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HomeMy WebLinkAboutItem 8.1 DPIE Exh 9~'t-,/
Dublin Partners ltn Education
January 25, 2009
Dublin Partners in Education
D~OFp~D
Bt,IN
SAN 2 g Z~09
Mr. Roger Bradley, Assistant City Manager ~~,ay~~~,p+s
Ms. Joni Patillo, City Manager ,„`'~~uu~~u'`tt ~~~r~~,
City of Dublin
100 Civic Plaza
Dublin, CA 94568
Dear Mr. Bradley and Ms. Patillo:
P.O. Box 2307
Dublin, CA 94568
925.828.2551 x8024
Fax: 925.803.9746
Email: dpie@dublin.kl2.ca.us
Website: www.dublin.k12.ca.us
Dublin Partners in Education (DPIE) is submitting our grant proposal request for
$25,000 for our programs-Promotion of the Arts Program, including Art Judging and
Awards, and our Vocational Mentoring Program, which includes our programs at
Dublin High School and Wells and Fallon Middle Schools.
This past year, in spite of the difbcult economic times, Dublin Partners in Education
experienced a significant amount of growth in all our programs. The Vocational
Mentoring Program has doubled in size in this past year, reaching more students and
involving more mentor volunteers in the schools than ever before. Our efforts to
work with the high school teachers and staff in publicizing the program and our
efforts in reaching out to new community partners has helped to make this program
even more successful. As slots for admission to college and vocational schools
become more competitive due to budget cutbacks and high numbers of applicants,
this program can be a powerful tool for our students.
The number of artist volunteers who spend their time and talent with our Dublin
students has increased as well. We engaged art coordinators at each school site who
arrange for the artists to work in the classroom and work with DPIE to provide the
necessary supplies. DPIE is able to utilize business donors who are framers to frame
the art and we coordinate a large award night for the student artists. This year, we
are expanding the program and our student artists will have an opportunity to
display their work at our partner, Stoneridge Mall during the weekend prior to our
annual event. Last year, over 475 parents, students, relatives and neighbors
attended the ceremony at the Dublin Regal Cinema.
We respectfully request that the City of Dublin consider supporting the growth of
these programs. We feel that these programs especially add value to our
community, and highlight how City stewardship, business and education go hand in
hand to support Dublin pride.
Kind regards,
Mary Beth Phillips, Ph.D.
Executive Director, Dublin Partners in Education
BXHIBIT
DPIE is a 501 (c) (3) Non-Profit organization
All donations are tax-deductible to the extent allowable by law. Federal Tax ID 94-3207780
Dublin Partners in Education is anon-profit foundation dedicated to foster mutually beneficial business, community and education
partnerships in order to maximize resources and enrich the learning experiences for all students in the Dublin Unified School District.
CITY OF DUBLIN
COMMUNITY GROUP/ORGANIZATIONAL
FUNDING REQUEST
APPLICATION PACKET
Fiscal.Year 2009-2010
Section 2:
Application for
Community Group/Organizational Funding
SECTION 2
Page 1 of 22
CITY OF DUBLIN
Fiscal Year 2009-2010
COMMUNITY GROUP/ORGANIZATION
APPLICATION FOR FUNDS
COVER PAGE
AGENCY NAME: DUBLIN PARTNERS IN EDUCATION (DPIE)
PROPOSED PROJECT/PROGRAM NAME:
OPERATIONAL EXPENSES FOR VOCATIONAL MENTORING, PROMOTION OF-THE
ARTS PROGRAM, AND CAREER DAYS
FUNDING AMOUNT REQUESTED: $25,000
SECTION 2
Page 2 of 22
CITY OF DUBLIN
Fiscal Year 2009-2010
APPLICATION FOR FUNDS
1.
2.
Please select one expense category: ^ Capital X Operating
Applicant Information:
Organization/Agency Name Dublin Partners in Education
Mailing Address P.O. Box 230?
Street Address 6800 Penn Drive
City Dublin State CA
Zip 94568
_Mary Beth Phillips PhD 8282551 X8024 Phillipsmar b~eth(a~dublin.kl2.ca.us
Executive Director/Chairperson Work Phone Email
8282551 X8024 d~ie(cr~,dublin.kl2.ca.us
Board President (if applicable) Work Phone Email
Please list the Primary Project Contact Person who would be able to answer questions about this application and
project/program during the funding period.
Mary Beth Phillips Ph.D. Executive Director
Contact Person for Project/Program Job Title
8282551X8024 Phillipsmar b~ eth(c~dublin.kl2.ca.us _ 925-803-9746
Work Phone Email Fax
Federal Tax Identification No. (required) 94-3207780
City of Dublin Business License No. (required) 10048
SECTION 2
Page 3 of 22
City of Dublin
Fiscal Year 2009-2010
Application for Funds
3. Proposed Project/Program Information (Do not describe organization.)
Amount of Funds Requested $ $25,000
(Maximum $25,000 per project.)
Proposed Project/Program Name: _Operational Expenses for Vocational Mentoring, Career
Days, Promotion of the Arts Program, including Student Arts Judging and Awards
Proposed ProjectlProgram Date(s): Start 07 / O1 / 09 and End 06 / 30 /10
mo. day yr. mo. day yr.
Please note: City Council Grant Funds are distributed on a reimbursement basis. If your Agency
needs a 100% disbursement at the beginning of the Fiscal Year, please. indicate this
below and please provide justification for this need.
X Agency is requesting 100% disbursement at the beginning of the Fiscal. Year.
If selecting this option, please provide justification in the blank space below,
^ Agency is not requesting 100% disbursement at the beginning of the Fiscal Year.
Please provide the frequency that reimbursements will be submitted to the City in the
blank space below; e.g., monthly, quarterly, at project completion, etc.
The ability for DPIE to budget funding to the Dublin Unified School District depends on our
ability to continue to provide for the programs we deliver and fund raise for the schools at the
same time. Receiving funds at the beginning of the year allows us to ensure that our programs
can continue while we work to write grants, plan fundraising events and collaborate with our
business partners to bring much needed funds to the schools.
SECTION 2
Page 4 of 22
City of Dublin
Fiscal Year 2009-2010
Application for Funds
a. How would the requested funds be used?
^ Describe, in detail, the PROPOSED PROJECT/PROGRAM (not the Agency).
^ Bulleted text is acceptable..
^ Identify if the proposed projectlprogram is a new service, or extension of an
existing one.
^ An additional page may be added, if needed.
Dublin Partners in Education is requesting this funding for .the. benefit of the 5,400+
students of the Dublin Unified School District,.. and the partnerships we have with our
Mentors and art volunteers, who are largely Dublin citizens
• Career Days. Local business and community volunteers spend a full day with
students, sharing valuable career information and personal professional experiences
with Fallon and Wells 8~` graders, helping them see all the future possibilities that
education can create for them.. Mentors experience the. enthusiasm of young people
who are anxious to hear what. the future might bring..
• Mentor Program. Dublin and Valley High School students attend a series of
presentations given by local business and community volunteers who share their
career knowledge and: professional experiences, offering a window into the world of
work: they share their own career paths, the wisdom they have gleaned from their
experiences and some of the values that have helped them become successful. at what
they. do. This program has doubled in .size in the past .year. Not only does it
support our students as they prepare for vocational school, the military; or college, but
Mentors experience the satisfaction of sharing their own lives with students and often
come away from the experience refreshed and more enthusiastic about what they do.
This program is a wonderful example of collaboration and community spirit, joining
business and education in a way that supports both.
• Promotion of the Arts. One cannot fully appreciate this program without
attending the annual Art Judging Contest and the Art Awards night. This program
links volunteer guest artists in our community with classrooms, engaging the spirit of
each artist and creating enthusiasm for art in education. Our young artists in the
schools are encouraged to explore their own creativity by teaming .with these
wonderful volunteers for whom art is a passion. Student art is submitted for the
SECTION 2
Page 5 of 22
annual Art Judging, which brings community volunteers in connection with our
schools. These students are then celebrated as a community at the Art Awards night,
where they receive recognition and encouragement for self expression by being
acknowledged publicly for their creations. This program is yet another way that
DPIE encourages Dublin pride and community building by linking business and
education. Not only are the students benefiting from this wonderful program, but the
volunteers, who help with the art, and the judges themselves, share in the enthusiasm
about community that this program generates.
b. How would the PROPOSED PROJECT/PROGRAM address. an unmet community
need and improve the quality of life for Dublin residents. Why is this project/program
needed? (Additional page may be added, if needed):
Now, more than ever, the quality of education desired by residents of Dublin far
exceeds the very basic education funded by the State. DPIE seeks to help the Dublin
Unified School District bridge the gap between what the'State provides in terms of
funding and what is needed to fund the type and` quality of programs offered to our
students.
Career Days and Mentoring Program: Studies have shown repeatedly that students
benefit from Mentoring programs. Mentoring programs help students discern the
opportunities and the skills necessary to compete in the world of work. This year, we
have seen admissions to vocational programs and schools of higher education become
highly competitive as budget cuts have affected the number of students who can be
admitted. Clarity and focus are important if students are going to be able to stand out
among peers. The Mentoring program links successful business men and women with
students in an effective and efficient way, while still allowing for personal interaction.
This program will be increasingly important, especially in these economic times. The
number of students participating in these programs has more than doubled this year. We
think that this is.an indication that students are also aware of how important mentoring
can be for them.
The Promotion of the Arts Program: Arts will be one of the first places the District
will have to cut in these economic times. This well established program provides support
SECTION 2
Page 6 of 22
for art in the schools by linking real artists with students in meaningful ways. For those
students who aspire to go on to be artists who are at the High School Level, our
scholarships and awards add value to their portfolios. In addition, this program allows
for a wonderful opportunity in community building in Dublin around the Arts and is a
tradition here in Dublin in many circles. The numbers of students and volunteers who
participate (over 800) underscore the value this program brings to Dublin.
c. What documentation/data/records support the need for this PROPOSED
PROJECT/PROGRAM? Please identify your data sources. (Additional page may be
added, if needed.)
With the grant funding we have requested, DPIE's programs will provide enriched learning opportunities,
and clearly ones that will not be funded any other way. Our Partnership activities are like other educational
foundations in surrounding areas and nationally. It has been demonstrated that Partnership: programs
positively impact. students and schools in these areas:. Academic achievement, School attendance, career
planning, student enrichment, self-image, and school pride.
(source: www.partnerstoledo.orb/partnership.html).
Mentor Program: Surveys of students and evaluations completed by Mentors indicate a highlevel of
satisfaction with the content of the program.. 70% of Mentors state that they want to participate again in the
program and currently we have more mentor applications than time available at the high school,' Students
also indicate that they learned a great deal from the Mentors and indicate that they would recommend the
program to fellow students. The High School staff also feels that this program is very valuable for students
and has increased support for the program through advertising and classroom. support.
Arts in the Schools Program: Over 700 students participated in this program last year. Another 250
students are exposed to art through the program. 65 teachers participated in the program. 12 Art
Coordinators participated in the program. 10 businesses supported students through framing art. 35
volunteers helped to judge the art that was submitted. More that 350 people attended the Awards Night.
This program is clearly one of the community programs that adds value to Dublin pride and spirit.
SECTION 2
Page 7 of 22
City of Dublin
Fiscal Year 2009-2010
Application for Funds
d. Specify the PROPOSED. PROJECTIPROGRAM population to be served.
Dublin students in the Dublin Unified School District, K-12, and Adult Education will be
the primary beneficiaries of the programs we are requesting funding for. However, we also
strongly believe that Community volunteers and business professionals who seek to contribute to
the Dublin community through the spirit of DPIE partnership and collaboration will also strongly
benefit from these programs.
e. Projects/programs must be evaluated to determine ifthey are being carried out efficiently
and if project/program goals are being met. Please describe how you plan to monitor
your protect/program's success and impact.
^ An additional page may be added, if needed.
Dublin Partners in Education .has added Measurement and Evaluation of Programs. as
one of its Strategic Goals (August, 2008).. To this end, DPIE. has created an Ad Hoc committee to
evaluate programs and events (January, 2009). We want. to ensure that the programs and
sponsorships we offer the District are consistent with District goals and support community
partnerships.
This past year, we have developed a close working relationship with the. District and
the Executive Director and Superintendent now meet on a regular basis. Dr. Dave Marken and
Tess Thomas Johnson serve on the DPIE Board;' both are leaders within the Dublin Unified
School District. Needs for programs and evaluations are regularly discussed at Board meetings.
Program participants (volunteers and students) complete evaluations and participate in phone
surveys. This information is compiled and reported back to the Board of Directors for use in
program planning and evaluation (August, 2008).
DPIE also has a formal Program committee, headed by Tess Johnson, Fallon
Principal. The Program Committee makes recommendations for expansion, maintenance, or
curtailment of programs and serves as the evaluation process for all programs.
A public report is given annually at a DUSD school board meeting. In addition, the
Superintendent's Council receives regular DPIE updates (new this year).
SECTION 2
Page 8 of 22
f. Specify numbers of clients served by agency, then by PROPOSED
PROJECT/PROGRAM:
A enc Partici ants
Total Number of Participants Served by Agency (if applicable) 5,470+ students
and 75 volunteers
Total Number of Dublin Residents Served by Agency (if applicable) 5,470students,
plus parents,
volunteers and
Partners (est.
additiona1200).
Pro'ect/Pro ram Partici ants
Total Proposed Participants Served by this ProjectlProgram 5,470 + students
and over 300
parents and
volunteers.
Total Number of Dublin Residents Served b this Pro'ect 5,670+
SECTION 2
Page 9 of 22
City of Dublin
Fiscal Year 2009-2010
Application for Funds
5. Financial Information -Operating Budget
a. Expense Budget
FY 2009-20:10 THIS PROJECT/
EXPENSE BUDGET ORGANIZATION PROGRAM. GRANT REQUEST
Personnel Costs
Employee Salaries Benefits $80,500 $20,000
Non-Personnel Costs
Services & Supplies $27,075 $1000
Capital Costs $500 easels)
Other (please specify)
1.Teacher Grants 3,100
2.Winter Concert 1,000 1,000
3.Education Grants 8,000.
4. DHS Art Awards 775
S.Science Fair 1500
6.Science Fair (HS) 500
7.Mentor Program 6,500 6,500
8.Barton/Wells Reading 7,000
9.PFC Fireworks grants 2000
IO.SAA program expenses 5,000- 5,000
11.SAA Performance grants
12.Golf Tournament 1,800
13.DUSD Leadership Grant 4,000
14.Principal for a Day
15.Career Days
16.Job Shadowing
17.Every Fifteen Minutes
Other (please specify)
18.SAA Event 12,000
19.Celebrity Waiter 11,000
20.Family Night Event (new) 10,000
SECTION 2
Page 10 of 22
TOTAL $181,750 $34,000 $25,000
Further Comments/Explanations (if necessary):
DPIE has elected to focus more efforts on grants that will go directly to projects within the
schools. We are in the process of putting more emphasis on our programs and on grant writing
in lieu of more events given the economy. These grants will likely be from sources with some
restrictions and are not shown here.
SECTION 2
Page 11 of 22
City of Dublin
Fiscal Year 2009-2010
Application for Funds
b. Revenue Budget
FY 2009-2010
REVENUE BUDGET ORGANIZATION PROJECT/PROGRAM
Committed/Restricted Funds
(s eci source
Grant for health related ro ram 5.,000
Grants for Barton/Wells program 7,000
itted/Restricted Funds
(s .eci source)
Grants from foundations(may be 20,000
restricted laterl
Interest income 500
SAA Event 34,000
SAA Products sales 2,000
Fireworks sales 6,500
Celebrity Waiter event 31,000.
DPIE Calendar ad sales
Family Event
Membership Night
Joint Community Partner event 500
20,000
2,000
1,000
Community Organizationl$300
DPIE Membership Business $15.000
DPIE Membership Individual $6,000
TOTAL ~ $150, 800.00
SECTION 2
Page 12 of 22
Further Comments/Explanations (if necessary):
DPIE's Board of Directors has initiated a new business partnership program called The Power of
Partnership. In this program, DPIE staff work directly with organizations to find ways they can
support the schools consistent with the organization's strategic plans and areas of philanthropic
interest. To this end, some of the income received through corporate sponsors and grants may be
restricted as to type of program the. donation can fund. Although this supports our efforts to
enhance the services and programs for the benefit of the students within the District, these are
not unrestricted funds and as such, cannot be used to support our Mentor and Promotion of the
Arts in the Schools Program..
SECTION 2
Page 13 of 22
City of Dublin
Fiscal Year 2009-2010
Application for Funds
6. General Agency Information
^X Past grant applicants may check this box in lieu of completing item 6 (a-d) if the
program/organizational description on file with the City is correct and current.
a. List all years that Organization has previously received City of Dublin funding. (not
Community Development Block Grant - CDBG}.
b. Describe the population(s) served by the Organization.
c. Describe all the services the Organization currently provides to Dublin residents.
^ An additional page may be added, if needed.
d. Has your agency ever previously received funds from the City of Dublin? If yes,
please specify in what Fiscal Years and the amount received each year.
SECTION 2
Page 14 of 22
City of Dublin
Fiscal Year 2009-2010
Application for Funds
7. Required Attachments:
o Only one (1) cony per A~encv of each of the following is required, even with multiple
projects/programs submitted.
o Applications without the following documents will not be reviewed for funding...
o Please label attachments: A, B, C. etc.
~ A. Names of Governing Board; .identify current Board officers.
Attachment A: Names of Governing Board; identify current Board officers..
Honorary Council:
Don Babbitt, Heartwood Communities
Stephen Brooks, Alameda. County of Education
Jim Gulseth, JG. P.C. Law
Stephen Hanke, Superintendent of Schools, DUSD
Janet Lockhart, Former. Mayor of Dublin
Roz Perazzo, Chevron Corporation
Tim Sbranti, Mayor of Dublin
John Sugiyama, Retired DUSD Superintendent
DPIE Executive Board:
Don Biddle, City Councilman
Tess Johnson, Principal Fallon School, Interim Acting President.
Chris Bennett,. Workvantage, Co-Secretary
Kathy De Jong, Performance Management. Co-Secretary
Bill Moy, Timpson Garcia, LLC, Treasurer
Board Members:
Ted Hoffman, Jr., Earl Anthony's Dublin Bowl
Fawn Holman, Community Volunteer
Kellee Jones, Community Volunteer
Dr. Dave Marken, Assistant Superintendent, Educational Services
Alcina Wegrzynowski, Sybase, Inc
Mona Lisa B ,Community Volunteer
Amy Frantz, DHS Student Representative
SECTION 2
Page 15 of 22
B. Current total Organization operating budget, including revenue.
^ Clearly label/identify the program that includes the PROPOSED
PROJECT/PROGRAM.
See Attached
C. Most recent audit report or tax return (if applicable).
See Attached
D. Resolution, letter or other document providing evidence of
Board/Organization approval of application,. and date approval was granted.
^ Board/Organization. approval may be pending.
^ See Attached
~ E. Organization's certificate of insurance showing coverage for liability and
workers' compensation.
See Attached
F. Application Verification Declaration Signature Page.
~- See Attached.
~ G. Signed affidavit form from each collaborating agency named in proposed
project/programplan (if applicablej. N/A
~. H. Copy of IRS Letter of Determination indicating. tax exempt status.
~ See Attached.
SECTION 2
Page 16 of 22
Dublin Partners in Education
P.O. Box 2307
Dublin, CA 94568
925.828.2551 x8024
Fax: 925.803.9746
Email: dpie@dublin.k12.ca.us
Website: www.dublin.kl2.ca.us
~-t i~'~U'1 Y1'\k.l'~,T
i
6~~~.d~ z~~-
DPIE is a 501 (c) (3) Non-Profit organization
All donations are tax-deductible to the extent allowable by law. Federal Tax ID 94-3207780
Dublin Partners in Education is anon-profit foundation dedicated to foster mutually beneficial business, community and education
partnerships in order to maximize resources and enrich the learning experiences for all students in the Dublin Unified School District.
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Dublin Partners in Education
P.O. Box 2307
Dublin, CA 94568
925.828.2551 x8024
Fax: 925.803.9746
Email: dpie@dublin.k12.ca.us
Website: www.dublin.k12.ca.us
~ }}c ~cl ~ vru~ ~
DPIE is a 501 (c) (3) Non-Profit organization
All donations are tax-deductible to the extent allowable by law. Federal Tax ID 94-3207780
Dublin Partners in Education is anon-profit foundation dedicated to foster mutually beneficial business, community and education
partnerships in order to maximize resources and enrich the learning experiences for all students in the Dublin Unified School District.
YY 67 200806
200850 171717
Department of the Treasury
internal Revenue Service
OGDEN, UT 84201-0074
670 9445 K
94568 iRS USE ONLY
029515.566713.009ii~~7.002 1 AT 0.346 530
~f~'oi~~nli't~e~'~n~nDy~'~euel~~a~~~~~~nof~n~~weli~fee~
>~~~ DUBLIN PARTNERSHIP IN EDUCATION
ANGELA FONTOS TREASIRER
PO BOX 2307
DUBLIN CA 94568-0230076
515
29404-327-56546-8
943207780
For assistance, call:
1-877-829-5500
Notice Number: CP2llA
Date: December 22, 2008
A0120720 211A
TE 3
Taxpayer Identification Number:
943207780
Tax Form: 990
Tax Period: June 30, 2008
APPLICATION FOR EXTENSION OF TIME TO FILE AN E~MPT
ORGANIZATION RETURN -APPROVED
We have received your Form 8868, Application for Extension of Time to File an Exempt Organization
Return, for the return (form) and tax period identified above.
We have approved your request. and have extended the due date to file your return to
February 15, 2009.
Please attach a copy of this letter to your return when you file it. It is evidence that we granted an
extension of time to file yaur returns. A copy is provided for your records.
If you have any questians, please call us at the number shown above,. or you may write us at the address
shown at the top left of this letter.
Reminder -You May Be Required to File Electronically
Exempt organizations may be required to file certain returns electronically. For tax years ending on or
after December 31, 2006, the electronic filing requirement applies to exempt organizations with $10
million or more in total assets if the organization files at least 250 returns in a calendar year, including
income, excise, employment tax and information returns. Private foundations and charitable trusts will be
required to file Forms 990-PF electronically regardless of their asset size, if they file at least 250 returns
annually. For more information, go to www.irs.gov .Click "Charities and Non-Profits" and look for the
"e-file for Charities and Non-Pro#its" tab.
For tax forms, instructions and information visit www.irs.gov. (Access to this site will not provide you
with your specific taxpayer account information.)
n___ ,
~I
Department of the Treasury
Internal Revenue Service
www.irs.gov
Notice 1369 {07-2007)
Catalog Number 50444M
~ 5
Correction Notice - CP 2y i A
The enclosed notice provides incorrect information
about extended due dates for some Form 990-T filers,
but provides correct information for other exempt
---- organization. forms fe.g., Form 990).
If you filed an extension for Form 990-T with a due date
of April 15, the extened due date on Notice CP 211 A
is correct. No further action is needed. This applies to
forms filed by an employee trust under Intemai Revenue
Code section 401 {a); an individual retirement accounts
(including SEPs and SIMPLEs}, a Rath IRA, a CoverdeA
ESA, and an Archer MSA.
If you filed an extension for Form 990-T with a due date
of May 15, the extended due date on Notice CP 211 A
is incorrect. The extended due date is November 15.
This applies to all filers other than those mentioned
above.
If after filing your return you receive a notice charging you a
penalty, please send us a copy of the enclosed notice
{CP 211 A-shown in the upper right hand corner), this page
the Notice 1369, and a copy of your extension as filed so we
may correct your account. These should be sent to the
address provided on the penalty notice {CP 14f ).
We are sorry far any inconvenience.
Form 990
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung
benefit trust or private foundation)
- The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
Inspection
A For the 2006 calendar year, or tax year beginning JUL 1 , 2 0 0 6 and ending JUN 3 0 , 2 0 0 /
B Checkrf please C Name of organization D Employer identification number
applicable.
use IRS
Address
~chan9e label or
print or
UBLIN PARTNERSHIPS IN EDUCATION
94-32077
~onamnge s~~ Number and street (or P.O. box if mail is not delivered to street address) Room/suite E Telephone number
Initial
return
Specific
0. BOX 2 3 0 7 (925) 828-2551
Final
~return Instruc-
bons.
Clty Or town, state or country, and ZIP + 4
F Accounting method: X Cash Accrual
etuended UBLIN , CA 9 4 5 6 8 ~ °Pe~~) -
~pending~on • Section 501(c)(3) organizations and 4947(a)(1) nonexempt charitable trusts Hand I are not applicable to section 527 organizations.
must attach a completed Schedule A (Form 990 or 990-EZ). H(a) Is this a group return for.affiliates? ~ Yes ©No
G Website: -N/A H(b) if "Yes;' enter number of affiliates- N/A
J Organization type (checlconryone)- X 501(c) (3 ) ~ (insert no.) 4947(a)(1) or 527 H(c) Are all affiliates included? N/A Yes No
t
"
"
K Check here - if the organization is not a 509(a)(3) supporting organization and its gross at
ach a list.)
No,
(If
H(d) Is this a separate return filed by an or-
receipts are normally not more than $25,000. A return is not required, but if the organization ganization covered by a group. ruling? ~ Yes ©No
chooses to file a return, be sure to file a complete return. I Group Exemption Number - N/A
M Check:- if the organization is not required to attach
L Gross receipts: Add lines 6b, 8b, 9b, and 10b to line 12 - 2 0 9 , 4 5 2 . - Sch. B (Form 990, 990-EZ, or 990-PF).
Part 1 Revenue. Exnenses_ and Chances in Net Assets or Fund Balances
1 Contributions, gifts, grants, and similar amounts received:
a Contributions to donor advised funds
...
. to
..
b .
Direct public support (not included on line 1a) --_. .... ., ib 2 9 , 4 6 6 .
c Indirect public support (not included on line la) _.__ ..............
_.. -- 1c
- . 20 966.
,
d Government contributions (grants) (not included on line 1a) -__.-._.,..,_ 1d 12 , 5 0 0 .
e Total (add lines 1a through 1d) (cash $ 6 2 , 9 3 2 . noncas h $ ) --. 1e 6 2 , 9 3 2 .
2 Program service revenue including governmentfees and contracts (from'PartVl (,1ihe 93) ._.__--_ .. ..........._-.......-_ 2
3 Membership dues and assessments
:
: ..__.----__.
. .._..........._--..-. 3
4 ...._._...-_.___..___..._--.----...-.-_.
.
_
Interest on savings and temporary cashinvestrnents
.
_
_; ......
- 4 440.
5 -_-_
_
-..._.._
Dividends and interest from securities
---
----_.
._..:............._.-........
- ...--.--.._--------... ...---.---_._-.-.- 5
6 a --------
-
-
-
Gross rents _, __:-.,....,.___.__ ,.. 6a
b Less: rental expenses .....__......---...-..-.----..--._..----__......__..-. --.._... ._ 6b
~, c Net rental income or(loss). Subtract line 6b from line 6a
.
.
,,, .,_,.__-.._..-.._-..... ...:__.._.......__ 6c
7 .-.-,_,_
,
-.-_-..___
Other investment income (describe - ) 7
d 8 a Gross amount from sales of assets other (A) Securities (B) Other
°C than inventor
Y ... - ............_....__..._......... 8a
b Less: cost or other basis and sales expenses .-,-_---, 8b
c Gain or (loss) (attach schedule) --.--__,,....._.__.:... 8c
d Net gain or (loss). Combine line 8c, columns (A) and (B) -_...... ~ ..................._ ___,_,--.--._-.....-.... ...-..._......---_--_ 8d
9 Special events and activities (attach schedule). If any amount is from gaming, check here -
a Gross revenue (notincluding $ 0 of contributions reported on line 1b) - _ 9a 14 6 , 0 8 0
b Less: direct expenses other than fundraising expenses--__.__._,_._-__.--.-_.-_... 9b 35,188.
c Net incomeor (loss) from special events- Subtract line 9b from line 9a SEE STATEMENT _1--_ 9c 110 , 8 9 2 .
10 a Gross sales of inventory, less returns and allowances ---------------------_._._..-. .-- 10a
b Less: cost of goods sold.---_-.-.----........._..-.._............_.---....._........__ ... 10b
c Gross profit or (loss) from sales of inventory (attach schedule). Subi"~act line 10b from line 10a _,-... _,.,..__-_..._.:--_ -iOe -
11 Other revenue (from Part VII, line 103) , 11
12 Total revenue. Add lines 1e, 2, 3, 4, 5, 6c, 7, 8d, 9c, 10c, and 11 ........__...._ ..................._.__. ........_.............. 12 74 , 2
13 Pro ram services from line 44, column B 13 10 0 , 3 8 7 .
H 14 Management and general (from line 44, column (C)) .
___
_,__,_.-...._-___ .,._.,-___.-__ ......... ........................ 14 31, 83 9 .
a 15 __
.
Fundraising (from line 44, column (D)) 15 8 , 7 4 3 .
w 16 Payments to affiliates (attachschetlule) .__
...........___..._...._ ............._.. ..._.........._..----.... ...._._....-..-....... 16
17 .
Total expenses. Add lines i6 and 44, column (A) ..........._ ................._....__ ................._-.._.. .._._................. 17 0 , 9
18 Excess or (deficit) for the year. Subtract line 17 from line 12 _ _ -_ _-... _._..-.-_. 18 3 3 , 2 9 5 .
~ H 19 Net assets or fund balances at beginning of year (from line 73, column {A)) _... __ _.. 19 4 6 , 6 5 4 .
zQ 20 Other changes in net assets or fund balances (attach explanation) 20 0
21 Net assets or fund balances atentlofyear.Combinelines18,19,and20-..._.-._ _.-.,_,-,__._.-._._- ---_ ................... 21 79,99.
of°ia-o7 LHA For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions. Form 990 (zuuti)
1
16550128 748525 19412 2006.08010 DUBLIN PARTNERSHIPS IN EDUC 19412_1
Form 990 (2006) DUBLIN PARTNERSHIPS IN EDUCATION 9 4 - 3 2 0 7 7 80 Page 2
art I Statement Of All organizations must complete column (A). Columns (B), (C), and (D)are required for section 501(c)(3)
Functional Expenses and (4) organizations and section 4947(a)(1) nonexempt charitable trusts but optional for others.
Do not include amounts reported on line
6b, 8b, 9b, 10b, or 16 of Part 1, (A) Total (B) Program
services (C) Management
and general (D) Fundraising
22a Grants paid from donor advised funds
(attach schedule)
(cash $ 0 . noncash$ 0 .
ff this anrount includes foreign grants, check here ,
2a
22b Other grants and allocations (attach schedule
(cash $ 3 0 , 71 0 • noncash $ 0
If this amount includes foreign grants, check here ~
22b
3 0 , 71 0 •
3 0 , 71 0 TATEMENT 3
23 Specific assistance to individuals (attach
schedule) ............_........-_..._... _ ...-........
23
24 Benefits paid to or for members (attach
schedule) .._.. _..._.-._...._.__.
24
25a Compensation of current officers, directors, key
employees, etc. listed in Party-A -._._-._-._._...-_
25a
35,345.
21,207.
10,604.
3,534.
b Compensation of former officers, directors, key
employees, etc. listed in Party-B -__-__----.-____._
25b
0 .
0 .
0 .
0 .
c Compensation and other distributions, not included
above, to disqualified persons (as defined under
section 4958(f)(1)) and persons described in
section4958(c)(3)(B) ._...._--.--.----......._....
5c
26 Salaries and wages of employees not
included on lines25a, b, and c .._--._.-.....-,.
26
24, 129.
11, 329.
8 , 533.
4 , 267 .
27 Pension plan contributions not included on
lines 25a, b, and c
27
28 Employee benefits not included on lines
25a-27
28
29 Payroutaxes --______ _.._---- ---------------------_ 29 5 , 529. 3 , 025. 1, 779. 725 .
30 Professional fundraising fees --------------__., 30
31 Accounting fees ........._.- _. _......_..........-. 31 1 , 200. 1 , 200.
32 Legal fees ..._....... - - - -- -- _..._ 32
33 Supplies ....-...._....._._____._..__ ............. 33 22. 22.
34 Tele hone _-
P -_ ................ -- .._..-. 34
35 Postage and shipping,.,...,-._____..___---.--_-_ 35 937. 937.
36 Occupancy - _. _ .......... ..... 36,
37 Equipment rental and maintenance ..
.......... 37
38 Printing and publications 38`
39 Travel ................_............__.........__._._ 39
40 Conferences, conventions, and .meetings -_- 40
41 Interest 41 2 0 6. 2 0 6.
42 Depreciation, depletion, etc. (attach schedule) 42
43 Other expenses not covered above (itemize):
a
43a
b 43b
c 43c
d 43d
e 43e
f 43f
g SEE STATEMENT 2 a39 42,891. 34,116. 8,580. 195.
44 Total functional expenses. Add lines 22a through
43g. (Organizations completing columns (B)-(D),
carry these totals to lines 13-15) .....................
44
14 0 , 9 6 9 .
10 0 , 3 8 7 .
31, 8 3 9 .
8 , 7 4 3 .
Joint Costs. Check - U if you are following SOP 98-2.
Are any joint costs from a combined educational campaign and fundraising solicitation reported in (8) Program services? ..................... - ~ Yes ®No
If "Yes," enter (i) the aggregate amount of these joint costs $ N/A ; (ii) the amount allocated to Program services $ N/A
iii the amount allocated to Management and general $ N /A ;and (iy) the amount allocated to Fundraising $ N/A
o,-2s-o~ Form 990 (2006)
2
16550128 748525 19412 2006.08010 DUBLIN PARTNERSHIPS IN EDUC 19412_1
Form 990
DUBLIN PARTNERSHIPS IN EDUCATION
94-3207780 Page3
(See the instructions.)
Form 990 is available for public inspection and, for some people, serves as the primary or sole source of information about a particular organization.
How the public perceives an organization in such cases may be determined by the information presented on its return. Therefore, please make sure the
return is complete and accurate and fully describes, in Part III, the organization's programs and accomplishments.
What is the organization's primary exempt purpose? - SEE STATEMENT 4 Program Service
Expenses
All organizations must describe their exempt purpose achievements in a clear and concise manner. State the number of
clients served, publications issued, etc. Discuss achievements that are not measurable. (Section 501(c)(3) and (4)
organizations and 4947(a)(1) nonexempt charitable trusts must also enter the amount of grants and allocations to others.) (Required for 501(c)(3)
and (4) orgs., and
4947(a)(1) trusts; but
optional for others.)
a TEACHER GRANTS - TO PROVIDE ADDITIONAL FUNDING TO ENHANCE
PROGRAMS THAT ARE OUTSIDE OF THE PURVIEW OF THE NORMAL SITE
BUDGET.
(Grants and allocations $ 3 0 , 710.) If this amount includes foreign grants, check here - 3 0.710
b STUDENT ACTIVITIES AND SCHOOL PROGRAMS - TO PROVIDE FUNDS
FOR VARIOUS ACTIVITIES INCLUDING INTERVENTION.::, SCIENCE
FAIRES, MUSIC AND PERFORMING ARTS PROGRAMS".
(Grants and allocations $ ) If this amount includes foreign grants, check here - 3 2 , 3 9 8 .
c SUPPORT OF PROGRAMS, ACTIVITIES, AND OTHER NONPROFIT
ORGANIZATIONS.
(Grants and allocations $ ) If this amount includes foreign rants, check here - 3 7 , 2 7 9 .
d
(Grants and allocations $ ) If this amount includes foreign grants, check here -
g Other program services (attach schedule)
(Grants and allocations $ ) If this amount includes foreign grants, check here - 0
f Total of Program Service Expenses (should equal line 44, column (B), Program services) .............__._. _................._ - ~
Form 990 (2006)
623021
01-18-07
3
16550128 748525 19412 2006.08010 DUBLIN PARTNERSHIPS IN EDUC 19412_1
Form 990 (2006) DUBLIN PARTNERSHIPS IN EDUCATION 9 4- 3 2 0 7 7 8 0 Page 4
Part IV Balance heats (see the instructions-1
Note: Where required, attached schedules and amounts within the description column (A) {B)
should be for end-of-year amounts only. Beginning of year End of year
45 Cash -non-interest-bearing 4 5 ,14 4. 45 9 2, 5 2 9.
46 Savings and temporary cash investments
.,..-.._.,._.... 46
___________________.,_.__-.-..__.
47 a Accounts receivable 47a
b Less: allowance for doubtful accounts 47b 47c
48a Pledges receivable .--_-_._.____. _.-_._--_-_.______ 48a
b Less: allowance for doubtful accounts 48b 48c
49 Grants receivable 49
50 a Receivables from current and former officers, directors, trustees, and
- key employees 50a
b Receivables from other disqualified persons (as defined under section
4958(f)(1)) and persons described in section 4958(c)(3)(B) ___---_-_-.-_.._--._._ 50b
N
~
N 51 a Other notes and loans receivable .._- ------------ 51a
a b Less: allowance for doubtful accounts 51b 51c
52 Inventories for sale or use 52
............
53 Prepaid expenses and deferred charges
... 53 465 .
._...,_---_-___._-_-.-,_--.-_ .
.
_ - 0 Cost 0 FMV
54 a Investments-publiGy-traded securities
.
_
, 54a
-_-
_. __
_
_
b Investments -other securities - 0 Cost ~ FMV 54b
55 a Investments -land, buildings, and
equipment: basis .........__.......__....__.. _..... 55a
b Less: accumulated depreciation _____...--.__ 55b 55c
56 Investments other
...:...-._ .:...............__ _.._....._ _ - -.::.::......_:.:.....-.. 58
.
57 a Land, buildings, and equipment: basis _,..-_.-. 57a 2 8 62
D Less: accumulated depreciation _.--,...._- _ , 57b 2 , 8 6 2 . 57c 2 , 8 6 2 .
5g Other assets, including program-related investments
(describe ~ ) 58
59 Total assets (must equal line 74 . Add lines 45 throw. h 58 ..:.._.._.__..-_ _.... 4 8 , 0 0 6 • 59 9 5 , 8 5
60 Accounts payable and accrued expenses
.
.
_
....-.._ ............._........
..
60
--_-_-_.
..
.
-
61 Grants payable
: 61
--.-._......_...._--.----...._
62 Deferred revenue 62
M 63 Loans from officers, directors, trustees, and key employees -_.-.-_„-..---.-_- ... 63
64 aTax-exempt bond liabilities
.,
...-.......__._.... 64a
w
;~ ................ ,
..__
b Mortgages and other notes payable -,_._____._,,,,-_.., ,. _._._.
_..._. ..
64b
65 Other liabilities (describe - SEE STATEMENT 5 ) 1 , 3 5 2 . 65 15 , 9 0 7 .
66 Total liabilities. Add lines 60throu h65 .__ ....................._.___........_......... 1,352. 66 15,907.
Organizations that follow SFAS 117, check here - and complete lines
67 through 69 and lines 73 and 74.
67 unrestricted
: 46 , 654. 67 79 , 949 .
.._
......................._._........____-__- .
68 Temporarily restricted
. 63
m -_.--__
._.--
69 Permanently restricted 69
3 Organizations that do not follow SFAS 117, check here - ~ and
"' complete lines 70 through 74.
y 70 Capital stock, trust principal, or current funds
................._........... 70
H --_-_.-_-_ ......
71 Paid-in or capital surplus, or land, building, and equipment fund ......... ......... li
Q 72 Retained earnings, endowment, accumulated income, or other funds ...-,,.--... 72
..
Z
73 Total net assets or fund balances. Add lines 67 through 69 or lines 70 through 72.
.
-._._--....._-_
(Column (A) mustequal line 19 and column (B) mustequal line 21) 46 , 654. 73 79 , 949 .
--__
_
74 Total liabilities and net assets/fund balances. Add lines 66 and 73 4 8 , 0 0 6 . 74 9 5 , 8 5
Form ~ (2006)
623031
01-20-07
16550128 748525 19412 2006.08010 DUBLIN PARTNERSHIPS IN EDUC 19412_1
Form 990 (2006) DUBLIN PARTNERSHIPS IN EDUCATION 9 4- 3 2 0 7 7 8 0 Page 5
art econci tatton o evenue per u i e mancia atemen s i evenue per eturn (see the
instructions.)
a Total revenue, gains, and other support per audited financial statements --._..-._._.--.... a N/A
b Amounts included on line a but not on Part I, line 12:
1 Net unrealized gains on investments ___-,-_.__._....-._..__ ......................._.._.-..-...........--.-.. b1
2 Donated services and use of facilities ,__...._.-- - b2
3 Recoveries of prior year grants -------------------- b3
4 Other (specify): b4
Add lines b1 through b4 b
c Subtract line b from line a
d Amounts included on Part 1, line 12, but not on line a:
1 Investment expenses not included on Part I, line 6b .......................... .............................. di
2 Other (specify): d2
Add lines d1 and d2
e Total revenue {Part I, line 12). Add lines c and d ..._ ............................................................. .....:.....:...:......_..-.--: ~ e
art - econci is ion o xpenses per u i e ~nancia atemen s t xpenses per eturn
a Total expenses and losses per audited financial statements _-...-_-.-_„_... __ ...........:...._.............. a N/A
b Amounts included on line a but not on Part I, line 17:
1 Donated services and use of facilities ..__...._ .............. .........-..._..........._._.-.-----._..--- b1'
2 Prior year adjustments reported on Part I, line 20 -._.-.,--.._„.. _„_..,_..-..__....,---_-.--.;..-_._.... b2
3 Losses reported on Part I, line 20 _........_.__..-..._ ...............__-......,.....-.--..-...._::_-.._.... b3
4 Other (specify): b4
Add linesblthroughb4 _______-_.-. _...-......._.-. ...-..._... b
c Subtract line b from line a _ .................. c
d Amounts included on Part I, Tine 17, but not on line a:
1 Investment expenses not included on Part I, line 6b -_..-...___..._._ .............._.--...-.:.__...... d1
2 Other (specify): d2
Add lines di and d2 d
e Tota}expenses (Part I, line 17). Add lines c and d ..--,.---.----._.:..:__=-........`_..._ ................... ..................__-.._.-.. ~ e
Part V-A urrent ICerS, IreCtorS, rusteeS, and ey mployeeS (List each person who was an officer, director, trustee,
or kev emolovee at anv time during the vear even if thev were not comoensated.l (See the instructions.)
(A) Name and address it a an average ours
per week devoted to
position ompensation
(If not paid, enter
-0-.) Contributions to
P, ~~s & de ~, d
compensation plans xpense
account and
other allowances
--------------
SEE STATEMENT 6
35,345.
0.
0.
---------------------------------
---------------------------------
---------------------------------
corm y~t~uubi
623041 01-18-07
5
16550128 748525 19412 2006.08010 DUBLIN PARTNERSHIPS IN EDUC 19412_1
Form 990 (2006) DUBLIN PARTNERSHIPS IN EDUCATION 9 4= 3 2 0 7 7 8 0 Page 6
Part V-A urrent tcers, Directors, rustees, an ey mp oyees (contlnuea) Yes No
75 a Enter the total number of officers, directors, and trustees permitted to vote on organization business at board
16
meetings _,......._..._ -- -.... - -...._ ................ _._................. - - -- ._ ~
b Are any officers, directors, trustees, or key employees listed in Form 990, Part V-A, or highest compensated employees
listed in Schedule A, Part I, or highest compensated professional and other independent contractors listed in Schedule A,
Part II-A or II-B, related to each other through family or business relationships? If "Yes," attach a statement that identifies
the individuals and explains the relationship(s) 75b X
c Do any officers, directors, trustees, or key employees listed in Form 990, Part V-A, or highest compensated employees
listed in Schedule A, Part I, or highest compensated professional and other independent contractors listed in Schedule A, ',
Part II-A or II-B, receive compensation from any other organizations, whether tax exempt or taxable, that are related to the
organization? See the instnactions for the definition of "related organization." ................. 75c X
If "Yes," attach a statement that includes the information described in the instructions.
d Does the organization have a written conflict of interest policy? ......_-._ .............._._._._._.............._::.:..:,:.._._.....:...__...-.. 75d X
Part V-B ormer ~cers, irectors, rustees, an ey mployees at eceive ornpensation or ter
BenefltS (If any former officer, director, trustee, or key employee received compensation or other benefits (described below) during
the year, list that person below and enter the amount of compensation or other benefi ts'in the appropriate column. see t he instrucnons.~
(A) Name and address
NONE
(B) Loans and Advances ( ompensabon
(if not paid,
enter -0-) Contributions to
employee benefit
plans & deferred
compensation plans (E) Expense
account and
other allowances
Part VI Other Information (see the instructions.) Yes No
76 Did the organization make a change in its activities or methods of conducting activities? If "Yes," attach a detailed
statement of each change .,..__..
76
X
77 Were any changes made in the organizing or governing documents but not reported to the IRS? .......................................... 77 X
If "Yes," attach a conformed copy of the changes.
78 a Did the organization have unrelated business gross income of $1,000 or more during the year covered by this return? ..___._„
78a
X
b If "Yes," has it filed a tax return on Form 990-T for this year? N /A 78b
79 Was there a liquidation, dissolution, termination, or substantial contraction during the year? If "Yes," attach a statement _._,.. 79 X
80 a Is the organization related (other than by association with a statewide or nationwide organization) through common
membership, governing bodies, trustees, officers, etc., to any other exempt or nonexempt organization? __._-.,.....__.-____._.,._,
80a
X
b If "Yes," enter the name of the organizations N/A
and check whether it is exempt or nonexempt
81 a Enter direct or indirect political expenditures. (See line 81 instructions.) ,_.,_--_.,..-.._-._....--.. 81a 0 •
b Did the organization file Form 1120-POLforthis year? ._-........_ .............................._...._..........._...__......._................_...
'
81b
X
rorm yw ~zuuoi
623161/01-18-07
6
16550128 748525 19412 2006.08010 DUBLIN PARTNERSHIPS IN EDUC 19412_1
Form 990 (2006) DUBLIN PARTNERSHIPS IN EDUCATION 9 4- 3 2 0 7 7 8 0 Page 7
Part VI ter In ormation (continued) Yes No
82 a Did the organization receive donated services or the use of materials, equipment, or facilities at no charge or at substantially
less than fair rental value? _ ................_..-.--..:._..- . ......__..-.....__-.-.. 82a X
b If "Yes," you may indicate the value of these items here. Do not include this
amount as revenue in Part I or as an expense in Part II.
(See instructions in Part IIL) ,,,,_,.-_- 82b N/A
83 a Did the organization comply with the public inspection requirements for returns and exemption applications? ........................ 83a X
b Did the organization comply with the disclosure requirements relating to quid pro quo contributions? .................................... 83b X
84 a Did the organization solicit any contributions or gifts that were not tax deductible? -_...._ ......................._--......_ NI!A_-_..._ 84a
b If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not
tax deductible?
...__.._..--.._._.. __..-.. - .. ...N/A ......
.
..
.
84b
85 ..
.
.
- ........ _ -- ........
501(c)(4), (5), or (6) organizations. a Were substantially all dues nondeductible by members? ,-,...-__ .................. N/A-___.... 85a
b Did the organization make only in-house lobbying expenditures of $2,000 or less? ..... . ...... ......... ...... N/_A-,....___ 85b
If "Yes" was answered to either 85a or 85b, do not complete 85c through 85h below unless the organizationreceived a
waiver for proxy tax owed for the prior year.
c Dues, assessments, and similaramountsfrom members.-,-_--.--_.-._..-,.-_._ .............. ......_- 85c N/A
d Section 162(e) lobbying and political expenditures , .-___ 85d N/A
_...
e Aggregate nondeductible amount of section 6033(e)(1)(A) dues notices „ , _ 85e N/A
f Taxable amount of lobbying and political expenditures (line 85d less 85e) _ ,,,, , _....... 85f' N/A
g Dces the organization elect to pay the section 6033(e) tax on the amount on line 85f? • ................._..._.._.-.._... N/A --_.-.. 85g
h If section 6033(e)(1)(A) dues notices were sent, does the organization agree to add the amount on line 85f
to its reasonable estimate of dues allocable to nondeductible lobbying and political expenditures for the
following tax year'? -._-.. N/A 85h
86 501(c)(7) organizations. Enter: a Initiation fees and capital contributions included on
86a N/A
line 12
b - - - _. _ __
Gross receipts, included on line 12, for public use of club facilities -_ -.--_-.,,,___...,.:... , 86b N/A
87 501(c)(12) organizations. Enter: a Gross income from members or shareholders .._,_„- _._.. 87a N/A
b Gross income from other sources. (Do not net amounts due or paid to other sources
aga~lst amounts due or received from them.) ---_ _,... 87b N/A
_.. --
88 a At any time during the year, did the organization own a 50%0 or greater interest in a taxable corporation or partnership,
or an entity disregarded as separate from the organization under Regula#ions sections 301.7701.2 and 301.7701-3?
If "Yes," complete Part IX 88a X
b At any time during the year, did the organization, directly or indirectly, own a controlled entity within the meaning of
section 512(b)(13)? If "Yes," complete Part XI ,._,-:,-,-_,-,- _,--_ - 88b X
89 a 501(c)(3) organizations. Enter: Amount of tax imposed on the organization during the year under.
section 4911- 0 . ;section 4912 - 0 . ;section 4955 - 0
b 501(c)(3) and 501(c)(4) organizations. Did the organization engage in any section 4958 excess benefit
transaction during the year or did it become aware of an excess benefit transaction from a prior year?
If "Yes," attach a statement explaining each transaction _-__--,-,,,,_-__--.--,-_..._. 89b X
c Enter: Amount of tax imposed on the organization managers or disqualified persons during the year under
sections 4912, 4955, and 4958 _._.:._ -._.._ ... .._. _...- _.._._ ........-.. - 0
d Enter: Amount of tax on line 89c, above, reimbursed by the organization --_-___--..,_„_.._........ - 0
e All organizations. At any time during the tax year, was the organization a party to a prohibited tax shelter transaction? ,........ 89e X
f All organizations. Did the organization acquire a direct or indirect interest in any applicable insurance contract? ..................... 89f X
g For supporting organizations and sponsoring organizations maintaining donor advised funds. Did the supporting organization,
or a fund maintained by a sponsoring organization, have excess business holdings at any time during the year? .................. 89g X
90 a List the states with which a copy of this return is filed -CA
b Number of employees employed in the pay period that includes March 12, 2006 __ .................._.....-__.._: 90b 2
91 a The books are in care of - WILLIAM E . MOY Telephone no. - (9 2 5) 8 2 9 -19 2 8
Locatedat- 8435 DAVONA DRIVE, DUBLIN, CA ZIP+4-9 4568
b At any time during the calendar year, did the organization have an interest in or a signature or other authority over @S
a financial account in a foreign country (such as a bank account, securities account, or other financial account)? .................. 91b X
If "Yes," enter the name of the foreign country - N/A
See the instructions for exceptions and filing requirements for Form TD F 90-22.1, Report of Foreign Bank
and Financial Accounts.
623162 /01-18-07
Form 990 (2006)
7
16550128 748525 19412 2006.08010 DUBLIN PARTNERSHIPS IN EDUC 19412_1
Form 990 (2006) DUBLIN PARTNERSHIPS IN EDUCATION 9 4- 3 2 0 7 7 8 0 Page 8
Part VI ter n ormation (continued) Yes No
c At any time during the calendar year, did the organization maintain an office outside of the United States? 91c X
If "Yes,° enter the name of the foreign country - N /A
92 Section 4947(a)(1) nonexempt charitable trusts filing Form 990 in lieu of Form 1041- Check here ......................:............................... -
and enter the amount of tax-exempt interest received or accrued during the tax year .._.___ .... ........._... - 92 N/A
Part VII na ys~s o neome- rocTueing~~-etiv~t~es (see the mstruct~ons.)
r
less otherwise
t
t
N
t
E Unte~at edbusiness income Exclud ed by section 512, 513, or b14 (E)
n
er g
oss amoun
s un
o
e:
indicated.
93 Program service revenue: (A)
Business
code (B)
Amount E~C~_
S;o~
code (~)
Amount Related or exempt
function income
a
b
c
d
e
f Medicare/Medicaid payments
__.__._,__,.___._.__.__
g Fees and contracts from government agencies
_,
94 Membership dues and assessments
..__.
...,._.
__.
_
95 Interest on savings and temporary cash investments
. 14 4 4 0 .
__
96 Dividends and interest from securities ____.._._.__..
97 Net rental income or (loss) from real estate:
a debt-financed property
.. ___,..__._._.._._.._..._
_.__.
b not debt-financed property _..__..,....._______._._,__
98 Net rental income or (loss) from personal property
99 Other investment income
100 Gain or (loss) from sales of assets
other than inventory
__.__.___.,_.._...._._.,___. ___,__
101 Net income or (loss) from special events
110 , 8 9 2 .
102 Gross profit or (loss) from sales of inventory
_____.
103 Other revenue:
a
b
c
d
e
104 Subtotal (add columns (B), (D), and (E)) . _ . _. _.. _ _ .: 0 . 4 4 0 . 110 , 8 9 2 .
columns (B), (D), and (E))
105 Total (add line 104 _._. - 11, 332 .
_.____
,
Note: Line 105 plus line 1 e, Part 1, should equal the amo .-.,__;...
unt on line 1 2, Part 1.
Part VIIF a ationship of etivities tote ccomplis ment o xempt Purposes (see the instructions.)
Line No. Explain how each activity for which income is reported in column (E) of Part VII contributed importantly to the accomplishment of the organization's
~ exempt purposes (other than by providing funds for such purposes).
101 HESE ACTIVITIES"ONLY INCIDENTALLY ACCOMPLISH AN EXEMPT FUNCTION. THE
RIMARY PURPOSE IS TO RAISE FUNDS THAT ARE OTHER THAN CONTRIBUTIONS TO
INANCE THE ORGANIZATION'S EXEMPT ACTIVITIES.
Part IX Information Regard ing Taxable Subsidiaries and Disregarded Entities (see the instructions.)
Name, address, and EIN of corporation,
partnership, or disregarded entity Percentage of
ownership interest Nature of activities Total income End-of-year
assets
N/A
%
cart x ~ tnrormazwn rtegaramg ~ ransrers f+-ssoc~azea wain rersvnar ~C~~~~u ~.v~n~a~aa ~~~ ~~~C ~~~~~~~~~~~~~~-~
(a) Did the organization, during the year, receive any funds, directly or indirectly, to pay premiums on a personal benefit contract? __...__.,.,. LJ Yes l.~J No
(b) Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....................................... ~ Yes 0 No
Note: If "Yes" to (b), file Form 8870 and Form 4720 (see instructions). _
Form 990 (2006)
623163
01-18-07
8
16550128 748525 19412 2006.08010 DUBLIN PARTNERSHIPS IN EDUC 19412_1
f=orm 990 (2006) DUBLIN PARTNERSHIPS IN EDUCATION 9 4- 3 2 0 7 7 8 0 Page 9
Part XI In ormation Regarding ransfers To and rom ontro a EntIt12S. Complete only if the organization is a
controlling organization as defined in section 512(b)(13). N / A
Yes No
106 Did the reporting organization make any transfers to a controlled entity as defined in section 512(b)(13) of the Code? If "Yes,"
complete the schedule below for each controlled entity.
(A) (B) (C) (D)
Name, address, of each Employer Description of Amount of
controlled entity Identification
Number transfer transfer
a
b
c
Totals
Yes No
107 Did the reporting organization receive any transfers from a controlled entity as defined in section 512(b)(13) of the Code? If "Yes,"
complete the schedule below for each controlled entity.
(A) (B)< (C) (D)
Name, address, of each Employer. Description of Amount of
controlled entity identifieation
Number transfer transfer
a
b
c
Totals
Yes No
108 Did the organization have a binding written contract in effect on August 17, 2006, covering the interest, rents, royalties, and
annuities described in question 107 above?
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct,
and complete. Declaration of preparer (other than officer)'.is-based on all information of which preparer has any knowledge.
Please s/ William E. Moy I 05/12/08
,
Sign ~Ignature o oi(icer ate
Here ' WILLIAM E. MOY, TREASURER
ype or pant name an td e
f c I Preparer's SSN a PTIN (See Gen. Inst. X)
Preparer's a e
Paid
' sel
signature ' ELAINE LEE KAWASAKI 0 5 / 12 / 0 8 employed - ~
Preparer
s Firm's name (or TIMPSON GARCIA
LLP Elty -
'
Use Only ,
Yours
rf _„
seN-employed), ' 7 0 WASHINGTON STREET , SUITE 3 0 0
address, and OAKLAND, CA 94607-3705 Phone no. - (510) 832-2325
ZIP + 4
Form 990 (2006)
szstsaiot-zs-o~
16550128 748525 19412 2006.08010 DUBLIN PARTNERSHIPS IN EDUC 19412_1
SCHEDULE A Organization Exempt Under Section 501(c)(3) OMB No. 1545-0047
(Form 990 or 990-EZ) (Except Private foundation) and Section 501(e), 501(f), 501(k),
501(n), or 4947(a)(1) Nonexempt Charitable Trust 2006
Department of the Treasury Supplementary Information-(See separate instructions.)
Internal Revenue Service ~ MUST be completed by the above organizations and attached to their Form 990 or 990-EZ
Name of the organization Employer identification. number
DUBLIN PARTNERSHIPS IN EDUCATION 94:3207780
Part 1 Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees
(See page 2 of the instructions. List each one. If there are none, enter "None.")
(a) Name and address of each employee paid
more than $50,000 i e an average ours
per week devoted to
position
(c) Compensation employee benefit
plans & deferred
compensation a xpense
account and other
allowances
NONE
---------------------------------
Total number of other employees paid
over $50,000._... .._ -_......._...-
0
~ hart a-w ~ compensation of the Five Highest Paid Independent Contractors for Professional Services
(See page 2 of the instructions. List each one (whether individuals or firms). If there are. none, enter "None:')
(a) Name and address of each independent contractor paid more than $5Q,000 (b) Type of service (c) Compensation
-----------------------------------------
NONE
Total number of others receiving over
$50,000 for professionalservices ,
_..:.... - .._:.:.. ..__..........- 0
Part II-B Compensation of the Five Highest Paid Independent Contractors for Other Services
(List each contractor who performed services other than professional services, whether individuals or
firms. If there are none, enter "None." See page 2 of the instructions.)
(a) Name and address of each independent contractor paid more than $50,000 (b) Type of service (c) Compensation
--------------------------------------------
NONE
Total number of other contractors receiving over
$50,000 for other services ._-...-- ... _ , ~ 0
sz3,ovo,-,a-o7 LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990 and Form 990-EZ. Schedule A (Form 990 or 990-EZ) 2006
10
16550128 748525 19412 2006.08010 DUBLIN PARTNERSHIPS IN EDUC 19412_1
Schedule A (Form 990 or 990-EZ) 2006 DUBLIN PARTNERSHIPS IN EDUCATION 9 4- 3 2 0 7 7 8 0 Page 2
Part II Statements About Activities (See page 2 of the instructions.) Yes No
1 During the year, has the organization attempted to influence national, state, or local legislation, including any attempt to influence
public opinion on a legislative matter or referendum? If'^(es,"enter the total expenses paid or incurred in connection with the
lobbying activities - $ $ (Must equal amounts on line 38, Part VI-A, or
line i of PartVl-B.) 1 X
Organizations that made an election under section 501(h) by filing Form 5768 must complete Part VI-A. Other organizations
checking "Yes" must complete Part VI-BAND attach a statement giving a detailed description of the lobbying activities.
2 During the year, has the organization, either directly or indirectly, engaged in any of the following acts with any substantial contributors,
trustees, directors, officers, creators, key employees, or members of their families, or with any taxable organization with which any such
person is affiliated as an officer, director, trustee, majority owner, or principal beneficiary? (/f the answer to any question is "Yes, "
attach a detailed statement explaining the transactions.)
a Sale,exchan e, orleasin of roe ~ _--__ ..............„
9 9 P P rtY~ - - _ -- _....._......_ .................... - - ----_ 2a X
b Lending of money or other extension of credit? -..___--_-_.,_.-.--.._-_. _-_...._-...;_ ..........:...._-_ ..---. 2b X
c Furnishing of goods, services, or facilities? --._..._.,__--_-- „-_ ..:........... ...._ 2c X
d Payment of compensation (or payment or reimbursement of expenses if more than $1,000)? -..-_,-__.-._,--_..., 2d X
e Transfer of any part of its income or assets? .,._-..._..-_-_._.-_.:...--_-_-,:,-,:,,.,-_,_.._..... .-_-. 2e X
3 a Did the organization make grants for scholarships, fellowships, student loans, etc:? (If "Yes," attach an explanation of how
the organization determines that recipients qualify to receive payments.) __-.._ ::-,.,,,,__---..___.__. _ .......
...... ...... 3a X
b Dd the organization have a section 403(b) annuity plan for its employees? ...-.._. _....-,-___„_-_„---------------:..::_...-.-_-...-_-.---.......-.. -..._ 3b X
c Did the organization receive or hold an easement for conservation purposes, including easements,to preserve open space,
the environment, historic land areas or historic structures? If"Yes;' attach a detailed statement _,.__,..-:_-.,-_,..-..,__----------------_.,._..-- ...-_ 3c X
d Did the organization provide credit counseling, debt management, credit repair, or debt negotiation services? . ___. _ ,,,,, _ . ....... ...... 3d X
4 a Did the organization maintain any donor advised funds? If "Yes," complete lines 4b through 4g. If"No,".complete lines 4f
and 49 ..._-......-.-_ .......... ......_..__......_.............._ _............ _ _ __ _ _ _ 4a X
b Did the organization make any taxable distributions under section 4966? _„--. _,,.__ ...:........... N/A -_.. 4b
c Did the organization make a distribution to a donor, donor advisor, or related person? .,.__.._.'._-. ,-..__--.._-..-.-._ .... ...... ... N/A _-_-_ 4c
d Enter the total number of donor advised funds owned at the end of the tax year __ _. _. _-.......
_. - .-... - 0
e Enter the aggregate value of assets held in all donor advised funds owned atthe end of the tax year __-------------------- ---------_..-...._..___ - 0
f Enter the total number of separate funds or accounts owned at the end of the year (excluding donor advised funds included on
line 4d) where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts --,-„ ,,,,.,-, - 0
g Enter the aggregate value of assets in all funds or accounts included on ine 4f at the end of the tax year --:- __,_, -_.--- _._..--. - 0
Schedule A (Form 990 or 990-EZ) 2006
623111
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16550128 748525 19412 2006.08010 DUBLIN PARTNERSHIPS IN EDUC 19412_1
Schedule A (Form 990 ,or 990-EZ) 2006 DUBLIN PARTNERSHIPS IN EDUCATION
94-3207780 Page3
Part IV Reason for Non-Private Foundation Status (See pages 4 through 7 of the instructions.)
I certify that the organization is not a private foundation because it is: (Please check only ONE applicable box.)
5 0 A church, convention of churches, or association of churches. Section 170(b)(1)(A){i).
8 ~ A school. Section 170(b)(1)(A)(ii). (Also complete Part V.}
7 0 A hospital or a cooperative hospital service organization. Section 170(b)(1)(A)(iii).
8 ~ A federal, state, or local government or governmental unit Section 170(b){1)(A)(v).
9 0 A medical research organization operated in conjunction with a hospital. Section 170(b)(1)(A)(iii)_Evter the hospital's name, city,
and state - __
10 0
iia 0
lib
,2 a
An organization operated for the benefit of a college or university owned or operated by a governmental unit. Section 170(b)(1)(A)(iv).
(Also complete the Support Schedule in Part IV-A.)
An organization that normally receives a substantial part of its support from a governmental unit or from the general public.
Section 170(b)(1)(A)(vi). (Also complete the Support Schedule in Part IV-A.)
A community trust Section 170(b)(1)(A)(vi). (Also complete the Support Schedule in Part IV-A.)
An organization that normally receives: (1) more than 33 1!3% of its support from contributions, membership fees, antl gross
receipts from activities related to its charitable, etc., functions - subject to certain exceptions, and (2j eo more than 33 1/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired
by the organization after June 30, 1975. See section 509(a)(2). (Also complete the Support Schedule ih Part IV-A.)
13 0 An organization that is not controlled by any disqualified persons (other than foundation managers) and otherwise meets the requirements of section
509(a)(3). Check the box that describes the type of supporting organization:
Type I ~ Type II 0 Type III-Functionally Integrated ~ Type III-Other
Provide the following information about the supported organizations.,(See page 7 of the instructions.)
(a)
Name(s) of supported organization(s) (b)
Employer
identification
number (EIN) (b)
Type of organization
(described in lines
5 through 12 above
or IRC section) (d)
Is the supported
organization listed in
the supporting
organization's
governing documents. (e) -
Amount of
support
Yes No
Total . -
14 ~ An organization organized ahd operated to test for public safety. Section 509(a)(4). (See page 7 of the instructions.)
Schedule A (Form 990 or 990-EZ) 2006
623121
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16550128 748525 19412 2006.08010 DUBLIN PARTNERSHIPS IN EDUC 19412_1
Schedule A (Form 990 or 990-EZ) 2006 DUBLIN PARTNERSHIPS IN EDUCATION 9 4- 3 2 0 7 7 8 0 Page 4
8 - Support Schedule (Complete only if you checked a box on line 10, 11, or 12.) Use cash method of accounting.
Note: You may use the worksheet in the instructions for converting from the accrual to the cash method of accounting.
a en ar year or isca year
beginning in) ...............___.__,. _. -
(a) 2005
(b) 2004
(c) 2003
{d) 2002
{e) Total
15 ~ s, grants, an contra utions
received. (Do not include unusual
grants. see line28.)....._-_, ,._
48,036.
35,564.
36,178.
50,510.
170,288.
16 Membership fees received ...
17 Gross receipts from admissions,
merchandise sold or services
performed, or furnishing of
facilities in any activity that is
related to the organization's
charitable, etc., purpose __-...,_,. 182,267. 129,350. 105,271. 80,582. 497,470.
18 Gross income from interest,
dividends, amounts received from
payments on securities loans (sec-
tion 512(a)(5)), rents, royalties, and
unrelated business taxable income
(less section 511 taxes) from
businesses acquired by the
organization after June 30, 1975
19 Net income from unrelated business
activities not included in line 18
20 ax revenues ewe or e
organization's benefit and either
paid to it or expended on its tiehalf
21 The value of services or facilities
furnished to the organization by a
governmental unit without charge.
Do not include the value of services
or facilities generally furnished to
the public without charge
22 er mcome. ac a sc e u e.
Do not include gain or (loss) from SEE STATEM T 7
sale of capital assets ..__-__._-_... 37, 300. 37, 300.
23 Total of lines l5 through 22
_.. 230,303. 16:4,914,' 141,449. 168,392. 705,058.
24 Line 23 minus line l7 ,.______.___ 48, 036. 35, 564. 36,178. 87, 810. 207, 588.
25 Enter 1% of line 23 2 , 3 0 3 . 1, 6 4 9 . 1, 414. 1, 6 8 4 .
26 Organizations described on lines 1 0 or 11: a Enter 2% of amount'in:column (e), line 24 __.,._.___..__._._._._..,..___,____ - 26a N/A
b Prepare a list for your records to show the name of and amount contributed by each person (other than a governmental
unit or publicly supported organization) whose total gifts for 2002 through 2005 exceeded the amount shown in line 26a.
Do not file this list with your return. Enter the total of all these excess amounts __..__.__._.__.__-.--_..-__...,._-,___..___._--- 26b N/A
c Total support for section 509(a)(1) test: Enter line 24, cotumn (e) - 26c N/A
d Add: Amounts from column (e) for lines: 18 19
22 26b - 26d N/A
e Public support (line26cminusline26dtotal)._._ _-.__,.__.._..____-__.-___.--_._,_-._..-,-.....- 26e N/A
f Public support percentage (line 26e (numerator),divided byline 26c (denominator)) ..-..._- _...... _ - 26f N/A
27 Organizations described on line 12: a for amounts included in lines 15, 16, and 17 that were received from a "disqualified person," prepare a list for your
records to show the name of, and total amounts received in each year from, each "disqualified person." Do not fife this list with your return. Enter the sum of
such amounts for each year:
(2005) ...... - - -............0.• (2004) ..._......._..__.._.._......_Q.._ 2003 _......0.:~. (2002) _...Q.~.
b For any amount included in line 17 that was received from each person (other than "disqualified persons"), prepare a list for your records to show the name of,
and amount received for each year, that was more than the larger of (1) the amount on line 25 for the year or (2) $5,000. (Include in the list organizations
described in lines 5 Through i ib, as weii as intlividuais.) Do not file this list with your return: After computing the difference between the amount received and
the larger amount described in (1) or (2j, enter the sum of these differences (the excess amounts) for each year:
(2005) ._.... _._......_.....Q:.:. (2004) Q.~. (2003) 0.~. (2002) 0-•.
c Add: Amounts from column (e) for lines: 15 17 0 , 2 8 8 . 16
17 497 , 470. 20 21 - 27c 667 , 758 .
d Add: Line 27a total 0 . and line 27b total 0 . - 27d 0 .
- ...
e Public support (line 27c total minus line 27d total) ....................... - 27e 6 6 7 , 7 5 8 .
f Total support for section 509(a)(2) test Enter amount on line 23, column (e) , _,.. _., - 27f 7 0 5 , 0 5 $ .
g Public support percentage (line 27e (numerator) divided by line 27f (denominator)) --------------------------------- - 27g 9 4.70 97%
h Investment income percentage (line 18, column (e) (numerator) divided by line 27f (denominator)) ... - 27h . 0 0 0 0
28 Unusual Grants: For an organization described in line 10, 11, or 12 that received any unusual grants during 2002 through 2005, prepare a listforyour records to
show, for each year, the name of the contributor, the date and amount of the grant, and a brief description of the nature of the grant. Do not file this list with your
return. Do not include these grants in line 15.
623131 01-18-07 NONE Schedule A (Form 990 or 990-EZ) 2006
3
16550128 748525 19412 2006.08010 DUBLIN PARTNERSHIPS IN EDUC 19412_1
Schedule A (Form 990 or 990-EZ) 2006 DUBLIN PARTNERSHIPS IN EDUCATION 9 4- 3 2 0 7 7 8 0 Page 5
Part V Private chool uestionnaire (See page 9 of the instructions.) N/A
(To be completed ONLY by schools that checked the box on line 6 in Part IV)
29 Does the organization have a racially nondiscriminatory policy toward students by statement in its charter, bylaws, other governing
instrument, or in a resolution of its governing body? _.. _--_. _ _, _. -.- _ _ _ . __.. _ _ _ ............. _.. _........... _.. _... 29
30 Does the organization include a statement of its racially nondiscriminatory policy toward students in all its brochures, catalogues,
and other written communications with the public dealing with student admissions, programs, and scholarships? .............. 30
31 Has the organization publicized its racially nondiscriminatory policy through newspaper or broadcast media during the period of
solicitation for students, or during the registration period if it has no solicitation program, in a way that makes the policy known
to all parts of the general community it serves? .,.___.__._ ._._..._.......____ ..................._... 3f
If "Yes," please describe; if "No,"please explain. (If you need more space, attach a separate statement)
No
32 Does the organization maintain the following:
a Records indicating the racial composition of the student body, faculty, and administrative staff? _... _.:-_
32a
b Records documenting that scholarships and other financial assistance are awarded on a racially nondiscriminatory basis? ........................ 32b
c Copies of all catalogues, brochures, announcements, and other written communications to the public dealing with student
admissions, programs, and scholarships? -..--__-___ _-.__,.,,_-___._-._.,.....
32c
d Copies of all material used by the organization or on its behalf to solicit contributions? -,..,__, ____- 32d
If you answered "No" to any of the above, please explain. (If you need more space, attach a separate statement.)
33 Does the organization discriminate by race in any way with respect to:
a Students'rightsorprivileges? -_ __.__,--._--_..._._._ _.,_..._--_._._._
33a
b Admissions policies? _.__-.__.-.. 33b
....._-,.- ,-_-____--.
c Employment of faculty or administrative staff? ................................
. 33c
.
.
d Scholarships or other financial assistance? _- -:.--,_ _.-..-.__-..._ .............._._-..._...__..........._...._ 33d
e Educational policies? --....-_-. _..__..-_-_-__-_-_,__ 33e
f Use of facilities? 33f
g Athletic programs? -...._._.._._ _._.. -...... - ~ .............._ - ..........._....... - 33g
h Other extracurricularactivities? .................._ .-._..-__-_. _..._.--.__---.-...-._. 33h
If you answered "Yes" to any of the above, please explain,. (If you need more space, attach a separate statement)
34 a Does the organization receive any financial aid or assistance from a governmental agency? ..._.-__,..-..,.-_._--..._,..__-_....-_-._ .............. 34a
b Has the organization's right to such aid ever been revoked or suspended? - __.._,. ..... ......... .....-...-_.. 34b
If you answered "Yes" to either 34a or b, please explain using an attached statement.
35 Does the organization certify that it has complied with the applicable requirements of sections 4.01 through 4.05 of Rev. Proc. 75-50,
1975-2 C.B. 587, covering racial nondiscrimination? If "No," attach an explanation _______ ____________,-..,._.-_.__-, .....-_.--......
35
Schedule A (form 990 or 990-EZ) 2006
623141
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16550128 748525 19412 2006.08010 DUBLIN PARTNERSHIPS IN EDUC 19412_1
Schedule A (Form 990 or 990-EZ) 2006 DUBLIN PARTNERSHIPS IN EDUCATION 9 4- 3 2 0 7 7 8 0 Page s
Part VI-A Lobbying Expenditures by Electing Public Charities (See page 10 of the instructions.) N/A
(To be completed ONLY by an eligible organization that filed Form 5768)
Check - a if the nrnani7atinn helnnns to an affiliated nrrnm Cherk - h if vrnl rherked "a"and "limited control" provisions cooly.
Limits on Lobbying Expenditures Affiliated group To be compbeted for all
(The term "expenditures" means amounts paid or incurred.) totals electing organizations
N/A
36 Total lobbying expenditures to influence public opinion (grassroots lobbying) --_ _-. _.-_.-_., __,_ 36
37 Total lobbying expenditures to influence a legislative body (direct lobbying) -,_....-„-__,__ ,__,___. 37
38 Total lobbying expenditures (add lines 36 and 37) --..-_--___.-_ _.-
_..._ ..............._......
38
39 Other exempt purpose expenditures -,___ „ _, .-_._.___--.-.--_,,. 39
40 Total exempt purpose expenditures (add lines 38 and 39) 40
41 Lobbying nontaxable amount Enter the amount from the following table -
If the amount on line 40 is - The lobbying nontaxable amount is -
Not over $500,000 20°h of the amount on line 40
Over $500,000 but not over $1,000,000 $100,000 plus 15% of the excess over $500,000
-...-...
Over $1,000,000 but not over $1,500,000 $175,000 plus 10% of me excess over $1,000,000 41.
Over $1,500,000 but not over $17,000,000 $225,OOD plus 5% of the excess over $1,500,000
Over $17,000,000 $1,000,000
42 Grassroots nontaxable amount (enter 25% of line 41) 42
43 Subtract line 42 from line 36. Enter -0- if line 42 is more than line 36 43 -'
44 Subtract line 41 from line 38. Enter -0- if line 41 is more than line 38 44
Caution: If there is an amount on either line 43 or line 44, you must file Form 4720.
4-Year Averaging Period Under Section 501 (h)
(Some organizations that made a section 501(h) election`do not have to complete all of the five columns
below. See the instructions for lines 45 through 50 on page 13 of the instructions.)
Lobbying Expenditures During 4-Year Averaging Period N /A
Calendar year (or (a) (b) (c) (d) (e)
fiscal year beginning in) - 2006 2005 2004 2003 Total
45 Lobbying nontaxable
amount ...-.._..... -....... 0.
46 Lobbying ceiling amount
(150% of line 45(e)) -....._. 0 .
47 Total lobbying
expenditures ._.........._. 0 •
48 Grassroots nontaxable
amount .__ ................._ 0.
49 Grassroots ceiling amount
(150% of line 48(e)) ......... 0 .
50 Grassroots lobbying
expenditures ._..__..._.._ 0 .
~ Part yl-6 ~ Lodpying Activity by Nonelecting Public Charities
(For reporting only by organizations that did not complete Part VI-A) (See page 13 of the instructions.) N/A
During the year, did the organization attempt to influence national, state or local legislation, including any attempt to Yes No Amount
influence public opinion on a legislative matter or referendum, through the use of:
a Volunteers
b Paid staff or management (Include compensation in expenses reported on lines cthrough h.) ..,__,,,,,,-___.--.,.._.-,,,_
c Media advertisements
d Mailings to members, legislators, or the public .--___-_,,,,,.,_,,,_,--,-,_.._-,_..--..,_„-_,_.,.__.__„_-.-_,.,-,.-._.-„-.,-,
e Publications, or published or broadcast statements
f Grants to other organizations for lobbying purposes,_,__-..-.-._
g Direct contact with legislators, their staffs, government officials, or a legislative body --,-,_.---__,,,,,,,,,,,,,_-.-.-,_-,__..,.,
h Rallies, demonstrations, seminars, conventions, speeches, lectures, or any other means ---------------- ----------- - -----------
i Total lobbying expenditures (Add lines cthrough h.) . --____ 0
If "Yes" to any of the above, also attach a statement giving a detailed description of the lobbying activities.
o1-1a-o7 Schedule A (Form 990 or 990-EZ) 2008
15
16550128 748525 19412 2006.08010 DUBLIN PARTNERSHIPS IN EDUC 19412_1
Schedule A (Form 990 or 990-EZ) 2006 DUBLIN PARTNERSHIPS IN EDUCATION 9 4- 3 2 0 7 7 8 0 Page 7
Part VII Information Regarding Transfers To and Transactions and Relationships With Noncharitable
Exempt Organizations (See page 13 of the instructions.)
51 Did the reporting organization directly or indirectly engage in any of the following with any other organization described in section
501(c) of the Code (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
a Transfers from the reporting organization to a noncharitable exempt organization oY. Yes No
(i) Cash -- ...._. ... 51a(i) X
(ii) Other assets - - - .....-.. - _ _- -- - ................._ __ ...._.... - _ _..... _.. a(ii} X
b Other transactions:
(i)Salesorexchangesofassetswithanoncharitableexemptorganization -..--,_...,,_--_-_._.._ .................._...-:.-....._......_.......... -.. b(~) X
(ii) Purchases of assets from a noncharitable exempt organization __.-.-. _ ...... ... ...... .............. ... b(ii) X
(iii) Rental of facilities,equipment, or other assets.-....... __.....:_-._...__ ................---.-.--.._..........-.....--.--.--.--.............._..._........ ... b(iii) X
(iv) Reimbursement arrangements _.,___..--.-._..--..-_.-.- b(iv) X
(v) Loans or loan guarantees --_--_.-.__.-.-._--.-_
b(v)
X
(vi) Pertormance of services or membership or fundraising solicitations __._._._--_..-__.-_..,--._ ......:......._..-,. -._ _-. b(vi) X
c Sharing of facilities, equipment, mailing lists, other assets, or paid employees _„ _ _._ ... c X
d If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the#air market value of the
goods, other assets, or services given by the reporting organization. If the organization received less than fair market value in any
transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received: N /A
(a) (b) (c) (d)
Line no. Amount involved Name of noncharitable exempt organization Description of transfers, transactions, and sharing arrangements
16
16550128 748525 19412 2006.08010 DUBLIN PARTNERSHIPS IN EDUC 19412_1
52 a Is the organization directly or indirectly affiliated with, orreiated to, one or more tax-exempt organizations described in section 501(c) of the
Code(otherthansection501(c)(3))orinsection527?-__,.____,._-_,_„-_,_ .................................._-...--....-,...._._.-._.__....- Yes OX No
b If "Yes," complete the following schedule: N/A
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Supplementary Information for
Tine 1 of Form 990, 990-EZ, and 990-PF (see instructions)
OMB No. 1545-0047
2006
Name of organization
DUBLIN PARTNERSHIPS IN EDUCATION
Organization type(check one):
Filers of: Section:
Forrn 990 or 990-EZ
Form 990-PF
© 501(c)( 3) (enter number) organization
4947(a)(1) nonexempt charitable trust not treated as a private foundation
527 political organization
0 501(c)(3) exempt private foundation
4947(a)(1) nonexempt charitable trust treated as a private foundation
501(c)(3) taxable private foundation
Employer identification number
94-3207780
Check if your organization is covered by the General Rule or a Special Rule. (Note: Onlya section 501(c)(7), (8), or (10) organization can check boxes
for both the General Rule and a Special Rule-see instructions.)
General Rule-
OX For organizations filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or property) from any one
contributor. (Complete Parts I and IL)
Special Rules-
For a section 501(c)(3) organization filing Form 990, or Form 990-EZ, that met the 33 1 /3% support test of the regulations under
sections 509(a)(1)/170(b)(1)(A)(vi), and received from any one contributor, during the year, a contribution of the greater of $5,000 or 2%
of the amount on line 1 of these forms. (Complete Parts I and 11.)
0 For a section 501(c)(7), (8), or (10) organization filing. Form 990, or Form 990-F2, that received from any one contributor, during the year,
aggregate contributions or bequests of more than $1,000 for use exclusively for religious, charitable, scientific, literary, or educational
purposes, or the prevention of cruelty to children or animals. (Complete Parts I, 11, and III.)
0 For a section 501{c)(7), (8), or (10) organization filing Form 990, or Form 990-EZ, that received from any one contributor, during the year,
some contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did not aggregate to more than
$1,000. (If this box is checked, enter here the total contributions that were received during the year for an exclusively religious,
charitable, etc., purpose. Do not complete any of the Parts unless the General Rule applies to this organization because it received
nonexclusively religious, charitable, etc., contributions of $5,000 or more during the year.) ___________________________ ~ $
Caution: Organizations that are not covered by the General Rule and/or the Special Rules do not file Schedule B (Form 990, 990-EZ, or 990-P~, but
they must check the box in the heading of their Form 990, Form 990-EZ, or on line 2 of their Form 990-PF, to certify that they do not meet the filing
requirements of Schedule 8 (Form 990, 990-EZ, or 990-P~.
LHA For Paperwork Reduction Act Notice, see the Instructions Schedule B (Form 990, 990-EZ, or 990-PF) (2006)
for Form 990, Form 990-EZ, and Form 990-PF.
623451 03-19-07
17
16550128 748525 19412 2006.08010 DUBLIN PARTNERSHIPS IN EDUC 19412_1
Schedule B (Form 990, 990-EZ, or 990-PF) (2006)
Page 1 of 1 of Part I
Name of organization
DUBLIN PARTNERSHIPS IN EDUCATION
Employer identification number
94-3207780
Part 1 COntrlbUtOCS (See Specific Instructions.)
(a)
No. (b)
Name, address, and ZIP + 4 (c)
Aggregate contributions (d)
Type of contribution
1 BANGOR PROPERTIES, LLC (REALTORS
GETTING REAL GRANT)
Person ~
2068 FIRST STREET
$ 14, 933. Payroll
Noncash
L I VERMORE , CA 9 4 5 5 0 (Complete Part II if there
is a noncash contribution.)
(a)
No. (b)
Name, address, and ZIP + 4 l~)
Aggregate contributions (d)
Type of contribution
2 CITY OF DUBLIN ~ Person
100 CIVIC PLAZA
$ 12, 500. Payroll 0
Noncash ~
DUBLIN , CA 9 4 5 6 8 (Complete Part II if there
is a noncash contribution.)
la)
No. (b)
Name, address, and ZIP + 4 (c)
Aggregate contributions (d)
Type of contribution
3 CHEVRON CORPORATION Person
6 0 01 BOLL INGER CANYON ROAD
$ 5 , 0 0 0 . Payroll 0
Noncash ~
SAN RAMON , CA 9 4 5 8 3 (Complete Part II if there
is a noncash contribution.)
(a)
No. (b)
Name, address, and ZIP + 4 (c)
Aggregate contributions (d)
Type of contribution
4 ORACLE USA, INC. Person
2 2 0 7 BRIDGEPOINTE PARKWAY
$ 5, 0 0 0. Payroll 0
Noncash 0
SAN MATEO , CA 9 4 4 0 4 (Complete Part II if there
is a noncash contribution.)
(a)
No. (b)
Name, address, and ZIP + 4 (c)
Aggregate contributions (d)
Type of contribution
Person
$ Payroll 0
Noncash
(Complete Part II if there
is a noncash contribution.)
(a)
No. (b)
Name, address, and ZIP + 4 (c)
Aggregate contributions (d)
Type of contribution
Person
$ Payroll
Noncash
(Complete Part II if there
is a noncash contribution.)
s2saea m-,a_n~ Schedule 8 (form 9 90. 990-EZ, or 990-PF) (2006)
18
16550128 748525 19412 2006.08010 DUBLIN PARTNERSHIPS IN EDUC 19412_1
DUBLIN PARTNERSHIPS IN EDUCATION 94-3207780
FORM 990 SPECIAL EVENTS AND ACTIVITIES STATEMENT 1
DESCRIPTION OF EVENT
GROSS
RECEIPTS
CONTRIBUT.
INCLUDED
GROSS
REVENUE
DIRECT NET
EXPENSES INCOME
GOLF TOURNAMENT 77,710. 77,710. .20,039. 57,671.
STUDENT ART AUCTION 55,865. 55,865. 14,999. 40,866.
FIREWORKS 12,505. 12,505. 150. 12,355.
TO FM 990, PART I, LINE 9 146,080. 146,080... 35,188. 110,892.
FORM 990 OTHER EXPENSES STATEMENT 2
(A) (B) (C) (D)
PROGRAM MANAGEMENT
DESCRIPTION TOTAL SERVICES AND GENERAL FUNDRAISING
BANK FEES 2,281.- 2,281.
INSURANCE 3,214. 3,214.
MARKETING AND
ADVERTISING 417. 417.
PROFESSIONAL
DEVELOPMENT 55. 55.
STUDENT ACTIVITIES
AND SCHOOL PROGRAMS 32,398.
WORKER'S
COMPENSATION
INSURANCE 1,485.
TAXES AND FEES 70.
OFFICE SUPPLIES 7$5.
BOARD MEETING
EXPENSES 438.
OFFICE EQUIPMENT
EXPENSE 22.
MEMBERSHIP DUES 100.
SUPPORT OF OTHER
NONPROFIT
ORGANIZATIONS 906.
MISCELLANEOUS
EXPENSE 720.
720.
195.
TOTAL TO FM 990, LN 43 42,891.
32,398.
34,1in". 8,580. 195.
812. 478.
70.
785.
438.
22.
100.
906.
19 STATEMENT(S) 1, 2
16550128 748525 19412 2006.08010 DUBLIN PARTNERSHIPS IN EDUC 19412_1
DUBLIN PARTNERSHIPS IN EDUCATION 94-3207780
FORM 990 CASH GRANTS AND ALLOCATIONS STATEMENT 3
TO OTHERS
CLASS OF ACTIVITY/DONEE'S NAME AND ADDRESS AMOUNT
TEACHER GRANTS
VARIOUS DUSD TEACHERS
DUBLIN UNIFIED SCHOOL DISTRICT
DUBLIN, CA 94568
30,710.
TOTAL INCLUDED ON FORM 990, PART II, LINE 22B 30,710.
FORM 990 STATEMENT OF ORGANIZATION'S PRIMARY EXEMPT PURPOSE STATEMENT 4
PART III
EXPLANATION.
TO FOSTER MUTUALLY BENEFICIAL BUSINESS EDUCATION PARTNERSHIPS IN ORDER TO
MAXIMIZE COMMUNITY RESOURCES FOR THE STUDENTS OF THE DUBLIN UNIFIED SCHOOL
DISTRICT.
FORM 990 OTHER LIABILITIES STATEMENT 5
DESCRIPTION AMOUNT
PAYROLL TAXES PAYABLE
DEFERRED GOLF REVENUE
TOTAL TO FORM 990, PART IV, LINE 65, COLUMN B
2,337.
13,570.
15,907.
20 STATEMENT(S) 3, 4, 5
16550128 748525 19412 2006.08010 DUBLIN PARTNERSHIPS IN EDUC 19412_1
DUBLIN PARTNERSHIPS IN EDUCATION
94-3207780
FORM 990 PART V-A - LIST OF CURRENT OFFICERS,
TRUSTEES AND KEY EMPLOYEES DIRECTORS,
- STATEMENT 6
EMPLOYEE
TITLE AND COMPEN- BEN PLAN EXPENSE
NAME AND ADDRESS AVRG HRS/WK SATION CONTRIB ACCOUNT
DONNA MCMILLION EXECUTIVE DIRECTOR
8435 DAVONA DRIVE 30.00 35,345. 0. 0.
DUBLIN,. CA 94568
DON BIDDLE PRESIDENT
8435 DAVONA DRIVE 0.00 0. 0. 0.
DUBLIN, CA 94568
TESS THOMAS VICE PRESIDENT
8435 DAVONA DRIVE 0.00 0. 0. 0.
DUBLIN, CA 94568
WILLIAM MOY TREASURER
8435 DAVONA DRIVE 0.00 0. 0. 0.
DUBLIN, CA 94568
DR. DAVE HARKEN BOARD MEMBER
8435 DAVONA DRIVE 0.00 0. 0. 0.
DUBLIN, CA 94568
ANGELA FONTES BOARD MEMBER
8435 DAVONA DRIVE 0.00 0. 0. 0.
DUBLIN, CA 94568
TED HOFFMAN, JR. BOARD MEMBER
8435 DAVONA DRIVE 0.00 0. 0. 0.
DUBLIN, CA 94568
KELLEE JONES BOARD MEMBER
8435 DAVONA DRIVE 0.00 0. 0. 0.
DUBLIN, CA 94568
CHRIS BENNETT CO-SECRETARY
8435 DAVONA DRIVE 0.00 0. 0. 0.
DUBLIN, CA 94568
KATHY DE JONG CO-SECRETARY
8435 DAVONA DRI`JE 0.00 0. 0. 0.
DUBLIN, CA 94568
BILL PRESCOTT BOARD MEMBER
8435 DAVONA DRIVE 0.00 0. 0. 0.
DUBLIN, CA 94568
21 STATEMENT(S) 6
16550128.748525 19412 2006.08010 DUBLIN PARTNERSHIPS IN EDUC 19412_1
DUBLIN PARTNERSHIPS IN EDUCATION 94-3207780
VICTOR UNO BOARD MEMBER
8435 DAVONA DRIVE 0.00 0. 0. 0.
DUBLIN, CA 94568
ALICE WATERMAN BOARD MEMBER
8435 DAVONA DRIVE 0.00 0. 0. 0.
DUBLIN, CA 94568
ALCINA WEGRYNOWSKI BOARD MEMBER
8435 DAVONA DRIVE 0.00 0. 0. 0.
DUBLIN, CA 94568
PAT KOHNEN LIAISON TO DUSD DOARD
8435 DAVONA DRIVE 0.00 0. 0. 0.
DUBLIN, CA 94568
MICHAEL HARTSHORN STUDENT REPRESENTATIVE
8435 DAVONA DRIVE 0.00 0. 0. 0.
DUBLIN, CA 94568
TOTALS INCLUDED ON FORM 990, PART V-A 35,345. 0. 0.
SCHEDULE A OTHER INCOME' STATEMENT 7
200'5 2004 2003 2002
DESCRIPTION AMOUNT AMOUNT AMOUNT AMOUNT
PROGRAM SERVICE REVENUE 0. 0. 0. 37,300.
TOTAL TO SCHEDULE A, LINE 22 0. 0. 0. 37,300.
22 STATEMENT(S) 6, 7
16550128 748525 19412 2006.08010 DUBLIN PARTNERSHIPS IN EDUC 19412 1
Form 8868 (Rev- 4-2007) Page 2
• If you are filing for an Additional (not automatic) 3-Month Extension, complete only Part II and check this box .............................. -
Note. Only complete Part II if you have already been granted an automatic 3-month extension on a previously filed Form 8868
• If you are filing for an Automatic 3-Month Extension, complete only Part 1(on page 1).
Part II Additional (not automatic) 3-Month Extension of Time. You must file original and one copy.
Name of Exempt Organization Employer identification number
Type or
print UBLIN PARTNERSHIPS IN EDUCATION 94-3207780
extendede Number, streets, and room? or suite no. If a P.O. box, see instructions. For IRS use only
due date for ~ O ~ BOA 2 3 0 '/
filing the
return. See City, town or post office, state, and ZIP code. For a foreign address, see instructions.
'nshu«.°ne. UBLIN , CA 9 4 5 6 8
Check type of return to be filed (File a separate application for each return):
© Form 990 0 Form 990-EZ ~ Form 990-T (sec. 401(a) or 408(a) trust) ~ Fonn 1041-A ~ Form 5227 0 Form 8870
0 Form 990-BL 0 Form 990-PF 0 Form 990-T (trust other than above) ~ Form 4720 ~ Form 6069
STOP! Do not complete Part II if you were not already granted an automatic 3-month extension on a previously filed Form 8868.
• The books are in the care of - WILLIAM E . MOY
TelephoneNo.- (925) 829-1928 FAxNo. - (510) 465`-2979
• If the organization does not have an office or place of business in the United States, check this box ,-__.._..___...,._ .................._....._ ~
• If this is for a Group Return, enter the organization's four digit Group Exemption Number (GEN) . If this is for the whole group, check this
box - 0 . If it is for part of the group, check this box - ~ and attach a list with the names and EINs of all members the extension is for.
4 I request an additional 3-month extension of time until MAY 15 , 2'0.0 8
5 For calendar year , or other tax year beginning JUL 1 , 2 0 0 6 ,and ending JUN 3 0 , 2 0 0 7
6 If this tax year is for less than 12 months, check reason: Initial returh Final return Change in accounting period
7 State in detail why you need the extension
MORE TIME IS REQUIRED TO FILE A COMPLETE AND ACCURATE RETURN.
8a If this application is for Form 990-BL, 990-PF, 990-T, 4720, or 6069, enterthe tentative tax, less any
nonrefundable credits. See instructions.
If this application is for Fonn 990-PF, 990-T, 4720, or 6069., enter any refundable credits and estimated
tax payments made. Include any prior year overpayment allowed as a credit and any amount paid
with Form 8868.
c Balance Due. Subtract line 8b from line 8a. Include your payment with this form, or, if required, deposit
with FTD coupon or, if required, by using EFTPS (Electronic Federal Tax Payment System). See instructions.
Signature and Verification
~ N/A
Under penalties of perjury, I declare that I have examined this form, including accompanying schedules and statements, and to the best of my knowledge and belief,
it is true, correct, and complete, and that I am authorized to prepare this form.
Signature - Title - CPA Date -
Notice to Applicant. (To Be Completed by the IRS)
We have approved this application. Please attach this form to the organization's return.
We have not approved this application. However, we have granted a 10-day grace period from the later of the date shown below or the due
date of the organization's return (including any prior extensions). This grace period is considered to be a valid extension of time for elections
otherwise required to be made on a timely return. Please attach this form to the organization's return.
We have not approved this application. After considering the reasons stated in item 7, we cannot grant your request for an extension of time to
file. We are not granting a 10-day grace period.
We cannot consider this application because it was filed after the extended due date of the return for which an extension was requested.
h-I Other
By:
Director
Date
Alternate Mailing Address. Enter the address if you want the copy of this application for an additional 3-month extension returned to an address
different than the one entered above.
Name
TIMPSON GARCIA, LLP
Type or
print
Number and street (include suite, room, or apt. no.) or a P.O. box number
70 WASHINGTON STREET, SUITE 300
City or town, province or state, and country (including postal or ZIP code)
os3oi o~ OAKLAND, CA 94607-3705
Form 8868 (Rev. 4-2007)
23
16550128 748525 19412. 2006.08010 DUBLIN PARTNERSHIPS IN EDUC 19412_1
Dublin Partners in Education
P.O. Box 2307
Dublin, CA 94568
925.828.2551 x8024
Fax: 925.803.9746
Email: dpie@dublin.k12.ca.us
Website: www.dublin.k12.ca.us
January 12, 2009
Mr. Roger Bradley
Administrative Analyst
City of Dublin
100 Civic Plaza
Dublin, CA 94568
Dear Mr. Bradley,
This letter certifies that the Board of Directors for Dublin Partners in Education, a
501(c)3 organization, approved the submittal of the Community Group
Organizational Funding Request Application on January 14, 2009.
Sincerely,
Mary Beth Phillips
Executive Director
Dublin Partners in Education
DPIE is a 501 (c) (3) Non-Profit organization
All donations are tax-deductible to the extent allowable by law. Federal Tax ID 94-3207780
Dublin Partners in Education is anon-profit foundation dedicated to foster mutually beneficial business, community and education
partnerships in order to maximize resources and enrich the learning experiences for all students in the Dublin Unified School District.
Dublin Partners in Education
P.O. Box 2307
Dublin, CA 94568
925.828.2551 x8024
Fax: 925.803.9746
Email: dpie@dublin.k12.ca.us
Website: www.dublin.kl2.ca.us
~}{~lC~1r~l~G
DPIE is a 501 (c) (3) Non-Profit organization
All donations are tax-deductible to the extent allowable by law. Federal Tax ID 94-3207780
Dublin Partners in Education is anon-profit foundation dedicated to foster mutually beneficial business, community and education
partnerships in order to maximize resources and enrich the learning experiences for all students in the Dublin Unified School District.
ACCIRIJ! CERTIFICATE OF L!A$!LlTY INSURANCE oP~D JF DATEIMMlDD/YYYY)
DUBLI-1 Ol 13 09
PRODUCER THIS CERTIFICATE tS tSSUED AS A MATTER OF INFORMATlO
Nonprofit Services Ins . Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
-F'~>nnis Costa HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
43 Hopyard Rd. #169 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
rseasanton CA 94588
Phone: 877-669-5101 Fax: 8'77-669-5109 INSURERS AFFORDING COVERAGE NAIC #
INSURED INSURER A: 23IAC
INSURER B: State Campensatian Inc. Fund
Dublin Partners In Education INSURER C:
P . O . BOX 2.307 INSURER D:
Dublin CA 94568-1599
INSURER E:
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN tSSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, fiERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT iNITH RESPECT TO WHICH THIS CERTIFICATE MAY BE tSSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED 8Y THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED 8Y PAID CLAIMS.
LTR NSR TYPE OF INSURANCE POLK:Y NUMBER DATEYMMlDD DATE MM1D UMITS
GENERAL IJABIUTY EACH OCCURRENCE $ 1 OOO ~ OOO
A X COMMERCIAL GENERALLiABILITY 2008-12954-NPO 03jb9j0$ 03/09J09 PREMISES (Easxcuren~ $ 100,000
CLAIMS MADE a OCCUR MED EXP (fury one person) $ 10 r OOO
PERSONAL 8 ADV INJURY $ 1 ~ OOO ~ 000
X liquor liabl.llty GENERAL AGGREGATE $ 1 r OOO ~ OOO
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPlOP AGG $ 1 OOO ~ OOO
POLICY PRO-
JECT LOC
AUT OMOBILE uAB1UTY
COMBINED SINGLE LIMIT $ 1
OOO
a0a
A ANY AUTO ZOOS-12954-NPO 03/09j08 03f09/09 (EaacadeM> ~
,
ALL OW NED AUTOS
BODILY INJURY $
SCHEDULED AUTOS (Per persrm)
HIRED AUTOS
BODILY INJURY
$
$ NON-0WNEDAUTOS (Peracadent)
PROPERTY DAMAGE
~
(Per accident)
GARAGE LU181UTY AUTO ONLY - EA ACCIDENT $
ANY AUTO EA ACC
OTHER THAN $
AUTO ONLY: AGG $
EXCESSlUMBRELLA LU-BIUTY EACH OCCURRENCE $
OCCUR ~ CLAIMS MADE AGGREGATE $
DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND
EMPLOYERS'LlABI X TORY LiMRS ER _
B LITY
ANY PROPRIETORIPARTNER/EXECUTIVE 1761723-08 12/01/08 12/01/09 E.L. EACH ACCIDENT S 1000000
OFFICERJMEMBER EXCLUDED?
tf
es
des
ibe und E.L. DISEASE-EA EMPLOYE $ 1OD000O
yy
,
cr
er
SPECIAL PROVISIONS below
E.L. DISEASE -POLICY LIMIT
$ ~ OOOOOO
OTHER
...........~.. .. ... ...-~.....,v..a. a. 'c,.vrtar vcrnt,r.caru~warvna AUUtu tll tl'1WKStMENTlSPELIAL PROVISIONS
* 10 days notice of cancellation for nonpayment of premium. Certificate
balder is included as an Additional-InsuredjLandlord as respects our
insured's use of the Regional Raom on 1J22J2009 for an appreciation event.
CERTIFICATE HOLDER CANCELLATION
C I TYDUB SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, T1iE ISSUING INSURER WILL ENDEAVOR TO MAIL 3O * DAYS 4vRtrrEN
NOTICE TO THE CERTIFICATE HOLDER NAMED 70 7HE LEFT, BUT FAILURE TO DO SO SHALL
City Of Dublin IMPOSE NO OBIJGATION OR uABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
- 100 C1V1C Plaza REPRESENTATIVES.
Dublin CA 94568 RUTH REPRESENTATt
~~~~ ,~,,
~ti ol~prof its'
. ~ ~~~~
i\onprofit~ Insurance
.alliance of California
COMMERCfAL GENERAL LWBILtTY COVERAGE PART DECLARATIONS
NONPROFITS' INSURANCE ALLIANCE OF CAL{FORMA
P.O. Box 8507, Santa Cruz, CA 95061
P: (800) 359-6422 Nonprofits' Insurance
F: (831)459-0853 Alliance of California
A tFM i0R 61SUQMICE... A tEARf f0! N5
PRODUCER:
Nonprofit Services (ns. Agency
2843 Hopyard Rd #169
Pleasanton, CA 94588
NAME OF INSURED AND MAIt_tNG ADDRESS:
Dublin Partners in Education
h.0. Box 2307
Dublin, CA 94568
POLICY NUMBER: 200&12954 -NPO
RENEWAL OF NUMBER: 2007-12954 -NPO
POLICY PERIOD: FROM 03/09/2008 TO 03109/2009
AT 12:01 AM. STANDARD TIME AT YOUR MA{LING ADDRESS SHOWN ABOVE
BUSINESS DESCRIPTION: Education
IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS 01= THIS
POLICY, WE AGREE WITH YOU TO PROVIDE THE COVERAGE AS STATED IN THIS POLICY.
LtMiTS OF COVERAGE:
-~ GENERAL AGGREGATE UMiT toTHER THAN PRODUCTS - coMPt.ErED OPERATIONS) $1,000,000
/ PRODUCTS -COMPLETED OPERATIONS AGGREGATE LIMIT ............................. $1,000,000
PERSONAL AND ADVERTISING INJURY LIMIT .................................................... $1,000,000
EACH OCCURRENCE L1MIT ................................................................•---..........---.. $1,000,000
DAMAGE TO PREMISES RENTED TO YOU ......................................................... $1~,OOOanyoneprelnises
MEDICAL EXPENSE L1MIT ..................................................................................•--- 10,000anyoneperscxr
ADDITIONAL COVERAGES;
SOCIAL SERVICE PROFESStONAL LIABILITY
EXCLUDED
CLASSIFICATtONiS) SEE ATTACHED SUPPLEMENTAL DECLARATIONS SCHEDULE G
PREMIUM ;775
FARMS AND ENDORSEMENTS APPLICABLE TO TMS POLICY ARE INCLUDED IN CCIAL LINES COMMMON POLICY DECLARATIONS
- ,OUNTERSIGNED: 02/19/2008 BY
(AUTHORIZED REPRESENTATIVE)
THESE DECLARATIONS AND THE COMMON POLICY DECLARATIONS, ff APPLICABLE, TOGETtIER YYlTH THE COMMON POLICY CONDITIONS, COVERAGE FORM(S)
ACID FORMS AND ENDORSENEN78, E' ANY, ISSUED TO FORM A PART THEREOF, COMPLETE THE ABOVE /flIMBERED POLICY.
NIAC - GL - NPO (02341)
NONPF~.drITS' INSURANCE ALLIANCE OF CAL.=.JRN1A
P.O_ Box 8507, Santa Cruz, CA 95061
P: (800) 359-6422
F: (839) 459-0853
NONPROFITS OWN
COMMERCIAL LINES COMMON POLICY DECLI~RATIONS
Nonprofits` Insurance
Alliance of California
A tF~D f~ ~IRANCE ... A HE/iRTPOR DIO1nY0Ri5
PRODUCER:
Nonprofit Services ins_ Agency
2843 Hopyard Rd #169
Pleasanton, CA 94588
NAME OF INSURED AND MAILING ADDRESS:
Dublin Partners in Education
P.O. Box 2307
Dublin, CA 94568
POLICY NUMBER: 2008-12954- NPO
RENEWAL OF NUMBER 2007-12954- NPO
POLICY PERIOD: FROM 03/09/200$ TO 03/09/2009
AT 12:01 A.M. STANDARD TIME AT YOUR MA}UNG ADDRESS SHOWN ABOVE
BUSINESS DESCRIPTION: Education
iN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS
POLICY, WE AGREE WITH YOU TO PROVIDE THE COVERAGE AS STATED IN THIS POLICY.
THIS POLICY CONSISTS OF THE FOLLOWB~G COVERAGE PARTS FOR WHICH A PREMIUM IS )rIDICATED_ THESE PRENIIL/MS MAYBE SUBJECT TO ADJUSTMENT.
PREMIUM
COMMERCIAL GENERAL LIABILITY COVERAGE PART -OCCURRENCE .................. $775
COMMERCIAL AUTO LIABILITY COVERAGE PART .................................:................ $150
COMMERCIAL AUTO PHYSICAL DAMAGE COVERAGE~PART .................................... Not Covered
IMPROPER SEXUAL CONDUCT COVERAGE PART .......................... Not Covered
COMMERCIAL LIQUOR LIABILITY COVERAGE PART ................................................... INCLUDED
TERRORISM COVERAGE (Certified Acts) --• .................................................................... Not Covered
TOTAL: _ __ 5925
FORMS} AND ENDORSEMENT(S) MADE A PART OF THIS POLICY AT•71ME OF ISSUE:•
NIAGGL-NPO NWGl1-NPO NIAC-AL-NPO SCHEECULE GJ0180.. SGt~DULE W180, SCHEDULE BAi0180. CG 00 01!07 98.
NPO-001/0208. NWC-X1/02, N1AC•E311.89. NIAC£IH004, NWC-E11t7-92, NtAG~E121S92. NIAG-E15r3~+94.
N{RC-E?TJ8-3rs. NWC-E25I0't 98. N1AG•E28-1~99, NIAC-E29J1-9.4. NtAC400. NtAGES3N-02, NIAC-E42/0706,
CG2101/11 85, CG 00 3310196, CG 2011-NP010196, CG 2012/07 ~, CG2018i11-85, CG2020111-85, CG 2(128107 04,
CG 20 34N7 04, CG 21 16107 ~, CG 2190ID1 O6, CG223Ql11-$5, CG2244111-85, CG2407fi 1-85, GG2504l11-85,
CG7794/04 93, IL 00 17111 98, IL 02 70!11 04,
'OlIMTS APPLICABLE FORMS AND ENDORSEMENT$ IF SHOWN !N
SPECIFIC COYERA6E PART /COVERAGE FORM DECLARATIONS.
~-
COUNTERSIGNED: 02119!2008 BY
(AUTHORIZED REPRESENTATIVE)
THESE DECLARATIONS AND THE COMMON POLICY DECLARATIONS, ~ APPUCI-BLE, TOGETHER W}TII THE C01lIMON POLICY CONDR}OHS, COVERAGE FORM(S)
AND FORMS AND ENDORSEMENTS. IF ANY. ISSUED TO FORM A PART THEREOF, COMPLETE TIC ABOVE NUMBERED POLICY.
NIAC - CO - NPO (02341 -AB>
PRODUCER:
NONPFt..rITS' INSURANCE ALLIANCE OF CAL. JRNIA
P.O. Box 8507, Santa Cruz, CA 95061
P: (800) 359-6422
F: {831) 459-0853
Nonprofits' Insurance
Alliance of California
A fEM fOR R~IIIR7AHCF ... A 4~ART FOR NOt~RROFIiS
NONPROFITS OWN
COMMERCIAL LINES COMMON POLICY DECLARATIONS
POLICY NUMBER: 2008-12954- NPO
Nonprofit Services Ins. Agency
2843 Hopyard Rd #169
Pleasanton, CA 94588
NAME OF INSURED AND MAILING ADDRESS:
Dublin Partners in Education
P.O. Box 2307
Dublin, CA 94568
RENEWAL OF NUMBER 2007-12954- NPQ
POLICY PERIOD: FROM 03/09/2008 TO 03/09/2009
AT 12:01 A.M. STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE
BUSINESS DESCRIPTION: Education
IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJEGT TO ALL THE TERMS OF THIS
POLICY, WE AGREE WITH YOU TO PROVIDE THE COVERAGE AS STATED iN THIS POLICY.
THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS Ft)R WHICH A PREMIUM iS >F~IDICAT®. THESE PREMIUMS MAY SE SUB.IECT TO ADJUSTMENT.
PREMIUM
COMMERCIAL GENERAL LIABILITY COVERAGE PART -OCCURRENCE .............:.... $775
COMMERCIAL AUTO LIABILITY COVERAGE PART .................................................. $150.
COMMERCIAL AUTO PHYSICAL DAMAGE COVERAGE'PART .................................... Not Covered
IMPROPER SEXUAL CONDUCT COVERAGE PART
.........................:. Not Covered
COMMERCIAL LIQUOR LIABILITY COVERAGE PART ................................................... INCLUDED
TERRORISM COVERAGE (Certified Acts) ...................................................:................... Not Covered
TOTAL: ;925
FORM(S) AND ENDORSEMENT(S) MADE A PART OF THIS POLICY AT TIME OF ISSUE:`
NIAC-GL-NPO NIAC-Li..-NPO NIAC-AL-NPO SCHEDULE G101 80, ~ SCHEDULE U01 80, SGHEflULE BA/01 80, Cc o0 o1ro~ sa,
NPO.001/02 08, RIIAGX1K18 O2, NIAC-E3/1-99, NIAC-E7110 04, NFAG-E41/7-92, NIAC-E1?/5.92, NIAC-E15/3-94,
NIAC-E22/8-95, NWC~2510198, NWC-E28/1-99. NU-GE29H-99. NIAC-E30/4~. NU1C-E33N-02. NIAC-Ed2J07 °8.
CG2101H 185, CG 00 3310198, CG 2011~JPOro1 9B, CG 2012roT 98, CG2018/i 1-85, CG2020/11~55, CG 20 26107 fl4,
CG 20 34!07 04. CG 21 16/07 98, CG 21 90ro1 06, CG2230H 1-85, CG224AN 1-85, CG2407/11,85, CG2504/11~5,
CG7794ro4 93, IL 0017!11 98, IL 02 70!11 04,
'OMITS APPUCABIE FORMS AND ENDORSEMENTS IF SHOWN IN
SPECIFIC COVERAGE PART /COVERAGE FORM DECLARATIONS.
COUNTERSIGNED: 02!19/2008 BY ,.~.~~. --
(AUTHORIZED REPRESENTATIVE)
THESE DECLARATIONS AND THE COMMON POLKY DECLARATIONS, N• APPLICABLE, TOGE'niER WITH'fHE COMMON POLICY CONDI'RONS, COVERAGE FORM(S)
AND FORMS AND ENDORSEMENTS. IF ANY, ISSUED TO FORM A PART THEREOF, COMPLETE THE ABOVE NUMBERED POLICY.
NIAC - CO - NPO t°23°1 -AS)
~ • • • NONPROFITS' INSURANCE ALLIANCE OF CALIFORNIA
P.O. Box 8507, Santa Graz, CA 95061
- P: (800} 359-6422
. .. F: (831) 459-0853
Nonprofits' Insurance
Alliance of California
A kEAO FOY BJS1mANCE ... A Nrl1RT FOR NONPRORI$
COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS
PRODUCER:
Nonprofit Services Ins. Agency
2843 Hopyard Rd #169
Pleasanton, CA 94588
POLICY NUMBER: 2008-12954 -NPO
RENEWAL OF NUMBER: 2007-12954 -NPO
NAME OF INSURED AND MA{LING ADDRESS:
Dublin Partners in Education
P.O. Sox 2307
Dublin, CA 94568
POLICY PERIOD: FROM 03/09/2008 TO 03/09/2009
AT 12:01 A.M. STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE
BUSINESS DESCRIPTION: Education
iN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS
POLICY, WE AGREE WITH YOU TO PROVIDE THE COVERAGE AS STATED IN THIS POLICY.
LIMITS OF COVERAGE:
GENERAL AGGREGATE LIMIT toTHER THAN PRODUCTS -COMPLETED OPERATIONS) $1,000,000
PRODUCTS -COMPLETED OPERATIONS AGGREGATE LIMIT ............................. $1,000,000
PERSONAL AND ADVERTISING INJURY LIMIT .................................................... $1,000,000
EACH OCCURRENCE LIMIT ................................................................................... $1,000,000
DAMAGE TO PREMISES RENTED TO YOU ......................................................... $100,000 any one premises
MEDICAL EXPENSE LIMIT ................................................ .... 10,OOOanyoneperson
ADDITIONAL COVERAGES:
SOCIAL SERVICE PROFESSIONAL LIABILITY
EXCLUDED
CLASSIFICATION(S) SEE ATTACHED SUPPLEMENTAL DECLARATIONS SCHEDULE G
PREMIUM $775
FORMS AND ENDORSEMENTS APPLICABLE TO THIS POLICY ARE INCLUDED )N COMMERCIAL LINES COMMMON POLICY DECLARATIONS
-_ ~ ~ ,~.
.;OUNTERSIGNED: 02/19/2008 BY
(AUTHORIZED REPRESENTATIVE)
FHESE DECLARATIONS AND THE COMMON POLICY DECLARATIONS, IF APPLICABLE, TOGETHER WITH THE COMMON POLICY CONDITIONS, COVERAGE FORM{S)
AND FORMS AND ENDORSEMENTS, IF ANY, ISSUED 70 FORM A PART THEREOF, COMPLETE THE ABOVE NUMBERED POLICY.
NIAC - GL - NPO {02341)
City of Dublin
Fiscal Year 2009-2010
Application for Funds
APPLICATION VERIFICATION
I attest that the information contained in this FY 2009-2010 grant application is accurate and that
the funds requested will not supplant any other monies secured by the organization.
Attached is a resolution, letter, or other document providing .evidence that the Board of Directors
approved the application as submitted. Successful applicants are required to submit a summary
report as soon as possible after submitting the reimbursement request, but not later than August
31, 2010. Failure to submit a report will result in ineligibility for future funding.
Signatures:
~~ ~~.,~~ _ ~;~- ~a
Executive irector Date
l
~~ ~~
Board President/Chairperson Date
SECTION 2
Page 17 of 22
w
Dublin Partners in Education
P.O. Box 2307
Dublin, CA 94568
925.828.2551 x8024
Fax: 925.803.9746
Email: dpie@dublin.kl2.ca.us
Website: www.dublin.k12.ca.us
Y`~`~LLI'~'1VYl-Eal~t t~
DPIE is a 501 (c) (3) Non-Profit organization
All donations are tax-deductible to the extent allowable by law, Federal Tax ID 94-3207780
Dublin Partners in Education is anon-profit foundation dedicated to foster mutually beneficial business, community and education
partnerships in order to maximize resources and enrich the learning experiences for all students in the Dublin Unified school District.
STATE OF CAUFORNtA
- ~ FRANCHDSE TAX BOARp
~~ PO BOX 942857
-~ ~" SACRAMENTO, CA 94257-0540
ENT#TY SY~41'l!S
in Reply Refer To: 657HEZ
Date t)3113106
Note: This letter does not
reflect the entity's status
with any other agency.
Entlfy Name :DUBLIN PARTNERSHIPS IN EDUCATION
ntityNumber...:..1.885462--_ __.-_ -------._-_ ___.--__ __ _ ___ ~.
~ 1. The above entity is in good standing with #his agency.
~ . 2. The above entity is currently exempt from tax under Revenue and Taxation Cade Section 237tH D.
~ 3. Our recards indicate the above enti#y is not incorporated, qualified, organized, or registered through the
Secretary of State to transact business in California.
~ 4. The above entity was incorporated, qualified, organized, or registered through the Secretary of State
on
~ 5. The above entity has an unpaid liability of $ for account period(s) ending
~ 6. Our records do not show that the above entity filed returns for account period{s} ending
~ 7. The above entity was effective
~ 8. The above entity's current address on record with this agency is:
~ 9. We do not have current informa#ion about the above entity.
omments:
REP NTA
SSISTANCE
;lephone assistance is available year-round from 7 a.m. until 8 p.m. Monday through Friday. From January through June, assistance
also available from 8 a.m. until 5 p.m. on Saturdays. We may modify these hours without notice to meet operational needs.
From within the United States, call ................................. (800} 852-5711
From outside the United States, call (not toll-free} .,...,,..~,,, (816} 845-8500
Website at: www.ftb.ca.gov
~sistance for person with disabilities: We comply with the Americans w'sth Disabilities Act. Persons with hearing or speech
pairments please call TfY/TOD (800) 822-6288.
t 4263A {REV OS-2002)