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HomeMy WebLinkAbout8.1 DPIE Attch 6 CITY OF DUBLIN COMMUNITY GROUP/ORGANIZATIONAL FUNDING REQUEST ApPLICA TION PACKET Fiscal Year 2008-2009 Section 2: Application for Community Group/Organizational Funding SECTION 2 Page 1 of21 /177lk:lH me.N T h CITY OF DUBLIN Fiscal Year 2008-2009 COMMUNITY GROUP/ORGANIZATION ApPLICATION FOR FUNDS COVER PAGE AGENCY NAME: DUBLIN PARTNERS IN EDUCATION PROPOSED PROJECT/PROGRAM NAME: VOCATIONAL MENTORING PROGRAMS FUNDING AMOUNT REQUESTED: $15,,000 SECTION 2 Page 2 of21 DPIE ~)Ublin Pm'tile!'s In Education Dublin Partners in Education PO Box 2307 Dublin, CA 94568 925.828.2551 x8024 925.803.9746 fax email: dpie@dublin.k12.ca.us January 25, 2008 Mr. Roger Bradley Administrative Analyst Ms. Joni Pattillo, Assistant City Manager City of Dublin 100 Civic Plaza Dublin, CA. 94568 ~~{[cr~:l\, .r) (' r\: 5 "A \ \ ,<Gt" Dear Mr. Bradley and Ms. Pattillo: Dublin Partners in Education (DPIE) is submitting a grant proposal request for $15,000 for three DPIE programs - Promotion of the Arts Program, Vocational Mentoring Program at Dublin and Valley High Schools and Career Days at Fallon and Wells Middle School. Last year DPIE experienced a significant amount of growth in all our programs. The Vocational Mentoring Program was expanded to both semesters as a result of the success at Dublin High School. In addition a Vocational Mentoring program was started at Valley High school and Career Days was started at the Middle Schools. DPIE also reinstated the Principal of the Day Program and due to the positive feedback and success, plans to increase the program to twice yearly. The number of guest artists who are visiting our Dublin schools has almost rippled in the last two years, thanks to many volunteer artists from around the Tri- V alley. We have art coordinators at each of the Dublin schools and they are requesting more guest artists, as the teachers many times do not have the expertise to demonstrate art in their classrooms. Besides coordinating guest artists, DPIE also funds art supplies for the schools, and coordinates a large Student Award night in May. Last year approximately 450 students, parents, relatives and neighbors attended the ceremony at the Dublin Regal Cinema. We respectfully request that U.e City of Dublin consider supporting the rapid growth of these three very important programs. All ~udents and their families in Dublin would benefit. Kirrp Regards. t ;//I'J ).1), If ~l/i 'V ~t, I tt"ii~ Don Biddle President, Board of Directors Federal Non-Profit :.0. #94-3207780 Dublin Partners in Education is a non-profit foundation dedicated to fostering Mutually beneficial business and educatio(l partnerships in order to Maximize community resources for the students of the Dublin Unified School District. CITY OF DUBLIN Fiscal Year 2008-2009 ApPLICATION FOR FUNDS 1. Please select one expense category: 0 Capital X Operating 2. Applicant Information: Organization! Agency Name Dublin Partners in Education Mailing Address P.O. Box 2307 Street Address 8435 Davona Drive City Dublin State California Zip 94568 Executive Director/Chairperson Work Phone Email Don Biddle Board President (if applicable) (925)828-2551 ext 8024 dpie@dublin,kI2.ca.us Work Phone Email Please list the Primary Project Contact Person who would be able to answer questions about this application and project/program during the funding period. Don Biddle Contact Person for Project/Program 925-828-2551 ext 8024 Work Phone Email DPIE Board President Job Title 925-803-9746 Fax Federal Tax Identification No. (required) 94-3207780 10048 City of Dublin Business License No. (required) SECTION 2 Page 3 of21 City of Dublin Fiscal Year 2008-2009 Application for Funds 3. Proposed Project/Program Information (Do not describe Organization.) Amount of Funds Requested $ (Maximum $25,000 per project.) $15,000 Proposed Project/Program Name Operational Expenses for Vocational Mentoring, Career Day, Principal for a Day, Promotion of the Arts Program and Student Arts Judging and Awards Night, Proposed Project/Program Date(s): Start 07 / 01/08 and End ~I 30 I~ 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. fitAgency is requesting 100% disbursement at the beginning of the Fiscal Year. If selecting this option, please provide justification in the blank space below. o 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. Budget Planning SECTION 2 Page 4 of21 City of Dublin Fiscal Year 2008-2009 Application for Funds a. How would the requested funds be used? . Describe, in detail, the PROPOSED PROJECTIPROGRAM (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. The current programs DPIE is requesting funding for benefit the 5,400 + students ofthe Dublin Unified School District. They are: . Career Dav (New) Local business and community volunteers spend a morning sharing valuable career information and personal professional experiences with Fallon and Wells 8th graders, helping them see all the future possibilities that education can create for them . Mentor Proe:ram: Dublin and Valley High School students attend a series of presentations given by local business and community volunteers who share their career knowledge and professional experiences, offering students "a real world perspective" and guidance. DPIE pays for the pizza and drinks at this lunchtime presentation to increase student participation. . Princioal for a Dav (New) Volunteer business leaders are invited to shadow each school principal (or district administrator) for a morning to experience first hand the challenges and successes in education today. A round table discussion involving all participants follows morning visits. This program was so successful in the fall that we were asked to repeat it twice yearly! . Promotion of the Arts: This program encourages our young artists to explore their own creativity by teaming volunteer artists with Dublin classrooms for additional art instruction. Art that is generated may be submitted for consideration for Student Awards Night and Student Art Auction. b. How would the PROPOSED PROJECTIPROGRAM address an unmet community need and improve the quality of life for Dublin residents. Why is this project/program needed? (Additional page may be added, if needed): The quality of education desired by residents of Dublin far exceeds the very basic education funded by the State. DPIE seeks to help the Dublin Unified School District bridge the gap in the type and quality of programs offered to the students. SECTION 2 Page 5 of21 c. What documentation!data/records support the need for this PROPOSED PROJECTIPROGRAM? Please identify your data sources. (Additional page may be added, if needed.) With the grant funding we've requested, DPIE's programs will provide enriched learning opportunities. Our Partnership activities are much like other Partnership programs nationwide (of which there are over 400,000) and it has been shown that Partnership programs positively impact students/ schools in these areas: Academic achievement, School attendance, Career planning, Student enrichment, Self-image and school pride. (source: www.partnerstoledo.orl:r/partnership.html) SECTION 2 Page 6 of21 City of Dublin Fiscal Year 2008-2009 Application for Funds d. Specify the PROPOSED PROJECT/PROGRAM population to be served. The students and families of the Dublin Unified School District 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. . The organizational board and committee structure of DPIE ensures that the programs and sponsorships offered to the teachers and students are appropriate with the goals of the School District and the community. Dr. Steven Hanke, Superintendent of DUSD, serves on DPIE's Honorary Council; Pat Kohnen, a member of DUSD's School Board, serves as a DPIE Board Liaison; Dr. Dave Marken, the Assistant Superintendent, serves on the DPIE Board of Directors, and Fallon School's Principal, Tess Thomas, serves on the DPIE Board and Chairs the Program Committee. The needs and evaluations of the current programs are regularly discussed at Board and committee meetings by the DUSD administrators and the DPIE Board of Directors. Program participants (volunteers and students) fill out written evaluation forms after the completion of the various programs. The information is reported back to the Board of Directors. A Program Committee of the Board of Directors was formally established to monitor program activities and outcomes. This year's Chair is Tess Thomas, Principal of Fallon School. The Program Committee makes recommendations concerning the expansion, maintenance or curtailment of programs and serves as the evaluation process for all programs. A public report is given annually at a formal televised DUSD school board meeting, and questions and comments are taken from the audience. SECTION 2 Page 7 of21 f. Specify numbers of clients served by agency, then by PROPOSED PROJECTIPROGRAM: SECTION 2 Page 8 of21 5,470 5,470 5,470 5,470 S .T l-I/.);: ;, .' " ,. City of Dublin Fiscal Year 2008-2009 Application for Funds 5. Financial Information - Operating Budget a. Expense Budget FY 2008-2009 THIs PROJECT/ EXPENSE BUDGET ORGANIZATION PROGRAM GRANT REQUEST Personnel Costs Employee Salaries & Benefits 75,160 20,000 Non-Personnel Costs Services & Supplies 12,675 Capital Costs Other (please specify) 1. Teacher Grants 50,000 2. Winter Concert 1,500 3. Performing Art 1,000 1,000 4. Science Fair 1,500 5. Art Scholarships 1,000 1,000 6. Mentor Program 5,000 5,000 7. New School Gift 5,500 8. Firework Grants 2,000 9. Unbudgeted Programs 1,750 10. Student Art Expenses 4,600 4,600 11. GT Incentive Grant 400 12. Leadership Grant 4,000 13. Principal for a Day 450 450 14. Career Days 200 200 Other (please specify) 1. Student Art Auction 15,500 2. Golf Tournament 21,000 3. CEO Dinner Event 13,450 4. Reserve ...........................5,000 r OTAL 221,685 32,250 15,000 Further Comments/Explanations (if necessary): SECTION 2 Page 9 of21 City of Dublin Fiscal Year 2008-2009 Application for Funds b. Revenue Budget FY 2008-2009 REVENUE BUDGET ORGANIZATION PROJECTIPROGRAM Committed/Restricted Funds (specify source) Non-Committed/Restricted Funds (specify source) Grants 12,500 Student Art Auction 60,000 Golf Tournament 70,000 DPIE Membership 28,400 CEO Dinner 51,500 Miscellaneous 2,200 Fireworks 5,000 Realtors Fund Raising Event 13 ,000 TOTAL 242,600 Further Comments/Explanations (if necessary): SECTION 2 Page 10 of21 City of Dublin Fiscal Year 2008-2009 Application for Funds 6. General Agency Information g Past grant applicants may check this box in lieu of completing item 6 (a-d) if the program/organizational description on file with the City is correct and current. o Although we have been past grant applicants, we have included most of the information needed to keep all records current. Thank you 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. The 5,470 students and their families of the of Dublin Unified School District c. Describe all the services the Organization currently provides to Dublin residents. · An additional page may be added, if needed. DUBLIN PARTNERS IN EDUCATION PROGRAMS & SUPPORT 2007-2008 I:l Vocational Mentoring Program at Dublin High School I:l Teacher and School Grants Program I:l Principal for a Day Program - Spring and Fall (New) I:l Mentoring Program (New) Q Career Day (New) CJ Promotion of the Arts Program Q Student Art Judging & Awards Night SECTION 2 Page 11 of21 CJ Performing Arts Grants CJ Winter Concert Sponsorship CJ Science Fair Sponsorship CJ Pacific Chamber Symphony Sponsorship CJ New School Gifts CJ New Teacher Gifts CJ Barton Reading Pilot Program for Dyslexic Students (at Wells Intermediate School) CJ Art Scholarship Program CJ Special Arts Projects Sponsorships CJ Dublin High School's Athletic Booster Sponsorship CJ Winter Concert Sponsorships 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. City of Dublin Grants 2001 through 2007 Date Oneratinf! Year Amount 1997 Tax Return Possibly 1996/1997 $10,000 1998 Tax Return Possibly 1997/1998 $10,000 1999 Tax Return Possibly 1998/1999 $10,000 3/20/2001 2000/2001 $10,000 4/22/2002 2001/2002 $10,000 8/26/2002 2002/2003 $10,000 10/27/2003 2003/2004 $10,000 8/27/2004 2004/2005 $10,000 11/21/2005 2005/2006 $12,500 8/28/2006 2006/2007 $12,500 8//01/2007 2007/2008 $12,500 SECTION 2 Page 12 of21 City of Dublin Fiscal Year 2008-2009 Application for Funds 7. Required Attachments: o Only one (l) COpy per A2enCy of each of the following is required, even with multiple projects/programs submitted. o Applications without the following documents will !!2! be reviewed for funding. o Please label attachments: A. B. C. etc. CJ A. Names of Governing Board; identify current Board officers. Attachment A A Honorary Council Don Babbitt, Heartwood Communities Stephen Brooks, Alameda County of Education Jim Gulseth, JG, P.C. Law Stephen Hanke, Superintendent Dublin Unified School District Janet Lockhart, Mayor of Dublin Roz Perazzo, Chevron Corporation Tim Sbranti, Dublin City Council John Sugiyama, Retired DUSD Superintendent DPIE Board President - Don Biddle Vice President - Tess Thomas Principal, Fallon School Co-Secretary - Chris Bennett W orkvantage Co-Secretary - Kathy De Jong Perfonnance Management Treasurer - Bill Moy Timpson Garcia, LLC SECTION 2 Page 13 of21 Board Members cont.: Angela Fontes Mom and Volunteer Ted Hoffman, Jr. Earl Anthony's Dublin Bowl Fawn Holman. Community Volunteer Kellee Jones Natural Wood Furniture Depot Dr. Dave Marken Assistant Superintendent, Educational Services Bill Prescott The Saranac Consulting Group, Inc. Victor Uno IBEW Local 595 Alcina Wegrzynowski Sybase, Inc. Pat Kohnen Liaison to DUSD Board Amy Frantz DHS Student Representative Class of 2009 SECTION 2 Page 14 of21 CI B. Current total Organization operating budget, including revenue. · Clearly label/identify the program that includes the PROPOSED PROJECTIPROGRAM. · See Attached CI C. Most recent audit report or tax return (if applicable). · See Attached CI D. Resolution, letter or other document providing evidence of Board/Organization approval of application, and date approval was granted. · Board/Organization approval may be pending. · See Attached - DPIE Board approved Grant request on 1-08-08 Board Meeting Notes attached. CI E. Organization's certificate of insurance showing coverage for liability and workers' compensation. CI · See Attached CI F. Application Verification Declaration Signature Page. · See Attached CI G. Signed affidavit form from each collaborating agency named in proposed project/program plan (if applicable). · N/A CI H. Copy of IRS Letter of Determination indicating tax exempt status. · See Attached SECTION 2 Page 15 of21 City of Dublin Fiscal Year 2008-2009 Application for Funds ApPLICATION VERIFICATION I attest that the information contained in this FY 2008-2009 grant application is accurate and that the funds requested will not supplant any other monies secured by the organization. Attached is a resolution, letter, or other document providing evidence that the Board of Directors approved the application as submitted. Successful applicants are required to submit a summary report as soon as possible after submitting the reimbursement request, but not later than August 30,2009. Failure to submit a report will result in ineligibility for future funding. Signatures: Executive Director Date Board President/Chairperson Date SECTION 2 Page 16 of21 City of Dublin Fiscal Year 2008-2009 N/A Application for Funds COLLABORATION AGENCY AFFIDA VIT FORM o This form is to be completed by each collaborating organization as named by the applicant agency in the proposed project/program. o Completed forms must be submitted at time of application. Collaborating Agency Name: N/A Agency Division/Department: Project/Program Title: Project/Program Role Description (Le., facility space, staff support, etc.): Agency Project/Program Contact Person Title Phone Email I attest that the applicant agency and our organization agree to work collaboratively to implement the proposed project/program as identified in the FY 2008-2009 funding application. Executive Director Date Project/Program Contact Person Date SECTION 2 Page 17 of21 CITY OF DUBLIN Fiscal Year 2008-2009 COMMUNITY GROUP/ORGANIZATIONAL FUNDING PROGRAM REQUEST FOR REIMBURSEMENT AGENCY NAME N/A MAILING ADDRESS FOR REIMBURSEMENT: PROJECT/PROGRAM NAME CLAIM # OF TOTAL FUNDING AMOUNT AWARDED TOTAL REIMBURSEMENT REQUESTED THIS PERIOD $ $ Amount of Expense Type Reimbursement Requested (please attach receipts, timesheets, etc. (Please describe.) Date supporting identified exoenses.) TOTAL Amount Reouested (If requesting project/program "start-up" funding, please describe initial funding use above.) I attest that the above listed expenses are accurate and true and have been used as represented in the approved funding application. Submitted by: Signature: Date: SECTION 2 Page 18 of21 CITY OF DUBLIN JF~caIYear2008-2009 COMMUNITY GROUP/ORGANIZATIONAL FUNDING PROGRAM SUMMARY REpORT (Summary Report must be completed and submitted prior to August 31,2009.) AGENCY NAME MAILING ADDRESS: TELEPHONE: PROJECT/PROGRAM NAME: TOTAL FUNDING AMOUNT AWARDED $ TOTAL REIMBURSEMENT RECEIVED $ 1.) How has the PROJECT/PROGRAM addressed an unmet community need and improved the quality of life for Dublin residents. (Additional page may be added, ifneeded): 2.) Please evaluate the success of your project/program. Were the goals outlined in the application met? Was the project/program carried out efficiently? Please use the objectives identified in your application to discuss your program/project's success and impact. Include any documentation!datalrecords you have that support your conclusions. SECTION 2 Page 19 of21 City of Dublin Fiscal Year 2008-2009 SUMMARY REpORT 3) How many total participants were served by this project/program? How many of those participants are Dublin residents? I attest that the above listed information is accurate and true. Submitted by: Signature: Date: SECTION 2 Page 20 of21 AGREEMENT BETWEEN CITY OF DUBLIN AND (insert organization name) THIS AGREEMENT, dated for identification this _ day of _ 2008, is entered into between the City of Dublin ("City") and (organization). RECITALS A. (organization) has asked City to contribute $ ( Dollars) for use by (organization) to cover costs in order to provide the services as described in Exhibit A. The services rendered pursuant to this agreement will be for the period July 1,2008 through June 30, 2009, B. City has determined that it is in the interest of the residents of the City of Dublin to make a donation of $ ( Dollars) for such purpose, provided certain conditions are met to ensure that the services will benefit the residents of City. AGREEMENT City and (organization) agree as follows: 1. Recitals The foregoing recitals are true and correct and are part of this agreement. 2. City Donation City shall donate $ ( Dollars) to be used by (organization) to be used for operational support for as described in Exhibit A to this Agreement. The donation shall be paid upon invoice to the City. 3. Records (Organization) shall maintain records for project/program review, evaluation, audit and/or other purposes and make them available to City upon request. 4. Periodic Reports Upon request by City, (organization) shall provide reports describing the progress made by (organization) accomplishing the goals and objectives outlined in the work plan. CITY OF DUBLIN Dated: By: Richard C. Ambrose, City Manager Dated: By: Title: SECTION 2 Page 21 of21 City of Dublin Application 2008-2009 Insert B Vocational Program Insert B- City of Dublin Grant Proposed Budget Funds Requested Income Expense Est. Beginning Balance Earned Interest Income $ 500 $ - SAA $ 60,000 $ 15,500 Golf $ 70,000 $ 21,000 Fireworks $ 5,000 $ - CEO Dinner Event $ 51,500 $ 13,450 Realtors Event $ 13,000 $ - Total Earned: $ 200,000 $ 49,950 Contributed Grant Income $ 12,500 $ - Teacher Grant Income (ACOE) $ 1,500 Corporate Membership $ 23,000 Individual Membership $ 5,400 Misc. Income $ 200 Restaurant Night Total Contributed: $ 42,600 $ - Total Income: $ 242,600 $ 49,950 Programs Student Board Scholarship $ - Teacher Grants $ 50,000 Winter Concert $ 1,500 Performing Arts Grant $ 1,000 $ 1,000 Science Fair $ 1,500 Art Scholarships $ 1,000 $ 1,000 Mentor Program $ 5,000 $ 5,000 New School Gift $ 5,500 Fireworks Grants $ 2,000 Unbudgeted Programs $ 1,750 SAA Program Expenses $ 4,600 $ 4,600 GT Incentive Grant $ 400 DUSD Leadership Training Grant $ 4,000 Principal For A Day $ 450 $ 450 Career Days $ 200 $ 200 Total Programs: $ - $ 78,900 Admin Office Supplies $ 1,500 City of Dublin Application 2008-2009 Insert B Postage $ 1,500 Bank Fees $ 1,500 Outside CPA $ 1,200 Corporate Filing $ 175 Ins - Liability & E&O $ 3,500 ED Expenses $ 300 Board Expenses $ 1,000 Marketing $ 1,500 Office Equipment $ 500 Other (unbudaeted) $ - Total Admin $ . $ 12,675 Payroll Payroll Worker's Comp Insurance $ 2,000 Executive Director $ 35,000 Program Director $ 20,000 $ 20,000 ED Incentive Package $ 2,000 Admin Services $ 15,360 Past Admin. Employee $ 150 Payroll Service (Paychex) $ 650 Total Payroll $ . $ 75,160 Mise Reserve $ 5,000 Grand Totals: $ 242,600 $ 221,685 $ 32,250 Fonn 8868 (Rev. April 2007) -) Application for Extension of Time To File an Exempt Organization Return ~ File a separate application for each return. <J..-b .1-1- (" ~1 ...'. .._"""'..... .._ OMB No. 1545-1709 Department of the Treasury Internal Revenue Service . If you are filing for an Automatic 3-Month Extension, complete only Part I and check this box........ ........... _....... ......... ~ [X] . If you are filing for an Additional (not automatic) 3-Month Extension, complete only Part II (on page 2 of this form). Do not complete Part 1\ unless you have already been granted an automatic 3-month extension on a previously filed Fonn 8868. Automatic 3-Month Extension of Time. Only submit original (no copies needed). Section 501 (c) corporations required to file Form 990-T and requesting an automatic 6-month extension. check this box and complete Part I only ................................ ....................................................... ....................... . ~ D All other corporations (including 1120-C filers), partnerships, REMICs, and trusts must use Form 7004 to request an extension of time to file income tax returns. Electronic Filing (e-file). Generally, you can electronically file Fonn 8868 if you want a 3-month automatic extension of time to file one of the returns noted below (6 months for section 501 (c) corporations required to file Form 990- T). However, you cannot file Form 8868 electronically if (1) you want the additional (not automatic) 3-month extension or (2) you file Forms 990-BL, 6069, or 8870, group returns, or a composite or consolidated Form 990.T. Instead, you must submit the fully completed and signed page 2 (Part II) of Form 8868. For more details on the electronic filing of this form, visit www.irs,gov/efile and click on e-file for Charities & Nonprofits. Type or Name of Exempt Organization Employer identification number print File by the due date for filing your return. See instructions. DUBLIN PARTNERSHIPS IN EDUCATION Number, street, and room or suite no. If a P.O. box, see instructions. P. O. BOX 2307 City, town or post office, state, and ZIP code. For a foreign address, see instructions. DUBLIN, CA 94568 94-3207780 Check type of return to be filed(file a separate application for each return): [X] Fonn 990 D Fonn 990-T (corporation) D Fonn 990.BL D Fonn 990- T (sec. 401 (a) or 408(a) trust) D Fonn 990.EZ D Form 990-T (trust other than above) D Fonn 990-PF D Fonn 1041-A D Form 4720 D Form 5227 D Fonn 6069 D Fonn 8870 . The books are in the care of ~ WILLIAM E. MOY TelephoneNo.~ (925) 829-1928 FAX No. ~ (510) 465-2979 . If the organization does not have an office or place of business in the United States, check this box ................................................... ~ D . If this is for a Group Retum, enter the organization's four digit Group Exemption Number (GEN) . If this is for the whole group, check this box ~ D. If it is for part of the group, check this box ~ D and attach a list with the names and EINs of all members the extension will cover. 1 I request an automatic 3.month (6.months for a section 501 (c) corporation required to file Form 990-T) extension of time until FEBRUARY 15, 2008 ,to file the exempt organization retum for the organization named above. The extension is for the organization's return for: ~ D calendar year or ~ [X] tax year begin~JUL 1, 2006 , and ending JUN 3 0, 2007 2 If this tax year is for less than 12 months, check reason: D Initial retum D Final return D Change in accounting period 3a If this application is for Fonn 990-BL, 990-PF, 990-T, 4720, or 6069, enter the tentative tax, less any nonrefundable credits. See instructions. 3a $ b If this application is for Form 990-PF or 990-T, enter any refundable credits and estimated tax payments made. Include any prior year overpayment allowed as a credit. 3b $ c Balance Due. Subtract line 3b from line 3a. Include your payment with this form, or, if required, deposit with FTD coupon or, if required, by using EFTPS (Electronic Federal Tax Payment System). - See instructions. 3c $ N/A Caution. If you are going to make an electronic fund withdrawal with this Form 8868, see Form 8453-EO and Form 8879.EO for payment instructions. LHA For Privacy Act and Paperwork Reduction Act Notice, see instructions. Form 8868 (Rev. 4-2007) 623831 05-01-07 19000123 748525 19412 2006.08010 DUBLIN PARTNERSHIPS IN EDUC 19412__1 Return of Organization Exempt From Income Tax Under secllon 501(0), 527, or 4947(a)(1) oUhe Internal Revenue Code (exceptblaok lung benefit trust or private foundation) 0epartm1l1t of ahe Trll8llllrY Inll!fl\lll RlMlI1Ul1 ServIce ~ The organization may have to use a copy 01 this relurn to satisfy stale reporting requirements. A For the 2005 calendar year, or tax year beginnIng JUL 1, 2 05 and endIng JON 30, 006 B Check If Plllllllll C Name 01 organization D Employer Identification number appllc&bla: useIRS lebel CI' print ar type. See SpIlCIII InallUc. lions. UBLIN PARTNERSHIPS IN EDUCATION Number and streel (or P.O. box II maills not delivered 10 street address) . O. BOX 2307 City or lown, stale or country, and ZIP + 4 F Amuntllltl mllhod: UBLIN, CA 94568 D ~~I~ · eotlon 50 (0)(3 organlzatlonsand 4 4 (a)(1) nonexempl e arltable trusts H and I are no~l/cable to section 527 organizations. must aUach a completed SchedUle A (Form 990 or 99D-EZ). H(a) Is thIs a g~m fO~/ates? D Ves [XJ No G Webslle:~N/A H(b) Jf"Yes:enler~.Dales~ N/A J OrganIzation type _anlyllltl~ 501(c)( 3 ).... ~l1lllIftno.1 4947(a)(1) or 527 H(e) N/A UVes UNo K Check here ~ If the organizatIon's gross receipts are normally not more than $25,000. The H(d) f~' organization need notllle a return wlll1 tha IRS; but If the organization chooses to Ole a lllturn, ba :Agan sure to file a completa return. Some slales require a oomplete return. I.. ; It Ai ,... Ch L Gross receipts: Add lines 6b, Bb, 9b, and 10b to line 12 ~ 23 0 , 39 a. ~ Sch. B €e~mli Revenue, Ex ses, and Changes in Net Assets or Fund ~Iance Contributions, gilts. grants, snd similar amounts received: a Direct pUblic support ........................................................................ b Indirect public support .................................................................... o Government contributions (grants) ........................................................ d Total (add lines 1a through 1c) (cash $ 48 , 035 ==non h $ 2 Program s8fVlce revenue Including government lees and contracts. . I, 3 MembershIp dues and assessments ...................................... . 4 Interest on savings and lemporary cash Investments ....... 5 Dividends and Interest from securities ........................ 8 a Gross rents ..................................................... ...... bLess: renlal expenses ..............,........................ o Net lllntallncome or (loss) (subtract line 6b from 7 D1her Invastmentlncome (describe ~ 8. Gross amount from sales 01 assets other than InvenlllfY .........................,...... b Less: cost Dr other basis and safes expen c Gain or (loss) (attach schedule) ... d Net gain or (loss) (combIne line 8 9 Special events and activities a Gross revenue (notlncludl rtlJlortBd on line is) ...... b Less: direct expenses oth c Nellncome or (10 10 a Gross sales oft b l.ess: cost of go old ..... e Gross profit or (10 S ' 11 Other revenue (from Pa ,line 103) ......................................................................................................... 12 Tolal revenue add lines 1d, 2, 3,4,5, 6e. 7 8d, 9e, 10e, and 11 ..................................................................... = 13 Program servIces (from line 44, column (B)) ................................................................................................ III 14 Management and general (from line 44, column (e)) .................................................................................... ! 16 Fundllllslng (from line 44, column (0)) ...........................,.......................................................................... .n 16 Payments to affiliates (attach schedule) ...................................................................................................... 17 Total ensel add lines 16 end 44, column A....................................................................................... 18 Excess or (deficit) for the year (subtract line 17 from line 12) .............................................................,............. ~i 19 Net assets or fund balances at beginning of year (from nne 73, column (A)) ......................................................... ~ 20 Oll1er changes In net assets or fund balances (attach explanation) ..................................................................... 21 Net assets or fund balances at end 01 year (combine lines 18, 19, and 20) ......................................................... 02-113-06 LHA For Privacy Act and Paperwork Reduction Act Nollce, Bee the Beparate Instrucllonl. / Form 990 D~-:a D=e D= DF/n81 retum D=ded D=~':ullan -P-~ Roomlsulle 94-3207780 GI ~ c ~ GI a: 10c 11 12 13 14 1& 18 17 18 19 20 21 10500515 748525 19412 Accrual 48,035. 96. 99 095. 2005.08010 DUBLIN PARTNERSHIPS IN EDUC 19412__1 Form 990'(2005) DUBLIN PARTNERSHIPS IN EDUCATION 94-3207780 Page 2 l~ea~II~1 Statement of All organizations must complete column (A). Columns (B). (e), anti (D) are required for sactlon 501(c)(3) Functional Expenses anti (4) organizations and section 4947(a)(1) nonexemptcharllable trusts but opllonal for others. Do not Include amounts reported on line (A) Total (B) Program (e) Management 6b, Bb,9b, 10b, or 16 of Part I. l5: services and I18neral 22 Grants and allocations (attach schedule) '!C8IlIl $ 0 . fIOlaSIl sO. If IhIs emaunt Includes fanllgn gmnIs, chICk here ~ 22 23 Specific assistance to Individuals (attach schedule) ......,............................................ 23 24 Benefits paId to or for members (attach schedule) ................................................... 24 25 Compensation of officers. dll'Bctors, etc. * ~. 25 3 6 , 618 . 26 Other salaries and wages .....................,..... 26 19 , 430 . 27 Pension plan contributions ........................ 27 28 Other employee benefits ........................... 28 29 PayroU taxes ............................................. 29 30 Professional fundralslng fees ..................... 30 31 Accounting fees ....................................... 31 1, 00. 1 , 200 . 32 Legal fees ................................................ 32 33 SuppAes ................................................... 33 34 Telephone ...............................................' 34 35 Postage and shipping ................................. 35 1 , 200 . 1 , 2 O. 36 Occupancy ................................................ 36 37 Equipment rental and maintenance ............ 37 38 Printing and publications ........................... 38 39 Travel ...................................................... 39 40 Confel'Bnces, conventions. and meetIngs... 40 41 Interest ...................................................... 41 42 Dapl'Bclatlon, depletion, etc. (attach schedule) 42 43 Other expenses not covered above (itemize): a b c d 13 717. 858. 1i~ 137,705. 94,425. 34,874. 8,406. OP 98.2. on and fundralslng solicitation raported In (8) Progmm services? ..................... ~ DYes [XJ No costs $ N / A ; (II) the amount allocated to Prngmm services $ N / A Bneml $ N / A . and Iv the amount allocated to Fundralsln $ N A Fonn 990 (20D5) ** SEE STATEMENT 3 5230 11 02-03-08 10500515 748525 19412 2005.08010 DUBLIN PARTNERSHIPS IN EDUC 19412__1 Form 990(2005) DUBLIN PARTNERSHIPS IN EDUCATION 94-3207780 Page 3 I~Bil~1 Statement of Program Service Accomplishments (See the Instructions.) Form 990 Is available for public Inspection and, for soma people, serves as the primary or sole source of Information about a particular organization. How tha public perceives an organization In such cases may be detennlned by the Infonnatlon presanted on Its retum. Therefore, please make sure the retum Is complete and accurate and fully describes, In Part JII, the organlzatlon's programs and accompDshmenls. What Is the organization's primary exempt purpose? ~ SEE STATEMENT 4 All organIzations must describe theIr exempt purpose achievements In a clear and concise manner. State the number of clients served, publications Issued, etc. DIscuss achievements that are not measurable. (Section 501 (c)(3) and (4) organizations and 4947(a)(1) nonexempt charitable trusts must also enter the amount of grants and allocations 10 others.) a TEACHER GRANTS - TO PROVIDE ADDITIONAL FUNDING TO EliijANCE PROGRAMS THAT ARE OUTSIDE OF THE PURVIEW OF THE NO~SI~ BUDGET. Grants and allocations $ (Grants and allocations $ c SUPPORT OF PROGRAMS, ORGANIZATIONS ~ (Grants and allocations $ d Gran1:$ and allocations $ e other program services (attach sc (Gran1:$ and allocations $ f Total of Program Service ExpiiiSea (sho If this amount Includes forel n gran1:$, check here ~ ) If this amount Includes foral rants. check here ~ D . . ualllne 44, column (B), Program services) ....................................... ~ 523021 Q2.(13-il6 10500515 748525 19412 Program Service Expensea (ReqUired for 501(c)(3) and (4) orgs.. and 4947(a)(1)lrUsls; but optional for others.) 30,233. 22,219. 41,973. 2005.08010 DUBLIN PARTNERSHIPS IN EDUC 19412__1 94-3207780 Page 4 DUBLIN PARTNERSHIPS IN EDUCATION U~ajjtiIV~ aJance ts (See the InsttVctfonsJ Note: Whet8 required, attached schedules and amounts within the description column (A) should be for end-of-year amounts only. BegInning of year 45 Cash - non-Interest-bearing ........................................................................... 46 Savings and temporary cash Investments '..................................................... 33,307. 47 1 Accounts receivable .................................... 47a b Less: allowance for doubtful accounts ......... 47b !'5EES'i --=:- ~ 481 b 49 50 .l!l 518 GI III en b < 52 53 54 55 a b 58 571 b 58 59 60 81 62 III i 63 :s 64 III ::i 66 Pledges receivable ....................................... 48a Less: allowance for doubtful accounts 4Bb Grants receivable .....,.. .... ............................................. .................. ..',.. ..,...... Receivables from officers, directors, trustees, and key employees ,..... ........................ ................ ...... ............. ....... ............... Other notes and loans receivable .................. 511 Lsss: allowance for doubtful accounts ......... 51b Inventories for sale or use ....,......................................................................... PrepaId expenses and deferred charges .................................................... Investments - securities .......................................... .. D Cost D F Investments -land, buildings, and A equlpmant: basis ........................'................. 668 PAYABLE 37,133. &9 80 61 62 63 84a 64b 65 O. 68 III i ii m 'a c ::lI II. ti 70 .l!l II 71 III .! 72 .. GI 73 z 74 70 71 72 S!!5!l!! --.= 523031 02.03-08 (8) End Df year 45,144. 2,862. 48,006. 1,352. 1 352. 46,654. O. 10500515 748525 19412 2005.08010 DUBLIN PARTNERSHIPS IN EDUC 19412__1 94-3207780 Page 5 evenue per e m (See the B b 1 2 3 4 B N/A b1 b2 b3 == e;;; = == == ~ c d 1 2 b c = =: N/A b 1 2 3 4 ~ E;E ~ = == = = d 1 2 b c E a ;;;;s == d (A) Name and address SEE-STATEMENT-S--------- 31,160. o. o. Fonn 990 (2005) 523041 Q2.Q3.D8 10500515 748525 19412 2005.08010 DUBLIN PARTNERSHIPS IN EDUC 19412__1 b (A) Name and address PAMELA GLYNN 8435DAVONA-DRlVE------------------ DUBLIlf-Ci-9456S------------------ 5,458. o. o. =============~~========== i.ei , ::lm er Infomration the fnstructlons.) DId the organization e In Ivlly not prevlously reported to the IRS? If 'Yes,' attach a detailed description of each .... ............. ......... on........... ........................ ............ _... .._. ............ ....... ................................. 77 Were any changes made In e organizing or govemlng documents but not reported to the IRS? .......................................... If "Yes,. attach a conformed copy of the changes. 18 a DId the organIzation have unrelated business gross Income of $1 ,000 or more during the year covered by this retum? ......... b If "Yes,. has It filed a tax retum on Form 990- T for this year? ....................................................................................1!!.l'!!: 79 Was there a liquidation, dissolution, termInation, or substantlal contraction during the year? If .Yes,. attach a statement ...... 80 a Is the organizatIon related (other than by association with a statewide or nationwide organization) through common membership, govemlng bodies, trustees, officers, etc., to any other exempt or nonexempt organization? .............................. b If .Yes,. enter the neme of the organization" N / A 81 a b and check whether It Is LJ exempt or LJ nDnexempt Enter direct Dr Indirect political expenditures. (See line 81Instnsctlons.) .............................. 81a 0 . DId the anlzatlon file Form 1120-POL for this r? ...................................................................................................... 5231B1m2-ll3-lI8 10500515 748525 19412 2005.08010 DUBLIN PARTNERSHIPS IN EDUC 19412__1 94-3207780 Page 7 Yes No 82a b 83 a b 84& b 85 b 0 d e , D h 86 b 87 b 88 89 a b c d 90 a b 918 b 0 92 Old the organization receive donated services or the use of materials, equipment. or facUlties at no charge or at substantially less than fafr rental value? ..........,. ............ .... .......,......,........'..'......... ....... ................ .............. .......... .... ......... ............,....... If "Yes, . you may Indicate the value of these Items here. Do not Include this amount as revenue In Part I or as an expense In Part II. (See Instructions In Part III.) ..............................................................................................., 82b N / A Old the organization comply with the pubnc Inspection requirements for retums and exemption applications? ........................ Old the organization comply with the disclosure requirements relating to quid pro quo contributions? .................................... Old the organization solicit any contrlbutlons or gifts that were not tax deductible? .............................................W.I.A......... If .Yes,. did the organization Include with every solicitation an express statement that such contrlbutlons or gifts were not tax deductible? ..... .... .....................'........,................. ......... ,....,......... '" ................. ....... .... ...... ...... ................... .w.1..~.,....... 501(a)(4), (5), oreS) organizations. 8 Were substantially all dues nondeductible by members? ............. ............w.I.~......... Did the organization make only In-house lobbying expenditures of $2,000 or less? ........................... .....~......... If .Ves. was answered to either 8Sa or 85b, do not compJste S5c through 8Sh below unless the Q!g ~ a waiver for proxy tax owed for the prior year. ..,. Dues, assessments, and similar amounts from members ...................................................... Section 162(e) lobbying and poDtlcal expenditures ......................................................... 85 N I A _...--........ "'..- 6033{e)~1(A) d.... _ ................~. Nt A Taxable amount of lobbying and political expenditures (line 85d less 85e) .............. ........ 5 ;: N I A Does the organization elect to pay the section 6033(e) tax on the amount on line as.. .........:::..................w.I..~.......,. If section Ei033(e)(1XA) dues notices were sent, does the organization agree to a&e am. " on One 8Sf to Its reasonable estimate of dues allocable to nondeductible lobbying and po I pend res forthe followlng tax year? .................. .,. ........ .... ..... .... ............. ....... .......,... ....... ................................,w.I.~. ........ 501(c)(7) organizations. Enter: a Initiation fees and capital contributions In line 12 .................................,..... ,.....'..... ..,...... ............ ....... ............ Gross J'8Ce/pts, Included on Une 12, for pubUc use of club facilities 501(c)(12) OIf1SIllzatlons. Enter: 8 Gross Income from members or. Gross Income from ather sources. (Do not net amounts due or p against amounts due or received from them.) ....,.............. 87b N/A At any time during the year, dld the organization own a 5 terest In a taxable corporation or partnership, or an entity disregarded as separate from the organ Ions sections 301.n01.2 and 301.no1.3? If "Yes,. complete Part IX ........................................ ................................................................................. 501 (a)(3) organizations. Enter: Amount of tax Impos'Etl 1%atlan during the year under: secUon 4911~ 0 . ; seeDo 0 . ; section 4955 ~ 501 (a)(3) and 501 (c)(4) organizations. Old the engage In any section 4958 excess benefit :~~:~::c~rI:~~=t:~I~~:c:. ~ e~:::.~~~.~~.~~:~~=.~~..~.~~~.~.~...................,........,..,... B9b Enter: Amount of tax Imposed on the . gers or disqualified persons during the year under sections 4912, 4955, and 49S8 ...... ............................................................,.................................... ~ Enter: Amount of tax on line 89c ed by the organization ............................................................... ~ Ust the states with which a c flied ~CA Number of employees amp! :. erlod that Includes March 12, 2005 ....................................... 90b The books are In care of ~ A' ~ NTES I TREASURER 20 05 - 0 6 Telephone no. ~ 9 5) 8 - 2 5 51 Located at ~ 8435A'AVO · RIVE , DUBLIN, CA ZIP + 4 ~ 94568 At. any time during endar. r, did the organization have an Interest In or a signature or other authority over a financial acca' n a to country (such as a bank account, securities account, or other financial ~~~~~~)~t;th~.~;;~~'fO;ig~.~~~~~;;'~..................N/A....................................................................,.....,......... See the Instructions for exceptions and flUng requlremants for Form TO F 90-22.1, Report of Foreign Bank and Rnancla! Accounts. At any time during the calendar year, did the organization maintain an office outsIde of the United States? If .Yes, · enter the name of the foreIgn country ~ N I A Section 4947(8)(1) nonexempt charitable trusts tllfng Form 990 fn Ueu of Form 1041. Check here ...................................................... ~ 0 and enter the amount of tax-exempt Interest received or accrued during the tax year ........................... ~ W N / A Form 990 (2005) B3a X 83b X 841 ~=~-~ == :...-:::: =_...3 BBa B6b 87a N/A N/A N/A X o. o. 2 523182 lJ2o.D3-D6 10500515 748525 19412 2005.08010 DUBLIN PARTNERSHIPS IN EDUC 19412__1 94-3207780 PageS (8) Amount Excluded by sectlllll512, 513. Dr 514 (e) (D) ":rd:' Amount code (E) Related Dr exempt function Income c d e 1 MedlcarelMedlcald payments ........................... D Fees and contracts from government agencies ... 94 Membership dues end assessments .................. 95 Interest on savings and temporary cash Investments ... 96 DIvidends and Interest from securities ............... 97 Net rentsllncome or (loss) from real estate: a debt.flnanced property ....................................... b not debt.flnanced property ................................. 98 Net rentsllncome or (loss) from personal property 99 Other Investment Income ................................. 100 Gain or Ooss) from sales 01 assets other than Inventory .......................................... 101 Net Income or (loss) from special events _._...._.._. 102 Gross profit or (loss) from sales of Inventory 103 Other revenue: 8 b c d 99,095. 96. .. .......... ............... ..... ...... ......................... ~ TO End-ol-year assets No [XJ No P,li..... SSN arPTlN 300 523183 02.D3-lIll Phone no. ~ (510) 832-2325 Form 990 (2005) 10500515 748525 19412 2005.08010 DUBLIN PARTNERSHIPS IN EDUC 19412__1 SCHEDULE A (Form 990 or 99D-EZ) Organization Exempt Under Section 501 (c)(3) (Exoept Prlvate FoundaUon) and SecUon 501(e), 501(1). 501{k), 501(n). or 4947(a)(1) Nonexempt Charitable Trust Supplementary Information-(See separate Instructions.) ~ MUST be completed by the above orllan/zaUons and attaohed to their Form 990 or 99D-EZ Employer IdenUnoation number DUBLIN PARTNERSHIPS IN EDUCATION 94i 3207780 Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees (See page 1 of the Inslrucllons. List each one. If there are none. enter .None.') (a) Name and address of each employee paid p~r v:e~k :~Pe~ tgurs (0) Compensation ~Td.ll:::t acc:unt f:S o~er more than $50,DOO position P c:ompensallon allowances OMS No. 1545-G047 Department at 1118 Tr8lUlUfY Inletnel RW8IlU8 Service 2005 ~Q~----------------------------- Total number of other employeBs paid (b) Type of service (c) Compensation NOjE---------------------------- ----------------------------- I other tIlan professional services, whetller Individuals or ge 2 of the InslrucUons.) (a) Name and address ch Indep Bnt contractor paid more than $50,000 (b) Type of service (0) Compensation -------------------------------------------- -------------------------------------------- Tolal number of other contractors receiving over $50,000 for other services ...............................,.................................. ~ o 523101JD2.Q3.0S lHA For Paperwortc ReducUOR Act Notice, lee the InatrucUons for Form 990 and Form 99l1-EZ. Schedule A (Form 990 or 99HZ) 2006 10500515 748525 19412 2005.08010 DUBLIN PARTNERSHIPS IN EDUC 19412__1 SchedUleA'(Form9900r990-EZ)2005 DUBLIN PARTNERSHIPS IN EDUCATION 94-3207780 Page 2 l~gartm'~1 Statements About Activities (See page 2 of the InslrUcUons.) Yes No 1 During the year, has the organization attemptad to (nDuence netlonal, stata, or local legislation, Including any attempt to Influence pUblic opInion on a legislative matter or referendum? If "Yes," enter the total expenses paid or Incurred In conneellon with the lobbying actlvlUes ~ $ $ (Must equal amounts on line 38, Part VI-A, or line i of Part YI-B.) 1 X Organizations that made an election under section 501(h) by flOng Form 5768 must complete Part VI-A. Other organizations checking "YeS' must complete Part VI-S AND attach a statement giving a delal/ed descrIption of the lobbyIng actlvllles. 2 During the year, has the organlzallon, ellher directly or Indlteclly, engaged In any of the following acts with any substantial contributors, trustees, directors, officers, creators, key employees, or members of their famlUes, or wIth any taxable organization with which any such person Is affiliated as an officer, director, trostae, majority owner, or principal beneficIary? (If the answer to any question is .Yes, · attach a detailed statement explaining the transact/ons.) 8 Sale, exchange, Dr leasing of property? .......................................,...,................,....................................... . 28 X The organization Is not a private loundation because It Is: (Please check 5 0 A church, convention of churches, or association of ch BOA school. Section 170(b)(1)(A)(D). (Also complete 7 0 A hospital or a cooperallve hospItal service or 8 D A Federa~ slate. or local government or gove 9 0 A medical research organlzaUon operated and slate ~ 10 0 An organization operated tor the beneftt (Also complete the Support Soh 111 0 An organization that normally r part of lis support from a governmental unit or from the general pUblic. Section 170(b)(1)(A)(vl). ( upport Schedule In Part IY.A.) 11b D A communlly trosl Sac v . Also complela the Support Schedule In Part IV-A.) 12 [XJ An orgenlzatlon that no ) more than 33 1J3'l1o of lis support from contributions, membership fees, and gross receipts from acllvlUes . table, ele., functions - SUbject to certain exceptions, and (2) no more than 33 1J3'l1o of Its support from n . me and unrelated business taxable Income (less sectlon 511 tax) from businesses acquired by the organlza r JIU 975. See sectlon 509(a)(2). (Also complete the Support Sohedule In Part IV-A.) 13 0 An organlzaUo at Is not lied by any disqualified persons (other than foundation managers) and supports organIzations dll$erlbed In: (1) lines 5 throu ..!8bo or (2) secUons 601(c)(4), (5), or (6), If they meet the test of section 509(a)(2). Check the box thatdesctlbes the type of supporting organization: ~ 0 Type 1 D Type 2 0 Type 3 ProvIde the following Informallon about the supported organlzatlons. (See page 6 01 the Insirucllons.) o Furnishing of goods, services, or faclllUes? ...........................................................................,............ 20 X b Lending of money or other extension of credit? ................,.................................................................. ..... 2b X d Payment of compensation (Dr payment or reimbursement of expenses If more than $1,OOO)? ........ 2d X 2e X n 170(h)? .................................... de advice 3a 3b 30 X X X 41 4b X X gh 6 of the InstrucUons.) . (b)(1)(A)(HI). n 'Il 170(b)(1)(A)(v). n with a hospitaL Section 170(b)(1)(A)(UJ). Enter the hospital', name, olty, lverslty owned or operated by a governmental unit SectIon 170(b)(1)(A)(lv). (a) Name(s) of supported organlzalJon(s) (b)Une number from above 14 [ J An organization orgenlzed and operated to test for pubHc safety. Section 509(a){4). (See page 6 01 the InstrucUons.) 523111 OZ-G3.OB Schedule A (Form 990 or 990-EZ) 2005 10500515 748525 19412 2005.08010 DUBLIN PARTNERSHIPS IN EDUC 19412__1 Si:heduleA(Form99Dor99D-€Z}2005 DUBLIN PARTNERSHIPS IN EDUCATION 94-3207780 Page 3 I~I~I Support Schedule (Complele only If you checked a box on line 10, 11, or 12.) Use cash method of accounting. - Note: You msy use lhe worksheet in the Instructions for converting from the E1CCrusJ to the cash method of accounting. I en ar yelr or ICI yelr beginning In) .............................. ~ (a) 2D04 (b) 2D03 (e) 2002 (d) 2001 (e) Tolal 15 IJIiIn ,an con u ns received. (Do not Include unusual grants. See line 28.) ........,......... 35,564. 36,178. 50,510. 37,735. 159,987. 18 Membership fees received ......... 17 Gross receipts from admissions, merchandise sold or services performed, or fumlshlng of faclntles In any activity that Is related to the orgenlzation's charllabte,e!c..purpose ............ 129,350. 105,271. 80,582. 50,312. 365,515 " 18 Gross Income from Interest, dividends, amounts received from payments on securities loans (sec- tion 512(a}(5)), renlS, royaltIes, and unrelated business taxable Inco me (Jess section 511 taxes) from businesses acquired by the organizaUon after June 30, 1975 1, 27 5 . 19 Net Income from unrelated business activities not Included In line 18 ... 20 ax re.venues ever e OrDanlZa1lon's benefit an either palel to It or expended on lis behalf 21 The value of services or facUllles furnished to the organization by a governmental unit without charge. Do not Include the value of services or facllilles generally furnished to the pooRe without charge ......... 22 r come. c asc e ue. Do not Include gain or (loss) from sale 01 capllal assels ............... 23 Tojal of lines 15 through 22 ...... 24 Line 23 minus line 17 ............... 25 Enter 1% of line 23 .................. , 4 . ~ 1 , .4 . 1, 84 . 1, 30. .. lItJ........ ......... .. ....10 ,,11: . En... ... "'I,lhoo 24 ............................................. ~ ... b Prepare a list for your records to show the name of and Dun n. tti; each person (other than a governmental unIt or pUblicly supported organization) whose total or iIf 2004 exceeded the amount shown In line 26a. Do not file thllllstwlth your return. EnlBr the tola . I, IS excess amounts ......................................................... ~ 26b o Tolal support for secllon 5D9(a)(1) test Enter II III ...................................................,...,........................ 28c d Add: Amounts from column (e) for lines: 18 19 :;:;:::51 28b ......... ~ 28d N/A e pubnc support (Hne 26c mInus line 26d ...................................................................................,.............. ~ 28e N A f Public IU 011 ereenll e line 281, lIP.lIlmto , : ded b line 260 denominator ................................................ ~ 281 N I A 0/. 27 Organizations deacrlbed on line Iuded In lines 15, 16, and 17lhat were received from a "disqualified person: prepare a list for your records to show the name of, an . eived In each year from, each "disqualified person: Do not file this nIt with your return. Enter the sum 01 such amounts for each year. (2004) .................... 0.. ....................................9..~. (2002) .................................9..~. (2001) .................................Q..~. b For any amount Include . was received from each person (other than "dIsqualified persons;, prepare a Ost for your records to show the name or, and amount received f as more than the larger of (1) the amount on line 25 for the year or (2) $5,000. (Include In the list organizations described In lines 5 thro ~b' II as individuals.) Do not file thll"at with your return. After computing the difference belw8en the amount received and the larger amount described In or (2), entsr the sum of these differences (the excess amounts) for each year. (2004) .................................9..~. (2003) ...... ..............................9..~. (2002) ...............,.................g..~. (2001) ............ .................... .g..~. c Add: Amounls from column (e) for IIne8: 15 159 , 987 . 16 17 365 , 515 . 20 21 ~ 270 d Add: LIne 27a lolal ... 0 . and line 27b lolal .................. O. ... ~ 27d e PUblic support (nne 27c lotal minus line 27d tOIal} ................................................................................................ ~ 27e f Tolal support for sectIon 509(a}(2} test Enler amount on line 23, column (e) ......... ~ 27f 617 , 760 . g Public support percentage (line ZTe (numerator) divided by line 27f (denominator)) '................................ ~ 27g h Investment income ercenta e line 18, column enumerator d"JVJded line 27. (denominator ......... ~ 21b . 2 0/. 28 Unusual Grants: For an organIzation described In line 10, 11, or 12 that received any unusual grants during 2001 through 2004, prepare a list for your records to show, for each year, the name of the contributor, the date end amount 01 the gran~ and a brlel description of the natura of the grant Do IIDt nle this IIat with your tetum. Do not Include Ihese grants In One 15. NONE 523121 02.03-08 Schedule A (Farm IIIlO or D91l-EZ} 2005 10500515 748525 19412 2005.08010 DUBLIN PARTNERSHIPS IN EDUC 19412__1 S'cheduIeA(Form 990 or 99D-€Z) 2005 DUBLIN PARTNERSHIPS IN EDOCATION 1~e.iUl~.A~1 Lobbying Expenditures by Electing Public Charities (See page 9 of the Inslnlcllons.) (To be completed ONLY by an eUglble organization that filed Form 5768) Check ~ a LJ If the organization belongs to an alfIHated group. Check ~ 94-3207780 Page 6 N/A Limits on Lobbying Expenditures (The term "expenditures. meens amounts paid or IncUrrell) b U If ou checked *a" and .nmlted conlror provisions apply. (8) (b) AlfIliated group To be completed for ALL totals electing organizations N/A 36 Tolal lobbying expenditures to Influence pubnc opinion (grassrools lobbylng) ........................... 37 TOlallobbylng expenditures to Influence a legislative body (direct lobbying) .............................. 38 Total lobbying expenditures (edd lines 36 and 37) ............................................................... 39 Other exempt purpose expenditures ... .............................................................................. 40 Total exemptpurposeexpendltUres (add lines 38 and 39) ................................................... 41 Lobbying nontaxable amounL Enter the amount from the following Iable- If the amount on line 40 Is - The lobbying nontaxable amount I. - NolllVllrS5ll0.aao .................................... l!D'll 01 lhll 8tnoURI 0" 11111140 ................................. Over $500,000 but"ot over $1.000.000 ............ S100.ooo plus15'l6 or lhe 8llCllSll OVIII' S5llO,OOO ......... Over $1,000,000 but not lMlr $1,500,000 ...,..... $175.000 plus10'l1a Dr lhellllCllSll 0VIII'51,000,ooo ......... Ov.. '1,500,000 but not over S 17,llOO,0ll0 ......... 5225,000 plus 5'l6 01 thll 8llCIISS lMlr $1,500,000 ......... Over 517,000,000 .................................... $1.llOO,OOO ...... ....... ...............,. ......... ............... 42 Grassrools nonlalCable amount (enler25% of line 41) ..................................................,. 43 Subtract nne 42 from line 36. Enter -o-If line 42 Is more than line 36 ............................... 44 Subtract line 41 from line 38. Enter -o-If line 41 15 more than line 38.............................. CauDon: If there Is 8Ilsmount on either line 43 or fine 44, you must file Fi 4-Year Averaging Per. (Some organizations that made a section 501 ( below. See the Instructions for lines ~ (a) 2005 (0) 2003 (d) 2002 N/A (8) Tolal o. o. o. o. o. o. Yes No o d e f II o. Sohedule A (Form 990 or 990-€Z) 2005 10500515 748525 19412 2005.08010 DUBLIN PARTNERSHIPS IN EDOC 19412__1 ScheduleAtForm9900r990-EZ)2005 DUBLIN PARTNERSHIPS IN EDUCATION 94-3207780 Page 6 I~RarnVJI~llnformation Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations (See page 12 of the Instructions.) 51 Old the reporting organization directly or Indirectly engage In any of the following with any other organization described In section 501(c} of the Code (other than section 501(c)(3) organizations) or in secllon 527, relating to ponUcal organizations? 8 Transfers from the reporting organization to a noncharltable exempt organization at (I) Cash ... '.................... ...... .... ......., .............................,...... ... ......... ,...., .'.. ..........' ........ ..,...... .... ... .............................. ...... 518(1 (II) Other assets ..... ..... ....'......... ...................... ............................................ ,....... ............. ................. .............. .............. ...... alII) b Other transactions: (I) sales or exchanges of assets with a noncharltable exempt organization .................................................................................... b(l) (II) Purchases of assets from a noncharltable exempt organization ..........................................................,..................................... b(lI) (III) Rental of facilities, equlpmen~ or other assets ........................................................................................................................ b(lll) (Iv) Reimbursement arrangements ... ................, ......' .................. ......... ............ ...... ......... ........... ....... ...~....................... b(lv) (v) loans or loan guarantees ...............................................................,............................................... ....I.......... b(v) (vi) Performance of services or membership or fundralslng solicitations ............................................... ..........~............... b(vl) c Sharing of facUmes, equlpmen~ mailing lists, other assets, or paid employees .................................... ~................ c d If the answer to any of the above Is "Yes,. complete the following schedule. Column (b) should always show ue of the goods, other assets, Dr servIces given by tho reporting organization. If the organlzallon received less t lue In any transaction or Sharing arrangemen~ show In column (d) the value of the ooods, other assets, or d. N / A (a) (b) (c) v (d) line no. Amount Involved Name of noncharltable exempt organlzallon ~ ~pUon 0 'ffiinsfers, transactIons, and sharing arrangements ~~ ~ ~ Yes No X X X X X X X X X 52 a Is the organization dJrecUy or fndlrecUy a Code (other than sectIon 501(c)(3)) or In b If "Yes," complete the following schelb!.l!. (a) Name of org III No (b) Type of organization (0) Description of relationship 02-03-08 Schedule A (Form geO or geD-El) 2005 10500515 748525 19412 2005.08010 DUBLIN PARTNERSHIPS IN EDUC 19412__1 DUBLIN PARTNERSHIPS IN EDUCATION 94-3207780 FORM 990 SPECIAL EVENTS AND ACTIVITIES STATEMENT 1 GROSS CONTRIBUT. GROSS DIRECT NET DESCRIPTION OF EVENT RECEIPTS INCLUDED REVENUE EXPENSES INCOME GOLF TOURNAMENT 50,357. 50,357. 32,417. STUDENT ART AUCTION 51,446. 51,446. 31,356. FIREWORKS 59,782. 59,782. 23,019. SUGIYAMA RETIREMENT 20,682. 12,303. TO FM 990, PART I, LINE 9 182,267. 99,095. FORM 990 OTHER EXPENSES STATEMENT 2 (A) (D) DESCRIPTION TOTAL FUNDRAISING BANK FEES 1,638. 1,638. INSURANCE 3,380. 3,380. MARKETING AND ADVERTISING 2,150. 2,150. PROFESSIONAL DEVELOPMENT 90. TEACHER GRANTS STUDENT SCHOLARSHIPS AND PROGRAMS WORKER'S COMPENSATION INSURANCE 522. 329. 132. TAXES AND FEES 250. PAYROLL TAX 2,859. 1,803. 726. OFFICE SUPPLIES 2,120. BOARD MEETING EXPENSES 960. OFFICE EQUIPMENT EXPENSE 837. 837. MEMBERSHIP DUES 100. 100. SUPPORT OF OTHER NONPROFIT ORGANIZATIONS 8,849. 8,849. MISCELLANEOUS EXPENSE 60. 60. TOTAL TO PM 990, LN 43 79,257. 64,682. 13,717. 858. 10500515 748525 19412 STATEMENT(S) 1, 2 2005.08010 DUBLIN PARTNERSHIPS IN EDUC 19412__1 DUBLIN PARTNERSHIPS IN EDUCATION 94-3207780 STATEMENT 3 FORM 990 OFFICER COMPENSATION ALLOCATION PART II, LINE 25 NAME OF OFFICER, ETC. EMPLOYEE EXPENSE COMPENSATION BEN. PLANS ACCOUNTS PAMELA GLYNN 5,458. A. PROGRAM SERVICES 3,275. B. MANAGEMENT AND GENERAL 1, 637 . C. FUNDRAISING 546. NAME OF OFFICER, ETC. COMPENSATION DONNA MCMILLION 31,160. . A. PROGRAM SERVICES B. MANAGEMENT AND GENERAL C. FUNDRAISING TOTAL PROGRAM SERVICES TOTAL FUNDRAISING TOTAL OFFICER, ETC., INCLUDED ON PARTS V-A AND V-B TOTALS 5,458. 3,275. 1,637. 546. TOTALS 31,160. 18,696. 9,348. 3,116. 21,971- 10,985. 3,662. 36,618. FORM 990 lZATION'S PRIMARY EXEMPT PURPOSE STATEMENT 4 PART III EXPLANATION TO FOSTER MUTUALLY BENEFICIAL BUSINESS EDUCATION PARTNERSHIPS IN ORDER TO MAXIMIZE COMMUNITY RESOURCES FOR THE STUDENTS OF THE DUBLIN UNIFIED SCHOOL DISTRICT. 10500515 748525 19412 STATEMENT(S) 3, 4 2005.08010 DUBLIN PARTNERSHIPS IN EDUC 19412__1 DUBLIN PARTNERSHIPS IN EDUCATION 94-3207780 FORM 990 PART V-A - LIST OF OFFICERS, DIRECTORS, STATEMENT 5 TRUSTEES AND KEY EMPLOYEES EMPLOYEE TITLE AND COMPEN- BEN PLAN EXPENSE NAME AND ADDRESS AVRG HRS/WK SATION CONTRIB ACCOUNT DON BIDDLE PRESIDENT 8435 DAVQNA DRIVE 0.00 o. O. o. DUBLIN, CA 94568 TESS THOMAS VICE PRESIDENT 8435 DAVONA DRIVE 0.00 o. o. DUBLIN, CA 94568 ROZ PERAZZO VICE PRESIDENT 8435 DAVONA DRIVE 0.00 o. o. DUBLIN, CA 94568 ANGELA FONTES 8435 DAVONA DRIVE o. o. o. DUBLIN, CA 94568 BILL PRESCOTT 8435 DAVONA DRIVE o . o. o. DUBLIN" CA 94568 DONNA MCMILLION ( CURRENT ) 8435 DAVONA DRIVE 31,160. o. o. DUBLIN, CA 94568 DR. SANDY HARE 8435 DAVONA DRIVE o. o. O. DUBLIN, CA 94568 VICTOR UNO BOARD MEMBER 8435 DAVONA DRIVE 0.00 o. o. o. DUBLIN, CA 94568 TIM SBRANTI BOARD MEMBER 8435 DAVONA DRIVE 0.00 o. o. o. DUBLIN, CA 9456~ ALICE WATERMAN a BOARD MEMBER 8435 DAVONA DRI 0.00 o. O. o. DUBLIN, CA 94568 TOTALS INCLUDED ON FORM 990, PART V-A 31,160. o. o. 10500515 748525 19412 STATEMENT(S) 5 2005.08010 DUBLIN PARTNERSHIPS IN EDUC 19412__1 DUBLIN PARTNERSHIPS IN EDUCATION , , 94-3207780 SCHEDULE A OTHER INCOME STATEMENT 6 DESCRIPTION 2004 AMOUNT 2003 AMOUNT 2002 AMOUNT 2001 AMOUNT PROGRAM SERVICE REVENUE TOTAL TO SCHEDULE A, LINE 22 o. o. o. o. 37,300. 37,300. 53,683. 53,683. 10500515 748525 19412 STATEMENT(S) 6 2005.08010 DUBLIN PARTNERSHIPS IN EDUC 19412__1 DPIE Meeting Minutes January 10, 2008 '- ) \!!J ~I ..~' ';' L ~C'e.- :'__JJLtll'.. 1:,~,(~ ":. /' I (. '-""""" o t "1 ~v {/ ::cl.:~? '-- ...--./ ft Attending: Executive Board Members: Don Biddle, Kathy de Jong, Tess Thomas, Chris Bennett, Bill Prescott Board Members: Alcina Wegrzynowski, Kellee Jones, Fawn Holman Board of Trustees rep: Pat Kohnen Excused:, Ted Hoffman, Victor Uno, Angela Fontes, Dave Marken, Bill Moy, Amy Frantz, Hannah Pulliam 5:15 p.m. Don Biddle opened meeting December meeting minutes were reviewed. Bill motioned to approve the minutes; Kellee seconded approval of December meeting minutes, The Board approved unanimously, Don introduced new Program Manager Michelle Haubert and new Event Manager Amy Miller to the Board. Amy asked everyone to check their calendars and to respond to her quest for volunteers the evening of February 1 st for the Waiter event. 12 volunteers are needed. DPIE Hiring Don announced that Nancy Silva's last day will be February 2nd and that we will keep the existing AA job description. Alcina will post the opening on the web site with a deadline of 2/15/08, Kathy will post an email blast with the job description for board members to send throughout the community; after one week if response is slow we will place an ad. Kathy expressed a concern about the knowledge transfer for Access database and Don stated he will have Nancy train Michelle the basics. In addition, Willa has volunteered to come and help with the transition of a new AA hire. ED position: Bill said we have 17 resumes and will try to set up 3-4 candidates, including Mary Beth Phillips to interview in the DPIE office sometime in the next week. It was discussed that the office had been rearranged somewhat by Amy and Michelle and that Don will contact Dave Marken and Tess will contact Julie to see if we can use the alcove office for additional space for a new ED. Celebrity Waiter: Fawn stated that she and the team are having a tough time getting responses to the invitation; however, they are please with the quality/number of our celebrity waiters: 16 with a goal of 160 guests. Alcina suggested that we re-check with the waiters to make sure we had received their latest responses. Don volunteered to bring (and taste-test) his stock of wine for the event Mentoring program/Middle School Career Day: Don and Chris gave a status update; the students and mentors both seem to like the new program structure. We'll do a day at Valley H.S. in the spring. p{) -7 Career Days are 1/17 (Fallon) and 1/31 (Wells); first time for both, we'll gather feedback. The original impetus was Gloria; since she left in the midst, the schools have fended for themselves with some limited support from Chris. DPIE question for follow-up: how do we bring this back to being a "DPIE" event, or do we need to? Funding: DPIE received $10,500 from Realtors Getting Real; thanks! Washington Mutual (through Alan Elias) asked DPIE to submit a grant application and awarded us $2000. Other: Meeting with DUSD Board has been re-scheduled for February; the plan is for a quick reminder and intro of new staff. City grant process: Board agreed to request $15,000 rather than increase amount. We may get some volunteer grant writing help from Sharon Marks. Paperwork due 1/25. Meeting adjourned at 6:25. Respectfully submitted by Board Member, Kathy de Jong and Chris Bennett -? /:C b- ACORDm CERTIFICATE OF LIABILITY INSURANCE OP 10 JF I DATE (MM/DDNYVY) DUBLI-l 01/22/08 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMA Tim ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW PRODUCER Nonprofit Services Ins. Agency Dennis Costa 2843 Hopyard Rd. #169 Pleasanton CA 94588 Phone:877-669-5101 Fax: 877-669-5109 INSURED INSURERS AFFORDING COVERAGE INSURER A: NIAC INSURER B: State Compensation Ins. Fund INSURER C: INSURER D: INSURER E: NAIC# Dublin Partners In Education P.O. Box 2307 Dublin CA 94568-1599 COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY 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. LTR NSR[ TYPE OF INSURANCE POLICY NUMBER 'ili~~TMMlDDIYY DATE IMM/DOIYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 "-- A ~ COMMERCIAL GENERAL LIABILITY 2007-12954-NPO 03/09/07 03/09/08 PREMISES (Ea occurence) $ 100,000 f-- ~ CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $10,000 PERSONAL & ADV INJURY $ 1,000,000 X liquor liabili ty GENERAL AGGREGATE $ 1 ,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COM PlOP AGG $1,000,000 II .nPRO- n POLICY JECT LOC ~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 A ANY AUTO 2007-12954-NPO 03/09/07 03/09/08 (Ea accident) f-- ALL OWNED AUTOS BODILY INJURY i-- $ SCHEDULED AUTOS (Per person) - ~ HIRED AUTOS BODILY INJURY $ ~ NON-OWNED AUTOS (Per accident) - PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ==l ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESs/UMBRELLA LIABILITY EACH OCCURRENCE $ :=:J OCCUR D CLAIMS MADE AGGREGATE $ $ R DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND I TOlty 'Ll~,'r't , IOJ~- B EMPLOYERS' LIABILITY 1761723-07 12/01/07 12/01/08 $ 1000000 ANY PROPRIETORlPARTNERIEXECUTIVE E.L. EACH ACCIDENT OFFICERlMEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ 1000000 ~~~MtS~~~~~1o~s below E.L. DISEASE - POLICY LIMIT $ 1000000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS * 10 days notice of cancellation for nonpayment of premium. CERTIFICATE HOLDER CANCELLATION Ci ty of Dublin 100 Civic Plaza Dublin CA 94568 CITYDUB SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 * DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO so SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTH 0 REPRESENTATIV @ ACORD CORPORATION 1 ACORD 25 (2001/08) 7T7 F City of Dublin Fiscal Year 2008-2009 Application for Funds ApPLICATION VERIFICATION I attest that the information contained in this FY 2008-2009 grant application is accurate and that the funds requested will not supplant any other monies secured by the organization. Attached is a resolution, letter, or other document providing evidence that the Board of Directors approved the application as submitted. Successful applicants are required to submit a summary report as soon as possible after submitting the reimbursement request, but not later than August 30,2009. Failure to submit a report will result in ineligibility for future funding. Signatures: Executive Director I · · {II,(/ ( lh{~li Date 1- 2~ --, () &- Board President/Chairperson Date SECTION 2 Page 11 of 16 -. . -. '.'-- .. -. - -....' -.... ..,.~-. -IF '- / !/1/~~/r- IT INTERNAL REVENUE SERVICE P. O. BOX 2508 CINCINNATI, OH 45201 DEPARTMENT OF THE TREASURY DUBLIN PARTNERSHIP IN EDUCATION PO BOX 2307 DUBLIN, CA 94568 Employer Identification Number: 94-3207780 DLN: 17053053731073 Contact Person: MICHAEL A LUDWIG ID# 31470 Contact Telephone Number: (877) 829-5500 Our Letter Dated: November 1994 Addendum Applies: No ,Date: APR 102003 Dear Applicant: This modifies our letter of the above date in which we stated that you would be treated as an organization that is not a private foundation until the expiration of your advance ruling period. Your exempt status under section 501(a) of the Internal Revenue Code as an organization described in section 501(c) (3) is still in effect. Based on the information you submitted, we have determined that you are not a private foundation within the meaning of section S09(a) of the Code because you are an organization of the type described in section 509(a) (1) and 170 (b) (1) (A) (vi). Grantors and contributors may rely on this determination unless the Internal Revenue Service publishes notice to the contrary. However, if you lose your section 509(a) (1) status, a grantor or contributor may not rely on this determination if he or she was in part responsible for, or was aware of, the act or failure to act, or the substantial or material change on the part of the organization that resulted in your loss of such status, or if he or she acquired knowledge that the Internal Revenue Service had given notice that you would no longer be classified as a section S09(a) (1) organization. You are required to make. your annual information return, Form 990 or Form 990-EZ, available for public inspection for three years after the later of the due date of the return or the date the return is filed. You are also required to make available for public inspection your exemption application, any supporting documents, and your exemption letter. Copies of these documents are also required to be provided to any individual upon written or in person request without charge other than reasonable fees for copying and postage. You may fulfill this requirement by placing these documents on the Internet. Penalties may be imposed for ,failure to comply with these requirements. Additional information is available in Publication 557, Tax-Exempt Status for Your Organization, or you may call our toll free number shown above. If we have indicated in the heading of this letter that an addendum applies, the addendum enclosed is an integral part of this letter. Letter 1050 (DO/CG) -2- DUBLIN PARTNERSHIP IN EDUCATION Because this letter could help resolve any questions about your privatp foundation status, please keep it in your permanent records. If you have any questions, please contact the person WD~r ..ame and telephone number are shown above. Sincerely yours, ~f~ Lois G. Lerner ~ Director, Exempt Organizations Letter 1050 (DO/CG)