Section 1 of 1 in this document

City of Sunny Isles Beach
18070 Collins Avenue
Sunny Isles Beach, FL 33160
305.792.1706
sibfl.gov

In-Kind Donation Request Application

Organization Name

Address

Address or Location

Phone Number

Website

Federal Tax Identification Number

Designated 501(c) Status

Yes

Contact Person's Name

Phone Number

Organization Details

Brief Description of Organization

Organization's Mission Statement

Types of services or programs provided

How many years has the organization been in operation?

What is the organization's total operating budget?

How many individuals does your organization service?

Donation Request Details

Description of in-kind donations requested:

How will the in-kind donation contribute the organization?

What specific services or programs will benefit the residents of the City of Sunny Isles Beach?

When will the requested in-kind donation be used?

How many City of Sunny Isles Beach residents are served by your organization?

Does any other organization, agency, governmental entity, or group provide you with funding or in-kind donations?

Yes

If so, please state the name(s) and the amount(s)/type of in-kind: Also, please provide a detailed budget breakdown with funding sources.

Have you requested funds or an in-kind donation from the City of Sunny Isles Beach previously?

Yes

If yes, please provide amount, purpose, and date of donation, or provide the reason for denial.

Is this funding request to assist in meeting a required match to fund existing programs or services, or for new services?

Yes

If so, please explain in detail:

Additional Documentation

Please attach the following documents to complete your application:

List of all Owners/Directors/Principals
Sunny Isles Beach Lobbyist Registration form
Organization's most recent tax returns

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I hereby certify that I have read, understand, and agree to the charitable donation request guidelines contained herein, and that the information provided is true and correct. I understand that the approval and denial of all charitable in-kind donation requests is in the sole discretion of the City of Sunny Isles Beach City Commission and that if the request is approved, a charitable donation agreement is required prior to the distribution of any funds.

I acknowledge that this application becomes a public record and may be subject to Florida's Sunshine Law. Florida has a very broad public records law. Most written communications to or from city officials regarding city business are public records available to the public and media upon request.

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I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.