'' ~ ~,~~ ~ ,~ - ~ ~ i -~~, ~ ~'`y~ ~ '~ '_ ~ '~- ~i~ ~ ' r'~-.iti ~' `~ l ~ a ( ~ ~ ~ ~' ~TOTAL ~ -, `__ .. ._ . '' ~ 48~9,615 r ~_T ; ~ '~ 1r5;000~,, '~, -- ~ ;) '~~ ~? (~15;000 ~ , ( ,~~~,~~ ~~ ~ ; r ~ o _ ~ ( i~ ~ _.a r I i -~ '' ~, , ~ ~~~ ~,~. ,~~ ~ I ~ ,~~, ~~f ~, '~~ _ - ~ ~-----~ ---- '~~ ~ ~ ~~ ~ , ~~ti :~ ~ ~ ~_ _ . ~ ~ Furtherl ~Comments/Explanations (if necessary)-:., ~~ ~ ~~, ~~( I ~ ~ i , ~'~ I~'! ~ ~~ ~ `,t ,~ r`` .''` ~ f ~ ~ , ,~ ~, ~ ~ ~ • -~ . ~ ~ _ ~ ~ ;. Th'ese ~b,udget~, f gures are anticipated and represent ou~r bestYestimate. ~, ~,~ ,, ; j 1 ( i ~ l ` _~- •'` ~ ~ ( ( ti ~,~ ~`'- - ~ ~ ~ ~ I ( ~ ' ~ ~ ~ ~ 1 i ~ ~i "~ i ~,t ,,' ,,,' ,ra ~ - ', ~ ~ ~ ~ ~~ ~I i ~ ~ ~ . .~ ~ ~,, ~ ~ i i ~ '~ ~ '7`~. '` __~ ,r'` ~--, '* ! ~,s ,~ ~ ,~ ~ ~ 1 i ~ ~ 'r ,i ~ i i ~ t ~ ,~ ~ ~ ''~ ~`t. ~a ~ r ~ ~ r ,r ~ ; 4 y r ,~ ~, ~ F~~ i ~ . `'1 ~ ) f 1 r ~~~~ ~~ i~~ I~, ~t ~~ ~ ~ ~;:~ ~ Ir , t ~~, , ~i. ~E '~',~,. 4 =, `'`'- _._ ~ ~ ~ ~~ ~~ ~r '~ ~~ (' ,''r i. ~ t ~ 't 1~ ~ 'M1'ti ~`~ e1 ~~ .~ 'l,~ "~ f _ _ r%~ F ~ ~~' ° ~ ~~ ~~ f ', ~~'~ ~,~ '~ `~4 R, 4,~ ~'~~ ~ ~ ;4 ~ ~~ ~ ~' ~~ ~ 1` ,~ r s ~ ,~t~ ~ '~ei i i~ y -y ~..,, ~~ `I~.~._ ~ 1 fr~ ,~~a r F ~ ~ f; ~~i4 ~ ~ ~ `4. ~'~'~ t .?~~ ~~ r~''~ ~~ ~ ~ ~~'~ 1~ ~~~~ ~ ~'~ S ti ' ~ ' ~:,"i. ~ ~,f~~, ~r': k~ '4~~ ~ r,-~- ''titi.y. ~.... ~~ ~ ~-~~`` ~ ~'-4,~ .~ f r' F ~4t .r t'.rl' `4 .. ~ `~,'`y ,` ~ r.l- r y 1.~ ~.. ,~~ ~ .. h ~ ~ ~- ~_. ~.r.r' ~ x " i'r 't`'~. > 1 ~ ~f ~1 '~-~-~.ti-_ -- ~~ ~ 'Nihk .~ . _^ _ -- ~. ~ ~ ~~ ~~ ,, ~,~~ ' f ~ ' _ ~ ~ " ~ ~ ~ ti ~;;. , .+~ (_ _ ~ `ti ,~ ~'~ t.m'`~ ~ ~~ ~1~ r'~~ ~ ~ .-- -_ r ',.~; ~,. ~ ~ ti ~1 ,`1 ' ir ~''~ r ~.~~ ( . f~~ ~, ~ 1 t . ti r~ ~'ti~~ :,~, 1 ~ ,~t~ j~ ( ~ ~ ~ ~,'t`~~~ ti,"~ I'r ~~ ~tii~ - ~, ,t ~'~,~~,~ -,~ ~ R r~ ~~~ ~, ~~ ~ j , ~ ~~ ^,i,, ~ 1'~', _~. ;:1 - ~ ~ ._Jr' ) ~ ~ ~ ~ ~ ! ~~ ~,-__ '' --,.' -:`~. ~`-,,,~ , ~ ~ ~ t ~i, ~ r ~ ~,~ _ - = ~" - ~. ``~,.`;. _~ - - SECTION Z Page 7 of 19 ai us ai o~ r v a City of Dublin Fiscal Year 2010-2011 Application for Funds Revenue Budget ~ T ~~- _ ~ T~:f - ~ ~ ~~ ~,-~4- _ _=~ ,''' 4`'1 ,, i , , ` - ~°;~-- FY 2010-2011 REVENU~ BUDGET ORGANIZATION PROJECT/PROGRAM Committed/Restricted Funds (specify source) f y~ x ~~ ,. ~- Alamed'a Count Workforce ~ _ - habot=Las~Positas C ,__ , GeneralfEmpl`q,yment and , ~~~ ~t , ~~~- ~~ ~. Inves~tment~Board~ ~ f~ ~~__. ~ ~ 7 i i ~~ ~ Commu~nity C~ollege . . ,, .. Trai~ning^Services Dislo'cated Work'er Services -332,129 ~~Distnct%Tri 'Valley ~~~, r, '~;< ~ ,~ r< < ~ ~, Adu~lt' Ser~`',vicesl~` ---1'42,4s86 ~ ~ "~ ~ ~ ' ~~f~ ~, ~~ ~ ~ One-Stop~Career--_ , , < ; r,~. ~ ~ ! ~ ~,~~ ~,~ ~~ ~, ~~, ', `~~ ~ ~ ' ,}z ~. ~ ~~ ~ ~ ~ ~ ~ ; ~ ~ ,',~ .~ ,~ ,' ,' ,' ~' ~' ~` ~ ~~~~~, ~ =t'~ ~ ~ ; ~ ~_ ~ .~ Cienter ~~ ,,~`~~~ ~ , ~, ~; , ~ , ~ , ~ ~`"~~ ~~`~. '~, ~~~ '~ ~~ `~ `~ ~~ i. ,~ City of Dubl~in 'r ~• ''~ ~~'15;0,00 Chabot=`Las Positas ~ 'General Empl~o`yment and .,~ a j =~, ~ ~~ .- L ~~ti ,! ~ ,~ : --~c,~ ~~ ~ ~ ~--~, ~Community_ College, 1 T aining Servi City of ces-,- ~ , ~ , ~ ' ~ ~ ~ ~ ~` ~ ' ~ 0 - ( ~~ i ~! '~ ~ '~ I ~ ~ ~ ~ District/Tri-V~al~le ~ ~ ' ~' I~~ , 1 D'ubl`in residerits ,, ~' outh ~ ~~' ` -- _ ~ ~ ; ~ ~ ..` - ~~`` ' ~~ ~~.,, ~~ F ~ I ~` ~ y ti ~ One Stop-Caree'r--r ~ ' a ~ ~ ~ ' ~ ~ k ~ _~ ~_ and'adults) ~`~'~ ~ ' ~ ~ I I ~ ~ ~ ~1.. ._._ ~; ~ , t~, ~!~ ~`~, ~.•' ,,~' ,~'' ~ .... I ._' Center '~ ~ ,, . _ ~ fi`'` ,~~~ ~ ' ,~~ ~ ~ - a ~ ~ ~o ~l ~l ( ~~ ~~ ~t ~i~ ~ ,,:~}`} ~ l ' ~ ' ~ ~ ` ' ~ ~ ~ ,.~ , - ti ' ~ ~i i ~ ~ ~ i~~ ~ ! ~ ~~~ ~ ~ ~~ ~ ; ~ ,I i I i : t / , ~ ~ - ~ ~ ~ l ~ ~ 7 ~~ z .- ~,~ , ~ ~ 4 .~ , ~,y _ .- ~,~ ~._ .. i ,ti ._ . ,~, ~._.~ ~~~ ti ~ ~ ; ~ i , ~ , i ,r'~r~~:~~ ~` ,~~ ~'~ ;~~ ~~ ~''~~ . . r ' ~ {~ ~j ~.~ ~~ l4 ~'~ ~ ~ s ~:,_ ~ ~, ~. ~, ~''t. ~ ~ , ~, ~,,ti. ~ ~ ~' ~ . ~.~ ~ ~ ~-=~v ~ ~ ~ . , ( ~~~ ~ ~fl )~ Jrv~( ~ I ~ ~ , ~ a~ ~ r' , , ~ 'S ~~ ' ~ ~ ,, ~ ~4 ,~i~ ~4 :~ ~~ :. ~~ ~, ~:, 4 .~ 4 ~, ~~ S 5~~. `''i 4 . .~.. ~ fr - ,; ~, f - .~ , ~ ~' ~• r r ft 'r` 3*r ~' f a 1 r ~'~ 1 Non-Committed/Restricted Funds (specify source) ' ..... .. ~ . _ ~ .. ;` _t- ...,v 5.`~. ~ C if ~ i,.`=,. I ~ ' .:?~ ~ __ ~ ' _ -'..._.. ~-_. - ~ - - 4 ._ '~r_ _.. ___..-• .- ~ ~~t. '~ . - 't ' ..~, '-~ ]~,~ `-ti rf ~"~f ~.~ ~'~ .. ~L 1 ~ ~ ,^~ s{ ;~ _ ' ~`~'`` NA ~' i E ~ ~L ~ - ~,, -~ s~ ~ ; ti ; y r.,~` ~-. ~ 4 ~~'`' ~ ~ . ~_ ~ ~ , ~. ~ ',;;~_`"-~ti I~~ ~;~ i.~ (~i ~ r ~ ~~`~- `i'~ ',,~ l'~ II 'j~ f ~ ~ ' `~yr~ ~" ; . ~ ~_ ~ ,~ ~ ~ ; ~ = ~ , i ~ ~- ~_ ~-~- , _ ._ _~~ , -~ ~_. =~,,, ~ ~~ ~ ~~- , - _ !~~ ~! ~~,~ _ ~ ~ ~~-~ ti - - ~ TOTAL $489,615 Further Comments/Explanations (if necessary): SECTION 2 Page 8 of 19 iv _~ °-j __- ~--..1 ~ .~~ry - ~.` . ~''~ ~,~`` '`~`~' J ~ ,ti, ~~~~~''- ,:~ i ~ ~p ~ ' ~ 1 ~ ( ~~ r ~ -~ ~-~-,.~,,-t ~.'~-` 4',j~ ~G~ ~ ~ I j ~ ~~ r ~ r~ lf~ ~{ ~ ';`ti ~ ~~f'~~~ ~~~ ~~ 4 =~ ~ ~ ~~' ~._5- 'f i ( f~~ ~ ~ 1 ~ ~ j. `' ~~ ry~I~Fz _ ' - .' - ~i. "~~r~ ~~ t~ ,j~~ r r ~4. ~~`L F J ` '~ ~. (` ' ` 4. ~ t'~ ~ ~ • J ~ ~~`, ~ ~, ~ 54', ~.. . ~., ~ ..,~jr'~,,~•' ~:,~ `~ ,'r~ ~,,~ ``y~`` ~r'".~` ~ ~. `k~ . ~`'~, _ ''~ r~ ~'~,'ti ~,~ ~'~ ~ ~',. ,~''~'fi ~' ~ ' ~~ '~,4 '~ ~,' ~''~ ~` ~ ...~ '~'~~. ~, r r ti i, '~.~ ; ~``~, .~ ~ ~ ` '`a ,, ~f it~ ~~~ ~ ~ ~_ ~ ~~*rj ~~j 1. ~~,4. ; ~` r~'' --~-i.,_ _'~ ti ~"'. ~ 1 I s. , ~ h ~L ~ ~ ~ -~- ~C F .i f~ Jp r ~~ ~ l ~~ ,r j . ~ ~ ~ ~... _~ ~,~~ ~ ~ ~-l ~~' ( ~ ~y ~C ` - f~ ~ ~_~ I.~ ~ '~:t i~~r -_ -'~~r ~ r ~- _ ~ .~ ~ .5 ~~`~ ~~ ~~ r,~ ,~.~<_ G----,~ ~. ~ ~ 4 t r~. ~'`~ +r ~ ~ 's' ~ ~ ~~ ~t `4~ ' ~ ~ i ' t ~~ ' ° , ~- ,~-~ ~;~ ~ ~~ ~ti~ ,~ ~~5- ,~ a~ , -~ ~~, ~ ~t ~ 1 i ~ -- ~~` ~ ~ - -- ~` -- ,~ 7~' ~ ~i ~~ i~ ~ i f x'~` ,t i I I . i~, i, t~ ~ 1 I ~ ~~ ~~ i~ r~ ~ ;~ ,~ "rl ~ ~~ ~ `r.f ~ ~ ~~ ,~ i -ti ~~~ ', I' i ~ ~ ~ 1 ~ I ~ f ~ ~ f~ '` _ `~, ~ ~~ '~ ~! 1~~ ~~ ~~ .- ~~~~ ~ ~ ~ ~=~~ ~~~ '~~ a~~~~~ ~~``~ ; ~ ~ _ ~~~~ ~~_-~ ~'~~~ ~~~~ ~~i .,., i ^ ,~ , , . ~ ~ . I _ - : _ , ~- ,~ ( ~ ~ _ti ~ ~~ ~ ,{' ,~ .- ~ ~ ~ _ _ __ ~ _~ ; J i ~ ~`` ~~ `'~ f , ~. _ _ ~ ~,'~`; ~'~. ~`~.~J,~ ~ ) , . - - -- 1~ ~ ~ J _ ,, i , ~ ~ ' r-~ r~' I ; ~ ~~, ~ << =~~ ~ ~ _ ~', ~____ ~ ~_ ~.~_ ~ ~`~ , ~` -z' r~ ~ ~I ~ ~~ ~~~ ~ ' - ~~ ~ t ~ ~:~ ~~ ~~ ~ ~~ ,-~ ~__, ~ ~ ~f ~_-~~~ -_ r' { ~ -7 r ~ ~ ~~ (~ ~~ ~ ~~ ~ J `~~ ~ ~ ~ ~~ ` '4 ~`~ ~` ~ ~ ~. ~ ` ~ ~ I ~ r,~ I~ ~ `'<,, ~ f'' ~. ~ {' ~ ~ ~ I- ~ 1' ~ ' - r ~ t f ti, ~i~ ~~ ~~ ~~ i ~i ~ ~~4 ~ ~` ~--- ~ ~ ~ ~``ti ~a ~_ r'~~ i~~ ,' ~l~ ~' ,! ~l ~~ ~~II ~~: I ~ i l~~it ~ ,r' I -,~ ` ~~r ~ I r~ i~ ~ ~ ~ ~ ii ~ ~ ~ ~ ~`<< ~-_~ ~ '" .,~'r - `-' `_--i ( ',,~ ~ '- -s ? i ,~ ri f ~~' ,' ti i ~i '' ~1 ~~. ~~ 4 ti ~ ' ~ s~ ~ y ~i~ ~ ~ .~ ~ .i' ~ ri a` G~ 1 l i I f y`. I~ t 1 J ~~~1 ~ ~ ~1 ~ ~ ~ ~ ~ + f ~~``'c~ 'lS`~-. ~~ ~ ~r' ~ .~ ~ ~ ~ ~~ f ~ '' ~ '~4,~~ ~'~ ',~`~~' 4''~~ 4 ~ '`~,~~; ~~-'~- ~~ ~r~ r' ~` ~ ' ' ,~~ a',~~ ~ ~ , ~ r ~ , ' ~y~ ~ `'~ ~ ''~j''1, ~4~. `` `1 ~' ~ ..~_-~ ~ fi~, ,, /~r'~ ~" ~'~~~` r~~ .fi ~ ~ ~'1 ~`',,~ `1, ti, ' ~ ~;",~ ~~ .~''` ~,r' ~~I ~~ ,~ ` • ,'r !' ~ r' r ~ ~4 ~'.'i. ~..._~w ti' ~ +``~ ,~'~}'r~ ~'`~~ r' ~ ~~r `'ih.~~~~ ~ ~r~ .: ~ i,', ~. . ..~' f,r ~F,+" ~i. ~ r'f '` 1 ~{, ~it '~:.-i, '~~, f .r . _ ~ ,`~. ti} `~"~ ~?!f ~' f r~ . `-~,. .,, ..F ~ r i .{. ti 1 J' f i ~ E~f` ' -~ ° - "'..r" ~ ~'i~ 4 ~~ ~" t ~ .r``r I ~ ~ - . -= . _. ~ ~ ~ ~{, '.~~ ,~1 ~ ~ ~ r } .~. .~ _ .~ T. ~ ~,~~ ~,~ ~ ~ j ~+' ,y~ `~. ~~, ~:! ,~ti '~.r ''k,- ~ .<. ~ ~ I I` ~ ~ 4`~ ~ -', ''_~-", -,,.`1 ` 'ty ~' `~'~-. ~~4 lr~ ~; f''~ ~',,, J~ l r ~ I ~ t.~ ~I~~ ~,.ti ~~G II ~i+ =-.z r,~' ~~ ~ ~_ r t~ ~ I'~ ~~1 !~ ! I i 4._~°~ i;~ -,,y r~ r n~ f~ t~ i! j I ~M1~ 4 ~1 ~ j ~l~ti-_ ~~N~,,,s: - . =~s ~ ~~ SECTION 2 Page 9 of 19 s iv City of Dublin Fiscal Year 2010-2011 Application for Funds 6. General Agency Infor_mation ~ ~_=-~~ . ~ - ~ (~_~ ~~= =~-~,, ~ ~ ~;.~ ,;`~ ``'~''i `,_ ~ f , a - -~- ~~ 1 i '~. ~~ f i~ f I i,~ ~~~ 5~ ,;~`~~. X Past grant appTi'cants~may clieck this box in lieu of completingritem~6_. (a-d) if the f "'~ ~':~. ~ -~~ ~ ~,~ ~~' :._ ; ~.-. :,-'' r ~~ ~t~ rr "~''~ ~~ . `~. program/organizational description--on=file wrth=the`Cit`y is correet and cur~rent. ~'~` ~ ~ ~ '~', ~;~ ~ ~-r=~.-~- - ~ti -'`, '`~`.;_= '~, ~~,'f`' ~'~ ~~, rf~ v.L ~ ~•ti ~ ~..r'` Jr'r " '° . ~'~; ` 1~4`.t j,^~`'~'~ ~ .~!~ ~,,f ~ i ''~4:. a. List all years~that Orgamzation has previously received City of:Dublin rfunding;(not ~ ` ~~ „ ~,^ ,~~' ,,~`~ , ,~, - -~ `+~ ~ ~.`~,,~~ ~,~-.~ ~~ r ,~ ' ,~~~ Community De~elopment Block Grant = CDBG) '~` ~~ ~~~.~ ~ ~ ~ ' ; ~f ~ ~ ~ -.: ~ss~ '` r''~ ~~- ` ~ ~' ~``~ ~'''~, i ~~' ~-'~ ~~'t ~ ~ -~ ~d l i rr~ ~~t -~ ,~~! ~ ! 'S'w '~'i , ~' r-,, J ~~` i i `~ ,,, ~ i~ ~. 8 , I~ ~~, ~ i ~'~ ~~i ~~~ ~ ~~ 7 _ s~~ `w 'i. f` ti ra~t' ,~'' ~ _ i ~`~ ~ i 'it ~~ i ~ ' ~~ , ~ ~ ~ ~ .. ~ _ ~ _ ~ '' ~, ~~, , I ' ~ ~ i ~ ~ i ~ `~ - -t `w, - ,P''~ ?~ -~ ~i~, `i r '~ 1 ~ ; ~ ~ 1~' ~ ~ I ( + ~f !~~ r~ ,~ ; `~,, ~ ( ~ '~~ ~ ~ w t~ i ~~ I~ !~ I I ~~ ~ c ,~ r i ~ I ~ I ~~i i i ~ ~~ ;~ r~'~~~ ~ °~ I~e '~; "`~ ~ ~ ~ ~'` ~`'~, '~ ~~~ I t_, ~I i' ~ `- ~ ,';' ~.~~` ,~ ,'.,-~, ~ ~ ~~I ~ I ~ ~ ~`-~ ~-~. ~~~ ~i~~ l ~ L~ _ ~ b. i~ ~~ Describe the o ulation s ser-ved-b." ~ the Or a~niza~tion~. ;~ l~ << ~~`~~ ~~~ ~`ti ' =~ , ~ 1? p r ~ ) ~ Y g _ _ '~, ~ ~ ~ ~ , ~ ° ~ ~~ ~~ ~ ~ ~ ~ 4 ' , ~ - ~, , ~- ~ ~ ,~~ '~ ~ ,~' ~ ~ ~ ~'~ ~' ~~ ~ ~~~ ° C~~ ~- ~ ~_1 ~ ~ ~,-~ ~ ~ ,~ I~ ~4~ ~ ~~~~~ ~~ I --- I -- ^ J _ , ~sf ~,~ '~ ~--~--~ ~ ~~_.~ ~ ~ _ I ,, ~ ~,,~~ ~ ~. to- _.~ r'~ ,~ ~ I i ! ~ , ~ , ~-,~ ~ '`~ ~ ~,. ~~ ~ ~ , ~~ .,,~ ~ ~ i . ~ ~ ~ i ~) ~i ~ ~ ~ , ~, i I ~ ~~ ~i ~ `~ ,~ " ,~ ~ ~~~ ,,.. r`~ .`` i ' ' ~ , [ ~ ~ ~~ ~~ ~I ~i ~[ ~~ (L ~l l ~' ~ ~ ~'~ '` ~ ~ ti' ~ ~ ~ '~ ~~ ~ I! ~~ ~! ~~ ~~ ~~ I ~ I ~~ ~ ~t ~ t i~i ~'` _ ~~ .____ I~~' ``~ '~ ~ . ~ ~ r J i ~ } i . ^,~ _ ~" ~ ,.r r ' ,, , ~r ; I ~ ~ , 'i ' ~, ~~ •~, ~ t'. ~ ' '', E . ', '_ ~ . c. ,~, ~D'escribe`'~all the services the Organization currently~lpr'ovides to Dubliri~'r,esidents. , ~ L ~ .~4 1 . ~.`_ _ ~ I ~ ~ f ~ ~~ i~ f I ~;~~~ ~ ~~An~'~acidihonal page may~~b~4added; if~needed ~''~ ~~ ~~f ~~ ~a`,r' ,~'~` , ' ' ~ ~ , . ~, ti ~ ~. ~. ~ '~ ~ ~ ~ ~ ~, ,~ ~, ~ '~, ti ~,~ '~~ ~~. ~ ~ .-~ ~ ~`~,r ~ ,~ ~~' ~~ ~~~ `~ ,,, ~ ~ y `~ ti~ .~ ~ •~,~ ~, '~ ~'~ ~; F ~:~,, ~' ,~ ~ r~ f,~` ~ ~ ~ 4~.~ ;.. ''•~~-, t~` ~ r.,^r ti'~ r' '` t.'r . ~ : '~ ~ ''~ ~` `' ~.~. ~~ 'T~,r' r f ,' E ,' ~y ;~~ . ~~~.~. ~ ~ ti y~ '~ _ ~ ~F _ r ,v.,._~t l, ; `~.(,f~f l;. ~''``''h.. ~ If: ~~ f ~ ~ - -`~ J~ ~ ~~ ~ C ~''~ t' y ~`~ ~ ';`I ~ ~~~~t ~~ -== _ ~ - ~~ ~;y ~''~4 ~'`~ ~~,~,~ ` ~,+'- ~ I ~ ' ~ ~ ~l ..4 'y+f~~ ~ 4~ ~,z,' ~- ''r~ ~~ ~ i~ f~ ~ 1 ~ ~ ~ . Lc ' ,~,lli ~4 ~ f~~'~ ~q x '.~ ,, ~ ~ ~ r ~~ j! ~~ ~ r ~ ~ ~ ~,~"~"~-,~,~~ t_ ~J ~ ~, °'1. 4 ~ `~'~..~,r' :.L t [ t _~ i ~,~ ~ ~ ~ ~ ~ ~~ „i,~ ~ ~ r . `~ -_ ~ '~: Ji` 1~ ~~ ~ f ~ ~ ~ ~ ~ `°_ `_~' _,,. =~ d. Has your agency ever~pre~iously received funds from the..City of Dublin? If yes, please specify in what Fiscal I'ears-arid-the amount received each year. SECTION 2 Page 10 of 19 J "~ iv City of Dublin Fiscal Year 2010-2011 Application fo~ Funds rL ~r 7. Required Attachments.:- ~ ~ ~ ~=;; z ~ , ~~ _ ~~~ r~~~ ~'~,~'ti ~` i~ ~ ~~ ~ ~ ~ _ ~~ ' ~.; ~ ' ~i ~ ,- ~, y i '~i(~ i ~.~r S~~ ~- ~~~ ,7 ~ ~ , . j , ~ r.~ t' ~~ r ~ ~ o Onlv one (1) coqy per Agencv of~each of~the following is reqwred,,even with~mi r .~ -~: ~ _-- t xf _._ ^ . - .~ r ; '' F~ -~ `~.. ~ ~''f~~S ~~, '~. ~ ~ ~ C i,~ >''(~ ~ ~ ';,~ projects/progra'ms submitted. ~ - _ _ ''~,v,~,,~ J ~ r,~~, 0 O f f4 '7 ~'r`'rF ! 1 r'~`~ o-=A.:=Naines of Govern n , , r,r ~ ~~ ~" J~ i ` 'r r~ ' ~ -r~ i',' ,~ ~~' ,' o; B;~';~`Current total-Or.gan' ~ I ~ i I i 1 f' ~~1 r' '~ ~+i ~ ~~ ~~ ~~ i~ ,~ ~~~~ ^ Clearl,y~~label/id_ !,~ (--R t~J ~_l~ .~~;. ~,PROJECT PRO y ~ • I „ ~ II . {r`~~'ti I~ f : .-~~~ LT_. ~ j' o~ ~C. ~'Most~receiit audi.t-r ~4 ~~ ! ' ~ ~ ~-~' '~ i ,~ ~~~ !; ~~ -(~ ~ p ` ~ I ~ i~ ~ ` ~o ~D. ~R~ lution, letter or ~ili .~ -tf ~r-=, ~i: ~ ~~~i Board/Qrganization ,I ~ i i' ~~~ !~ i f~,I i^ Board/Organi ~ ~'i~i ~~t ~~ ~ ~~~ O, ~~;E;~'~,~TgaTllZat1011~S C Ttlj ~ 4~ ~ ti ~ ~, 1,, ,~~ i C ', ~ ~ ', ~ ~ ~, ~ workers' compensat: '~, i~ ~. ~ ~ ~~, S ~``, i ' , ,0,~ ~ ~` ti~ ~~ ti~ ~.'4~~` ,~ ` t`~~~,~o`~~F4~~Ap lication Verific~ '~~l,~l,,~,~ a.: _¢.~'`:~t be ~-~ ~~~ ` j ~,,,I ~~ t4 y ~ 1,~;4tii ~ ~ ~ ~J ~r g B`oard~ identify current Board office; ~- ~ ~ ~~ ii , ~ ~ ~ ~ ```., ,~, ``1 '~~"t ~ ~ ization .operating bud~et;-iricluding re~ entify the pro~gram that includes the PF ~ ~ GRAM,.~( ~~ ~~~` ~' '~. `` ~'`~ - - - - _.. ~ r" I . ~ epor-t-or tax return-(i~f-applicabl'e). i~ , ~_ j i' ~ i'-~,_ .~ ~~ ~,--~ , ---- . ; . `~ >r ~' , , .ppTication, and mav~b'e,,pe din. ~ I V ~i~ ~r ~_ cate,.of insurance D ^~~., G. SiQned affidavit form 'r..e1 ~..1~ ~ ing coverage r` ~ ~~'r ature Pase -~`~ t ~~. p ~oject/pro~am_plan (if applicable)._ ~'~`' °~1; `~.~ ~~~ _~~ r ..~ ~ ~.-~ ~ - " ~ _ ~ ~~ ~` _ Iti, ~"~',.ti ~ ~~ ~ ~~ ~{ ~ ~~i~~ '~ ~ i~ ~;f~~.~ =y,~`'1 ,~ .~t~ ~~ ~~ ~ 4 ^ H. Copy of IRS Let~er+of D,ete~rmmatio~ imdi~cating ta~x ~-'-~ ~ ,'' _'s ~^~ , 4, ~I i ~ = ~ ;,r~~~ - - - '~.;'»~~,-~~` ~ ~~ ;- SECTION Z Page 11 of 19 '1 '~ ~~ ~ i ~~c~ ~_ ~ ~~y 1~ ~it~ i eriue `~ ~', ` ', `~ ~,'; ~ ~POSED', ~'~i 1~ ~~ ',`~ ~~ i ~ ~~ ~`l ~_~ ~ I 4t. I ~ _~-,~, ' I II t~ I ~" ~I I~ ~ I , ~ ~` , i ~ '-; ~ r' ! ~ ti .~a ~ ~ ,f~ ,' ._ ~ , i~ ~val~ was ~ganted. '! ~ I ' i i ~~~I i f ~~ ~~~ ~~ _i I ~ ( I ,~( ~ j ~ I ~ ~i .1~~ ,i~ [ ~, ~ ~'~ I ~ ~~ ( ~T~ l~iability,~andl ~ ~ , ~, ~ ~~ ' , ~ ,J ;a ~~ f~ ,~'r , ~ ~ ~,~' ~ ~ ,r f _, f, ~ ~ r` ~ ,. , ~ ~ ,~' r ?~ s ~~ f~` r~~~ ~~` r ,~; ,~'' f a,% status. d6 n~ ~i ~~ Q~ City of Dublin Fiscal Year 2010-2011 Applacation for Funds _ - - ~- ~,1 ---_ _ a_ -- -~ ~ _ ~.. rrAPPLfICATION~`VERI'FIC`AT-I ~ ~~ ''~ ;,! ~ ( ~ ~~ ~a~~' ~"~~ ~, d ~ ~ ~ .~'' ~`-,I '~-``- ~};r _~ _ "~,•~ i' ~ ; I attest that the in~for-riiation contained in_th'is F-Y=2'0 ~ ~ .;~r ~~ .~. y ti,~ - --- the funds requested will ,not supplant any other mor ~ r r,~ ~ `` '~''~, ~`'- '~ '`~ , ~ `'~, `r f 'i ~ :~''~ ~''~`` ~., ~-~-- - Attached~ is a resolution; letter, or other docurrierit ~ r~!,( 4~ __.~ ''~fr' I` ~,~ `~ ~ ~ I approved the application as submitted~`` Succe`s_sful,~ re ort as:`soon,as ~,~ossible after_submitti~n the~rein ~ P ~ - ~ .,~ g 31, ,~2011.~'~ Failure to subrnit asrepor~`t`wi~ll~ result in i ~ , ~~ I~~~ _,~ i_.[ 1 ~~ ai~ ,,,,~'' it' ~~ , ~ i~ ~ ~ -`~ ~~,~ ~ } ~ ~ I ~ ~'~ _~~ 4~I ~ ~. r I ~~ ~~ ~y ~~ ~,^'''~ J {' r-°- Signatures:~„! ` i : t1 t'' ~ ~ ~ I ~~ , I l ~~ I r :~ ~ , I( L _.~ ~ ~ _. ~ _~ `1 ~ - 'I ~ ~``~- '~~ - - ~ I ._ , - ~~ . • `, ~ 4'`' ~r' ~ "~ '~''jr~ i i Executive Director~ ; i ~ , ~ ~ ~ ~ ~ ~, ~ ~ ~~~ = ~'~ ~ . ~ ~ ~ ~ ~ ~ , 4 , ~ ~ a,~~, ~r, ~ ~ ~ , ~ ~ ~ ~~~ ~ _ ~_._~ ~~, ' '~. ~!i `z ~1 '~ ~i~ -- -- , ~ , t ~ ~ `,~ '~ ~' ~~~, ti ~`~ i ~` ~~ ~G :~ ~~, 1,~~, 4 ~ ~ `~, ~~,4. ~: '~ _ . . _ ~~.,~--=. secured b; tne or amzatrom:~~ y,~~ .g t -~ ~ ~ '~" r~ ~,k ~ ~~. .~" ~~ ~ ~~~ `'~ ~~~v f :-~`'`~} ,~r 1 ~. ~'; :dingYevidence that,~tlie Board~ of ` ,, kca ts ~are required to;~ubmit a s ement'~reauest, but not later,than ~.~ r -- -iI Y.r-,.Z '~ ~,. _._.._._ ._.._~I ~ ~ ~ f _ _' 4 r~~ ~ ~ _ . . I , 4~ r ~ `,, _~ ~ ,~, ~ ~ 'w,._t~ ~ ~{ i~ ~ _ .%` " ~~4 x.. r ~~ ~,r i ~ ~ i and that ,,~, ~ , ,t ~, ~, ~ _, ~ iding' ``, ~ "i ', `~ ~ ' ~ ~i ~i~i ~ ~~~~~ ~~ ~~ ~~~, ~_~ I~ ti I ' `~ F =~ -`1 , I' ~~ ~r ~' i '~~ O ~ ,~ J r~ 1 i , i~ ~ ~ ~ ~~ i + _ iJ~ ~~, _ ~ ~ ~~ 1 ~ i' l ~ ~ ir ~~ ~ , r. _ Date r,~ ~~~ ~' ~~ ~ ~,~~~ ~ , ~ ~ r' ' ~' ~ ~ ~ ~~ ,' ,,,a ~~ ~ ; ;. ,, , , ~ ~ ('~O~.~C~ C~:~~~~ ~e _~:i ~1 ~~_ ;~-~z 5 o r -~ ti, .r _-~''~-' : 4 ~ r ti.~ t , ~ ~ ~, ~._ _ . ~ ~.- ~ -,, ~ ~t ..~: ~~ r I .~~ ~.-~ _ _ _ , ~,, ,~ s, ~~~ kti ;-a.- .~';~~1 I~ 3~~ ~ ~ 7 r . - '~ ~" ,i l 1~~ ~, '~~''l ~ ;~. "r ~,F~`:r ~. i t~ ~ ~ ~~f ~~z ~`' t ir .f'~,. ~`-~' ~ ir r , ~~ ~ 9r ~ _~ ~~ i ~ )~ ~~~ ``~~.4 ~,.~-~ 4[ i: ~M1 ~ l i 1~i 1 j L ~r ~ w ~ ~' ~ • ~ ~ ~ ~ (~ ~~~ ~~ ~~ d= ~ ~ ~-~ w_':s j D~~~ ~ 1 ~(=~=,. _ _~ _ - _. -, ~-_ y ~ ~ - -~ SECTION 2 Page 12 of 19 J,r ~ ~~ a cl f ~l'~ ~v City of Dublin Fiscal Year 2010-2011 Application for Funds o This form is o C Coll; StOj~ i :r="=`~~ s~rAFFIDA completed by each n~~the proposedf pro Chabot- Project~Program Title: General named by the ~ r~,f'ti .;;a tted at time of apphcation ,~ ,.r , ~: 1 ~ ry ~., ~=.~ ~ ~,,` r,~ .~~`~, y L ~ ~` 4 . r -,., '~4. Positas Corrimunity College Di'stnct/Tn Valley One- . ~~ - ~~ "~. ~~` ~;,~r' ~ y ~f f r J ~ 1 ~4 r` _~ ~ - ~'-,1 ~ - .4 -~.y, 5~~ e~ ,~~' ,~L ~aree'r`Center~,, ~`~~ ~ti~ a'~ ~ `~~, - -, 7 i ~-~'` ~ ~ ~nt'and-Traiiiing~;Services-City of Dt,4ublin residerits I( ~ ~ ~ _ _ ~yC _JI y,~ ~+~ I~Y. , ~ (~ l' ~ 1~ t~ J.lf' 1. ~~ - ~ 1~ ~Youth.arid~~adults); , ~.._~ ~ ~. '~ ; ~ .~'' ~ ._.... 4`~ .- , ', ~'~ ~'~ ; ,'~ ~~ i i ~i ii i ~ t i: ~, ~*~, `'~. r .~ -~ ~-'_" ,tr .f r -_. i~i i I ~ I i 1! ~ Project/Prograril,'Role Descr~ption (i~.e~, facility~space, ~stafffsuppor.t, etc ): '~~,'~ ~, ~~ ~, ~ ~~ ~';i f ~ ~ ~ , ~ ~ .-~. ~ , , ~ ~ ~ ~ ~. ~ : , ~ Our, ov,erall;"mission,~is~-~to~pr-.ovid'e resour'ces a-nd~se~rvices in suppo,r;t'~o~f~ I; i~ ~ ~ ~ I • i , , :~ ~, ~, ' ~ ~ ~ ,:r ; x ~ ~ ~ . ~ I ~; ~ ! emp!loyer-s and all;~~ ob, tra~ning and educationJ see'kersi All. servi i es a-re free of~~charge to~j our community~w~ ~ Specifi'ca~lly-~;`~the additi`orial f.urid~ingf wo,ul~d ~be ~~ ~ r~~' . r -I i % ~ ~_____~ ~ i.,-z~ '~ l ~''~ ~~,r" ~ ~! used `to continue ~to,~serve? Dublin residents in _the folloWing ways :, ~, ~, , I ~ ~ ( ,,~ _ ~ ~ ~ .r~,~ ~ ~ ,~,,.`" ~ ~ r ~~ ~~- :~ ~~` ~ ' ~'~ ~. ~ ~~ ~i~° ° ~ C~ ~- . ~ ___ , . - ~ ~ i~'°~-_~ ~ ~ ~ ~~ r ', ~l~ y^ IRequest~ed =f:unds'-~ wou-l-d-be used to--pY ~I activities to Dublin cit'`izeris~`'categ I~ r~ j~` ~~I, seekers, ~`laid off"~workers%di~splaced '~,I~~ ~; !~ ~~ ~~ `Ito the wo~kforce,,,~veteraris, fperso`ns ~~, ,`,. ', ~, ~ of~fenders and ser"vices; for employez ~~i ~t ~~',^`~,'~,T~h'i.s program is an .extension of seY ~ y ~ ~ j' 1 i~ ~ f r~,•: -'".? : ~,~ i, ~, ~~ La~s';~Positas CollecTe/Tr-i=_UalleY One- ,', i~ ' 't, ~!com~ ;.~, ~~ ~ ti , ~ .~ 1, L4 ~ 4 4 ; ~, ~, y4 `~ Agency Project/Rro `'~4 ~: ~,~ Title Director Phone (925) 485 ance with the~~Federal', Wc ~. ~~ -~` ~ 1 ON AGENCY ~ ~,_~ - _ _. >vide workforce~,~de~ eLlopmerit ' >r.ically classified as job I~~ `workers,r youth, rieva~eiitrant's :~ ~ ~~ i~ ~ ( ~ , ~ ~~ ~with disabilitie~s,~ ~eX , ~ , , ~ ~r ~ ~ , ~ ! , "*,, . ~.~ ~~ )' ii ~ ~ ~ ~~,, ~ices offered at~" .th`er' Ch~abot- p Career C Investment Contact Person `~~ John Alves "*~,ti, l~-'~ _ _ ' ~M+~ ~ ..~ ~ ~~ ~ ~q ~ + f. ~~ ~~ -- _ - L' ^..1 I , i_ ~.._ _ ~. '~-. 7TE 'mail+,jal es@clpuced org~~~ ~ ~'~~ .~ ~~~r` ~~ ~, f u~ ~ r i 1 i~ ~ ~~ .~[__ J~ ~ ~~ ~ ( ~t [~ =t_ agericy~and-our orgariization)a~ee~f~ I attest that the applicant the proposed project/program as Executive Director },.Jrrr ~ ~''~. F ... ~ ~''~~ ~,['~,~ 4~ .~ _ti ~~ .~,~4 l~ ~`:. 4 "k. ~i. ~' t ~~ ,I}' ,, '~y,,, ~~'~ 4 .,~`~' ~ ~ ;~• ~.. ,t ~"~;,. ~ ~ r ~1 _ J ~ _~. ~_t'! ork collaboratively to implement funding application. Date ~~ ~~ I~( ~`~ Project~ ogram Contact Person Date ~,~~x,~~~ ~~~ SECTION 2 ~~` Page 13 of 19 ~ ~ ~ ~~ ~ j ~ .~~ .! '~ 'f. ter ~acting~',~in ~ct' of~ 199,8`~. f Y / i' . F ~,' ~ r r' ~, ~ ,~" '~r, ,~'~,~~'' ~ f''~~'~ ~; ` `- r f .f f r' ~ ~ L ~~ ~~ _ ~ --~ `~-il , - 1- _ ,r-~= ~ ;` ~~, ~``, i ~~~ ' ~~ ~;'~ 7 ~ `~~'`~_ -" s~ 1~ il I~ I f~ I ~' ~''~-, ~ I ~ . ,,!.'~ ~~ ~~_ - ~ f ~ i r 7 7Fc ~`'~, _.ti_ ~ '1 i !d ~~ i ~ ~ J F ~F ~4 ''-Y4,. ur .C ~ ~ ~ r,,~ ' ~ '` ~~~ ~~ ~ ~-.~-- ~ t~ ~ ~4 r i ~ ~ L : ~ ~r--' ;, ~ S _ - . - t (, ~'f r ~~ ',, ~i'` r~.~ ~. .: - -` ~'~ ~~,;, ~---- ^^ ` -`' ,` ',-' r ~~' ~r `' 4. . f~~.r 'i~. ~'+'~ ~' ? '`.+-` '~. -~' ~_,-` jAf`i ; ~ r~ zY:~~i~~ ~ . _~ _ v `s.v, `~titi~ f~ ~' ...~1 ~~. Ij + .,~'~ ~.~-'~ '4. ~,'~ ~. ~ ~ 1 '..4~ ~'~ f' =.. y ~ f .,,~ ''' ''' ~~;•`~ti.''~ ,?'r ',` ~ `~. '~v~ .i~`r ~~ j'I~" ~~ _ . T_~ ~ '•~~~ ~r~~f ,}'4~~?~ I f ~ I r' ~ ~ f'`~ ) i;[-~ I-l tt :'4 5~~ , r.F ~ M i ~~ k~ 'r~ ~,'~~ t_•~' ~ i ~ I~, 4,~ i r~A' ~''~f ~ ._- 'Yf ~{.1 . }° ~P - _'s ~ L~t ~~ti ~,r~ ~~ii ) ~~~ ~r~ ~ ~ ~ ~~~ '~ ~j ~I ~'' ~ ~jr i ~ ;cr ! ~~ ~ fl r ~ ~ ~ _ ~~ -~ ~ ' l .I ~ r ~ i ~ ~ r, ~~r !1 ~ ~ - ~ ''L~~-'1 ~* r r ~ ~ ; i ~ t 1' fl fl ( "~ i _ _.._.... _, ~ ' ' i f ,( '. ( i~ i r-~~-~ ~ ~.~ ~ Y` it~ ~,' i ~ I l ~~ 1, r f 1' I ~ ,~^' ~ 1 I ) .~ I ~ ~ Y~I i ~ 4 ~~ ~ ~ll ~~i 1i I' 1 l ~~~ ~J~ I ~I ~ Ir .~, +' ~7~r ~{~ i~~k~~ ~ ~ I'{ l~ '' ~~ ( ~~ I~ ~+ ir ~.~ ~~i a ~~ !r ,, i :5 ~, ~ ~,'` `,~ ~. ~ i ~ i ~i ~, ~i I ~ s ~ ~ ~=..~1 I ~ 1~ ~- , ~ {~ __, ~ ~ ,{ r--t: ~~ ' ~~ ~~ r'`'~ `t' ~ -1(_~ ~ ',_ . _. _ ~ ~ 4 I ~ ~' +'~~'} ~~=.-, i ~ ) ~ ~ ~ ~ ~ ~ ~ ;~" r~ ~ ~ - - '*, ~~ } ~ ~~,` ~,~ ~ I i ~ _+ ~;, f s- ~ ~ ~ i,` ~ ~`-=~i i I~ P ~ ~ [1 r~ ( ~ ~ ~ E _ ._ ~ 1 ~ ~ i'..z ~ ~ ~ ~~ ,;,` ~ f r ~ ~ I ~ ~ ~ ~, ~~(__, ~ ,,~ ~ ~_ 1~. , ~ ~ ~~,. i ~ ~~~ ~ ~ ~~''~ ~ I ~ ~ -~ ~ ~ '`~~~~~ ~ ~ ~ ~ ~ i i ~ ( '~ , _ } ~~ i4 ~ ~~' ~ ~~ ~ -'~ r I 1 r , j ~~I l ~'t ~ i ~~~~ ~ ~''4, ~' ,,r ~'' { ,. ;~ ?'`~ l~~~ 1 ~ ~~ ~~ I f i ~ ~ I ~ I ~ ~ ~, E ~~ i _~,- ,,~`` ,~''~ ~ ~ ~ ~ _ = ~ ~ r ,' ~ ~ i ~ I t ~ i ~ii i 1 ~I i ~i 5 ~'~ ~~ ~" ~'' 1 ~ti, ~ ~ ~, '~~ i ~ ~ i ' ~~ i~~ r ~ i ~ ~ 1 ~ t ~ ~ ._ .~ ~~ ~ ~.. ~L~.~.~ .1 h ~ '1, ~ ^~. JJ ~ ~ rl! ~I ~ ~) ~ ,~ ~ ii ! i~ l! 1 Il .. ~ ~ r, ~ I ~ I~~( ,~ ~~ ~i ~, 'i ~~, ~ ~~ ~ u-, ' ~t ,',~ ~' ~ ; ~ << ~'r , ~ ~ ~ ~~ ~ ~ ~ ., ~1 a ~ r i ~ r , ~ i ~~ ~ i ~t ~ ,`e ~ ~ ~<__ ~ti _ ~ ~ ~ ~ ~ ~ J , ~r t~~~ ~ ~ ~, ~. ,~ 4 ;~. 1 l '~, ~~~' f"' ~r r ~f ~ ' ~, ' ,,~ ~~ ~a e~ 4 ~`ti~ 1~ ., - ~' ;~,~ ~~ ~ ` 1' j ~ ~` ~ ~ , ~. y','~ ~~,~ ~ ,~ ';~~,,`~ ,, '~,~ L=',~ ~ ~,; ,~; ; f• ~'' r~ ~ r',+; ~ . ;~, ~,, ti ~,, ~,, ~.`~,~ ', ` ~;,'` `.~,~ ,1 r` , ~ ~' ? 4 ~ 4 ~~ ~.. C F '' ,' ~~~ ~~ ~~ ~ ~ ~ ~,~titi~;~ 'y ,.fi '~ :~. `4,` ~''~ ~ .~'''_, f`` tir'`~t~ ,~ r ti ~, ti ~ .~,r' ~ ~' i~-.. ~,r'~' ~.,'4,4t''~~'' r"f- _`' _~-~ -~.,1 ~`~ ` ~ ~^'.~~'r~ t~ ~-. '~,.~ t~ 14 (~ ~~ 1"~c, Z L,`-v_Y _ =. ,'~! / .~ '~~ _ t ~. ~ ~f ~~ .~~-- - .~. ~.~ 11 ti .-y Y , !j ~ - ~._ _ - . ~ ~~,`~~ ~~~ 'f '~' ._ ~-~ ~,,~ ~ ~I _. ~ -- _ ~~ t ~ ;, ~ ~ ~, ~~ ~ ~ ~ ~` ~'``~ ~~, ~~ r i~ ~i ~~ ~~~ ~~~ ~~ ~ ;r~~~``.~`. 7~ ~t ~~~~~) ~~ ~ , ~~4i ~'~ ': F `~' `,,,,-ti. ~ f r ~l 1 ~~~ t -~ su '.r" -ry_ _ r' ,s ~ ij ~(~~ ~' ~ t ~,~ . i4-, ,_ __ __~"'u~~' I ~ ~ { ) El ~~~ I'~~, -_ ~ P,~ - _'S ~-.. ``ti '~, }F` ~ - SECTION 2 Page 14 of 19 ~ '1 L IP al CITY OF DUBLIN Fiscal Year 2010-2011 COMMUNITY GROUP/ORGANIZATIONAL FUNDING PROGRAM REQUEST FOR REIMBURSEMENT AGENCY NAME _ - =-^ ~. ~ [ 1 ~ ? i ^~~-~ 1^--= - yrr r~"" ,~'" ~ 5't i , I~{~ ~I~~ ~1-y ~ ~;~~-~ ~ , ~ ''` ~~ I i', ~ ~ ~ I~ ,~(~r~ ~f J ~ _ -,f~~ ~~4- ~, ~ ~ `~ ~ '~, ~ "'~!' ' 1 ~~ '~' ~ -~~ ~~`_~'-"'~. MAILING ADDRESS~F„OR-REIMBURSEMENT:-~ - ~ ~ ~ ;', i' ;'f r ~``~; ~ --., ~ ~,. t , ti '~" '`;~'~4 ~ _ - - - _ -_ _''- ,'~~ ' J ~ ,r ~ . ~ ,~ ~ ~4 ~,k' ~ `~ '~~ _~-~ _-,_ -Y ~, ' ~''. ,,~: y '~ `•t'~ ~' ~.r .,-z,, ;= ,,~~f'~ ~ ~~ PROJECT/PROGRAIVI NAME~:~ `j ~-`'~~, ~ ~`~,,~'' ~ . ~ ,~ ~ ~ ~, ~'~4 y _ ~ t • ~ t' ~i ,, ~f ~ - J--~~, '~,y~`' ~ ~~ ,~ ~ ~`,, ,'r I~ ,I ~ l, 1`~ ~ ,r . ~y ~l y's 'S f.4 .~a ~ r ~ ( l I-'~ ~ i `~ ' 1~ r y ~ S ~ ~ . ~ Ji~~ ~~ . _~J~~ ff I~L.E~~ 1f~r c~ ~ I I~F ~Y ~~ ,~t'~, r ~ i ~ ~ '~ ~ ~ ; r ~ r ' ~ s, , ~ ' ~~ ~~ r i' ~ ~ ; ~ ~', ~ r-~-' ` i ` ~ : ~ ~ ~ r ~ ~ ~'~', - ' ~ ', , ~~ r 7 ,~~ .`~'~ -_ ~~ `~ ~ - ~ ~ ~ ~~ --- ~ 4 .; -~ ~ ~, , ~ ~~; ~ TOTAL FiJNDING~AMOUNT~AWARDED ti~TOTAL REIMBURSEMENT~REQUESTED TI3IS'PERIOD ~ ~I~ ~ (~ ~ ~ ~~ ~ ~~ ~~ ~~ ~~ ~~~ ~ ~ ~ ~ ~ ~~~ ~ ~ ~~ ~ ~ ~ ~i ~~ ~. ' ~~ ~ $ ~ ' r i ' i ! ,~' ~^, ~ '''~. $ I ! r'`' _r'' '`ti ' ~ ~, ' I ~ ~, i i r I ~, ~'~1 -' ~~~I - ! ~'I ~~ ~ ~,~''' ~ I ~,~,fJ,r' ~` ~ .~-'~~`! ,,,~'~, ~ l~ L-f ~ Amount of Reimbursement Requested Expense Type (Please attach receipts, timesheets, etc. (Please describe.) Date supporting identified ex enses.) ~ r~ ~, ~~ i ~ ~ ~~ ji ~ ~ ~~~ ~ ~ ~ ~ ` ~~~~ ~ - -~ f"~~~ i i r - ~ ~ i I i ~~_ ~` ~" ,~i~ ; ( ~ ~ ,~ ,~ ,~~ ``_ f ,~i ~ ~ , ~~ ~ ~' ' ~~ ~ ~ ~~ ~ ~ i t i ~~I ~ ~~ l I l ~t jl. ~ -~_,~_ I ! ~ I l 1 t ~~ ~ ,_~ ti_~ ~~~h~',~ ~ ~ ~'.,i~~--,_. _~ , ~~ '~ f~ ~~ ( 1 .f i~~ 1 ~ ~ i . i ~ i .~ '. I .~ t J 1 i i 1 i I ' ' '- / ac. 1 1 ~ I I ~ 1 ,t ~ ~ . ~ .~ ~ ~~ >> 4 I ~, ., , ' ' _ . ._ ,`- ~ ~` n -- - , ' ~ j , . . ~ J ~ ~, r r ; ~` ~ ~~ ~ i f ~ ~r ~' ~ ~ ~ ` ~y ` ~ .4 ,y ~ ...4 ,4 ~ ~ l , _ j ~~ ~. , . j, . f ~( '~ ~ ~ ~ f , (~ I ... ,. , ~ ~ ~ 4 ~~ , -- ` f "1 ~ ` , - ' ~ ! ~ ~ r' ~~ y4 ~ ~ ~ ~ ` ~ ~ r M~ ~f J , r~r l r,(r ,r '' r '' ` ' ~, ~ ~- ~, k ~ , ~ , % ,, ~ f ~ _ .~ ~ 1 ~ ~ ; ~~r. _,~-~,r~` ,`w ~' , h ~ ~ - -~ , ,~~~ - - ~ . I~ y,r~ ~l Z ~~~•~ : ~~ , , ~ ~~ `ti,, : ~ I uF ~ ~ ~ ~ ( ~ - ~ ~ ~ i4 y r L ,, ~ ~` ^^7r` ~ ~ ,'~ ~ i -~- - '~`~ .~ ~i TOTAL Amount Re uested (lf requesting project/prograrri "start,'up'~~ ~furiding, pl~ease_d'escnbe _ ni~fi~a1 funding use above.) - =- - ~'' -s ~~~ ~ ~~ -_-, _~` ~1~ ~ ~ ~` - I attest that the above listed expenses are accurate and-true and have been used as represented in the approved funding application. Submitted by: Signature: Date: SECTION 2 Page 15 of 19 J L nv ~n CITY OF DUBLIN Fiscal Year 2010-2011 COMMUNITY GROUP/ORGANIZATIONAL FUNDING PROGRAM _- _SUMMARY-REPORT r-:.T~= -=~'~ _ _- ?. i- r ~ ~ (-_~~~-=; ==_,-~,~ ir ~~,,`'t ', ) i , ~ 7 - (Summary~Report must be completed and su6nufted prior to August 31, 2011.) .~.~ ~ , i , , ~ , ~ ~ ~ ~ ~ r ~, ~ ~ ,~ -r~ ~ ~ ~ ~ ~ ~ , r ,~ ,~ ~ r- ~ '`, , ~ , f ._ ~ '_ '''` ~' i , ~ r~ -~,I ` `~, f ~~ ' '~~; ~ ~~,~ ~ -~- -- - - ~ ~ '1~ AGENCY NAME '~``f.~ ~ 4° ``" ~',`'~ -_ _ - - `~'='..1~ ~ l ~I ,~f`- ~ ;ti~ ,*''r`F` ,~ ,~ ~ ~ ` _ - --~`. - ~ ~"-'-``~.~'f j`'„~''' `ti 'ti ,'`~`4 ```~ f ~, r~ -'' - ~ ,}`'' ,'~ . r . ' ,'~ , .~ _r_ s ~ -`~ , ~ ' F ~ , 1 ~,~ MAILING~ADDRESS'~;'`; frf d'~ ~ `~, `~,-~ .~; r~~ ~'~~`~ r~'` ~~ ~ ~~ ~; ` ~'" ,~ ~ ~, - 4 ~,~. ti ~ ~ ~ r ,' .~ -=' `~; ~ ~,`~ ~,`~ ~ ,~~ , ~' _ ~ ~~ ~4~ .~ +~~, ~. J.~ `r ~ ~ ~~~~ , ~f~ ~~~ ! ~ ~ i ~ ~ ~l J ~-'` t ~._ i TELEPHONE: ~'f f r~ -~' rn~t ,i `; -, 3`'- (`_ ' Y 1 ~ 1~. ,i "Y~' i) l~' I ~^,I ~ i I ~ ~ I f ) ` ' ~~~ -- ~ - . ~ ~` -- _ ~~~ "'- ~i~~ ~i ~ ~.~I ~~ ~~ r f~ ~ 1 ~ ~'~ ~ ti~~ I ; ~ ~ ~~ ~~.~ ~' I ~i ~ ~ ~~~ ( I ~ . ~' ~ j f, 1 ~.~'Y ,, ~ f i I , ~~~ ~'~ ~ ~ PROJECT/PROGRAM NAME:.-' ~'~., `~. '~ ~~f'-~~,~ '~ ~ ~, ~ ~ i ~, ' ~ i i r ~ ~~ ~ ~ ( ~ ~~ 1~~ ~ I~~ ~ ~ }`,r ~ ~ ~ ~~ ~~ ~ ~~~ ~ ~ ~~' ~~ ~~ ~_.. ~/ 1 ~~ ~ ~~ ~~ ~- ~r l I I I'~I ~ ~,~J l ~, ~ ~~ J I '~ ~y i ~' I I i-~_ _ ' TOTAL FiJNDING AMOUNT-AWARDED TOTAL REIMBURSEMENT~'RECEIVED ~ i.~ ~~~ '~i ' i i ! `~ ( I ~ ~ ~--~ ~ ~ I ~r- _ ____•' ~ , , = i' `~ ~ ~ ~ ~~ i ~ $ ~ ,'~' ~ 1 i t' ~ ~ ~~ f I ~- $ ~ - ~'~ ~ ~'`'-~ 'r ,~` . ,~ ~__ : ~ ~ `-~ ~ --- _ _~ ,~ , ~ ~ _a ~'~ ~s - ~ ~ ~'~ , I ; ~~ ~ ~ ~~ ,,~~ - ~ _ ' « ," ~ ~ i , -' ' ~ ''~ ~ ~'f ~ ' I ``~+ A" .. ~ ~ ~ r ,~''~ ~ I ' -i - _ - i , 1.) ~` Ho~w has ~~the PROJECT/PROGRAM addressed`an unrnet cominumty need~' antl,irilproved ~~, , ~ ~i , , ,, ~~~ ~,, ~ ~~ ~ ,'' ~ ~ . ~ ~~ _,:~ ~,r`' ,r' + ~ ; ~ , ~ the quality oftili~fe~~for Dubl'in,residerits (Additional page may~~be added, if need'ed):~'~ a' ,` ~' ~' ,',' ` I 1 1 ~ , ~ J'' . i ~ 'r Jl' ~ ~~ ,I r i `, ti ~~ i~ i., i ~ ..~~~ ~'1 ,' f~ ~~ ~ ~~>> ~~ i ~~ ~,, , ~~ ~~ ~'~~, -~ ~_ ~ ~ ~ ~ ~ i.5 J._ f 1' ~ ' ~ r i'~! i l . ' l ` `~ 4 ~'~` ~ ~ ~ ~ ~ ~ ~_ ~ f~ ~ ~ 1r s~ ~ 'y ~ ~ ~~ i~ ', 4 ~`.;4 ti ~~ ~, ~~ ~ ~ 't ,r~ ,r` r~ d f ~ r ~ %'' ,, r ' 1, ` ''ti ~ i ~4 4 ti ~ ~ ~,`t ~, ~~ 7 4 '~ `y `4,, ~'~, -~~~ ~ ~ ~`: ~f,, ~r ~ ,~' f' , , ~ `~' ~ . `~~ ~ f' : -~ l: ` ; r''" ~ ~% ,1''i 4,~ ~` ~' .% '~..-., ~r'f -~ ~ r 1,~'' ~ f ~' ,` k ~'~ ~. ,•'~,~ ~ f ~`` ~' ,~ f',~~: ''~~y'`'~ ~~' ~~~,`'-;~,,~.~ ~~,, _ J fi _ f r~ `i.,~` ~'"~ ,,~` 4 1 ~' • ~ - - -= tC1~1 F I, ~ ,.~ f ', ~ .- , '-~ ~ ti i ~. ~ ~ 4 4~; '~ ~`,~ ~`'~ ~~~~4 ~~; ~' J~,, ~`~_ _ r -- _ __ ~ ;~ ~,.~, ~~,L~~4~~~~ .y ~ ~_ ~ "~ i ~ i . ,.~ 4 ~ i ;' I ~i ~ ' ~ `l ~ - r~- 2.) Please evaluate the~success of,'your',pro~ect/program ~ Were the-goalsroutlined in the I application met? Was the projec_t/pro'gram'carried out~efficiently?~rPlease use the objectives identified in your application to discuss=your=program/project's success and impact. Include any documentation/data/records you have that support your conclusions. SECTION 2 Page 16 of 19 ~ ~ City of Dublin Fiscal Year 2010-2011 SUMMARYREPORT 3} How many total participants How many of those I attest ~~~t ' - Submii`t,ed by: _ r ~'~ i ~r ,' ~ ,-_, ~,' ~;~ '~ Signature,. i` ~' ,~ ; ~~~~ ~~ {~~~ I -~~ !~r 1 ~~~ ~ , ~ ,.~. 'i`~ iI ~ I~ ~~ ~'=1r ~~ i~ I ,f~ -,.. r~~-~ ~h ~ ~~• ~ ~*~ ~~~4a ~ ~' ~~~. -~_~-~_:~~_ -~ _~ i.11;f - ,~.'^ --_m ~.' i , ~ ,. icipants`'are Dubliri resident`s? ,~! ~( ~~, ;I ~ i ~ ~~,.r ~ ~~ `~ti ,~.`F '_~ ~-=~~_=~-?'~'~~'r ~~, _- _- - ` ~: ~? ~~~ -~'- - ~ - r'~." _ - -; r ~ `=~, f'~..r~ ~r ~ .- ~ • ,_` ~''rl `l, " tion is accurate and true. , ~ _ ~ ~ h. ~ rr~l ~_I ~ ~ i~ ~ r` t~ :z ~ ' ti 4'y ij r~- ''__~,-- ~i ~, t J''~-~,,~ ----r-~ '- ~ ~) i gram~ h~~ ~ `a, ~~y~ I ?'~F ~ ~'~. ~~,,~' s~'~,''`~ ~ rT .''~ 4'` S ~'. ~ ~J~ ~ f •li, ~~4 ~- ~ ~fi f~ ~` ~. S-'''.f' Y~ i I ; 1 (f,~ f~~~t ~~~ ~ ~ yL r ~ `` ~ ~ ;~ ~.~I ,c ,~ ~~ ,~ '~',~~,_ ~ i'~ ~~l`~ , r~ , ,.~'r`~ 1. ~ ~ " ~~' ~ ~, = ~ i ~~ ~ ~~ ,t , _ ~ `~, ~ -.., r' - -. 4 q , ~~ ~ ', , , ~ ~ 1 ~ ~ ~z' i i ~ I~ .. r=~ ,f'`~ ~-~ `~~. ~` f ~ I ~~1,~''~`;~''"~~~Date• 5'~~ '~ ~~ ~~ ~' '+ ~~. ~~~ ~ ~ ~ ~ r~ ~~ ~,, ~, ~ ; ~ ~ ` ,I ~I , I , ~ * ~ ~u. '~,, ~ I' ~'' ,.'''~ ,,~ ``~ ~ i ~ i ~~ ~ ~ -` ~ ~ ~ ~ I ,_~ ~~~ `, ~ ~ `~ r 4f G - ! _ ~ ' -~- _ _ ~ _ '~, r _ ~ --- ~-~ '~~ ~- - _ --~ ti J~,.~'~~t ~,, i l i ~~,~ ~F^`~',i ~ ~ ~ ~`~ _ ~ , , ~----- ( ~ ~ ( ~ ~ ~i E~ fJ d ~~'~ ~ ~ 1-- --- - ~~`~' ~''-~ ' ~ I i f~- z, `, , r, ~t ~ ~~' ~-,-~_---.~.~ ,-----~ -- « m ~ ~~~~ ~ r, ~`~ ~'~,.~,~' ~ ~ ~ ~ ~~ ~~~~ ~ ~ fi~r ~ ~~ ~~ ~ ~ ~~~ ~~~~ ~ ~~~~ ,1 ' l ~ ~ ~. l.. ~ ~i ~ .~. ./~ s''~'`~ , ~ ~4.1~`''~, ti_~, '`' ~ 1~~~ 1 ( ~~ ~( j ~ I ~~ 1. ~ 1 I ~ i I; 4 ,, , ~~ J~ ~ . :~ _ ,f' f ~~f I~ t~ ) i~ i~ I ~' el _ ~il ~ ~ ~~ ~i 'i ~ ~~~~, ~ -~'``~ ~ ~ ~"' ~ t~l , , ' ` ! ' i,~ ~~~ ~ ~~ Il ll 11 ~~ ~~i -__-,-" a'. ~~..~ ~.._._ ~~ \'4 ~" ..~ "`~ ~~ i j I f~ ; ( r - ~ ` ( I I ~~ I I l, 1~ i~. 4~ i ;' ~~ 'a, ~i .i ~ f ~ r i i i i l ~ ` ~~'~ ~i ~ ~ [~ 9 ~ c '' ~~ ~~~,T ~ j ~ ~~~ ~I~~ ~1~ ~~ ~ ~~ ~4~~ f ', ~`_- I ~ ~ ~ ~~1~ ~ ~ ( i I ~~i~ ti ~ i~ 4~ 1 , ~~ ~ ~-`~~~ r 1~ ,~',r r , ~ ,~ ~r 1 ~ i.. t~ ~~ 4 ~ r ~ `~ ~,~ ti ~~~ _ '',, ,{ `r~ ~ :~ ``~/ ~,r ~ ~ ~' r` ~ ` ~ ~ ~ ~4. '' . '•`.~ `-~ ~'. ~ ~ ~ ~.r ,l~ ;. f f ~ J r~ ; ` r `~`~ i.` ~; ~h ~} '^4, ~ ..~'t r~ ~ ~ ~ y4 ~ ~ ~~ r,, ~`aP .,y?,~ ~ f, .r' :'~'f' ~,r'` ~ F 3 rf .~~r ~.,4r l `4 ~\ ~~ • r, +''' '``"~{ ~.t` '`~ f 'l~' ~ ~ ~4 ~! ;ti _.. ''~x' . ~~``~~ ~ ~ }-r~` f``.. '!' r' ?t'~` z,`';'~., ' ~ ~ ~~~t~ ~`'v'~ =i ~`~ ~-'~''~ r;' l~,-1 -~v.. ~' '~+` !~ r -` •.., s ~ ~ 4 ?~z~~ ~ ' ~ ~~ ~1 y` __ ~-- ~4 ~ ti ~ ~t, ~.. ~ ~ ~ ~ ``h. ~t ~ ,4 7L1 ~ l~/ ~ : ~-~~ =v- ~~: --= ,, ~ ~ ~,, ~-.~`~.~''"~-~..~ -'~ ~ ~ ~~ r ~ i ' ~ ,~,_,- -~ -.;ti. ~ ,~ .~i7 ~ ~ ~``~ ~'" r.,F. "'~~~~. ~' ~ ~ ~I ! ( ~ ~ ~'!~,,''~'`~ '' ~-~~) l ~~~ ~~~` ~ U' ~`X t '~y~ ~ ~'~ t ~~ ~~ , l! I f L ~ ~ ~ 4 ~ _, ~ '~, ~ ; ~i ~f t i~ I W-=~'r ~-~_ '-,,;. .i.~ _~ ` ~ s , ~~`- _:,.~' _ ~ ~ ~ ~ 'J SECTION 2 Page 17 of 19 ~ ~~ am ~ ro .,_ iv AGREEMENT BETWEEN CITY OF DUBLIN AND Chabot-Las Positas Communitv College District/Tri-Vallev One-Stop Career Center THIS AGREEMENT, dated for identification this day of 2010, is entered into between the City of Dublin ("City'~)=and`~CLPGD/TVOS): =~~- ;~ - ii'C ~ ~' -_ ~ ~ -'~~. .~ :-- ~ -= z ~'i`~ ~~, `, ~ - , ~ 7 . RECITALS ~ ;~~ ;'t ' ; ~ i' ~I i i ~'~ ~ 5` ``~'~,,~.. A. ~CLPCD/T~ ~'r i ` ~~ y_ '~ I ~ ~ ~ ,~ ,~ -,.~ VOS)-has asked Cit. to~coritribute'$$15,000 FifteeriaThousand Dollars) for use by (CLPC~D''/TV'OS) to cover-operafional costs in`'order~~fo p'r,ovi'd`e tlie;services as descnbed'~in`~Exhibit A;, ~ The services rendered pursuant to-this agreement w;ill be for the penod~July~l; 2010 tlirough June 30, 2011. ~``~ '~~~~ ~~~`~ s~; ~~~~y ,~r'~~ f ~:?J'" ~r -~-~ ~,1 J~/~~~ iy ~~ B. Cit ~has determ~ined that it is ~in the,inter',est of~the residents of the~City of?Dublin~~to make Y'~ti ~~ ~ ~~ ~~ ~ ~ , ~ ;~. ;'a donation of%$ ~(~° ~- ,- -,Dollars)~ for such purpose,~tprovided ce`r,tain ,~, , ~ ) ~ ~ ~~~ ~ conditions,are met to ensure that the services~wi~ll benefit the residents,of City:, ~; ~, ~,~ i ~` ~~ i' ~l r - ~~ ~'~ -- -z `~ '``~, ~ - - ~~; ~ --- ~~4 ,~~~ i ~i i ~~ ~; ~ ~ J I J ~~( ~ ( _~ f~ ~~ ~~ l ~I I ~ ~ ~ ~~ ~ I 1 r I I I 1 '~~ ~ ~-. ~~ ~`` AGREEMEN~T~'~~ ;~,, ~~~:'~, ~ , ~ ~ '~~~ , ~ ~, ', ~~ ~ ',~ '~ ~ I ~ ~ ~ ~:= ~ ~ ,, ~~ ~ i ~`~ ~i~ ~ ~ ~ t ~l ~~ i City and~~CLPC~D/TV.OS)~agree~,as follows: ~ ~ ~ ,~'' `~ ~i '~~ ~-~ - ~ i ~~ ~~ ~' ~~~ ~~~ , ~~''~,I ,. ~ ,- ~, ~``~ II ~~ _ ~, 1. ~ `~ Reci~tals , ~ r - ~ ~ ~ - - - - ---- '~ ~~' ~ ~ '~'~ ~ ~ ~`~,~ ~~ ~~,,~ I - ~, ' - , ' ~. .. _. 4 ~ Tlie; oregoing recitals a'reltrue_and_correct arid are part of this'agreement. '~~ ~' ;r' ~ ~ ' f ~~ _ -_- ~---~ - i -- - -~ , ~_ ~; ~~ i~~ '~~~_-~~ ~ I ~ . ( . ~'~, ~ ~ ,,r' ~ ,:~~ i 2. ~ , Citvrponation~,,~~ ~ ,,,F ,~ ~ ~ ~ ~.~', ~- '' , _~ ~ ~, : ~ ~. y ~~,'~~'~ ~-~i ~~i ', 'C~ity shal~l donate~$ `~:t ~(~~'.~ Dollars)'to b~e used~~by~fCLPCD/TVOS)~to be ,. , ~ ',~~ ' us'ed for operatic ~`. - ~~ ~' ~ _ . ~ ; I , ~. ,. . -,. .~. ,. '~ ~ ~ ~' ~ ~~.Exhibit A'to this ~, ~ ~ , ~ ~ ,t ~~, ~ ~ ~'~ `~,~, , ~ ,~, 1 ~ 1 4 ~ti~ 3. Record's, '' _ ~, ~~ 4. Dated: Dated: By: John Alves, Director Upon rec made by plan. ent The donation shall b~ p fid upon i r y r _^ _,,~` J I l ~ ~` ~,, ~ ~-`~~ ~. ',, ~~,, -= f . . . ~~`~ . '~ .. --i . . ~.~`r and make ~them4a ~. _ `-•i ~ . _ `-~. ~-• s ' ~,1 -,__ ,.= ~ ~ i ,~.~ ~ i-, ^ _ ,~'(CLPCD/TVO~S); .~..., . ,. , ~ vailabrle~to City upon_..re~ ~ 'J `~F :. J~~f~ ..'r ` -- - -- ~ ~~,~i ~~`~ -- --_- ; ti_ '~~ ti4. the as descnbed~iri ,~,~ r ~e;to'~tlie' Cit'y'' ,;;' ~ ~ ,,~ ~; ~, , ~ ,,. f ~ 1 r' ~ ~, / i' ~' ~ ~ ` f r .~ ~~ ~' f . r: ~ evaluation; ~audit r; `~~ , ~,,.~`~ ~` .'r ~` ,~F ~~ .J'~~ 7bing the progress outlined in the work . - - `';-``- `~' ' ~ ; ~ ' ~ ~'~` .~ `~-_- _T~; ~ - __ '~ ~ -~ - _ _ _ - -_- _- "CITY OF DUBLIN By: Joni L. Pattillo, City Manager SECTION 2 Page 18 of 19 a~ ~~` v ~ ~~ T~ ~ ~ ~,T ~ ~ ~ r~ ~,~'i ~ ~~ 1 ~~ ~'''; ~~ ~~ ~ ~-~ -~.. -Y r r ~, ~^ ~ ..( i ~ f ~ ~ I ! i r I ~r- ,-~ ''"~~`",-, Yf ~~ f~y ~-~ ~< i 1 S~ ~l ~' ~-.`~~. 'L`-~. ,r-t' ~, i i~ ~~ ~..~ i( ~r~~ ~, J a~~ ~~ ~~ f , ~._~ ~ ~~.iL ~f' - ~ - 1 1 ;~~ ,, ~~ ti ','.. ~.~ 'i t ~ _ ~ ~. ._ . ~ ,~ ; 4;-'w '`~ 4~ - _ ~ - ~ ~ ~ ~ ~~ ~'~ ~,~`~ ~ ~*;; ., r ~`:,.4~ ~~s',~'Y`,~ 4.4 `h~, ~ ~. ~"~-`:'r' - "`-"-. ~ . ~'"`."~-;-._..~..~,r''f+`'n' rti ~~'"~4~ ..~,~`~ ,. ~,'`,, ~ ~ ~', t ~`'~y ~,:-~~ ,a ~ ,r'~ ~ ~ I4;~ti F ^. ~',,~f',~ ( fr~ r~r^yi3 ~~ ~~~ ~ ~ r---+_. _ ~~'. ~!`4~~ f ~ °'~ ~ ~~ ~ s fF .h T ~ ~~~ ~~7 ~ ~y ~t~ i ~+ ~ ~~ ~ ~ ~~ ,~:r~ ~ ~ ~ ~ ~ ~'~~ J ~~ ~ ~ ~4 rr,~' j,~~•y ~ r`~~ r' ~-~ ~ f-_~ E~ k °y `'+;~"+_ ~ ~ r,+' ~~ ~1" -,.~`.f f. ' J~ 'A' ~'` " `~~~~ ~l ~tir` ~J'~'r"' ~~i ~ ~ - ___._ '"{ I (` ~T ''- ~ '~ 4 7 ~~~~ r"~- ~~r 1 [~ }i~t~ .~f ' ~`i'~ ,'~~ji ~'~ )~ r' ~"-~ ~'{ ~ ~~ +~ ,"r ~~rt' .~` .~~ ~' ,_ .r~``~ ~ii !~ ~~~t i ~ ( i' I! ~ fr t ~r' ~'~I` r----_,, ~''~,, ~~ ~ _ ._. ~~ ~' ' ---- ~ -E ~i ~t ~~ t~ ~ t~ ~i I t~ ~ J i j~ ,~ r' , ~~ ~ x-,, ~~ ~ ~~-_' =~ ~ ~~ i ~ ~~ I ~ i I ! i~ ~.i! ~ ~~ a~ r~ ,~ fr ~,: ~ ~ ~ ~,,, ,-< < ~ ~ ~~ ~ ~ ~ ~ ~ ~~~~ ~' ~ ~ ~ ~ ~~ ~i ~~ 4_,! ~E~ ,~ ~ ~~. ~'~ ~ I.~`~~ ~~ _- ~''`~ ~~~ ~~ S `-~ ~~ ~~~, ~,~ •` ~ ~ ~ ~ , ~, , ~ ~ ~ _ .- . ,'~f`~'~' ~ ~ r' ~ A _ [~ ~ L _. '-'" ~ j e~ ~~ `4 i ~~`~, f r =~'+, ~ -~ ~ ~~'~~ ~ ~ ~ ~ ~~~~~ ~ _~ f ~ r- - ~ ~ - - r~ ~ (~ ~ 5 ~~ V ~ r , , ______ , ~ l~ i 1 ; ~ i ~ ~!~~~ r i] ~ ~ ~ ~ ' a ~ _ _ . ... ~ t _ ~ ~~~, f° ~ ~T ~' ,~`~ , ~~ ~ r ~. .: ~ ~ .--:~_s r..~.~._._. ~1 .t _ ~t a _ ~-i I ~~~ ~~~-i !~ ~I~~ ~~y ~`' ~,' a ~ ~ I~~ ~ _ ~~~ ~~ , ~ { ~ '`~, ,.~'~ ~'' .~' ~ ~`~. f ; 4 i ~ , ~ r-, i 4 ,~ I I ( , II '1 ~t ~~ ` ~ E ~~~ i ~ ~~'`..~~,-'~~ ,,~~,~ ~ ~' ti ~~ ~w { ~ j~ ~ ~ i~ I + ' ~~ ~~ f F~ ~ ~~1~~. ~~ ~~i ~~ ~~ ~~ ~t ~~t~~ ~~'~- _.,- ~ ~ { L~~ ~ '~ `"' ~-, ~. .~ ~i~~~~~; ~~~ i~ ~~~ ~' !~ 3~~ ~ ,,, ~, ~ ~ ~t tiy ~~. `~ M~ .~ t ; ~, , , ~. ~~ ~~~ ~i l~ t i rr ~. ~ '~~ f ~ rI 3. `! '~:' } I~~ ~ ~ ~1 ~ ~ ~ ~ i r P ~.~~ ~ ~ ( '~ ~ ~ ~ ~ r ' r ~ F ~ ~ ~ l ~ 2t. ~'~~. ~, ~~''"`'- f ~ r~' r `~ S t~ ~ ~~~t ~~t ~' `~~`, ~ ~ ~k'~`'~ ~ ~ ~ ;~, ~. ~ f l' ~ '~ r~~ p~ ~[ tr~ i~ 1 ~. f~l- ~`~~ ~4 i,y_ ~~ `~~ ___. - ~. ~ f~~ ~ r' rT f r~ ~~~` , ` ~ `~?'1 44 \ `4 ~; .4 _ '~ ' ~ ~ .,''F`~ . ~ / 5 4 ~+ '4 ti 'o, y ''._~, ~'~ ~ ~ ~~- ~ ~~' ~'~ ~,,' .~ ~ ,, ,'< ' ~s ~{~ ~, ti `~ `~. r' ~" ~; ' `~ ~' 1 f ,,~' ,~ ~;',t 4, ~ k, 'v.~.. ~ ,r ~~~~ ~ `~'y.,~~ . ~, f ,~`. ~~t '~~= ~, 4, '~ ,~ ~:,~~ ~~.4 ~ ~''~~ ~' ~` r ~ ~ ~ '~ ti '',s- . f.: ~~ ~ ti ~ - . ~- ~ ~~ !~ `~ '~. ~ ~,,,f ~14. a~d- 'i~`-.: ~~``.._ ~-'~~~ r~ ~ - -`' ; f ,r ~ ! C ~ z'-~ 1 si ' - - . ~~ I ~ ~ .. ~~. ti r ~.~ ~ ~If ~ ~ W~ ~~~ ~ ~ ~~ ~ ~ ~~ ~~~ ~"~`~. ~'~ ~ ~ ~ 1~:_ ~-° ~-- ~ _- ~• , ~;,~ ~ ~, ,a. ~ I I'' ~~--- r -'` 2 " t~ "~ti ~~'r 1_ ''~~.~ --~ 7'~ ~ ( i~ ~ ~~' ~-~ - ~.~„ti,. ~ ~~'. tz,~~t~ y .~ . ~';F . ti~,. I , ; ,l ; ~ ~ ~ q ~! ~f` ,, ~~ ~ , ) ( ~ '~~ ,r-''"~'~` ~`'.,-`'- ~4A 3 tf ~~ ~ I ~'~~ ~ ( ~ ( ~) l- .F!` 4, , ti~ -r.'" '-~; -.~ ,~ ~~ ~ I ~ ~~ C ~ ~t _ _ ~-. ` ~'"'`_ -_ ~" ~,s J ,, ~ ~ -- - `'~,. ~. _.rF` ~= - y.,,~ o~ SECTION 2 Page 19 of 19 ~ ~~C:~\~1CY~ -'1~ ~` ~~f • ; i • ~ ~ _ ~~: ~ . . ~ Board of Trustees Members of the Board • Dr. Hal G. Gin (President) represents Trustee Area 6(Hayward, San Lorenzo) since 2005. • Mr. Donald L. "Dobie" Gelles (Board Secretary) represents Trustee Area 4 (Castro Valley and portions of Oakland) since 1998. • Dr. Arnulfo Cedillo represents Trustee Area 3(Union City and South Hayward) since 1985. • Ms. Isobel F. Dvorsky represents Trustee Area 2(San Leandro) since 1985. • Dr. Barbara Mertes represents Trustee Area 7(Livermore and portioiis of Pleasanton) since 2000. • Dr. Marshall Mitzman represents Trustee Area 1(Hayward) since 2008. • Mr. Carlo Vecchiarelli represents Trustee Area 5(Pleasanton, Dublin, Sunol) since 2004. ~ ~ .. .....: x:~. .... . ~ e .>..~..a•r~a..i,u~a:.~.c..w... ..~~,.~.a~,.., ~su ~. ~~ .:s:x~.~a ...,..,.,:.n,.- ~.~,_..nvr,v .,,wY.~.~::~.xx, R, ,..r._»:. _ou,..~...c.~~,u.~...-. i..,b ~.ra, _::.. ..._,.n..: rbx.._..,v..a.....~~.....:~r~.~..~.~r.:,...~a.:..a..., . ~,:...r..~a_..~ c a.cc,.:u~.,..axc-:>~~. r, e. ~ y.~ S, '` . ~`~ ,'~~~r11rY1~=~~t .~ ~; . ~: ~: ,~ ~ City of Dublin '.. ~' Fiscal Year 2010-2011 't' ;_ f ~ Application for Funds r ; ~ ;; . 5. Financial Information - Operating Budget ' r a. Expense Budget ~ ~ ~ . ~ .,: : _ FY 2010.-2011 , ~: ~ EXP-ENSE,BUD 'GET :. . _ . ,. ORGANIZATION. Txis Pxo.rECT/: PROGRAM - ~ ,., , GRANT.REQUEST Personnel Costs T ` . Employee Salaries & Benefits 348,000 12,000 12,000 N,,on-Personnel Costs. . ~ . _ - ~ Services & Supplies 60,615 3,000 3,000 Capital Costs 66,000 Services to Dublin Residents 15,000 15,000 Other (please specify) TOTAL 489,615 15,000 15,000 ;i Further Comments/Explanations (if necessary): ; _ . ; €, ~- These budget f gures are anticipated and represent our best estimate. -- ; , . ' fi F E 4. - , i ~ ' ' ~' . . f ! f; . ` p• ' y f` . - " . . ~ - ~ i; f ~ ~ 4 4 i `: 4, I ~ ~ ~ ` ~ E; ` 'i,' i: . ` ; ~ ' j; ~ i E f', r h ° SECTION 2 '~ €~ ~i Page 7 of 19 ~; ~,; ~; F, . ~~ ;~ ~ ~ ~~ ~.. ~; ~, ~_ z~--~:y:~.;~~..-~~,~: ~w~.,~. . F,~ ~ ~.~_~~.~.- ~.:..~ ~.~~~~.~.~,.~~-~ ~.~~~.w.:~: ~.....~.__Y .~... :. : .~.~:..~~ ~~,_~z,~~ ~ ..zw~,... z-~.~~.- : :~: ~.,:.~,~-.~--~.r.-a~-,~ti COMMUNITY BASED ORGANIZATION ~~~~~~~~f ~~e-~ PY 09-10 Master Contract Exhibit A and B Coversheet C~ l~~-~- ~> Dept. Name: WIB Dept / 320400 vendor ~D #: 27284 eoard PO #: SOCSA - Business Unit: SOCSA Master Contract # 900035 Procurement Contract # Budget Year 2010 ACCOUNT FUND DEPT PROGRAM SUB PROJECT-GRANT Amount to be Total Coniract Encumbered Amount 610341 22404 320400 32000 SSGPCP091000011 $474,615.00 5474,615.00 Procurement Contract: Begin Date: July 1, 2009 Expire Date: June 30, 2010 Contract Maximum: ~474,615.00 Period of Funding: From: JUIy 1, 2009 To: June 30, 2010 Department Contact: David Harkess Telephone: 510-259-3832 FAX: 510-259-3845 QIC: 50306 Contract Name: Chabot-Las Positas Community College District (C-LPCCD) Tri-Valley One-Stop Contractor Address: 5020 Franklin Drive BOS Dist #: 2 Pleasanton CA 94588 Location #: 13 Remittance Address: Same as above Federal Tax I.D. #: 94-1670563 Contractor Telephone #: (925) 485-5262 EmaiC jalvesna clpccd.orq Contractor Contact Person: John Alves FAX #: (925) 485-5273 Contract Service Category: WIA GRANT PROGRAM: ONE-STOP CAREER CENTER OPERATION -- TRI-VALLEY AREA Estimated Units ot Service: Provide One-Stop services as described in Exhibit A/ Statement of Work Maximum Single Payment & Exceptions: Not to exceed 110% of expenditure plan calculated on a monthly basis. Method of Reimbursemenf ( Invoicing Procedures): Line-item cost reimbursement per periodic (monthly) invoice. TOTAL CUMULATIVE INVOICED AMOUNT SHALL NOT EXCEED CONTRACT MAXIMUM. History of Funding ~~ Original ~ Amendment # 1 Funding Level. ~545,000.00 Exhibit Number Amount of Encumbrance ~474,615.00 File Date 6/9/09 File Number Reason Board Approval Funding Source I Federal - CFDA #@ Exhibit B State, ' of Aliocation: I ~474,615.00 -, . The signatures below signify that the attached Exhibits A and B have been reviewed, negotiated and finalized. The Contractor also signifies agreement with all provisions of the Master Contract DEPARTMENT CONTRACTOR Signature Yolanda Baldovinos Title Social Services Agency, Director Amendment # 2 I Amendment # 3 I Amendment # 4 BY Signatu~e Print Name Lorenzo S. Lagaspi r~ue Vice-Chancellor, Business Services oate ,ounry Date i/15/D9 - WIB / drh Print Name Title 7/9/2009 71:34~ Date A-B Cvr 2010 One-Stop 5-15-09.x1s 4~~~c:1~~m~~ C~ NYSTROM & COMPANY LLP CERTIFIED PUBLIC ACCOUNTANTS REDDING, CALIFORNIA INDEPENDENT AUDITORS' REPORT Board of Trustees Chabot-Las Positas Community College District Pleasanton, California We have audi ted the accom panying financi al statements of the busi ness-type activities of the Chabot-Las Positas Community College District (District) as of and for the year ended June 30, 2009, which collectively comprise the DistricYs basic financial statements as listed in the table of contents. These financial statements are the responsibility of the District's management. Our responsibility is to express opinions on these financial statements based on our audit. We conducted our audit in accordance with auditing standards generally accepted in the United States of America; the standards applicable to financial audits contained in Government Auditing Standards, issued by the Comptroller General of the United States; and the standards prescribed by the California State Department of Finance. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatement. An audit includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements. An audit also includes assessing the accounting principles used and the significant estimates made by management, as well as evaluating the overall financial statement presentation. We believe that our audit provides a reasonable bas is for our opinions. In our opinion, the financial statements referred to above present fairly, in all material respects, the financial position of.the business-type activities of the District, as of June 30, 2009, and the changes in financial position and cash flows for the year then ended in conformity with accounting principles generally accepted in the U nited States of America. In accordance with GovernmentAuditing Standards, we have also issued our report dated December 2, 2009, on our consideration of the District's internal control over financial reporting and on our tests of its compliance with certain provisions of laws, regulations, contracts and grant agreements and other matters. The purpose of that report is to describe the scope of our testing of internal control over financial reporting and compliance and the results of that testing, and not to provide an opinion on the i nternal control over financial reporting or on compliance. That report is an integral part of an audit performed in accordance with GovernmentAuditing Standards and should be considered in assessing the results of our audit. Page 2 NYSTROM 8 COMPANY LLP 4v'~ ~~ \ `I Y ~'~ ~ ~ ~~'~~1 1~ CERTIFIE~ PUBLIC ACCOUNTANTS ~ ~ -~S ~ ~ The ManagemenYs Discussion and Analysis (MD&A) on pages 4 through 15 is not a required part of the basic financial statements but is supplementary information required by accounting principles generally accepted in the U nited States of America. We have applied certain lim,ited procedures, which consisted principally of inquiries of management regarding the methods of measurement and presentation of the requi red supplem entary information. However, we did not audit the information and express no opinion on it. Our audit was conducted for the purpose of forming opinions on the financial statements that collectively comprise the District's basic financial statements. The remaining supplementary information as listed in the tabie of contents, including the Schedule of Expenditures of Federal Awards, which is presented for purposes of additional analysis as required by the U.S. Office of Management and B udget Circular A-133, Audits of States, Local Governments, and Non-Profit Organizations, and the Schedule of State Financial Awards, which is presented for purposes of additional analysis as required by the California Community Colieges Chancellor's Office, are not a required part of the basic financiaf statements of the District. Such information has been subjected to the auditing procedures applied in the audit of the basic financial statements and, in our opinion, are fairly stated in all material respects in relation to the bas ic financial statements taken as a whole. ~~~~ ~ ~~~ December 2, 2009 Page 3 ~ ~~C~C.1'1C~~~~1~ ~ CHABOT-LAS POSITAS COMMUNITY COLLEGE DISTRICT December 14, 2009 Agenda Item: Subject: $15,000 funding request from the City of Dublin Background: The Tri-Valley One-Stop Career Center submitted a request for funding for $15,000 to the City of Dublin on 12/14/09. This request for funding was submitted pending Board approval as instructed to due so by the City of Dublin. The Tri-Valley One-Stop is requesting the Board to approve this request. The City of Dublin is awaiting Board approval to further continue the review process. Recommended Action: Board approval. It is further recommended that the Board authorize the Vice Chancellor, Business Services, to execute the agreement and any further augmentations or amendments to the agreement on behalf of the District. Submitted: Lorenzo Legaspi/Date Approved: Joel Kinnamon/Date SWACC CERTIFICATE Ot= COVERAGE I ISSUEDATE o7/zo/o7 ADMINISTRATOR: LICENSE # 0451271 THIS CERTIFICAT~ IS 15SU~D AS A MATTcR OF INFORMATION KEENAN & ASSOCIATF'S ONLYAND CONFcRS NO RIGHTS UPON THc C~RTIFICAT~ 1111 Broadway HOLD~R. THIS CERTI~ICAT~ DOES NOT AMEND, EXT~ND OR SU 1 t° 2 0 0 O ALTER THE COVC~RAGES AFFORD~D BY THE COVc"RAGc Oakland CA 94607 ~ocuM~NT58ELOW. COV~R!=D PARTY: ~NTITIES AFFORDING COV~RAGE cNrirYA Stat~wide Pssoc. of Chabot-Las Positas Comm. College Disc. Community Co1leg~s 5020 Franklin Drive Pl~asanton, CA 94588-3354 a,TrN: Lorenzo Legaspi THIS IS TO CEFFTIFY THA7 THE COVcR4GES LISTcD BELOW HAVc" BEEN ISSUED TO THE COVERcD PkRTY NAMED ABOVE FOR THE PERIOD INDICATED, N07WITHSTANDING ANY REOUIR~MENT, TERM, OR CONDITION 0= ANY CONTRACr OR OTH~R DOCUMCNT WITH RESPECT TO WNICH THIS CcRTIFICATE MAY BE ISSUED OR MAY P~RTAIN THE COVERAGE AFFORDED HEREIN IS SUBJECT TO ALL 7HE TERMS, ANQ CONDITIONS OF SUCH COVERAGE DOCtIMENTS. ENT TYPE OF COVERAGE COVERAGE EFFECTIVE/ MEMBER LTR DOCUMENTS EXPIR.4TION DATE RETAINcD LIMIT LIMITS / DEDUCTIBLE GENERAL LIABILITY A [~GCNERAL LIABILITY [ ]CU~IMSMADE[y,]OCCURRENCE SWC0150007 07~01~07 COMBINED 51NGLE LINIT ~y~GOVERNMENT CODES 0 7 O 1 0 8 ~ ~ $25, 000 EACH OCCURRENCE $ l, 000 000 (XjERRORS80M15510NS ~ ] , - AUTOMOBILE LIAHILITY A (~ANYAU70 [}f]HIRED AUTO SGdC0150047 07 O1 07 I ~ COMBINED 51NGLE LIMIT EACH OCCURRENCE [}{]NON-OWNEDAUTO 07/Ol/OB ~25, 000 $ 1, 000, 000 ~~GARAGE LIABILITY ~XJAUTO PHYSICAL DAMAGE PROPERTV A ALLRISK SWC0150007 07/Ol/07 EXCLUDES EARTHQUAKE & FLOOD $10, 000 07~01~08 $ 250, 000, D00 EACH OCCURRENCE A I STUDENTPROFESSIONALLIABILITY ISWC0150007I 07~01~07 I I 07/O1/08 ~5,000 $Included EACH OCCURRENCE ~cSCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / RESTRICTIONS /SPECIAL PROVISIONS: s respects to the City Grant Recipient Agreement between Las Positas ~rnmunity College, dba Tri-Valley One-Stop Career Center and the City of leasanton dated 7/11/07. ERTIFICATE HOLDER: CITY OF PT EASAi~ITON 200 Old Bernal Avenue Pleasanton, CA 94556 CANCELLAIION...... SHOULD ANY OF 7}iE ABOVE DESCWBED COVERAGES BE CANCELED BEFOR~ THe EXPIRAlION DATE 7HEREOF, THE ISSUING EN i7TY/ JPA WILL ~~PS MAIL 3 O DAYS WrZTfFJd NOT1Cc TO THE CERT7FlCqTE HOLDER NAMED TO THE LEFT, ~~p~Ph~}~~~js~~ ~~i'c-lY'J~'lYilY.YtY`vS'i`-Jl liYaElY'I~l:'YL`ri`1'~aYi3'tiriYr11~'X.'.'J ~~ ~At~~K~X~~9~1~4~ w ~ ~~ A~N: Nelson Fialho, City Manager a..P/L,.D6/20001 of 1 nS83533/M77153 AUTHORIZED REPRCSENTATIVE R3M . .~-.~.;:.~.-...,..}.. , r.~ t.,,,. .~,.,<ti~~ :-. ~.~ ,...... ..~.~. ~. w, .,~ ....,_ ~,_ .r_~ u~~.T.._~ ~,~.. ~..~ ,~..~... . ., ~ ~ ..,.-~u W-. ~.x... .,.,~.ix ~.,.,,~~;~ . ,_ , r.~F,,. ,.. ~ ~ ., , z..~. ~, _,,, .,. _ ,~~_ < _ _ _ . .. r~'~~:.1r1~'1~1~~~ ~ e~ A ~ ~ ~~ ' City of Dublin F~ ~~ Fiscal Year 2010-20ll ~ s ~; ~r }~ Application fo~ Funds ~~ ~ ; ~: r. D 4; rt ~ k ' APPLICATION VERIFICATION ~~ I !1 S' f ~ _ ; I attest that the information contained in this FY 2010-2011 grant application is accurate and that " ~~ ~~ the funds requested will not supplant any other monies secured by the organization. r; F i+ s. ;, i i` 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 , s. ~ report as soon as possible after submitting the reimbursement request, but not later than August " ~ ~-~~ 31, 201 l. Failure to submit a report will result in ineligibility for future funding. ~~ I ~, ; . ~ f ~ Signatures: ~: ~~ ~; f~ ~ ~ F i~ ;° Executive Director Date ` i; i _' ~ ~: ~ r ; r ~, ~~ Board President/Chairperson Date ; E: ' ~ ~~ - ~; i: ~ t ~C i~,l1r1C ~ E; '~ '~ ~x~'Y~rG1 C~~~(~~,~~ ~. ;~ ~F ~. ;; ~ ~: ~ F ~~ ;° t -'` 'i~n ~ ~-~- l ~~ ~ `~ ~ `! ~, ~ t; 6. i • R; i 1.. i f (,: F ~ ~ ' SECTION 2 ~ ~; ;: j Page 12 of 19 ~' ~ ~ ~ ~: f . .,~ i: .^. 1 wL^'...ei11L..'?'i~i:'.£:i~~1..L.T^i:.tiiu,?'i~£C+'_'3La~.~~Sen'..r w~r.i.~ ~w~"'Gr%~~~:~-"~~ IYS~ ~.._.: ~.....iSY:_~ .T+e:4iL'.^=_..av~..?.~. ~..T'J'.5:.°:`iv.:iY!T_i€: 6 __._ ~r_.: .s. a.._..» .~...d~. ~ '~..:.,~: S.'.TT"..^'exw`.F3~:T.~F'a4".u.."Z'~"12:. '~~ .'4J.sT'~:"JrK'3~~.;._...-~..... _.. ~ COLLABORATION I~GENC~ AFFIDAVIT FOIZM o This form is to be completed by each collaborating organization as named by the applicant agency in the proposed project/program. o Completed forms must be submitted at time of application. Collaborating Agency Name: Chabot-Las Positas Community College District/Tri-Valley One- Stop Career Center Agency Division/Department: One-Stop Career Center Project/Program Title: General Employment and Training Services-City of Dublin residents (youth and adults) Project/Program Role Description (i.e., facility space, staff support, etc.): Our overall mission is to provide resources and services in support of employers and all job, training and education seekers. All services are free of charge to our community. Specifically, the additional funding would be used to continue to serve Dublin residents in the following ways: ^ Requested funds would be used to provide workforce development activities to Dublin citizens categorically classified as job seekers, laid off workers/displaced workers, youth, new entrants to the workforce, veterans, persons with disabilities, ex offenders and services for employers. ^ This program is an extension of services offered at the Chabot- Las Positas.College/Tri-Valley One-Stop Career Center acting in compliance with the Federal Workforce Investment Act of 1998. Agency Project/Program Contact Person John Alves Title Director Phone (925) 485-5266 Email jalves@clpccd.org I attest that the applicant agency and our organization agree to work collaboratively to implement the proposed project/program as identified in the FY 2010-2011 funding application. Executive Director Date ~ ~ , 1 ~ ~'~ ~`1 ~~ Projec / rogram Contact Person Date , , SECTION 2 ~ ;~ , :~k- I~C~.~(C+ C~,~~~'~~,1 ~~~~ . Page 13 of 19 ~: ~ , ~, ~ _.a'.-f:~ ..~..:~i..~.~ ... ~us.c.r,. .1 G.~e v.. -..:~ ..._. . '.l~v... 5',~...:.i...... , ..:L:.L~wv_. ...~.:.~..~e..2~ ......>.,..::._ .. ~_i:...~ ~.s:.........~ ~_a~:,.„ `....^..wr,..~i..3 :.~~:'S" .sa..A~:..._::a.. ..: .:......,'fi . -.Y~. ~.:..:.... ~. ~ 1~_...:.i....:.., .:..4~-..:]...~ ....:.}fw i1_~ m.a..X~.i.e.~._ ~ ititCi i~ni ncvciiuc .~ci v~~.v Departmant of tf~e Treasut'y ~~~C~~~~~~P. 0. Box 2508 ate: January 3, 2007 ~ C~ncinnafr, OH ~5201 Person to Contact: CHABOT-LAS POSfTAS COMMUIJfTI' COLLEGE Nfr, Schaiz ID 31-08701 DIST~9ICT Custom~r S~rvice Repres°ntative 5020 FRANKUN DRIV= Tofl ~ree Telephone Number: PLEAS,ANTON CA 94588-0000 877-B29-5500 Federal IdentiTication Number: 94-1670503 Dear Sir or ~adam: This is in response to your request of January 3, 2007, regarding your organization's federal tax status. ~ur records indicate that your organization may be a governmental instrum~ntality or a pofitical subdivision of i state. !o pravision of fhe Internal Revenue Code imposes a tax on the income of govemmental units (such as states -id their pofitical subdivisions). Therefore, it has been the position of the Service that income of governmental nits is not generally subject to federal income taxation. If, however, an entity is not itseif a governmental unit ~r an "infegral part" thAreof), its income will be subject to tax unless an excfusion or exemption appfies. ne exclusion is provided by section 115(1) of the Code, which exciudes from gross income: °...income derived from ... ths exercise of any essentia{ governmental function and accruing to a State or any political subdivision thereof ..." ~ur organization's income may not be subject to tax, either because tfie organization is a governmental unit an "integral part" thereof), or because the income is exciuded under section 115. (n addition, your ~anization may also be e(igible to receive charitable contributions, which are deductible for federal income, ate, and grft tax purposes, Afso, your organization is probably exempt trom many federal excise taxes. ~r o; g4nization may obtain a letter rufing on its s#atus under section 115 by rollowing the procedures cified in Rev. Proc. 2002-1 or its successor. - r organization may also quali'ry for exemption from federal income fax as an organization described in ion 501(c)(3) of the Code. If the organization is an entity separate from the state, county, or municipal :rnment, and if it do~s not have powers or purposes inconsistent with exemption (such as tn~ power to tax ~ exercise enrorcem~nt of regulatory powers), your organization would qualify under saction 501(c)(3), 70 y for exemption, compf~te Form 1023 and pay the required user fee, Attachment I a. How would the requested funds be used? ^ Describe, in detail, the PROPOSED PROJECT/PROGRAM (not the agency). ^ Bulleted text is acceptable. ^ Identify if the proposed project/program is a new service, or extension of an existing one. The Tri-Valley One-Stop Career Center, which is primarily funded by the Alameda County Workforce Investment Board (ACWIB) and fiscally operated by Las Positas Community College, is applying for funding to support the continuing efforts of our career center. Our overall mission is to provide resources and services in support of employers and all job, training and education seekers. All services are free of charge to our community. Specifically, the additional funding would be used to continue to serve Dublin residents in the following ways: Requested funds would be used to provide workforce development activities to Dublin citizens categorically classified as job seekers, laid off workers/displaced workers, youth, new entrants to the workforce, veterans, persons with disabilities, ex offenders and services for employers. ~ This program is an extension of services offered at the Chabot-Las Positas College/Tri-Valley One-Stop Career Center acting in compliance with the Federal Workforce Investment Act of 1998. Examples of services offered are as follows; Core, intensive training and outreach proa ams to youth and ex-offenders. Additionally, in the 2009l2010 fiscal year, The Tri- Valley One-Stop Career Center continues with programs catered to the Women Correctional Institution, as well as the Alameda County Jail both located in the city of Dublin. Core services consist of labor market infonnation, initial assessment of skill levels, job search and placement assistance. Initial assessment and development of Individual Employment Plan, vocational counseling, development of professional resume(s), personalized and video-taped mock interview sessions and feedback, job development and job referrals, financial assistance addressing mental health concerns, testing services (i.e. typing tests, software assessment skills tests, etc), financial assistance to purchase appropriate textbooks or job-specific equipment/licenses (i.e: tool sets, nursing uniforms, construction steel toe boots, Hazmat endorsements, etc), reimbursement of certain parking fees, reimbursement of certain transportation fees; vocational training programs; job retention services; and on-the-job training (OJT) services. Intensive services are available to eligible unemployed individuals who have completed at least one core service, but have not been able to obtain employment, or employed individuals needing additional services to obtain or keep employment that will lead to personal self-sufficiency. The youth component outreach services started in May 2406. It has provided employment and educational services as well as career exploration services to Dublin youth ages 14-21. The Tri-Valley One-Stop Career Center has created a separate youth friendly area within the facility which includes job listings for youth, books, and other materials specifically addressing the needs of our young customers. Counselors and staff are especially sensitive to their needs. Goals are to continue the expansiori of the youth program, to include the following; ^. Provide on-going outreach, emplo}nnent and vocational counseling services to Dublin youth, with a particular focus on at-risk, foster youth and youth with disabilities: ^ Meet with youth at local High Schools and Dublin City Library, work closely with High School Counselors and Workability Coordinators, Apprenticeship program coordinators, participate in High School or local Youth Job Fairs, participate in other events relating to youth employment, work with local businesses to create youth-friendly jobs, provide opportunities for volunteer work, job shadowing, or internships. ^ Increase the selection of books and materials (i.e. DVDs, software, test preparation books, job search guidance books for youth, apprenticeship training materials, etc.) _ b. How would the PROPOSED PROJECT/PROGRAM address an unmet comrriunity need and improve the quality of life for Dublin residents. Why is this projectiprogram needed? The past contributions of the City of Dublin have played a significant role in the success we have had in providing resources and services to job seekers, with education and training to the city's residents. The $15,000 requested funds would address the ever present need especially during these difficult economic times. Dublin residents would have access to up-to-date local area job market information and workforce related services designed for local needs. In the midst of this ongoing recession the number of laid-off/displaced workers continues to rise and has placed a strain on the Center. However, the Center has continued to maintain a high level of achievement through its awards of excellence and will continue to provide this high level of service to the City of Dublin and all those seeking assistance from the Center. The Tri-Valley One Stop in partnership with the Employment Development Department renders mutual assistance to job seekers. For example: A job seeker will come to the Tri-Valley Center and use the 2 phone, fax, and computer to commensurate the opening of the Unemployment Insurance Claim. The economic slump has increased the length of time of being unemployed but however long it takes, the Center will diligently work with the client from the opening of the unemployment claim to the time upon which the client obtains gainful employment. Additionally, the Tri-Valley One Stop will continue to assist with outreach programs targeting the incarcerated prior to release. Specifically, the Alameda County Jail and the Women Federal Correctional Institution, as both facilities are located in Dublin. The Tri- Valley One Stop goal and vested interest is to improve the quality of life for Dublin residents through pride in gainful employment and thereby reducing public assistance. ADULT SERVICES The prediction of this recession worsening, will mean additional lay-offs for the 2009/2010 fiscal year. Displaced workers will not only come from the financial/mortgage industry but also from retail and manufacturing. These are serious times and it will take serious, committed professionals to see those displaced workers through these difficult times. The staff and services of the Chabot-Las Positas College/Tri-Valley One-Stop Career Center will meet the challenges imposed by the looming economy. Additionally, many Dublin clients with unemployment issues have psychosocial concerns that need to be addressed, i.e. divorce, substance abuse, mental health issues, fear of losing one's home/and not being able to provide for one's family. Staff assisted job search guidance and strategizing, labor market research, vocational and personal counseling, job development, retraining for skills upgrading, and appropriate referrals, to naine a few, may all be services useful in stabilizing their situations and providing assistance in once again becoming economically self-sufficient through proper employment. Another large group from within our Dublin service area seeking assistance is comprised of individuals wishing to re-enter the workforce after a prolonged absence (i.e. 3 years+). These numbers are on the rise. Mainly, these are women who have stayed home to raise their children and are now in a desperate position to re-enter the workforce to contribute financially to their families. More often than not, these customers lack the in-demand skill, expertise and knowledge of the current labor market. Our comprehensive services allow them to become reacquainted with current working conditions. In these uncertain and difficult economic times, noticeably, many others are currently employed but, now wish to upgrade their skills in order to become more invaluable to their employer. The protection and retention of their present position has become foremost for some. Our staff and services assist these clients with the necessary tools, education, and training for job retention. YOUTH SERVICES On a daily basis, students drop out of High School and even Middle School. Without a high school diploma, many of these individuals will most likely enter a perpetual cycle of unemployment, government assistance, and possibly prison. According to the California Department of Education, almost one-third of high school students drop out. This problem is further exacerbated by the fact that another third will graduate without the credits needed to attend a four-year university. While many may try to attend college, a large percentage fail as they do not have the skill to decide on a major or understand how the classes relate to the world of work. Youth, in particular at-risk, foster youth and those with disabilities face particular challenges when it comes to job search and decision making about future careers and or educational choices. The purpose of our youth service is to provide assistance to young people in their vocational endeavors and to help them develop skills, habits and attitudes conducive to job success and personal growth. ~ Many youth in our Dublin service area are unaware of potential employers. While many have a need to work in order to assist in the provision of the family or to become financially independent, they lack the skill and the knowledge of how to locate and secure employment. With a strong vocational project, many of these youth will have ' assistance in locating appropriate and fulfilling work or making appropriate educational choices. In addition, the State of California - Department of Children and Family services - now mandates that all foster youth register with their local One-Stop Career Center upon turning 15 '/~. Henceforth, our One-Stop is.busy trying to accommodate and assist our local foster youth. Overall, the program and services will assist Dublin residents, both youth and adults, to become economically self-sufficient and to empower them with the skills, tools, and resources to remain competitive in a rapidly changing global economy. The Dublin community will ultimately be able to reap the benefits of an educated and competitive workforce. c. What documentation/data records support the need for this PROPOSED PROJECT/PROGRAM? Please identify your data sources. Based upon the SmartWare tracking software for the 2009/2010 fiscal year, the Chabot- Las Positas College/Tri-Valley One-Stop Career Center provided basic to intensive services to 853 Dublin residents. This number of 853 does not include the additional number of Dublin merchants and their employees reached in the seminars provided by the Center. These seminars were provided to Dublin merchants prior to the closing or reducing employees. The basic services included but were not limited to access to high 4 speed internet, fax, telephone, copy machine (at no charge) and work related workshops/seininars, to more intensive type services such as career counseling, mock interviews and referrals to various social service type agencies. Additionally, out of the 853, some Dublin residents needed additional intensive training. In this current fiscal year, the total cost of the additional intensive training services provided to Dublin residents, has thus far totaled in excess of $40,000.00. All of the above services mentioned including the intensive training was provided to all 853 + Dublin residents free of charge. As the economy continues to decline, displaced workers from all phases of commerce and trade are being affected. Continued funding of the One-Stop Career Center will be crucial not only for the East Bay but also for Dublin residents. d. Specify the PROPOSED PROJECT/PROGRAM population to be served. All Dublin youth, ages 14-21, with a particular emphasis on at-risk, foster youth, and youth with disabilities. Dublin adult population (18+) (i.e. laid off workers, long-tenn unemployed or underemployed individuals, individuals wishing to reenter the workforce, individuals in need of skills upgrade training, vocational counseling, or strategic job search guidarice) e. Projects/programs must be evaluated to determine if they are being carried out efficiently and if project/pro~ am goals are being met. Please describe how you plan to monitor your project/program's success and impact. In regards to monitoring the program's success and impact on the individual participants, all participants enrolled in the intensive services program component are being tracked and followed up continuously throughout enrollment and for up to 12 months after the program completion by our Case Managers. Therefore, Case Managers are able to develop excellent rapport and close relationships with those clients receiving intensive services, i.e., training or counseling services. Case Managers are ab~le to keep accurate records and data on a client's educational and training achievements as well as employment and job retention infonnation. Certain data, i.e. a client's training and employment status are also being reported to and monitored by the Alameda County Workforce Investment Board, with data supported by the Employment Development Department based on the participant's social security number. Based on our submitted information as well as the data provided by the (EDD), Alameda County (WIB) issues monthly progress reports as well as a final annual report. The reports are made available to staff, all Board inembers, all ACWIB staff, community partnership agencies, and other local One-Stop Career Center staff. Clients who are not enrolled in the intensive component of the program are being . followed up with using our tracking software and database information -`SmartWare.' In addition, we inail surveys to all previously enrolled customers exploring their level of satisfaction with the proj ect as well as ideas for improvement. 5 Alameda County (WIB) also conducts an annual `customer satisfaction' survey, which is being biven to all enrolled and non-enrolled (universal) customers. Since the survey's inception five years ago, the Chabot-Las Positas/Tri-Valley One-Stop Career Center has ranl:ed highest in the last four years among all 14 career centers (in Alaineda and Contra Costa counties included in the survey. As a result, we the Chabot-Las Positas Tri-Valley One-Stop Career Center again received the "Goldstar" for Exemplary Customer Service award. 6 B~JSINESS LICE"JSE The Licensee paid to the City of Dublin the required business license fee and is hereby granted a license for the period stated, to conduct, carry on or engage in the business set forth herein, in conformity ~vith Dublin Municipal Code 4.04 within the City limits. :ty of Dubiin 100 Civic Plaza Dublin, CA 94568 (925) 833-6620 DESCRIPTION: One-Stop Career Center Number: BL-010043 Effective Date: 10/1/2009 Expiration Date: 9/30/2010 TO BE POSTED IN A CONSPICUOUS PLACE • NOT TRANSFERABLEJ Print View http: //~w 5 mai l.clpccd. cc. ca.us: 8000/~w/w ebacc?User. context=pyeq... ~~~~C.I~~~~;~ ~ From: "Marangoni, Eugene" <EMarangoni@aciibrary.org> To: <]Alves@clpccd.org> CC: <jsimerman@clpccd.org> Date; Thursday - December 3, 2009 4:46 PM Subject:Job Seeker's Workshops Presented by Jerry Simerman at Dublin Library in 2009 Dear Mr. Alves: Since 2008, Dublin Library has hosted three different job seeker's workshops, all of which have been presented by Mr. Jerry Simerman of the Tri-Valley One-Stop Career Center in Pleasanton, California. These three workshops - Job Search from A to Z, Resume / Cover Letter Writing, and Resume One-to-One Critique generally attract an average of 12 participants and sometimes more. The first two workshops (Job Search, and Resume/Cover Letter Writing) last 2 hours. In 2009, Mr. Simerman presented his.two workshops on job searching and resume / cover letter writing, and his one-to-one resume critique in March and again in October . The Resume One-to-One Critique, which provides for a 20-minute critique of an individual resume with a specialist from the One-Stop Career Center, usually attracts so many participants that a waiting list is necessary, and once Mr. Simerman had to bring along a colleague to help handle the all the people who wanted to participate. Mr. Simerman and I will be meeting later in December to discuss other program ideas that would help job seekers in the Dublin areas to successfully land new employment. Dublin Library definitely wants to continue making this an ongoing program, and offering job search classes on a quarterly basis. Sincerely, Eugene Marangoni Librarian II Dublin Library 200 Civic Plaza I of 2 12/ l 4/2009 l 0:44 AM _. _ . ~ ~~~.~C~~~~~ ~~-~- ~ ,. ~ ` :~ • 'i ~ . . . Board of Trustees Members of the Board • Dr. Hal G. Gin (President) represents Trustee Area 6(Hayward, San Lorenzo) since 2005. • Mr. Donald L. "Dobie" Gelles (Board Secretary) represents Trustee Area 4 (Castro Valley and portions of Oakland) since 1998. • Dr. Arnulfo Cedillo represents Trustee Area 3(Union City and South Hayward) since 1985. • Ms. Isobel F. Dvorsky represents Trustee Area 2(San Leandro) since 1985. • Dr. Barbara Mertes represents Trustee Area 7(Livermore and portions of Pleasanton) since 2000. • Dr. Marshall Mitzman represents Trustee Area 1(Hayward) since 2008. • Mr. Carlo Vecchiarelli represents Trustee Area 5(Pleasanton, Dublin, Sunol) since 2004. ':~~Vi~a~~n.:a:.dy:••+v . i.K.:~._.~q~~~....v~...,.:~ .=;c.c.. ~..iu.xnf'~...r.~R',:..-...vr.rt .~..~..._..:.M.~ . ,va-....n'u.::+. ^~:.'l.t. .rt..k-~.~...'...:9+.~L~,i-~ul~.RW«.~..5.wd..T.¢<..u.+..Ca...nt.ti.i~c[.: .1_'i~.w.t'...~....._,~iTGt.«,~ ~w~tY.~:lE..r.... .~L.~,+J~'. S. .` i ' r~l ~t ~'~~_~r11'l'1~1~ .~ ~ ~ City of Dublin • i~ '~ Fiscal Year 2010-2011 i:. ~: ~: . ~ ; ~ Application for Funds ~ E. ; ~ ~ ~ ~ ~ 5. Financial Information - Operating Budget t~ ~ F{ a. Expense Budget E: ~. ~~ r; ; 4` f, I; s~ i' ~: F ~r P k' f' ~~ t !~ F r " i. {, ~ i. f E~ ~, k h it f !'~ i ¢: , ~:. ~~ Further Comments/Explanations (if necessary): c, _; . ~'" - These budget figures are anticipated and represent our best estimate. - ~ (~ i. i r I: ; ;~ ;' SECTION 2 ;. _ , ; Page 7 of 19 ~: ~; , . ~~ .:1 6 ~_ CW'iY'Se:~.Fa,~.i'~4,:r.:.'.ZP.:.3-'a.S^u~vS^~~.u3ZS:<_ ~ ~...:~..:«,_.....a:.~.m~...\:.iM`~s~..,.:.:i...~. .•....ie.~'W 11lL.. ,:..~ TM1.~:..a2~.~s;k."...~..A.:..~_~...~".,r'wT~'•T`~TC~.:.~a_..~. .. ~.~1L'T3~^..':i'.es'e .T.3aa:~.'.^.:SZS:S.B~c.3~.+.9~~"_':s~iLS:.~e'....~1L._..,u..a'.3~,".~..,:L'. WIA ne p/ PY 09-10 COMMUNITY BASED ORGANIZATION ~~~,~`~~~Y~I~ Master Contract Exhibit A and B Coversheet C~l ~~,~~ ~> Dept. Name: WIB Dept / 320400 Vendor ID #: 27284 Board PO #: SOC$A - Business Unit SOCSA Master Contract # 900035 Procurement Contract # Budget Year 2010 ACCOUNT FUND DEPT PROGRAM SUB °ROJ~CT-GRANT Amount to be Total Contract Encumbered Amount 610341 22404 320400 32000 ~ SSGPCP091000011 $474,615.00 5474,615.00 ~ Procurement Contract: Begin Date: July 1, 2009 Expire Date: June 30, 2010 Contract Maximum: ~474,615.00 Period oi Funding: From: JUIy 1, 2009 To: June 30, 2010 Departmenf Contact: David Harkess Telephone : 510-259-3832 FAX: 510-259-3845 QIC: 50306 Contract Name: Chabot-Las Positas Community College District (C-LPCCD) Tri-Valley One-Stop Contractor Address: 5020 Franklin Drive BOS Dist #: 2 Pleasanton CA 94588 Location #: 13 Remittance Address: Same as above Federal Tax I.D. #: 94-1670563 Contractor Telephone #: (925) 485-5262 Email: ialves anclpccd.orq Contractor Contact Person: John Alves ~ FAX #: (925) 485-5273 Contract Service Caiegory: WIA GRANT PROGRAM: ONE-STOP CAREER CENTER OPERATION -- TRI-VALLEY AREA Estimated Units of Service: Provide One-Stop~services as described in Exhibit A/ Statement of Work - Maximum Single Payment & Exceptions: Not to exceed 110% of expenditure plan calculated on a monthly basis. Method of Reimbursement ( invoicing Procedures): Line-item cost reimbursement per periodic (monthly) invoice. TOTAL CUMULATIVE INVOICED AMOUNT SHALL NOT EXCEED CONTRACT MAXIMUM. History of Funding ~~ Original ~ Amendment # 1 Funding Level ~545,000.00 Exhibit Number Amount of Encumbrance 5474,615.00 File Date 6/9/09 File Number Reason Board Approval Funding Source I Federal - CFDA #@ Exhibit B State. CO of Allocation: 5474,615.00 - The signatures below signify that the attached Exhibits A and B have been reviewed, negotiated and finalized. The Contractor also signifies agreement with all provisions of the Master Contract. Amendment # 2 ~ Amendment # 3 ~ Amendment # 4 DEPARTMENT By TiUe Date Signature Yolanda Baldovinos CONTRACTOR Bv Signature Print Name Lorenzo S. Lagaspi ~ Tille Vice-Chancellor, Business Services Date Social Services Agency, Director Print Name Date i/15/09 - WIB / drh ~ 7/9/2009 71:34 A-8 Cvr 201 D One-Stop 5-15-09.z1s (~'~~1~~m~e~ C~ NYSTROM & COMPANY LLP CERTIFIED PUBLIC ACCOUNTANTS REDDING, CALIFORNIA INDEPENDENT AUDITORS' REPORT Board of Trustees Chabot-Las Positas Community College District Pleasanton, California We have audited the accompanying financial statements of the business-type activities of the Chabot-Las Positas Community College District (District) as of and for the year ended June 30, 2009, which callectively comprise the DistricYs basic financial statements as listed in the table of contents. These financial statements are the responsibility of the DistricYs management. Our responsibility is to express opinions on these-financial statements based on our audit. We conducted our audit in accordance with auditing standards generally accepted in the United States of America; the standards applicable to financial audits contained in Government Auditing Standards, issued by the Comptroller General of the United States; and the standards prescribed by the California State Department of Finance. Those standards require that we plan and perform the audit to obtain reasonable ass urance about whether the financial statements are free of material misstatement. An audit includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements. An audit also includes assessing the accounting principles used and the significant estimates made by management, as well as evaluating the overall financial statement presentation. We believe that our audit provides a reasonable bas is for our opEnions. In our opinion, the financial statements referred to above present fairly, in all material respects, the financial position of the business-type activities of the District, as of June 30, 2009, and the changes in financial position and cash flows for the year then ended in conformity with accounting principles generally accepted in the U nited States of America. In accordance with GovernmentAuditing Standards, we have also issued our report dated December 2, 2009, on our consideration of the DistricYs internal control over financial reporting and on our tests of its compliance with certain provisions of laws, regulations, contracts and grant agreements and other matters. The purpose of that report is to describe the scope of our testing of internal control over financial reporting and compliance and the results of that testing, and not to provide an opinion on the i nternal control over financial reporting or on compliance. That report is an integral part of an audit performed in accordance with Government Auditing Standards and should be considered in assessing the results of our audit. Page 2 NYSTROM 8 COMPANY LLP 4v1 ~"~/` \( \~' ~ ~i~ ~ ~ ~C~~` l> CERTIFIED PUBLIC ACCOUNTANTS ~ ~ ~~~'S The Management's Discussion and Analysis (MD&A) on pages 4 through 15 is not a required part of the basic financial statements but is supplementary information required by accounting principles generally accepted in the U nited States of America. We have applied certain limited procedures, which consisted principally of inquiries of management regarding the methods of measurement and presentation of the requi red supplementary information. However, we did not audit the information and express no opinion on it. Our audit was conducted for the purpose of forming opinions on the financi al statements that collectively comprise the DistricYs basic financiai statements. The remaining supplementary information as listed in the table of contents, including the Schedule of Expenditures of Federal Awards, which is presented for purposes of additional analysis as required by the U.S. Office of Management and B udget Circular.A-133, Audits of States, Local Governments, and Non-Profit Organizations, and the Schedule of State Financial Awards, which is presented for purposes of additional analysis as required by the California Community Colleges Chancellor's Office, are not a required part of the basic financial statements of the District. Such information has been subjected to the auditing procedures applied in the audit of the basic financial statements and, in our opinion, are fairly stated in all material respects in relation to the bas ic financial statements taken as a whole. y1~~~`~ ~ L~~ Decem ber 2, 2009 Page 3 ~ ~~~~,1~r~~~ ~-~ ~ J CHABOT-LAS POSITAS COMMUNITY COLLEGE DISTRICT December 14, 2009 Agenda Item: Subject: $15,000 funding request from the City of Dublin Background: The Tri-Valley One-Stop Career Center submitted a request for funding for $15,000 to the City of Dublin on 12/14/09. This request for funding was submitted pending Board approval as instructed to due so by the City of Dublin. The Tri-Valley One-Stop is requesting the Board to approve this request. The City of Dublin is awaiting Board approval to further continue the review process. Recommended Action: Board approval. It is further recommended that the Board authorize the Vice Chancellor, Business Services, to execute the agreement and any further augmentations or amendments to the agreement on behalf of the District. Submitted: Lorenzo Legaspi/Date Approved: Joel Kinnamon/Date SWACC CERTIFICATE OF COVERAGE ~ 15SUEDATE o7/20/07 I ADMiNISTR,4TOR: LICE~~SE # 0451271 THIS C=RTI~ICkTE 15 ISSU~D AS A MATT~R OF INFORMATION KEENAN & AS.SOCIATES ONLYAND CONrERS NO RIGHTS UPCN THE CERTIFICAT~ 1111 Broadway HOLD~P.. TH15 C~RTIrICAT~ DO~S NOi ANicND, EXT~ND OR SU1 t° 2000 ALTER TH~ COV~RAGcS AFrORDtD BY THE COV~RAGC Oakland CA 94607 DOCUNcNTSB~LOW. COVERcD PARTY: ~NTI I IcS AFFORDING COVCRAGE ~NTIIYA SLdt°W1C~° P.SSOC. OI Chabot-Las tcsitas Comm. College Dist. Community Co11?ges 5020 Franklin Drive Pl~asanton, CA 94588-3354 A1iN: Lorenzo Legaspi 7HIS IS TO CERTIFY THAT THE COVEr24GE5 USTED BELOW HAVc BEEN ISSUED TO THE COVERED PARTY NAM~D ABOVE FOR THG PERIOD INDICATED, NOTWITY,STANDING ANY REOUIREMENT, TERM, OR CONDITION Or" ANY CONTRACT OR OTH~R DOCl1MENT WITH R; SPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE COVER,4GE AFFORDED HEREIN IS SUBJ~CT TO ALL THE TERMS, AND CONDITIONS OF SUCH COVERAGE DOCUMENTS. ENT TYPE OFCOVERAGE COVERAGE EFFECTIVE/ MEMBER LTR DOCUMcNTS EXPIRATION DATE RETAINED LIMIT LIMITS _ /DEDUCTIBLE GENERAL LIABILITY A ~}{JGENERAL LIABILITY [ ]CLAIMSMADE~}~OCCURRENCE 5WC0150007 07~01~07 COMBINED SINGLE LIMIT ~]{jGOVERNMENT CODES 07/O1/OB g25,000 EACH OCCURRENCE $1 000 000 [X]ERRORS & OMISSIONS ~ ] , , AU70MOBILE LIABILITY A (~{JANYAUTO [}{]HIRED AUTO SWC0150007 07 O1 07 ~ ~ COMBINED SINGLE LIMIT EACH OCCURRENCE [}~JNON-OWNEDAUTO 07/O1/08 $25, 000 ~ 1, 000, 000 (}{JGAR,4GE LIABILITY (X]AUTO PHYSICAL DAMAGE A ALRRPSKTM SWC0150007 07/O1/07 EXCLUDES EARTHQUAKE & FLOOD 0 7/ O l/ 0 8 $10 , 0 0 0 ~ 2 5 0, 0 0 0, 0 0 0 cACH OCCURRcNCE A STUDENTPROFESSIONALLIABIL(TY SWC~150007 07~01~07 07/O1/08 ~5,000 ~Included EACH OCCURRENCc ~ESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES / RESTRICTIONS / SPECIAL PROVISIONS: s respects to the City Grant Recipient Agreement between Las Positas ~mmunity College, dba Tri-Valley One-Stop Career Cent~r and the Cicy o~ ieasanton dated 7/11/07. ERTIFICATE HOLDcR: CITY OF PLEASANTON 200 Old Bernal Avenue Pleasanton, CA 94566 A7TN: Nelson Fialho, City Manager a..P/L..06/20001 of 1 #563533/M77153 CANCcLLA710N ...... SHOULD ANY OF TH~ ABOV~ D~SCRIBED COVER4GES BE CANCELED 9EFOFZ THE EXPIR4TlON DATE THERt'OF, THE ISSUING ENIITY/JPA WILL ~~~ MAIL 3 O DAYS rV~d'TfEN NOiICE TO THG C~R1lrlCqTE HOLDER NAMED TO THE LEr7, ~~~{PJ4~~:~y$~j~~r~~}~~~1 ~~ 'b'~~J~C~A~-~'1{4~~~~{4.'~~.~f'i~37}~. ~~ ~~~x~~~ex~~x~x W i ~J ~ AUTHORIZED REPRESENTATIVE R3M :~,~> >_.,., ~s _.~:.:;.>_v~, ..~~~ ~,~ ,. ~,ti_.~. ~a:y~. ~. ,.,~s~a ~ ~.;,,~-~. ,-~~ <.... .,,. .,,....._~... ,v..k..xx . ,~~_ ~..zr _ ,. >r.,. ~x~ s,~.,,_.~.~ _ ~~ t~ ~~~,`~~~~~-t~.. ~, ~ b ~_ ~' City of Dublin ~~~ Fiscal Year 2010-2011 Application foN Funds APPLICATION VERIFICATION I attest that the information contained in this FY 2010-2011 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 31, 2011. Failure to submit a report will result in ineligibility for future funding. Signatures: Executive Director Board President/Chairperson '` ~~~~G1 G~:~~(~~,L~~ ~C'I~,11`~1C~ ~ ~ '1~ ~ ~~-~ i ~. ~ y ~ `! ~ ~~ Ij f~ ~{ , SECTION 2 Date Date ~ Page 12 of 19 ;~ ,, ~. ,~ G, ~ :~~Cn:^.Ffwv..:~^_'io~i...v.~'.i~v:GT.i~..-.y~.1L...Sbii.u'. ..~~~ ..:..:.......u~u~w.L~.~. ~..v.._~:s3~'.9..+.~~.:x Sw.iw.:^Cr.:.i.].:.o~.~a.~ClCi ti.'._,£..i~.^~bc~:...x.~~.a."E~L ~+~.w..i.,'i'._?^wii.`b'.:_..~...5:~22~..~IvYAi,w':"~" =o-."'~'"~....i~'b'S:.F. " ~. -uMFT.~:`.:"..: - '~'_':s.:~-.5... .~.c..'.t~~~ +.+...'.« ..,c::vi - ti5....~>.~~~.t.... ~~cca.k:c~~.A'U-... 1 ~ 7....__ sT'_.v~ tl...s..~'v.-.......,........~.~Rati~-U.~.i.:A..:~_... ~: s1.r;--~..:_1L•:..~~~_ ~s~~..:_ ..~~ _.~st.T+....fK.........w,a.~.._.:.i...•~c. 3....5._~~w~.tw'W ' ; ~~xC,~~l~-~'~" ~ T; ~ ~ City of Dublin ;- - Fiscal Year 2010-2011 ' Application fo~ Funds COLLABORATION AGENCY AFFIDAVIT FORM o This form is to be completed by each collaborating organization as named by the applicant agency in the proposed project/program. o Completed forms must be submitted at time of application. Collaborating Agency Name: Chabot-Las Positas Community College District/Tri-Valley One- ~` Stop Career Center Agency Division/Department: One-Stop Career Center Project/Program Title: General Employment and Training Services-City of Dublin residents (youth and adults) Project/Program Role Description (i.e., facility space, staff support, etc.): Our overall mission is to_provide resources and services in support of employers and all job, training and education seekers. Al1 services are free of charge to our community. Specifically, the additional funding would be used to continue to serve Dublin residents in the following ways: ^ Requested funds would be used to provide workforce development activities to Dublin citizens categorically classified as job seekers, laid off workers/displaced workers, youth, new entrants to the workforce, veterans, persons with disabilities, ex offenders and services for employers. ~ This program is an extension of services offered at the Chabot- Las Positas College/Tri-Valley One-Stop Career Center acting in compliance with the Federal Workforce Investment Act of 1998. Agency Project/Program Contact Person John Alves Title Director Phone (925) 485-5266 Email jalves@clpccd.org I attest that the applicant agency and our organization agee to work collaboratively to implement the proposed project/program as identified in the FY 2010-2011 funding application. Executive Director , Projec / rogram Contact Person Date I~ ~~ ~'Y Date ~ SECTION 2 ' ;' ~ ~~~~1 ~~`~~` ~~~1(~ Page 13 of 19 ~ ' J ~ f...'`-":~.' ^'SSE'S".:.~'. ..~-.:_"'.~.:k~"E,.^Sm3~r..^~'l.T~'~avT..i..~3~.~w,£,~~~~_....ii«..3'~:'.:~tuS}:i::YS'.,~.r.'~JC:".Cr. iSau~:.~'~7's.:,...6~.........~..^w.`.. .:....~__:.. .:~:::<.`.__.. _ ...:~'-+'..:~'_i..II~._..J: ~PC ....:._=2CE~."'^~.I.1:d.S:y.Bti..:.~:ICL.:. i~it :i ~ini ncvci~uc ..,o~ v~~.c: ate: January 3, 2007 CHABOT-LAS POSfTAS DISTRIC I 5020 FRANKUN DRIVE Depar~ment of tf~e Treasury ~~~C~~~~~~P: 0. Box 2~08 ~ Crncinrati, OH 4~201 COMIv1UNITl' COLLEGE PLEAS.aNTON CA 9458B-0000 Dear Sir or Nadam: Person to Contact: Nfr, Scnatz ID 31-08701 Custom~r 5~rvic~ R~presentative Toll ; ree Telephone Number: 8~-B29-5~00 Federal IdentiTication Number: ~ 94-1070503 This is in response to your r~quest of January 3, 2007, regarding your organizafion's federal tax status. ~ur records indicate that your organization may be a governmental instrumentality or a polifical subdivision of i state. 1o provision of the Internai Revenua Code imPoses a tax on the income of governmental units (such as states -~d their polrtical subdivisions). Therefore, it has been the posrtion of the Service that income of governmental ~its rs not generally subject to federal income taxation. If, however, an entiiy is not itself a governmental unit ~r an "integral part" thereof), its income will be subject fo tax unless an exclusion or exemption applies. ne exclusion is provided by secTion 115(1) of the Code, which excludes from gross income: "...income derived from ... the exercise of any essential governmental function and accruing to a State or any polifical subdivision thereof ..." ~ur organization's income may not be subject to tax, either because the organization is a governmenfai unit an "integral part" fhereof), or because the income is excluded under section 115. In addition, your ~anization may also be e(igible to receive charitable contributions, which are deductible for federal income, ate, and gift tax purposes. Also, your organization is probably exempt from many iederal excise taxes. ~r org4nization may obtain a letter ruling on 'rts status under s~ction 115 by following fhe procedures ciTied in Rev. Proc. 2002-1 or its successor, r organization may also quafi'ry for exemption from federal income rax as an organization described in ion 501(c)(3) of th~ Code. If the organizafion is an entity s~parate from the stafe, county, or municipal ;rnment, and if it do~s not hav~ pow~rs or purposes inconsistent with ~xemption (such as the power fo tax exerciss enr'orc~ment of regufatory powers), your organization would qualify under s~ction 501(c)(3). To ~ for exemption, comp(~t~ Form 1023 and pay the raquired us~r f~?.