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City of Atlantic Beach
Contribution Awards:
Cultural Arts and Recreation Programs
FY2019-2020
A pplica tion Guidelines Package
For ORGA NIZA TIONS
APPLICATION GUIDELINES FORFY2019-2020 CONTRIBUTION AWARDS
Funding Availability: The City Commission has allocated funding for FY2019-2020 to support
artistic, recreational, or cultural programs, events or projects which benefit the residents of
Atlantic Beach. Applications for contributions are invited from eligible non-profit, 501(c)(3)
community organizations, providing extra-curricular/extramural programs, arts, cultural and
recreation programs, activities or events that serve Atlantic Beach residents.
Only one (1) Contribution application may be submitted per eligible non-profit, 501(c) (3)
community service organization, with award request of $100 - $3,000 per applicant. Final
Contribution Award amount may be allocated as determined by the Cultural Arts and Recreation
Advisory Committee.
In the event that the amount awarded is less than the amount requested, applicants must
be prepared to submit a revised program budget and description reflecting changes in
scale if applicable.
Please note relevant code pertaining to contributions:
Sec. 2-2. Charitable contributions prohibited.
The City shall not contribute City funds to any charitable, non-profit, or other worthy cause. However, the City
may contribute City funds or other support to artistic, recreational, or cultural programs, events or projects which
benefit the residents of Atlantic Beach, as follows:
(1) Requests for contributions to such programs, events or projects shall be submitted to the Cultural Arts and
Recreational Advisory Committee.
(2) The Cultural Arts and Recreational Advisory Committee will make recommendations on any such requests to
the City Commission, who will then make the final decision on funding the request.
(3) Any request for contributions which are not artistic, recreational, or cultural in nature shall be submitted
directly to the City Commission for consideration.
(Ord. No. 95-91-50, § 1, 10-28-91; Ord, No. 05-02-37, § 1, 7-8-02)
Editor's note— Ord. No. 95-91-50,_§I, adopted Oct. 28, 1991, amended the Code by adding (b). For purposes of
classification, 5(b) has been codified as �� at the discretion of the editor.
REQUIRED APPLICATION DOCUMENTS
Documents Required for Submittal: All applicants must complete the attached application
form and provide the following documents:
Z Completpd Application Form
Er"'Summary of organization's current budget
13/ Program budget
Er-11Proof of current Non -Profit 501(c)(3) certification form issued by the State of Florida
&-'List of Current Organization's Board of Directors
9,"Most current IRS W-9 Form
Applications will not be processed for review if complete package is not received together
ELIGIBLE NON-PROFIT ORGANIZATIONS ONLY
Non-profit organizations which have officially filed as a non-profit with the State of Florida must
attach a copy of its current year 501(c) (3) non-profit certification form. For organizations filed
with the State, the Cultural Arts and Recreation Advisory Committee, at its discretion, may
consider their application.
APPLICATION DEADLINE: 4:30 p.m., August 23, 2019
Applications must be RECEIVED by deadline time and date 4.30 P.m. August 23, 2019. No
Exceptions.
Hand deliver applications to
Mail applications to:
Must be RECEIVED in
The Recreation Office by
August 23, 2019
NOT postmarked by this date
Adele Grage Community Center
716 Ocean Blvd, Atlantic Beach, FL 32233
City of Atlantic Beach
Recreation & Special Events
Contribution Application
716 Ocean Boulevard
Atlantic Beach, FL 32233
For more information contact: City of Atlantic Beach Recreation Office:
Email (preferred method of contact) tjohnson@coab.us
or call (904) 247-5828.
DISQUALIFICATION CRITERIA AT TIME OF SUBMITTAL
Any applications received after the deadline time and date are immediately disqualified from
funding consideration. No exceptions.
➢ APPLICATIONS RECEIVED AFTER DEADLINE DATE ARE NOT ACCEPTED.
➢ E-MAILED APPLICATIONS ARE NOT ACCEPTED.
QUALIFYING CRITERIA
Applications are limited to non-governmental, non-profit organizations serving the Atlantic
Beach community. Excluded entities include the following: municipal organizations, state or
local government organizations and private individuals. (NOTE: Duval county schools applying
for funding for extra -curricular or extramural activities/programs/services, after-school programs,
or authorized student activity organizations that serve Atlantic Beach residents should apply
using the SCHOOL application package). Organizations already receiving funds or financial
support from the City of Atlantic Beach FY 20192020 may not apply for additional funding.
PROPOSAL GUIDELINES
Applications will be Judged and selected for funding consideration by the Cultural Arts and
Recreation Advisory Committee on a number of criteria.
1. Serves Atlantic Beach residents. Proposal describes how many residents of Atlantic
Beach are expected to participate and how many hours participants will be engaged in
the program or event. The event or program is open to all residents of Atlantic Beach,
and is non-discriminatory and free from inherently religious activities.
2. Cultural, Arts and Recreation: Program, event or activities are cultural arts and
recreation in nature (or support access to participation in cultural, arts, recreation
programs or events).
3. Community need: The proposal addresses an existing need in the community (for
example there is currently a need to increase opportunities for cultural, arts and
recreation programs or activities for teens and young adults, and there is currently a
need for programs and events in Jordan Park and Donner Park areas of Atlantic Beach).
4. Evidence Based: The program or event is supported by evidence of successfully
achieving expected outcomes
5. Affordability: The event or program is free or made affordable to residents of Atlantic
Beach. Proposal describes planned steps to ensure that participants are not denied the
opportunity to participate due to their inability to pay the registration or other related fees.
6. Accessibility: The program or event is made accessible 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
7. Program Costs: Fair and justifiable program costs (detailed program/event budget
required).
8. Adequately resourced: The proposal includes evidence of supplemental funding, such
as leveraging matching funds, collaboration, volunteers or other resources.
9. Originality and creativity. Applications of projects or programs that are new and
unique to the community or which provide a new or unique twist on an existing program
are strongly encouraged.
3
10. Evaluation: There is in evaluation plan that measures participation/impact and will
provide useful/actionable data.
11. Timely: Completion of Special Event/Program Activity between: October 2019 and
September 30, 2020.
CONTRIBUTION AWARD EXPENDITURES
Contributions will be funded upon approval of the City Commission and announcement of
recipients. Expenses must be directly related to proposed program or event services, materials
or activities occurring within the award period.
Awardees will be required to maintain financial records to support claimed expenditures and
project accomplishments.
Funds for the proposed special event or program activity must not be used to replace or offset
funding sources normally available for any portion of the special event or program activity, nor
be used by the applicant to fund/supplement its own monetary giving.
Funds may not be used for capital expenses, lobbying or other excluded activities. Funding may
not be used for inherently religious activities.
FINAL REPORT AND RECEIPTS
The City Staff will review submitted copies of paid receipts/invoices and a written final report to
ensure that funds were spent in compliance with the approval application. Applicant will be
required to reimburse the City of Atlantic Beach for all inappropriately spent funds.
Final Report is due 30 days following completion of the program or event.
PRIOR FINANCIAL ASSISTANCE
Information provided on application will be used to review prior performance history. Significant
non-compliance issues will be taken into consideration and may affect future funding decisions
jointly made by the City Commission.
NOTE: Eligibility for FY2019-2020 Contribution Awards may be affected if an organization has
previously received a Contribution Award by the Atlantic Beach City Commission, or has not
fully disclosed that a Contribution Award was not fully expended, or did not complete required
financial or other reporting requirements for a previous Contribution Award. All eligibility criteria
is administered and determined by the Recreation Director, and Cultural Arts and Recreation
Advisory Committee. All decisions made on eligibility by the Atlantic Beach City Commission,
the Recreation Director and the Cultural Arts and Recreation Advisory Committee are deemed
final.
CONTRIBUTION AWARD MAXIMUM' AWARD AMOUNT
Contribution Awards: Most of the award amounts are expected to be between $100 and
$3,000
*NOTE: The City Commission and/or the Cultural Arts and Recreation Advisory Committee, at
its discretion, may modify the Contribution award to qualified recipients based on merit of
proposal, number of other qualified applications received and other criteria. The Contribution
award may not exceed the maximum amount of available financial resources for the FY2019-
2020 Annual Atlantic Beach Community Contribution Program as approved under the City's
Annual Operating Budget.
KEY TIMELINES FOR,FY2019-2020 PROGRAM PERIOD
July 15, 2019 Distribute Request for Proposals (RFP) and issue press
notification
(Notice of RFP will also be included in newsletter distributed
September 25, 2019 City Commission approval of total funding amount for FY2019-
2020 Contributions Program
August 23, 2019 Deadline for FY2019-2020 Contribution Awards proposals.
The Recreation Director will review each application as they are
received and forward eligible applications to the Cultural Arts and
Recreation Advisory Committee within 3 business days of receipt
August 27, 2019 Notify semi-finalists who will be required to present a brief
summary of their proposal/answer questions to the Cultural Arts
and Recreation Advisory Committee
September 3, 2019 MANDATORY presentations to the Cultural Arts and
Recreation Advisory Committee are required by all short-list semi-
finalists.
The Recreation Director will calculate final scores based on both
proposal content and presentations.
October 14, 2019 City Commission Approval: City Commission awards
Contributions and appropriates funds at Regular City Commission
Meeting
October 17, 2019 Applicants notified regarding application outcome
October 24, 2019 Contribution Awards Disbursed: All FY2019-2020 Contribution
awards released to award recipients
FINANCIAL AND OUTCOME REPORTING FOR AWARD RECIPIENTS FY2019-2020
LETTER NOTIFICATION: Upon completion of the program or
event, all FY2019-2020 award recipients will be notified to submit
their final reports and copies of receipts.
DEADLINE: All FY2019-2020 award recipients must submit
copies of paid receipts/invoices and a written report, including
number of Atlantic Beach citizens served and program or event
outcomes within 30 days of completion of the program or event.
If the paid receipts/invoices and written report is not received, the
award recipient will be required to immediately reimburse City of
Atlantic Beach Contribution funds.
General guidelines for reports
1. Report should clearly state how deliverables described in the proposal were met
2. Report should be clear regarding how funding was used to benefit residents of Atlantic Beach.
3. Describe what was accomplished in general and pertaining to AB specifically,
4. Description of the steps taken to reach out to AB residents to participate or attend the program
5. Report how many from AB attended/participated (number and percent of total participants is
preferred)
6. Include feedback received from participants, especially highlight any from AB.
7. Include evaluation results
8. Submit the paid receipts showing how the money from COAB was used
Note: All Contribution Award recipients' final reports will be submitted before the Recreation
Director for approval of expenditures. If determination is made that funds were expended
inappropriately, the Recreation Director will direct award recipients to reimburse the City of
Atlantic Beach.
APPLICATION FORM WITH SCORING AND REVIEW CRITERIA AND GUIDANCE
Funding amount requested: $ ' y 0 U Dates of event/program start-end---
Yes/No Conditions
A. Fair and justifiable program costs (Program/Event Budget required)0
B. Serves Atlantic Beach residents
C. Program/event pertains to cultural, arts, recreation No
D. Program/event activities completed by September 30, 2020 0
E. Program/event is non-discriminatory 0
F. Is the event free from inherently religious activities? 0
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)
Location(s) where program/event will take place,�� �-
❑ Total estimated number of participants `�_0 U
Number and percent of participants who are Atlantic Beach residents % (�.=
❑ Total number of hours each participant will be directly engaged in
program/event [ D '2
❑ Frequency an duration of program/event (e.g. 1 time event for 2 hours, or 1 x/month for
1 hour 0 0�S - IMAM'
❑ Is the event o en to all residents of Atlantic Beach w may want to participate? "I ` S
❑ Is the event to occur in Atlantic Beach or to serve primarily Atlantic Beach?[
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?
Does the program/event target a population group that is currently underserved?
(e.g. teens, children with special needs, low-income residents, etc.)
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 tqe goals and objectives artistic, recreational and/or cultural in nature
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?
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?
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?
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)?
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 pav fees oncosts?
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?
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?
Indemnification
Contribution Award applicants and recipients agree to indemnify and hold harmless the City
from any and all liability, defense costs, including other fees, loss 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.
Meraki Wellness, Inc.
Beaches WeIlFest - March 7, 2020 at Johansen Park
Funding amount requested: 3000
Board of Directors:
Tracy Marko - President / Director
Thomas Marko - Vice President / Director
Jena Pugh - Director
Elizabeth Brown - Director
Dates of event/program start -end: March 7. 2020
Budget:
Our non-profit was established to support the start and growth of the WeIlFest events. The
organization's budget below shows the cost of starting our non-profit along with some items
needed for the first event that we will be able to use for future events as well.
Organization Budget / Start- Jr) Cost - Meraki Wellness Inc.
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Our event buds -et below shows the sponsorships collected and the cost we incurred to run our
first event for the day (March 2, 2019). We anticipate the needs for our Beaches 2020 event to
be more costly as we hope to purchase a tent for our stage area in case of rain, increase our
advertising, add a for -charity run prior to the start of the event, and establish an on-line pre
registration for small -group education sessions.
Event Budget - Beaches WellFest 2019
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Meraki Wellness, Inc,
Beaches WeIlFest - March 7, 2020 at Johansen Park
Funding amount requested: 3000 Dates of event/program start -end: March 7, 2020
Yes/No Conditions:
A.
Fair and justifiable costs (Program/Event Budget required)
Yes
B.
Serves Atlantic Beach residents
Yes
C.
Program/event pertains to cultural, arts, recreation
Yes
D.
Program/event activities completed by September 30, 2020
Yes
E.
Program/event is non-discriminatory
Yes
F.
Is the event free from inherently religious activities?
Yes
Application Questions:
1. Participants
Location: Johansen Park
Estimated Participants: 500 people
AB Residents: 300 / 60% estimated
Participant Engagement: Full 6hours of the event
Frequency / Duration: 1 day event for 6hours - 10am to 4pm
Open to all AB residents: Yes
Event to occur in AB: Yes
2. Need
The goal of WeIlFest is to provide education to the beaches communities on the
importance of a healthy lifestyle and the various options in which to achieve success in
self and family wellness.
Currently the only events within the entire county that are listed as `health and wellness'
events focus primarily on the sales and promotion of products and services. Other health
festivals may include nutritional specific events, however currently there is no event like
what was held this past March and what we plan to provide to Atlantic Beach this coming
March 2020.
The goal of WeIlFest is to provide lifestyle information and screenings to help build
awareness of health risks and provide information on how an individual can make
behavioral changes to enhance his or her health, as well as the health of their families.
In our community the pieces we need to make this happen are right in front of us - and
this is how we put them all together. This is our chance to educate our community.
Although we continue to be flooded with information for business and services claiming
to be about health, obesity percentages continue to grow throughout Duval County and
the State of Florida. In Florida, approximately 29% of the population is categorized as
obese; and in Duval County the statistics show closer to 30% are obese. Information is
available on health and wellness, but it's overwhelming for most and our community is
suffering. Focus should be on what is needed, what is effective, and what is available to
support a lifestyle change that provides a connection between the resource and the
target audience. That is where WeIlFest will bridge the gap; allowing attendees to
discover health and connect local. With 93.7% of our City having access to exercise and
26% continuing to be inactive, there is a reason we're missing the connection; and it's
time to make changes.
3. Description of Program / Event
3.1 Goals and Objectives
WeIlFest was built on the foundation of providing education to communities and
empowering individuals to take control of the health of themselves and their families.
To do that we need to build a strong network of local businesses that want to work
together for the greater good of their community. This network will allow for
individuals to be supported on their health journeys.
Outside of our big picture goal of building networks and educating the community, we
set a goal from our last event in March to have every person who walked through our
festival leave with one piece of information they can immediately put into practice to
improve their health. After our event we sent out a survey through Facebook and
every single response confirmed that we had met our goal and that our beaches
community wanted a WeIlFest 2020. We hope that for this next event we can provide
attendees with a survey card to return at the end of the event (perhaps with a raffle
incentive) to allow us to collect more data on the needs, wants, and success of our
event.
Our main proposed goals from the beginning of the concept of WeIlFest are listed
below, and we believe our first event met these goals and as we grow we will
continue to focus on these and create the community impact needed to make a
change.
• Educating our community on impactful and immediate ways to improve health
and well-beir, Every attendee of the event will have their own personal
understanding and background into what health and wellness means to them.
The overall goal of the event and the selected sponsor representation is to
expose the attendees to every facet of a healthy lifestyle, including those that
may not have been a previous focus. With the event, we aim to have each
attendee walk away having learned at least one new thing they can change
immediately to improve their overall health. Specifically, something that doesn't
require a product or membership.
• Raising community awareness through local small businesses:. By focusing on
local businesses as sponsors for the event, attendees will have the opportunity to
be face-to-face with companies in our neighborhood. The availability of local
resources allows for reinforcement of the convenience and accessibility of health
and wellness providers.
• Partnering with health professionals and local resources to promote a healthy
and mindful lifestyle: Opportunities for sponsorship will include a range of
fitness, physical health, mental health, nutritional health, and environmental
sustainability organizations. By having representation from various health and
wellness resources, attendees will be exposed to the ecosystem of health that
includes a holistic approach to a healthier lifestyle.
3.2 Activities
We strive to make WeIlFest as hands-on as possible, meaning that not only do we
allow our sponsors to set up their space as they see fit, but we encourage
demonstrations and interactive activities throughout the day to enhance the
educational opportunities at the event. We also had a stage set up last year allowing
for presentations and classes throughout the day. Our 2019 event had a small
platform stage but we would like to upgrade to a full trailer stage as our event grows
to allow for more visual presentations from our gold -level sponsors. This past year,
for example, we had a yoga class, bootcamp class, guided mindful meditation,
cooking demonstrations, and interactive education on the physical therapy approach
to back pain.
We also plan to expand into smaller breakout sessions to allow for small -group
learning and education to encourage interaction with our sponsors and attendees.
We would like to invest in the capability to allow for on-line registration to allow
attendees to set up their own schedule for the day as well, which is something we
hope to use our grant funds for.
3.3 Advertised
We plan to advertise this upcoming event as we did for our 2019 event. We had
posters and flyers placed around the beaches, not just at the locations of our
sponsors but at other businesses as well. We ran a press release in the Beaches
Leader and Parents Magazine. We distributed over 2000 flyers to the local schools to
be sent home with students. We also had event listings online and/or print with Void,
Jax Moms Blog, and Natural Awakenings Magazine. Lastly, we had a booth set up at
the Donna Marathon Expo and distributed another 2000+ flyers throughout the
weekend as well as placed seven yard signs and three banners along the race
course. A website, facebook page, and instagram page was also established for the
event.
4. Facilitated Access
At our 2019 event we offered bike valet with The Bike Bus as well as transportation with
Beachside Buggies from City Hall to Johansen Park. We believe this gave alternatives to
accessing Johansen Park for those either unable to drive and those with difficulty
parking close to the event. The City Hall lot provided overflow parking and closer access
for those needing city bus transportation as it is closer to the Plaza Road bus stop. We
also believe that promoting the bike valet encouraged attendees to be active.
We did contact Fleet Landing about using their transportation for their residents that
wished to attend but were unable to confirm for last March, but we fully intend on
attempting to secure that contact for the 2020 event.
5. Evidence Based
Statistics on the increase of preventable health-related chronic illness with behavior risk
factors, as pulled from the Department of Health, show the need for this type of event.
For example, in Florida, approximately 29% of the population is categorized as obese;
and in Duval County the statistics show closer to 30% are obese. In 2016, only 21.7% of
adults aged 18 and older in the state of Florida met the physical activity guidelines for
both aerobic and muscle strengthening activities. Diabetes, the nation's seventh -leading
cause of death, has had a steady increase in death rates in Duval County since 2014.
Although we are aware that there are varying factors to chronic illness, consistent
lifestyle changes in regards to physical activity and nutrition are documented to have
positive effects and improved wellbeing.
These statistics only touch the physical and nutritional side of what WeIlFest is all about.
We also include mental health and environmental sustainability as two other focus areas
at our events and truly believe that research backs the need for education and
accessibility to resources for improving individuals, families, and communities.
The success of our Beaches 2019 event lead to the partnership with the City of
Jacksonville for the growth of WeIlFest into Riverside (scheduled for October 5th, 2019).
We also have the majority of our Beaches sponsors signed on to return to Atlantic Beach
in 2020.
6. Fee or Cost
There is no cost or fee to attend the program or participate in any of the activities
provided throughout the day by our sponsors. We also offer free participation to other
501 c3 companies wishing to participate.
7. Evaluating Success
As with our previous event we plan to send out surveys through social media following
the 2020 event (as well as our upcoming Riverside event). We also hope to do survey
cards at the event with potential raffle opportunities for cards submitted the day -of. We
also truly believe the success of the event is shown not just in the returning of our
sponsors/vendors, but also the increased number of sponsors and vendors and the
community attendance and participation. Our inaugural 2019 event had consistent rain
throughout the day and we still had 30+ attendees on their mats, in the rain, for our
10am kick-off yoga class.
We have mentioned our survey for attendees, but we did also send satisfaction and
feedback surveys to our sponsors to ensure that their specific goals and expectations for
the event were met and we plan to continue to do so, improving in any areas needed as
we grow.
Volunteers for our first event included our Board of Directors and family members and
friends, however as we grow we plan to extend invitations for community service hours
to area schools and community groups. We truly believe in building community
connections and networks and will keep that at the core of every event.
8. Resourcing
Our volunteer plans include reaching out to local schools and community groups to
provide community service hours. In terms of other funding and donations, we currently
have not looked into opportunities as our first event, with our sponsorships, allowed us to
cover the cost of the event. No payments were made to any of our members of the
Board of Directors. In-kind donations allowed us advertising in multiple outlets as well as
all of our graphics, and we plan to explore those options for future events as well.
Form 11' = 9
(Rev. October 2018)
Department of the Treasury
Internal Revenue Service
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1 Name (as
Request for Taxpayer
Identification Number and Certification
► Go to www.irs.gov/FormW9 for instructions and the latest information.
on your income tax return).
required on this line; do not leave this line blank.
MERAKI WELLNESS, INC
2 Business name/disregarded entity name, if different from above
Give Form to the
requester. Do not
send to the IRS.
3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the 4 Exemptions (codes apply only to
following seven boxes. I certain entities, not individuals; see
❑
❑✓ C Individual/sole proprietor or Corporation ❑ S Corporation El Partnership ❑ Trust/estate instructions on page 3):
single -member LLC Exempt payee code (if any)
❑ Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership) ►
Note: Check the appropriate box in the line above for the tax classification of the single -member owner. Do not check Exemption from FATCA reporting
LLC if the LLC is classified as a single -member LLC that is disregarded from the owner unless the owner of the LLC is code (if any)
another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single -member LLC that
is disregarded from the owner should check the appropriate box for the tax classification of its owner.
LJ Other (see instructions) op -
5
5 Address (number, street, and apt. or suite no.) See instructions.
1939 BRISTA DE MAR CIR
6 City, state, and ZIP code
ATLANTIC BEACH, FL 32233
7 List account number(s) here (optional)
Number
(Applies to accounts maintained outside the U.S.)
Requester's name and address (optional)
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid social security number
backup withholding. For ietor, or ds, this is generally your social security number (SSNr. However, for a
resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a
TIN, later. or
Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and I Employer identification number
Number To Give the Requester for guidelines on whose number to enter.
8 31 — 2 1 6 1 0 1 5 1 9 1 0 5
Gernirication
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding; and
3. 1 am a U.S. citizen or other U.S. person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because
you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid,
acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments
other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part II, later.
Sig�gnature of
Here U.S. person►
General Instructions
Section references are to the Internal Revenue Code unless otherwise
noted.
Future developments. For the latest information about developments
related to Form W-9 and its instructions, such as legislation enacted
after they were published, go to www.irs.gov/FormW9.
Purpose of Form
An individual or entity (Form W-9 requester) who is required to file an
information return with the IRS must obtain your correct taxpayer
identification number (TIN) which may be your social security number
(SSN), individual taxpayer identification number (ITIN), adoption
taxpayer identification number (ATIN), or employer identification number
(EIN), to report on an information return the amount paid to you, or other
amount reportable on an information return. Examples of information
returns include, but are not limited to, the following.
• Form 1099 -INT (interest earned or paid)
Date ► I `7 11 I I
• Form 1099 -DIV (dividends, including those from stocks or mutual
funds)
• Form 1099-MISC (various types of income, prizes, awards, or gross
proceeds)
• Form 1099-B (stock or mutual fund sales and certain other
transactions by brokers)
• Form 1099-S (proceeds from real estate transactions)
• Form 1099-K (merchant card and third party network transactions)
• Form 1098 (home mortgage interest), 1098-E (student loan interest),
1098-T (tuition)
• Form 1099-C (canceled debt)
• Form 1099-A (acquisition or abandonment of secured property)
Use Form W-9 only if you are a U.S. person (including a resident
alien), to provide your correct TIN.
If you do not return Form W-9 to the requester with a TIN, you might
be subject to backup withholding. See What is backup withholding,
later.
Cat. No. 10231X Form W-9 (Rev. 10-2018)
0000019 03(09/14
r
FLORIDA
85-8017720747C-8
Certificate Number
This certifies that
Consumer's Certificate of Exemption
Issued Pursuant to Chapter 212, Florida Statutes
MERAKI WELLNESS INC
1939 BRISTA DE MAR CIR
ATLANTIC BEACH FL 32233-4525
03/07/2019 1
03/31/2024
Effective Date Expiration Date
DR -14
R. 01/18
501(C)(3) ORGANIZATION
Exemption Category
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.
HORIDA
2
Important Information for Exempt Organizations
DR -14
R. 01/18
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.).
Your Consumer's Certificate of Exemption is to be used solely by your organization for your organization's
customary nonprofit activities.
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 lease 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 about your exemption certificate, please call Taxpayer Services at 850-488-6800. The
mailing address is PO Box 6480, Tallahassee, FL 32314-6480.