HomeMy WebLinkAboutGrant Request - NOVAEconomic Development Fund
Discretionary Grant Program
Organization: Network of Volunteer Administrators (NOVA)
Organization Description: The mission of NOVA, made up of volunteer coordinators,
is to increase professionalism in volunteer management through training and support of
member volunteer coordinators.
Project Name: NOVA Volunteer of the Year Event
Project Description: This grant request is for the purchase of food and gifts for NOVA's
annual volunteer of the year event, which is scheduled for May, 8, 2008. NOVA's only
source of income is a $40 yearly membership fee which is used for training. Additional
support for this event will be provided in the form of in-kind donations of food and door
prizes.
Project Period: May 8, 2008
Amount of Request: $2,000 (Budgeted event cost = $2,890)
Previous Grants:
• February 2007 - $2,000 Volunteer of the Year ($1,000 Luke, $1,000 Baney)
• March 2006 - $1,000 Volunteer of the Year ($500 Luke, $500 Clarno)
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 ECONOMIC DEVELOPMENT FUND
DISCRETIONARY GRANT PROGRAM APPLICATION
Direct Application to:
Commissioner Tammy Baney
Commissioner Dennis R. Luke
Date: ra/20/0x
x
Project Name:
Project Beginning Date:
Amount of Request:
Commissioner Michael M. Daly
All Three Commissioners
NOVA Volunteer of the Year event
$2000.00
Applicant/Organization:
Address:
Project End Date: ay- s
Date Funds Needed:
Tax ID #:
City & Zip:
Telephone:
Email:
Network of Volunteer
Administrators
1300 NW Wall Street Suite 103
Contact Name(s):
Fax:
Lin Gardner, Membership Chair
541-693-8994
Alternate Phone:
420-1317
When available
43-2012466
Bend, Oregon 97701
541-693-8988
Lin.H.Gardnen state.or.us
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.
Amount Approved: By: Date:
Declined: By: Date:
1. The Network of Volunteer Administrators (NOVA) is made up of volunteer
coordinators of Deschutes County non-profit agencies. NOVA's mission is to
increase professionalism in volunteer management; and to support member
volunteer coordinators in fulfilling the mission of their own organizations. This is
accomplished by providing training and support for members and by hosting the
annual NOVA Volunteer of the Year event each year in the Spring. The 2008
event will be held at the Bend Senior Center on May 8, 2008.
Chair:
Membership Chair:
Secretary:
Treasurer:
NOVA officers for 2008 are:
Woody Medeiros / Grandma's House of Central Oregon
Betsy Warriner / Volunteer Insights
Lin Gardner / Department of Human Services
Julie Spackman / Commission on Children and Families
Sheila Pyott / Bend Area Habitat for Humanity
2. Prior to the NOVA Volunteer of the Year event, each member agency has the
opportunity to nominate an adult and a youth volunteer for the honor of Volunteer
of the Year. The nominations are independently read and voted on by a panel of
judges chosen from Deschutes County community members. Member agencies
invite their volunteers to attend the event, held this year on May 8, 2007. Nominees
and member programs are introduced at the event and recognized by the local
media.
NOVA members have always relied heavily on community and business donations
to provide food for the event as well as gifts for the Volunteers of the Year. NOVA's
only source of income is a $40 yearly membership fee which is also used for
training during the year. Previously those funds have been used to buy items
needed for the event that weren't donated. It has become increasingly difficult to
find donations due to the growing number of requests made to businesses and
restaurants each year plus the cost of renting space for the event increases every
year.
NOVA is asking the Deschutes County Economic Development Fund for $2,000 to
help defray costs of producing the 2008 Volunteer of the Year event.
3. Timeline
• January—committee assignments; reserve space; pick theme
• February—Develop invitation; finalize assignments.
• March—Develop nomination packets and mail at the end of month; secure
community members to serve as judges and mail ballots the end of March.
• April—committees meet to finalize tasks; pick up prize donations; develop
packets of completed nominations to deliver to community judges for Volunteer
of the Year selection. Committee meets to open judge's ballots; order awards
for adult & youth volunteers of the year; prepare certificates for all nominees;
prepare basket of prizes for volunteers of the year; members meet at 2:00 :o
decorate on May 8th; set up food / desserts / beverages; event begins at 6 00
p.m.
4. Volunteerism is a vital part of a healthy community. Increasing volunteerism is
a goal of the Deschutes County 2001-2010 Community Plan. Organizations such
as NOVA and the Volunteer of the Year event help to increase awareness of the
need for volunteers and of the organizations and programs in the area that provide
services to the communities. As Deschutes County continues to grow both the
opportunity for volunteerism and the need for services volunteers provide will
increase.
5. Raising the visibility of the event will benefit both NOVA member agencies and
local communities—Bend, Redmond, Sisters, Terrebonne, Tumalo, Crooked River
Ranch, Sun River, and La Pine—by increasing awareness of the services provided
by agencies and volunteers which is a valuable marketing tool for the county.
6. Budget:
Table cloth rental $ 60.00
Facility Rental 250.00
Entertainment 300.00
Food 1,300.00
Beverages 200.00
Flowers/decorations 250.00
Plaques/Awards 80.00
Certificates/frames 150.00
Paper products/utensils 100.00
Gift Certificates for Volunteers of Year 100.00
Gift Certificates for Volunteer MC's 100.00
Balance $ 2890.00
• We will also receive in-kind donations for this event such as: door prizes for the
volunteers attending the event; pizza/beverages for the youth setting up the
tables and cleaning up after the event; coffee/condiments; items for the baskets
given to the volunteers of the year; baskets; Insurance policy for the event
provided by Department of Human Services; postage for mailing packets to
member programs and desserts.
Form W-9
(Rev. January 2005)
Department of the Treasury
Internal Revenue Service
Request for Taxpayer
Identification Number and Certification
Give form to the
requester. Do not
send to the IRS.
Print or type
See Specific Instructions on page 2.
Name (as shown on your income tax return)
DHS, Office of Financial Services
Business name, if different from above -
Check appropriate
Individual/❑
Exempt
❑ Exempt from backi:p
withholding
box: Sole proprietor Corporation Partnership Other
❑ ❑
Address (number, street, and apt. or suite no.)
500 Summer Street NE
Requester's name and address (optional)
City, state, and ZIP code
Salem Oregon 97301-1066
List account number(s) here (optional)
Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on Line 1 to avoid
backup withholding. For individuals, this is your social security number (SSN). However, for a resident
alien, sole proprietor, or disregarded entity, see the Part 1 instructions on page 3. For other entities,. it is
your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3.
Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose number
to enter.
Social security number
or
Employer identification number
4 3+210 1 2141
Part 11
Certification
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to .me), and
2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal
Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has
notified me that I am no longer subject to backup withholding, and
3. I am a U.S. person (including a U.S. resident alien).
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup
withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply.
For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement
arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the Certification, but you must
provide your correct TIN. (See the instructions on page 4.)
Sign
H ere
Signature of
U.S. person P
Purpose of Form
c.i
A person who is required to file an information return with the
IRS, must obtain your correct taxpayer identification number
(FIN) to report, for example, income paid to you, real estate
transactions, mortgage interest you paid, acquisition or
abandonment of secured property, cancellation of debt, or
contributions you made to an IRA.
U.S. person. Use Form W-9 only if you are a U.S. person
(including a resident alien), to provide your correct TIN to the
person requesting it (the requester) and, when applicable, to:
1. Certify that the TIN you are giving is correct (or you are
waiting for a number to be issued),
2. Certify that you are not subject to backup withholding,
or
3. Claim exemption from backup withholding if you are a
U.S. exempt payee.
Note. If a requester gives you a form other than Form W-9 to
request your TIN, you must use the requester's form if it is
substantially similar to this Form W-9.
For federal tax purposes you are considered a person if you
are:
• An individual who is a citizen or resident of the United
States,
• A partnership, corporation, company, or association
created or organized in the United States or under the laws
of the United States, or
Date
6-,)6 -a c
• Any estate (other than a foreign estate) or trust. See
Regulations sections 301.7701-6(a) and 7(a) for additional
information.
Foreign person. If you are a foreign person, do not use
Form W-9. Instead, use the appropriate Form W-8 (see
Publication 515, Withholding of Tax on Nonresident Aliens
and Foreign Entities).
Nonresident alien who becomes a resident alien.
Generally, only a nonresident alien individual may use the
terms of a tax treaty to reduce or eliminate U.S. tax on
certain types of income. However, most tax treaties contain a
provision known as a "saving clause." Exceptions specified
in the saving clause may permit an exemption from tax to
continue for certain types of income even after the recipien
has otherwise become a U.S. resident alien for tax purpose.
If you are a U.S. resident alien who is relying on an
exception contained in the saving clause of a tax treaty to
claim an exemption from U.S. tax on certain types of incorr
you must attach a statement to Form W-9 that specifies the
following five items:
1. The treaty country. Generally, this must be the same
treaty under which you claimed exemption from, tax as a
nonresident alien.
2. The treaty article addressing the income.
3. The article number (or location) in the tax treaty that
contains the saving clause and its exceptions.
Cat. No. 10231X Form W-9 (Rev. 1-200:
regon
Theodore R. Kulongoski, Governor
To whom it may concern:
Department of Human Services
Administrative Services
Financial Services Section
500 Summer Street NE, E-81
Salem, OR 97301-1090
(503) 945-6800
Fax (503) 947-5226
TTY (503) 945-5929
The Department of Human Services qualifies as a non-profit governmental agency under
U.S. Code Title 26, 501-(c)(1). A corporation organized under Act of Congress, which is an
instrumentality of the United States and is exempt from taxation. Department of Human
Services, Office of Financial Services, federal ID number is 43-2012466.
Sincerely,
Andy Tyssen
Department of Human Services
Financial Services
Tax Policy Administrator
(503) 945-6081
"Assisting People to Become Independent, Healthy and Safe"
An Equal Opportunity Employer
00 225S (51/03)