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i m.l L!! G' V CITY OF DUBLIN Fiscal Year 2010-2011 12-16-09P04~25 RCVD COMMUNITY GROUP/ORGANIZATION -APPLICATI=ON FOR FUNDS ~ -m COVER PAGE AGENCY~NAME: COMMUNITY RESOURCES FOR INDEPENDENT LIVING (CRIL~ PROPOSED PROJECT/PROGRAM NAME: DUBLIN INDEPENDENT LIV-ING.SERVICES FOR PEOPLE WITH. DISABILITIES FUNDING AMOUNT REQUESTED:.$1 k1,925 3 SECTION 2 Page 1 of 13 ~}TT~c~/f-f~JV? / a~ o, G~ !p _ v CITY OF DUBLIN Fiscal Year 2010-2011 APPLICATION FOR FUNDS 1. Please select one'-,expense category: , ? Capital y Q Operating t ` 2. Applicant Information: Organization/Agency Name Community Resources for Independent Living (CRIL) Mailing Address 439 AStreet,-Hayward, CA' 94541 '(Main Office)- Street Address 3311 Pacific Avenue (Tri-Valley Branch=0ffice) - ' ' - City Livermore' ~ State CA Zip-94550 t i ~~5~ ` ~ ~ ~ Sheri Burns ~ 510-.88.1:-5:743.,. Sheri.Bur~is cr,cril-online.org ExecutiveDirector/Chairperson Work,Phone - Email F Chris Finn - 510-881-5743 ~ Chris.Finn~crl-onliue.org Board President (if applicable) Work-Phone Email Pro ect/iMoth amrimary Project Contact Person who would be able to answer questions about this application and p ~ p g during the funding period. ~ ' ~ , - - John Ouinn ~ ; : Program Director ~ ' _ , ' Contact Person for Project/Program Job Title ; 510-881-5743 John:Quim1(k~,cr1-onlineorg - ~ -510-881-1593 Work Phone Email - - Fax Federal Tax Identification No. (required) 94-2598873 City of Dublin Business License No. (required) BL-009274 SECTION 2 Page 2 of 13 s o I d._.. 4 o~ ~n v a City of Dublin Fiscal Year 2010-2011 Application for Funds 3. Proposed Project/Program Information (Do not describe Organization.) Amount of Funds Requested $11,925 - (Maximum $25,000"per project.) ~ ~ = . Proposed Project/Program~Name: ' - DUBLIN INDEPENDENT LIVING SERVICES~FOR PEOPLE WITH DISABILITIES ~ ~ , Proposed Project/Program Date(s): Start 07 / 0,1 / 2Q10 7 and End 4 06./ 30 /2011. ~ ~ , r ' mo.~ day yr. mo. day yr. Please note: City Council. Grant Funds are distributed on a"reimbursement' basis.'If your Agency needs a 100% disbursement at the beginning of`the;Fiscal Year;'please indicate this • below and provide justification for this need. ,.x,. ~ . , ? Agency is requesting 100% disbursement at the beginning pf the Fiscal Year:'= If selecting this option, please provide justifcation;in,the blank space below.' . ? Agency is not requesting 100% disbursement at' the beginning of the Fiscal Year.' Please~provide the frequency that reimbursements will be submitted to'the City in the blank space below; eg., monthly, quarterly,-"at project=completion; etc., Monthly " ~ ; , , SECTION 2 Page 3 of 13 ® d o' 6 O' l~ Q City of Dublin Fiscal Year 2010-2011 Application for Funds 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 existingone. ¦ An additionaLpage maybe added, if needed. CRIL has maintained 'a full=service branch office in the Tri-Valley area for. several years, and CRIL's Dublin fndependent Li'ving_(IL) Services Program=for~People witli`Disabilities has been grovidinq no-cost IL training, -advocacy and support services fo'hundreds of very low=income Dublin. residents with disabilities~and:xseniors with functional'Iimitatons since 2006. Because the,~majority of CRIL's staff and board have disabilities themselves, Dublin's most; vulnerable residents areable to obtain peer- , based training and counselinga to meet .their personal independent._living goals, thereby maintaining or achieving self-sufficiency and avoiding institutionalization. Through. CRIL's comprehensive, bi-lingual, multi-service team approach, Du61in's frail seniors and people with disabilities of aIP'ages'and cultures 'are better equipped with a variety of 'life -skills needed to live, vuork and' participate fully in 'their community. ' . Comprehensive ILServices-provided-include: _ - _ • Healthy Living Workshops (in conjunctionwith Kaiser Permanente and theAC Food Bank); • Disease Rrevention Workshops and 1:1 Assistance (in conjunction vvith.Kaiser Permanente); • Disaster Planning & Preparedness~Workshops (with-CARD support'; include free 3-day emergency supply/food°';kit); ~ • 'Disability Benefits and Pre-Employment Counseling; • ASsistive Technology Information & Referral and Loan Program; • Peer Support Groups and Individual Peer Counseling; . • Disability Resource .Information; ~ ` ~ , • Self-Advocacy Training~.and Community Advocacy Groups.; _ • Tax Assistance (EKS/VITA); • Census 2010 outreach`assistance and QAC;. - • CRIL also provides.Dublin's'disabled residents with Housing Assistance Through CDBG funding from the cities of Dubl~' ~ ' in; Livermore and Pleasanton.' ~ - - CRIL has an excellent track record in assisting Dublin's residents with disabilities in achieving or maintaining self-sufficienc~r. Last fiscal year, CRIL exceeded its service goals with the City, providing seventeen (17) Dublin residents with disabilities with direct 1:1 support and assistance through one or more IL service; providing indirect information & referral services to another 51 Dublin residents with disabilities and providing 21 businesses and agencies with ADA and other disability information and referral. Moreover, 93% of survey respondents indicated that they had met one or more goals and achieved greater independence. SECTION 2 Page 4 of 13 es a - - r.. nj !o . o a..... One of the many Dublin residents who CRIL assisted last year with funding support from the City of Dublin's Community Grant, is Jon 0., a 49 year old man with a brain injury. Jon and his brother, Jan, were referred by Sue Cervantes, The Groves Property Manager, for support in getting Jon's medical needs met. In May 2009, Jon became a new consumer, and an Independent Living Plan or ILP was developed with Jon. His main objective was to obtain a neurologist to manage his long-term medical needs. His short term goals included: 1) Obtain medical records from Kaiser; and 2) Obtain referral for primary healthcare provider. Both goals were met by July, 2009. To date, Jon has been connected to the appropriate health care professionals for_ongoing support and care, and is now able to adequately focus his efforts on other_personal goals:. " i. It is through the support'of the City of Dublin Community Grant'that CRIL i`s able to impact directly the lives of people with disabilities, Iike~Jon~-who strive to inarease.or maintain their self-sufficiency.:. CRIL is r equesting,;City of Dublin Community- Grant funding support to ,continue our ,partnership in providing more than fifteen, non-housing independent living services and advocacy to seniors with functional limitations and people ofall ages;with-disabilities living in the City of Dublin. With a sustained allocation of $11,925, CRIL will be able to assist a. minimum of 65 low-income Dublin residents with disabilities in meeting their independent, livmg goals and achieving self-sufficiency, Fifteen (15) of these 'residents with receive individualized, 'direct; non-housing services. and fifty '(50) 'will receive intlirect~` information and referral assistance, ''An additional 20 businesses and agencies will "receive .disability information.and consultation services. ` a _ , With an,investment of~just $183~per person; the City of DublirrCommunify Grant.'will g~eatly~incre`ase the number of low-income residents with disabilities who are more self=sufficient and able~to participate fully in their community. - ~ , b. How. would the PROPOSED.~=PROJECT/PROGRAM' address an unmet community need arid' improve the quality of life for Dublin residents. Why is this project/program needed? (Additional page may be added, if needed):.: - i There are close; to 50 000 ,residents in the`~~City of Dublin with upwards of 7 000 (14%) iivinq with a disability (ICF;2004; Hanson, 2004; City of Dublin 2008. CRIL is the only independent~living center in the Tri-Valley.., areas serving- people =with multiple "disabilities:= Inherently, ~=servicesp, to persons with disabilities are services to the' most impoverished members of `our corrimuriity. Additionally, Alameda County has a higher'rate of poverty among adults with disabilities ages 18~'to 64- years than most other bay area counties (Kaye; 2005)..Compounding the poverty; ,people with disabilities are often segregated, isolated in their homes, or in otherwaysdismfranchised:-from their communities. Dublin's mission focuses on supporting a high quality of life and ensuring a safe and secure environment for its diverse community. As our nation is in the midst of experiencing a significant recession, the City's mission plays an even greater role in the lives of its residents. There has been an increased need for support and self-sufficiency services to our community's most vulnerable residents. Independent Living Services, like those provided by CRIL, triumph over the barriers that confront low-income persons with disabilities and disconnect them from full and meaningful participation in their communities, SECTION 2 Page 5 of 13 s a r O~ ; Q v CRIL's Independent Living Services for frail seniors and people with disabilities are free to consumers, and designed to help lower income individuals with disabilities maintain their quality of life, become fully integrated into society, and live as independently as possible. Across several studies and over time, Independent.Living activities have been proven to affect positive outcomes for persons living in the community and to reduce the risks for persons with disabilities to develop secondary conditions (Resnick, 2002; White, 1994 Similarly, peer support is a fundamental principle of the independent living-movement. because, it Phelps -people recognize possibility and the potential of their own abilities: More.;than half of all CRIL staff .are persons with disabilities, and are thereby able to provide both professional 'social services and peer support to Dublin residents with disabilities. - Additionally,_vuhile it~is common knowledge that the'rate~of disability increases~with age, the 2000 Census found that 32:4% of the senior population in Alameda County has a disability; and the City of Dublin is no exception. CRIL has been focusing ,marketing., and outreach efforts to seniors with. disabling conditions .over the, past few years in an effort to; increase the self-sufficiercy of` Dublin. seniors and positively affect their ability to remain in-their own homes. The most utilized CRIL services by Dublin'sseniors are personal assistant / homecare worker~referral and matching, benefits counseling and assistance;' and assistive technology information and referral. rSince .2007, CRIL has added three new services in response to the emerging`needs,of seniors and ,others watt`disabilities and functional limitations: Disaster; Planning and Preparedness,.~workshops, _ Healthy Living and Disease Prevention workshops, and Taz Preparation Assistance (Earn It, Keep~It, Save-Jt 1 VITA)...We would not have been ablefo ad'd these new-programs withoutongoing funding assistance from the'publin~City Gommunity"Grant, the Kaiser' PermanenteTQiablo Valley' Grant, and the~`United Way of the, Bay Area EKS Grant. Moreover, all ,of hese programsyare, available in Spanish to Dublin's significant! Latino population (13.5%), as CRIL's Tr'i-Valley Coordinator,:is awoman with a disability who.; is bicultural and bilingual. One-third of CR1L's other service provider's are also Latino and bilingual,--and one is'Asian and speaks T s., , ~ Cantonese. ~ ~ , r ra.~ Lastly, the federal. government has,. recently mandated,that:all state and local:. i'urisdictions ~inplement disaster. plans that include accessible mass sheltering and ,evacuation of people with disabilities (DoJ, 2008). National and~Statesurveys continue toshow thaf only a minority ofAmericans are.prepared for a significant disaster and have`the needed three `to seven day "shelter in'place" supplies (Kailes, Ostrom, 2006). CRIL's Disaster Planning'-and Preparedness Training_Program-'for Feople..with Disabilities and Seniors with Functional Limitations was, made possible- in large part~;~,due}to _the,,:forward thinking and support of the City of Dublin. Since 20,07, .CRIL- has trained,~nearly,:200- Tri-Valley residents with disabilities in Disaster, Preparedness and;'` provided each with a free light-weight, easily transportable, water-resistant-Survival Kit which includes fist aid -information, 3-day supply of water and food, a mylar blanket, safety light, CRIL-emergency communication device, emergency planning guide and Vial of Life sticker. More than two-thirds of the participants have been seniors with disabilities and the majority request more information on CRIL and/or wish to become a consumer in order to obtain additional services. Post-workshop, four out of five participants consistently state that they feel better prepared and able to respond effectively in the event of a disaster or emergency. Disaster Preparedness Workshops, along with the Healthy Living and Disease Prevention workshops, will continue to be offered to Dublin residents with disabilities through funding support from Dublin City Community Grant and Kaiser's Diablo Valley Community Fund. SECTION 2 Page 6 of 13 a ~o ~I I~ _P ~ What documentation/data/records support the need for this PROPOSED PROJECT/PROGRAM? Please identify your data sources. (Additional page maybe added, if needed.) A number of sources are referenced to support the need and efficacy of CRIL's IL Program for Persons with Disabilities and Seniors with Functional-.Limitations..-Several are listed below. Other data is gleaned from CRIL's database on-Dublin Consumers and from CRIL's Consumer Surveys. - n. . Demographic Profiler The City of Dublin:='The Official`'Website of Dublin; CA., 2008 Census Figures <http://www.ei:dublin.ca.us%DepartmentSubLevel2cfm?PL:=econ&SL=demog&dsplylD=862> Department of Justice. "ADA Guidelines.From fhe U:S. Department of Justice oa-Sheltering for Mass Care," National Organization on Disability, January 8, 2008: " ` Hanson, S., ef.al. "Community Needs Assessment," Cenfer for Applied Local Research, 2004 ICF Publishing.'Human Services NeedsAssessment for fhe .Tri-Valley --Incorporating fhe~,Cities of Dublin, Livermore, and; Pleasanton; Cerifer for'Applied Local-Research; 2003. Kailas; J.."Including: People with Disabilities-and Seniors in Disaster Services"; CDIHP,:June 2006 Kaye, PhD, `Stephen."Disability, Health=&~Employment in California",,Disability Statstics'Center, University of California, San Francisco, 2005 Ostrom, M: "Quake Worries on he Decline", San Jose Mercury,News. April 18, 2006 Resnisk, B. "The impact of self-efficacy`and `outcome expectations on functional status in older adults", Topics in Geriatric Rehabilitation, 1'4(4),,1-10, 2002. White, et al: "Preventing Secondary Conditions: A Role for Independent Living Centers',.National Institute on 'Disability and .Rehabilitation Research;1994'. . U.S. Census Bureau.. Statistic`s: Alameda Coanfy ~Tri-Valley..Cities, 2000 ~ SECTION 2 Page 7 of 13 a ~i F A City of Dublin Fiscal Year 2010-2011 Application for Funds d. Specify the PROPOSED PROJECT/PROGRAM population to be served. CRIL's Independent Living Project-will serve low-income Persons with Disabilities and Seniors with Functional Limitations who reside in the City of Dublin, Specifically., the program will positively impact the lives of Dublin residents who are among :the most impoverished. and vulnerable of the community. _ _ 1. Fifteen (15) low-income residents with disabilities will receive directindependent living skills training in one or mare non-housing services, such as peer counseling, health information, benefits counseling, self-advocacy training, .and assistive technology referral CRIL's ..peer support and ~';fraining will result in a significantly increased ability for Dublin residents with disabilities fo be self- sufficient in their home, work, school, families and community. Services and materials will also be available irr'Spanish and alternate formats. 2. Fifty (50) low-income seniors and- persons with disabilities will receive indirect. ;education, information & referral, and advocacy services .that provide a foundation for improved self- - sufficiency and community participation, including Disaster Planning and Preparedness Training, Healthy Living and Disease Prevention workshops.. ~3. Twenty (20) businesses andlor agencies will receive disability-related education, sensitivity awareness and accessibility consultation resulting in increased structural and services access to consumers with disabilities and. disabling conditions. e. Projects/programs must be evaluated. to ~deteimine if they are beingrcairied out efficiently and~if~project/p'rogram goals are beingmet. Please describe how you plan to monitor your' project/program's success and impact. - ~ - ¦ An additional page,.may be added, if deeded. -~i CRIL has several~solid datasources listed below.to~providequantitative and qualitative information for CRIL staff to evaluate the progress of° its programs: and services. The CRIL database format and programming validity°are:evaluated annually with programming modifications made as needed. • CRIL's Intake Form is used with every. person who wishes to become a consumer of CRIL and participate in creating a plan or set of goals to meet their objective or desired outcome. • Independent Living (IL) Coordinators work with consumers to articulate their personal goals and action steps to achieve greater independence. Each month IL Coordinators submit a list of goals set with consumers so that CRIL's database can maintain a cumulative tracking of consumer goals that are set and met. • Sample Outcome Measure: SECTION 2 Page 8 of 13 A consumer whose outcome objective is to obtain In-Home Supportive Service assistance may create one or more goals with the PAS Coordinator to help him or her reach that objective (e.g., _ meet with the PAS Coordinator to discuss income levels and personal care and homemaking needs, complete the IHSS application process, obtain a list of providers that match the consumer's needs and type of assistance, utilize the Coordinator as an advocate if necessary, and interview and hire an attendant/care provider). The goals are set at Intake, tracked a minimum of monthly with the consumer, then recorded as met when the consumer self-reports to the Coordinator that he or she has achieved the desired outcome (e.g., obtained an attendant or care provider). • CRIL tracks the number of services; their length of time, and the number of contacts per consumer for all consumers seeking IL Coordination services through reporting monthly on our statistics tracking system. • Volunteers who support. CRIL ,.operations and provide peer counseling services complete our volunteer service log. • For individuals who do-not become consumers; CRIL's monthly indirect statistics-;tracking log records any Dublin resident, regardless of disability status, who has received information and .,referral, community education, publications; disability awareness training;. outreach services, and `technical assistance that enhances inclusiveness of services. •Year=round, CRIL administers a consumer satisfaction survey to solicit feedback regarding the equality of its direct service staff. Information is tabulated and presented to CRIL Management and 3 ~ Board ofDirectors for review and any necessary program modification. • Workshop participants are requested to complete aself-evaluation, rating their level of knowledge 'and activity before and after the Disease Prevention or Disaster Preparedness training. Staff"`then ~c'ontacts each participant who becomes a consumer 6 months post-workshop fo again evaluate _'w..the.p~actical impact of CRIL's training. "Quarterly file reviews`ensure quality of documentation and correlate with the direct statistics sheets that account for daily contacts with all consumers. The IL Coordinators meet with the Program .Director regularly for Independent Living Plan sessions to explore solutions related to consumer goal development. This provides both supervision for difficult consumer situations, and an opportunity to note consumer trends that may not be obvious elsewhere. Additionally, all CRIL staff members meet bi- weekly. to discuss community involvement, program activities, and consumer trends. f. Specify numbers of clients servedby agency,then by PROPOSED PROJECT/PROGRAM: AgeneyParticipantInform~ti®n Total Number of Participants Served by Agency (if a~~E~licable) 880 directly; 4,000 indirectly Total Number of Dublin Residents Served by Agency (if applicable) 30 directly; _ 85 indirectly Pu•o'ec~ t/Prc~~ra~~ ParticipantInforanatio~ Total Proposed Participants Served by this Project/Program 15 directly; 50 indirectly SECTION 2 Page 9 of 13 li Total Number of Dublin Residents Served by this Project 15 directly; 50 indirectly _s i SECTION 2 Page 10 of 13 ffii R City of Dublin Fiscal Year 2010-2011 Application for Funds 5. Financial Information -Operating Budget a. Expense Budget ZOlO~~OI 1 Tfii~ 6'iiu.~r~`r/ L\1'l~:A'SF. ~X 1DCoF~f ©1~Gr~~ 17:1T1O~~ PRO(AIZ.~JI l1~N'~ I2EQ[JE S'I' PersonllelCosts ~ _ ~ - EMPLOYEE SALARIES & BENEFITS 575,968 54,319 10,537_ ~~n-Pe~-s®nnel Costs - A000MODATIONS- STAFFIBOARD 1,133 0 0 AUDIT AND ACCOUNTING 5,899,. 458 103 BUIL'DING;`REPAIR`S & MAINTENANCE E 9,598 ~ 5.7 -0 CONSULTANT SERVICES 53,433 1.,839 ' ti 382 DUES,~,PUBS, &-BOOKS 3,500 248. ~ ~ 52 EMPLOYEEFRECRUITMENT ~ " ' 250 0 0 EQUIPMENT &-..FURNITURE , ACQUISITIONS 1,500 0 p . . EQUIPMENT MAINTENANCE 4,000 97 0 FUNDRAISING COSTS 2,500 0 0 INSURANCE 8,503 773 ' 157 INTEREST 500 0 0 OCCUPANCY-RENT & OTHER 4,287 194. 30 OUTREACH 400 75 ~ 0 OTHER COSTS-FOOD/, VOLUNTEER RECOG./STAFF ..An: 0 /BOARD 4,000 0 POSTAGE/PRINTING & COPYING 6,972 716 136 STAFF DEVELOPMENT 4,872 0 0 SUPPLIES-OFFICE & PROGRAM 16,312 454 96 TELEPHONE 12,346 1,844 419 TRAVEL 8,342 80 . 0 UTILITIES 9,899 0 0 TOTAL $734,214 61,154 $11,925 Further Comments/Explanations (if necessary): SECTION 2 Page 11 of 13 - _n City of Dublin Fiscal Year 2010-2011 Application for Funds b. Revenue Budget _ ~ - - F1' ?®10-201 y ~Z@~:~~~~ACiE+ ~$l~l)(~~T ~~IZG.~117.:~'hIO\ NIZOJF:(°l~/~'!:O(~~E~1~11 ('ummitted/R~st~-ictcd 9' dr~~ds i - ~eci f~~~ source) _ Department of Rehabilitation. ~0~,165 3;122 Department of Education" 86,1'05 3,662 Department of Education-ARRA Funds* 50,188 Independent Living Partnership 20.,000 HAAS Foundation 10,000 Non-C®m~~tted7Restii-icted Funds ~ . ~eci I ~ sol~r~~c City of Livermore 6,123 (1,123 City of Pleasanton CDBG 5,182 15,182 City~of Pleasanton. Social Services 5 000 5 000 City~of.Dublin Community-Organization Grant 11,925 11,925 City of Dublin CDBG 5 086 5 086 City of Hayvvard 35,71.$ Gity of San Leandro ,l 0,008 City of Fremont .10,000 United Way of the Bay Area~Fouridation 5,000 San=Francisco Foundation 30,000 Kaiser Permanen"fe:Cammunity Benefit, 11,054 11,054 Diablo Area Foundation General Funds-Fee for Seivice;13;600 Donations, Interest, Fundraisin Total 734,214 61,154 *Note-Multi-year contracts, actual awarded amount may vary, estimated same amount as current year Further Comments/Explanations (if necessary): SECTION 2 Page 12 of 13 m - . ~ _ r ~i i= ® a City of Dublin Fiscal Year 2010-2011 Application for Funds 6. General Agency Infor-mation e D Past grant applicants may check this box in lieu of completing item 6 (a-d) if the program organizational description on-file with-the City is correct and current. a. List all yearsahat Organization has previously received City of~Dubliri funding (not - "i Community Development Block Grant = CDBG). ~4r , ~ ~ ~ b. Describe the population(s) served by the Organization. ' , . c. Describe all the services the,Organization currently provides to Dublin residents. ¦ ` An additional page maybe added, if,needed. ' ' - , - d. Has your agency ever previously received funds from the City of Dublin? If yes, please specify in what Fiscal Years ands the amount received each year. SECTION 2 Page 13 of 13 ~ d 41 to L i~ V City of Dublin Fiscal Year 2010-2011 Application for Funds 7. Required Attachments: - o Only one (1) copy per Agency of each of 'the following is requii•ed,;even wifh multiple ro ects/ ro ra p j p g ms submitted. o Applications without the"following documents will.not be reviewed for funding. . o Please label attachments: A, B, C, etc. ~ A. Names of Governing Board; identify" current Board officers. ~ _B. =Current total Organization operafin'g budget, including revenue., ¦ Clearly labeUideritfy the.. program that" includes ,the PROPOSED,. PROJECT/PROGRAM. " ~ 'C. Most recent"audit report or tax return (if applicable): ~ , _ ~ ~ ~ ~ , ~ , ~ 'D. Resolution, letter or-other document providing evidence of ~ " BoardlOrganization approval of application, and date approval; was granted. ¦ Board/Orgarization appr'ovalmay.begending. , ' ; ; ~ ~ . ~ E. Organization's certificate of insurance.showing coverage for.liability and' workers' compensation: 3 ~ F. Application Verification DeclaratiomSigriature Page. - G.", , ~ ' " Signed.affidavit form from each collaborating_agency-named in"proposed project/program~plan (if applicable). N/A ~ . ~ ' ' - _ i - r f ~ H. Copy of IRS Letter of Determination indicating tax exempt status. SECTION 2 ~a ro i City of Dublin Fiscal Year 2010-2011 Application for Funds _ - r _ _ _--.-APPLICATION VERIFICATION _ ~ I attest that the information contained_in-this F-Y-2010-201.1 grant application is accurate and that the funds regaestedtwill 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 a$er_subrnitfing the~~reimbursement~~request, but not'later than August 31, 201,1.' Failure to submit a report will result iin ineligibilityJfor-future.funding',, ' ~ - - r Signatures ~ _ ~ ~ ~ ~ ~ i ti _ ~ . i ~ / / .I _ _ ~ ~ / 7i b ec iv irec fr~ `~Dat ~~Board~ President/Chairperson. _ - ~ ;Date ti _ ti - ti v- - - - ~ _ - - - .F.: _ _ ~ ~ ~ _ _ ~ _ _ , _ _ y f! _ SECTION 2 Page 16 of 21 Attachment A Is tt any tens a ~ase7 Board of Directors: Chris Finn President Marsha Burch Vice President Randy Dana Secretary/Treasurer Jeffrey Rosen Member-at-Large Dorene M. Giacopini H. Stephen Kaye, PhD William Christensen Steven Mendelsohn , Attachment B Community Resources for Independent Living Proposed Agency Budget FY 2010-2011 PROPOSED PROPOSED AGENCY PROJECT BUDGET BUDGET REVENUE FY 2010.11 FY 2010.11 CITY HAYWARD SS $ 35,718 DUBLIN- COMMUNITY $ 11,925 $ 11,925 SAN LEANDRO-SS $ 10,008 FREMONT SS $ 10,000 LIVERMORE-CDBG $ 6,123 $ 6,123 PLEASANTON SS $ 5,000 $ 5,000 DUBLIN CDBG $ 5,066 $ 5,086 FEE FOR SERVICE•CONTRACTS PLEASANTON CDBG (FEE FOR SERVICE) $ 15,182 $ 15,182 FOUNDATION SAN FRANCISCO FOUNDATION $ 30,000 KAISER PERMENTE COMMUNITY DIABLO AREA FOUNDATION $ 11,054 $ 11,054 HAAS FOUNDATION $ 10,000 UNITED WAY OF THE BAY AREA $ 5,000 GOVERNMENT DEPT OF REHAB-204 $ 339,165 $ 3,122 DEPT OF ED - VIIC ~ $ 86,165 $ 3,662 DEPT OF REHAB - ASSISTIVE TECH $ 70,000 DEPT OF ED-ARRA $ 50,188 INDEPENDENT LIVING PARTNERSHIP $ 20,000 OTHER SOURCES FEE FOR SERVICE-GENERAL $ 5,000 DONATIONS $ 3,000 FUNDRAISING -EVENTS $ 5,000 INTEREST $ 600 TOTAL REVENUE $ 734,214 $ 61,154 OPERATING EXPENSES WAGES $ 454,165 $ 43,656 BENEFITS $ 121,803 $ 10,663 AUDIT AND ACCOUNTING $ 5,899 $ 456 CONSULTANT SERVICES $ 53,433 $ 1,839 DUES, PUBS, AND BOOKS $ 3,500 $ 248 INSURANCE $ 8,503 $ 773 OCCUPANCY -RENT, UTILITIES & OTHER $ 14,186 $ 194 POSTAGE, PRINTING & COPYING $ 6,972 $ 716 SUPPLIES-OFFICE & PROGRAM $ 16,312 $ 454 TELEPHONE $ 12,346 $ 1,644 ACCESS-PROGRAM/STAFF $ 1,133 $ - BUILDINGREPAIRS &MAINT. $ 9,596 $ 57 EMPLOYEE RECRUITMENT $ 250 $ - EQUIPMENTAND FURNITURE ACQUISITIONS $ 1,500 $ - EQUIPMENT MAINT./REPAIRS $ 4,000 $ 97 FUNDRAISING COSTS $ 2,500 $ - INTEREST $ 500 $ - OUTREACH $ 400 $ 75 MEETING COSTS/ ENTERTAINMENT/ STAFF, BOARD, VOLUNTEER RECOGNITION $ 4,000 $ - STAFF DEVELOPMENT $ 4,872 $ - TRAVEL $ 8,342 $ 80 TOTAL OPERATING EXPENSES $ 734,214 $ 61,154 NET EXCESS (DEFICIT) S E • ~ .a AUDIT REPORT ON COMMUNITY RESOURCES~FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA FINANCIAL STATEMENTS AND SUPPLEMENTARY INFORMATION 0 JUNE 30, 2009 AND 2008 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA TABLE OF CONTENTS Page INDEPENDENT AUDITOR'S REPORT 1-2 FINANCIAL STATEMENTS: Statements of Financial Position 3 Statements of Activities 4 Statements of Cash Flows 5 Statements of Functional Expenses 6 Notes to Financial Statements 7-13 SUPPLEMENTARY INFORMATION: INDEPENDENT AUDITOR'S REPORT ON 14 SUPPLEMENTARY INFORMATION INDEPENDENT AUDITOR'S REPORT ON SCHEDULE OF 15-16 EXPENDITURES OF FEDERAL AWARDS SCHEDULE OF EXPENDITURES OF FEDERAL AWARDS 17 INDEPENDENT AUDITOR'S REPORT ON INTERNAL CONTROL 18-19 OVER FINANCIAL REPORTING AND ON COMPLIANCE AND OTHER MATTERS BASED ON AN AUDIT OF FINANCIAL STATEMENTS PERFORMED IN ACCORDANCE WITH GOVERNMENT AUDITING STANDARDS INDEPENDENT AUDITOR'S REPORT ON COMPLIANCE WITH 2O-22 REQUIREMENTS APPLICABLE TO EACH MAJOR PROGRAM AND ON INTERNAL CONTROL OVER COMPLIANCE IN ACCORDANCE WITH OMB CIRCULAR A-133 BOARD OF DIRECTORS AND MANAGEMENT 23 SUMMARY SCHEDULE OF PRIOR YEAR AUDIT FINDINGS 24 SCHEDULE OF FINDINGS AND QUESTIONED COSTS 25 CORRECTIVE ACTION PLAN 26 CHART INFORMATION 27-31 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA INDEPENDENT AUDITOR'S REPORT To: The Board of Directors Community Resources for Independent Living, Inc. Hayward, California We have audited the accompanying statements of financial position of Community Resources for Independent Living (CRIL), Inc., a not- for-profit Corporation, as of June 30, 2009 and 2008 and the related statements of activities, functional expenses, and cash flows for the years then ended. These financial statements are the responsibility of Community Resources for Independent Living Inc.'s management. Our responsibility is to express an opinion on these financial statements based on our audits. Prior year summarized comparative information has been derived from 2008 financial statements and our report dated November 11, 2008 in which we expressed an unqualified opinion on those financial statements. We conducted our audits in accordance with auditing standards generally accepted in the United States of America and the standards applicable to financial audits contained in Governmental Auditing Standards issued by the Comptroller General of the United States. 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 audits provide a reasonable basis for our opinion. In our opinion, the financial statements referred to above present fairly, in all material respects, the financial position of Community Resources for Independent Living, Inc. as of June 30, 2009 and 2008, and changes in its net assets and its cash flows for the years then ended in conformity with accounting principles generally accepted in the United States of America. . In accordance with Government Auditing Standards, we have also issued our report dated September 30, 2009 on our consideration of Community Resources for Independent Living, Inc.'s internal control over financial reporting and on our tests of its compliance with certain provisions of laws, regulations, contracts 1 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA INDEPENDENT AUDITOR'S REPORT (CONT'D) 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 internal 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 audits. Our audits were conducted for the purpose of forming an opinion on the basic financial statements of Community Resources for Independent Living, Inc. taken as a whole. The accompanying schedule of expenditures of federal awards is presented for purposes of additional analysis as required by U.S. Office of Management and Budget Circular A-133, Audits of States, Local Governments, and Non-Profit Organizations, and is not a required part of the basic financial statements. Such information has been subjected to the auditing procedures applied in the audit of the basic financial statements, and, in our opinion, is fairly stated, in all material respects, in relation to the basic financial statements taken as a whole. DENNIS L. LORETTE ACCOUNTANCY CORPORATION Pinole, California September 30, 2009 2 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA STATEMENTS OF FINANCIAL POSITION JUNE 30, 2009 AND 2008 ASSETS 2009 2008 Current Assets: Cash on hand and in bank $ 162,388 $ 99,638 Grants and contracts receivable (Note 3) 128,831 115,979 Unconditional promise to give (Note 4) 78,995 64,243 Prepaid expenses 13,452 15,218 Total Current Assets 383,666 295,078 Property and equipment, net (Note 5) 497,083 515,765 Other Assets: Deposit (Note 6) 1,458 940 TOTAL ASSETS $ 882,207 $ 811,783 LIABILITIES AND NET ASSETS Current Liabilities: Accounts payable and accrued expenses (Note 9) $ 7,723 $ 5,308 Accrued vacations 22,597 22,197 Total Current Liabilities 30,320 27,505 Net Assets: Unrestricted 745,055 699,696 Temporarily restricted (Note 7) 106,832 84,582 Permanently restricted - - Total Net Assets 851,887 784,278 TOTAL LIABILITIES AND NET ASSETS $ 882,207 $ 811,783 * For comparative purposes only The accompanying notes and supplemental information are an integral part of these financial statements. 3 1 ~ COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA STATEMENTS OF ACTIVITIES ' JUNE 30, 2009 AND 2008 TEMPORARILY TOTALS UNRESTRICTED RESTRICTED 2009 2008 SUPPORT AND REVENUE: Government Grants and Contracts $ - $ 666,541 $ 666,541 $ 643,573 Non-Government Grants and Contracts Kaiser Community Fund - 9,000 9,000 8,500 CIL-WIPA - 14,000 14,000 12,723 American Lung Assoc. of CA - 28,700 28,700 - Fees for Service-Contracts Public Authority IHSS - 50,523 50,523 49,051 City of Pleasanton - 14,504 14,504 14,081 United Way of the Bay Area - 4,999 4,999 2,500 Fees for Service-Other PDBTAC-ADA 3,233 - 3,233 2,927 Bus Passes 1,460 - 1,460 49 Kaiser Permanente 5,400 - 5,400 - Contributions 4,155 - 4,155 7,105 Fundraising 5,333 - 5,333 4,224 Interest 1,877 - 1,877 1,196 In-kind Rent and Donations 5,751 - 5,751 4,179 Miscellaneous Revenue 15 - 15 3,117 Total Support 27,224 788,267 815,491 753,225 Net assets released from restrictions 766,017 (766,017) - - Total Support and Revenue 793,241 22,250 815,491 753,225 EXPENSES: Program Services 614,832 - 614,832 614,697 Support Services: Management and general 114,470 - 114,470 124,553 Fundraising and development 18,580 - 18,580 14,977 Total Support Services 133,050 - 133,050 139,530 Total Expenses 747,882 - 747,882 754,227 Changes in net assets 45,359 22,250 67,609 (1,002) NET ASSETS, Beginning of Year 699,696 84,582 784,278 785,280 NET ASSETS, End of Year $ 745,055 $ 106,832 $ 851,887 $ 784,278 * For comparative purposes only The accompanying notes and supplemental information are an integral part of these financial statements. 4 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA STATEMENTS OF CASH FLOWS JUNE 30, 2009 AND 2008 2009 2008 CASH FLOWS FROM OPERATING ACTIVITIES: Changes in net assets $ 67,609 $ (1,002) Adjustments to reconcile changes in Net assets to net cash provided (used) by operating activities: Depreciation 33,378 33,499 (Increase) decrease in: Grants and contracts receivable (12,853) 16,188 Promises to give (14,752) 296,297 Prepaid expenses 1,766 (7,953) Deposits (518) 139 Increase (decrease) in: Accounts payable 2,415 3,656 Accrued expenses 400 3,984 NET CASH PROVIDED BY OPERATING ACTIVITIES 77,445 344,808 CASH FLOWS FROM INVESTMENT ACTIVITIES: Purchase of improvements, equipment and furniture (14,695) (305,176) NET CASH USED BY INVESTMENT ACTIVITIES (14,695) (305,176) NET INCREASE (DECREASE) IN CASH AND CASH EQUIVALENTS 62,750 39,632 CASH AND CASH EQUIVALENTS, BEGINNING OF YEAR 99,638 60,006 CASH AND CASH EQUIVALENTS, END OF YEAR $ 162,388 $ 99,638 * For comparative purposes only The accompanying notes and supplemental information are an integral part of these financial statements. 5 COMMUNITY SERVICES FOR INDEPENDENT LIVING, INC. , (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA STATEMENTS OF FUNCTIONAL EXPENSES YEAR ENDED JUNE 30, 2009 AND 2008 SUPPORT SERVICES FUNDRAISING TOTAL PROGRAM MANAGEMENT AND SUPPORT TOTALS SERVICES AND GENERAL DEVELOPMENT SERVICES 2009 2008 Salaries and related expenses: Salaries $ 381,787 $ 71,879 $ 7,615 $ 79,494 $ 461,281 $ 463,195 Employee benefits 48,541 9,138 969 10,107 58,648 59,688 Payroll taxes 41,963 7,901 836 8,737 50,700 51,449 Total salaries and related expenses 472,291 88,918 9,420 98,338 570,629 574,332 Other operating expenses: Accommodations 1,114 - - - 1,114 196 Building repairs and maintenance 7,783 1,466 155 1,621 9,404 11,319 Bus passes 1,465 - - - 1,465 - Consultants and outside services 23,395 2,455 - 2,455 25,850 29,347 Donations in-kind - - 4,551 4,551 4,551 2,979 Dues, books and publications 3,533 - - - 3,533 3,765 Employee recruitment 200 - - - 200 475 Equipment rents 113 21 2 23 136 68 Equipment repairs and maintenance 1,394 263 28 291 1,685 2,413 Fundraising - - 2,694 2,694 2,694 521 In-Kind-rent 1,200 - - - 1,200 1,200 Insurance 6,510 1,226 130 1,356 7,866 7,805 Interest and service charges - 366 - 366 366 1,019 Legal and accounting - 3,484 - 3,484 3,484 8,289 Meeting costs/refreshments 1,722 324 34 358 2,080 2,819 Miscellaneous - - - - - 3,pg2 Outreach 537 - - - 537 2,801 Postage 4,118 775 82 857 4,975 2,776 Printing and copying 3,638 685 73 758 4,396 800 Rent 3,402 - - - 3,402 3,364 Staff and board recognition 1,815 - - - 1,815 1,622 Staff development 2,377 419 - 419 2,796 7,031 Supplies 15,504 2,920 309 3,229 18,733 20,427 Supplies-(AT Loan Program) 7,469 - - - 7,469 - Taxes and licenses - 709 - 709 709 585 Telephone 11,012 2,073 220 2,293 13,305 11,795 Travel 9,533 1,795 190 1,985 11,518 11,994 Utilities 7,081 1,333 141 1,474 8,555 7,814 Volunteer Recognition - 37 - 37 37 90 Subtotal 587,206 109,269 18,029 127,298 714,504 720,728 Depreciation 27,626 5,201 551 5,752 33,378 33,499 TOTAL EXPENSES $ 614,832 $ 114,470 $ 18,580 $ 133,050 $ 747,882 $ 754,227 * For comparative purposes only NOTE: The accompanying notes and supplementary information are an integral part of these financial statements. COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA NOTES TO FINANCIAL STATEMENTS Page 1 of 7 NOTE 1 - THE ORGANIZATION Community Resources for Independent Living, Inc. (CRIL), is a not- for-profit California Corporation established in March 1979 for the purpose of serving physically disabled adults with programs and activities designed to enhance life styles and increase opportunities for full participation in the life of the community. CRIL is a cross-disability, community-based organization. Anyone with a disability is eligible for services regardless of race, color, national origin, gender, sexual orientation, age, marital status, familial status, religion, or human immunodeficiency virus (HIV) status. CRIL supports, empowers, and teaches skills to persons with disabilities so that they may more fully participate in community and life activities. CRIL teaches and advocates for change to remove barriers to access for persons with disabilities. CRIL derives a substantial portion of its support and revenue from reimbursement type grants with the State of California, Department of Rehabilitation and the U.S. Department of Housing and Urban Development under Community Development Block Grants. The Corporation's Mission Statement is: "Community Resources for Independent Living is a peer- based disability resource agency that advocates and provides resources for people with disabilities to improve lives and make communities fully accessible." NOTE 2 - SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES o Basis of Accounting The financial statements of CRIL are prepared on the accrual basis of accounting and, accordingly, reflect all significant receivables, payables, and other liabilities. 7 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA NOTES TO FINANCIAL STATEMENTS Page 2 of 7 NOTE 2 - SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (CONT'D) o Basis of Presentation Financial statement presentation follows recommendations of the Financial Accounting Standards Board in its Statement of Financial Accounting Standards (SFAS) No. 117, Financial Statements of Not-for-Profit Organizations. Under SFAS No. 117, CRIL is required to report information regarding its financial position and activities according to three classes of net assets: unrestricted net assets; temporarily restricted net assets; and permanently restricted net assets. o Grants and Contracts Support received under grants and contracts is recorded as public support in the appropriate account when related costs are incurred. Grants receivable represent amounts due for expenditures incurred prior to year-end. o Contributions/Donations The Corporation accounts for contributions in accordance with recommendations of SFAS No. 116, "Accounting for Contributions Received and Contributions Made." In accordance with SFAS No. 116, contributions received are recorded as unrestricted, temporarily restricted, or permanently restricted support depending on the existence and/or nature of any donor restrictions. All other donor-restricted support is reported as an increase in temporarily or permanently restricted net assets depending on the nature of the restriction. When a restriction expires (that is, when a stipulated time restriction ends or purpose restriction is accomplished), temporarily restricted net assets are reclassified to unrestricted net assets and reported in the Statement of Activities as net assets released from restrictions. o Functional Expenses CRIL allocates expenses on a functional basis among its programs, support services and fundraising. Expenses that can be identified with program and support service are allocated directly according to expenditure classifications. 8 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA NOTES TO FINANCIAL STATEMENTS Page 3 of 7 NOTE 2 - SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (CONT'D.) o Promises to Give Promises to give (an agreement to. contribute cash or other assets) are recorded as revenue in the period received. Assets received with donor stipulations that limit the use of the asset are reported as restricted support. When the donor restriction expires, that is, when a stipulated time restriction ends or purpose restriction is substantially met, temporarily restricted net assets are reclassified to unrestricted net assets and reported in the statement of activities as net assets released from restrictions. o Property and Equipment Donated property and equipment are recorded as support at estimated fair values. Donated assets are reported as unrestricted support unless the donor has restricted the donated asset to a specific purpose. Assets donated with explicit restrictions regarding their use and contributions of cash that must be used to acquire property and equipment are reported as restricted support. Absent donor stipulations regarding how long those donated assets must be maintained, CRIL reports expirations of donor restrictions when the donated assets are placed in service. Major categories of property and equipment, including their depreciable lives are as follows; Buildings and improvements 15-30 years Equipment 5- 7 years Furniture and furnishings 3- 5 years o Estimates The preparation of financial statements in conformity with generally accepted accounting principles requires management to make estimates and assumptions that affect certain reported amounts and disclosures. Accordingly, actual results could differ from those estimates. 9 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA NOTES TO FINANCIAL STATEMENTS Page 4 of 7 NOTE 2 - SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (CONT'D.) o Cash and Cash Equivalents For purposes of the Statements of Cash Flows, CRIL considers all demand deposits with banks and money market accounts with securities firms to be cash. CRIL had no cash equivalents during the period. o Income Tax Status CRIL has been granted tax-exempt status by the Internal Revenue Service under Code 501(c)(3) and the California Franchise Tax Board under Section 23701 (d) of the Revenue and Taxation Code. o Bad Debts Bad debts are provided for by the direct write-off method of accounting which approximates the same result that would be achieved under a generally accepted accounting method. o Comparative Information The financial statements include certain prior year summarized comparative information in total but not by net asset class. Such information does not include sufficient detail to constitute a presentation in . conformity with generally accepted accounting principals. Accordingly, such information should be read- in conjunction with CRIL's financial statements for the year ended June 30, 2008, from which the summarized information was derived. 10 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA NOTES TO FINANCIAL STATEMENTS Page 5 of 7 NOTE 3 - GRANTS AND CONTRACTS RECEIVABLE Grants and contracts receivable at June 30, 2009 and 2008 are: 2009 .2008 Northridge - CATS $ 4,704 $ - Center for Independent Living 3,619 3,356 US Department of Education, Title VII 24,252 13,798 State of California Department of Rehabilitation 8,681 6,192 Public Authority for IHSS-fee for services 4,844 15 735 City of Livermore - 1,216 City of Fremont 790 4,613 City of Dublin Community Grant 2,849 1,128 City of Pleasanton CDBG 655 2,637 City of San Leandro 833 - Kaiser Community fund 9,000 ~ - State of California Department of Rehabilitation 68,604 67,304 $ 128,831 $ 115,979 NOTE 4 - UNCONDITIONAL PROMISES TO GIVE 2009 2008 Center for Independent Living $ 8,354 $ 6,617 US Dept. of Education Title VII 20,194 35,328 CA Dept. of Rehabilitation 29,247 22,298 American Lung Association of CA 21,200 - $ 78,995 $ 64,243 NOTE 5 - PROPERTY AND EQUIPMENT Property and equipment at June 30, 2009 and 2008 consist of: 2009 2008 Land $ 54,271 $ 54,271 Building and improvements 667,810 667,810 Equipment 91,239 78,532 Furniture 74,977 72,989 888,297 873,602 Less: Accumulated depreciation (391,214) (357,837) $ 497,083 $ 515,765 11 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA NOTES TO FINANCIAL STATEMENTS Page 6 of 7 NOTE 5 - PROPERTY AND EQUIPMENT (CONT'D) Depreciation expense for years ended June 30, 2009 and 2008 was $33,378 and $33,499, respectively. Capitalized fixed assets acquired for years ended June 30, 200'9 and 2008 totaled $ 14,695 and $ 305,176, respectively. NOTE 6 - DEPOSIT This account represents a deposit with Workman's Compensation. NOTE 7 - TEMPORARILY RESTRICTED NET ASSETS At June 30, 2009 and 2008 temporarily restricted net assets consisted of: 2009 2008 Center for Independent Living $ 8,354 $ 6,617 CA Dept. of Education Title VII 20,193 35,328 CA Dept. of Rehabilitation 29,246 22,298 IBM Grant 1,000 1,000 BART Legal Settlement 19,339 19,339 American Lung Association of CA 28,700 - Total $ 106,832 $ 84,582 NOTE 8 - CONCENTRATION OF CREDIT RISK Grants receivable consists of fees and reimbursements due from federal, state, county, and city governments or their agents including pass-throughs from other not-for-profit organizations. At June 30, 2009, receivables from federal agencies or their agents accounted for about 86 percent of the total, while state, county and city governments or their agents account for about 14 percent. 12 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA NOTES TO FINANCIAL STATEMENTS Page 7 of 7 NOTE 9 - ACCRUED EXPENSES - OTHER Accrued expenses-other as of June 30, 2009 and 2008 consists of: 2009 2008 Audit fee $ 3,484 $.4,099 Unemployment insurance 3,485 755 Worker's Compensation insurance 754 455 $ 7,723 $ 5,309 NOTE 10 - LEASES The Center primarily operates from it's headquarter offices in Hayward which are owned by the Corporation. A branch office in Fremont ( $ 2 8 0 /mo . through Jan . 31, 2 0 0 9 and $ 2 9 0 /mo . f rom Feb . 1, 2009 to Jan. 31, 2012) is on a three year lease, and a branch office in Livermore 100/mo.) is on a one-year, in-kind lease that is renewed annually. The annual payment for Fremont in 2008- 09 was $ 3,402, and $ 1,200 for Livermore as in-kind. NOTE 11 - LINE-OF-CREDIT CRIL maintains an unsecured $ 150,000 line-of-credit with its bank. Interest is payable at 7.75 percent. At June 30, 2009 there was no balance outstanding against this line-of-credit. 13 SUPPLEMENTARY INFORMATION COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA INDEPENDENT AUDITOR'S REPORT SUPPLEMENTARY INFORMATION To: The Board of Directors Community Resources for Independent Living, Inc. Hayward, California Our report on the audit of the basic financial statements of Community Resources for Independent Living, Inc. as of June 30, 2009 appears on pages 1 and 2 of this report. The audit was made for the purpose of forming an opinion on the basic financial statements taken as a whole. The supplemental information is presented for purposes of additional analysis and is not a required part of the basic financial statements. Such information for the period has been subjected to the auditing procedures applied in the audit of the basic financial statements and, in our opinion, is fairly stated in all material respects in relation to the basic financial statements taken as a whole. DENNIS L LORETTE ACCOUNTANCY CORPORATION Pinole, California September 30, 2009 14 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA INDEPENDENT AUDITOR'S REPORT ON SCHEDULE OF EXPENDITURES OF FEDERAL AWARDS Page 1 of 2 To: The Board of Directors Community Resources for Independent Living, Inc. Hayward, California We have audited the accompanying statement of financial position of Community Resources for Independent Living, Inc. (a not-for- profit Corporation) as of June 30, 2009, and the related statements of activities, functional expenses, and cash flows for the year then ended. These financial statements are the responsibility of Community Resources for Independent Living, Inc.'s management. Our responsibility is to express an opinion on these financial statements based on our audit. We conducted our audit in accordance with auditing standards generally accepted in the United States of American and the standards applicable to financial audits contained in Government Auditing Standards, issued by the Comptroller General of the United States. 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 basis for our opinion. In our opinion, the financial statements referred to above present fairly, in all material respects, the financial position of Community Resources for Independent Living, Inc. as of June 30, 2009, and the changes in its net assets and its cash flows for the year then ended in conformity with accounting principles generally accepted in the United States of America. In accordance with Government Auditing Standards, we have also issued our reported dated September 30, 2009, on our consideration of Community Resources for Independent Living, Inc.'s roternal control over financial reporting and on our tests of its compliance with certain provisions of laws, regulations, contract, and grant agreements and other matters. The purpose of 15 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA INDEPENDENT AUDITOR'S REPORT ON SCHEDULE OF EXPENDITURES OF FEDERAL AWARDS Page 2 of 2 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 internal 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. Our audit was conducted for the purpose of forming an opinion on the basic financial statements of Community Resources for Independent Living, Inc. taken as a whole. The accompanying schedule of expenditures of federal awards is presented for purposes of additional analysis as required by U.S. Office of Management and Budget Circular A-133, Audits of States, Local Governments, and Non-Profit Organizations, and is not a required part of the basic financial statements. Such information has been subjected to the auditing procedures applied in the audit of the basic financial statements and, in our opinion, is fairly state, in all material respects, in relation to the basic financial statements taken as a whole. DENNIS L. LORETTE ACCOUNTANCY CORPORATION Pinole, California September 30,2009 16 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA SCHEDULE OF EXPENITURES OF FEDERAL AWARDS FOR YEAR ENDED JUNE 30, 2009 PASS-THROUGH FEDERAL ENTITY PASS-THROUGH GRANTOR/. CFDA IDENTIFYING FEDERAL REVENUE GRANTOR/PROGRAM NUMBER NUMBER AWARDS RECOGNIZED Major Program Passed through State of 84.169A 27088 $ 339,866 $ 339,709 California, Department 84.169A 27088 70,000 70,000 of Rehabilitation 26522 22,298 18,377 26522 68,181 38,934 Other Programs U.S. Department of Education Centers for Independent 84.132A H132A010032-08 35,327 35,327 Living Programs 84.132A H132A010032-09 80,727 20,113 Programs U.S. Department of Housing and Urban Development Community Development Block Grant (Independent Living) Passed through the City of Livermore 14.218 N/A 6,000 6,000 City of Dublin CDBG N/A 3,488 3,488 City of Pleasanton CDBG N/A 14,504 14,504 Center for Independent Living Passed through Social Security N/A 8,617 8,617 Administration N/A 12,000 3,646 State Independent Living Council N/A 1,300 1,300 Passed through State of California The University Corporation N/A 10,000 10,000 California State University, Northridge N/A 13,333 13,333 Passed through State of California, Department of Rehabilitation Alameda County Social Services 93.778 23,494 23,494 Total Awards $ 709,135 $ 606,842 The above Schedule of Expenditures of Federal Awards includes the federal grant activity of CRIL and is presented on the accrual basis of accounting. The information in the Schedule is presented in accordance with the requirements of OMB Circular A-133, Audits of States, Local Governments, and Non-Profit Organizations. Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of the basic financial statements. 17 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA INDEPENDENT AUDITOR'S REPORT ON INTERNAL CONTROL OVER FINANCIAL REPORTING AND ON COMPLIANCE AND OTHER MATTERS BASED ON AN AUDIT OF FINANCIAL STATEMENTS PERFORMED IN ACCORDANCE WITH GOVERNMENT AUDITING STANDARDS Page 1 of 2 To: The Board of Directors Community Resources for Independent Living, Inc. Hayward, California We have audited the financial statements of Community Resources for Independent Living, Inc. (a not-for-profit Corporation) (CRIL) as of and f or the year ended June 3 0 , 2 0 0 9 , and have i s sued our report thereon dated September 30, 2009. We conducted our audit in accordance with auditing standards generally accepted in the United States of America and the standards applicable to financial audits contained in Government Auditing Standards, issued by the Comptroller General of the United States. Internal Control Over Financial Reporting In planning and performing our audit, we considered CRIL's internal control over financial reporting as a basis for designing our auditing procedures for the purpose of expressing our opinion on the financial statements, but not for the purpose of expressing an opinion on the effectiveness of CRIL's internal control over financial reporting. Accordingly, we do not express an opinion on the effectiveness of CRIL's internal control over financial reporting. A control deficiency exists when the design or operation of a control does not allow management or employee, in the normal course of performing their assigned functions, to prevent or detect misstatements on a timely basis. A significant deficiency is a control deficiency, or combination of control deficiencies, that adversely affects CRIL's ability to initiate, authorize, record, process, or report financial data reliably in accordance with generally accepted accounting principles, such that there is more than a remote likelihood that a misstatement of CRIL's financial statements that is more than inconsequential will not be prevented or detected by CRIL's internal control. 18 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA INDEPENDENT AUDITOR'S REPORT ON INTERNAL CONTROL OVER FINANCIAL REPORTING AND ON COMPLIANCE AND OTHER MATTERS BASED ON AN AUDIT OF FINANCIAL STATEMENTS PERFORMED IN ACCORDANCE WITH GOVERNMENT AUDITING STANDARDS Page 2 of 2 A material weakness is a significant deficiency, or combination of significant deficiencies, that results in more than a remote likelihood that a material misstatement of the financial statements will be prevented or detected by CRIL's internal control. Our consideration of internal control over financial reporting was for the limited purpose described in the first paragraph of this section and would not necessarily identify all deficiencies in internal control that might be significant deficiencies or material weaknesses. We did not identify any deficiencies in internal control over financial reporting that we consider to be material weaknesses, as defined above. Compliance and Other Matters As part of obtaining reasonable assurance about whether Community Resources for Independent Living's financial statements are free of material misstatements, we performed tests of its compliance with certain provisions of laws, regulations, contracts and grant agreements, noncompliance with which could have a direct and material effect on the determination of financial statement amounts. However, providing an opinion on compliance with those provisions was not an .objective of our audit and, accordingly, we do not express such an opinion. The results of our tests disclosed no instances of noncompliance or other matters that are required to be reported under Government Auditing Standards. This report is intended solely for the information and use of management, others within the entity, Board of Directors, and federal awarding agencies and pass-through entities and is not intended to be and should not be used by anyone other than these specified parties. DENNIS L. LORETTE ACCOUNTANCY CORPORATION Pinole, California. September 30, 2009 19 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA INDEPENDENT AUDITOR'S REPORT ON COMPLIANCE WITH REQUIREMENTS APPLICABLE TO EACH MAJOR PROGRAM AND ON INTERNAL CONTROL OVER COMPLIANCE IN ACCORDANCE WITH OMB CIRCULAR A-133 Page 1 of 3 To: The Board of Directors Community Resources for Independent Living, Inc. Hayward, California Compliance We have audited the compliance of Community Resources for Independent Living, Inc. (a not-for-profit Corporation) with the types of compliance requirements described in the U.S. Office of Management and Budget (OMB) Circular A-133 Compliance Supplement that are applicable to each of its major federal programs for the year ended June 30, 2009. Community Resources for Independent Living, Inc.'s major federal programs are identified in the summary of auditor's results section of the accompanying schedule of findings and questioned costs. Compliance with the requirements of laws, regulations, contracts, and grants applicable to each of its major federal programs is the responsibility of Community Resources for Independent Living, Inc.'s management. Our responsibility is to express an opinion on Community Resources for Independent Living, Inc.'s compliance based on our audit. We conducted our audit of compliance 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 OMB Circular A-133, Audits of States, Local Governments, and Non-Profit Organizations. Those standards and OMB Circular A-133 require that we plan and perform the audit to obtain reasonable assurance about whether noncompliance with the types of compliance requirements referred to above that could have a direct and material effect on a major federal program occurred. An audit includes examining, on a test basis, evidence about Community Resources for Independent Living, Inca's compliance with those requirements and performing such other procedures as we considered necessary in the ,circumstances. We believe that our audit provides a reasonable basis for our opinion. Our audit does not provide a legal determination of Community Resources for Independent Living, Inc.'s compliance with those requirements. 20 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT ORGANIZATION) HAYWARD, CALIFORNIA INDEPENDENT AUDITOR'S REPORT ON COMPLIANCE WITH REQUIREMENTS APPLICABLE TO EACH MAJOR PROGRAM AND ON INTERNAL CONTROL OVER COMPLIANCE IN ACCORDANCE WITH OMB CIRCULAR A-133 Page 2 of 3 In our opinion, Community Resources for Independent Living, Inc. complied, in all material respects, with the requirements referred to above that are applicable to each of its major federal programs for the year ended June 30, 2009. Internal Control Over Compliance The management of Community Resources for Independent Living, Inc. is responsible for establishing and maintaining effective internal control over compliance with the requirements of laws, regulations, contracts, and grants applicable to federal programs. In planning and performing our audit, we considered Community Resources for Tndependent Living, Inc.'s internal control over compliance with the requirements that could have a direct and material effect on a major federal program in order to determine our auditing procedures for the purpose of expressing our opinion on compliance, but not for the purpose of expressing an opinion on the effectiveness of internal control over compliance. According, we do not express an opinion on the effectiveness of Community Resources for Independent Living, Inc.'s internal control over compliance. A control deficiency in an entity's internal control over compliance exists when the design or operation of a control does not allow management or employees, in the normal course of performing their assigned functions, to prevent or detect noncompliance with a type of compliance requirement of a federal program on a timely basis. A significant deficiency is a control deficiency, or combination of control deficiencies, that adversely affects the entity's ability to administer a federal program such that there is more than a remote likelihood that noncompliance with a type of compliance requirement of a federal program that is more than inconsequential will not be prevented or detected by Community Resources for Independent Living, Inc.'s internal control. A material weakness is a significant deficiency, or combination of significant deficiencies, that results in more than a remote likelihood that material noncompliance with a type of compliance requirement of a federal program will not be prevented or detected by the entity's internal control. 21 ~ ~ 9 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA SUMMARY SCHEDULE OF PRIOR YEAR AUDIT FINDINGS YEAR ENDED JUNE 30, 2008 There were no prior year findings. 24 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA CORRECTIVE ACTION PLAN YEAR ENDED JUNE 30, 2009 There were no reportable conditions. 26 Attachment D State of California BOARD RESOLUTION a Original Amendment # Community Resources for Independent Living WHEREAS, the Board of Directors of Community Resources for Independent Living (CRIL) has read the proposed 2010-11 Dublin City Grant application between the City of Dublin and CRIL and said Board of Directors acknowledges the benefits and responsibilities to be shared by both parties to said agreement, NOW, THEREFORE, BE IT RESOLVED that said Board of Directors does hereby authorize the following person or persons: Name of Person Authorized to Sign Agreement Title of Person Authorized to Sign Agreement Chris Finn Board President Sheri Burns Executive Director of Community Resources for Independent Living on behalf of the organization to sign and execute said application and all amendments there to, except to increase the financial liability of said organization. CERTIFICATION I, the Recording Secretary named below, hereby certify that the foregoing resolution was duly and regularly adopted by the Board of Directors of Community Resources for Independent Living at a meeting of said Board regularly called and convened at which a quorum of said Board of Directors was present and voting, and that said resolution was adopted by a vote of the majority of all Directors present at said meeting. IN WITNESS WHEREOF, I have hereunto set my hand as Recording Secretary of Community Resources for Independent Living. Address Where Board Meeting was Held: 439 A Street, Hayward, CA 94541 Date of Board Meeting ~gnature of B~~~ard P - i ent Date Signed December 17, 2008 December 15, 2009 Attachment E POLICYHOLDER COPY NB STATE P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 COMPENSATION I N S U R A N C E FUN D CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 08-07-2009 GROUP: POLICY NUMBER: 0537734-2009 CERTIFICATE ID: 49 CERTIFICATE EXPIRES: 08-07-2010 08-07-2009/08-07-2010 CITY OF DUBLIN NB 100 CIVIC PLZ DUBLIN CA 94568-2658 This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This .policy is not subject to cancellation by the Fund except upon 80 days advance written notice to the employer. We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. ~~,~~1;~.--r..c.~ THORIZED REPRESENTATI PRESIDENT • EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT /{2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 08-07-2000 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NON-PROFIT CORP.) 439 A ST HAYWARD CA 94541 M0410 IRev.2-o5) PRINTED 07-17-2009 ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID JF DATE (MM/DDlYYYY) COMML702 06 24 09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO Nonprofit Services Ins. Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Dennis Costa HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 2843 Hopyard Rd. #169 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Pleasanton CA 94588 Phone: 877-669-5101 Fax:877-669-5109 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: NIAC INSURER B: Comm. Resources for Ind Living INSURER C: 439 A Street INSURER D: Hayward CA 94541 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE MMIDDIYY DATE MMIDD/YY GENERAL LIABILITY EACH OCCURRENCE $ l O O O O O O A X COMMERCIAL GENERAL LIABILITY 2009-16173-NPO 07/01/09 07/01/10 PREMISES (Eaoccurence) $ 500000 CLAIMS MADE ~ OCCUR MED EXP (Any one person) $ 2 0 0 Q 0 PERSONALBADV INJURY $ lOOOOOO X Prof. Liab. inclu GENERAL AGGREGATE $ 3000000 . GEN'L AGGREGATE LIMIT APPLIES PER: ~ PRODUCTS -COMP/OP AGG $ 3 O O O O O O POLICY PRO- JECT Loc Em Ben. 1000000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1000000 A ANY AUTO 2009-16173-NPO 07/01/09 07/01/10 (Ea accident) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ $ HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ ' (Per accident) GARAGE LIABILITY ~ AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR ~ CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND TORY LIMITS ER EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYE $ If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS * 10 days notice of cancellation for nonpayment of premium. Certificate Holder is included as an Additional Insured - Funding Source. CERTIFICATE HOLDER CANCELLATION CITYDUB SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3 O * DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL City o f Dublin IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 100 Civic Plaza REPRESENTATIVES. Dublin CA 94568 AUTH I DREPRESENTATIV 'A~ ~ v ACORD 25 (2001/08) ©ACORD CORPORATION 1 INSURED: Comm. Resources for Ind Living POLICY #2009-16173-NPO COMMERCIAL GENERAL LIABILITY CG 20 26 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Name of Person or Organization: City of Dublin Any person or organization that you are required to add as an additional insured on this policy, under a written contract or agreement currently in effect, or becoming effective during the term of this policy, and for which a certificate of insurance naming such person or organization as additional insured has been issued, but only with respect to their liability arising out of their requirements for certain performance placed upon you, as a nonprofit organization, in consideration for funding or financial contributions you receive form them. The additional insured status will not be afforded with respect to liability arising out of our related to your activities as a real estate manager for that person or organization. (If no entry appears above, information required to complete this endorsement will be shown in the Declaration as applicable to this endorsement) Section II -Who is an insured is amended to include as an insured the person (s) or organization (s) shown in the schedule, but only with respect to liability for "bodily injury", "property damage" or personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned or rented to you CG 20 26 07 04 Page l of 1 Attachment F Attachment H a x ~ E" - . , ~CFRZIFB~C~1~"E':~F.~it"!~S : IQ~IWI~E~TI~ ~G~l!'~!I~+~J~~;TI~J(V' I, K~1/(tJ $HELLEY~ Secretary of State of the ~f~te of Calif~orno~,. hec~eby.~rtify: TYta.t. an the ~ ~ciii d~~i.. n~' .PJlarch ~ 9~~, ~C3,6E!11Mt.I P+tJ;TY :R~S+a!U9~GEa - It~1®~P~NQ?EiNT I,Jtl+~t+li~;: INC b.e~cara~e ira~corfio~ted: t.rr~ier ttie 9s ,~f l:'h~e State of Cal'rfomia by filling its Articles 4f incorpgratioru in ~this.oftac~. That r~o r+ecord exists in this . off"ace of a;- c~rtficage: of: dissoUutian . o€ said corporafion nor of a caurt.octl~r declanng:;d;issotut?on th~rer~f :nor of: a meter nor CorAli~l~lio~t v~rhich terminated its:.exister~~, and': That said cocpQfatiora's cooperate : powers; rigFrts Arad: privEleges are . not sa,aspend~ed on the- recQr!ds Qf'this offir~; ~nd~ TI-aat according tc t}~e :i~cords of.this:~officQ the>~aid coi-~oTation is aukhorized t~o exrr~cise a!P iits corporate . ~we~s; rights:. ar?d prrvilr~s and is : in: good legal stand'ony in the State of ~a,lifomi'a„ ~r~d That no information i~ available in:~this office or3:the tirtar~ciaf candifion, baa~in~ess activity or practices of ttnis ~corpvr~tian. - - 1F~1 ~1UIT'~1~SS'u'~1.HER~~~ 1 ezec,ule_this carti~icate atoll afFIX t~1.~e;.Great S~:a(: i - ofttae.~#~f~.af.Califom?ai tfiis day •of Jariuary:.fi,:2~t}4:': . i ~~C,o..a,~: - KE~IIN' SH~LLFY S~creta.ry ~E S#~'iCc' ro Int~xr~sl Reu~~~ Segv~ic~ D:~.srtm~~.~af t~~e:°~r~eas~ry ~Cinc~u~trs?~, QH ~l~~t~i L3~.1`?~; P+~o~~rnber ZO~Z P~•es~~rotn Gorotact~ :.~,~t~r~~r S~r~rr~~ Sp~ci~lrst Cc~rra~turlity R~our~es 1=vr Rn~er~i~nt La'~ir~g, Ind T~P~ ~re~ T~Ie~~pon~e r'~nmb~.s: 9~ ~l ~treeC a~~o toy ~~~a pm~ ~~ti Hap^nrard,~G~ X454.'1-~1~ ~7~'~82~~~t?~ . . -F~~ ~~psnb~p-, t=~r~~er~al icE~~~fti~~tl~n P~u?~b~r:...... ~~-~~~8$; 3" ~e?r fir a. r M!1~d~~a= - T~i~ I~~k~r irs un: Asa t~a your r~q~est faa~ a ~coyp~r ~f yQnr oc~niz~~rra'~ ~tet~rmgratptan l~tf>ur_ ft~ms f~il:~r>~I :t~ak~ flip ~~c~ ~of.tf.~~ay: r~~u:~s _ D+ur r2o6C~d~ Gr~diicate N~~:t-~ ~d~eter>rrifnatl~,rl wett~l' ~ur~d Cf~ ~QCt~b~r ~18'~9 9~~t~Ci' yt~ur Qr~~nl~'tl~f1 ~3C~8h11p~t1cNi` ~tro?'~ 6~9 inct~me tax un~d~r ~~eti~n ~0~a ~~c~{~j ~i;~ infetrEal I~ev~~,ne ~Co~e_ Ttt~t letter Is:still on ~ffec~: ` tin `it7~~q~7_rlr~..s~h~~gU~n sa~fae~artl:ed, cla~~il`aed ~on~r or~aerazation a~ one fhat rs raot p~w~6~ f~r+undat~on wrfra~ rr~~r~i~g.~f rr ~C?~~,~f d~ ~ec~~us~ it is:an ~rgarrf~ati~`ra ~~~crub~d nri °fhis ~I~ssfr~tl~',r~ :~~s Raa~~l t~a~ ~s~apti~n ~t~at y~r or~ar~~z~ti~on's o~~r~t~o~ v~ould ao~tinue as st~t~i! iry ap~f~tiiorr. ifyi~ur~ar~ae~za~rrn'S~ ~~urc~s ~f sport, or i;t~ ~~t~~~r;'m~t1~~d ~f op~tati~rt5~, . s~~?~s~es i~~v~~~l~g~d, E~~' I~t ~~r9 e~on~ad~r kta~ ~f#"~# ~f ~n t1~`~x~nlpt s~la~u~ ~d f~r~~bot~'~afv~;vf ~rour z~r~~nfz~~;t~n Your ~org~rdization ~s ~e~Juir~ its ~1~ F~~`i~'t ~~4, R~'r~arn ~F Or~~n~ation ~xpt ir~m' Iroc~ame ~~c,' ~~lyrF i?t~~ ~gr~o~~ r~~ipt~ each; dear ire n~nall~r rrtt~ t#~~ ~2~0~7~4. If ~ r~T~rr~,i:s r~~ui~~d, it r~:u~t~faa tal~ct bar tt~`-15th ~i~~ ~R th~fuf#~~ rr~pryth aFfer tt~e;~~nd of the fl~aniia~o~r's ~r?n~l'~cct~i~;br~r~ p~r%dt~. ~e 8a_ur imp~ases a ~er~~ty 4f 2~ a ray, yap t~ a a~amurn $:1p~,fi~t~U; v~rhar~ a r~~~n ?s f?Ied ~at¢, unC~ss tf1~r~~is.~e~,~oa~~te , case • the dsla~. Atl exerrr~st ~rg~n~i~~~ti~ns (ural~ess ~aei~~y excta~~ed) ire li~l~ fo~t t~c~s ~c~ert~~ Fe~t~~i Pr7~ur~n~~ Confr~b~rtiton~ Act ~so~ial.~~1<urity tax~s~ or~:e~e~n~an~raborti.of $1 Q~ ~r rn~r~ ~ t~ e~c#~ Gay d~rin~g i~r~rf.~cy~ar. Yoa~r ar€~ani2~ti~n as rx~t l~tal€~ fvr~~ tic irnpo~~rf under- the Federal IJne~pl~ryrrrr~t'~~c:~tt (FU~Aj. . ' ~ I Or~~nitr~n$ t~a# are nod p~uat~ f~~~rtr~il;: ~,a'~ blot ~j~ct l~ tla~ taxes ~ari~ier Cti~~te~~~2 +af the . 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C~arnm~nt~ R.esouu~~s for lrodnnd~t':Liw"sng, ~rac_ 9~-258873 Your - o~~ni~tion is not rec~u~-~ci tai fig federal rn~om~:~t~x r~e~x~rn$ unl~s~ ~t is $uf~~ct-k~'kh~ ~;G~~~Ea~a~;, - b~psanes~ i~.com~ ~a.d~r ttoQ o~~_ tt your ~o~g~r~~fior~ is s~r~bpeot.to ~~s t~ at ri~~u~E;~C~. , income t~x,r~tum on:tli~ 9~Y Exe171~rk-~7r~~rei~~tiara ~u~iai~~~ Irecosa~ Ta~c R~turh~ Ip~ tlr?~s I~,tk~r, ~~+e~':: are 1G4~t Cf~~:iQT'nlfllt1~ 'u~rtpa~Y". ~~y of dour ol'~~n¢~tian's 'pr~s~rat c~r.pro~as~d ~~ivit~es ~[e ern~lat~d: hr~d~:flr business ~s d~~in~e~:in s~kion ~1~:a~f d~~°;Cade _ Tie Four ~~~r~s y~a~a tea imak~ y'~~r;~F~eP1~k~t~'~ a~¢~~l N-~t~ia7 au~~i~bR~ fc?r p~u~+l~c ~nsp~cti~ra','~v~1~?uk ~i~r.. 'C~r three yae~'~Ft~r the dtae cl~te ~~.the'r~turn- If ~~o~r~r c~rg~nez~ti~on a of its a,~p~iti~~a i`~o` rooo~nituo~ of ±exer7~~ti~n ~r~ Joly ~ ~ 'I'~~7 at is al~n r~ulre~ ~o m~.1~~ ~il~>hre fir ia~k~li~ i~p~e~l~~ra,;~ ~aixy ~oP the eX~tf~r7.~p~l~~flart, ~m,~' sup~critfa~~oc~rrrj~nts ~d~ tha? e~cc~ption ~~tt~erto.~n~ arti~iivsdal.~C wha ir~u~sts:' s~ do~currrent~ ~n pers~i na+'art vsm'hn~, You e~r~:~hr~r~~ ar~ly ~ re~s~an~b~~: tee fer re~prd~u~#o~r a~cl:~:a~Ra~al ~~stage sts:~or ~e ~le~: ~#e~~l~ Thy r'~w e~ nit r~~~Era ~r~~ ~ ~r~~ida c~t~s af,pu~i~ errs ri~aaments yak are wict~eiy r~v~art~bPe- suc9~;~-f~y'pa~stiatg tt`aem on the`Ir~t~rrl~k~ P.!; be Qf~ble fQU' ~ p~n~lkr':~f $~{~.'a rt~r:t~ar e~cfia €E~~r,'~n+u da aa~t mike t~e~se ~i~cumea"nks ~u~nlab9e-far pcu~ilc: insp~ectivr5 {up~ t~ ~ r'n~mior~'c~P ~~~O~~Q sry khe a ~f an a~~n~l return} , ~~ecavse this f~e'kit~r cra~ld help: res~a~r~ an~r~~~~s=abut }roar ar~iar~izak~~rb s exern~~ ste~~ arpd ;f~u~de~~rt sk~t~s; ~hauld [~e~ it ~n!j~a die ~nez~to~o's~~erala~nent r~cor~ds IP'yc~e~, Vtav~ ~n~r ~~~stlc~rt~," pP~~~ C..~~ u~ tliue:f~elepttoa~e~raumb~r ~ ~r~` ~ ~u~a~dta~~'~aF#t~~~~ett~er-: ~'h~is letter ~~fu-~$ ya~ur ar€~iz~x~iara'~ ~ernp~ a.~?~s ray ,~u;hr~ ~Ri~cket~, [~ir~ter, T~'~ Custc~r~er A~c~~rat r~ri