Instructions for completing the Grant Funding Application:

Transcription

1 Instructions for completing the Grant Funding Application: Please be as descriptive as you wish in completing this application. Our intent, particularly in this economically challenging environment, is to focus on the public purpose and impacts of County funding on services to our residents and the consequences of potential reductions in County funding. Please type and single-space all proposals Please answer all of the questions in the order listed. Please use headings as provided Please submit only one copy (electronic preferred) Thank you for this information, and thank you for your dedication and service to the residents of Martin County. If we can be of assistance to you, please do not hesitate to contact us: Jennifer Manning, Budget Manager (772)

2 Cover Sheet Date of application: Name of organization to which grant would be paid. Please list exact legal name: Purpose of grant (brief one/two sentences): Address of organization: Telephone number: Executive Director: Contact person and title (if not executive director): Is your organization an IRS 501(c)(3) not-for-profit? (yes or no): If no, please explain: Grant request: Check one: General Support Project Support one-time request recurring request Total organization budget (for current year): Dates covered by this budget if fiscal year differs from County (mm/dd/yy): Total project budget (if requesting project support): Dates covered by project budget (mm/dd/yy): Project name (if applicable):

3 Grant Proposal Format Proposal Summary Please summarize the purpose of your agency. Explain why your agency is requesting this grant, what outcomes you hope to achieve, and how you will spend the funds if a grant is made. Background Describe the work of your agency, addressing each of the following: 1. A brief description of its history and mission. 2. The need or problem that your organization works to address, and the population that your agency serves. Approximate number of people/animals that are served in an average year by your organization. 3. Current programs and accomplishments. Please emphasize achievements of the recent past. 4. Number of paid full-time staff; number of paid part-time staff; number of volunteers. 5. Your organization s relationships with other organizations working to meet the same needs or providing similar services. Please explain how you differ from these other agencies. Funding Request Please describe the program for which you seek funding 1. If applying for general operating support, briefly describe how this grant would be used and how it contributes to the County s strategic goals. 2. If your request is for a specific project, please explain the project including: a. A statement of its primary purpose and the need or problem that you are seeking to address. b. The population that your plan to serve (include approximately how many served) and how this population will benefit from the project. c. Strategies that you will employ to implement your project. d. Anticipated length of the project. e. How the project contributes to your organization s overall mission. f. How the project contributes to the County s strategic goals. Evaluation Please explain how you will measure the effectiveness of your activities. Describe your criteria for a successful program and the results you expect to have achieved by the end of the funding period. Reduction Strategies 1. What strategies have you used to date for reducing costs or increasing revenues? 2. Do you expect to lose other funding from other sources during FY17? 3. Will County funding be used as match to leverage other dollars?

4 Grant Application Attachments Financial Information Your organization s most recent Financial Statement List of all financial supporters of the organization as well as all other sources of income, with amounts, for the fiscal year in which the grant request is being made (see attachment A ). Line-item detail operating budget for the organization for the fiscal year in which the grant request is being made (see attachment B ). List of all sources of income towards the project if your request is for a specific project (use attachment A and be specific to the project). A current expense budget for the project if your request is for a specific project (use attachment B and be specific to the project). Grant Application Attachments Other Supporting Materials List of the Board of Directors, with their affiliations Copy of organization s most recent Form 990, Department of the Treasury, Internal Revenue Service, Return of Organization Exempt from Income Tax (501 (c)(3) tax-exempt status) The organization s organizational chart Most recent annual report Certified resolution by the Applicant s Board of Directors authorizing submission of the grant application

5 Statement of Assurances As a condition of receipt of County funds, the applicant must comply with the requirements of courts, local, state, and federal laws, rules, regulations, and guidelines. As a part of the application and as a part of acceptance and use of County funds, the applicant agrees that: 1. It possesses legal authority to apply for the assistance, that the application has been approved by the applicant's governing body, including all assurances contained herein. 2. It will utilize County funds to provide a range of services and activities having measurable and potentially major impact on the community's mental or physical welfare needs. 3. It will submit copies of executed grant contracts when match funds are requested. In addition, the County will be advised of amendments and provide copies of each amendment to grant contracts. 4. It possesses the sound fiscal control and fund accounting procedures necessary to assure the proper disbursal of an accounting for County funds. 5. It will permit and cooperate with county, state, and federal investigations designed to evaluate compliance with the law. 6. It will give the Board, the Clerk of Circuit Court, or any authorized representative complete access to examine all records, books, papers, or documents related to the assistance. 7. It will, in accordance with Florida Statutes, comply with nondiscrimination provisions. 8. It will, in accordance with Florida Statute , comply with the provisions of public examination of records in regards to said funds. 9. It will attest, the application and its various sections, including budget data, are true and correct. Information contained in this application accurately reflects the activities of this agency and that the expenditures or portions thereof for which County funds are being requested are not reimbursed by any other source. 10. Upon being awarded assistance, the applicant agrees to have an audit* performed after each assistance period in accordance with accepted accounting procedures. 11. An organizational chart of the Board of Directors and Administrators, including their names and offices or position held will be submitted as part of the application. 12. The application will become part of a contract between the Board and the Applicant.

6 Statement of Assurances Continued (Please attach to grant proposal/application) AGENCY AUTHORIZED OFFICIAL: Name: Title: Signature: Date: * On an annual basis, the Recipient shall submit to the County either: a) an Audit Report if grant funds exceed 50,000; b) a Review Report if grant funds are between 25,000 to 50,000 (or an Audit Report if available); or c) a Compilation Report if grant funds are below 25,000 as each of the foregoing terms is defined by the American Institute of Certified Public Accountants (AICPA).

7 STATEMENT OF FINANCIAL OFFICER Accounting System Certification (Please attach to grant proposal/application) I am the Chief Financial Officer of (name of organization) and, in this capacity, I will be responsible for providing financial services adequate to insure that establishment and maintenance of an accounting system for (name of organization), which is a nonprofit agency charged with carrying out a program(s) under County funding. The accounting system will have internal controls adequate to safeguard the assets of such agency, and the accuracy and reliability of accounting data, promote operating efficiency, and encourage compliance with prescribed management policies of the agency. (Name of Chief Financial Officer) (Signature of Chief Financial Officer) (Date) (Telephone Number)

8 Application Checklist The Application must be complete, including all necessary attachments and signatures. Cover Sheet Grant Proposal Format Grant Application Attachments Financial Information Grant Application Attachments Other Supporting Materials Statement of Assurances Accounting System Certification Applications are due on Friday, April 29, 2016 by 5:00 p.m. Applications must be submitted to and (electronic copy) or to the first floor reception desk to the attention of Sabrina Ferrara, Budget Office, 2401 S.E. Monterey Road, Stuart, Florida Incomplete proposals or proposals received after 5:00 p.m. on April 29, 2016 will be ineligible for funding. For further information, contact Jennifer Manning, Budget Manager (772)

9 Attachment A Financial Supporters and Income Information Sources Name(s) of Funder(s) Amount Pending, Expected, or In-hand? Foundation grants Corporate grants Individual contributions Board contributions Government United Way Earned Income Interest Income In-Kind Support Other Total

10 Attachment B Operating Budget Information Budget for Time Period (mm/dd/yy to mm/dd/yy): Expenses Salaries Budget Employee benefits, taxes Affiliate organizations or contracts Professional fees Equipment, supplies, materials Telephone, utilities Postage, mailing Occupancy Insurance Training, staff development Travel Conferences Evaluations Other (please explain below) Total Expenses Please explain any items requiring additional explanation: