Outreach Ministries InternationalAPPLICATION FORM WITH SCORING AND REVIEW CRITERIA AND GUIDANCE
Funding amount requested: $ 3,000
Yes/No Conditions
Dates of event/program start -end 8/191 4/20
A. Fair and justifiable program costs (Program/Event Budget required) Yes/No
B. Serves Atlantic Beach residents Yes/No
C. Program/event pertains to cultural, arts, recreation Yes/No
D. Program/event activities completed by September 30, 2020 Yes/No
E. Program/event is non-discriminatory Yes/No
F. Is the event free from inherently religious activities? Yes/No
NOTE: If the Yes/No conditions are not met, the application is not eligible for funding,
and will not be processed for review.
NOTE: Questions reviewers will consider are listed in italics as a helpful guide for applicants
1. Participants (Maximum 35 points)
Donner Park, Jordan Park, or publicly
Location(s) where program/event will take place accessable facility within COAB.
Total estimated number of participants 16 to 25 participants per week.
Number and percent of participants who are Atlantic Beach residents # 100 %
Total number of hours each participant will be directly engaged in
program/event 8 to 10 hours per week.
Frequency and duration of program/event (e.g. 1 time event for 2 hours, or 1 x/month for
1 hour) 4 to 12 times per month
Is the event open to all residents of Atlantic Beach who may want to participate? Yes
Is the event to occur in Atlantic Beach or to serve primarily Atlantic Beach? Yes
NOTE: An important criteria for funding is to ensure that an adequate number of
Atlantic Beach residents will benefit from the program/event relative to the
amount of funding requested. To address this criteria, a per -person -per -hour cost
will be calculated by the reviewers.
2. Need (Maximum 20 points)
Briefly describe any community needs or gaps that the program/event is intended to
address. Please state if the program/event targets a population or age group that is currently
underserved in Atlantic Beach.
NOTE: Reviewers will consider the following questions when assigning points:
IT Is there a demonstrated need for the program/event?
Is the program/event duplicative of other programs/events in the area?
Is the program/event a response to a need articulated from the community?
Does the program/event target a population group that is currently underserved?
(e.g. teens, children with special needs, low-income residents, etc.)
ThP CIE Program targets rnmmunities that struggle with Goria1 and economic
injustices by providing a nurturing environment in which families and youth
can engage in self -enrichment activities that stimulate personal growth and
se_ f-relia.
3. Description of program/event
3.1 Describe the goals and objectives of the program/event, and benefits to the
residents of Atlantic Beach, please make sure goals and objectives are specific,
measurable, achievable, results -focused and time -bound (Maximum 15 POINTS)
NOTE: Reviewers will consider the following questions when assigning points:
o Are the goals and objectives described in the application SMART
(specific, measurable, achievable, results -focused, and time- bound)
o How will the program/event benefit residents of Atlantic Beach (pertaining
to cultural arts and recreation?
o Are the goals and objectives artistic, recreational and/or cultural in nature
By the end of the grant period, nor gnal is to have 100° of rnir partinipants rated/
measured as r.roficient in the r,ro[ram that thew have chosen, using our CDEP Rubric.
(See Attachment labeled "Reubric.")
3.2 Describe program/event activities (Maximum 40 POINTS)
NOTE: Reviewers will consider the following questions when assigning points:
o How appropriate are these activities are in terms of achieving the stated
goals and objectives
o Originality and creativity — is the program or event new and unique to the
community or provide a new or unique twist on an existing program or
event?
o Is this a family oriented and wholesome event that City funding should
support?
Our program activities are STEAM based. They include: Science, Technology,
Engineering, Art,and Math. Specifically, our CDE Program offers: cultural
visual and performing or martial movements that can be displayed in any
physical form, Movie production,robotics, electronics, coding/programming
and IT Certifications. Note: The scope of the program greatly depends upon
full funding.
3.3 Describe how the program/event will be advertised too ensure adequate
participation (Maximum 5 POINTS)
NOTE: Reviewers will consider the following questions when assigning points:
o Is there a plan for promoting/marketing the program/event?
o Is this plan likely to be effective and feasible?
1
The CDE Program will be advertised on the internet via targeted marketing
campaignes. in ocal schools, business, community organizations, han'outs and
and o`r,er mesa.
4 Describe how you will facilitate access to the program or event so that residents of Atlantic
Beach who do not live near the program/event location and/or who do not have
transportation can still participate. (Maximum 10 POINTS)
NOTE: Reviewers will consider the following questions when assigning points:
o is there a plan to ensure that access is not a barrier?
o Is this plan effective and feasible?
Many of our programs will be located in facilities within walking and safe biking distance
within those communities who tend to struggle with transportation.
We also ofter on:ine access .o some of our course work trainings.
5 Describe if the program is evidence based (i.e. has a record of achieving expected
outcomes) (Maximum 15 POINTS)
NOTE: Reviewers will consider the following questions when assigning points:
o Is the program or event based on published evidence?
o Does the program or event have a demonstrated history of success (in other
contexts or similar cities, or in previous years)?
During our 2017-2018 program year, we achieved 100% of our COAB participant
goal.
We documented that by program end, we had delivered our program to COAB
residents .hti limes.
6 If there is a fee or cost to participate, describe how you will ensure that participants are not
denied the opportunity to participate due to their inability to pay any registration or other
related fees or costs. If there is no fee or cost please state N/A (Maximum 15 POINTS)
NOTE: Reviewers will consider the following questions when assigning points:
o Is the program/event free for residents of Atlantic Beach?
o If there is a fee or cost, does the proposal describe steps to ensure that
participants are not denied the opportunity to participate due to their inability
to pay fees or costs?
The current funding request will be used to ensure that those individuals who cannot afford
fees and supplies needed for their course, will be able to have access at no cost.
IndivitJu ] s wno •-1.: 1 nen is t nt=ez1 ar_coroing to Mabilax income gut aeLLnes, ma
neeto pas f..7- s.,:tl. a.1% 57r01�s.
Possible Fees are as follows (for upper income participants):
1. CompTIA Certification: $350 per test
2. Robotics course materials: $150 per student
3. Movie/film production: $160 per student
For the most part, we will try to avoid charging fees.
7. Evaluating Success (Maximum 30 POINTS)
Briefly describe how you will measure success. This should include how you will assess
participant satisfaction, number of participants and (if applicable) changes in knowledge,
attitudes, skills or behaviors. Describe data collection methods and who will be
surveyed. Please also describe how data will be used to inform program improvement.
NOTE: Reviewers will consider the following questions when assigning points:
o Is there an adequate evaluation plan for measuring participation,
participant satisfaction and (if applicable) changes in knowledge,
attitudes, skills or behaviors
o Will data provide actionable information for future planning?
o Will results be useful for dissemination to the community?
o Does evaluation include feedback from participants/audience as well as
planners/ organizers and volunteers?
pie use a rubric that measures five key elements for successful outcomes: Perseverance &
ompleteness,Skill & Consistency, Creativity & Inventiveness, Composition, Work Habits.
'ur KPI Social Outcome is as follows:1) 90% of participants are COAB residents benefiting frn
ur program.2) 100% of our participants (ages 12 -19) to achieve proficiency in their progran
f choice thus increasing 'rear Level or awareness.
8. Resourcing (Maximum 15 POINTS)
Please describe any plan to leverage additional resources (e.g. other funding,
volunteers, in-kind donations) or collaboration with others to offset expenses
NOTE: Reviewers will consider the following questions when assigning points:
o Is there a plan to leverage additional resources (other funding, volunteers,
and/or in-kind donations)?
o Is there collaboration with other organizations that will help to offset
resources and expenditures?
o Is this a for-profit event?
We currently receive support from three primary veins. First, grant support from foundati¢..s
and local governments. Secondly. in-kind contributions from CompTTA. Microsoft Corp, Googii,
JetBrains, and SCA Barista. Finail;, individual donors, and volunteers
[Course title] Mastery Rubric
Perseverance /
Completeness
Student Name: Date:
CDEP
Score
A
Superior
B
Excellent
Course project
is as complete
as the student
could make it.
Course work is
complete. Could
use some
finishing
touches.
C
Proficient
D
Progressing
Course work is
complete at the
most basic level.
Could be worked
on further.
Craftsmanship /
Skill /
Consistency
Course work
reflects
deliberate control
of media.
Advanced
craftsmanship.
Creativity /
Inventiveness
Course work is
innovative,
completely original,
well thought out, and
thoroughly
developed.
Course
work reflects
control of the
media. Proficient
craftsmanship.
Course work is
thought out and
developed
throughout.
Course work
reflects adequate
control of the
media. Basic
craftsmanship.
Course work
appears to still
be in -progress.
Composition
Work Habits
Advanced
composition
incorporating several
of the design
elements (balance,
contrast, harmony,
emphasis, movement,
proportion, pattern,
variety, unity, rhythm,
reL•etition).
Course work has the
basics.
Course work
appears to still
be in -progress.
Proficient
composition.
Student worked in class
entire period. Did not
need to be reminded to
focus on task. Table
conversation was focused
on Course talk.
Student worked in class
most of the period.
Needed very few
reminders to focus on
task. Table conversation
was focused on Course
talk.
Basic composition.
Course work
appears to still be in -
progress.
Student worked in class
part of the period.
Needed several
reminders to focus on
task. Table
conversation partially
focused on Course talk.
Course work appears
to still be in -progress.
Student needed lots of
reminders to focus on
task. Table conversation
barely focused on Course
talk.
U/F would only be given for unsatisfactory or not passing work
Students are graded each time they complete a course project. I explain the day's objective and I write
what I am grading on the board. I write the directions on the board and explain what is expected for each
project. I also explain to them if they do not participate and follow directions they will not receive a grade
for the project.
O.M.I. International
CDE Beaches Area Program Budget
Fiscal Year
19-20
Income
Contributions 8,500.00
Royalties 0.00
Gifts -in-kind 33,500.00
Partnerships 2,500.00
Grants 15,000.00
Membership Fees 0.00
Program Revenue
Total Income 59,500.00
Expenses
Personel Expenses
Salaries & Wages
Compensation
Reimbursments
Office Expense and Rentals
Telephone
Utilities
Postage, Shipping, Delivery
Supplies
Copies
Total
Total
Rental & Maintenance Contracts
Lease/ Facilities & Equipment 6,802.50
Programs
C.D.E. Program Materials
Accreditations/ Certifications
Technology (hardware & software)
Insurance/Legal/Taxes/ Fees
Technical Support
Training Costs
Total 6,802.50
19,505.56
8,000.00
10,905.56
650.00
5,000.00
7,494.44
Total 51,555.56
Other Operating Expenses
Marekting 1,150.00
Total 1,150.00
Total Expenses 59,508.06
Net Increase or (Decrease) - 8.06
O.M.I. International
C.D.E. Duval County Operational Budget
2019 2020
Unrestricted Restricted Total Unrestricted Restricted
SUPPORT AND REVENUE
Total
Contributions 16,192.94 14,016.92 30,209.86 17,746.28 24,709.28 42,455.56
Royalties 3,000.00 3,000.00 3,500.00 3,500.00
Gift -in-kind - 300,000.00 300,000.00 - 300,000.00 300,000.00
Church partnerships 5,000.00 - 5,000.00 2,500.00 2,500.00
Membership fees - - -
-
Grants 50,000.00 50,000.00 79,000.00 - 79,000.00
Total 74,192.94 314,016.92 388,209.86 102,746.28 324,709.28 427,455.56
EXPENSES
By program activities
C.D.E. Program Duval County
Total
88,209.46 300,000.00 388,209.46 127,455.56 300,000.00 427,455.56
88,209.46 300,000.00 388,209.46 127,455.56 300,000.00 427,455.56
Net (14,016.52) 14,016.92 0.40 (24,709.28) 24,709.28 0.00
APPLICATION FORM WITH SCORING AND REVI W CR TE # A AND GUIDANCE
Funding amount requested: $ 3,000
Yes/No Conditions
Dates of event/program start -end 8/191 4/20
A. Fair and justifiable program costs (Program/Event Budget required) Yes/No
B. Serves Atlantic Beach residents Yes/No
C. Program/event pertains to cultural, arts, recreation Yes/No
D. Program/event activities completed by September 30, 2020 Yes/No
E. Program/event is non-discriminatory Yes/No
F. Is the event free from inherently religious activities? Yes/No
NOTE: If the Yes/No conditions are not met, the application is not eligible for funding,
and will not be processed for review.
NOTE: Questions reviewers will consider are listed in italics as a helpful guide for applicants
1. Participants (Maximum 35 points)
Donner Park, Jordan Park, or publicly
L Location(s) where program/event will take place accessable facility within COAB.
Total estimated number of participants 16 to 25 participants per week.
Number and percent of participants who are Atlantic Beach residents # 100 %
Total number of hours each participant will be directly engaged in
program/event 8 to 10 hours per week.
Cl Frequency and duration of program/event (e.g. 1 time event for 2 hours, or 1 x/month for
1 hour) 4 to 12 times per month
LI Is the event open to all residents of Atlantic Beach who may want to participate? Yes
r Is the event to occur in Atlantic Beach or to serve primarily Atlantic Beach? Yes
NOTE: An important criteria for funding is to ensure that an adequate number of
Atlantic Beach residents will benefit from the program/event relative to the
amount of funding requested. To address this criteria, a per -person -per -hour cost
will be calculated by the reviewers.
2. Need (Maximum 20 points)
Briefly describe any community needs or gaps that the program/event is intended to
address. Please state if the program/event targets a population or age group that is currently
underserved in Atlantic Beach.
NOTE: Reviewers will consider the following questions when assigning points:
❑ Is there a demonstrated need for the program/event?
Is the program/event duplicative of other programs/events in the area?
Is the program/event a response to a need articulated from the community?
Indemnification
Contribution Award applicants and recipients agree to indemnify and hold harmless the City
from any and all liability, defense costs, including other fees, Toss or damage which the City may
suffer as a result of claims, demands, costs or judgment against it, arising from all activities
engaged in by Recipient in its use of the public funds.
Site Visits
Applicants must be available for site visits during the application process and successful
applicants must be available for site visits during program activities or events
Save the Date
It is recommended that all applicants consider holding time on their calendars for a 10 minute
presentation on SEPTEMBER 3, 2019 in the event that they should make the short-list of semi-
finalists (applicants may send any member of their staff or team to represent the application at
the presentation).
All decisions are final.
FLORIDA
85-8015863016C-9
Certificate Ntirnberr
This certifies that
Consumer's Certificate of Exemptionl
Issued Pursuant to Chapter 212, Florida Statutes
DR -14
R. 10/15
03/14/2017 03/31/2022 J 501(C)(3) ORGANIZATION
Effective Date Expiration Date Exemption Category
OUTREACH MINISTRIES INCORPORATED
INTERNATIONAL
13245 ATLANTIC BLVD STE 4-233
JACKSONVILLE FL 32225-7121
is exempt from the payment of Florida sales and use tax on real property rented, transient rental property rented, tangible
personal property purchased or rented, or services purchased.
a;
FLORIDA
Important Information for Exempt Organizations
DR -14
R. 10/15
You must provide all vendors and suppliers with an exemption certificate before making tax-exempt purchases.
See Rule 12A-1.038, Florida Administrative Code (F.A.C.).
2. Your Consumer's Certificate of Exemption is to be used solely by your organization for your organization's
customary nonprofit activities.
3. Purchases made by an individual on behalf of the organization are taxable, even if the individual will be
reimbursed by the organization.
4. This exemption applies only to purchases your organization makes. The sale or tease to others of tangible
personal property, sleeping accommodations, or other real property is taxable. Your organization must register,
and collect and remit sales and use tax on such taxable transactions. Note: Churches are exempt from this
requirement except when they are the lessor of real property (Rule 12A-1.070, F.A.C.).
5. It is a criminal offense to fraudulently present this certificate to evade the payment of sales tax. Under no
circumstances should this certificate be used for the personal benefit of any individual. Violators will be liable for
payment of the sales tax plus a penalty of 200% of the tax, and may be subject to conviction of a third-degree
felony, Any violation will require the revocation of this certificate.
6. If you have questions regarding your exemption certificate, please contact the Exemption Unit of Account
Management at 800-352-3671. From the available options, select "Registration of Taxes," then "Registration
Information," and finally "Exemption Certificates and Nonprofit Entities." The mailing address is PO Box 6480,
Tallahassee, FL 32314-6480.
Date:
FEB 23 Z2
OUTREACH MINISTRIES INCORPORATED
INTERNATIONAL
13245 ATLANTIC BLVD STE 4-233
JACKSONVILLE, FL 32225
Dear Applicant:
Employer Identification Number:
27-3868926
DLN:
17053200375001
Contact Person:
JACOB A MCDONALD
Contact Telephone Number:
(877) 829-5500
Accounting Period Ending:
December 31
Public Charity Status:
170(b) (1) (A) (vi)
Form 990 Required:
Yea
Effective Date of EXemption:
January 1, 2011
Contribution Deductibility:
Yes
Addendum Applies:
No
ID# 31649
We are pleased to inform you that upon review of your application for tax
exempt status we have determined that you are exempt from Federal income tax
under section 501(c)(3) of the Internal Revenue Code. Contributions to you are
deductible under section 170 of the Code. You are also qualified to receives
tax deductible bequests, devises, transfers or gifts under section 2055, 2106
or 2522 of the Code. Because this letter could help resolve any questions
regarding your exempt status, you should keep it in your permanent records.
Organizations exempt under section 501(c)(3) of the Code are further classified
as either public charities or private foundations. We determined that you are
a public charity under the Code section(s) listed in the heading of this
letter.
Please see enclosed Publication 4221 -PC, Compliance Guide far 501(c)(3) Public
Charities, for some helpful information about your responsibilities as an
exempt organization.
Enclosure: Publication 4221 -PC
Sincerely,
1
Lois G. Lerner
Director, Exempt Organizations
Letter 947 (DO/C
O.M.I. International Board of Directors
CHAIRPERSON, BYNUM, YOLANDA
13245 ATLANTIC BLVD SUITE 4-233
JACKSONVILLE, FL 32225
EXEC. SECRETARY, HAWKINS, MICHELLE
13245 ATLANTIC BLVD SUITE 4-233
JACKSONVILLE, FL 32225
VP, DODD, ANTHONY
13245 ATLANTIC BLVD SUITE 4-233
JACKSONVILLE, FL 32225
CHAIRMAN, DAVIS, SWANSON
13245 ATLANTIC BLVD SUITE 4-233
JACKSONVILLE, FL 32225
VP OPERATIONS, Acosta -Cruz, Policarpo
13245 ATLANTIC BLVD SUITE 4-233
JACKSONVILLE, FL 32225