Item E3M
C ounty of f Monroe
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BOARD OF COUNTY COMMISSIONERS
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Mayor David Rice, District 4
Th e Florida Keys
Mayor Pro Tem Sylvia J. Murphy, District 5
Danny L. Kolhage, District 1
George Neugent, District 2
Heather Carruthers, District 3
County Commission Meeting
January 17, 2018
Agenda Item Number: E.3
Agenda Item Summary #3764
BULK ITEM: Yes DEPARTMENT: Tourist Development Council
TIME APPROXIMATE: STAFF CONTACT: Ammie Machan (305) 296 -1552
N/A
AGENDA ITEM WORDING: Approval of FY 2019 Fishing Event Funding Application
ITEM BACKGROUND: Fishing Umbrella approved same at their meeting of November 1, 2017
TDC approved same at their meeting of December 19, 2017
PREVIOUS RELEVANT BOCC ACTION:
CONTRACT /AGREEMENT CHANGES:
N/A
STAFF RECOMMENDATION: Approval
DOCUMENTATION:
FY 2019 Fishing Event Application
FINANCIAL IMPACT:
Effective Date:
Expiration Date:
Total Dollar Value of Contract:
Total Cost to County:
Current Year Portion:
Budgeted:
Source of Funds:
CPI:
Indirect Costs:
Estimated Ongoing Costs Not Included in above dollar amounts:
Revenue Producing:
Grant:
County Match:
Insurance Required:
Additional Details:
If yes, amount:
REVIEWED BY:
Maxine Pacini
Christine Limbert
Cynthia Hall
Kathy Peters
Board of County Commissioners
Completed
12/28/2017 10:17 AM
Skipped
12/28/2017 10:53 AM
Completed
12/28/2017 2:14 PM
Completed
12/28/2017 2:27 PM
Pending
01/17/2018 9:00 AM
DATE: January 2, 2018
To: Monroe County Board of County Commissioners
RE: Approval of FY 2019 Fishing Umbrella Event Application
The Fishing Umbrella at their meeting of November 1, 2017 moved approval the following
revisions to the FY 2019 Fishing Event Funding Application:
• Added "How Many Room Nights" and calculation table (pg. 4)
• Added requirement for event to place at least 30% of total funds allocated in the Media
Placement and Production Cost line item in their budget to be utilized for out of county
advertising (pg. 13)
The TDC at their meeting of December 19, 2017 approved same.
Approval is requested of the attached FY 2019 Fishing Umbrella Event Application.
FISHING UMBRELLA EVENT FUNDING
APPLICATION
THIS APPLICATION IS FOR A FISHING RELATED EVENT BY ROD, REEL,
LINE & HOOK TO TAKE PLACE BETWEEN THE FOLLOWING DATES:
OCTOBER 1, 2018 AND SEPTEMBER 30, 2019
All respondents must use the current application. Use of any other application will
result in your application being rejected.
APPLICATION DEADLINE: APRIL 2, 2018
All applications should be received no later than 4:00 p.m.
All applications submitted should be addressed to:
FLORIDA KEYS FISHING TOURNAMENTS, INC.
ATTENTION CHRISTINA WEINHOFER
FISHING UMBRELLA EVENT FUNDING APPLICATION
USPS: P.O. Box 420358
Summerland Key, Fl. 33042
OR
FedEx /UPS: 24386 Overseas Hwy.
Summerland Key, Fl. 33042
Applicants must submit:
A. One (1) disc OR (1) USB flash drive with complete copy of application as a .pdf (all
attachments must be merged into one document: Please DO NOT include the
instruction pages) and........
B. One (1) signed and marked as ORIGINAL paper copy PLUS.......
C. Two (2) paper copies
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All inquiries and correspondence should be made to Christina Weinhofer
by telephone: (305) 872 -2233. All email correspondence should be
addressed to fishumbrellai,5aol.com
Applications may be submitted by the following entities:
1. Fishing Tournament Event applicants under their own name can apply, but must be
aware that the contract will be entered into in their name, and they will become the
event contractor within the final funding contract. All invoices and documentation must
show their name (event contractor) as written within the final funding contract.
2. A public entity governed by a county or municipality; or a profit or not - for - profit; or a
private business in good standing with the Division of Florida Corporations. Prior to
completing an Fishing Tournament event application, please go to www.sunbiz.org to
ensure that your organization is registered to do business in the State of Florida. Only
entities (applicants) that are duly registered will be accepted. Contract will be entered
into in the name exactly as it appears on sunbiz.org, and that official name will become
the event contractor within the written final funding contract. All invoices and
documentation must be in the event contractor name as written within the contract.
It is important that every tournament fill out completely the enclosed funding agreement
application, attach all the proper information that is requested, and return to Florida Keys
Fishing Tournaments, Inc. Refer to the applicant check list at the back of this application.
Applicants are encouraged to return the completed applications prior to the deadline noted on
cover sheet. This provides an opportunity for the Fishing Umbrella to spot any errors that need
to be corrected prior to the deadline date.
It is the responsibility of the event applicant and the event contractors (contracted entity) to
keep apprised of all Monroe County Tourist Development Council's policies and procedures
pertaining to event funding.
When event applications are received, they will be distributed to the Fishing Umbrella for
review and their recommendations will be placed before the TDC for approval. Upon approval
of the TDC a contract will be submitted to the Monroe County Board of County Commissioners
(BOCC) for final approval.
Only events held within Monroe County shall be considered for event funding. Only events that
use rod, reel, line and hook are eliaible to aooly for fishina tournament event fundina.
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Fishing Umbrella Event Funding Application FY 2019
08 Oct, 18
Columbus Day
31 Oct, 18
Halloween
11 Nov, 18
22 Nov, 18
Thanksgiving Da v
25 Dec, 18'
Christmas
01 Jan, 19
21 Jan, 19
M L King Da x
14 Feb, 19'
Valentine's Day
18 Feb, 19
19 Apr, 19
Good Friday
21 Apr, 19'
Easter Sunday
12 May, 1S
27 May, 19
Memorial Da v
16 Jun, 19',
Father's Day
04 Jul, 19
02 Sep, 19', Labor Day
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Fishing Umbrella Event Funding Application FY 2019
EVENTS MUST TAKE PLACE BETWEEN
OCTOBER 1, 2018 AND SEPTEMBER 30, 2019
NAME OF EVENT CONTRACTOR:
(Event Applicant or as it appears on www.sunbiz.ora )
OFFICIAL TITLE OF TOURNAMENT:
DATE(S) OF TOURNAMENT:
(For dates of event you are applying for funding for: refer to calendar on page 2)
AMOUNT OF FUNDS REQUESTED? $
This application is to request funding from the following District(s):
❑ District I: Key West - (shall encompass the city limits of Key West)
❑ District II: Lower Keys - (city limits of Key West to West end of Seven Mile Bridge)
❑ District III: Marathon — (west end of Seven Mile Bridge to Long Key Bridge)
❑ District IV: Islamorada - (between Long Key Bridge and Mile Marker 90.939)
❑ District V: Key Largo - (from Mile Marker 90.940 to the Dade /Monroe County line and any
portions of mainland Monroe County)
DESIGNATED TOURNAMENT CONTACT PERSON
(Please note that the TDC Administrative Office conducts most of its correspondence,
including contract and reimbursement material by email, so the person listed below should be
able to accept responsibility for receipt of this information).
Name & Title:
Telephone /mobile no:
E -mail:
Address:
TYPE OF APPLICANT: ❑ Non - Profit ❑ For Profit
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Fishing Umbrella Event Funding Application FY 2019
Date(s) of Last Tournament:
Location of Last Tournament:
❑ District I ❑ District II ❑ District III ❑ District IV ❑ District V
Age of Tournament:
Amount of Entry Fees Collected in the last Tournament: $
Number of Fishing Days:
Total Number of Registered Anglers:
Use the table below to calculate number of room nights,:
a. How many out of County visitors /Anglers to this a.
distrirt?
What Was Your Target Specie(s)?
Total Number of Targeted Specie(s) Hooked?
Total Number of Targeted Specie(s) Caught?
Tackle Requirements:
Daily Fishing Hours:
How Many Vessels Participated?
------------------------------------------------------------------------------------------------------
FOR FKFT USE ONLY
NUMBER OF VESSELS = X TOTAL HOURS OF EFFORT =
HOURS OF EFFORT
NUMBER OF TARGETED SPECIE(S) HOOKED AND HOURS OF EFFORT = HPUE
NUMBER OF TARGETED SPECIE(S) CAUGHT AND HOURS OF EFFORT = CPUE
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Fishing Umbrella Event Funding Application FY 2019
TOURNAMENTS DIRECTOR'S REPORT FOR LAST EVENT
WINNERS BY CATEGORY
DATE OF TOURNAMENT RESULTS
CHAMPION:
NAME:
CITY /STATE:
CATCH:
CAPT /BOAT:
1ST PLACE:
NAME:
CITY /STATE:
CATCH:
CAPT /BOAT:
2ND PLACE:
NAME:
CITY /STATE:
CATCH:
CAPT /BOAT:
3RD PLACE:
IU_1�1�
CITY /STATE:
CATCH:
CAPT /BOAT:
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Fishing Umbrella Event Funding Application FY 2019
Check the box below for the format of your proposed tournament:
❑ Release ❑ Modified Release ❑ Weight ❑ Fish
❑ Other, please specify:
Check the box below that shows your target species:
❑
Blue Marlin
❑
White Marlin
❑
Sailfish
❑
Spearfish❑ Sword Fish
❑
Kingfish
❑
Dolphin
❑
Wahoo
❑
Tuna ❑ Barracuda
❑
Cobia
❑
Grouper
❑
Snapper
❑
Jacks and Sharks
❑
Cero
❑
Mackerel
❑
Tarpon
❑
Permit ❑ Bonefish
❑
Redfish
❑
Snook
❑
Sea Trout
❑
Other, please specify:
Tournament entry fees are for: ❑ Angler
N
Below, Enter your Entry Fees:
Adult fee: $
Child fee: $
Social fee: $
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Fishing Umbrella Event Funding Application FY 2019
In the space below describe the soundness of your tournament and how it will benefit and
no tourism witnin the district you are applying Tor tunainq.
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Fishing Umbrella Event Funding Application FY 2019
In the space below, tell us about your Tournament Rules:
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Fishing Umbrella Event Funding Application FY 2019
In the space below, tell us about your Tournament Scoring System:
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Fishing Umbrella Event Funding Application FY 2019
Media Placement & Production Costs Newspapers and magazines (inserts will also be
considered); radio; and TV. The TDC will pay for the following digital advertising on websites,
website links, pre roll video, banners, mobile and email blasts. Digital advertising links may go
to the event website. The TDC Logo must be placed on all print, TV, websites, pre roll video,
banners and email blasts. Radio advertising does not require the logo but all radio
announcements must say "Brought to you by the Monroe County Tourist Development
Council ". No payment will be made for development or operations (hosting) of websites.
Promotional Signs Posters and banners (hanging and displayed outdoors).
Promotional Items T- shirts and hats* (Fishing Tournaments only).
*Sales /Resale of TDC funded items: Items funded by the BOCC /TDC, including creative and
resulting work product, in accordance with Florida Public Records Law, are owned by the
BOCC /TDC and as such may not be sold.
Direct Mail Promotions Brochures /postcards and pamphlets including postage /shipping .
This is a direct mail promotional brochure /postcard /pamphlet utilized for pre -event advertising.
Programs TDC will pay up to fifty percent (50 %) for the cost of production or printing of an
event program showing scheduled activities and information on the event, as outlined in
contract budget.
Public Relations (PR): Print and electronic public relations materials for distribution to media,
such as, but not limited to, press releases, public service announcements, photography and
videography as approved by the public relations agency of record. Only permissible PR
material produced by the TDC agency of record and /or a professional public relations agency
shall be acceptable.
In -House Production: In -house production of any permissible expenditures will not be
considered for reimbursement.
Trophies: Framed art work, framed photography, engraved crystal and glass, plaques,
trophies, sculptures (fiberglass, metal, glass & wood) and framed certificates shall constitute a
trophy. All such trophies must include the appropriate information as outlined in the policies
(tournament name, date (year), and location). For trophy reimbursement, Tournament
Directors must present the original invoice of the trophies, a notarized list of winners of the
event, and a notarized list of the plates and /or glass etching from the engraving company.
Amendments to Contract Budgets No amendments to the line item budget will be permitted
after the contract has been reviewed and approved.
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Fishing Umbrella Event Funding Application FY 2019
Color ads four (4) color processing printing 06/12/91
Black & white ads shall include the Florida Keys and Key West logo in high resolution
Use on all printed material as listed under the Acceptable Event Marketing Expenses list
TV: logo must appear at the conclusion of commercial
Hats and t- shirts: must carry the "The Florida Keys & Key West" logo
Radio Advertising No logo is required. All radio announcements must say "Brought to you
by the Monroe County Tourist Development Council"
Trophies Logos are not required on trophies.
In- County Logo
The logo below indicating the "Monroe County Tourist Development Council" designation is to
be utilized on in- county print newspaper and magazine ads, brochures, postcards, pamphlets,
programs, posters, banners (hanging and displayed outdoors), and digital advertising on
websites, website links, pre roll video, banners, mobile and email blasts. Radio commercials
should include "Brought to you by The Monroe County Tourist Development Council ". To seek
approval, clarification and /or logo in electronic format (eps or jpg file), contact Karen Piedra or
John Underwood with Tinsley Advertising at 305 - 856 -6060.
The
Floridd
& Ke est
Come as you are
MONBOE ( :OUNrY R)L[K ST DEVILOPME \7 COUNCIL
Out -of- County Logo
The logo below that does NOT include the "Monroe County Tourist Development Council"
designation is to be utilized out -of- county newspapers and magazines, brochures, postcards,
pamphlets, programs, posters, and digital advertising on websites, website links, pre roll video,
banners, mobile and email blasts. Radio commercials should include "Brought to you by The
Monroe County Tourist Development Council ". To seek approval, clarification and /or logo in
electronic format (eps or jpg file), contact Karen Piedra or John Underwood at Tinsley
Advertising at 305 - 856 -6060.
The
Floridd
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e5
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Fishing Umbrella Event Funding Application FY 2019
TOURNAMENT SCHEDULE OF EVENTS
FISCAL YEAR 2019
PRINT OFFICIAL TOURNAMENT NAME
DAY 1
AM
LINES IN WATER
PM
LINES OUT OF WATER
PM
EVENING EVENT
PM
WEIGH -IN OVER
PM
OTHER EVENT:
DAY 2
AM
LINES IN WATER
PM
LINES OUT WATER
PM
EVENING EVENT
PM
WEIGH -IN OVER
PM
OTHER EVENT:
DAY 3
AM
LINES IN WATER
PM
LINES OUT WATER
PM
EVENING EVENT
PM
WEIGH -IN OVER
PM
OTHER EVENT:
DAY 4
AM
LINES IN WATER
PM
LINES OUT WATER
PM
EVENING EVENT
PM
WEIGH -IN OVER
PM
OTHER EVENT:
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Fishing Umbrella Event Funding Application FY 2019
Below, fill in the line items as to where you will spend the dollars you have requested. This
budget may need revising depending on your final funding allocation. The budget shall be
approved by the TDC agencies of record prior to contract approval. Prior to completing your
line item budget — refer to Exhibit A of this application for allowable event marketing
expenditures under the individual line items.
FISHING UMBRELLA EVENT BUDGET - FISCAL YEAR 2019
THERE WILL BE NO AMENDMENTS TO THIS BUDGET {EXHIBIT D} AFTER BOCC APPROVAL OF
AGREEMENT
OFFICIAL TOURNAMENT NAME
*MEDIA PLACEMENT & PRODUCTION COST:
$
PROMOTIONAL SIGNS:
$
PROMOTIONAL ITEMS:
$
DIRECT MAIL PROMOTIONS:
$
PROGRAMS:
$
PUBLIC RELATIONS:
$
* *TROPHIES:
$
** *GENERAL NON - ALLOCATED:
$
TOTAL
$
* At least 30% of total funding allocation must be placed' in the Media Placement & Production
Cost' line item and be utilized for out of County advertising (FKFT ,11 /, /,7)
* *Tournaments may not place more than 30% of their total funding allocation in the Trophy line
item, except when special approval from FKFT, Inc. Board of Directors has been received.
(FKFT 3/5/97)
** *The General Non - Allocated line item should not exceed 15% of the total funding allocation,
and may only be utilized for acceptable event marketing expenses (see Exhibit A of
application).
Actual expenditures may deviate no more than 10% from the budgeted line items noted above.
SIGNATURE: DATE:
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Fishing Umbrella Event Funding Application FY 2019
Submit a detailed action plan including appropriate permit(s) if applicable, as to how
parking /security and road closures will be handled during your event. The plan should include
the following information:
1. Describe how your event plan will handle road closures. If applicable, enclose a copy of
the approval by the appropriate county /municipal entity.
?. Describe how your event plan will accommodate parking and transportation.
3. Describe how your event plan will handle security.
4. Event Sustainability.
Our visitors come to enjoy events, but in the process, a tremendous amount of waste is
generated, much of it recyclable. The single most effective tool in reducing waste at
special events is planning ahead. On the next page (page 15) complete a narrative on
how you plan to reduce waste during your event by doing the following:
a. Encourage recycling message within programs and brochures to recycle during
the event and also at home.
b. Encourage "Green" advertising (broadcast and digital).
C. Encourage vendors to use biodegradable and compostable products
(utensils; plates and cups; paper or canvas bags).
d. Encourage the use of clearly identified recycling containers.
e. Discourage use of single use plastic bags and other products.
Useful contact'.numbers'
Monroe County: (305) 289 -6037
city ... of. Marathon: (305) 289 -6037
City of Key West: (305) 809 -3902
Islamorada Village of Islands: (305) 853 -3433
Fishing Umbrella Event Funding Application FY 2019
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EVENT SUSTAINABILITY ACTION PLAN
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Fishing Umbrella Event Funding Application FY 2019
INCOME:
SPONSORS {CASH}
ENTRY FEES
T- SHIRTS & CAPS
(Excluding TDC Items)
BANQUET
OTHER
TOTAL
OTHER FUNDS:
FISHING UMBRELLA
TOTAL INCOME:
EXPENSES:
POSTAGE
T- SHIRTS & CAPS
DIRECTOR FEES
BROCHURES & PATCHES
KICKOFF /AWARD BANQUET
PRIZES AND /OR TROPHIES
KICK -OFF TOURNAMENT
DUES, LICENSES,
INSURANCE
MEDIA ADVERTISING
STATIONARY, OFFICE
SUPPLIES
PHOTO PROGRAM
BROCHURE, PRINTING
SIGNAGE
Oct. 1, 2016
Sept. 30, 2017
Actual
Oct. 1, 2017
Sept. 30, 2018
Projected
Oct. 1, 2018
Sept. 30, 2019
Projected
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Fishing Umbrella Event Funding Application FY 2019
DONATED SERVICES:
MEDIA ADVERTISING
Oct. 1, 2016
Oct. 1, 2017
Oct. 1, 2018
$
Sept. 30, 2017
Sept. 30, 2018
Sept. 30, 2019
$ $
Actual
Projected
Projected
OTHER
$
$
$
OTHER
$
$
$
TOTAL EXPENSES:
$
$
$
INCOME LESS EXPENSES:
$
$
$
DONATED SERVICES:
MEDIA ADVERTISING
$
$ $
OTHER
$
$ $
OTHER
$
$ $
TOTAL
$
$ $
NET PROFIT (LOSS)
$
$ $
RETAINED PROFIT (LOSS)
FROM PRIOR YEAR
$
$ $
RETAINED PROFIT AT END
OF EACH YEAR
$
$ $
I certify that the above financial information is correct to the best of my knowledge:
Applicants Signature
The above being well known to me, or having provided
acceptable identification deposes and states that the information is correct to the best of
his /her knowledge as of the
day of
20
Notary Public, State of , County of
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Fishing Umbrella Event Funding Application FY 2019
SEAL:
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Name of Tournament:
Name of Event Contractor (Person /organization who will be signing contract):
I HEREBY CERTIFY that I understand that any items purchased with Monroe County Tourist
Development Council and Board of County Commission funds cannot be sold.
Applicants Name Typed
Sworn to and subscribed before me this
Applicants Signature
day of , 20_
personally appeared , and
known to be the persons named in and who executed the
foregoing document.
My commission expires: Notary Public
State of
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Fishing Umbrella Event Funding Application FY 2019
I, , of the City according to
on my oath, and under penalty of perjury, depose and say that:
1) 1 am, the applicant making the application for the event.
2) The prices in this application have been arrived at independently without collusion,
consultation, communication or contract for the purpose of restricting competition, as to any
matter relating to such prices with any other applicant or with any competitor;
3) Unless otherwise required by law, the prices which have been quoted in this
application have not been knowingly disclosed by the applicant and will not knowingly be
disclosed by the applicant prior to application opening, directly or indirectly, to any other
applicant or to any competitor;
4) No attempt has been made or will be made by the applicant to induce any other
person, partnership or corporation to submit, or not to submit, a application for the purpose of
restricting competition; and
5) The statements contained in this affidavit are true and correct, and made with full'
knowledge that Monroe County' relies upon the truth' of the statements contained in this
affidavit in awarding contracts for said project,.
VERIFICATION
I HEREBY CERTIFY that I have read the forgoing application and that the facts stated herein
are true and correct to the best of my knowledge and belief.
Applicants Name Typed
Sworn to and subscribed before me this
Applicants Signature
day of , 20_
personally appeared , and
known to be the persons named in and who executed the
foregoing document.
My commission expires: Notary Public
State of
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Fishing Umbrella Event Funding Application FY 2019
We, the undersigned, do hereby petition the Florida Keys Fishing Tournaments, Inc., to
become a member Tournament under the guidelines set forth by the Monroe County Board of
County Commissioners and the Monroe County Tourist Development Council as set forth in
the corporation by laws.
As a member Tournament it is understood that we may apply for tournament funding under the
provisions outlined in the Florida Keys Fishing Tournaments, Inc., Funding Application.-
It is further understood that the Florida Keys Fishing Tournaments, Inc., is an umbrella
organization in contractual agreement with the Monroe County Board of County
Commissioners to function as primary agent for dispersal of allocated funds received from the
Monroe County Tourist Development Council for the promotion and advertising of fishing
tournaments in the Florida Keys (Monroe County).
By this petition it is agreed that the undersigned will cooperate with the Florida Keys Fishing
Tournaments, Inc., its corporate sponsors (if applicable), and officers to increase the quality of
fishing tournaments in the Florida Keys.
Enter Complete Name of Person or Organization (Event Contractor):
(If this is a registered business name, it must be exactly as it appears on www.sunbiz.orq )
Event Contractor Address:
If this is a registered business on www.sunbiz.orq then fill in the box below:
Officers; (print name) Position; (print position)
Print off this page, sign below, and include as part of application
(insert signed page into pdf for electronic version)
Applicant's Signature and Date
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Fishing Umbrella Event Funding Application FY 2019
nn Print off this page. complete, and include as part of application
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7 LI::I arannit nulTll)CIi.^>] hctc ?optioned]
JUM Taxpayer Identification Number (TIN)
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 individuals, this is generally your social security number (88N). Hove ever, for a
resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other - -
entities, ii is your employer identification number (EIN). If you do not have a number, see How to get a
TIN on page 3. or
Note. If the account is in more than one name, see the instructions for line 1 and the chart an page 4 for Employer ldentificati on n umber
guidelines on whose number to enter.
Certification
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number for I am ;waiting for a number to he issued to m% and
2. 1 am not subject to backup'ajithholdillg because. fa) I am exempt from backup , Jthholding. or (b) I have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup vii thholding 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 beIov!) ; 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 retiremerd arrangemerd !IRA!. and
generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct T1N- See the
instructions on page 3.
Sign Signature of
Here U.S. person■ Date■
General Instructions
Seclian refar,rnr.(as pre ire lha InternNl ]le�•enue Cor.le unless olher•::isr noted.
Futuna dove Eopments- Il tkam :fion ghoul drunk {mv :ntr: vIMCIRWI F 01111 YJ 11 (MWh
am 10JISIehon (:na( :tad after ::n rrlr :nse 11) 1F np l: ^.n�.;: x.�n•!
Purpose of Form
An III( II V I(Ill:f l or e. rMty- (I ()r 111 W -� Ie Cline` :fen]': -'111) 1': r(.ILllred to file an iI1hN m nil 111 r1
rOMh 'VAth the IRS molt +l obtain Volt CcIrr0,t taxpc1y -;r 11:1alhllaatinn rarmbi:r (I IN)
l rIIN, May ba y(urr s(rclal ReUlrl ly ni 1IT16er (S,' N) 1nr.h•nrk laI taxp :rrer i der It i h r:a h(xl
number rITINj. adoptiwl trexpaVe•r 11:1 4111 number (ATIN]. of employer
xli -nt 161,a Ii rpl mum bar (EIN). to re prxI ❑rl an Ink rang n lio re. Ii l rn th n
e+ aurunl pa111 to
v ou- w otll er al ufxell repo table on an in ton uall01 relur n. Exaluples o lnfon n atrfnl
re lur ns irxaulle- LaII Nre nrrl linllf ad it r- the Iell tomrlq:
• Farm 1CISIFI -INT irnl+xcca earnwl err pr .1
• Form 1 (KO -DIV (r.li v n.Ir rld-s- lndud rn yl I xsr Ifonr slacks or nnrli lal funds)
• Form 1ow -miso yarl(Il1s ty pes of inr —rte. prl-e a•r: an .l s. or r.pr k— pr- -ll.yj
• For In IOV) Et(slock IIr mutual fund safes and certain other transartl"rl' by
bmker.x)
•for rn 1OW -S fix ocee +.is fr0111 real estac! t r at art bar lr•J
• F(Ir In 1(00 -K (1)1ft' :halt r:ard Adel IN pa rtv ro't :: [Irk it a rl ]artlpl.Sj
• I or Ill 1 OK' (h(Ime Innrt1aa11e -ntiai Q. 10S)13 -L Olt Cl ellt foam Inleresl], 109
�hntirxl�
• I-a 1n 111! ?B C =�'alnrlcl rlrilp]
• For 111 1O7 ?P -A i;il;(1[11ti1 (9) Or a (Ii 10ckjr A px(IpI?rN)
11kr'. "v rIn V•1 -9 rally if emu men 11 S. pe. rtun (1n( 1r1111 r1 x rem ident AiF11) In
pll CWJCII - YOW "CMI I','I IIN.
U yrnr ❑u lxir w 'J'n Ful'n 171 J !;, th, rcy l:lnsh :r rant :, f IN. i'n:j uglhl brr u�t; :4,r :r
! i tm,ekrip ..Irh14Aio xj. &4,e :Vhar is f„ (r:ko,p % "#hhnldilxl? rill pmje P.
6a sn.pning the Iilwd -rrul lfxlu- VIXP:
, . C: r '1 tltv Ihat thc: 1 I yrllr :n(. JIVIl lft I.•; r(31r C!0 (Or yrMJ ill (� l:' :1It1111J t(x :1 I1lllll fey
f o Lm= IRm uerl j.
P. (1 r,Aty Ihat you ale not wlbiert to 6x(: k1Ppl • :nl hhr>Irll ncp. or
3. (:INiul exert l ptrf.,rl Irvin baf:kup •;:l lhhr rldn uj rt you are x U.S. exempt }rayre. II
:Ipp,llratnlr;, yrxl ar(; alr:o nrR,lrvirlll th:d a5 vI U.S. pra.uln. Van fit any pnsw In H A 1i p, In' ranr: fr ran x I. ttnCie. ur hu. nI 1F not al Jbii -(:I in the
r;dh I rJdlm) lax ()I I IrM Clan pril inert' shale oI lively (xnlnc.0t .d In(xMn C% and
-1. Crl tl ry Itl:tt I-A IGA'.talc( ^] nnt':rud on th 11: ICM nl (d any) ln•.fir itlnlJ th:lt yalilk r:
e.x Bin pt hran the, FATCA rgxM lmq im Ool .,a - Sea / /kal ie FA T(14 4- pnl;rx!? nn
p) :lfl J 101 tl lrthe-1 1114A M :ltl(Ilt-
Cat. No. 1(12315(
F 4,x 111 W -9 (Re.v. 1 ?- Fi15.1)
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21
Fishing Umbrella Event Funding Application FY 2019
Print off this page, complete, and include as part of application
APPLICATION L1ST (su with app(icat on)
Check the box below to show that you have completed the following items:
❑ Applicant has reviewed the sample contract at
http: / /fl- monroecount .civicplus.com /index.aspx ?nid =328
❑ Attached printed advertising from last event (scanned as an attachment to the electronic version and
placed as paper attachment to paper copies)
❑ Provided photo copies of photographs of last event (scanned as an attachment to the electronic
version and placed as paper attachment to paper copies)
❑ Brochures of last event (scanned as an attachment to the electronic version and placed as paper attachment
to paper copies) M
❑ Brochures of proposed event (if available) ❑ Not available at this time
(Scanned as an attachment to the electronic version and placed as paper attachment to paper copies)
❑ Poster of last event if applicable (scanned as an attachment to the electronic version and placed as paper
attachment to paper copies) 0
❑ Poster of proposed event (if available) ❑ Not available at this time LU
(Scanned as an attachment to the electronic version and placed as paper attachment to paper copies) CD
❑ Tournament rules — page 8
i�
❑ Tournament scoring system — page 9
❑ Schedule of events — Exhibit C — page 12
❑ Budget — Exhibit D — page 13
❑ Statement of Income and Expenses — notarized — page 16/17 (scanned as an attachment to the
electronic version and placed as paper attachment to paper copies)
❑ No resale agreement — notarized — page 18 (scanned as an attachment to the electronic version and
placed as paper attachment to paper copies)
❑ Applicant has completed and signed the Non - Collusion Affidavit and Verification form
included within the application — page 19 (scanned as an attachment to the electronic version and
placed as paper attachment to paper copies)
❑ Applicant has completed the Intent to Affiliate with Florida Keys Fishing Tournament,
Inc. — notarized — page 20 (scanned as an attachment to the electronic version and placed as paper
attachment to paper copies)
❑ Applicant has printed and completed the W -9 form included within the application (page
21).
❑ Each section of the application has been completed.
Print off this page, sign below, and include as part of application (scan and add to your
application for the electronic version)
Signed By:
icant Name:
22
Fishing Umbrella Event Funding Application FY 2019