Item E4 E.4
County f � .�� ��� BOARD OF COUNTY COMMISSIONERS
Mayor David Rice,District 4
Mayor Pro Tem Craig Cates,District 1
The Florida Keys '
Y � �F' Michelle Coldiron,District 2
Vacant,District 3
--' Holly Merrill Raschein,District 5
County Commission Meeting
February 16, 2022
Agenda Item Number: E.4
Agenda Item Summary #10174
BULK ITEM: Yes DEPARTMENT: Tourist Development Council
TIME APPROXIMATE: STAFF CONTACT: Ammie Machan (305) 296-1552
N/A
AGENDA ITEM WORDING: Approval of FY 2023 Fishing Event Funding Application.
ITEM BACKGROUND: Attached is the FY 2023 Fishing Event Application for approval.
Fishing Advisory Committee approved at their meeting of January 13, 2022
Pending TDC approval at their meeting of February 8, 2022
PREVIOUS RELEVANT BOCC ACTION:
CONTRACT/AGREEMENT CHANGES:
N/A
STAFF RECOMMENDATION: Approval
DOCUMENTATION:
FY 2023 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:
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E.4
Indirect Costs:
Estimated Ongoing Costs Not Included in above dollar amounts:
Revenue Producing: If yes, amount:
Grant:
County Match:
Insurance Required:
Additional Details:
REVIEWED BY:
Maxine Pacini Completed 02/01/2022 9:36 AM
Christine Limbert Completed 02/01/2022 11:52 AM
Liz Yongue Completed 02/01/2022 1:32 PM
Board of County Commissioners Pending 02/16/2022 9:00 AM
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FY 2023 Fishing El vent Fundima Schedule
FAC APPROVAL: January 13, 2022
TDC APPROVAL: February 8, 2022
BOCC APPROVAL: February 16, 2022
NOTICES SENT TO INTERESTED PERSONS February 28, 2022
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ADVERTISE APPLICATION March 2, 2022
FAC WORKSHOPS: March 16, 2022
Advertise for 38 Days
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APPLI A, IO DEADLINE- April8.
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FAC DEADLINE: May 6, 2022
FAC APPROVAL: May 17, 2022
TDC APPROVAL: July 19, 2022
BOCC APPROVAL AFTER OCTOBER 2022 >
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MMMMMM E.4.a
FISHING EVENT FUNDING APPLICATION
T111IS AIPIPLICATIONIS FOR FIS111INGRIF ,.t..E ID EVENT BY ROD,
REEL, LINE & 11OOK TO TAKE PLACE BETWEEN "'t""1°1IF FOLLOWING
C,,.t.... IB IF R 1, 2022 AND SEIPTEMBER 30, 2023
IF IF respondents must use the currentapplilicatlion. Use of any other
applilicatlion wilill result in our° applilicatlion beingrejected.
APPLICATION DEADLINE: Friday April 8, 2022
All applications should be received no later than 5:00 p.m.
All applications should be submitted by one of the following methods: >
• By aiFIF : FishidiiIii even 1 (preferred method)
• 11and ID IF iFr= /I it IF d: T
Fishing Event Application N
TDC Administrative Office N
1201 White St. Suite 102
Key West, FL 33040
If mailing your application, we encourage you to send with delivery
confirmation or tracking as applications received after the deadline
date and time will not be accepted.
A. Preferred r°r° Method, if i ema
,. IF i il.. One completed copy of the
application as a .pdf (all attachments must be merged into one document.
Please DO NOT include the instruction pages). If ,you do not receive an -
automation response confirming receipt of your application or if your file size
is 25KB or larger please call our office (305-296-1552).
B. If submitfing by Han Hver /ICE aHI One (1) completed paper copy of
application and (1) USB Flash drive with completed copy of application as a
.pdf (all attachments must be merged into one document. Please DO NOT
include the instruction pages)
All inquiries and correspondence should be made to the TDC Administrative
office via email to Krin I - s.com. It is the applicant's responsibility
to follow up via phone call (305-296-1552) if a response is not received within
72 hours. Please do not hesitate to contact the Administrative Office
with any questions.
FY 2023 Fishing Event Funding Application
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APPLICANT RESPONSIBILITIES
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; a profit or not-for profit; or
a private business in good standing with the Division of Florida Corporations.
Prior to completing a Fishing Tournament Event Application, please go to
www.sunbiL.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. The Contract will be entered into with the name exactly as it appears
on Sunbiz.org and that official name will become the event contractor within the
final funding contract. All invoices and documentation must be in the event _
contractor name as written within the contract.
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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 the TDC
Administrative Office. Refer to the application check list at the back of this application. -
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 Advisory
Committee for review and their recommendations for funding allocations will be placed T
before the TDC for approval. Upon approval by the TDC a contract will be submitted to
the Monroe County Board of County Commissioners (BOCC) for final approval.
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Only events held within Monroe County shall be considered for event funding. Only events
that use rod, reel, line and hook are eligible to apply for Fishing Tournament Event
Funding.
FY 2023 Fishing Event Funding Application
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FY 2023
October 2022 November 2022 December 2022
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16 17 18 19 20 2122 20 2122 23 24 25 26 18 19 20 21 22 23 24
23 24 25 26 27 28 29 27 2829 30 25 26 27 28 29 30 31
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January 2023 February 2023 March 2023
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1 2 3 4 5 6 7 1 2 3 4 1 2 3 4
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15 16 17 18 19 20 21 12 13 14 15 161718 12 1314 15 161718
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29 3031 26 2728 26 2728 293031
April 2023 May 2023 June 2023
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July 2023 August 2023 September 2023
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USA Holidays and Observances `CD
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10 Oct, 22 Columbus Day 31 Oct, 22 Halloween 11 Nov, 22 Veterans Day >-
24 Nov, 22 ThanDkagiving 25 Dec, 22 Christmas 01 Jan, 23 New Year's Day
02 Jan, 23 New Year's Day 16 Jan, 23 M L King Day 14 Feb, 23 Valentine's Day
Holiday
20 Feb, 23 Presidents' Day 07 Apr, 23 Good Friday 09 Apr, 23 Easter Sunday
14 May, 23 Mother's Day 29 May, 23 Memorial Day 04 Sep, 23 Labor Day
19 Jun, 23 Juneteenth 18 Jun, 23 Father's Day 04 Jul, 23 Independence
Day
FY 2023 Fishing Event Funding Application
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Events must take place between October, 1, 2022 and September, 30, 2023
NAME OF EVENT CONTRACTOR:
(Event applicant or as it appears on
www.sunWL.org or name of individual/sole
proprietor) 0
TITLE OF TOURNAMENT-
DATE(S) OF TOURNAMENT- <
(For, at of event you are applying for funding for, refer to calendar, on p g. 31
*If registered on Sunbiz.org, are you a: F-1 Non-Profit F-1 For Profit u_
FUNDS REQUESTED- $
(Funds requested may not exceed $49,999)
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This application is to request funding from the following District(s): u_
F-1 District 1: Key West— (shall encompass the city limits of Key West)
F-1 District III: Lower Keys — (city limits of Key West to West end of Seven Mile Bridge)
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F-1 District III: Marathon — (West end of Seven Mile Bridge to Long Key Bridge)
F-1 District IV: Islamorada — (between Long Key Bridge and Mile Marker 90.939)
F-1 District V: Key Largo— (from Mile Marker 90.940 to the Dade/Monroe County line and
any portions of mainland Monroe County)
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DESIGNATED TOURNAMENT CONTACT PERSON
Please note that the TDC Administrative Office conducts most of its correspondence,
including contract and reimbursement materials by email, so the person listed below
should be able to accept responsibility for receipt of this information.
Name & Title:
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Telephone/Mobile No.-
E-Mail-
Address:
FY 2023 Fishing Event Funding Application
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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 Last Tournament $
Number of Fishing Days
Number Fishing Days of Registered Anglers
Use the table below to calculate number of room nights:
a. How many out of County visitors/Registered
Anglers to this district
b. How many visitors to a room Note: avg. is 3 T
c. How many nights will visitors stay?
d. Calculate: Room Nights = (a/b) x c
divide line a by line b. Then multiple by line c >-
*room nights will automatically calculate
What was your Target Specie(s)
Total Number of Targeted Specie(s) Hooked?
Total Number of Targeted Specie(s) Caught?
Tackle Requirements
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Daily Fishing Hours
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How Many Vessels Participated?
FY 2023 Fishing Event Funding Application
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TO II 1""S REPOIR r FOR LAST EVEN r
DATE OF TOURNAMENT RESULTS:
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CHAMPION:
NAME-
CITY/STATE-
CATCH- U-
CAPT/BOAT- >
1st Place:
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NAME- U-
CITY/STATE-
CATCH:
CAPT/BOAT-
2"' Place:
NAME-
CITY/STATE-
CATCH- T
U-
CAPT/BOAT-
31 Place:
NAME- E
CITY/STATE-
CATCH:
CAPT/BOAT-
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PROPOSED E TOURNAMENT,, III T INFORMATION
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 T
❑ Other, pleasespecify-
Are tournament entry fees: ❑ per Angler ❑ per Boat
Below, Enter your Entry Fees:
Adult Child Social Boat
Fee: $ Fee: $ Fee: $ Fee: $
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E S S OF P R..O P 0 SE D T 0 U R N A M E N T
In the space below describe the soundness of your tournament and how it will benefit
and expand tourism within the district you are applying for funding.
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IO the space below, tell us about your Tournament R l
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FYZUZ3 Fishing Event Funding Application
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ScoringIn the space below, tell us about your Tournament
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FYZUZ3 Fishing Event Funding Application
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Exhibit A
ACCEPTANCE EVENT MARKETiNG EXPENSES FOR FISHING V A TS
The following are the only acceptable expenses. This will become part of your approved
contract
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, social media promoted posts, 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, social media promoted posts, 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. At least 30% of total funding allocation must be placed within
the Media Placement and Production Cost line item and shall be expended on advertising media
cost attributable to out of county placement.
Promotional Signs: Posters and banners (hanging and displayed outdoors).
Promotional Items: T-shirts and hats*, trophies (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 y
BOCC/TDC and as such may not be sold.
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Direct Mail Promotions: Brochures, postcards and pamphlets including postage and shipping.
This is a direct mail promotional brochure, postcard or 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. Digital Programs: TDC will pay up to fifty percent (50%) of the production only (on click
through cost) for digital programs showing scheduled activities and information as outlined in the
contract and contact budget. TDC will pay for print or digital programs, but not both.
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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 expenditure 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.
FY 2023 Fishing Event Funding Application
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Exhibit B
III 0GO/ACKNOWI-EDGEMENT USAGE GUIDELINES
This will become part of your approved contract
Color ads four (4) color processing printing
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" Out-of-County logo
Radio Advertising: No logo is required. All radio announcements must say "Brought to you by 2
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, >
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programs, posters, banners (hanging and displayed outdoors), and digital advertising on
websites, website links, pre roll video, banners, mobile and email blasts. Radio commercials E
should include "Brought to you by The Monroe County Tourist Development Council". To seek T
approval, clarification and/or logo in electronic format (eps or jpg file), contact Danielle Salman-
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Villasuso or John Underwood with Tinsley Advertising at 305-856-6060.
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MJNROE COUNTY 1MK15T DEVEI,OPMEh:1 C;pUNCK >
Out-of-County Logo
The logo below that does NOT include the "Monroe County Tourist Development Council"
designation is to be utilized in out-of-county newspapers and magazines, brochures, postcards, _
pamphlets, programs, posters and digital advertising on websites, website links, pre roll video,
social media promoted posts, 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 Danielle Salman-Villasuso or
John Underwood at Tinsley Advertising at 305-856-6060.
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F10---riddKeys
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G}rne YOU dre
FY 2023 Fishing Event Funding Application
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Exhibit C
SCHEDULE OF EVENTS
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This will become part of your approved contract
TOURNAMENT SCHEDULE OF EVENTS
FISCAL YEAR 2023
PRINT OFFICIAL TOURNAMENT NAME
Day 1 —AM LINES IN WATER Day 2 —:—AM LINES IN WATER
PM LINES OUT OF WATER PM LINES OUT OF WATER
PM EVENING EVENT PM EVENING EVENT
PM WEIGH-IN OVER PM WEIGH-IN OVER
PM OTHER EVENT: PM OTHER EVENT:
Day 3 —AM LINES IN WATER Day 4 —:—AM LINES IN WATER
PM LINES OUT OF WATER PM LINES OUT OF WATER U-
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PM EVENING EVENT PM EVENING EVENT N
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PM WEIGH-IN OVER PM WEIGH-IN OVER �-
PM OTHER EVENT: PM OTHER EVENT:
Below describe any activities, not outlined above, that will take place during your event
that will draw overnight out of county visitors (examples: Welcome/Kick-off Party, Awards >
Ceremony, Dinner Events, etc.). These activities will become a part of your final contract:
Example: T
Day 1 — Welcome Party
Day 3 —Awards CeremonyN
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EXHIBIT D
BUDGET
Approved revised budget after allocations will become part of your approved contract
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 EVENT BUDGET — FISCAL YEAR 2023
There will be no arriendments to this budget (Exhibit ) after BOCC approval of agreement �
OFFICIAL TOURNAMENT NAME
MEDIA PLACEMENT & PRODUCTION COST $
PROMOTIONAL SIGNS $
PROMOTIONAL ITEMS $ >
DIRECT MAIL PROMOTIONS $
PROGRAMS $ y
PUBLIC RELATIONS $
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kkTROPHIES $ �-
`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 >
**Tournaments may not place more than 30% of their total funding allocation in the Trophy line
item, except when special approval from Fishing Advisory Committee has been received N
***The General Non-Allocated line item should not exceed 15% of the total funding allocation, and
may only be utilized for acceptable event marking expenses (see Exhibit A of application) cV
Actual expenditures may deviate no more than 10% from the budgeted line items noted above.
What is the total amount of your Marketing Plan: $
How much is the applicant contributing to the
marketing of this event in "Hard Dollars"? Please do
not include funds requested from TDC or other grants
— funds listed on this line should only include what the
applicant organization itself is providing towards the
marketing of the event. $
FY 2023 Fishing Event Funding Application
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Action Plan
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 email-
1. Describe how your event plan will handle road closures. If applicable, enclose a
copy the approval by the appropriate county/municipality entity.
2. Describe how your event plan will accommodate parking and transportation.
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3. Describe how your event will handle security.
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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 evens is planning ahead. On the next page (page 16), complete a narrative on
how you plan to reduce waste during your event by doing the following:
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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 the use of single use plastic bags and other products.
Useful contact number's r' for c clin-
Monroe
c (305, " - it, of lie ° ,Nes : ( - "
( -" - isl m r d , Villacje of lsl dCll ( 853-3433
FY 2023 Fishing Event Funding Application
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E.4.a
Oct. 1, 2020 Oct.1, 2021 Oct. 1, 2022
Sep. 30, 2021 Sept. 30, 2022 Sept. 30, 2023
Actual Projected Projected
INCOME:
SPONSORS (CASH) $ $ $
0
ENTRY FEES $ $ $
T-SHIRTS &CAPS
(EXCLUDING TDC ITEMS) $ $ $
BANQUET $ $ $
OTHER $ $ $
TOTAL $ $ $
OTHER FUNDS:
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FISHING ADVISORY $ $ $
COMMITTEE
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Total Income $ $ $
Expenses:
POSTAGE $ $ $
T-SHIRTS &CAPS $ $ $
DIRECTOR FEES $ $ $ >
BROCHURES & PATCHES $ $ $
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KICKOFF/AWARDS BANQUET $ $ $
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PRIZES AND/OR TROPHIES $ $ $
KICK-OFF TOURNAMENT $ $ $
DUES, LICENSES, INSURANCES $ $ $ E
MEDIA ADVERTISEMENTS $ $ $
STATIONARY, OFFICE
SUPPLIES $ $ $
PHOTO PROGRAM $ $ $
BROCHURE, PRINTING $ $ $
SIGNAGE $ $ $
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E.4.a
Oct. 1, 2020 Oct.1, 2021 Oct. 1, 2022
Sep. 30, 2021 Sept. 30, 2022 Sept. 30, 2023
Actual Projected Projected
OTHER $ $ $
OTHER $ $ $
TOTAL EXPENSES $ $ $
INCOME LESS EXPENSES $ $ $
DONATED SERVICES:
MEDIA ADVERTISING $ $ $
OTHER $ $ $
OTHER $ $ $
TOTAL $ $ $ N
NET PROFIT(LOSS) $ $ $ N
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
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Subscribed and sworn to (or affirmed) before me, by means of ❑ physical presence or
❑ online notarization, on (date) by
(name of affiant). He/She is personally known to me or has produced
(type of identification) as identification.
NOTARY PUBLIC
My Commission Expires:
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NO RE-SALE AGREEMENT
Name of Tournament:
Name of Event Contractor
1 HERBY 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 Applicants Signature
Subscribed and sworn to (or affirmed) before me, by means of ❑ physical presence or
❑ online notarization, on (date) by N
(name of affiant). He/She is personally known to me or has produced
(type of identification) as identification.
NOTARY PUBLIC
My Commission Expires:
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NON-COLLUSION AFF.DAVIT
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VERIFICATION
I, of the city of according to
law on my oath, and under penalty of perjury, depose and say that:
a. I am the applicant
making the application for the event and that I executed the said proposal
with full authority to do so;
b. the prices in this bid have been arrived at independently without collusion,
consultation, communication or agreement for the purpose of restricting
competition, as to any matter relating to such prices with any other bidder or
with any competitor;
C. unless otherwise required by law, the prices which have been quoted in this _
bid have not been knowingly disclosed by the bidder and will not knowingly
be disclosed by the bidder prior to bid opening, directly or indirectly, to any
other bidder or to any competitor; and
d. no attempt has been made or will be made by the bidder to induce any other
person, partnership or corporation to submit, or not to submit, a bid for the
purpose of restricting competition;
e. 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.
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Subscribed and sworn to (or affirmed) before me, by means of ❑ physical presence or
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❑ online notarization, on (date) by
(name of affiant). He/She is personally known to me or has produced
(type of identification) as identification.
NOTARY PUBLIC
My Commission Expires:
FY 2023 Fishing Event Funding Application
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Packet Pg. 1476
E.4.a
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LLC If eta LLC is dasisfied as a irngle-ffearttbe,LLC rims a disregarded meorn the owner UIVM are owner W ere-LLC is
arwrlyn LLC Brat is net egFromd From tire awn ar tear U.S.federal tars.purpriars.Ctieswise,a angle-mm rice,LLC that code(it any)
is dot`=flexed aunt the awtier druukm disCk file appropriate box For the tax el slneabon of its owner..
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Cr dress(rauar# r,alriaER,.anti -urn seatt>9 nra.p instxuet6ost'S. ___ --- t quastea"s Hamra asru srtrir s(opik',* _
g Oty.state,and ZIP eves
7 Liam account rafflitiefel'.hw a(optliwiso
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Enter your TIN In the appropriate box.The T1N provided must match this name given on liras 1 to avow mostly nuareser
backup withholding.For Individuals,this is generally your social smunty,number ESN).However,far a
resident allm.so proprietor,or disregarded entity,see the instructions for Pot I,leer.For other �
entitters,it is employer Identification numbox(EIN),if you not have a number, How to get a _-.
nN,later. or
Nots:If the account is In more than one name,see the Instructions for line 1.Also see What Name and amployer 1,----_..__PAMrJW
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To Gwe the.Flaquestorfor guidelines an whose number to der. _
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Under penalties of I that --
perjury,
1.The number shown n on titre farm is my correct taxpayer identification n (or I am waiting for a number to be issued to me);and
2.1 am not subject to backup withholding Cause:Oak I am exempt from backup withholding,or(b)I have not been notified by the Intemal Revenue
Service OW that I am subject to backup withholding as a result of a failure to report all interest ordividends,or(c)the IRS has notified no that I ant
no longer subject to backup withholding;slid
3-1 am a U.&Citizen or other U.S.parson(defined Marv);and
A.The FATCA s)entered on this form Of any)indicating that I am exempt from FATCAreporting is correct_
mte You mast cam rant ftern 2 above if you have been ratified by the IFS that you am curriandy suloject to baDkup withhokfing because
you have farearci to report all interest and dividends as your tax reatams,For real estate item 2 does not apply.For mortgage inweem paid,
acquisition or abandonment of secured Property,cancellation of art,ociriffibutions to an individual ratroment aminglemerit ORA),and generally,payments
other than in and dividends, required you we not r to sign.the ation,.but you Hurst provide yawn coact.TIN. the Instructions for Pan It,!alter.
Sign
Here U$per""- i CD
{`.11nfr1 Instructions
Form 1099-DIV(dividends,Including those from stocks or murb W
Section references are to the Internet Revenue Code unless otherwise a Fore 1009-WSC(various types of income,prima,awards,or gross N
noted. proceeds)
Future dewkWamwft.For the latest information about developments
related to Fawn§�i-9 and its tnatruct ns,such as lsislion enacted •Form 10 -B(stock or mutual fund sales and n other
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after that'were published,go to aiv in govil=or -For transactions S brokers) N
.Farm 1CM394S fpnceads from read estate., dons)
Purpose of Fear -Form 1000-K(merchant card and third party network transactions) >-
An individual or entity(Fcrrn W-9 requester)who is requited to file as r Farm 1098 Ol me mortgage interest),109®-€(student loan Interest),
information returm with the IFS must obtain your correct taxpayer It -T(turtiort) ¢
Kdentificatzat rhumba(TIN)which may to your social security number s Form 1099-C(canceled debt) 0)
(SSN),irxtivdduatl taxpayer iderrtafication numb(ITIN),adoption
taxpayer cancan number(AT1N),or employer identification number "Fors 11 9-A(acquisition or abandonment of cured property)...
(8M.to report on an information return the amount paid to your,or other Use Form'IM-9 only it you are a U.S (inckufing a resident
amount reportable on an intoExamples of nafornudion alien),to...provide your correct TIN, t`3
reruns include,but are not limited to,the following. If you do not return Farm W 9 to the requarster w(df a TIN,you might ¢
•Form 10904NT("interest earned or paid) be subject to bacAulp wNitickMg.,'ere what is backup witlifixilding.
later.
CaL No.10231 x Forma W-9 ff".1 D-2018)
FY 2023 Fishing Event Funding Application
21
Packet Pg. 1477
E.4.a
APPLICATION CHECK LIST
(submit pit, Dli a i )
Check the box below to show that you have completed the following items:
❑ Applicant has reviewed the sample contract at: hl!LL://www.monroecounty-
F-1 le-Fishin -Event-Fundin -A reement
❑ Attached printed advertising from last event (scanned as attachment to the electronic version
and placed as paper attachments in the paper copies)
❑ Brochures of last event (scanned as attachment to the electronic version and placed as paper
attachments in the paper copies)
❑ Brochures of proposed event (if available) ❑ Not available at this time
(scanned as attachment to the electronic version and placed as paper attachments in the paper
copies)
❑ Poster of last event (if applicable) (scanned as an attachment to the electronic version and
placed as paper attachment to paper copies)
T)
❑ Poster of proposed event (if available) ❑ Not available at this time
(scanned as an attachment to the electronic version and placed as paper attachment in paper
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copies)
❑ Tournament Rules — page 9
❑ Tournament scoring system — page 10
❑ Schedule of events — Exhibit C — page 13
❑ Budget — Exhibit D — page 14
❑ Statement of Income and Expenses — notarized — page 17/18 (scanned as attachment to
the electronic version and placed as paper attachments in paper copies) >
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❑ No-resale Agreement—notarized —page 19 (scanned as attachment to the electronic version
and placed as paper attachments in paper copies) y
❑ Non-Collusion Affidavit and Verification Form — notarized — page 20 (scanned as `V
attachment to the electronic version and placed as paper attachments in paper copies)
❑ Applicant has printed and completed the W-9 form - 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:
Applicant Name:
FY 2023 Fishing Event Funding Application
22
Packet Pg. 1478