City of Sunnyvale
Office of the City Manager

CO-SPONSORSHIP STATUS RENEWAL APPLICATION

TO THE OFFICE OF THE CITY MANAGER

FY 2003/2004 (July 1,2003 – June 30, 2004)

Please submit application, attachments and co-sponsorship benefits request form by March 7, 2003. Late applications will not be accepted. Complete all sections.

To request an electronic file of this application (in Microsoft Word 97 for Windows), send an email to: mtaiariol@ci.sunnyvale.ca.us

Legal Name of Organization: Sunnyvale Leadership Development Institute

Tax-Exempt ID #77-0530856

President David. D. Simons

Address 1514 South Mary Ave

City/State/Zip Sunnyvale, CA 94087

Telephone (home) 408/749-8227

Telephone (work) N/A

E-Mail Address simonsdavid@yahoo.com

Note: To facilitate communications, staff will work with only the current president of the organization.

Fiscal Year 2002/03 Current Status

Fiscal Year 2003/04 Requested Status

  
 

75%

Full (at least 75% of membership are Sunnyvale residents)

50%**

  

Full, based on 50% residency exception
   

Affiliated (at least 55% of membership are Sunnyvale residents)
   

Associated (at least 15% of membership are Sunnyvale residents)

** 94% are either residents or employed in Sunnyvale

  1. Membership
  1. Identify what year your organization uses for purposes of determining membership and budget. (For example, from January 1 – December 31; or July 1 – June 30.)
    2.

     

    From:

    July 1

    To:

    June 30

  2. How many total community members were served by your organization for each of the last two full years of operation? (Use your organization’s definition of year.)

Current Year:

Year:2002-2003

Number of People:18

(Count each person only once.)

How many of these members live in Sunnyvale?

#9

and

50%

Previous Year:

Year:2001-2002

Number of People:23

(Count each person only once.)

How many of these members live in Sunnyvale?

#19

and

82%

  1.  Attach Roster of Program Attendees for last full year of operation dated and signed by the organization president. (Required with this application.)

What is the time frame for which the roster is valid?

2002-2003

  1. Discuss changes that have occurred since March 2002, if any, to your group’s operations as relates to the following:

    Group’s purpose:

    No Change ___X__

    Changes _____ (discuss changes below)

    Community needs met by your group

    No Change ___X__

    Changes _____ (discuss changes below)

    Membership criteria (i.e., age, geographic area served)

    No Change __X___

    Changes _____ (discuss changes below)

    Fee schedules/dues

    No Change _____

    Changes __X___ (discuss changes below)

    Tuition for 2003-2004 will be $1,600 to cover higher cost of doing business

  1. Governing/Organizational Structure
  1. Board of Directors/Officers Roster

    2. Attach copy of Board of Directors/Officers Roster showing names, addresses, and telephone numbers.

  2. Do Sunnyvale residents comprise a minimum of 50% of the Board of Directors/Officers Roster?

    3. Yes:X

    No:

  3. Have your enabling documents (e.g., Articles of Incorporation, Constitution, and/or By-Laws) changed since March 2002?

    4. Yes:

    No:X

  4. If the answer to question 3.c) is Yes, have these changes been approved by Council?

    5. Yes:

    No:

  5. If the answer to question 3.d) is No, please attach a copy of your enabling documents with the changes noted. These enabling documents are subject to approval by the appropriate City of Sunnyvale Commission following a review of the criteria set forth for consideration of co-sponsorship status.

  1. Insurance Coverage
  1. Is a copy of your group’s current certificate of liability insurance that states coverage amounts and policy period attached to this application?
    2.

    Yes:X

    No:

  2. If yes, is the City of Sunnyvale listed as an "additional insured"?

    3. Yes:X

    No:

  3. If no, is a letter attached to this application requesting a waiver of the insurance coverage requirement?

Yes:

No:

Note: PROOF OF CURRENT INSURANCE COVERAGE OR AN ANNUAL CITY-APPROVED WAIVER IS REQUIRED OF ALL CO-SPONSORSHIP APPLICANTS.

Exception: Organization may petition the Office of the City Manager for a one-year waiver of the insurance coverage requirement. A letter outlining the basis for an insurance waiver must be included with this application. If the request for waiver is not granted, the organization will be required to provide proof of insurance.

  1. COMPLETE BUDGET SUMMARY OR ATTACH A COPY OF YOUR BUDGET

Please complete the following Budget Summary---OR---Attach a copy of your budget for your current and last fiscal year (as defined in 1.a.), including a complete listing of revenues and expenditures. Do not include in-kind services in your total income. Round all amounts to the nearest dollar.

   

BUDGET
   

Actual Last Fiscal Year of Operation

Current Year of Operation

Income

Beginning Balance

    
 

Membership Dues/Fees

    
 

Fund Raising/Donations (Cash)

    
 

Ticket Sales

   
 

Concessions

    
 

Sponsors

    
 

Reserve Funds

    
 

Other -

    
       

A.

Total Income

    

Expenditures

Salaries/Employee Benefits

    
 

Prizes/Awards

    
 

Insurance

    
 

Concession Supplies

    
 

Uniform/Equipment Purchases

    
 

Office Expenses

    
 

Refreshments

    
 

Printing/Publication/Promotions

    
 

Transportation

    
 

Other -

    
       

B.

Total Expenditures

    
 

NET INCOME (A - B)

   

STATEMENT OF COMPLIANCE FOR CO-SPONSORSHIP

I (We) have read and understand the requirements for Co-Sponsorship as outlined in the Policy and Guidelines for Obtaining Co-Sponsorship Status Within the City of Sunnyvale. In compliance with the stated requirements, I (We) agree to do as follows:

I. COMPLETE ANNUAL APPLICATION PROCESS

  1. Submit application packet to the appropriate City department by the established deadlines.

II. DOCUMENTS AND PUBLISHED MATERIALS

  1. Include the statement "Co-sponsored by the City of Sunnyvale, Office of the City Manager" on all materials published by the City of Sunnyvale.
  2. Include Americans with Disabilities Act (ADA) Statement on all publications.
  3. Submit documents and published materials for review by assigned staff liaison prior to publication in those instances where the City is to pay for printing or is to reimburse the group for printing.

III. ORGANIZATION
  1. Maintain non-profit and tax-exempt status under state and federal laws.
  2. Maintain a membership ratio of a minimum of 75% Sunnyvale residents for Full Co-Sponsorship; 55% Sunnyvale residents for Affiliated status; and 15% Sunnyvale residents for Associated status.
  3. Elect a slate of officers that has a ratio of at least 50% Sunnyvale residents for Full and Affiliated co-sponsored organizations.

IV. REPORTS/APPEARANCES

  1. Submit the following notices or reports to the assigned City staff liaison:

    1. Changes in Board of Directors/Officers, regular meeting time and place, fees or membership dues.
    2. Submit all changes in Constitution and/or By-Laws to assigned City staff liaison for approval by Commission in accordance with the terms set forth in the Co-Sponsorship Policy.
    3. Participant data as requested by Office of the City Manager.

Signature of Organization President

RESOLUTION/CERTIFICATION

WE, THE BOARD OF DIRECTORS OF Sunnyvale Leadership Development Institute

DO HEREBY RESOLVE THAT ON March 2, 2003 , THE BOARD REVIEWED THE APPLICATION ENTITLED Co-Sponsorship Status Renewal Application, SUBMITTED TO THE CITY OF SUNNYVALE FOR CONSIDERATION FOR FISCAL YEAR 2003/2004 AND, FURTHERMORE, THE BOARD IN A PROPER MOTION AND VOTE APPROVED THIS APPLICATION FOR SUBMISSION.

WE HEREBY CERTIFY THAT THE AGENCY MAKING THIS APPLICATION IS NON-PROFIT AND MAINTAINS TAX-EXEMPT STATUS IN THE STATE OF CALIFORNIA, AND HAS COMPLIED WITH ALL APPLICABLE LAWS AND REGULATIONS. WE FURTHER CERTIFY THAT THE INFORMATION PROVIDED IN THIS APPLICATION IS CORRECT TO THE BEST OF OUR KNOWLEDGE.

WE HEREBY PROPOSE TO PROVIDE THE SERVICES IN ACCORDANCE WITH THE CO-SPONSORSHIP POLICY OF THE CITY OF SUNNYVALE AS STATED IN THIS APPLICATION. IF THIS PROPOSAL IS APPROVED, IT IS AGREED THAT RELEVANT FEDERAL, STATE AND LOCAL REGULATIONS, AND OTHER ASSURANCES AS REQUIRED BY THE CITY OF SUNNYVALE, WILL BE ADHERED TO.

FURTHERMORE, AS THE DULY AUTHORIZED REPRESENTATIVE OF THE APPLICANT ORGANIZATION, I CERTIFY THAT THE APPLICANT IS FULLY CAPABLE OF FULFILLING ITS OBLIGATION UNDER THIS APPLICATION AS STATED HEREIN; AND FURTHERMORE CERTIFY THE APPLICANT WILL ADHERE TO THE STATEMENT OF COMPLIANCE THAT ACCOMPANIES THIS APPLICATION.

THIS APPLICATION AND THE INFORMATION CONTAINED HEREIN ARE TRUE AND CORRECT AND COMPLETE, TO THE BEST OF MY KNOWLEDGE.

Date:

3/2/03

Sunnyvale Leadership Development Institute

   

(Organization Name)
     
     
 

BY:

David Simons

   

President of the Board of Directors

On behalf of the Board of Directors
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