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HomeMy WebLinkAbout8.1 Community Group CRIL Attach 3 .J CITY OF DUBLIN Fiscal Year 2008-2009 !... ., I COMMUNITY GROUP/ORGANIZATION ApPLICATION FOR FUNDS COVER PAGE AGENCY NAME: COMMUNITY RESOURCES FOR INDEPENDENT LIVING (CRIL) PROPOSED PROJECT/PROGRAM NAME: DUBLIN INDEPENDENT LIVING SERVICES FOR PERSONS WITH DISABILITIES AND SENIORS WITH FUNCTIONAL LIMITATIONS FUNDING AMOUNT REQUESTED: $19.,214.00 SECTION 2 Page 1 of 13 ATTAcHmENT 3 CITY OF DUBLIN Fiscal Year 2008-2009 ApPLICATION FOR FUNDS 1. Please select one expense category: D Capital [8] Operating 2. Applicant Information: Organization/Agency Name Community Resources for Independent Living (CRIL) Mailing Address 439 A Street, HayWard, CA 94541 Street Address (Tri-Valley Branch Office): 3311 Pacific Avenue City Livermore Zip State CA Sheri Bums Executive Director/Chairperson Chris Finn Board President (if applicable) (510) 881-5743 X 5930 Work Phone (510) 667-0209 Work Phone Sheri.B urnsCZilcril-online.org Email Chris.Finn@cril-online.org 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. John Quinn Contact Person for Project/Program (510) 881-5743 X 5943 John.QuinnCalcril-onlinc.org Work Phone Email Federal Tax Identification No. (required) 94-2598873 City of Dublin Business License No. (required) 009274 SECTION 2 Page 2 of 13 Program Director Job Title (510) 881-1593 Fax City of Dublin Fiscal Year 2008-2009 Application for Funds 3. Proposed Project/Program Information (Do not describe Organization.) Amount of Funds Requested $19,214.00 (Maximum $25,000 per project.) Proposed Project/Program Name Dublin Independent Livin2 Services for People with Disabilities and Seniors with Functional Limitations Proposed Project/Program Date(s): Start 07 / 01 /08 and End 06/30/09 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. o Agency is requesting 100% disbursement at the beginning of the Fiscal Year. If selecting this option, please provide justification in the blank space below. [8] Agency is not requesting 100% disbursement at the beginning of the Fiscal Year. If selecting this option, 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. Quarterly Reimbursements SECTION 2 Page 3 of 13 City of Dublin Fiscal Year 2008-2009 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 project/program is a new service, or extension of an existing one. An additional page may be added, if needed. . Last fiscal year, Community Resources for Independent Living (CRIL) assisted 107 very low-income Dublin residents with disabilities and seniors with functional limitations in meeting their personal independent living goals. Of these residents, CRIL provided in-depth, comprehensive IL services to 23 residents with disabilities, and disability resource information, advocacy and Disaster Planning & Preparedness training to another 84 residents. This was a 13% increase over our proposed benchmarks for CRIL's "Dublin Independent Living Services Program for Persons with Disabilities and Seniors with Functional Limitations" funded by the Dublin City Community Organization Grant. Mr. Ram-J. H. is one of the Dublin residents who CRIL was able to assist in 2007 thanks to Dublin City funding. Ram requested assistance appealing a Social Security denial for SSDI benefits. His situation was somewhat complicated in that he was denied because he did not submit sufficient proof of his disability within the maximum period of five years after becoming disabled. Ram completed a comprehensive, Independent Living Plan with CRIL's Tri-Valley Coordinator, detailing steps to appeal his SSDI claim. On July 6, 2007, he contacted the Coordinator to report enthusiastically that he had been granted his SSDI benefits. In addition, Ram stated that he obtained Medicare health benefits, and had begun searching for a doctor. CRIL provided him with the number to the Palo Alto Medical Foundation. The best news of all was since Ram now had a steady income and secure housing, he was able to reunite with his two children. Ram-J.H. is extremely appreciative of CRIL's disability services in Dublin and the array of support services available in his community. With support, he was able to advocate for himself effectively in order to get his much needed benefits and reunite with his family. It is through the City of Dublin Community Organization Grant that CRIL is able to impact directly the lives of people with disabilities, like Ram, who strive to increase or maintain their self- sufficiency. CRIL is requesting City of Dublin Community Organization funding support to continue and expand our partnership in providing more than fifteen, non-housing independent living services and advocacy to seniors with functional limitations and people of all ages with disabilities living in the City of Dublin. With an allocation of $19.214.00, CRIL will be able to assist a minimum of 110 low-income Dublin residents with disabilities in meetinq their independent livinq qoals, includinq expandinq our hiqhly successful Disaster Planninq and Preparedness Traininq workshops to prepare more of the City's most vulnerable residents for the next siqnificant disaster in our area. With an investment of just $174 per person, the Dublin Community Organization Fund will greatly increase the number of low-income residents with disabilities who are more self-sufficient and able to participate fully in their community. SECTION 2 Page 4 of 13 b. How would the PROPOSED PROJECT/PROGRAM address an unrnet community need and improve the quality of life for Dublin residents. Why is this project/program needed? (Additional page may be added, if needed) Dublin's mission focuses on supporting a high quality of life and ensuring a safe and secure environment for its diverse community. Independent Living Services, like those provided by CRIL, triumph over the barriers that confront persons with disabilities and disconnect them from full and meaningful participation in their communities. There are over 256,000 people with disabilities IivinQ in Alameda County, with over 5,000 livinQ in the City of Dublin alone (DATA, 2006: Hanson, 2004). Inherently, services to persons with disabilities are services to the most impoverished members of our community. Since 2000, and despite seventeen years post passage of the Americans with Disabilities Act, which was among other things, to improve employment rates among people with disabilities, poverty has increased dramatically for persons with disabilities (Census, 2000). Moreover, Alameda County has a higher rate of poverty among adults with disabilities ages 18 to 64 years than most other bay area counties (Kaye, 2005). Compounding the poverty, people with disabilities are often segregated, isolated in their homes, or in other ways disenfranchised from their communities. CRIL's Independent Living Services for Seniors and People with Disabilities are free to consumers and designed to help individuals with disabilities maintain their quality of life, become fully integrated into society, and live as independently as possible. Independent LivinQ activities have been proven to affect positive outcomes for persons IivinQ in the community and to reduce the risks for persons with disabilities to develop secondary conditions (Resnick, 2002; White, 1994). Similarly, peer support is a fundamental principle of the independent living movement because it helps people recognize possibility and the potential of their own abilities. More than half of all CRIL staff are persons with disabilities, and are thereby able to provide both professional social services and peer support to Dublin residents with disabilities. Additionally, while it is common knowledQe that the rate of disability increases with aqe, the 2000 Census found that 32.4% of the senior population in Alameda County has a disability, and the City of Dublin is no exception. CRIL has been focusing marketing and outreach efforts to seniors with disabling conditions over the past few years in an effort to increase the self-sufficiency of Dublin seniors and positively affect their ability to remain in their own homes. The most significant CRIL service needs of seniors include: personal assistant referral and matching (homecare aides), benefits counseling and assistance, and assistive technology information and referral. In the past year, CRIL added three new services in response to the emerging needs of seniors and others with disabilities and functional limitations: Disaster Planning and Preparedness workshops, Healthy Living workshops, and Tax Credit (Earn It, Keep It, Save It I VITA) Counseling. We would not have been able to add these new programs without funding assistance from the Dublin City Community Organization Grant, Kaiser Permanente Diablo Valley fund, and the United Way of the Bay Area EKS program. Lastly, the federal Qovernment has recently mandated that all state and local iurisdictions implement disaster plans that include accessible mass shelterinq and evacuation of people with disabilities (DoJ, 2008), most significantly in reaction to the poor responsiveness and performance of local and State officials in Louisiana, slow and dysfunctional response of FEMA officials, and the lack of accessible shelters and services set up by the American Red Cross after the 2005 gulf hurricane and floods. National and State surveys continue to show that only a minority of Americans are prepared for a significant disaster and have the needed three to seven day "shelter in place" supplies (Kailes, Ostrom, 2006). CRIL's 2007 Disaster Planning and Preparedness Training Program for People with Disabilities and Seniors with Functional Limitations was made possible in large part due to the forward thinking and support of the City of Dublin. In the first six months of F.Y. 2007-08, CRIL has trained over 100 Tri-Valley residents with disabilities in Disaster Preparedness and provided each with a free light-weight, easily transportable, water- SECTION 2 Page 5 of 13 resistant Survival Kit that includes first aid information, 3-day supply of water and food, a mylar blanket, safety light, CRIL emergency communication device, emergency planning guide and Vial of Life sticker. More than two-thirds of the participants were seniors with disabilities and the majority requested more information on CRIL and/or to become a consumer in order to obtain additional services. Post-workshop, four out of five participants stated that they felt better prepared and able to respond effectively in the event of a disaster or emergency. With the City of Dublin's Community Orqanizational Fund support, CRIL will be able not only to continue providinq, but also be able to expand this valuable and needed traininq to the most vulnerable residents of 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.) A number of sources are referenced to support the need and efficacy of CRIL's IL Program for Persons with Disabilities and Seniors with Functional Limitations: Department of Justice. "ADA Guidelines From the U.S. Department of Justice on Sheltering for Mass Care," National Organization on Disability, January 8,2008. Hanson, S., et.al. "Community Needs Assessment," Center for Applied Local Research, 2004 ICF Publishing. Human Services Needs Assessment for the Tri-Valley --Incorporating the Cities of Dublin, Livermore, and Pleasanton; Center for Applied Local Research, 2003 Kailes, J. "Including People with Disabilities and Seniors in Disaster Services", CDIHP, June 2006 Kaye, PhD, Stephen." Disability, Health & Employment in California", Disability Statistics Center, University of California, San Francisco, 2005 National Organization on Disability. "New Poll Highlights Need for More Emergency Planning for and by People with Disabilities", January 30,2004. Ostrom, M. "Quake Worries on the Decline", San Jose Mercury News. April 18, 2006 Resnisk, B. "The impact of self-efficacy and outcome expectations on functional status in older adults", Topics in Geriatric Rehabilitation, 14(4), 1-10,2002. White, et al. "Preventing Secondary Conditions: A Role for Independent Living Centers", National Institute on Disability and Rehabilitation Research,1994. U.S. Census Bureau. Statistics: Alameda County - Tri-Valley Cities, 2000 SECTION 2 Page 6 of 13 City of Dublin Fiscal Year 2008-2009 Application for Funds d. Specify the PROPOSED PROJECT/PROGRAM population to be served. CRIL's Independent Living Project will serve low income Persons with Disabilities and Seniors with Functional Limitations who reside in the City of Dublin. Specifically, the program will positively impact the lives of Dublin residents who are among the most impoverished and vulnerable of the community. 1. Twenty (20) low-income residents with disabilities will receive direct skills training in one or more non- housing IL areas, such as peer counseling, health information, benefits counseling, assistive technology referral and personal safety, resulting in a significantly increased ability to be self-sufficient in their home, work, school, families and community. Services and materials will also be available in Spanish and alternate formats. 2. Sixty-five (65) low-income seniors and persons with disabilities will receive indirect education, information & referral, and advocacy services that provide a foundation for improved self-sufficiency and community participation, including Disaster Planning and Preparedness Training. 3. Twenty-five (25) businesses and/or agencies will receive disability-related education, sensitivity awareness and accessibility consultation resulting in increased structural and services access to consumers with disabilities and disabling conditions. e. Projects/programs must be evaluated to determine if they are being carried out efficiently and if project/program goals are being met. Please describe how you plan to monitor your project/program's success and impact. · An additional page may be added, if needed. CRIL has several solid data sources listed below to provide quantitative and qualitative information for CRIL staff to evaluate the progress of its programs and services. The CRIL database format and programming validity are evaluated annually with modifications made as needed. . CRIL's Intake Form is used with every person who wishes to become a consumer of CRIL and participate in creating a plan or set of goals to meet their objective or desired outcome. (Please see attached Intake Form.) . Independent Living (IL) Coordinators work with consumers to articulate their personal goals and action steps to achieve greater independence. Each month IL Coordinators submit a list of goals set with consumers so that CRIL's database can maintain a cumulative tracking of consumer goals that are set and met. Sample Outcome Measure: A consumer whose outcome objective is to hire a Personal Assistant so s/he can remain in his/her own home, may create one or more goals with the PA Service Coordinator to help him or her reach that objective (e.g., participate in CRIL's PAS training class, obtain a list of providers that match the consumer's needs and type of assistance, interview potential PA's, set up a job description for the PA, etc.). The goals are set at Intake, tracked a minimum of monthly with the consumer, then recorded as met when the consumer self- SECTION 2 Page 7 of 13 reports to the Coordinator that he or she has achieved the desired outcome (e.g., hired a Personal Assistant). . CRIL tracks the number of services, their length of time, and the number of contacts per consumer for all consumers seeking IL Coordination services through reporting monthly on our statistics tracking system. . Volunteers who support CRIL operations and provide peer counseling services complete our volunteer service log. . For individuals who do not become consumers, CRIL's monthly indirect statistics tracking log describes any Dublin resident, regardless of disability status, who has received information and referral, community education, publications, disability awareness training, outreach services, and technical assistance that enhances inclusiveness of services. . CRIL conducts a quarterly consumer satisfaction survey to solicit feedback regarding the quality of its direct service staff. (Please see attached Survey Form.) . Workshop participants will be requested to complete a self-evaluation, rating their level of disaster knowledge and readiness before and after CRIL's Disaster Preparation and Planning training. Staff will contact each participant 6 months post-workshop to again evaluate the practical impact of CRIL's training. NOTE: During F.Y. 2007-08 (the first year of the Disaster Prep. Program), 90% of Dublin seniors and residents with disabilities rated this workshop excellent or outstanding and indicated that they felt more knowledgeable and prepared in the event of a major emergency or disaster after participating in CRIL's workshop. Quarterly file reviews ensure quality of documentation and correlate with the direct statistics sheets that account for daily contacts with all consumers. The IL coordinators meet with the Program Director for a weekly Independent Living Plan session to explore solutions related to consumer goal development. This provides both supervision for difficult consumer situations, and an opportunity to note consumer trends that may not be obvious elsewhere. All CRIL staff members meet monthly to discuss community involvement, program activities, and consumer trends. f. Specify numbers of clients served by agency, then by PROPOSED PROJECT/PROGRAM: Total Number ofPartici 1,000 + 3,000* 20 + 65 + 25** Total Pro osed Partici ants Served by this Project/Pro ram 165 + 120 + 75 Total Number of Dublin Residents Served by this Project 20 + 65 + 25** . * 1,000 unduplicated, directly served county-wide consumers + 3,000 people with disabilities and seniors indirectly served through I & R, advocacy and workshops. **20 low-income Dublin residents directly served + 65 Dublin residents indirectly served + 25 Dublin businesses provided consultation. SECTION 2 Page 8 of 13 City of Dublin Fiscal Year 2008-2009 Application for Funds 5. Financial Information - Operating Budget a. Expense Budget Fr{2998-2Po,~/i'i..i hI" ' ---= . <roo. .."li1~I&~.....,... ii .......M'-'i ;ii< r"...i-.. c.ii EXPENSE Boo GET <, i........ '.. '<'~'< i< ..,." IJ. 111<'0.;'1 Personnel Costs ..'....,...,. < ",.,., ,.../. "'.. < , '.". I ii Employee Salaries & Benefits 628,801 55,128 15,498 . .... ACCESS - PROGRAM/STAFF 1 ,420 0 0 AUDIT AND ACCOUNTING 6,002 406 114 BUILDING REPAIRS AND MAINTENANCE 9,597 0 0 CONSULTANT SERVICES 40,831 780 220 DUES, PUBS, AND BOOKS 3,502 226 64 EMPLOYEE RECRUITMENT 250 0 0 EQUIPMENT AND FURNITURE ACQUISITIONS 2,500 0 0 EQUIPMENT MAl NTENANCE/REP AI RS 2,242 0 0 FUNDRAISING COSTS 2,000 0 0 INSURANCE 8,499 768 216 INTEREST 250 0 0 OCCUPANCY-RENTAND OTHER 3,577 99 29 OUTREACH 600 0 0 POSTAGE 7,677 1,655 442 PRINTING AND COPYING 7,481 669 177 REFRESHMENTS AND ENTERTAINMENT 914 0 0 STAFF AND BOARD RECOGNITION 1,500 0 0 STAFF DEVELOPMENT 7,100 200 59 SUPPLIES-OFFICE AND PROGRAM 23,009 4,679 1,993 SECTION 2 Page 9 of 13 SUPPLIES - OFFICE WATER 1,200 0 0 TELEPHONE 15,399 1,387 402 TRAVEL 11,170 0 114 UTILITIES 9,897 0 0 VOLUNTEER RECOGNITION 1,000 0 0 TOTAL $796,435 $65,997 $19,214 SECTION 2 Page 10 of 13 City of Dublin Fiscal Year 2008-2009 Application for Funds b. Revenue Budget Department of Rehabilitation** $411,782 Department of Rehabilitation-Community $68,186 Or anizing Department of Education $86,515 CIL - WIPA $10,000 City of Fremont $10,000 City of Livermore City of Pleasanton CDBG City of Pleasanton Kaiser Foundation City of Dublin Community Organization Grant City of Dublin CDBG Department of Rehabilitation VIIB Grants** $11,500 City of Hayward $41,200 City of San Leandro $10,800 Public Authority $51,504 CSUN $20,000 General Funds-Fee for Service, $8,950 Donations, Interest, Fundraising Total $796,345 $11,630 $14,504 $6,000 $8,649 $19,214 $3,452 $65,997 Note*-Have been informed that the City Staff is recommending this awarded amount to CRIL* Note**-Have not applied for grants as of 01124/08. SECTION 2 Page 11 of 13 City of Dublin Fiscal Year 2008-2009 Application for Funds 6. General Agency Information [8] Past grant applicants may check this box in lieu of completing item 6 (a-d) ifthe 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 12 of 13 City of Dublin Fiscal Year 2008-2009 Application for Funds 7. ReQuired Attachments: o Onlv one (1) copv 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. o A. Names of Governing Board; identify current Board officers. o B. Current total Organization operating budget, including revenue. · Clearly label/identify the program that includes the PROPOSED PROJECT/PROGRAM. o C. Most recent audit report or tax return (if applicable). o 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. o E. Organization's certificate of insurance showing coverage for liability and workers' compensation. o F. Application Verification Declaration Signature Page. o G. Signed affidavit form from each collaborating agency named in proposed project/program plan (if applicable). o H. Copy of IRS Letter of Determination indicating tax exempt status. SECTION 2 Page 13 of 13 COMMUNITY RESOURCES FOR INDEPENDENT LIVING (CRIL) INTAKE FORM Circle your primary language: 1. English 2. Espanol 3. _*ffiS' 4. ~~ 5. ~1j 6. Other (Cantonese) (Mandarin) (Farsi) Other languages spoken: Date: / / Phone: ( ) Legal First name: Other phone: ( ) Sex: M F Last Name: Mailing Address: Zip code: County: If homeless, in which city did you sleep last night? What is your most pressing need (service): Check all the services requested: 0 1. Advocacy/Legal (Benefits) 0 2. Assistive Devices 0 3. Children o 4. Communication 0 5. Family 0 6. Housing/Home Mod/Shelter 0 7. IL Skills Training o 8. I&R 0 9. Mobility Training 0 10. Peer Counseling 0 11. Personal Assistance o 12. Preventative 0 13. Transportation 0 14. Youth 0 15. Vocational 0 16. Other 00 you identify as Hispanic/Latino for your ethnicity? Yes No Please circle all Race categories that additionally apply: 1. American Indian or Alaskan native 2. Asian 3. Black or African American 4. Native Hawaiian or Pacific Islander 5. White or Caucasian 6. Other or Decline Please circle your current living arrangement: 1. Family or friends 2. Independent 3. Homeless 4. Institution How many in household? Are you head of the household? Yes No Single parent? Yes No Number of children under 18? Monthly household income: $ Monthly individual income: $ Please circle your source(s) of income: CAPI General Assistance or CalWorks Pension Social Security SSI SSOI SOl Worker's Compo Unemployment Work Please check all of the following disability categories that apply: o Cognitive List: 0 Emotional/Mental List: o Physical List: 0 Other List: o Hearing List: J Vision List: Please check any of the following specific disabilities that also apply: o Traumatic Brain Injury J Learning Disability M.1. City: Preferred Name: Email: Birth date: / / o Multiple disability List: o Developmental Disability 1. How did you hear about CRIL? 1. Friend or family 2. Another agency: 4. Flyer 5. Street/Senior Fair 6. Newspaper 7. Television or radio 8. Drop-in 2. If looking for housing, how many will live in unit? 3. Do you have Section 8? Yes No 4. Do you need accessible housing? Yes No 5. Looking for work? Yes No 6. If working, type of job: 7. Health insurance: 1. Medicare 8. Wheelchair User? Yes No 9. Do you use paratransit? Yes No 10. Can CRIL send you additional information and announcements? Yes No 11. Do you prefer material in: English? Espanol? List any additional format needed: 12. Do you have a history of alcohol or drug abuse? Yes No If so, are you attending recovery meetings or counseling? Yes No (If "Yes" & "No," share/discuss "Alcohol and Drug Problems" flyer in intake packet.) 13. Are you experiencing domestic violence? Yes No If Yes, is there a police report? Yes City Date / / Report No. (If "Yes", share/discuss "Some Resources for Victims of Domestic Violence" flyer in intake packet.) Please check the following, as applicable: o Voter registration form was presented. o Eligibility: Consumer has a disability and would benefit from Independent Living Services. o Livermore and Dublin consumers verified low-income status via bank statements, check stubs or SSA Statements of Benefits. Additional contact Contact address: 3. Presentation 9. Other Name of company: 2. Medi-Cal 3. HMO: Other Assistive Technology? Yes: 4. Other: 5. None No No Phone number: ( ) Consumer's signature verifying that all the information on this form is correct: Primary IL coordinator signature: Additional Notes: JQ 7-2007 CRIL Independent Living Plan (ILP) Consumer name: (last name) IL coordinator signature: Consumer signature confirming ILP: I was directly involved in developing the ILP below. Consumer signature waiving I LP: Date: I have been told about the ILP and its purpose. I don't wish to develop an ILP now but understand I may do so later. (first name) Date: Date: Long-term goals: Responsible party's initials Deadlines Short-term goals: . Responsible party's initials Deadlines Short-term goals (continued): To be completed by CRIL coordinator: (1) Self-advocacy (2) Communication (3) Mobility (4) Housing (5) Education (6) Vocational (7) Healthcare access (self-care) (8) Access Technology (AT) (9) Economic (10) Relocation from nursing home (11) Community participation (12) Other JQ 6/2007 City of Dublin Fiscal Year 2008-2009 Application for Funds 7. ReQuired Attachments: o Only one (1) copy per Al!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. ti.. A. Names of Governing Board; identify current Board officers. ~ B. Current total Organization operating budget, including revenue. · Clearly label/identify the program that includes the PROPOSED PROJECT/PROGRAM. -91- C. Most recent audit report or tax return (if applicable). ~ 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. 'rp. E. Organization's certificate of insurance showing coverage for liability and workers' compensation. ;z!- F. Application Verification Declaration Signature Page. o G. Signed affidavit form from each collaborating agency named in proposed project/program plan (if applicable). N/A -j1. H. Copy of IRS Letter of Determination indicating tax exempt status. SECTION 2 Page 13 of 13 Attachment A Is it any less a rose? ~ Board of Directors: Chris Finn President Marsha Burch Vice President Mark Baur Secretary/Treasurer Jeffrey Rosen Member-at-Large Randy Dana Jeffrey Rosen Marty Stenrud Samuel Wiley Jr. H. Stephen Kaye, PhD Bruce Blanco Waseem Sufi AM 01/08 Attachment B Proposed Annual tJudget 2008-2009 PROPOSED --0. I n"'''' FY 2008-2009 1 REVENUE 2 DEPT OF REHAB - 204 $ 344,330 3 DEPT OF REHAB - ASSISTIVE TECH 70,000 4 DEPT OF REHAB - TECHNICAL ASSISTANCE 11,500 5 DEPT OF ED - VIIC 86,515 6 DEPT OF REHAB - COMMUNITY ORGANIZING 68.186 7 HAYWARD - H.S.S.P. 41 ,200 8 SAN LEANDRO 10,800 9 PUBLIC AUTHORITY (FEE FOR SERVICE) 51 ,504 10 PLEASANTON CDBG (FEE FOR SERVICE) 14.505 11 PLEASANTON SS 6,000 12 LIVERMORE 11.630 13 FREMONT 10,000 14 DUBLIN CDBG 3,452 15 DUBLIN 19,214 16 CIL WIPA 10,000 17 KAISER FOUNDATION 8,649 18 GENERAL FUND 8,950 19 CSUN 20,000 20 21 22 23 TOTAL REVENUE 796,435 24 25 EXPENSES 26 SALARIES & BENEFITS 27 WAGES 495,679 28 BENEFITS 133,139 29 30 31 TOTAL SALARIES & BENEFITS 628,818 32 33 OPERATING EXPENSES 34 35 ACCOMMODATIONS '1,420 36 AUDIT AND ACCOUNTING 6,002 37 BUILDING REPAIRS AND MAINTENANCE 9,597 38 DEPRECIATION 39 DUES, PUBS, AND BOOKS 3,502 40 EMPLOYEE RECRUITMENT 250 41 EQUIPMENT AND FURNITURE ACQUISITIONS 2.500 42 EQUIPMENT REPAIRS & MAINTENANCE 2,242 43 FUNDRAISING COSTS 2,000 44 INSURANCE 8,499 45 INTEREST & SERVICE CHARGES 250 46 OUTREACH 600 47 CONSULTANT SERVICES 40.831 48 POSTAGE 7.677 49 PRINTING AND COPYING 7,481 50 OCCUPANCY - RENT AND OTHER 3,577 51 STAFF DEVELOPMENT 8,600 52 SUPPLIES-OFFICE AND PROGRAM 24,209 53 TELEPHONE 15.399 54 TRAVEL 11.170 55 UTILITIES 9,897 56 MEETING EXPENSES 914 57 VOLUNTEER RECOGNITION 1.000 58 I i 59 60 TOTAL OPERATING EXPENSES 167,617 61 62 TOTAL EXPENSES 796 ,435 l:~ ;::v 63 tW 64 NET EXCESS (DEFICIT) iD.',,';,::;,': ""','."",,., ,'"""",' Attachment C AUDIT REPORT ON COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA FINANCIAL STATEMENTS AND SUPPLEMENTARY INFORMATION JUNE 30, 2007 AND 2006 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA TABLE OF CONTENTS Page INDEPENDENT AUDITOR'S REPORT 1-2 FINANCIAL STATEMENTS: Statements of Financial Position 3 Statements of Activities 4 Statements of Cash Flows 5 Statements of Functional Expenses 6 Notes to Financial Statements 7-14 SUPPLEMENTARY INFORMATION: INDEPENDENT AUDITOR'S REPORT ON 15 SUPPLEMENTARY INFORMATION INDEPENDENT AUDITOR'S REPORT ON SCHEDULE OF 16 EXPENDITURES OF FEDERAL AWARDS SCHEDULE OF EXPENDITURES OF FEDERAL AWARDS 17 INDEPENDENT AUDITOR'S REPORT ON INTERNAL CONTROL 18-19 OVER FINANCIAL REPORTING AND ON COMPLIANCE AND OTHER MATTERS BASED ON AN AUDIT OF FINANCIAL STATEMENTS PERFORMED IN ACCORDANCE WITH GOVERNMENT AUDITING STANDARDS INDEPENDENT AUDITOR'S REPORT ON COMPLIANCE WITH 20-21 REQUIREMENTS APPLICABLE TO EACH MAJOR PROGRAM AND ON INTERNAL CONTROL OVER COMPLIANCE IN ACCORDANCE WITH OMB CIRCULAR A-133 BOARD OF DIRECTORS AND MANAGEMENT 22 SUMMARY SCHEDULE OF PRIOR YEAR AUDIT FINDINGS 23 SCHEDULE OF FINDINGS AND QUESTIONED COSTS 24 CORRECTIVE ACTION PLAN 25 CHART INFORMATION 26-30 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA INDEPENDENT AUDITOR'S REPORT To: The Board of Directors Community Resources for Independent Living, Inc. Hayward, California We have audited the accompanying statements of financial position of Community Resources for Independent Living (CRIL), Inc., a not- for-profit Corporation, as of June 30, 2007 and 2006 and the related statements of activities, cash flows, and functional expenses for the years then ended. These financial statements are the responsibility of Community Resources for Independent Living Inc.'s management. Our responsibility is to express an opinion on these financial statements based on our audits. Prior year summarized comparative information has been derived from financial statements and our report dated November 14, 2006 in which we expressed an unqualified opinion on those financial statements. We conducted our audits In accordance with auditing standards generally accepted in the United States of America and the standards applicable to financial audits contained in Governmental Auditing Standards issued by the Comptroller General of the United States. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatement. An audit includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements. An audit also includes assessing the accounting principles used and the significant estimates made by management, as well as evaluating the overall financial statement presentation. We believe that our audits provide a reasonable basis for our opinion. In our opinion, the financial statements referred to above present fairly, in all material respects, the financial position of Community Resources for Independent Living, Inc. as of June 30, 2007 and 2006, and changes in its net assets and its cash flows for the years then ended in conformity with accounting principles generally accepted in the United States of America. In accordance with Government Audi ting Standards, we have also issued our report dated September 10, 2007 on our consideration of Community Resources for Independent Living, Inc.'s internal control over financial reporting and on our tests of its compliance with certain provisions of laws, regulations, contracts 1 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA INDEPENDENT AUDITOR'S REPORT (CONT'D) and grant agreements and other matters. The purpose of that report is to describe the scope of our testing of internal control over financial reporting and compliance and the results of that testing, and not to provide an opinion on the internal control over financial reporting or on compliance. That report is an integral part of an audit performed in accordance with Government Audi ting Standards and should be considered in assessing the results of our audits. Our audits were conducted for the purpose of forming an opinion on the basic financial statements of Community Resources for Independent Living, Inc. taken as a whole. The accompanying schedule of expenditures of federal awards is presented for purposes of additional analysis as required by U. S. Office of Management and Budget Circular A-133, Audits of States, Local Governments, and Non-Profit Organizations, and is not a required part of the basic financial statements. Such information has been subjected to the auditing procedures applied in the audit of the basic financial statements, and, in our opinion, is fairly stated, in all material respects, in relation to the basic financial statements taken as a whole. DENNIS L. LORETTE ACCOUNTANCY CORPORATION Pinole, California September 10, 2007 2 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA STATEMENTS OF FINANCIAL POSITION JUNE 30, 2007 AND 2006 ASSETS Current Assets: Cash on hand and in bank Grants and contracts receivable (Note 3) Unconditional promise to give: (Note 4) Capital improvement (Note 12) Other (Note 12) Prepaid expenses 2007 $ 60,006 132,167 301,767 58,773 7,265 Total Current Assets 559,978 Property and equipment, net (Note 5) 244,088 Other Assets: Deposit (Note 7) 1,079 TOTAL ASSETS $ 805,145 LIABILITIES AND NET ASSETS Current Liabilities: Accrued vacation Accrued expenses-other (Note 10) Total Current Liabilities Net Assets: Unrestricted Temporarily restricted (Note 8) Permanently restricted Total Net Assets TOTAL LIABILITIES AND NET ASSETS * For comparative purposes only $ 18,213 1,652 19,865 404,402 380,878 785,280 $ 805,145 2006 * $ 83,129 101,631 301,767 27,701 6,060 520,288 222,086 1,358 $ 743,732 $ 9,900 2,855 12,755 381,170 349,807 730,977 $ 743,732 The accompanying notes and supplemental information are an integral part of these financial statements. 3 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA STATEMENTS OF CASH FLOWS JUNE 30, 2007 AND 2006 CASH FLOWS FROM OPERATING ACTIVITIES: Changes in net assets Adjustments to reconcile changes in Net assets to net cash provided (used) by operating activities: Depreciation (Increase) decrease in: Accounts receivable Grants and contracts receivable Promises to give Prepaid expenses Deposits Increase (decrease) in: Accounts payable Accrued expenses NET CASH PROVIDED BY OPERATING ACTIVITIES CASH FLOWS FROM INVESTMENT ACTIVITIES: Purchase of equipment and furniture NET CASH USED BY INVESTMENT ACTIVITIES NET INCREASE (DECREASE) IN CASH AND CASH EQUIVALENTS CASH AND CASH EQUIVALENTS, BEGINNING OF YEAR 2007 2006 * $ 54,303 $ 82,426 24,288 20,052 (30,536) (31,072) (1,205) 280 590 1,919 (80,626) 633 859 7,110 (1,301) (178 ) 23,168 24,374 (46,291) (15,968) (46,291) (15,968) (23,123) 8,406 83,129 74,723 CASH AND CASH EQUIVALENTS, END OF YEAR $ 60,006 $ 83,129 Supplemental disclosures of cash flow information Cash paid during the year for: Interest (net of amount capitalized) Income taxes * For comparative purposes only $ 713 10 The accompanying notes and supplemental information are an integral part of these financial statements. 5 COMMUNITY SERVICES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) Salaries and related expenses: Salaries Payroll taxes Employee benefits Total salaries and related expenses Other operating expenses: Accommodations Building repairs and maintenance Bus pass Consultants and outside services Dues, books and publications Employee recruitment Equipment repairs and maintenance Fundraising costs Insurance Interest and service charges Legal and accounting Meeting costs/refreshments Outreach Postage Printing and copying Rent Staff development Staff and board recognition Supplies Taxes and licenses Telephone Travel Utilities Miscellaneous Subtotal Depreciation TOTAL EXPENSES * For comparative purposes only NOTE: The accompanying notes and supplementary information are an integral part of these financial statements. HAYWARD, CALIFORNIA STATEMENTS OF FUNCTIONAL EXPENSES YEAR ENDED JUNE 30, 2007 AND 2006 PROGRAM SERVICES $ 356,670 37,104 53,667 447,441 658 4,791 1,168 28/026 4,168 249 1,193 6,109 2,090 1,877 3,703 3,078 4,309 4,600 764 14,488 10,438 11,607 4,750 555,507 19,959 $ 575/466 MANAGEMENT AND GENERAL $ 70,352 7,319 10,586 88,257 945 6,907 235 1/205 713 3,725 412 730 607 812 2,857 998 2,059 2/289 937 179 113,867 3,937 $ 117,804 SUPPORT SERVICES FUNDRAISING AND DEVELOPMENT $ 7,003 729 1,054 8,786 94 23 79 120 41 73 60 284 205 228 93 30 10,116 392 $ 10,508 TOTAL SUPPORT SERVICES $ 77,355 8,048 11 /640 97,043 1,039 6,907 258 79 1/325 713 3,725 453 803 667 812 3,141 998 2/264 2,517 1,030 209 123,983 4,329 $ 128,312 2007 $ 434,025 45,152 65,307 544,484 658 5,830 1,168 34,933 4,168 249 1,451 79 7,434 713 3,725 2,543 1,877 4,506 3,745 4,309 5,412 764 17,629 998 12,702 14,124 5,780 209 679,490 24,288 $ 703,778 TOTALS 2006 * $ 413,249 40,742 61,350 515,341 961 6,883 44,581 3,867 885 1,532 185 7,631 43 8,033 1,948 342 3,242 311 4,499 2/300 11,315 543 11,569 4,948 6,541 10 637,510 20,052 $ 657,562 COMMUNITY RESOURCES FOR INDEPENDENT LIVING,INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA NOTES TO FINANCIAL STATEMENTS Page 1 of 8 NOTE 1 - THE ORGANIZATION CRIL is a cross-disability, community-based organization. Anyone wi th a disability is eligible for services regardless of race, color, national origin, gender, sexual orientation, age, marital status, familial status, religion, or human immunodeficiency virus (HIV) status. Community Resources for Independent Living, Inc. (CRIL), a not- for-profit California Corporation, was established in March 1979 for the purpose of serving physically disabled adults with programs and activities designed to enhance life styles and increase opportunities for full participation in the life of the community. In 1996 the Corporation amended its Articles of Incorporation to reflect its purpose. CRIL supports, empowers, and teaches skills to persons with disabilities so that they may more fully participate in community and life activities. CRIL teaches and advocates for change to remove barriers to access for persons with disabilities. CRIL derives a substantial portion of its support and revenue from reimbursement type grants with the State of California, Department of Rehabilitation and the U. S. Department of Housing and Urban Development under Community Development Block Grants. CRIL's Mission Statement is: "CRIL ADVOCATES AND PROVICES RESOURCES FOR PEOPLE WITH DISABILITIES TO IMPROVE THE QUALIFTY OF LIFE AND MAKE COMMUNITIES FULLY ACCESSIBLE. If NOTE 2 - SUM~RY OF SIGNIFICANT ACCOUNTING POLICIES o Basis of Accounting The financial statements of CRIL are prepared on the accrual basis of accounting and, accordingly, reflect all significant receivables, payables, and other liabilities. 7 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA NOTES TO FINANCIAL STATEMENTS Page 2 of 8 NOTE 2 - SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (CONT'D) o Basis of Presentation Financial statement presentation follows recommendations of the Financial Accounting Standards Board in its Statement of Financial Accounting Standards (SFAS) No. 117, Financial Statements of Not-for-Profit Organizations. Under SFAS No. 117, CRIL is required to report information regarding its financial position and activities according to three classes of net assets: unrestricted net assets; temporarily restricted net assets; and permanently restricted net assets. o Grants and Contracts Support received under grants and contracts is recorded as public support in the appropriate account when related costs are incurred. Grants receivable represent amounts due for expenditures incurred prior to year-end. o Contributions/Donations The Corporation accounts for contributions in accordance with recommendations of SFAS No. 116, "Accounting for Contributions Received and Contributions Made. If In accordance with SFAS No. 116, contributions received are recorded as unrestricted, temporarily restricted, or permanently restricted support depending on the existence and/or nature of any donor restrictions. All other donor-restricted support lS reported as an increase in temporarily or permanently restricted net assets depending on the nature of the restriction. When a restriction expires (that is, when a stipulated time restriction ends or purpose restriction is accomplished), temporarily restricted net assets are reclassified to unrestricted net assets and reported in the Statement of Activities as net assets released from restrictions. o Functional Expenses CRIL allocates expenses on a functional basis among its programs, support services and fundraising. Expenses that can be identified with program and support service are allocated directly according to expenditure classifications. 8 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA NOTES TO FINANCIAL STATEMENTS Page 3 of 8 NOTE 2 - SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (CONT'D.) o Promises to Give Promises to give (an agreement to contribute cash or other assets) are recorded as revenue in the period recei ved. Assets received with donor stipulations that limi t the use of the asset are reported as restricted support. When the donor restriction expires, that is, when a stipulated time restriction ends or purpose restriction is substantially met, temporarily restricted net assets are reclassified to unrestricted net assets and reported in the statement of activities as net assets released from restrictions. o Property and Equipment Donated property and equipment are recorded as support at estimated fair values. Donated assets are reported as unrestricted support unless the donor has restricted the donated asset to a specific purpose. Assets donated with explicit restrictions regarding their use and contributions of cash that must be used to acquire property and equipment are reported as restricted support. Absent donor stipulations regarding how long those donated assets must be maintained, CRIL reports expirations of donor restrictions when the donated assets are placed in service. Major categories of property and equipment, including their depreciable lives are as follows; Buildings and improvements Equipment Furniture and furnishings 15-30 years 5- 7 years 3- 5 years o Estimates The preparation of financial statements in conformity with generally accepted accounting principles requires management to make estimates and assumptions that affect certain reported amounts and disclosures. Accordingly, actual results could differ from those estimates. 9 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA NOTES TO FINANCIAL STATEMENTS Page 4 of 8 NOTE 2 - SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (CONT'D.) o Cash and Cash Equivalents For purposes of the Statements of Cash Flows, the Corporation considers all demand deposits with banks and money market accounts with securities firms to be cash. CRIL had no cash equivalents during the period. o Income Tax Status The Corporation has been granted tax-exempt status by the Internal Revenue Service under Code 501(c) (3) and the California Franchise Tax Board under Section 23701 (d) of the Revenue and Taxation Code. o Bad Debts Bad debts are provided for by the direct write-off method of accounting which approximates the same result that would be achieved under a generally accepted accounting method. o Comparative Information The financial statements include certain prior year summarized comparative information in total but not by net asset class. Such information does not include sufficient detail to constitute a presentation . in conformity with generally accepted accounting principals. Accordingly, such information should be read in conjunction with CRIL's financial statements for the year ended June 30, 2006, from which the summarized information was derived. 10 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA NOTES TO FINANCIAL STATEMENTS Page 5 of 8 NOTE 3 - GRANTS AND CONTRACTS RECEIVABLE Grants and contracts receivable at June 30, 2007 and 2006 are: 2007 2006 Center for Independent Living $ 2,524 $ 1,603 Department of Education 21,425 4,037 State of California Department of Rehabilitation 17,030 59,925 Public Authority for IHSS 2,639 City of Hayward - CDBG 20,269 City of Livermore 2,030 2,092 City of Fremont 2,972 3,157 City of Pleasanton-fee for services 3,955 3,895 City of Dublin 3,938 4,014 City of Pleasanton 1,970 Department of Rehabilitation 76,323 $ 132,167 $ 101,631 NOTE 4 - UNCONDITIONAL PROMISES TO GIVE 2007 2006 Capital Improvements City of Hayward-CDBG $ 183,972 $ 183,972 City of Fremont-CDBG 65,192 65,192 City of Pleasanton-CDBG 5,000 5,000 County of Alameda 47,603 47,603 $ 301,767 $ 301,767 Others Center for Independent Living $ 9,342 $ CA Dept. of Education Title VII 20,593 19,701 CA Dept of Rehabilitation 26,368 8,000 City of Livermore 2,470 $ 58,773 $ 27,701 11 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA NOTES TO FINANCIAL STATEMENTS Page 6 of 8 NOTE 5 - PROPERTY AND EQUIPMENT Property and equipment at June 30, 2007 and 2006 consist of: Less: Accumulated depreciation 2007 2006 $ 54,271 $ 54,271 367,312 367,312 75,326 97,668 71,516 34,620 568,425 553,871 (324,337) (331,785) $ 244,088 $ 222,086 June 30, 2007 and 2006 was Land Building and improvements Equipment Furniture Depreciation expense for the year ended $ 24,288 and $ 20,052, respectively. Capitalized fixed assets acquired for the year ended June 30, 2007 and 2006 totaled $ 46,291 and $ 15,968, respectively. CRIL disposed of $ 31,736 in fully depreciated equipment during the period. NOTE 6 - LINE-OF-CREDIT CRIL maintains an unsecured $ 150,000 line-of-credit with its bank. Interest is payable at 7.75 percent. At June 3D, 2007 there was no balance outstanding against this line-of-credit. NOTE 7 - DEPOSIT This account represents a deposit with Workman's Compensation. 12 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA NOTES TO FINANCIAL STATEMENTS Page 7 of 8 NOTE 8 - TEMPORARILY RESTRICTED NET ASSETS At June 30, 2007 and 2006 temporarily restricted net assets consisted of: Center for Independent Living CA Dept. of Education Title VII CA Dept. of Rehabilitation City of Livermore IBM Grant BART Legal Settlement Capital Improvement: City of Hayward, CDBG City of Fremont, CDBG City of Pleasanton, CDBG County of Alameda Total NOTE 9 - CONCENTRATION OF CREDIT RISK 2007 2006 $ 9,341 20,593 26,368 2,470 1,000 19,339 $ 19,701 8,000 1,000 19,339 183,972 65,192 5,000 47,603 183,972 65,192 5,000 47,603 $ 380,878 $ 349,807 Grants receivable consists of fees and reimbursements due from federal, state, county, and city governments or their agents including pass-throughs from other not-for-profit organizations. At June 30, 2007, receivables from federal agencies or their agents accounted for about seventy percent of the total, while state, county and city governments or their agents account for about thirty-two percent. NOTE 10 - ACCRUED EXPENSES - OTHER Accrued expenses-other as of June 30, 2007 and 2006 consists of: 2007 2006 Supplies $ $ 495 Unemployment insurance 761 1,062 Worker's Compensation insurance 891 1,298 $ 1,652 $ 2,855 13 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA NOTES TO FINANCIAL STATEMENTS Page 8 of 8 NOTE 11 - LEASES The Center primarily operates from its headquarter offices in Hayward which are fully-owned by the Corporation. Branch offices in Fremont ($ 275) and Livermore ($ 100) are on a month-to-month lease. The two operating leases both are renewed annually. The annual payments are $ 3,300 and $ 1,200 for Fremont and Livermore, respectively. NOTE 12 - SUBSEQUENT EVENT In March 2007, CRIL started its building renovation. The renovation is funded by Community Block Grants with Contractors directly paid by City of Hayward. At June 30, 2007 no building improvement costs were recorded because the final cost of the renovation is unknown and renovation invoices were submitted after June 30, 2007. 14 SUPPLEMENTARY INFORMATION COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA INDEPENDENT AUDITOR'S REPORT SUPPLEMENTARY INFORMATION To: The Board of Directors Community Resources for Independent Living, Inc. Hayward, California Our report on the audit of the basic financial statements of Community Resources for Independent Living, Inc. as of June 30, 2007 appears on pages 1 and 2 of this report. The audit was made for the purpose of forming an opinion on the basic financial statements taken as a whole. The supplemental information is presented for purposes of additional analysis and is not a required part of the basic financial statements. Such information for the period has been subj ected to the auditing procedures applied in the audit of the basic financial statements and, in our opinion, is fairly stated in all material respects in relation to the basic financial statements taken as a whole. DENNIS L LORETTE ACCOUNTANCY CORPORATION Pinole, California September 10, 2007 15 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA INDEPENDENT AUDITOR'S REPORT ON SCHEDULE OF EXPENDITURES OF FEDERAL AWARDS To: The Board of Directors Community Resources for Independent Living, Inc. Hayward, California We have audited the basic financial statements of Community Resources for Independent Living, Inc. (a not - for-profi t Corporation) as of and for the year ended June 30, 2007, and have issued our report thereon dated September 10, 2007. Our audit was performed for the purpose of forming an opinion on the basic financial statements taken as a whole. The accompanying schedule of expenditures of federal awards is presented for purposes of additional analysis as required by u.S. Office of Management and Budget Circular A-133, Audits of States, Local Governments, and Non-Profit Organizations, and is not a required part of the basic financial statements. Such information has been subjected to auditing procedures applied in the audit of the basic financial statements and, in our opinion, is fairly stated, in all material respects, in relation of the basic financial statements taken as a whole. This report is intended solely for the information and use of management, Board of Directors, and federal awarding agencies and pass-through entities and is not intended to be and should not be used by anyone other than these specified parties. DENNIS L. LORETTE ACCOUNTANCY CORPORATION Pinole, California September 10, 2007 16 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA SCHEDULE OF EXPENITURES OF FEDERAL AWARDS FOR YEAR ENDED JUNE 30, 2007 PASS-THROUGH FEDERAL ENTITY PASS-THROUGH GRANTOR/ CFDA IDENTIFYING FEDERAL GRANTOR/PROGRAM NUMBER NUMBER AWARDS Major Program U.S. Department of Education Passed through State of 84.169A 26065 $ 338,816 California, Department 84.169A 26065 70,000 of Rehabilitation 84.169A 26689 1,013 84.169A 26522 48,300 Other Programs U.S. Department of Education Passed through Centers for Independent Living 84.132A H132A010032-07 62,456 Programs 84.132A H132A010032-06 19,701 U.S. Department of Housing and Urban Development Community Development Block Grant Passed through the City of Dublin 14,218 N/A 10,300 City of Livermore 14.218 N/A 11,529 U.S. Department of Social Security Administration Passed through the Center For Independent Living N/A 3,659 Total Awards $ 565,774 The accompanying schedule of expenditures of federal awards includes the federal grant activity of CRIL and is presented on the accrual basis of accounting. The information in the schedule of expenditures of federal awards is presented in accordance with the requirements of OMB Circular A-133, Audits of States, Local Governments, and Non-Profit Organizations. Therefore, some amounts presented in the schedule of expenditures of federal awards may differ from amounts presented in, or used in the preparation of the basic financial statements. 17 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA INDEPENDENT AUDITOR'S REPORT ON INTERNAL CONTROL OVER FINANCIAL REPORTING AND ON COMPLIANCE AND OTHER MATTERS BASED ON AN AUDIT OF FINANCIAL STATEMENTS PERFORMED IN ACCORDANCE WITH GOVERNMENT AUDITING STANDARDS Page 1 of 2 To: The Board of Directors Community Resources for Independent Living, Inc. Hayward, California We have audited the financial statements of Community Resources for Independent Living, Inc. (a not-for-profit Corporation) (CRIL) as of and for the year ended June 30, 2007, and have issued our report thereon dated September 10, 2007. We conducted our audit in accordance with auditing standards generally accepted in the United States of America and the standards applicable to financial audits contained in Government Auditing Standards, issued by the Comptroller. General of the United States. Internal Control Over Financial Reporting In planning and performing our audit, we considered CRIL1s internal control over financial reporting as a basis for designing our auditing procedures for the purpose of expressing our opinion on the financial statements, but not for the purpose of expressing an opinion on the effectiveness of CRIL's internal control over financial reporting. Accordingly, we do not express an opinion on the effectiveness of CRIL's internal control over financial reporting. A control deficiency exists when the design or operation of a control does not allow management or employee, in the normal course of performing their assigned functions, to prevent or detect misstatements on a timely basis. A significant deficiency is a control deficiency, or combination of control deficiencies, that adversely affects CRIL's ability to initiate, authorize, record, process, or report financial data reliably in accordance with generally accepted accounting principles, such that there is more than a remote likelihood that a misstatement of CRIL's financial statements that is more than inconsequential will not be prevented or detected by CRIL's internal control 18 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA INDEPENDENT AUDITOR'S REPORT ON INTERNAL CONTROL OVER FINANCIAL REPORTING AND ON COMPLIANCE AND OTHER MATTERS BASED ON AN AUDIT OF FINANCIAL STATEMENTS PERFORMED IN ACCORDANCE WITH GOVERNMENT AUDITING STANDARDS Page 2 of 2 A material weakness is a significant deficiency, or combination of significant deficiencies, that results in more than a remote likelihood that a material misstatement of the financial statements will be prevented or detected by CRIL's internal control. Our consideration of internal control over financial reporting was for the limited purpose described in the first paragraph of this section and would not necessarily identify all deficiencies in internal control that might be significant deficiencies or material weaknesses. We did not identify any deficiencies in internal control over financial reporting that we consider to be material weaknesses, as defined above. Compliance and Other Matters As part of obtaining reasonable assurance about whether Community Resources for Independent Living's financial statements are free of material misstatements, we performed tests of its compliance with certain provisions of laws, regulations, contracts and grant agreements, noncompliance with which could have a direct and material effect on the determination of financial statement amounts. However, providing an opinion on compliance with those provisions was not an objective of our audit and, accordingly, we do not express such an opinion. The results of our tests disclosed no instances of noncompliance or other matters that are required to be reported under Government Auditing Standards. We noted certain matters that we reported to management of CRIL ln a separate letter dated September 10, 2007. This report is intended solely for the information and use of management, Board of Directors, and federal awarding agencies and pass-through entities and is not intended to be and should not be used by anyone other than these specified parties. DENNIS L. LORETTE ACCOUNTANCY CORPORATION Pinale, California September 10, 2007 19 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA INDEPENDENT AUDITOR'S REPORT ON COMPLIANCE WITH REQUIREMENTS APPLICABLE TO EACH MAJOR PROGRAM AND ON INTERNAL CONTROL OVER COMPLIANCE IN ACCORDANCE WITH OMB CIRCULAR A-133 Page 1 of 2 To: The Board of Directors Community Resources for Independent Living, Inc. Hayward, California Compliance We have audited the compliance of Community Resources for Independent Living, Inc. (a not-for-profit Corporation) with the types of compliance requirements described in the U.S. Office of Management and Budget (OMB) Circular A-133 Compliance Supplement that are applicable to each of its major federal programs for the year ended June 30, 2007. Community Resources for Independent Living, Inc.'s major federal programs are identified in the summary of auditor's results section of the accompanying schedule of findings and questioned costs. Compliance with the requirements of laws, regulations, contracts, and grants applicable to each of its maj or federal programs is the responsibility of Community Resources for Independent Living, Inc. ' s management. Our responsibility is to express an opinion on Community Resources for Independent Living, Inc.'s compliance based on our audit. We conducted our audit of compliance in accordance with auditing standards generally accepted in the United States of America; the standards applicable to financial audits contained in Government Auditing Standards, issued by the Comptroller General of the United States; and OMB Circular A-133, Audits of States, Local Governments, and Non-Profit Organizations. Those standards and OMB Circular A-33 require that we plan and perform the audit to obtain reasonable assurance about whether noncompliance with the types of compliance requirements referred to above that could have a direct and material effect on a major federal program occurred. An audit includes examining, on a test basis, evidence about Community Resources for Independent Living, Inc.' s compliance with those requirements and performing such other procedures as we considered necessary in the circumstances. We believe that our audit provides a reasonable basis for our opinion. Our audit does not provide a legal determination of Community Resources for Independent Living, Inc. 's compliance with those requirements. 20 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT ORGANIZATION) HAYWARD, CALIFORNIA INDEPENDENT AUDITOR'S REPORT ON COMPLIANCE WITH REQUIREMENTS APPLICABLE TO EACH MAJOR PROGRAM AND ON INTERNAL CONTROL OVER COMPLIANCE IN ACCORDANCE WITH OMB CIRCULAR A-133 Page 2 of 2 In our opinion, Community Resources for Independent Living, Inc. complied, in all material respects, with the requirements referred to above that are applicable to each of its major federal programs for the year ended June 30, 2007. Internal Control Over Compliance The management of Community Resources for Independent Living, Inc. is responsible for establishing and maintaining effective internal control over compliance with the requirements of laws, regulations, contracts, and grants applicable to federal programs. In planning and performing our audit, we considered Community Resources for Independent Living, Inc.' s internal control over compliance with requirements that could have a direct and material effect on a major federal program in order to determine our auditing procedures for the purpose of expressing our opinion on compliance and to test and report on the internal control over compliance in accordance with OMB Circular A-133. Our consideration of the internal control over compliance would not necessarily disclose all matters in the internal control that might be material weaknesses. A material weakness is a reportable condition in which the design or operation of one or more of the internal control components does not reduce to a relatively low level the risk that noncompliance with applicable requirements of laws, regulations, contracts, and grants caused by error or fraud that would be material in relation to a major federal program being audited may occur and not be detected within a timely period by employees in the normal course of performing their assigned functions. We noted not matters involving the internal control over compliance and its operation that we consider to be material weaknesses. This report lS intended solely for the information and use of management, Board of Directors, and federal awarding agencies and pass-through entities and is not intended to be and should not be used by anyone other than these specified parties. DENNIS L. LORETTE ACCOUNTANCY CORPORATION Pinole, California September 10, 2007 21 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA BOARD OF DIRECTORS AND MANAGEMENT AT JUNE 30, 2007 Mark Baur, Member Bruce Blanco, Member Marsha Burch, Member Randy Dana, Secretary/Treasurer Chris Finn, President Janet Jones, Vice President H. Stephen Kaye, Member Jeffrey A. Rosen[ Member-at-Iarge Marty Stenrud, Member Waseem Sufi, Member Samuel R. Wiley Jr., Member Executive Director Sheri Burns 22 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA SUMMARY SCHEDULE OF PRIOR YEAR AUDIT FINDINGS YEAR ENDED JUNE 30, 2007 There were no prior year findings. 23 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA SCHEDULE OF FINDINGS AND QUESTIONED COSTS JUNE 30, 2007 A. SUMMARY OF AUDITOR'S RESULTS 1. The auditor's report expresses an unqualified opinion on the financial statements of CRIL. 2. There were no reportable conditions disclosed during the audit of the financial statements. 3. No instances of noncompliance material to the financial statements of CRIL were disclosed during the audit in accordance with Government Auditing Standards. 4. There were reportable conditions in internal control over major federal award programs disclosed during the audit. 5. The auditor's report on compliance for the major federal award programs for CRIL expresses an unqualified opinion on all major federal programs. 6. Audit findings that are required to be reported in accordance with Section 510 (a) of OMB Circular A-133 are reported in this Schedule. 7. The programs tested as maj or programs Department of Education, CFDA No. 84.169A. included 8. The threshold for distinguishing Type A and B programs was $ 300,000. 9. CRIL was determined to be a low-risk auditee. B. FINDINGS - FINANCIAL STATEMENTS AUDIT No matters were reported. C. FEDERAL AWARD FINDINGS AND QUESTIONED COSTS No matters were reported. 24 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NOT-FOR-PROFIT CORPORATION) HAYWARD, CALIFORNIA CORRECTIVE ACTION PLAN YEAR ENDED JUNE 30, 2007 There were no reportable conditions. 25 COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. 439 "A" ST. HAYWARD, CA 94541 August 22, 2007 Dennis L. Lorette Accountancy Corporation 2131 San Pablo Ave. Pinole, CA 94564 We are providing this letter in connection with your audit of the statement of the financial position of Community Resources for Independent Living, Inc. as of June 30, 2007 and the related statements of activities, cash flows, and functional expenses for the year then ended for the purpose of expressing an opinion as to whether the financial statements present fairly, in all material respects, the financial position, changes in net assets, and cash flows of Community Resources for Independent Living, Inc. in conformity with U.S. generally accepted accounting principles. We confirm that 'we are responsible for the fair presentation in the financial statements of financial position, changes in net assets, and cash flows in conformity with generally accepted accounting principles. We are also responsible for adopting sound accounting policies, establishing and maintaining effective internal control, and preventing and detecting fraud. We confirm, to the best of our knowledge and belief, as of August 22, 2007, the following representations made to you during your audit. 1. The financial statements referred to above are fairly presented in conformity with U.S. generally accepted accounting principles and include all assets and liabilities under the Organization's control. 2. We have made available to you all- a. Financial records and related data. b. Minutes of the meetings of the Board of Directors or summaries of actions of recent meetings for which minutes have not yet been prepared. August 22, 2007 Community Resources for Independent Living, Inc. Representation Lett~r Page 2 3. There have been no communications from regulatory agencies concerning noncompliance with, or deficiencies in, financial reporting practices. 4. There are no material transactions that have not been properly recorded in the accounting records underlying the financial statements. 5. We acknowledge our responsibility for the design and implementation of programs and controls to prevent and detect fraud. 6. We have no knowledge of any fraud or suspected fraud affecting the Organization involving- a. Management, b. Employees who have significant roles in internal control, or c. Others where the fraud could have a material effect on the financial statements. 7. We have no knowledge of any allegations of fraud or suspected fraud affecting the Organization received in communications from employees, former employees, grantors, regulators, or others. 8. The Organization has no plans or intentions that may materially affect the carrying value or classification of assets, liabilities, or net asset balances. 9. The following, if any, have been properly recorded or disclosed in the financial statements: a. Related party transactions, including revenues, expenses, loans, transfers, leasing arrangements, and guarantees, and amounts receivable from or payable to related parties. b. Guarantees, whether written or oral, under which the Organization is contingently liable. August 22, 2007 Communi ty Resources for Independent Living, Inc. Representation Letter Page 3 c. All accounting estimates that could be material to the financial statements, induding the key factors and significant assumptions underlying those estimates, and we believe the estimates are reasonable in the circumstances. 10. There are no estimates that may be subject to a material change in the near term that have not been properly disclosed in the financial statements. We understand that near term means the period within one year of the date of the financial statements. In addition, we have no Imow1edge of concentrations existing at the date of the financial statements that make the organization vulnerable to the risk of severe impact that have not been properly disclosed in the financial statements. 11. We are responsible for compliance with the laws, regulations, and provisions of contracts and grant agreements applicable to us; and we have identified and disclosed to you all laws, regulations and provisions of contracts and grant agreements that we believe have a direct and material effect on the determination of financial statement amounts or other financial data significant to the audit objectives. 12. Community Resources for Independent Living, Inc. is an exempt organization under Section 501(c)(3) of the Internal Revenue Code. Any activities of which we are aware that would jeopardize the Organization's tax-exempt status, and all activities subject to tax on unrelated business income or excise or other tax, have been disclosed to you. All required filings with tax authorities are up-to-date. 13. There are no-- a. Violations or possible violations oflaws and regulations and provisions of contracts and grant agreements whose effects should be considered for disclosure in the financial statements, as a basis for recording a loss contingency, or for reporting on noncompliance. August 22, 2007 Community Resources for Independent Living, Inc. Representation Letter Page 4 b. We are not award of any pending or threatened litigation,-claims, or assessments or unasserted claims or assessments that are required to be accrued or disclosed in the financial statements in accordance with Statement of Financial Accounting Standards No. 5 (or which would affect federal award programs), and we have not consulted a lawyer concerning litigation, claims, or assessments. c. Other liabilities or gain or loss contingencies that are required to be accrued or disclosed by Statement of Financial Accounting Standards No.5. d. Designations of net assets disclosed to you that were not properly authorized and approved, or reclassifications of net assets that have not been properly reflected in the financial statements. 14. The Organization has satisfactory title to all owned assets, and there are no liens or encumbrances on such assets nor has any asset been pledged. 15. We have complied with all restrictions on resources (including donor restrictions) and all aspects of contractual and grant agreements that would have a material effect on the financial statements in the event of noncompliance. This includes complying with donor requirements to maintain a specific asset composition necessary to satisfy their restrictions. 16. With respect to federal award programs: a. Weare responsible for complying and have complied with the requirements of OMB Circular A-133, Audits of States, Local Governments, and Non-Profit Organizations. b. We have, in accordance with OMB Circular A-133, identified in the schedule of expenditures of federal awards, expenditures made during the audit period for all awards provided by federal agencies in the form of grants, federal cost-reimbursement contracts, loans, loan guarantees, August 22, 2007 Community Resources for Independent Living, Inc. Representation Letter Page 5 property (including donated surplus property), cooperative agreements, interest subsidies, insurance, food commodities, direct appropriations, and other assistance. c. Weare responsible for complying with the requirements of laws, regulations, and the provisions of contracts and grant agreements related to each of our federal programs and have identified and disclosed to you the requirements of laws, regulations and the provisions of contracts and grant agreements that are considered to have a direct and material effect on each major federal program. d. Weare responsible for establishing and maintaining, and have established and maintained, effective internal control over compliance requirements applicable to federal programs that provides reasonable assurance that we are managing our federal awards in compliance with laws, regulations, and the provisions of contracts and grant agreements that could have a material effect on our federal programs. We believe the internal control system is adequate and is functioning as intended. Also, no changes have been made in internal control over compliance and other factors to the date of this letter that might significantly affect internal control, including any corrective action taken with regard to reportable conditions (including material weaknesses) reported in the schedule of findings and questioned costs. e. We have made ayailab1e to you all contracts and grant agreements (including amendments, if any) and any other correspondence with federal agencies or pass-through entities relating to federal programs. f. We have received no requests from a federal agency to audit one or more specific programs as a major program. g. We have complied, in all material respects, with the compliance requirements, including when applicable, those set forth in the OMB Circular A-J 33 Compliance Supplement, relating to federal awards and August 22, 2007 Community Resources for Independent Living, Inc. Representation Letter Page 6 have identified and disclosed to you all amounts questioned and any known noncompliance with the requirements of federal awards resulting from other audits or program reviews. h. Amounts claimed or used for matching were determined in accordance with relevant guidelines in OMB Circular A-122, Cost Principles for Nonprofit Organizations, and Subpart C, Cost Sharing and Matching, of OMB Circular A-lID, Grants and Agreements with Institutions of Higher Education, Hospitals, and Other Nonprofit Organizations. 1. We have disclosed to you our interpretation of compliance requirements that may have varying interpretations. J. We have charged costs to federal awards in accordance with applicable cost principles. k. We have made available to you all documentation related to the compliance requirements, including information related to federal program financial reports and claims for advances and reimbursements. 1. Federal program financial reports and claims for advances and reimbursements are supported by the books and records from which the basic financial statements have been prepared. m. The copies of federal program financial reports provided you are true copies of the reports submitted, or electronically transmitted, to the respective federal agency or pass-through entity, as applicable. n. Weare responsible for and have accurately prepared the summary schedule of prior audit findings to include all findings required to be included by OMB Circular A-133, and we have provided you with all information on the status of the follow-up on prior audit findings by federal awarding agencies and pass-through entities, including all management decisions. August 22, 2007 Community Resources for Independent Living, Inc. Representation Letter Page 7 o. We are responsible for and have accurately prepared the auditee section of the Data Collection Form as required by OMB Circular A-l33, and we are responsible for preparing and implementing a corrective action plan of each audit finding. p. We have disclosed to you all contracts or other agreements with service organizations, and we have disclosed to you all communications for the service organizations relating to noncompliance at the service organizations. 17. We have identified to you any previous financial audits, attestation engagements, performance audits, or other studies related to the objectives of the audit being undertaken and the corrective actions taken to address significant finds and recommendations. 18. We have provided our views on reported findings, conclusions, and recommendations, as well as our planned corrective actions, for the report. No events have occurred subsequent to the statement of financial position date and through the date of this letter that would require adjustment to, or disclosure in, the financial statements or in the schedule of findings and questioned costs. Signed: Signed: Date: Date: Title: Executive Director Title: Board President Attachment D State of California BOARD RESOLUTION [KJ Original D Amendment # - Community Resources for Independent Living WHEREAS, the Board of Directors of Community Resources for Independent Living (CRIL) has read the proposed agreement between the City of Dublin and CRIL and said Board of Directors acknowledges the benefits and responsibilities to be shared by both parties to said agreement, NOW, THEREFORE, BE IT RESOLVED that said Board of Directors does hereby authorize the following person or persons: Name of Person Authorized to Siqn Agreement Title 0 Person Authorized to Sign Aqreement Board President Chris Finn Executive Director Sheri Burns f of Community Resources for Independent Living on behalf of the organization to sign and execute said agreement and all amendments there to, except to increase the financial liability of said organization. CERTIFICATION I, the Recording Secretary named below, hereby certify that the foregoing resolution was duly and regularly adopted by the Board of Directors of Community Resources for Independent Living at a meeting of said Board regularly called and convened at which a quorum of said Board of Directors was present and voting, and that said resolution was adopted by a vote of the majority of all Directors present at said meeting. IN WITNESS WHEREOF, I have hereunto set my hand as Recording Secretary of Community Resources for Independent Living. Address Where Board Meeting was Held: 439 A Street, Hayward, CA Date of Board Meetin December 13, 2007 Attachment E POLICYHOLDER COpy NB STATE COMPENSATION INSURANCE I=UNO P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 12-14-2007 GROUP: POLICY NUMBER: 0537734-2007 CERTIFICATE 10: 38 CERTIFICATE EXPIRES: 08-07-2008 08-07-2007/08-07-2008 CITY OF DUBLIN NB PARKS AND COMMUNITY SERVICES DEPARTMENT 100 CIVIC PLZ DUBLIN CA 94568-2658 This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. d:::-REPRESENT A TI EMPLOYER'S LIABILITY LIMIT ~~ PRESIDENT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 08-07-2000 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER COMMUNITY RESOURCES FOR INDEPENDENT LIVING, INC. (A NON-PROFIT CORP.) 439 A ST HAYWARD CA 94541 [CAM.CS] IREV.2-051 PRINTED 12-14-2007 ACORD~ CERTIFICATE OF LIABILITY INSURANCE OPID COMMU02 09 18 THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 07 'RODUCER ~onprofit Services Ins. Agency )ennis Costa 2843 Hopyard Rd. #169 ?leasanton CA 94588 Phone: 877-669-5101 Fax:877-669-5109 . INSURERS AFFORDING COVERAGE i INSURER A NIAC . INSURER B. i INSURER C. NAIC# NSURED ----'-. .~--------' Comm. Resources for Ind Living April Monroe 439 A Street Hayward CA 94541 COVERAGES _._-~_._...._.,"------'--- , INSURER D INSURE" E, THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOT\NITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFIC;'.TE MM BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDiTIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS NSR ADD'I..! LTR INSRtl TYPE OF INSURANCE GENERAl. LIABILITY r--, : X : COMMERCI."l GENERAL LIABILITY 2 0 0 7 -161 7 3 - NPO ~I __ r-"] ! , ' CLAIMS MADE ~i OCCUR flOLlCY NUMBER -1 POl.ICY EFFECTIVE'TPOUCY EXPIRATION I : DATE (MMIODIYY i DAlE MM./ODIYY . EACH OCCURRENCE ! $ 1000000 / / : UAMA,-,~ I O-m:N I CU - ~-~..._--- 07 01 08 :,PREMiSES(EaC"""r~c.i_,~~Q,9g_oo___ . MED EXP (Any ene perso_n) : S 5000....__ : PERSONAL&ADVINJURY '$1000000 -------~..,.""---_.-_.~.~.., : GENERAL AGGREGATE f $ 3000000 :PRODUCTS-COMP/OPAGG Is 3000000 I 4 IEm Ben. . 1000000 LIMITS A 09/01/07 :b Prof. Liab. incl u I GEN'L AGGR~GA~E LIMIT A;;P~~;' '-'1 PRO- ----; JECT I LOC A 2007-16173-NPO 09/01/07 COMBINED SINGLE LIMIT 07/0.1/08 (Ea accidenl) $ 1000000 BODILY INJURY (Per person) HIRED AUTOS NON-OWNED AUTOS BODll Y INJURY (Per 2codant) PROPERTY DAMAGE (Per accidam) AUTO ONL Y . EA ACCIDENT lOA ACC $ CLAIMS MADE s DEDUCTIBLE WORKERS COMPENSATION AND EMflLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED' If yes, daSct1be under SPECIAL PROVISIONS below OTHER DESCRIPTION OF OflERA TIONS / LOCATIONS / VEHICl.ES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS * 10. days notice of cancellation for nonpayment of premium. Certificate Holder is included as an Additional Insured - Funding Source. Replaces certificated dated 8/31/0.7 - change in expiration date. CERTIFICATE HOLDER CANCELLATION City of Dublin Parks and Community Svcs. Dept Attn: Char Young 100 Civic Plaza Dublin CA 94568 CI TYDUB SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, TliE ISSUING INSURER WIl.l. ENDEAVOR TO MAIL 30* DAYS WRlTTEN NOTICE TO THE CERTIF1CA TE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL IMPOSE NO Oil LIGATION OR LlAillLlTY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. /! (~-/ AUTHORJZED RJ;;PRE$ENTA"~E / _-/vI/'Y,t/rl/' /- @ACORDCORPORATION 1988 ACORD 25 (2001/08) INSlJRED: Comm. Resources for Ind Living POLICY #20Q7-l6173-NPO COMlv1ERCIAL GENERAL LIABILITY CG 20 26 07 04 THIS ENDORSEMENT CHA.NGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modi ties insurance provided under the following: COlvfMERCIAL GENER..A.l. LIABILITY COVERAGE PART. SCHEDULE Name of Person or Organization: City of Dublin Any person or organization that you are required to add as an additional insured on this policy, under a written contract or agreement currently in effect, or becoming etlective during the tenn of this policy, and for which a ccrti11cate of insurance naming such person or organization as additional insured has been issued, but only with respect to their liability arising out of their requirements for certain perfonnanee placed upon you, as a nonprofit organization. in consideration for funding or financial contributions you receive foml them. The additional insured status will not be afforded with respect to liability arising out of our related to your activities as a real estate manager for that person or organization. (If no entry appears above, infonnation required to complete this endorsement will be shown in the Declaration as applicable to this endorsement) Section 11 _ Who is an insured is amended to include as an insured the person (s) or organization (s) shown in the schedule, but only with respect to liability for "bodily injury", "property damage" or personal and advertising injury" caused. in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned or rented to you CG 20 26 07 04 Page 1 of 1 Attachment F City of Dublin Fiscal Year 2008-2009 Application for Funds ApPLICATION VERIFICATION I attest that the inforrnationcontained in thisFY 2008-'2009 gI'antap~~i~a.!.~9h isa~~urate and that the funds requested will not supplant any secured by theqrganizatiou; Signatures: < a surn;mary ,:.,~;,:_ I;' August Attached-is aresolution; letter, or approyeg t~e <ippllcation as repor~?sgonaspossible 30, 20Q9.SFaililre to SECTION 2 Page 11 of 16 ~ At r!ii. .i Attachment H It SECRETARYOFSTA.TE CERTIFICATEQF'STATVS IDOMESTICCOR,PORATION J, KEVIN SHELLEY, Secretary of Sta,. te ofthiStgte ofCal[fqmia.. herebyoortITy: ., . ,"..". . .' : .. -',..,. .., ~. .:, . '-'-"'" . .' '....' ," . . . That on the 19th day of March19!9,COMMl./Nil1!fRESouRCES FOR INDEPENDENT L1MNG,INC. becamejncorPoratedund~Flht:i laws of the State of California by filing its Article$ of IncorpDration in this office; "lid That 00 fOCOrO exists in this offICe of aCl3rtificateof dissotJution, of saki corporation nor of a court or'der declaring .dissolution thereof; nQr of a, merger or conwlid~tion which terminated its exfstenoe; and That said corporatroo's corporate ROwers; rights and privfJeges are not suspended on the records ofthisoffice; and That according tothet.ecords ofthlsofflce,the:SaidcorpQration is authorized to e)(erclse all ffts corporate. powers, rightsandprivil~es and is in good legal standhng in the Slate' or Calilornia; ;and' . That no information is ;)'I/ailable in this offic~ em the finaliCiafcoodition, business activity or practices of this corporation.' . .INWITNESS WI-.fEREOF; I execule this certificate ;1JfJd affixtheGreatSeal 'Of ~e State of California this day ,ofJanuary6. 2004. ){~~ KEVIN SHE1LE-; , (/ Secretary of St(J.!i! r" ~~ Internal Revenue Se:-vice Department ofth:eTreasury P."O..iBox.:2508 CinciinlPafi,OH 45201 Date: November 7, 2002 . . p.e.~{)f,) to,C9ntact: J~5it;!~.oh,,$on31.:-07453 .Qj~omer/9~rviceS~~aa[st ToiF.!...F...re........e.......T .;,.e J.e.tJbo.... ". ne :.... Number. .... ........ ,"-'-' ..... .,',.." . . ",,-'.' ","-, ,-' :g~[) JU'I\. to .1)1:J.1O:P.in. EST 877~~2ft$500 FaxN~mb~r; . .5.1~263-;3700. ~d~r:aIJ~>tific:ation '.Number: . '94-2598S73 Community Resources For lndendent UVinQ'.lnc. 43'9 A Slreet Hayward, CA 94541-5013 Dear Sir or Madam: . - ,. . . .',,'.. .....,..'..,' :-'," ......- ."..-.....; ", .,' ',,'.', .' . This letter irs in ~onSB toyour~LJf}StJoiacpp)'ofy(Juvqfg?J'lI~ls,detenninati6na~tt#l'm5 l,etterWiI.'" take the pJaceoftlhecopyyour:eque~~ ..... .... ..... ..>, ....... ..... .' ...... '. .' '. . . Our records indicale.lhat a determlnatiqnlett?fissue9.:~lliQctob~r1979grantedyourorgaf)ization . exemption from 'federal incom~ tax under section501(c){3)or~,.lri~I:RevenUeCode~ Th8t1etlerisstiJlin effect - . . '.. - . . ,', ,. :',:...' "" .' ,:.' , Based on ..jntorma.tion..suPsequentlysu!Jrn..~~,~~~~~~~~~prn~~~~~?~,:<Js"6t1~;~~tj~-rU9~~priv~le foundation within. the .meanirmQf...~.Ction5QEI{a):()f~.'~de':t>e~ifJs~...~iS::an.()iganlz~lonlde'~cribedin".. sedions509(a)(1) .and170{b)(1)(AX"Q.' . . '. . . ...... .... .' .... . ThIs classification was based on tnaassYmBtf9n;tq~~X~E?~:a.II.~~tj9Q~$OPf),ratiqns.WOIJI~:%'ntjnueas stated in tlleapp~caliorL. If.your or~niza:~Qnr~S()11~Qf~,~.P9m.i~~:i~<#JtJ~~r/~th~Pf9R~(~~psl'Of purposes have changed:. please.lt;!tus.~~.~:.%:~o::~h~~):..tti~;~ff'aci:Ofth~.ct.a.iig.~:or(~'~empt. status and fOUf1l00lionstatus ofyour()1'98n~{l~9J)./.' . '. . ... ......-.,..-., '"".:' .....,'.,.- -. -" . . ,,"- . ", ," -'. " . ,'" ' . :',.' - " ,..... Your ofga~jzaoon' is require<i' tOfil~F(JfI11.f)~O~;R~.ty~i9t~~.nr~fJ~~~P.t:fIBT..ilnc.9lll~i[~i?nIY fff;ts gross receIpts each year are nonnaIIYJn~,~Jl;~?P;99Q;clf:;.~IIS~m~;.r~qy~~q.,ltm~~J~:fjr"e(:tbYwa .151h day oilhefiM' month after theendOftheOrm~n~ll.~'~f)li:~I.~~~fiQ;~~iiod~TtI~'I~~;,.i(,rlptJ$e~a penally of $20 a day, up to-a maximum'of~10,0QO~""'h~!1;l~rrli:$'fiJ~dDE;iw,cunressthe~is;reasomilile cause for the delay, . All exempt orgal1li~~tions (un[essspecificaDx~clu~e9)ar~ tifJib!efut hix~$wader .tt't~ . F~d~G'lltn~urance ContmbuOOns Act (social security taxesYonJemuner.ation;Of$1q(lprmo/e~kttoe,;:jchemp./qYee during a calendar year. Your organizationijs not .liab]~forthetaxjmpgsed1Uncfeithefederalt1nerl1p49ymentTax Act (FUTA). . . Organizations that are not pnvate fOUOOa1ionsere.not$UbJe#tlo.theex~setaxes under Chapter 42 . of the Code. However, these organizations are'not automatic:a1lye:>;:empHromotherfede~r ~xcise.taxes. Dono;s may~educt contributions.' to your org.ani~llo~a.s .1?[gyJ~~in$B~17o,{)f~C.o,d~.>~q~stsJ leg,aCles, devISes, transfers. or glttsto)r(JUrOfganI2:a1JpnorJprif:$psearededuqtlbleJorfeder9I'e~ate and ". : - - - '.: _' -1-- -", - _ -".- .' " ... '_._- -- _ '_ '-:- _ . gDft tax purposes if they meet the applfcable provisions ofse{:ijons2D55;2105, and 2522 offrleCode. -2- Community Resources For lndendent Living,lnc" 94-2598873 Your Ot'ganization is not required tofilefederalJng>metax returns unlessdtis Sybj~t9ith~ta.x.orlllnrekJttrd business income lmOOrsection 511 of ll1s:COiPe... JfY9LJrorg~nKultiQnj~sU1bjectto1h~t~itrnLJ:itfi!e~n income tax return on . the.. form 99ChT,: Exemp:l()rgi:trtil:ation8us[ne$~'li)(;oaneTaxR:~tL3i)}.:IH:'~9'iI~tt~FrW!?: are nolcfetemrlliningwbether anyolyourprgl;Ing,aiipo'$ prssent or pr.o;P(}sedactivitfesare;Unrela~:'lra.de or business as defined insectioo513'oftheOode. .. . ",. . .'.. . '.-",- ..' ," ....".... -'..""..' Yhelaw requiires you to makeyoUir. o...JQ.a.niza... ..liqn. ~:s.. oonu?l.re..t.u..'m av.a. i.l.a. ...b......kt.. ...'...f.PT. p. 1J...._b<l..._. lc._.in....s..p. .......~._..... _...o..n..........~...........-Ul....O..'ulcharge 'for three ye a. rs' aftsrthe. duedate.ofthgretJuJn"i]f)'.owo~anizafurl;tm~:a.'~Plfolit~;<ili~j~tip(Jifor.,'. recognition of exemption on Jul:y 15,.1 !987,it is aLso re.<illlir:ed tomaR~'-a.~j1ap~for"plU~i$iir#pg~~?~i~copyOf tMe exemptlon.ap?mca,tion,. a~$U~q~ng82~~m~;.~.9i,~h~c~~g~,~!!:~:~~n!9;~'1i:':~~,~~I,~~ryB:,.~per.~ such documgnts.rn. persOfi'.or"Hnwn~n~~Yop'C{ll)'Ch~~~>-Q9~i~'~?$Qm:l~~'J~~'JQr'rep~tl~OQK~,rt(ltag~~k-" ~==~=~':~~"fv~l::';;~~~~~I~ga:~l~4I~~~lrl~WllPj~it: be If-able for a penii1uyof$20admrJor~aqh:i:JaYY9'Ug6il[}t'mal\elhs~~do6umffits avm~~efor'public inspection (up toO a marximum ol$10,000 in'lhe.caseofanaonu.alretum). .' . . . . . Because this lelter could' help. res'.YJv,e'anyqlll!1!/;;1~~.~tl9LJt.Y99r.o;r9~ni~ai~i()n',sexemp~st.atqs:and' fo.undalion status, you should keepR wiR1tlJ~organ~qnr~p':riT;I~neJ1trecords:~:.. . " ", ..-," -. ',", '." -. ,'-. '. -.. '. . -, - . '-. , ~f you have anyques,tions, ptease.~Qus'.a.tU)e,:t~~prooerlumbf$FstlOWI:ir1toohe,ad~Qi(Or'~~feM:er~ TNs .Ietteraffirrns your organizationJs exempt status; Sif)Ce[~y, . ~i!~ J()tin..I;-....Rick.~, ...pj~r~...T8G~ CustomerAccou'ntServices ...