HomeMy WebLinkAboutGrant Request - La Pine Senior Activity CenterEconomic Development Fund
Discretionary Grant Program
Organization: La Pine Senior Activity Center
Organization Description: The purpose of this organization is to serve and enhance the
lives of seniors by providing information, referrals and activities. Some of the areas
addressed include: balanced, nutritional meals, physical fitness, wellness education,
health maintenance, recreational opportunities, socialization, art programs, dancing and
quilting.
Project Name: Nutritional Program
Project Description: This grant is requested to purchase a commercial range to enable
this organization to meet the growing need for nutritional meals. The current range for
the facility is not operating properly and requires funds for ongoing repairs and
maintenance.
Project Period: August 1, 2010 to June 30, 2011
Amount of Request: $2,000 (Estimated cost = $3,500 to $6,000; installation $2,000)
Previous Grants:
• October 2002 - $3,500 Architectural services ($3,500 Luke)
• October 2004 - $2,000 Permit fees for activity room ($2,000 Luke)
• FY 2009 Community Grant: $4,000
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La Pine Senior AYity (eater
dune 28, 2010
Deschutes County Board of Commissioners
1 300 NW Wall Street
Bend, Or 97701
Ron Sommerfeldt
La Pine Senior Activity Center
PO Box 1279
La Pine, Or 97739
16450 Victory Way
PO Box 1279
La Pine, OR. 97739
(541) 536-6237
Re: Deschutes County Discretionary Grant Program Application
The La Pine Senior Activity Center is pleased to submit this request for your
review. Our proposal request of $6000 will enable us to continue to effectively
serve the seniors of our impoverished community.
Thank you for your interest in the La Pine Senior Activity Center.
Sincer
Ron So ' merfeldt
Board Chairman
City & Zip:
Telephone:
Email:'
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Deschutes County Board of Commissioners
1300 NW Wall St., Bend, OR 97701-1960
(541) 388-6570 - Fax (541) 385-3202 - www.deschutes.org
DESCHUTES COUNTY DISCRETIONARY GRANT PROGRAM APPLICATION
Direct Application to:
Commissioner Tammy Baney
Commissioner Dennis R. Luke
Date.
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Project Name:
Project Beginning Date:
Amount of Request:
Commissioner Alan Unger
All Three Commissioners
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Applicant/Organization:
Address:
Project End Date:
Date Funds Needed:
Tax ID #:
La Pin hor
Po Box 12.1
Contact Name(s):
Fax:
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541-51,320
Alternate Phone:
On a separate sheet, please briefly answer the following questions:
1. Describe the applicant organization, including its purpose, leadership structure, and activities.
2. Describe the proposed project or activity.
3. Provide a timeline for completing the proposed project or activity.
4. Explain how the proposed project or activity will impact the community's economic health.
5. Identify the specific communities or groups that will benefit.
6. Itemize anticipated expenditures*. Describe how grant funds will be used and include the
source and amounts of matching funds or in-kind contributions, if any. If the grant will
support an ongoing activity, explain how it will be funded in the future.
Attach:
Proof of the applicant organization's non-profit status.
* Applicant may be contacted during the review process and asked to provide a complete line item budget.
Tammy Baney: Amount: Signature:
Dennis Luke: Amount: Signature:
Alan Unger: Amount: Signature:
Deschutes County Discretionary Grant Program Application
Requested Information
Organizational Overview
The La Pine Senior Citizens, Inc. is a 501c3 non—profit organization. Its
purpose is to serve and enhance the lives of the senior population by
providing information/referrals and activities. Our hope is to add quality of
life by encouraging healthy living through programs that promote
independent living.
Leadership
The La Pine Senior Citizens, Inc. is managed by a Board of Directors
consisting of nine (9) members and one (1) member at large. The nine
elected directors of the board shall constitute the Executive Board. The term
of each director shall be three years or until their successors are elected.
Primary Activities and Programs
To encourage healthy living and enhance the lives of seniors by:
• Balanced Nutritional Meals
• Physical fitness
• Wellness education
• Health maintenance
• Recreational opportunities
• Socialization
• Creative forms of art such as painting
• Dancing
• Quilting
• Information and referral
Project Description
The La Pine Senior Activity Center seeks to purchase a commercial range.
We are in desperate need of this piece of equipment to continue providing
the essential growing need of nutrition. Our current range does not operate
properly. We continue to spend time and money on repairs and have
reached the realization that it is no longer cost effective.
In order to meet the growing needs of nutritional value among the senior
population we must meet requirements and maintain high standards. In
order to do that we need to have a kitchen range that operates efficiently and
safely.
This grant award would allow us to continue to have a positive impact of
providing meals to our senior population. We strive to meet the important
challenge of health and nutritional needs of a large underserved population
that is living longer and therefore growing older. By fulfilling this need it
provides quality of life and independence. Our meal program also provides
a time for socialization and interaction.
Community's Economic Health
The La Pine Senior Citizens, Inc aim to allow all seniors in our community
to take advantage of the economic opportunities allowed to them. Our
program services the following groups:
• Low income seniors
• Physically challenged
• Mentally challenged
• Underserved
• Indigent populations
Expenditures
We have received quotes from vendors on commercial ranges.
• These quotes range from $3500 to $6000.
• An approximate cost of installation is $2000.
The La Pine Citizens, Inc. seeks an amount up to $6000 to be utilized for the
purchase of a commercial range.
We have many members and volunteers that take pride in our senior center
and the programs and activities provided. We strive for excellence and
maintain high standards of quality care for our kitchen equipment along with
ongoing preventive maintenance checks.
internal Revenue Service Department of the Treasury
P. O. Box 2508
Cincinnati, OH 45201
Date: April 17, 2003 Person to Contact:
Paul M Perry 31-07423
Customer Service Representative
La Pine Senior Citizens Inc. Toll Free Telephone Number:
P.O. Box 1279 8:00 a.m. to 6:30 p.m. EST
La Pine, OR 97739-1279 877-829-5500
Fax Number:
513-263-3756
Federal Identification Number:
93-0921983
Dear Sir or Madam:
This is in response to your request of April 17, 2003, regarding your organization's tax exempt status.
Our records indicate that a determination letter issued in July 1991 granted your organization exemption from
federal income tax under section 501(c)(3) of the Internal Revenue Code. That letter is still in effect.
Based on information subsequently submitted, we classified your organization as one that is not a private
foundation within the meaning of section 509(a) of the Code because it is an organization described in
sections 509(a)(1) and 170(b)(1)(A)(vi).
This classification was based on the assumption that your organization's operations would continue as stated
in the application. If your organization's sources of support, or its character, method of operations, or
purposes have changed, please let us know so we can consider the effect of the change on the exempt status
and foundation status of your organization.
Your organization is required to file Form 990, Return of Organization Exempt from Income Tax, only if its
gross receipts each year are normally more than $25,000. If a return is required, it must be filed by the 15th
day of the fifth month after the end of the organization's annual accounting period. The law imposes a penalty
of $20 a day, up to a maximum of $10,000, when a return is filed late, unless there is reasonable cause for the
delay.
All exempt organizations (unless specifically excluded) are liable for taxes under the Federal Insurance
Contributions Act (social security taxes) on remuneration of $100 or more paid to each employee during a
calendar year. Your organization is not liable for the tax imposed under the Federal Unemployment Tax Act
(FUTA).
Organizations that are not private foundations are not subject to the excise taxes under Chapter 42 of the
Code. However, these organizations are not automatically exempt from other federal excise taxes.
Donors may deduct contributions to your organization as provided in section 170 of the Code. Bequests,
legacies, devises, transfers, or gifts to your organization or for its use are deductible for federal estate and gift
tax purposes if they meet the applicable provisions of sections 2055, 2106, and 2522 of the Code.
-2 -
La Pine Senior Citizens Inc.
93-0921983
Your organization is not required to file federal income tax returns unless it is subject to the tax on unrelated
business income under section 511 of the Code. If your organization is subject to this tax, it must file an
income tax return on the Form 990-T, Exempt Organization Business Income Tax Return. In this letter, we are
not determining whether any of your organization's present or proposed activities are unrelated trade or
business as defined in section 513 of the Code.
The law requires you to make your organization's annual return available for public inspection without charge
for three years after the due date of the return. You are also required to make available for public inspection a
copy of your organization's exemption application, any supporting documents and the exemption letter to any
individual who requests such documents in person or in writing. You can charge only a reasonable fee for
reproduction and actual postage costs for the copied materials. The law does not require you to provide
copies of public inspection documents that are widely available, such as by posting them on the Internet
(World Wide Web). You may be liable for a penalty of $20 a day for each day you do not make these
documents available for public inspection (up to a maximum of $10,000 in the case of an annual return).
Because this letter could help resolve any questions about your organization's exempt status and foundation
status, you should keep it with the organization's permanent records.
If you have any questions, please call us at the telephone number shown in the heading of this letter.
This letter affirms your organization's exempt status.
Sincerely,
John E. Ricketts, Director, TE/GE
Customer Account Services