FY 2009-2010 Community Grants Program Application
Program Administrator: Dana Pezoldt
111 NW 1st Street, Suite 625Miami, FL33128
Phone: (305) 375-2161 Fax: (305) 375-3068 / FY 2009-2010 Community Grants Program
Quarter/Category
(1) Please check one: / First Quarter (10/01/09-12/31/09) / Third Quarter (04/01/10-06/30/10)
Second Quarter (01/01/10-03/31/10) / Fourth Quarter (07/01/10-09/30/10)
Organization Information / Dun & Bradstreet DUNS #
(2) OrganizationName(exactly as it appears on Articles of Incorporation):
(For More info:
Organization Address:
City: / State:FL / Zip: / Website:
(3) Applicant Institution Type: Cultural Non-Cultural / (5) Year of Incorporation:
(4) FEI#: - / (6) State of Incorporation: FL
(7) Required Pre-application Consultation: / Date: / Time:
(8) Name: / Mr. / Mrs. / Ms. / Miss / Dr.
Title: / Phone (day): () - ext.
Email: / Fax: () - / Phone (other): () - ext.
Project Information
(9) Project Title:
(10) Actual Dates of Activities:
(11) Grant Start Date (month/day/year): / (12) Grant End Date (month/day/year):
(13) Municipality in which project will take place(use codes): / Primary: # / Secondary: #
01 Miami
02 Miami Beach
03 Coral Gables
04 Hialeah
05 Miami Springs
06 North Miami
07 North Miami Beach
08 Opa-Locka
09 South Miami / 10 Homestead
11 MiamiShores
12 BalHarbour
13 Bay Harbor Island
14 Surfside15 West Miami
16 Florida City
17 Biscayne Park
18 El Portal
/ 19 Golden Beach20 Pinecrest
21 Indian Creek Village
22 Medley
23 North Bay Village
24 Key Biscayne
25 Sweetwater
26 VirginiaGardens
27 HialeahGardens / 28 Aventura
29 Islandia
30 Sunny Isles Beach
31 MiamiLakes
32 Palmetto Bay
33 MiamiGardens
34 Doral
35 Cutler Bay
99 Unincorporated
(14) Miami-Dade Commission District: # / Florida State Senate District: #
Florida State House District: # / U.S. Congress District: #
(Please call the Miami-DadeCounty Elections Board at (305) 375-4600 for assistance with district information.
(15) Primary Audience: / White, Not Hispanic / Hispanic / Caribbean / General(no specific emphasis)
(check only one) / Black, Not Hispanic / Asian / Other(specify):
(16) Primary Population: / Children / At-Risk Youth/Adults / Persons w/ Disabilities
(check only one) / Senior Citizens / Minorities / General(no specific emphasis)
(17a) Numbers of children to be served by project (Attending, Participating and/or Performing COMBINED):
# of Infants/Preschool (Ages 0-5): / # of Youth (Ages 13-18):
# of Children (Ages 6-12): / Total # - All Ages (Ages 0-18):
(17b) Total Participation:
(All Adults PLUSAll Children) / Audience/Attending: / Performing/Instructing:
Project Synopsis
(18) Describe the project in two or three short sentences beginning “Funds are requested to support . . . ”:
Budget Summary
Prior Fiscal Year 2008-2009 / Current Fiscal Year 2009-2010
Amount Requested/Awarded: / (19) / / / (22)
(requested/awarded) / (request from pg. 6, #34)
Total Project Budget: / (20) / (23)
(total from final report) / (total from pg. 6 , #37)
Total Organizational Budget: / (21) / (24)
(total from pg. 8) / (total from pg. 8)
funding history
(25) List all Miami-Dade Department of Cultural Affairs grants to your organization over the past three years.
Fiscal Year / Grant Program Name / Project Name / Request/Award
(26) List funding for this project, both secure and pending, from all other Miami-DadeCounty departments.
Month/Year / County Department / Amount Requested / Amount Received
project narrative
(27) Describe your proposed project in a clear and concise narrative. Provide as many details as possible while specifically answering the following questions. WHAT is the proposed project? Exactly WHEN and WHERE will the event(s) take place (provide an event schedule)? WHO are your target audience, principal participants as well as artists involved? Justify howthis program has both cultural and community components and why this project should receive County funding?
USE THIS SPACE ONLY
project details
(28) Describe your current marketing plan. (Attach your detailed marketing plan, if available.)
(29) Describe your method of evaluating the project. (Attach a sample survey tool, if available.)
(30) Does this project have tourist appeal? If so, describe.
(31) State your organization’s mission.
(32) How does this project enhance your organization’s mission?
organizational structure
(33) The Department of Cultural Affairs and the Cultural Affairs Council are committed to supporting high-quality cultural and community activities that reflect and are directed to the diversity of Miami-DadeCounty. Please provide full paragraph answers to the following four questions regarding your organization’s efforts to develop and/or implement cultural diversity at all levels. Please use format.
a)BOARD/VOLUNTEERS: Describe your organization’s efforts to develop and/or implement cultural diversity within your board and volunteers.
b)STAFF: Describe your organization’s efforts to develop and/or implement cultural diversity within your staff.
c)PROGRAMMING: Describe your organization’s efforts to develop and/or implement cultural diversity through the involvement of artists and/or collaborations with community organizations.
d)MARKETING: Describe your organization’s efforts to develop and/or implement cultural diversity by developing marketing and outreach strategies to attract diverse audiences to your programs.
USE THIS SPACE ONLY
PROJECT EXPENSE BUDGET
List all project expenses. Round amounts to the nearest dollar (do not show cents). Provide an additional sheet with an itemized budget for any items in the “Other Costs” category above $5,000. NOTE: Total project expenses and revenues must equal.
Total Cash
Expenses / = / Grant
Dollars
Allocated / + / Cash
Match / *In-kind
contributions
Personnel
Administrative: Number of Employees:
Artistic: Number of Artists:
Technical: Number of Employees:
Outside Artistic Fees: Number of Artists:
Outside Other Fees: Number of Employees:
Marketing/Publicity
Printing
Postage
In CountyTravel
Out of CountyTravel
Equipment Rental
Equipment Purchase
Space Rental
Insurance
Utilities
Supplies/Materials
Other Costs (itemize below):
(34) GRANT AMOUNT REQUESTED
(Must equal #38 on Page 7)
(35) TOTAL CASH EXPENSES
(Must equal #39 on Page 7) / = / +
(36) TOTAL *IN-KIND CONTRIBUTIONS
(Must equal #40 on Page 7)
(37)TOTAL PROJECT EXPENSES
(CASH + IN-KIND) (Must equal #41 on Page 7) / * $ / Sum of #35 Cash & #36 In-kind
*In-kind contributions are the documented fair market value of non-cash contributions provided to the grantee by third parties which consist of real property or the value of goods and services.
PROJECT REVENUE BUDGET
List all project RELATED revenues. Round amounts to the nearest dollar (do not show cents). Provide an additional sheet with an itemized budget for any items in the “Other Revenues” category above $5,000. NOTE: Total project expenses and revenues must equal.
Cash Income / In-kind Value / In-kind Source
Admissions
Contracted Services
Tuitions
Corporate Support
Foundation Support
Private/Individual Support
Government Grants – (identify Source)
Federal
State
Local
Applicant Cash on Hand
Other Revenues (itemize below):
(38) GRANT AMOUNT REQUESTED
(Must equal #34 on Page 6)
(39) TOTAL CASH REVENUES
(Must equal #35 on Page 6)
(40)TOTAL IN-KIND CONTRIBUTIONS
(Must equal #36 on Page 6)
(41) TOTAL PROJECT REVENUES
(Must equal #37 on Page 6) / $ / Sum of #39 Cash and #40 In-Kind
ORGANIZATIONAL BUDGET
Fiscal Year (month/day): / to
Current / Completed
Expenses / FY / - / FY / -
Personnel – Administrative
Personnel – Artistic
Personnel – Technical
Outside Artistic Fees/Services
Outside Other Fees/Services
Marketing/Publicity
Printing
Postage
In CountyTravel
Out of CountyTravel
Equipment Rental
Equipment Purchase
Space Rental
Insurance
Utilities
Supplies/Materials
Remaining Operating Expenses
Total Cash Expenses
In-kind Contributions (Attach Itemized List)
TOTAL EXPENSES
Revenues
Admissions
Contracted Services
Tuitions
Corporate Support
Foundation Support
Private/Individual Support
Government Grants - Federal
Government Grants - State
Government Grants - Local
Applicant Cash on Hand
Other Revenues
Total Cash Income
In-kind Contributions (Attach Itemized List)
TOTAL INCOME
Certification/Signature
I certify that all information contained in this application and attachments is true and accurate. No County employee shall be signatory on behalf of an organization requesting funds from the Department of Cultural Affairs.
AUTHORIZING SIGNATURE / DATE
TYPED/PRINTED NAME / TITLE
GRANT COMPLIANCE REQUIREMENTS
A Final Report is required within forty-five (45) days of the project completion date. Final Report forms will be provided to grantees with their executed grant agreement and are available on the Department website at
Funded activities must take place within the County's fiscal year for which they are approved (October 1 - September 30). All funding recommendations are contingent upon approval of the Department of Cultural Affairs’ FY2009-2010 budget by the Miami-Dade County Mayor and Board of County Commissioners, and are subject to the availability of funds. FY2009-2010 grant awards will be available for release during the County’s fiscal year, October 1, 2009 - September 30, 2010. Grant awards will not be released until all final reports for previous years’ funding from all Department programs are received.
Grant funds not encumbered (contracted for) by the end of the County’s fiscal year in which they were awarded, or for which a project extension has not been approved, shall revert to the Department of Cultural Affairs on September 30, 2010.
All funded activities must provide equal access and equal opportunity in employment and services, and may not discriminate on the basis of race, color, religion, ancestry, national origin, sex, pregnancy, age, disability, marital status, familial status, sexual orientation or physical ability, in accordance with Title VI and Title VII of the Civil Rights Act of 1964, the Age Discrimination Act of 1975, Title IX of the Education Amendments of 1972 as amended (42 U.S.C. 2000d et seq.), the Americans with Disabilities Act (ADA) of 1990, Section 504 of the Rehabilitation Act of 1973, and Miami-Dade County ordinances No. 97-170, § 1, 2-25-97 and No. 98-17, § 1, 12-1-98.
The Grantee must include the following credit line in all promotional and marketing materials related to this grant including web sites, news and press releases, public service announcements, broadcast media, event programs, and publications: “With the support of the Miami-Dade County Department of Cultural Affairs and the Cultural Affairs Council, the Miami-Dade County Mayor and Board of County Commissioners.”
The grantee must also use the Department’s logo in marketing and publicity materials whenever possible. Please call the Department to request an electronic logo file or download it from our website (
Grantees are required to recognize and acknowledge Miami-DadeCounty’s grant support in a manner commensurate with all contributors and sponsors of its activities at comparable dollar levels.
Miami-Dade County provides equal access and equal opportunity in employment and services and does not discriminate on the basis of race, color, religion, ancestry, national origin, sex, pregnancy, age, disability, marital status, familial status, sexual orientation or physical ability, in accordance with Title VI and Title VII of the Civil Rights Act of 1964, the Age Discrimination Act of 1975, Title IX of the Education Amendments of 1972 as amended (42 U.S.C. 2000d et seq.), the Americans with Disabilities Act (ADA) of 1990, Section 504 of the Rehabilitation Act of 1973, and Miami-Dade County ordinances No. 97-170, § 1, 2-25-97 and No. 98-17, § 1, 12-1-98.
The Miami-Dade County Department of Cultural Affairs and the Cultural Affairs Council develop cultural excellence, diversity and participation throughout Miami-Dade County by strategically creating and promoting opportunities for artists and cultural organizations, and our residents and visitors who are their audiences. Through staff, board and programmatic resources, the Department and the Council promote, coordinate and support Miami-DadeCounty’s more than 1,000 not-for-profit cultural organizations as well as thousands of resident artists through grants, technical assistance, public information and interactive community planning. The Department receives funding through the Miami-Dade County Mayor and Board of County Commissioners, the National Endowment for the Arts, the State of Florida through the Florida Department of State, Division of Cultural Affairs and the Florida Arts Council, The Children’s Trust and the John S. and James L. Knight Foundation. Other support and services are provided by Ticketmaster for the Culture Shock Miami program, the Miami-Dade County Communications Department, the Greater Miami Convention and Visitors Bureau, the South Florida Cultural Consortium and the Tourist Development Council.
Please include this form ONLY if the contact person listed on the cover page of the application is not the same person who consulted for and/or prepared the application. Complete this form with information on how to contact the grants writer, fold it in half, and affix it with a staple to the front of the ORIGINAL APPLICATION, ONLY.
GRANTWRITER/CONTACT InformationContact Name: / Mr. / Mrs. / Ms. / Miss / Dr.
Title: / Phone (day): () -
ext.
Email: / Fax: () - / Phone (other): () -
ext.
Address:
City: / State:FL / Zip:
Note to Administrator:
FY2009-2010 Community Grants Program Application Page 1of 10 CG-10