Agenda Item No. 10
CITY OF YUCAIPA
AGENDA REPORT
TO: Honorable Mayor and City Council
FROM: Jennifer Crawford, Assistant City Manager
Kimberly Everts, Deputy Rent Administrator/Records Technician CMC� FOR: City Council Meeting of October 10, 2022
SUBJECT: Fiscal Year 2021/2022 Accountability Report and 2022/2023 Community Activity Grant In -Kind Grant Requests
RECOMMENDATION:
That City Council:
1. Receive the Community Activity Grant Accountability Report and deem the program requirements complete for Redlands Bicycle Classic, Inc. — 2022 Redlands Bicycle Classic Yucaipa Road Race; and
2. Review and consider the FY 2022/2023 Community Activity Grant Application submitted by Cali-Caipa Nooners Lions Club requesting $1,020 for in -kind support to waive the rental fees for the Yucaipa Community Center Amphitheater and Shelter #2 to host the Veterans Days Ceremony on November 11, 2022; and
3. Review and consider the FY 2022/2023 Community Activity Grant Application submitted by the Rotary Club of Yucaipa requesting $8,713 for in -kind support to cover the costs associated with conducting the Annual Christmas Parade on December 10, 2022.
DISCUSSION:
Pursuant to the Community Activity Grant (CAG) Guidelines, the following awarded CAG applicant has completed the CAG funded program and has submitted the Event Reporting Financial Worksheet and Event/Program Summary for Council review and approval. The following details the awarded agency, the amount granted, the actual grant amount spent, and the event reporting worksheet:
Awarded
Awarded
Actual
Financial
FY 2021/2022
Financial
In -Kind
Reporting
ACCOUNTABILITY REPORTS
Amount
Amount
Worksheet
Attachment
Redlands Bicycle Classic, Inc.
N/A
$7,731.25
$5,034.80
A
2022 Redlands Bicycle Classic
Yucaipa Road Race
-178-
The City has received the following applications for in -kind support for the FY 2022/2023 Community Activity Grant (CAG) Cycle. For Council information, the table below provides the name of the requesting applicants, a brief description of the proposed project scope, and the amount of in -kind support requested.
Community Activity Grant
FY 2022/2023 In -Kind Applications
Amount
Amount
CAG
APPLICANT
Description of Use
Requested
Requested
Application
Financial
In -Kind
Exhibit
Support
Support
Use of the Yucaipa
Cali-Caipa Nooners
Community Park Amphitheater
N/A
$1,020
B
Lions Club
and Shelter #2 to host the
Veterans Day Ceremony
The grant is seeking in -kind support to cover the costs associated with the use of the Yucaipa Community Park Amphitheater and Shelter 42 to host the Veterans Day Ceremony on November 11, 2022. Total residents projected to serve: 200+
Additional financial support in the amount of $500 is included in the FY202212023 Non -Department Not -For -Profit Budget.
In -kind support to cover costs
Rotary Club of Yucaipa
associated with conducting the
N/A
$8,713
C
2022 Christmas Parade
The grant is seeking in -kind support to cover the costs associated with conducting the 2022 Christmas Parade on December 10, 2022. Total residents projected to serve: 5,000 Additional financial support in the amount of $1, 000 is included in the FY 202212023 Non - Department Not -For -Profit Budget.
FISCAL IMPACT:
The FY 2022/2023 CAG Fund for in -kind requests has a current balance of $18,775.88. The total in -kind assistance requested from the CAG applications submitted by Cali-Caipa Nooners Lions Club and the Rotary Club of Yucaipa is $9,733, leaving a remaining balance in the amount of $9,042.88 if the grant applications are approved, as submitted.
Exhibits:
A — Redlands Bicycle Classic, Inc. Accountability Report B - Cali-Caipa Nooners Lions Club Application
C — Rotary Club of Yucaipa Application
Approved by:
-179-
Exhibit A
Rec,_ : , _ V,
City of Yucaipa Community Activity Grant City of Yucaipa Event Reporting Financial Worksheet MAY 0 9 2022
Fiscal Year 2021-2022 Grants
*INCLUDE BACK-UPDOCUMENTATION WITH REPORT INCLCbfm ,raI Services/ COPIES OF CHECKS, COPIES OF INVOICESIQUOTE31 t y C l e i- k's D e p a r t n-i e n t Name of Organization: Redlands Bicycle Classic, Inc
Contact Name: Marc Shaw
Phone Number: 909-963-9099
Email: [email protected]
Description of Event/Project Funded: Professional bicycle race Total Cost to Operate Event/Project: $
Amount Granted by City: $ Section 1 (Monetary) $ 7731.25 Section 2 (In Kind) Justify City Grant Monetary Amount: (if applicable)
SECTION 1
Description
Item # Date (Please be specific. List vendor and purpose for each disbursement related ONLY to the grant amount) Amount
2. 3.
4. 5.
Justify City Grant In -Kind Amount: (if applicable)
SECTION 2
Description
Item # Date
(Please be specific. List vendor and purpose for each disbursement related ONLY to the grant amount)
\\
Amount
1. 4/21/2022
Police services C��
`�hC_i1l 6(-rC i oci �S+, J
$
2. 4/21/2022
Fire services
viaen_9 by CT rar+
$ SO, L50
3. 4/21/2022
Public Works Services
$
4. 4/21/2022
Miscellaneous expenses
$
5. $
Total Disbursements (Justifying City Grant Monetary and/or In -Kind) Amount): $ _ ; i [� Monetary Grant Funds Remaining: $
Notes/comments/additional
information:
PLEASE MAKE SURE TO PROVIDE BACK-UP RECEIPTS / PROOF OF PAYMENT TO JUSTIFY AMOUNTS AWARDED BY GRANT P"gJ � 0-
°"Y OF City of Yucaipa Community Activity Grant
Event/Program Summary
Fiscal Year 2021-2022 Grants
In an attempt to assist all awarded agencies, the City has developed an Event Reporting Financial Worksheet (attached) to ensure consistent and accurate reporting of the awarded agencies use of City funding and/or in -kind services. Along with your Event Reporting Financial Worksheet, please provide the information requested below:
1. Did the event/program meet the original intended goal? Yes. The event was conducted in a safe and efficient manner, due in large part to the assistance provided by the various city departments )using in -kind funding) to cover personnel costs.
2. If funded in the future, what would the organization do differently? The Race Committee is slated to meet with the City on May 10, 2022, to conduct a debriefing of the event and determine what could be improved upon in 2023.
3. What type of feedback did organization received from the participants? The feedback was overwhelmingly positive. Attendees and participants appreciated the fact that, after a two year pandemic hiatus, the event came back to town.
4. What other financial/in-kind contributions did the organziation seek or receive to fund the event/program (separate from City funding)?
The event receives funding from a variety of sponsors, as well as in -kind fee waivers from the City of Highland and Redlands.
5. List the total number of residents served.
All residents benefited, as they were able to witness a top -tier professional cycling event in their city.
Additionally, they were able to travel through town on alternate routes in an efficient manner.
Attach copies of marketing/promotional materials for the event/program.
Notes/comments/additional information:
PLEASE SUBMIT ALONG WITH EVENT REPORTING FINANCIAL WORKSHEET TO THE CITY CLERK'S OFFICE
WITHIN ONE MONTH FOLLOWING THE EVENT/PROGRAM
PdJA1-
y���FF•COq� � a
Rol..
SHANNON D. DICUS
SHERIFF•CORONER
CONTRACT CITY
Mr. Ray Casey
City Manager
City of Yucaipa
34272 Yucaipa Blvd.
Yucaipa, CA 92399
DATE
INVOICE #
8/5/2022
21951
CHIEF OF POLICE
Yucaipa Police Dept.
Captain James Williams
PERIOD OF SERIVCE
P.O. NO.
CONTRACT #
Apr -June (FY 21/22, Q4)
94-526 A-31
DESCRIPTION
1st Month
2nd Month
3rd Month
TOTALS
RATE
AMOUNT
OVERTIME CHARGES -
APR '22
MAY '22
JUNE '22
REDLANDS BICYCLE CLASSIC
RBC
Deputy
46.00 0.00
0.00 46
86.30 3,969.80
Subtotal
3,969.80
PLEASE MAKE REMITTANCE PAYABLE TO:
Total $3,969.80
San Bernardino County Sheriffs Department
Payments/Credits $0.00
Bureau of Administration
Attn: Accts Rec
PO Box 569
L, ... n........-. _A:.... nA nn Anil nEnn
Balance Due $3,969.80
_
JO11 Gee a u111U, V/1 Z71e-'iUL-U1)U1-j
-182-
ciry of �.��- T Exhibit B ;
COMMUNITY ACTIVIT`
Gl �� FINANCIAL / W-KIND / FEE WA VER
APPLICATION
Fiscal Year: 2022-2023
Date Application submitted: Z ,
Submit to:
City of Yucaipa
General Services/City Clerk Department
34272 Yucaipa Blvd.
Yucaipa, CA 92399
Attn: Kimberly Everts
Received
City of YucaipLl
SEP /2 2022
General Services/
City Clerk's Department
All sections of the application must be returned complete and all supporting documentation provided prior to City Council review. Incomplete applications received will be returned to the applicant. ,SECTIONINFORMATION
Name of Applicant/Organization: �l�% L Gt�i(� ✓ i' OOf�2YJ/Oi'�S C�b Applicant/Organization Mailing Address: Z csf. yV6a4_00_ e f2s 9 Applicant/Organization Phone Number:
Contact (1) kL1i& Jbzl�a( (���' ✓< ' ��� ��
Name Phone Number
/arGS 5 dtlL&'In latX Cry f�--7
E-mail address
Contact (2)
Name Phone Number
E-mail address
SECTIONREQUIREMENTS:
Yes No
Is your organization located in another community? ❑
Will the program/event take place in another community? ❑ �� Are you aware of any other City program providing this service? ❑ ©� If so, which one?
*:: you answered "Yes" to any of the questions listed above, your request is not eligible for the Community Activity Grant.
City of Yucaipa Community Activity Grants Application, Rev. 03/2022 -1 °J- Page 1
SECTION 3 - ORGANIZATION INFORMATION/APPLICANT BACKGROUND Your organization must be an established 501(c) to be considered for Community Activity Grant funding.
Please submit documentation verifying organization 501(c) status along with this application.
Yes
No
Is your organization a 501(c)?
�/
❑
p
37/ 37f
If yes, please provide Tax ID# �^% " r and attach all supporting documents.
Does this application include submittal of documentation verifying 501(c) status?
❑
❑�
How long has your 501(c) organization been in existence? 3 % %�
Number of Employees working for organization:
4P'
Number of Volunteers working for organization:
1 r
Is a current City Council Member on your board?
❑
Qom'
How many Yucaipa residents does your organization currently serve? �� 6 06)
Does the organization charge admission, membership fees, dues, etc.? 0"
❑
If yes, please describe: / Cy % P-e� Yea' r
Names and Titles of Officers and Board of Directors: (Please attach an organization chart, if available) Gv maNlonq s/ 7
L� n da- ►-r� �� �e C-1
■.yI[llTI*1 CsRKIZll 741071 ]IfSCH- "71YO►/SCOPADDITIONAL Name of the program/event: I %f�CGG yl s -7?� y
Date(s) of program/event: ��� / �, Z2.
Describe the program/event that organization is seeking support for:
(Attach any event/program promotional materials associated with program/event) E0l� year YOC(-
J;)a CO 1-17 11'�
D Vr lets.
City of Yucaipa Community Activity Grants Application, Rev. 03/2022 ' — ' Page 2
Describe how the program/event benefits the residents and/or community of Yucaipa:
Program/Event Primary Target Population (check all that apply):
❑ Children or Youth
❑ Low Income
❑ Persons with Disabilities
Number of Residents Projected to Serve
❑
Seniors
❑
Victims
❑
Welfare Recipients
2-004-
V61--c-rafil' s
SECTION1REQUEST
Please identify what your organization is seeking:
Financial Support: ❑ Yes M'No $
4f�-
$+f-a§SEP Fee
Waiver: L] Yes ❑ No
In -kind Support: Police $
Reassigned
Staff $
Fire $
Other $
In -Kind Financial Support
Total Amount of Request: $ c" � $
❑
Women
❑
Homeless
REntire
Community
Public
Works $ CS/Rental $%`
Explain )
42'a© Ad oli+e-cl LY C_DL(rerrf 4 l h7/ �v
1 6.75 SEP Total Overall
Fee Waiver Request
Provide a detailed description of how the financial support will be used:
PV-1 ;:57� A-/
i411h f7Lh'!fr1-`V1 d�`
/ /Uo V. A � 2- .
Ma� l p� a �i vk1 �-I I er j., 2
CornCn b n rf-x Ctr+1 f
City of Yucaipa Community Activity Grants Application, Rev. 03/2022 -1 "� Page 3
What other in-kind/financial contributions has your organization received to fund this event/program (separate from City funding)?
In -Kind
Amount
Total Funds Received To Date:
Total Funds Requested Via Grant Application:
Remaining Balance That Will Be Funded By
Organization:
E-1
SO
Financial
Support Amount
Provide City funding received by organization in the past three years (required):
Program In -Kind Financial $16.25 SFP Date Total Received Support Fee Waiver Received
❑ c� .0 2D I $
Er ❑� o �a $ '
s � © 02 $ 3 o
I, the undersigned, do hereby attest that the above information is true and correct to the best of my knowledge, and understand that the awarded financial grant amou eeds to be spent prior to submitting another grant request.
Signature Title Date
Date Received: Date Reviewed:
Amount Funded: $
Type of Grant: ❑ In -Kind
Date City Council received follow up report:
City Council Meeting:
❑ Financial Support ❑ Fee Waiver
City of Yucaipa Community Activity Grants Application, Rev. 03/2022 - ` Page 4
1014/22, 5:22 PM
Permit
City of Yucaipa Community
Services
34272 Yucaipa Blvd
Yucaipa, CA 92399
PermitContract
COMMUNITY�'a(r°cs
SERVICES Lifee
Fetter!
PHONE:(909) 790-7460 Permit # R4741
FAX:(909) 790-2589
Status Tentative
EMAIL:[email protected]
Date Sep 29, 20221:22 PM
Expiration Date Sep 29, 2023
Organization Name
Cali Caipa Nooners Lions Club - 373
Customer Type
Non -Profit (NR)
Organization Address
37025 Oak View Rd
Yucaipa, CA 92399
Agent Name
Linda Molina
System User Tish Christian
Organization Phone 1 (626) 731-2335
Number
Home Phone Number (626) 731-2335
Cell Phone Number (909) 518-9954
Email Address [email protected]
Rental Fee
$720.00
Discounts
$0.00
Subtotal
$720.00
Deposits
$100.00
Deposit Discounts
$0.00
Total Permit Fee
$820.00
Total Payment
$0.00
Refunds
$0.00
Balance
$820.00
Veteran's Day
Booking Summary
1 resource(s) 1 booking(s) Subtotal: $270.00
START DATE/TIME END DATE/TIME ATTENDEE I AMT W/O TAX
Nov 11, 2022 7:00 AM Nov 11, 2022 8:00 PM 100 $0.00
Resource level fees $270.00
Rental - Daily $270.00 / Day x 1 $270.00
Veteran's Day Annual Ceremony
Booking Summary
START DATE/TIME END DATE/TIME
Nov 11, 2022 7:00 AM Nov 11, 2022 8:00 PM
https:Hanprod.active.com/yucaipa/ui.do?method=showPermitContract&permit U=1DB7078C0A39 1 resource(s) 1 booking(s) Subtotal: $550.00
ATTENDEE I AMT W/O TAX
80 $0.00
M
1014/22, 5:22 PM
Resource level fees
Deposit
Rental - Daily
X:
PermitContract
$100.00 / Each x 1 $100.00
$450.00 / Day x 1 $450.00
$550.00
Deposit
EVENT RESOURCE I DEPOSIT FEE I CHARGE I TAX I AMOUNT PAID I REFUNDS I BALANCE Veteran's Day Amphitheate Deposit $100.00 $0.00 $0.00 $0.00 $100.00 Annual r
Ceremony
Payment Schedules Original Balance: $820.00 Current Balance: $820.00
DUE DATE I AMOUNT DUE I AMOUNT PAID I WITHDRAWAL ADJUSTMENT I BALANCE Oct 4, 2022 $300.00 $0.00 $0.00 $300.00
Oct 28, 2022 $520.00 $0.00 $0.00 $520.00
Date:
City of Yucaipa Community Services
Mailing Address: 34272 Yucaipa Blvd, Yucaipa, CA
92399
Phone Number: (909) 790-7460
Fax Number: (909) 790-2589
Email Address: [email protected]
a
Date:
Cali Caipa Nooners Lions Club
Customer Type: Non -Profit (NR)
Customer ID: 30072
Mailing Address: 37025 Oak View Rd, Yucaipa, CA
92399
Organization Phone 1 Number: (626) 731-2335
Authorized Agent Name: Linda Molina
Home Phone Number: (626) 731-2335
Cell Phone Number: (909) 518-9954
Email Address: [email protected]
https://anprod.active.com/yucaipa/ui.do?method=showPermitContract&permit UbB7078C0A39 2/2
>ctails 111DOLlt IMCI-MltiOffi l aSS0C1a(1011 Of I1011S ClUbs lit rl)s:,/apps.lrs.gov%app/cos/detailsPage?ein=473719378&name - Q HELP® MENU
Home > Tax Exempt Organization Search > International Association Of Lions Clubs Other Names
CALIMESA YUCAIPA NOONERS LIONS CLUB
Form 990-N (e-Postcard) o
Organizations who have filed a 990-N (e-Postcard) annual electronic notice. Most small organizations that receive less than $50,000 fall into this category.
> Tax Year 2018 Form 990-N (e-Postcard)
Tax Period:
2018 (07/01/2018 - 06/30/2019)
EIN:
47-3719378
Legal Name (Doing Business as):
International Association Of Lions Clubs
Mailing Address:
13491 La Paz Ct
Yucaipa, CA 92399
United States
Principal Officer's Name and Address:
Linda Amerault
248
13491 La Paz Ct -189-
0172 5! 12/202 l . 8:51 :1A
Exhibit C
CITY OF
Fiscal Year:
COMMUNITY ACTIVITY GRANT
FINANCIAL / IN -KIND / FEE WAIVER
APPLICATION
2022-2023
Date Application submitted: y/byh7 - t2 --
Submit to:
City of Yucaipa
General Services/City Cleric Department
34272 Yucaipa Blvd.
Yucaipa, CA 92399
Attn: Kimberly Everts
Received
City of Yucaipa
SEP 14 2922
General Services/
City Clerk's Denartm(
All sections of the application must be returned complete and all supporting documentation Provided prior to City Council review. Incomplete applications received will be returned to the applicant. 1N 1 — GENERAL INFORMATIO
Name of Applicant/Organization: Rotary Club of Yucaipa
Applicant/Organization Mailing Address: PO Box 661 Yucaipa, CA 92399 Applicant/Organization Phone Number:
Contact (1) Todd Gutjahr
Name
[email protected]
E-mail address
Contact (2) N/A
Name
N/A
address
SECTION 2 - ELIGIBILITY REQUIREMENTS:
Is your organization located in another community?
Will the program/event take place in another community? Are you aware of any other City program providing this service? If so, which one? N/A
(909 ) 900-9537
Phone Number
Phone Number
Yes
No
❑
❑✓
*If you answered "Yes" to any of the questions listed above, your request is not eligible for the Community Activity Grant.
City of Yucaipa Community Activity Grants Application, Rev. 03/2022 -190-
SECTION 3 — ORGANIZATION INFORMATION/APPLICANT BACKGROUND Your organization must be an established 501(c) to be considered for Community Activity Grant funding.
Please submit documentation verifying organization 501(c) status along with this application.
Yes
No
Is your organization a 501(c)?
❑✓
❑
If yes, please provide Tax ID# 45-5149308 and attach all supporting documents.
Does this application include submittal of documentation verifying 501(c) status? ❑✓
❑
How long has your 501(c) organization been in existence? 1956 Number of Employees working for organization: 0
Number of Volunteers working for organization: 40
Is a current City Council Member on your board?
❑
❑✓
How many Yucaipa residents does your organization currently serve? 51,000 Does the organization charge admission, membership fees, dues, etc.? ❑✓
❑
If yes, please describe: $140/year
Names and Titles of Officers and Board of Directors: (Please attach an organization chart, if available) Chris Markarian, President
Donnakaye Ostrander, President Elect
Joan Dendinger, Treasurer
SECTION 4 - PROGRAM DESCRIPTION/SCOPE: (PLEASE USE ADDITIONAL PAGES IF NECESSARY) Name of the program/event:
Date(s) of program/event:
67th Annual Christmas Parade
Saturday, December 10, 2022
Describe the program/event that organization is seeking support for:
(Attach any event/program promotional materials associated with program/event) The 67th Annual Christmas Parade will be held on Saturday, December 10, 2022. This year will mark the third year that the parade will be organized by the Rotary Club of Yucaipa.
The Parade will start on the confer of A venue D and California Street. The route proceeds north on A venue D to California Street, where it will then travel west onto Yucaipa Boulevard. The route will travel west on Yucaipa Boulevard and then will turn south onto 6th Street and end at the Oak Valley Educational Center campus.
City of Yucaipa Community Activity Grants Application, Rev. 03/2022 -191-
Describe how the program/event benefits the residents and/or community of Yucaipa:
The 67th Annual Christmas Parade rings in the holiday season for Yucaipa residents. The parade is estimated to bring out over 5,000 residents to watch the parade and to then stroll around the Historic Uptown.
Program/Event Primary Target Population (check all that apply):
0 Children or Youth
❑N Low Income
❑m Persons with Disabilities
Number of Residents Projected to Serve: 5,000
0 Seniors
❑e victims
0 Welfare Recipients
❑� Women
Homeless
© Entire Community
SECTION' 11REQUEST
Please identify what your organization is
\ seeking:
c11 f he blc,� rbccss)Financial Support: s eN0 $ :,000 ,o $16.25 SEP Fee
Waiver: Yes eTq
ff !QI.
In -kind Support: Police Fire $
Reassigned
Staff $ Other
In -Kind
Total Amount of Request: $ 8100
1 'D "V v
Public
Works $'-,900 CS/Rental $
Explain
W`_p0SEP
M 25-•SEP
Fee Waiver
Zoo'
Provide a detailed description of how the financial support will be used:
Total Overall
Request
S-T+3
The In -Kind Support received from the Community Activity Grant program will cover the costs of police and fire personnel presence and provide Public Works support for street closures (personnel and equipment).
�Fy"I�IIeiRt w�p$2 Ieee1v�ed�6IY2't13�113i�d�trr nt <x ill occiot <uitll rnvarinn tlxp r© —t e 1^Aable rl A'��+ ar- <<t 41.- pnrr�nria rnnta
c
City of Yucaipa Community Activity Grants Application, Rev. 03/2022 -192-
SECTION i 1
What other in-kind/financial contributions has your organization received to fund this event/program (separate from City funding)?
In -Kind
Amount
None
Total Funds Received To Date:
Total Funds Requested Via Grant Application:
Remaining Balance That Will Be Funded By
Organization:
Financial
Support Amount
$
$ 1,000
Provide City funding received by
organization in the past three years (required):
Program
In -Kind
Financial
$16.25 SEP Date
Support
Fee Waiver Received
2021
271
F71
F"(�
2019
0 r'71
F77 1
2018
7✓
7 ❑✓
Total Received
$ 5,851.37
$ 4,831
m 3.477
I, the undersigned, do hereby attest that the above information is true and correct to the best of my knowledge, and understand that the awarded financial -mat-amount needs to be spent prior to submitting another grant request. 4/225' /y z
Signature Title Date
TO BE I' 1
. BY CITY
Date Received: 9,'"' Date Reviewed:
Amount Funded: $ City Council Meeting:
Type of Grant: [2/ln-Kind ❑ Financial Support ❑ Fee Waiver Date City Council received follow up report:
City of Yucaipa Community Activity Grants Application, Rev. 03/2022 -193-
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Wo are pleased to inform you that upwi roviaw of your applicatlnn for ::f]x oxorimnt status wu have dotni-minod tat You wo exam" t(•Om va(ie(•il iI mwo tax under sactibn :i Qu of tho Wtarnn; itovunuu Cwhn C:untr;buLluns to you xrtl deductible under section 101 of tao Coda, You urn also qui-ilMue Lo rocnivo tax deductible Wouosia, dovisos, transfers or U-19a Ulldoi• sactkn 205, 710::
or 2522 of tbo Codo. SUMIUSU this letter could hoip resoivo any quo:)i.iens regarding your oxnmpt Mum, You shou;d tcnop It in your t)ormanunt rca:"w,_ Ornanizationa uxam t under saotWn 5C)1 t,C' f ; of the Coda ar•a fur I.h(Ir !):SICS! { I,wt; as oi%her-public Charitiou or private faurld "ans. WO (!(!Co(-minud thnL you 11rt1 u public wr ity under the Coda suction(si t ;sted in 4.111) hoodill,: of thlli For nortunt information about your respnnslihi°;sties us a ta"u;(ompi. a manization, 1'!O to www.irs.govicharitios , tatter in tiin ,irur(,tl hall' to viow 1)"Ticalloi 4221-:)C, Comalknou Guido for CIar•ltlun' 5Yl RA doncribas your rocardkoopinq, ruport'!n!1, and discinnur•o rn(lnil'( memo.
Dil-OCtor, 1iX0111W 01-ci IIIZ,1ttrn)s
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-194-
Yucaipa Police Request Form (Exhibit A)
Attachment to the Community Activity Grant Application/SEP Process
CITY OF
Fiscal Year: 2022-2023
Date Application submitted:
SECTION' 1' 1
Name of Applicant/Organization Rotary Club of Yucaipa
Mailing Address:
Phone Number:
Contact:
PO Box 661 Yucaipa, CA 92399
Todd Gutjahr
Name
[email protected]
E-mail address
Applicant Signature:
909-900-9537
Phone Number
1 1' 1
Event Name: 66th Annual Christmas Parade
Title:
6/14/22
Event Location: Yucaipa Blvd (CA. St. to 6th St.)
Event Date: 12/10/22 Event Time: 8 a.m.-3 p.m.
Estimated Event Attendance Number: 5,000
SECTIONI'• POLICE SERVICES REQUESTED
Number of Officers Requested: Sworn Officers: 1 1 Citizen Patrol (COPS): 16 Dates Officers/COPS Requested:
Equipment Requested
Additional Information:
12/10/22 Times Officers/COPS Requested:
11 a.m.-3 p.m.
Patrol Cat: ❑ Motorcycle: ❑ Other: ❑
F tea t-: S_�'��, s s
4bDom,t-= �3,su(.z0 ZM>.Q-yt--"350,3v 35s52'C'e,s-. CS
TO BE COMPLETED BY YUCAIPA POLICE
Reviewed by: <o�
Signature: Title: �b�.v �C��(,��{i Date
Total Cost for In -Kind Request: S-6 /Z- Ur d
City of Yucaipa Community Activity Grants Application, Rev. 03/2022 Page t -195-
Yucaipa Fire Request Form (Exhibit B)
Attachment to the Community Activity Grant Application/SEP Process 7 CM' OF
FIRE DEPZ, ^' Fiscal Year: 2022-2023
f� Date Application submitted: 6/14I2022
SECTIONINFORMATION
Naive of Applicant / Organization Rotary Club of Yucaipa Mailing Address: PO BOX 661 Yucaipa, CA 92399
Phone Number:
Contact: Todd Gutjahr 909-900-9537
Name Phone Number
[email protected]
E-mail address
Applicant Signature: Title:
SECTIONINFORMATION
EventNarne: 67th Annual Christmas Parade
Event Location: Yucaipa Blvd (CA ST to 6th St)
Event Date: 12/ 10/2 2 Event Time: 8 a.m.-3 p.m.
Estimated Event Attendance Number: 5000
SECTIONREQUESTED
Number of Fire/EMS Requested: TBD
Dates Requested: 12/10/2022 Times Requested: 11 a.m.-3 p.m.
Additional Information:
1 BE COMPLETED BY '
Reviewed by:
Signature: Title: r c L e Date
Total Cost for In -Kind Request:
City of Yucaipa Community Activity Grants Application, Rev. 03/2022 -196-
CITY OF
z
Public Works Department Request Form (Exhibit C)
Attachment to the Community Activity Grant Application/SEP Process Fiscal Year: 2022-2023
Date Application submitted: 6/14/22
SECTIONINFORMATION
Name of Applicant / Organization Rotary Club of Yucaipa Mailing Address:
Phone Number:
Contact:
PO Box 661 Yucaipa, CA 92399
Todd Gutjahr 909-900-9537
Name Phone Number
[email protected]
E-mail address
Applicant Signature:/ Title:
SECTION
Event Name: 67th Annual Christmas Parade
Event Location: Yucaipa Blvd (CA. St. to 6th St.)
Event Date:
12/10/22 Event Time: 8 a.m.-3 p.m.
AttendanceEstimated Event 111
SECTION 3 - PUBLIC WORKS SERVICES REQUESTED
Number of Public Works Staff Requested:
Equipment Rentals and Quantity Requested:
0✓ Cones 100 0✓ Delineators 40
Dates Requested:
12/10/22
0✓ Street Closures 13 Z✓ Signage 13
ThnesRequested: 8:30 a.m.-3:30 p.m.
Projected Staff Time Expense: $ 2,000 Equipment Expense: $ 900 Additional information: Items to include staff time (set-up and take -down of road closures, assisting with clean up of trash boxes, use of electronic message boards, a small generator, small announcing stage/riser, and misc. traffic control equipment).
TO BE COMPLETED BY PUBLIC WORKS DEPARTMENT
Reviewed by:
a C"tn. Title: tcz. 6� D �, S �Gj Date
Signature: G2r.�, ��
Total Cost for In -Kind Request: Q Zi jo o
City of Yucaipa Community Activity Grants Application, Rev. 03/2022 -197-
9/14/22, 8:18 AM
Permit
City of Yucaipa Community
Services
34272 Yucaipa Blvd
Yucaipa, CA 92399
PermitContract
-�
COMMUNITY
Mace
SERVICESi�,,
C�r;1f�Tn1Fi' T
Bett(- !
PHONE:(909) 790-7460
Permit #
R4703
FAX:(909) 790-2589
Status
Tentative
EMAIL:[email protected]
Date
Sep 14, 2022 8:18 AM
Expiration Date
Sep 14, 2023
Organization Name Rotary Club Of Yucaipa - 336 Organization Phone 1 (909) 900-9537 Customer Type Non -Profit (R) Number
Organization Address PO Box 661
Yucaipa, CA 92399
Agent Name Todd Gutjahr Home Phone Number (909) 900-9537 System User Tish Christian
Rental Fee
$200.00
Discounts
$0.00
Subtotal
$200.00
Deposits
$0.00
Deposit Discounts
$0.00
Total Permit Fee
$200.00
Total Payment
$0.00
Refunds
$0.00
Balance
$200.00
67th Annual Yucaipa Christmas Parade
Booking Summary
1 resource(s) 1 booking(s) Subtotal: $200.00
START DATE/TIME END DATE/TIME ATTENDEE I AMT W/O TAX
Dec 10, 2022 8:00 AM Dec 10, 2022 4:00 PM 50 $200.00
Special Event Fee (Res -IV) $200.00 / Each x 1 $200.00
Payment Schedules Original Balance: $200.00 Current Balance: $200.00
DUE DATE I AMOUNT DUE I AMOUNT PAID WITHDRAWAL ADJUSTMENT I BALANCE Nov 26, 2022 $200.00 $0.00 $0.00 $200.00
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