HomeMy WebLinkAbout2012 10-08 City Council Meeting PacketThe Listening Forum begins at 6:30 p.m. before the second and fourth regularly scheduled City
Council meetings and replaces Visitor Presentations on the City Council Agenda.
AGENDA
MAPLEWOOD CITY COUNCIL
7:00 P.M. Monday, October 8, 2012
City Hall, Council Chambers
Meeting No. 18-12
A. CALL TO ORDER
B. PLEDGE OF ALLEGIANCE
1. Acknowledgement of Maplewood Residents Serving the Country
C. ROLL CALL
Mayor’s Address on Protocol:
“Welcome to the meeting of the Maplewood City Council. It is our desire to keep all
discussions civil as we work through difficult issues tonight. If you are here for a Public
Hearing or to address the City Council, please familiarize yourself with the Policies and
Procedures and Rules of Civility, which are located near the entrance. Before addressing the
council, sign in with the City Clerk. At the podium please state your name and address
clearly for the record. All comments/questions shall be posed to the Mayor and Council. The
Mayor will then direct staff, as appropriate, to answer questions or respond to comments.”
D. APPROVAL OF AGENDA
E. APPROVAL OF MINUTES
1. Approval of September 24, 2012 City Council Workshop Minutes
2. Approval of September 24, 2012 City Council Meeting Minutes
F. APPOINTMENTS AND PRESENTATIONS
1. Resolution of Appreciation for Gary Pearson – Planning Commission and Housing &
Redevelopment Authority
G. CONSENT AGENDA – Items on the Consent Agenda are considered routine and non-controversial
and are approved by one motion of the council. If a councilmember requests additional information
or wants to make a comment regarding an item, the vote should be held until the questions or
comments are made then the single vote should be taken. If a councilmember objects to an item it
should be removed and acted upon as a separate item.
1. Approval of Claims
2. Approval of Toy Donations to Police Department
3. Approval of 2012 Budget Transfers
4. Approval of 2012 Budget Adjustments
5. Approve Closure of Open Space Land Acquisition Fund
6. Approval of Annual Maplewood Historical Society Payment
7. Approval of Temporary Gambling Permit and Fee Waiver – Friends of the Mississippi River for
The Fish Creek Affair
8. Approval of Resolution Certifying Election Judges for the November 6, 2012 General Federal
and State Election
9. Authorization to Enter into a Service Agreement with The Active Network
10. Approval of Permitted Facilities Agreement with BP Products North America Inc., Maplewood
Mall Sidewalk Improvements, City Project 11-09
11. Approval of Cost Participation Agreement with Ramsey-Washington Metro Watershed District,
TH 36/English Street Interchange Improvements, City Project 09-08
12. Approval of the Annual Renewal License for EZ Cash Maplewood, LLC – 3035 White Bear
Avenue
H. PUBLIC HEARINGS
None
I. UNFINISHED BUSINESS
1. Approval of Ordinance Amending Xcel Franchise Fees – 2nd Reading
J. NEW BUSINESS
1. 2013 Review of Requests - Charitable Gambling 2. Consider Resolution Adopting 2013 Rates for Utilities 3. Consider Recommendation of No Further Action on Reinforced Turf Parking Surfaces for Residential Parking Needs
K. AWARD OF BIDS
None
L. ADMINISTRATIVE PRESENTATIONS
1. Response to Council Member Cardinal’s Questions Submitted at the September 24, 2012
Council Meeting.
M. COUNCIL PRESENTATIONS
None
N. ADJOURNMENT
Sign language interpreters for hearing impaired persons are available for public hearings upon
request. The request for this must be made at least 96 hours in advance. Please call the City Clerk’s
Office at 651.249.2001 to make arrangements. Assisted Listening Devices are also available. Please
check with the City Clerk for availability.
RULES OF CIVILITY FOR OUR COMMUNITY
Following are some rules of civility the City of Maplewood expects of everyone appearing at
Council Meetings – elected officials, staff and citizens. It is hoped that by following these simple rules,
everyone’s opinions can be heard and understood in a reasonable manner. We appreciate the fact that
when appearing at Council meetings, it is understood that everyone will follow these principles: Show
respect for each other, actively listen to one another, keep emotions in check and use respectful
language
September 24, 2012
City Council Workshop Minutes 1
Item E1
MINUTES
MAPLEWOOD CITY COUNCIL
MANAGER WORKSHOP
5:15 P.M. Monday, September 24, 2012
Council Chambers, City Hall
A. CALL TO ORDER
A meeting of the City Council was held in the City Hall Council Chambers and was called to order
at 5:18 p.m. by Mayor Rossbach.
B. ROLL CALL
Will Rossbach, Mayor Present
Robert Cardinal, Councilmember Present
Kathleen Juenemann, Councilmember Present
Marvin Koppen, Councilmember Present
James Llanas, Councilmember Present
C. APPROVAL OF AGENDA
Councilmember Llanas moved to approve the agenda as submitted.
Seconded by Councilmember Koppen Ayes – All
The motion passed.
D. UNFINISHED BUSINESS
1. Gladstone and Economic Development Initiatives Review
City Planner Martin presented the staff report and answered questions of the council. Mark
Jenkins, Business and Economic Development Commission Chair, was present and addressed
the council. Gary Kloncz, Business and Economic Development Commissioner, was also present
and addressed the council.
2. Declaration of Intent to Close Meeting, MN State Statute 13D.03
a. Discussion on Labor Negotiations
Mayor Rossbach moved to close the meeting as is permissible under MN State Statute 13D.03 to
discuss labor negotiations.
Seconded by Councilmember Koppen Ayes – 4-0 (Councilmember Llanas was not
present for the vote)
The motion passed.
Mayor Rossbach summarized the closed session as a discussion regarding labor negotiations.
E. NEW BUSINESS
None.
F. ADJOURNMENT
Mayor Rossbach adjourned the meeting at 6:34 p.m.
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September 24, 2012
City Council Meeting Minutes 1
Item E2
MINUTES
MAPLEWOOD CITY COUNCIL
7:00 p.m., Monday, September 24, 2012
Council Chambers, City Hall
Meeting No. 17-12
A. CALL TO ORDER
A meeting of the City Council was held in the City Hall Council Chambers and was called to order
at 7:04 p.m. by Mayor Rossbach.
B. PLEDGE OF ALLEGIANCE
C. ROLL CALL
Will Rossbach, Mayor Present
Robert Cardinal, Councilmember Present
Kathleen Juenemann, Councilmember Present
Marvin Koppen, Councilmember Present
James Llanas, Councilmember Present
D. APPROVAL OF AGENDA
The following item was tabled until the next EDA meeting is called to order:
E3 Approval of September 10, 2012 Economic Development Authority Minutes
The following items were added to the agenda under Council Presentations:
M1. Trash Collection
M2. Citizens Forum
M3. Community Development
M4. Citizen’s Questions
Councilmember Juenemann moved to approve the agenda as amended.
Seconded by Councilmember Llanas Ayes – All
The motion passed.
E. APPROVAL OF MINUTES
1. Approval of September 10, 2012 City Council Workshop Minutes
Councilmember Juenemann moved to approve the September 10, 2012 City Council Workshop
Minutes as submitted.
Seconded by Councilmember Llanas Ayes – All
The motion passed.
2. Approval of September 10, 2012 City Council Meeting Minutes
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September 24, 2012
City Council Meeting Minutes 2
Councilmember Juenemann moved to approve the September 10, 2012 City Council Workshop
Minutes as submitted.
Seconded by Councilmember Koppen Ayes – All
The motion passed.
3. Approval of September 10, 2012 Economic Development Authority Minutes
This item was tabled until the next Economic Development Authority Meeting.
F. APPOINTMENTS AND PRESENTATIONS
1. Award Recognition for Maplewood’s Participation in the EMS Immediate Trial Study
Dr. Aaron Burnett, Healtheast St. John’s Hospital Deputy Medical Director, was present and
addressed the council to give a brief overview of the EMS Immediate Trial Study. He presented
Fire Chief Lukin with a plaque in recognition of appreciation, recognizing the Maplewood Fire
Department on behalf of Regions Hospital EMS and Critical Care Research Center.
G. CONSENT AGENDA
Councilmember Juenemann requested that agenda items G5, G6 and G7 be highlighted.
Councilmember Juenemann moved to approve agenda items G1-G9.
Seconded by Councilmember Llanas Ayes – All
The motion passed.
1. Approval of Claims
Councilmember Juenemann moved to approve the Approval of Claims.
ACCOUNTS PAYABLE:
$ 109,391.45 Checks # 87851 thru # 87892
dated 9/5/12 thru 9/11/12
$ 380,610.56 Disbursements via debits to checking account
dated 9/4/12 thru 9/7/12
$ 804,540.88 Checks # 87893 thru # 87953
dated 9/13/12 thru 9/18/12
$ 272,898.53 Disbursements via debits to checking account
dated 9/10/12 thru 9/14/12
$ 1,567,441.42 Total Accounts Payable
PAYROLL
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September 24, 2012
City Council Meeting Minutes 3
$ 526,654.02 Payroll Checks and Direct Deposits dated 9/14/12
$ 1,475.50
Payroll Deduction check # 9987441 thru #
9987443
dated 9/14/12
$ 528,129.52 Total Payroll
$ 2,095,570.94 GRAND TOTAL
Seconded by Councilmember Llanas Ayes – All
The motion passed.
2. Approval of a Lawful Gambling License for Merrick Inc. at Jake’s City Grill, 1745
Beam Ave E
Councilmember Juenemann moved to approve the Lawful Gambling Resolution for Merrick Inc. to
operate at Jake’s City Grill.
RESOLUTION 12-9-789
BE IT HEREBY RESOLVED, by the City Council of Maplewood, Minnesota, that
the premise license for lawful gambling is approved for Merrick Inc. to operate at Jake’s Grill
located at 1745 Beam Avenue, Maplewood, Minnesota.
FURTHERMORE, that the Maplewood City Council waives any objection to the
timeliness of application for said permit as governed by Minnesota Statute §349.213.
FURTHERMORE, that the Maplewood City Council requests that the Gambling
Control Division of the Minnesota Department of Gaming approve said license
application as being in compliance with Minnesota Statute §349.213.
NOW, THEREFORE, be it further resolved that this Resolution by the City Council
of Maplewood, Minnesota, be forwarded to the Gambling Control Division for their approval.
Seconded by Councilmember Llanas Ayes – All
The motion passed.
3. Approval of Cleaning Service Agreement with Marsden Cleaning Maintenance LLC,
for Campus Buildings
Councilmember Juenemann moved to approve the continual use of Marsden Maintenance LLC,
for Campus Buildings and the monthly service agreement expenditures.
Seconded by Councilmember Llanas Ayes – All
The motion passed.
4. Approval of Extended Lease for 170 Ton Air Cooled Chiller for Maplewood
Community Center
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City Council Meeting Minutes 4
Councilmember Juenemann moved to approve the extended Lease for a 170 Ton Air Cooled
Chiller at the Maplewood Community Center.
Seconded by Councilmember Llanas Ayes – All
The motion passed.
5. Approval of 2012 Justice Assistance Grant (JAG)
Chief of Police Thomalla presented the staff report.
Councilmember Juenemann moved to approve the acceptance of Justice Assistance Grant in the
amount of $9,028 and Agreement with the St. Paul Police Department.
Seconded by Councilmember Llanas Ayes – All
The motion passed.
6. Approval of Fall Clean Up Event – October 13, 2012
Mayor Rossbach presented the report on the Fall Clean-Up Event. Assistant City Manager Ahl
presented additional information on the event.
Councilmember Juenemann moved to approve the 2012 Fall Clean-Up Event and fee schedule.
Seconded by Councilmember Llanas Ayes – All
The motion passed.
7. Approval of Resolution Accepting a Donation to the Fire Depart from Lorry Houle
and Ken and Nancy Schak
Fire Chief Lukin presented the staff report.
Councilmember Juenemann moved to approve the resolution to accept the donation in the
amount of $40 to the Fire Department and the necessary budget adjustments be made so the
funds can be expended by the fire department as needed.
RESOLUTION 12-9-790
AUTHORIZING GIFT TO CITY
WHEREAS, Maplewood is AUTHORIZED to receive and accept grants, gifts and devices
of real and personal property and maintain the same for the benefit of the citizens and pursuant to
the donor’s terms if so-prescribed, and;
WHEREAS, Lorry Houle and Ken and Nancy Schak wishes to grant the city of Maplewood
the following: $40.00, and;
WHEREAS, Lorry Houle and Ken and Nancy Schak has instructed that the City will be
required to use the aforementioned for: use by the fire department to directly improve the
community, and;
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City Council Meeting Minutes 5
WHEREAS, the city of Maplewood has agreed to use the subject of this resolution for the
purposes and under the terms prescribed, and;
WHEREAS, the City agrees that it will accept the gift by a four-fifths majority of its
governing body’s membership pursuant to Minnesota Statute §465.03;
NOW, THEREFORE, BE IT RESOLVED, pursuant to Minnesota Statute §465.03, that the
Maplewood City Council approves, receives and accepts the gift aforementioned and under such
terms and conditions as may be requested or required.
The Maplewood City Council passed this resolution by four-fifths or more majority vote of its
membership on September 24. 2012.
Seconded by Councilmember Llanas Ayes – All
The motion passed.
8. Approval to Sell a Surplus Old Fire Truck
Councilmember Juenemann moved to declare three fire trucks as surplus equipment and allow
the Fire Department to sell them and approve the sale of the 1983 Ford LN9000 fire engine to
Michael Waltzing in as is condition.
Seconded by Councilmember Llanas Ayes – All
The motion passed.
9. Approval of Amendment of the Educational Facilities Revenue Note, SERIES 2010
(Hill-Murray School Project)
Councilmember Juenemann moved to approve the resolution authorizing the Amendment of the
Educational Facilities Revenue Note, SERIES 2012 (Hill-Murray School Project).
RESOLUTION 12-9-791
AUTHORIZING AMENDMENT OF THE
$5,900,000 EDUCATIONAL FACILITIES REVENUE NOTE, SERIES 2010
(HILL-MURRAY SCHOOL PROJECT)
AND AUTHORIZING THE EXECUTION OF DOCUMENTS RELATING THERETO
WHEREAS, on December 23, 2010, the City of Maplewood, Minnesota (the “City”) issued
its $5,900,000 Educational Facilities Revenue Note, Series 2010 (Hill-Murray School Project) (the
“Note”) made payable to Premier Bank (the “Lender”) and loaned the proceeds of the Note to The
Hill-Murray Foundation, a Minnesota nonprofit corporation, (the “Borrower”), pursuant to a Loan
Agreement dated as of December 23, 2010, between the City and the Borrower (the “Loan
Agreement”) to refinance certain tax exempt and conventional debt used to acquire land and
construct improvements to the Hill-Murray School; and
WHEREAS, pursuant to a Pledge Agreement dated as of December 23, 2010 between
the City and the Lender, the City assigned its rights and interests under the Loan Agreement
(except for certain rights of payment and indemnification) to the Lender; and
WHEREAS, the Borrower has secured payment of its obligations under the Loan
Agreement, including repayment of the Note, by delivery to the Lender of the Mortgage, two
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City Council Meeting Minutes 6
Security Agreements and a Pledge and security Agreement (all as defined in the Loan
Agreement); and
WHEREAS, in order to lower the interest rate on the Note, the Borrower and the Lender
have agreed to modify certain provisions in the Note and related documents and have asked the
City to enter into an amendment of the Note to effect such changes.
NOW THEREFORE, BE IT RESOLVED by the City Council of the City of Maplewood,
Minnesota, as follows:
The forms of the Loan and Note Modification Agreement (the "Agreement") on file with the City is
hereby approved and the Mayor and Manager are authorized to execute the Agreement together
with such other documents as Bond Counsel considers appropriate in connection with the
amendment of the Note. In the event of the absence or disability of the Mayor or Manager such
officers of the City as, in the opinion of the City Attorney, may act in their behalf, shall without
further act or authorization of the Council do all things and execute all instruments and
documents required to be done or executed by such absent or disabled officers. The execution
of any instrument by the appropriate officer or officers of the City herein authorized shall be
conclusive evidence of the approval of such documents in accordance with the terms hereof.
Adopted by the City Council of the City of Maplewood, Minnesota, this 24th day of September,
2012.
Seconded by Councilmember Llanas Ayes – All
The motion passed.
H. PUBLIC HEARING
None
I. UNFINISHED BUSINESS
1. Consideration of Petition Requesting 24-Hour Parking Adjacent to Cottages of
Legacy Village (Hazelwood Street and Legacy Parkway)
Public Works Director/City Engineer Thompson presented the staff report and answered
questions of the council.
Mayor Rossbach moved to deny the Petition Request for 24 Hour Parking on the two identified
sections of Hazelwood Street and Legacy Parkway.
Seconded by Councilmember Juenemann Ayes – Mayor Rossbach, Council
Members Cardinal and
Juenemann
Nays – Council Members Koppen and
Llanas
The motion passed.
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J. NEW BUSINESS
1. Approval of an On-Sale Intoxicating Liquor License for Freddy’s Tiki Hut, 1820 Rice
Street
City Clerk Guilfoile presented the staff report and answered questions of the council. John
Robert Klein, owner of Freddy’s Tiki Hut and Pete Kielas, property owner were present and
addressed the council.
Mayor Rossbach moved to approve an On-Sale Intoxicating Liquor License for Freddy’s Tiki Hit,
1820 Rice Street.
Seconded by Councilmember Koppen Ayes – All
The motion passed.
2. Approval of Penalties for Alcohol Compliance Failures
City Clerk Guilfoile presented the staff report and answered questions of the council. Wayne
Belise from Champps of Maplewood and Pat Conroy from Sluggers Bar & Grill were present and
addressed the council.
Councilmember Llanas moved to approve the Penalties for Alcohol Compliance Failures as
indicated by staff except Merwin’s Liquor to be tabled until a future meeting.
AMF Maplewood Lanes $1,000
Champps of Maplewood $2,000
Chili’s Bar & Grill $1,000
Chipotle Mexican Grill $500
Richard’s Market $1,000
Rookies Sports Bar & Grill $500
Sluggers Bar & Grill $500
Seconded by Councilmember Juenemann Ayes – All
The motion passed.
3. Approval of Resolution Approving Plans and Specifications and Advertising for
Bids, TH 36 / English Street Interchange Improvements, City Project 09-08
Public Works Director/City Engineer Thompson presented the staff report and answered
questions of the council. Deb Forbes, Maplewood Resident was present and addressed the
council.
Mayor Rossbach moved to approve the resolution Approving Plans and Specifications and
authorize the Advertising for Bids, TH 36 / English Street Interchange Improvements, City Project
09-08; and staff review the height of the fence one more time with a limit of 12 feet maximum.
RESOLUTION 12-9-792
APPROVING PLANS AND SPECIFICATIONS
AUTHORIZING ADVERTISING FOR BIDS
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City Council Meeting Minutes 8
WHEREAS, pursuant to resolution passed by the city council on April 9, 2012 plans and
specifications for the TH 36 / English Street Interchange Improvements, City Project 09-08, have
been prepared by (or under the direction of) the city engineer, who has presented such plans and
specifications to the council for approval on September 24, 2012;
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF
MAPLEWOOD, MINNESOTA:
1. Such plans and specifications, a copy of which are attached hereto and made a part
hereof, are hereby approved and ordered placed on file in the office of the city clerk.
2. The city clerk shall prepare and cause to be inserted in the official paper and in the
Construction Bulletin an advertisement for bids upon the making of such improvement under such
approved plans and specifications. The advertisement shall be published at least twice, and at
least thirty-one days before the date set for bid opening, shall specify the work to be done, shall
state that bids will be publicly opened and read aloud at city hall on the date and time agreed to
by the City and MnDOT, and that no bids shall be considered unless sealed and filed with the
clerk and accompanied by a certified check or bid bond, payable to the City of Maplewood,
Minnesota for five percent of the amount of such bid.
3. The city clerk and city engineer are hereby authorized and instructed to receive, open,
and read aloud bids received at the time and place agreed to by the City and MnDOT, and to
tabulate the bids received. The council will consider the bids, and the award of a contract, at a
regular city council meeting date to be determined by the City and MnDOT.
Approved this 24th day of September 2012.
Seconded by Councilmember Cardinal Ayes – All
The motion passed.
4. Approval of Ordinance Amending Xcel Franchise Fees – 1st Reading
City Attorney Kantrud presented the staff report and answered questions of the council.
Councilmember Juenemann moved to approve the 1st reading of the ordinance amending Xcel
Franchise Fees.
Seconded by Councilmember Llanas Ayes – Mayor Rossbach, Council Members
Juenemann, Koppen and Llanas
Nays – Councilmember Cardinal
The motion passed.
K. AWARD OF BIDS
None
L. ADMINISTRATIVE PRESENTATIONS
1. Notice of Cancellation of the October 1st City-Manager Workshop
City Manager Antonen informed the council that the October 1, 2012 City-Manager Workshop
Meeting has been cancelled.
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City Council Meeting Minutes 9
M. COUNCIL PRESENTATIONS
1. Trash Collection
Councilmember Juenemann reminded residents that the new organized trash collection system
will begin on October 1, 2012 with Allied Waste. If residents haven’t received their new trash bin
by Wednesday, September 16, 2012, they should contact Shann Finwall or Allied Waste.
2. Citizen Forums
Councilmember Llanas informed residents that there will be a Voter ID forum sponsored by the
Human Rights Commission. It is scheduled for Tuesday, October 9, 2012 from 7:00 p.m. to 9:30
p.m. in the Council Chambers at City Hall. The Commission will also conduct a forum on the
Marriage Amendment on Tuesday, October 23, 2012 from 7:00 p.m. to 9:30 p.m. in the Banquet
Room at the Maplewood Community Center.
3. Community Involvement
Councilmember Llanas spoke about an incident in St. Cloud where a young college student was
assaulted which ended in his death. Llanas encouraged residents to be involved in their
community and watchful of things happening in their neighborhood.
4. Citizen’s Questions
Councilmember Cardinal submitted two questions regarding the organized trash hauling system
and requested that they be answered at the next council meeting.
N. ADJOURNMENT
Mayor Rossbach adjourned the meeting at 8:52 p.m.
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MEMORANDUM
TO: James Antonen, City Manager
FROM: Tom Ekstrand, Senior Planner
Chuck Ahl, Assistant City Manger
SUBJECT: Resolution of Appreciation for Gary Pearson
DATE: October 1, 2012
INTRODUCTION
Gary Pearson has submitted his resignation as a member of the Maplewood Housing
and Redevelopment Authority and as a member of the Planning Commission. Gary has
served the city on the HRA since November 13, 1989 and the planning commission
since December 10, 1990.
COMMISSION ACTION
September 18, 2012: The planning commission moved to approve the resolution of
appreciation.
RECOMMENDATION
Accept the attached resolution of appreciation for Commissioner Pearson.
P:Planning Commission\Resolution of Appreciation for Gary Pearson CC Report 10 12 te
Attachment:
Resolution of Appreciation for Gary Pearson
Agenda Item F1
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JOINT RESOLUTION OF APPRECIATION
WHEREAS, Gary Pearson has been a member of the Maplewood Housing and
Redevelopment Authority since November 13, 1989 and has served faithfully in that
capacity; and
WHEREAS, Gary Pearson has been a member of the Maplewood Planning
Commission since December 10, 1990 and has served faithfully in that capacity as well;
and
WHEREAS, Gary has freely given of his time and energy, without
compensation, for the betterment of the City of Maplewood; and
WHEREAS, the membership of both commissions have appreciated the
experience, insights and good judgment Gary has provided over these many years; and
WHEREAS, Gary has shown sincere dedication to his duties and has
consistently contributed his leadership, time and effort for the benefit of the City.
NOW, THEREFORE, IT IS HEREBY RESOLVED for and on behalf of the
City of Maplewood, Minnesota, and its citizens that Gary Pearson is hereby extended our
gratitude and appreciation for his dedicated service.
Passed by the Maplewood
City Council on ___________, 2012
____________________________________
Will Rossbach, Mayor
Passed by the Maplewood
Planning Commission
On _____________, 2012
____________________________________
Lorraine Fischer, Chairperson
Attest:
________________________________
Karen Guilfoile, City Clerk
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S:\FINANCE\APPROVAL OF CLAIMS\2012\AprClms - 9-21-12 and 9-28-12.xlsx
AGENDA NO.G-1
TO:City Council
FROM:Finance Manager
RE:APPROVAL OF CLAIMS
DATE:
1,084,967.47$ Checks #87954 thru # 88010
dated 9/14/12 thru 9/25/12
372,180.61$ Disbursements via debits to checking account
dated 9/17/12 thru 9/21/12
772,240.59$ Checks # 88011 thru # 88052
dated 9/25/12 thru 10/2/12
235,667.68$ Disbursements via debits to checking account
dated 9/24/12 thru 9/28/12
2,465,056.35$ Total Accounts Payable
503,587.16$ Payroll Checks and Direct Deposits dated 9/28/12
1,475.50$ Payroll Deduction check # 9987475 thru # 9987477
dated 9/28/12
505,062.66$ Total Payroll
2,970,119.01$ GRAND TOTAL
sb
attachments
Attached is a detailed listing of these claims. Please call me at 651-249-2902 if you have any questions on the
attached listing. This will allow me to check the supporting documentation on file if necessary.
PAYROLL
AGENDA REPORT
October 8, 2012
Attached is a listing of paid bills for informational purposes. The City Manager has reviewed the bills
and authorized payment in accordance with City Council approved policies.
ACCOUNTS PAYABLE:
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S:\FINANCE\APPROVAL OF CLAIMS\2012\AprClms - 9-21-12 and 9-28-12.xlsx
Check Description Amount
87954 05063 ACOUSTICAL STUDY OF GUN RANDE 4,000.00
87955 05093 PROJ 09-08 PMT FOR PARCELS 12/13 38,500.00
87956 05095 PROJ 09-08 PMT FOR PARCELS 14/15 25,000.00
87957 02947 PROJ 09-08 PMT FOR PARCEL 29 5,000.00
87958 05094 PROJ 09-08 PMT FOR PARCEL 17 128,300.00
87959 05096 PROJ 09-08 PMT FOR PARCEL 20 210,000.00
87960 00842 LITIGATION SETTLEMENT 37,500.00
87961 05097 LITIGATION SETTLEMENT 95,000.00
87962 04206 ATTORNEY SERVICES FEES/RENT-OCT 15,150.00
87963 00687 TREE TRIMMING & REMOVAL 1,621.00
00687 TREE TRIMMING & REMOVAL PROJ 10-14 1,534.38
00687 TREE TRIMMING 641.25
00687 TREE STUMP WORK 213.75
87964 00985 WASTEWATER - OCTOBER 202,927.10
87965 01202 SEPT SEASON PUBLISHING 1,522.73
87966 01574 1100 TON 41 WEAR~6,393.24
87967 01190 ELECTRIC & GAS UTILITY 3,879.81
01190 ELECTRIC & GAS UTILITY 2,167.23
01190 ELECTRIC & GAS UTILITY 242.55
01190 FIRE SIRENS 50.18
87968 01798 CONTRACT DIESEL FUEL - SEPT 9,528.90
87969 00058 REIMB FOR SAFETY BOOTS 09/07 186.99
87970 02411 COMPRESSOR SERVICE 1,275.00
87971 00090 TRAINING FOR LIFEGUARDING/WSI CLASS 2,235.45
87972 05098 ESCROW RELEASE 1978 KENNARD ST 500.00
87973 00209 ESCROW RELEASE 2541 DAHL AVE 5,015.89
87974 05052 SOUND SYSTEM RENTAL MCC OCT 13 600.00
87975 00460 STRUCTURE FOR IDE ST STORM SEWER 243.68
87976 04911 RENTAL OF LINENS FOR BRIDAL EXPO 192.83
87977 00451 REPAIR A/C STATION 3 526.98
87978 05028 CITY HALL SOLAR SYS LEASE - SEPT 397.00
05028 MCC SOLAR SYS LEASE - SEPT 369.00
87979 02567 PROJ 09-08 ACQUISITION AGENT 772.20
87980 05064 FIRE HOSE TESTING 4,370.00
87981 04867 IMPLEMENTATION OF TRASH PLAN 1,537.50
87982 00531 BLACK DIRT - EDGERTON PROJ 64.13
87983 03339 SHIRTS FOR NSP 5K 632.00
87984 04846 MEDICAL SUPPLIES 81.00
87985 05018 REMOVE OAK BRANCH AT NATURE CTR 800.00
87986 05030 LEASING OF CARDIO EQUIP 4,344.07
87987 00789 BULK OIL 6,059.81
87988 00827 WORK COMP QUARTERLY OCT-DEC 126,011.25
00827 INSURANCE QTR PREMIUM OCT-DEC 44,757.75
87989 00846 PHONE-BASED INTERPRETIVE SRVS 133.88
87990 00857 PATROL ONLINE SUBSCRIPTION 35.42
87991 00001 REFUND P EATON MEMBERSHIP 191.21
87992 00001 REFUND B JAMBOR MEMBERSHIP 136.10
87993 00001 REFUND G EDGETT - TREE REBATE 100.00
87994 00001 REFUND A HUSTINGS BCBS BENEFIT 100.00
87995 00001 REFUND M HUBERTY BCBS BENEFIT 100.00
87996 00001 REFUND S STOLTE - TREE REBATE 91.60
87997 00001 REFUND S ERICSON SOCCER 68.00
87998 00001 REFUND LEE MEDICA BENEFIT 60.00
87999 00001 REFUND T SMITH BDAY PARTY 50.00
88000 00001 REFUND H RUSSELL HP BENEFIT 40.00
88001 04581 SUBSCRIPTION FOR LETS - SEPT 150.00
88002 04272 AXIS CAMERAS FOR PD 887.24
04272 AXIS CAMERA FOR PD 403.10
88003 02001 PHONE SERVICE - SEPTEMBER 1,436.20
88004 01387 ADMIN FEE FOR STRESS TEST - SEPT 100.00
88005 05099 PRESENTER FOR MUSHROOM CLASS 75.00
88006 01836 RADIO SHOP SERVICES - AUGUST 65.00
88007 03826 REPLACEMENT LIGHT POLES/FIXTURES 8,845.00
88008 04104 RENTAL AGREEMENT MCC CONDENSER 9,176.16
88009 04334 AMMUNITION 1,392.00
88010 03606 PROJ 11-09 MW MALL SIDEWALK PMT#2 71,186.91
Check Register
City of Maplewood
09/21/2012
Date Vendor
09/14/2012 ERICH THALHEIMER
09/20/2012 MAPLEWOOD BUSINESS CENTER, INC
09/20/2012 ROGER LOGAN
09/20/2012 LANDMARK INC
09/20/2012 SUMMIT COMMUNITY BANK
09/20/2012 BBD INVESTMENTS, INC.
09/20/2012 A A METCALF MOVING STORAGE CO
09/25/2012 HUGO'S TREE CARE INC
09/25/2012 HUGO'S TREE CARE INC
09/25/2012 HUGO'S TREE CARE INC
09/20/2012 MILLER & STEVENS, P.A.
09/25/2012 H.A. KANTRUD
09/25/2012 HUGO'S TREE CARE INC
09/25/2012 XCEL ENERGY
09/25/2012 XCEL ENERGY
09/25/2012 XCEL ENERGY
09/25/2012 METROPOLITAN COUNCIL
09/25/2012 NYSTROM PUBLISHING CO INC
09/25/2012 T.A. SCHIFSKY & SONS, INC
09/25/2012 ALEX AIR APPARATUS INC
09/25/2012 AMERICAN RED CROSS
09/25/2012 ATLANTIS POOLS
09/25/2012 XCEL ENERGY
09/25/2012 YOCUM OIL CO.
09/25/2012 CRAIG AICHELE
09/25/2012 DECKCI DECOR
09/25/2012 EGAN COMPANIES INC
09/25/2012 ENERGY ALTERNATIVES SOLAR, LLC
09/25/2012 BRANDL ANDERSON HOMES INC
09/25/2012 CHAPS PRODUCTIONS, INC.
09/25/2012 CRETEX CONCRETE PRODUCTS NORTH
09/25/2012 FOTH INFRASTRUCTURE & ENVIR
09/25/2012 FRA-DOR INC.
09/25/2012 GRAFFIC TRAFFIC LLC
09/25/2012 ENERGY ALTERNATIVES SOLAR, LLC
09/25/2012 EVERGREEN LAND SERVICES
09/25/2012 FIRE CATT, LLC
09/25/2012 KATH FUEL OIL SERVICE CO
09/25/2012 L M C I T
09/25/2012 L M C I T
09/25/2012 HEALTHEAST
09/25/2012 HELKE'S TREE SERVICE, INC.
09/25/2012 KANSAS STATE BANK
09/25/2012 ONE TIME VENDOR
09/25/2012 ONE TIME VENDOR
09/25/2012 ONE TIME VENDOR
09/25/2012 LANGUAGE LINE SERVICES
09/25/2012 LEAGUE OF MINNESOTA CITIES
09/25/2012 ONE TIME VENDOR
09/25/2012 ONE TIME VENDOR
09/25/2012 ONE TIME VENDOR
09/25/2012 ONE TIME VENDOR
09/25/2012 ONE TIME VENDOR
09/25/2012 ONE TIME VENDOR
09/25/2012 ONE TIME VENDOR
09/25/2012 CITY OF ROSEVILLE
09/25/2012 DR. JAMES ROSSINI
09/25/2012 RONALD C. SPINOSA
09/25/2012 ORION SYSTEMS/NETWORKS
09/25/2012 PARAGON SOLUTIONS GROUP, INC.
09/25/2012 PARAGON SOLUTIONS GROUP, INC.
09/25/2012 ULTRAMAX
09/25/2012 URBAN COMPANIES
1,084,967.47
57 Checks in this report.
09/25/2012 CITY OF ST PAUL
09/25/2012 STERNBERG LIGHTING, INC
09/25/2012 TRANE U.S. INC.
Packet Page Number 16 of 224
S:\FINANCE\APPROVAL OF CLAIMS\2012\AprClms - 9-21-12 and 9-28-12.xlsx
Settlement
Date Payee Description Amount
9/17/2012 MN State Treasurer Drivers License/Deputy Registrar 30,556.99
9/17/2012 VANCO Billing fee 117.25
9/17/2012 U.S. Treasurer Federal Payroll Tax 99,912.50
9/17/2012 P.E.R.A.P.E.R.A.90,845.51
9/18/2012 MN State Treasurer Drivers License/Deputy Registrar 27,910.41
9/18/2012 MidAmerica - ING HRA Flex plan 13,833.14
9/18/2012 Labor Unions Union Dues 2,114.90
9/19/2012 MN State Treasurer Drivers License/Deputy Registrar 33,220.20
9/19/2012 MN State Treasurer State Payroll Tax 21,638.25
9/20/2012 MN State Treasurer Drivers License/Deputy Registrar 19,807.31
9/20/2012 MN Dept of Revenue Sales Tax 5,485.00
9/21/2012 MN State Treasurer Drivers License/Deputy Registrar 24,695.06
9/21/2012 MN Dept of Natural Resources DNR electronic licenses 525.00
9/21/2012 Optum Health DCRP & Flex plan payments 1,519.09
TOTAL 372,180.61
CITY OF MAPLEWOOD
Disbursements via Debits to Checking account
Packet Page Number 17 of 224
S:\FINANCE\APPROVAL OF CLAIMS\2012\AprClms - 9-21-12 and 9-28-12.xlsx
Check Description Amount
88011 02464 FUNDS FOR ATM - MCC 10,000.00
88012 00001 REFUND K CUMMINGS AMB - MN RR 1,000.00
88013 02464 FUNDS FOR ATMS 10,000.00
88014 00216 LEGAL OPINION ON BOND ISSUE 3,000.00
88015 02149 MARKETING & ADVERTISING - SEPT 4,000.00
88016 04137 KARATE INSTRUCTION JULY & AUG 1,242.00
88017 00585 NET BILLABLE TICKETS - AUGUST 996.45
00585 NET BILLABLE TICKETS - JULY 936.70
88018 04316 AUTO PAWN SYSTEM - AUGUST 653.40
88019 01819 LOCAL PHONE SERVICE 08/15 - 09/14 766.64
88020 01546 VOLLEYBALL SHIRTS 1,852.50
88021 01574 PROJ 11-14 BARTELMY-MEYER PMT#6 227,197.64
01574 1100 TON 41 WEAR~12,225.93
88022 01190 ELECTRIC & GAS UTILITY 17,456.72
01190 ELECTRIC & GAS UTILITY 4,179.66
88023 04407 CONCERT MCC SEPT 21 2,775.50
88024 00111 PATROL HOURS & CALL-OUT 9/3-9/23 2,033.00
00111 ANIMAL MEDICAL & DESTRUCTION FEES 1,870.90
88025 04471 SOUND TECHNICIAN FOR MCC SEPT 14 450.00
88026 05100 SPEAKER AT PD IN-SERVICE TRAINING 500.00
88027 02750 REIMB FOR BOOT 9/21 155.99
88028 05051 CONSULTING WORK WITH BEDC/EDA 2,312.84
88029 05060 LABLES FOR ACCUVOTE MACHINES 32.95
88030 04947 PROJ 11-15 MILLS/OVERLAYS PMT#4 448,071.72
88031 02995 AWARE RIGHT-TO-KNOW TRAINING 1,128.00
02995 AWARE RIGHT-TO-KNOW TRAINING-PD 540.00
02995 SAFETY TRAINING PUBLIC WORKS 370.00
88032 00827 CLAIM DEDUCTIBLE C0013354 1,194.90
88033 02530 PROJ 09-08 APPRAISAL OF EASEMENTS 5,000.00
88034 00983 LEASE PMT 09/15/12 TO 10/15/12 484.14
88035 02617 DARE SUPPLIES - PRIZES 17.92
88036 01060 REGISTRATION FEE 210.00
88037 01175 MONTHLY UTILITIES - SEPT 3,325.94
01175 FIBER OPTIC ACCESS CHG - SEPT 1,000.00
88038 02300 MAKE KEYS FOR MCC 24.37
88039 00001 REFUND A RODRIGUEZ TRANS MEDIC 1,535.00
88040 00001 REFUND F MARTIN BCBS BENEFIT 120.00
88041 00001 REIMB K THOMPSON LANDSCAPING 100.00
88042 00001 REFUND K GUSICK VOLLEYBALL 57.00
88043 00001 REFUND B TAPE CANCELLED TRIP 56.00
88044 00001 REFUND M HAUSLADEN TRANS MEDIC 40.00
88045 00001 REFUND D NOVAK BLUE CROSS 40.00
88046 00001 REFUND M HURTLEY HP BENEFIT 20.00
88047 00001 REFUND J BOROVSKY MEDICA BENEFIT 20.00
88048 01359 CAR WASHES - AUGUST 138.91
88049 01418 VENDING MACHINE SUPPLIES 299.46
01418 CONCESSIONS 195.20
01418 RETIREMENT PARTY 81.03
01418 SUPPLIES FOR NSP 5K 59.68
88050 01455 SECURITY OFFICER FOR MCC SEPT 15 245.00
88051 01616 SECURITY OFFICER FOR MCC SEPT 22 227.50
88052 03606 ESCROW RELEASE 1850 WHITE BEAR AVE 2,000.00
772,240.59
42 Checks in this report.
10/02/2012 MICHAEL SHORTREED
10/02/2012 PAUL THIENES
10/02/2012 URBAN COMPANIES
10/02/2012 SAM'S CLUB DIRECT
10/02/2012 SAM'S CLUB DIRECT
10/02/2012 SAM'S CLUB DIRECT
10/02/2012 ONE TIME VENDOR
10/02/2012 REGAL AUTO WASH BILLING
10/02/2012 SAM'S CLUB DIRECT
10/02/2012 ONE TIME VENDOR
10/02/2012 ONE TIME VENDOR
10/02/2012 ONE TIME VENDOR
10/02/2012 ONE TIME VENDOR
10/02/2012 ONE TIME VENDOR
10/02/2012 ONE TIME VENDOR
10/02/2012 OAKDALE LOCKSMITHS
10/02/2012 ONE TIME VENDOR
10/02/2012 ONE TIME VENDOR
10/02/2012 MN STATE FIRE CHIEFS ASSOC
10/02/2012 CITY OF NORTH ST PAUL
10/02/2012 CITY OF NORTH ST PAUL
10/02/2012 MCKINZIE METRO APPRAISAL
10/02/2012 METRO SALES INC
10/02/2012 ALESIA METRY
10/02/2012 INTEGRATED LOSS CONTROL INC
10/02/2012 INTEGRATED LOSS CONTROL INC
10/02/2012 L M C I T
10/02/2012 GBS INC
10/02/2012 HARDRIVES, INC.
10/02/2012 INTEGRATED LOSS CONTROL INC
10/02/2012 BROCKTON D. HUNTER P.A.
10/02/2012 RICHARD DAWSON
10/02/2012 ECONOMIC DEVELOPMENT SRVS INC
10/02/2012 ANIMAL CONTROL SERVICES
10/02/2012 ANIMAL CONTROL SERVICES
10/02/2012 B&B AVM INC.
10/02/2012 XCEL ENERGY
10/02/2012 XCEL ENERGY
09/28/2012 KERI NOBLE
10/02/2012 SUBURBAN SPORTSWEAR
10/02/2012 T.A. SCHIFSKY & SONS, INC
10/02/2012 T.A. SCHIFSKY & SONS, INC
10/02/2012 GOPHER STATE ONE-CALL
10/02/2012 CITY OF MINNEAPOLIS RECEIVABLES
10/02/2012 PAETEC
10/02/2012 THE EDGE MARTIAL ARTS
10/02/2012 GOPHER STATE ONE-CALL
09/25/2012 ONE TIME VENDOR
09/27/2012 US BANK
10/02/2012 BRIGGS & MORGAN, P.A.
Check Register
City of Maplewood
09/28/2012
Date Vendor
09/25/2012 US BANK
10/02/2012 HEIDI CAREY
Packet Page Number 18 of 224
S:\FINANCE\APPROVAL OF CLAIMS\2012\AprClms - 9-21-12 and 9-28-12.xlsx
Settlement
Date Payee Description Amount
9/24/2012 MN State Treasurer Drivers License/Deputy Registrar 27,567.33
9/24/2012 MN Dept of Revenue Fuel Tax 381.05
9/25/2012 MN State Treasurer Drivers License/Deputy Registrar 32,751.03
9/26/2012 MN State Treasurer Drivers License/Deputy Registrar 18,131.71
9/26/2012 Pitney Bowes Postage 2,985.00
9/27/2012 MN State Treasurer Drivers License/Deputy Registrar 15,813.15
9/27/2012 ING - State Plan Deferred Compensation 27,555.00
9/27/2012 US Bank Bank fees 109.28
9/28/2012 MN State Treasurer Drivers License/Deputy Registrar 45,560.14
9/28/2012 MN Dept of Natural Resources DNR electronic licenses 415.50
9/28/2012 US Bank VISA One Card*Purchasing card items 59,875.66
9/28/2012 Optum Health DCRP & Flex plan payments 53.68
9/28/2012 ICMA (Vantagepointe)Deferred Compensation 4,469.15
TOTAL 235,667.68
*Detailed listing of VISA purchases is attached.
CITY OF MAPLEWOOD
Disbursements via Debits to Checking account
Packet Page Number 19 of 224
S:\FINANCE\APPROVAL OF CLAIMS\2012\AprClms - 9-21-12 and 9-28-12.xlsx
Transaction Date Posting Date Merchant Name Transaction Amount Name
09/11/2012 09/12/2012 UNIFORMS UNLIMITED INC.$15.68 CLINT ABEL
09/20/2012 09/21/2012 HENRIKSEN ACE HARDWARE $4.50 DAVE ADAMS
09/20/2012 09/21/2012 UNIFORMS UNLIMITED INC.$39.96 MARK ALDRIDGE
09/10/2012 09/11/2012 WILD MOUNTAIN $100.00 MANDY ANZALDI
09/13/2012 09/14/2012 OLD LOG THEATER $322.50 MANDY ANZALDI
09/19/2012 09/20/2012 ARROWWOOD RESORT & CONF C $230.86 GAYLE BAUMAN
09/20/2012 09/21/2012 ARROWWOOD RESORT & CONF C $130.86 GAYLE BAUMAN
09/10/2012 09/12/2012 PAPER PLUS-ROS00108803 $10.60 REGAN BEGGS
09/10/2012 09/12/2012 PAPER PLUS-ROS00108803 $30.34 REGAN BEGGS
09/10/2012 09/12/2012 PAPER PLUS-ROS00108803 $468.82 REGAN BEGGS
09/10/2012 09/12/2012 PAPER PLUS-ROS00108803 $466.64 REGAN BEGGS
09/10/2012 09/12/2012 PAPER PLUS-ROS00108803 $791.43 REGAN BEGGS
09/19/2012 09/21/2012 OFFICE MAX $52.48 REGAN BEGGS
09/10/2012 09/11/2012 BEST BUY MHT 00000109 $321.31 CHAD BERGO
09/10/2012 09/11/2012 BEST BUY 00027011 $160.65 CHAD BERGO
09/15/2012 09/17/2012 STONE MOUNTAIN PET LODG $221.21 BRIAN BIERDEMAN
09/16/2012 09/17/2012 DELTA AIR 0068279116474 $25.00 BRIAN BIERDEMAN
09/16/2012 09/18/2012 MAIN TERM CHIL20358107 $14.33 BRIAN BIERDEMAN
09/16/2012 09/18/2012 SOCORRO SPRINGS BREWING C $12.69 BRIAN BIERDEMAN
09/17/2012 09/18/2012 BUCKHORN $17.84 BRIAN BIERDEMAN
09/17/2012 09/19/2012 NMT CHARTWELLS28099539 $7.00 BRIAN BIERDEMAN
09/18/2012 09/19/2012 CHARTWELLS DIN21099536 $7.00 BRIAN BIERDEMAN
09/18/2012 09/20/2012 OLD TOWN BISTRO $16.23 BRIAN BIERDEMAN
09/18/2012 09/20/2012 MCDONALD'S F5808 $6.09 BRIAN BIERDEMAN
09/19/2012 09/20/2012 CHARTWELLS DIN21099536 $7.00 BRIAN BIERDEMAN
09/19/2012 09/21/2012 BODEGA BURGER CO & LOU $30.73 BRIAN BIERDEMAN
09/20/2012 09/21/2012 CHARTWELLS DIN21099536 $7.00 BRIAN BIERDEMAN
09/20/2012 09/21/2012 BUCKHORN $17.05 BRIAN BIERDEMAN
09/10/2012 09/11/2012 DICKS SPORTING GOODS#393 $21.40 NEIL BRENEMAN
09/10/2012 09/12/2012 STRAUSS SKATES AND BIC $85.70 NEIL BRENEMAN
09/13/2012 09/14/2012 HENRIKSEN ACE HARDWARE $7.48 NEIL BRENEMAN
09/14/2012 09/17/2012 PARTY CITY #768 $12.80 NEIL BRENEMAN
09/07/2012 09/10/2012 DIAMOND VOGEL PAINT #807 $224.44 TROY BRINK
09/20/2012 09/21/2012 SIMPLEX SUPPLIES $205.25 TROY BRINK
09/20/2012 09/21/2012 BROCK WHITE ST PAUL 180 $124.85 TROY BRINK
09/13/2012 09/17/2012 OAKDALE RENTAL CENTER $202.47 BRENT BUCKLEY
09/13/2012 09/17/2012 OAKDALE RENTAL CENTER $207.82 BRENT BUCKLEY
09/14/2012 09/17/2012 THE HOME DEPOT 2801 $27.83 BRENT BUCKLEY
09/18/2012 09/20/2012 MIKES LP GAS INC $55.13 BRENT BUCKLEY
09/10/2012 09/11/2012 PANERA BREAD #1305 $89.96 SARAH BURLINGAME
09/11/2012 09/13/2012 MENARDS 3022 $4.27 JOHN CAPISTRANT
09/11/2012 09/13/2012 THE HOME DEPOT 2801 $2.55 SCOTT CHRISTENSON
09/11/2012 09/13/2012 THE HOME DEPOT 2801 $24.26 SCOTT CHRISTENSON
09/14/2012 09/17/2012 THE HOME DEPOT 2801 $413.76 SCOTT CHRISTENSON
09/12/2012 09/13/2012 BEST WESTERN HOTELS - ST.$86.53 KERRY CROTTY
09/08/2012 09/10/2012 G&K SERVICES 182 $91.80 CHARLES DEAVER
09/20/2012 09/21/2012 MENARDS 3022 $40.33 CHARLES DEAVER
09/06/2012 09/10/2012 THE HOME DEPOT 2801 $55.04 TOM DOUGLASS
09/08/2012 09/10/2012 ECOLAB EQUIP CARE - GCS $1,836.18 TOM DOUGLASS
09/10/2012 09/12/2012 THE HOME DEPOT 2801 $8.74 TOM DOUGLASS
09/10/2012 09/13/2012 GENERAL PARTS, LLC ($138.40)TOM DOUGLASS
09/12/2012 09/13/2012 HENRIKSEN ACE HARDWARE $4.48 TOM DOUGLASS
09/12/2012 09/14/2012 THE HOME DEPOT 2801 $106.48 TOM DOUGLASS
09/14/2012 09/17/2012 NUCO2 01 OF 01 $196.21 TOM DOUGLASS
09/14/2012 09/17/2012 NUCO2 01 OF 01 $93.93 TOM DOUGLASS
09/14/2012 09/17/2012 NUCO2 01 OF 01 $167.69 TOM DOUGLASS
09/14/2012 09/17/2012 NUCO2 01 OF 01 $156.20 TOM DOUGLASS
09/14/2012 09/17/2012 NUCO2 01 OF 01 $102.33 TOM DOUGLASS
Packet Page Number 20 of 224
S:\FINANCE\APPROVAL OF CLAIMS\2012\AprClms - 9-21-12 and 9-28-12.xlsx
09/14/2012 09/17/2012 NUCO2 01 OF 01 $279.97 TOM DOUGLASS
09/19/2012 09/20/2012 EXCEL DRYER INC $404.00 TOM DOUGLASS
09/14/2012 09/17/2012 HENRIKSEN ACE HARDWARE $5.32 JOHN DUCHARME
09/16/2012 09/17/2012 DELTA AIR 0068279316887 $25.00 MICHAEL DUGAS
09/16/2012 09/18/2012 MAIN TERM CHIL20358107 $23.89 MICHAEL DUGAS
09/16/2012 09/18/2012 SOCORRO SPRINGS BREWING C $16.10 MICHAEL DUGAS
09/17/2012 09/18/2012 BUCKHORN $15.19 MICHAEL DUGAS
09/17/2012 09/19/2012 NMT CHARTWELLS28099539 $7.00 MICHAEL DUGAS
09/18/2012 09/19/2012 CHARTWELLS DIN21099536 $7.00 MICHAEL DUGAS
09/18/2012 09/20/2012 OLD TOWN BISTRO $20.00 MICHAEL DUGAS
09/19/2012 09/20/2012 CHARTWELLS DIN21099536 $7.00 MICHAEL DUGAS
09/19/2012 09/21/2012 BODEGA BURGER CO & LOU $34.12 MICHAEL DUGAS
09/20/2012 09/21/2012 CHARTWELLS DIN21099536 $7.00 MICHAEL DUGAS
09/20/2012 09/21/2012 BUCKHORN $26.73 MICHAEL DUGAS
09/13/2012 09/17/2012 ADVANCE SHORING COMPANY $179.02 DOUG EDGE
09/07/2012 09/10/2012 HENRIKSEN ACE HARDWARE $6.95 DAVE EDSON
09/20/2012 09/21/2012 JOHN DEERE LANDSCAPES530 $634.09 DAVE EDSON
09/13/2012 09/14/2012 TARGET 00011858 $201.08 PAUL E EVERSON
09/14/2012 09/17/2012 BOUND TREE MEDICAL LLC $166.00 PAUL E EVERSON
09/16/2012 09/17/2012 KOHL'S #0052 $34.99 PAUL E EVERSON
09/06/2012 09/10/2012 THE TRANE COMPANY $904.50 LARRY FARR
09/08/2012 09/10/2012 G&K SERVICES 182 $434.94 LARRY FARR
09/08/2012 09/10/2012 G&K SERVICES 182 $763.03 LARRY FARR
09/13/2012 09/14/2012 ELECTRO WATCHMAN INC $188.76 LARRY FARR
09/16/2012 09/18/2012 THE HOME DEPOT 2810 $129.40 LARRY FARR
09/17/2012 09/18/2012 TARGET 00006197 $44.74 LARRY FARR
09/18/2012 09/20/2012 WW GRAINGER $1,475.94 LARRY FARR
09/19/2012 09/20/2012 AQUA LOGICS INC $738.51 LARRY FARR
09/19/2012 09/20/2012 AQUA LOGICS INC $619.88 LARRY FARR
09/20/2012 09/21/2012 TWIN CITY HARDWARE HADLEY $286.93 LARRY FARR
09/14/2012 09/17/2012 BEST WESTERN HOTEL $198.66 DAVID FISHER
09/14/2012 09/17/2012 BEST WESTERN HOTEL $198.66 DAVID FISHER
09/14/2012 09/17/2012 BEST WESTERN HOTEL $198.66 DAVID FISHER
09/14/2012 09/17/2012 BEST WESTERN HOTEL $198.66 DAVID FISHER
09/14/2012 09/17/2012 LA POLICE GEAR INC $99.98 TIMOTHY FLOR
09/10/2012 09/12/2012 PAY FLOW PRO $67.55 MYCHAL FOWLDS
09/19/2012 09/20/2012 TOSHIBA BUSINESS SOLUTION $588.37 MYCHAL FOWLDS
09/19/2012 09/20/2012 TOSHIBA BUSINESS SOLUTION $853.88 MYCHAL FOWLDS
09/19/2012 09/20/2012 TOSHIBA BUSINESS SOLUTION $764.42 MYCHAL FOWLDS
09/20/2012 09/21/2012 CABLING SERVICES $573.00 MYCHAL FOWLDS
09/20/2012 09/21/2012 CABLING SERVICES $4,457.45 MYCHAL FOWLDS
09/21/2012 09/21/2012 COMCAST CABLE COMM $54.00 MYCHAL FOWLDS
09/08/2012 09/10/2012 IDU*INSIGHT PUBLIC SEC $313.47 NICK FRANZEN
09/08/2012 09/10/2012 B & H PHOTO-VIDEO.COM $254.00 NICK FRANZEN
09/11/2012 09/12/2012 IDU*INSIGHT PUBLIC SEC $604.65 NICK FRANZEN
09/19/2012 09/20/2012 UNIFORMS UNLIMITED INC.$9.62 DEREK FRITZE
09/11/2012 09/12/2012 FOOTLOCKER $79.99 ANTHONY GABRIEL
09/17/2012 09/19/2012 OFFICE DEPOT #1090 $80.26 JEAN GLASS
09/19/2012 09/21/2012 NIHCA $125.42 JEAN GLASS
09/10/2012 09/11/2012 FRATTALLONES WOODBURY AC $85.69 JAN GREW HAYMAN
09/19/2012 09/20/2012 HANCOCK FABRICS 1794 $11.91 JAN GREW HAYMAN
09/20/2012 09/21/2012 TARGET 00024067 $32.89 JAN GREW HAYMAN
09/07/2012 09/10/2012 VZWRLSS*APOCC VISN $107.44 KAREN GUILFOILE
09/11/2012 09/12/2012 BATTERIES PLUS #31 $187.09 MARK HAAG
09/11/2012 09/12/2012 HENRIKSEN ACE HARDWARE $1.49 MARK HAAG
09/18/2012 09/20/2012 YOCUM OIL CO $64.01 MARK HAAG
09/08/2012 09/10/2012 AMAZON.COM $28.44 TIMOTHY HAWKINSON JR.
09/10/2012 09/11/2012 UNIFORMS UNLIMITED INC.($40.51)TIMOTHY HAWKINSON JR.
09/12/2012 09/13/2012 MENARDS 3059 $27.60 GARY HINNENKAMP
Packet Page Number 21 of 224
S:\FINANCE\APPROVAL OF CLAIMS\2012\AprClms - 9-21-12 and 9-28-12.xlsx
09/12/2012 09/14/2012 THE HOME DEPOT 2801 $254.58 GARY HINNENKAMP
09/20/2012 09/21/2012 ARC*SERVICES/TRAINING $27.00 RON HORWATH
09/20/2012 09/21/2012 ARC*SERVICES/TRAINING $27.00 RON HORWATH
09/07/2012 09/10/2012 BLUE RIBBON BAIT & TACKLE $12.81 ANN HUTCHINSON
09/13/2012 09/17/2012 THE HOME DEPOT 2810 $140.86 ANN HUTCHINSON
09/07/2012 09/10/2012 THE HOME DEPOT 2801 $35.91 DAVID JAHN
09/19/2012 09/20/2012 WALMART.COM 8009666546 $36.25 DAVID JAHN
09/14/2012 09/17/2012 LA POLICE GEAR INC $99.98 KEVIN JOHNSON
09/13/2012 09/17/2012 THE HOME DEPOT 2801 $74.96 TOM KALKA
09/11/2012 09/12/2012 PIONEER PRESS SUBSCRIPTI $573.50 DUWAYNE KONEWKO
09/20/2012 09/20/2012 COMCAST CABLE COMM $143.80 DUWAYNE KONEWKO
09/17/2012 09/18/2012 LA POLICE GEAR INC $169.97 TOMMY KONG
09/17/2012 09/18/2012 UNIFORMS UNLIMITED INC.$15.50 NICHOLAS KREKELER
09/10/2012 09/11/2012 THE GRAFIX SHOPPE $335.00 DAVID KVAM
09/10/2012 09/11/2012 UNIFORMS UNLIMITED INC.$28.50 DAVID KVAM
09/12/2012 09/13/2012 UNIFORMS UNLIMITED INC.$29.25 DAVID KVAM
09/13/2012 09/13/2012 COMCAST CABLE COMM $41.00 DAVID KVAM
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Packet Page Number 22 of 224
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09/10/2012 09/12/2012 PIONEER PRESS ADVERTISING $350.00 CHRISTINE PENN
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Packet Page Number 23 of 224
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09/19/2012 09/21/2012 OFFICE DEPOT #1090 $246.57 KAREN WACHAL
09/12/2012 09/13/2012 UNIFORMS UNLIMITED INC.$239.56 JAY WENZEL
09/17/2012 09/18/2012 LA POLICE GEAR INC $199.96 KAO XIONG
09/13/2012 09/14/2012 AMAZON.COM $82.10 TAMMY YOUNG
09/20/2012 09/21/2012 MEDICBATTERIES COM $88.79 SUSAN ZWIEG
$59,875.66
Packet Page Number 24 of 224
S:\FINANCE\APPROVAL OF CLAIMS\2012\AprClms - 9-21-12 and 9-28-12.xlsx
CHECK #CHECK DATE EMPLOYEE NAME
09/28/12 ALDRIDGE, MARK 3,156.49
09/28/12 THOMFORDE, FAITH 1,497.35
09/28/12 ABEL, CLINT 2,878.21
09/28/12 SVENDSEN, JOANNE 2,140.16
09/28/12 THOMALLA, DAVID 4,961.38
09/28/12 PALANK, MARY 1,905.17
09/28/12 POWELL, PHILIP 2,932.46
09/28/12 CORCORAN, THERESA 1,900.55
09/28/12 KVAM, DAVID 4,209.55
09/28/12 SCHOENECKER, LEIGH 1,646.15
09/28/12 WEAVER, KRISTINE 2,356.55
09/28/12 OSTER, ANDREA 1,907.49
09/28/12 RICHTER, CHARLENE 941.61
09/28/12 MECHELKE, SHERRIE 978.07
09/28/12 MOY, PAMELA 1,520.44
09/28/12 CORTESI, LUANNE 1,109.02
09/28/12 LARSON, MICHELLE 1,827.76
09/28/12 SCHMIDT, DEBORAH 2,884.82
09/28/12 SPANGLER, EDNA 948.26
09/28/12 BEGGS, REGAN 1,497.35
09/28/12 GUILFOILE, KAREN 4,207.64
09/28/12 SINDT, ANDREA 2,113.80
09/28/12 ARNOLD, AJLA 1,617.69
09/28/12 KELSEY, CONNIE 2,594.79
09/28/12 RUEB, JOSEPH 2,642.60
09/28/12 DEBILZAN, JUDY 1,327.92
09/28/12 JACKSON, MARY 2,126.07
09/28/12 BAUMAN, GAYLE 4,186.17
09/28/12 ANDERSON, CAROLE 1,582.99
09/28/12 JAHN, DAVID 1,860.28
09/28/12 RAMEAUX, THERESE 3,061.18
09/28/12 CHRISTENSON, SCOTT 2,158.35
09/28/12 FARR, LARRY 3,215.25
09/28/12 BURLINGAME, SARAH 2,074.90
09/28/12 KANTRUD, HUGH 184.62
09/28/12 AHL, R. CHARLES 5,008.64
09/28/12 ANTONEN, JAMES 5,352.58
09/28/12 STRAUTMANIS, MARIS 50.00
09/28/12 VALLE, EDWARD 100.00
09/28/12 LLANAS, JAMES 435.16
09/28/12 ROSSBACH, WILLIAM 494.44
09/28/12 JUENEMANN, KATHLEEN 435.16
09/28/12 KOPPEN, MARVIN 435.16
CITY OF MAPLEWOOD
EMPLOYEE GROSS EARNINGS REPORT
FOR THE CURRENT PAY PERIOD
AMOUNT
09/28/12 CARDINAL, ROBERT 435.16
Packet Page Number 25 of 224
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09/28/12 BASSETT, BRENT 242.40
09/28/12 ANDERSON, BRIAN 309.88
09/28/12 BAHL, DAVID 335.84
09/28/12 WENZEL, JAY 3,086.32
09/28/12 XIONG, KAO 2,878.21
09/28/12 THIENES, PAUL 4,587.18
09/28/12 TRAN, JOSEPH 2,992.55
09/28/12 TAUZELL, BRIAN 2,871.44
09/28/12 THEISEN, PAUL 3,150.93
09/28/12 SYPNIEWSKI, WILLIAM 2,845.55
09/28/12 SZCZEPANSKI, THOMAS 3,060.04
09/28/12 SHORTREED, MICHAEL 4,091.18
09/28/12 STEINER, JOSEPH 3,079.58
09/28/12 REZNY, BRADLEY 2,980.55
09/28/12 RHUDE, MATTHEW 3,144.76
09/28/12 OLSON, JULIE 2,937.06
09/28/12 PARKER, JAMES 2,453.48
09/28/12 METRY, ALESIA 3,038.70
09/28/12 NYE, MICHAEL 3,551.63
09/28/12 MARTIN, JERROLD 3,826.83
09/28/12 MCCARTY, GLEN 3,092.20
09/28/12 LYNCH, KATHERINE 2,453.48
09/28/12 MARINO, JASON 2,984.41
09/28/12 LANGNER, TODD 2,980.04
09/28/12 LU, JOHNNIE 3,117.16
09/28/12 KROLL, BRETT 2,891.66
09/28/12 LANGNER, SCOTT 3,092.20
09/28/12 KONG, TOMMY 2,964.17
09/28/12 KREKELER, NICHOLAS 876.00
09/28/12 JOHNSON, KEVIN 4,142.24
09/28/12 KALKA, THOMAS 940.28
09/28/12 HER, PHENG 2,819.55
09/28/12 HIEBERT, STEVEN 3,377.35
09/28/12 GABRIEL, ANTHONY 3,263.36
09/28/12 HAWKINSON JR, TIMOTHY 2,884.73
09/28/12 FRASER, JOHN 3,203.29
09/28/12 FRITZE, DEREK 3,443.61
09/28/12 ERICKSON, VIRGINIA 3,209.56
09/28/12 FLOR, TIMOTHY 3,725.17
09/28/12 DOBLAR, RICHARD 4,005.46
09/28/12 DUGAS, MICHAEL 4,311.20
09/28/12 CROTTY, KERRY 3,611.21
09/28/12 DEMULLING, JOSEPH 2,897.56
09/28/12 CARNES, JOHN 1,918.52
09/28/12 COFFEY, KEVIN 3,143.71
09/28/12 BOHL, JOHN 3,151.33
09/28/12 BUSACK, DANIEL 3,808.28
09/28/12 BENJAMIN, MARKESE 2,819.55
09/28/12 BIERDEMAN, BRIAN 3,683.24
09/28/12 BARTZ, PAUL 3,616.77
09/28/12 BELDE, STANLEY 2,990.84
09/28/12 BAKKE, LONN 3,045.48
Packet Page Number 26 of 224
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09/28/12 WESSELS, TIMOTHY 193.92
09/28/12 STREFF, MICHAEL 3,159.96
09/28/12 SVENDSEN, RONALD 2,930.49
09/28/12 SCHULTZ, JEROME 303.00
09/28/12 SEDLACEK, JEFFREY 3,651.10
09/28/12 RICE, CHRISTOPHER 282.82
09/28/12 RODRIGUEZ, ROBERTO 290.88
09/28/12 RAVENWALD, CORINNE 145.44
09/28/12 REYNOSO, ANGEL 296.94
09/28/12 RANK, NATHAN 727.20
09/28/12 RANK, PAUL 436.32
09/28/12 POWERS, KENNETH 315.12
09/28/12 RAINEY, JAMES 851.43
09/28/12 PETERSON, MARK 551.48
09/28/12 PETERSON, ROBERT 2,973.40
09/28/12 OPHEIM, JOHN 438.36
09/28/12 PACHECO, ALPHONSE 169.68
09/28/12 NOWICKI, PAUL 290.88
09/28/12 OLSON, JAMES 2,726.51
09/28/12 NIELSEN, KENNETH 145.44
09/28/12 NOVAK, JEROME 441.36
09/28/12 MONSON, PETER 266.64
09/28/12 MORGAN, JEFFERY 246.19
09/28/12 MILLER, NICHOLAS 484.80
09/28/12 MONDOR, MICHAEL 3,259.74
09/28/12 LOCHEN, MICHAEL 206.04
09/28/12 MILLER, LADD 494.92
09/28/12 KUBAT, ERIC 2,993.47
09/28/12 LINDER, TIMOTHY 3,880.34
09/28/12 KERSKA, JOSEPH 218.16
09/28/12 KONDER, RONALD 690.84
09/28/12 KANE, ROBERT 841.38
09/28/12 KARRAS, JAMIE 395.36
09/28/12 JONES, JONATHAN 266.64
09/28/12 JUREK, GREGORY 1,033.60
09/28/12 IMM, TRACY 339.36
09/28/12 JANSEN, CHAD 303.00
09/28/12 HAWTHORNE, ROCHELLE 2,662.42
09/28/12 HUTCHINSON, JAMES 537.34
09/28/12 HALE, JOSEPH 339.38
09/28/12 HALWEG, JODI 2,743.95
09/28/12 FOSSUM, ANDREW 3,354.54
09/28/12 HAGEN, MICHAEL 581.76
09/28/12 EATON, PAUL 593.88
09/28/12 EVERSON, PAUL 3,630.60
09/28/12 CRUMMY, CHARLES 290.88
09/28/12 DAWSON, RICHARD 4,000.00
09/28/12 CAPISTRANT, JOHN 848.44
09/28/12 CRAWFORD - JR, RAYMOND 663.57
09/28/12 BOURQUIN, RON 824.16
09/28/12 CAPISTRANT, JACOB 436.32
09/28/12 BAUMAN, ANDREW 3,143.01
Packet Page Number 27 of 224
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09/28/12 CARVER, NICHOLAS 3,244.09
09/28/12 MARTIN, MICHAEL 2,762.95
09/28/12 BRASH, JASON 2,393.35
09/28/12 EKSTRAND, THOMAS 3,829.34
09/28/12 FINWALL, SHANN 3,233.35
09/28/12 THOMPSON, DEBRA 760.22
09/28/12 YOUNG, TAMELA 2,015.75
09/28/12 KROLL, LISA 1,900.55
09/28/12 SWANSON, CHRIS 708.00
09/28/12 GAYNOR, VIRGINIA 3,244.09
09/28/12 ERICSON, MICHAEL 1,000.00
09/28/12 SOUTTER, CHRISTINE 496.14
09/28/12 WACHAL, KAREN 913.88
09/28/12 HAYMAN, JANET 1,394.05
09/28/12 HUTCHINSON, ANN 2,649.16
09/28/12 DEAVER, CHARLES 577.77
09/28/12 GERNES, CAROLE 677.28
09/28/12 NORDQUIST, RICHARD 363.46
09/28/12 BIESANZ, OAKLEY 1,308.08
09/28/12 HINNENKAMP, GARY 2,268.46
09/28/12 NAUGHTON, JOHN 2,146.15
09/28/12 HAMRE, MILES 1,513.60
09/28/12 HAYS, TAMARA 1,539.75
09/28/12 KONEWKO, DUWAYNE 4,413.24
09/28/12 EDSON, DAVID 2,191.39
09/28/12 ZIEMAN, SCOTT 241.40
09/28/12 JANASZAK, MEGHAN 1,497.35
09/28/12 LOVE, STEVEN 3,446.87
09/28/12 THOMPSON, MICHAEL 4,261.37
09/28/12 KREGER, JASON 2,173.80
09/28/12 LINDBLOM, RANDAL 3,269.89
09/28/12 ENGSTROM, ANDREW 2,631.75
09/28/12 JAROSCH, JONATHAN 2,924.73
09/28/12 BURLINGAME, NATHAN 2,087.21
09/28/12 DUCHARME, JOHN 2,740.37
09/28/12 RUNNING, ROBERT 2,619.05
09/28/12 TEVLIN, TODD 2,146.15
09/28/12 OSWALD, ERICK 2,340.28
09/28/12 RUIZ, RICARDO 1,539.75
09/28/12 MEISSNER, BRENT 2,006.15
09/28/12 NAGEL, BRYAN 3,560.40
09/28/12 EDGE, DOUGLAS 2,125.00
09/28/12 JONES, DONALD 2,146.15
09/28/12 BUCKLEY, BRENT 2,292.51
09/28/12 DEBILZAN, THOMAS 2,146.15
09/28/12 NIVEN, AMY 1,425.42
09/28/12 BRINK, TROY 2,750.33
09/28/12 ZWIEG, SUSAN 1,706.92
09/28/12 KNUTSON, LOIS 2,054.95
09/28/12 GERVAIS-JR, CLARENCE 3,985.69
09/28/12 LUKIN, STEVEN 4,616.93
09/28/12 WHITE, JOEL 484.80
Packet Page Number 28 of 224
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09/28/12 JANSON, ANGELA 76.50
09/28/12 HOLMBERG, LADONNA 570.00
09/28/12 HORWATH, RONALD 2,738.98
09/28/12 GRUENHAGEN, LINDA 355.85
09/28/12 HEINRICH, SHEILA 281.00
09/28/12 GIEL, NICOLE 114.00
09/28/12 GIPPLE, TRISHA 339.88
09/28/12 FOX, KELLY 60.00
09/28/12 FRAMPTON, SAMANTHA 181.50
09/28/12 ERICKSON-CLARK, CAROL 49.00
09/28/12 FONTAINE, KIM 478.63
09/28/12 DUNN, RYAN 1,094.53
09/28/12 EHLE, DANIEL 21.04
09/28/12 DEMPSEY, BETH 164.13
09/28/12 DIONNE, DANIELLE 234.46
09/28/12 BUTLER, ANGELA 102.00
09/28/12 CRANDALL, KRISTA 200.08
09/28/12 BAUDE, SARAH 73.00
09/28/12 BUCKLEY, BRITTANY 214.20
09/28/12 BAETZOLD, CLAIRE 73.50
09/28/12 BAETZOLD, SETH 36.25
09/28/12 ANDERSON, ALYSSA 13.56
09/28/12 ANDERSON, JOSHUA 393.55
09/28/12 VUE, LOR PAO 333.63
09/28/12 AICHELE, MEGAN 363.20
09/28/12 PENN, CHRISTINE 2,332.74
09/28/12 SHERRILL, CAITLIN 799.42
09/28/12 KULHANEK-DIONNE, ANN 355.50
09/28/12 PELOQUIN, PENNYE 520.05
09/28/12 HOFMEISTER, MARY 1,119.96
09/28/12 HOFMEISTER, TIMOTHY 426.73
09/28/12 GLASS, JEAN 2,125.10
09/28/12 HER, PETER 100.10
09/28/12 CRAWFORD - JR, RAYMOND 280.73
09/28/12 EVANS, CHRISTINE 1,363.62
09/28/12 SCHULTZ, SCOTT 3,090.82
09/28/12 ANZALDI, MANDY 1,467.38
09/28/12 HAAG, MARK 2,486.51
09/28/12 ORE, JORDAN 1,539.75
09/28/12 TAYLOR, JAMES 2,738.98
09/28/12 VUKICH, CANDACE 228.75
09/28/12 SCHALLER, SCOTT 80.63
09/28/12 SHERWOOD, CHRISTIAN 313.50
09/28/12 ROBBINS, AUDRA 3,019.96
09/28/12 ROBBINS, CAMDEN 185.50
09/28/12 FRANK, PETER 425.00
09/28/12 LARSON, KATELYN 210.00
09/28/12 BERGER, STEPHANIE 223.26
09/28/12 BRENEMAN, NEIL 2,267.65
09/28/12 SWAN, DAVID 2,766.15
09/28/12 WELLENS, MOLLY 1,894.71
09/28/12 FISHER, DAVID 3,807.86
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9987456
9987457
9987458
9987459
9987460 09/28/12 HEI, SAMUEL 70.00
09/28/12 BOEHM, BRIAN 76.25
09/28/12 CATTANACH, SETH 76.25
09/28/12 FORSYTHE, MARCUS 2,206.06
09/28/12 AYD, GWEN 122.00
09/28/12 FRANZEN, NICHOLAS 2,623.62
09/28/12 KRATTENMAKER, MATTHEW 1,147.50
09/28/12 BERGO, CHAD 2,628.80
09/28/12 FOWLDS, MYCHAL 3,791.22
09/28/12 PRIEM, STEVEN 2,415.66
09/28/12 WOEHRLE, MATTHEW 2,322.83
09/28/12 COUNTRYMAN, BRENDA 1,110.00
09/28/12 AICHELE, CRAIG 2,203.79
09/28/12 THOMPSON, BENJAMIN 440.50
09/28/12 VANG, GEORGE 130.50
09/28/12 PRINS, KELLY 1,690.15
09/28/12 REILLY, MICHAEL 1,934.15
09/28/12 KRECH, ELAINE 174.00
09/28/12 MALONEY, SHAUNA 240.00
09/28/12 BORCHERT, JONATHAN 137.75
09/28/12 DOUGLASS, TOM 1,756.55
09/28/12 LANGER, CHELSEA 144.50
09/28/12 LANGER, KAYLYN 110.50
09/28/12 BOSLEY, CAROL 153.60
09/28/12 HITE, ANDREA 206.00
09/28/12 TUPY, MARCUS 213.75
09/28/12 WARNER, CAROLYN 475.20
09/28/12 TAYLOR, MYLES 66.15
09/28/12 TREPANIER, TODD 176.00
09/28/12 SMITLEY, SHARON 336.70
09/28/12 STEAD, KIMBERLY 120.00
09/28/12 SMITH, ANN 121.80
09/28/12 SMITH, CASEY 69.83
09/28/12 SCHREINER, MARK 65.70
09/28/12 SCHREINER, MICHELLE 180.06
09/28/12 RONNING, ISAIAH 180.95
09/28/12 SCHREIER, ROSEMARIE 285.00
09/28/12 RESENDIZ, LORI 2,257.76
09/28/12 RICHTER, DANIEL 132.30
09/28/12 PROESCH, ANDY 794.09
09/28/12 RANEY, COURTNEY 620.00
09/28/12 NORTHOUSE, KATHERINE 68.88
09/28/12 POVLITZKI, MARINA 76.00
09/28/12 NADEAU, TAYLOR 65.70
09/28/12 NELSON, ELEONOR 100.00
09/28/12 LAMSON, ELIANA 36.00
09/28/12 MCCANN, NATALIE 76.00
09/28/12 KOZDROJ, GABRIELLA 50.00
09/28/12 LAMEYER, BRENT 43.50
09/28/12 JOYER, ANTHONY 64.75
09/28/12 KOHLER, ROCHELLE 36.00
09/28/12 JOHNSON, BARBARA 382.40
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9987461
9987462
9987463
9987464
9987465
9987466
9987467
9987468
9987469
9987470
9987471
9987472
9987473
9987474 09/28/12 STEFFEN, MICHAEL 87.00
503,587.16
09/28/12 CRAWFORD, SHAWN 480.00
09/28/12 CUSICK, JESSICA 125.06
09/28/12 WEINHAGEN, SHELBY 310.65
09/28/12 RANGEL, SAMANTHA 170.00
09/28/12 SCHREIER, ABIGAIL 25.73
09/28/12 WALES, ABIGAIL 76.50
09/28/12 COSTA, JOSEPH 300.00
09/28/12 MILLER, MELISSA 282.00
09/28/12 ADAMS, DAVID 1,452.40
09/28/12 VANG, TIM 582.00
09/28/12 O'BRIEN, REBECCA 15.00
09/28/12 YANG, CHINU 277.50
09/28/12 MASON, KYLE 178.75
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Agenda #G-2
AGENDA REPORT
To: City Manager James Antonen
From: Chief of Police David J. Thomalla
Subject: Approval of Donation of Toys to Police Department
Date: October 1, 2012
Introduction
The Maplewood Police Department has received 300 wooden toys from LivINN Hotels,
Ltd., and City Council approval is required before this donation can be accepted.
Background
LivINN Hotels, Ltd., has a program whereby they donate toys to Police Departments as
part of "Toys 4 Smiles." They provided 300 handcrafted wooden cars and trucks for
police officers to distribute to children as the department sees fit. Typically these toys
are given to children in need or that the officers have contact with in the community and
are intended to be a way to create a strong relationship between police officers and
children.
The toys have been provided to us free of charge; but the estimated dollar value is $3
each, making the monetary value of the donation $900.
City Council approval is required for us to accept this donation.
Recommendation
It is recommended that City Council approval be given for the Police Department to
accept this donation from LivINN Hotels, Ltd.
Action Required
Submit to the City Council for review and approval.
DJT:js
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RESOLUTION AUTHORIZING GIFT TO CITY
WHEREAS, Maplewood is AUTHORIZED to receive and accept grants, gifts and
devices of real and personal property and maintain the same for the benefit of the
citizens and pursuant to the donor’s terms if so-prescribed, and;
WHEREAS, LivINN Hotels, Ltd., wishes to grant the City of Maplewood the following:
300 handcrafted wooden toy cars and trucks, and;
WHEREAS, LivINN Hotels, Ltd., has instructed that the City will be required to use the
aforementioned for: distribution to children in the City of Maplewood, and;
WHEREAS, the City of Maplewood has agreed to use the subject of this resolution for
the purposes and under the terms prescribed, and;
WHEREAS, the City agrees that it will accept the gift by a super majority of its
governing body’s membership pursuant to Minnesota Statute §465.03;
NOW, THEREFORE, BE IT RESOLVED, pursuant to Minnesota Statute §465.03, that
the Maplewood City Council approves, receives and accepts the gift aforementioned
and under such terms and conditions as may be requested or required.
The Maplewood City Council passed this resolution by a super majority vote of its
membership on _________________________, 20_____.
Signed: Signed: Witnessed:
___________________ ____________________ ___________________
(Signature) (Signature) (Signature)
Mayor______________ Chief of Police_________ City Clerk____________
(Title) (Title) (Title)
___________________ _____________________ ____________________
(Date) (Date) (Date)
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Agenda Item G3
AGENDA REPORT
TO: James Antonen, City Manager
FROM: Gayle Bauman, Finance Manager
SUBJECT: Approval of 2012 Budget Transfers
DATE: September 24, 2012 for October 8, 2012 council meeting
DISCUSSION
The 2012 Budget calls for transfers from the General Fund to the Park Development and
Redevelopment Funds as directed by the Council during the preparation of the budget
document.
The transfers needed are as follows:
From To
Amount Fund Fund
$ 30,000
101 General Fund
403 Park Development (equipment replacement)
10,000 101 General Fund 430 Redevelopment (housing replacement)
10,000 101 General Fund 430 Redevelopment (commercial redevelopment)
FINANCIAL IMPACT
There is no financial impact to the city as the proposal is to transfer money between funds.
RECOMMENDATION
It is recommended that the Council authorize the transfers listed above and direct the Finance
Manager to make the appropriate budget adjustments if needed.
P:\COUNCIL FILES\AGENDAS\2012\101 2012 transfers CONSENT.doc
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Agenda Item G4
AGENDA REPORT
TO: James Antonen, City Manager
FROM: Gayle Bauman, Finance Manager
SUBJECT: Approval of 2012 Budget Adjustments
DATE: September 24, 2012 for October 8, 2012 council meeting
BACKGROUND
Annually when the General Fund budget is prepared, revenue and expenditure accounts are
analyzed and a re-estimate for the current year is prepared. This information is used to
forecast the ending fund balance for the current year. The size of this balance is an important
factor for the preparation of the budget for the next year. The proposed 2013 budget includes
an estimated fund balance of $7,600,902 for 12-31-12.
RECOMMENDATION
After the budget for the next year is prepared, the re-estimates for the current year are more
important than the original budget. Therefore, it is recommended that the Council authorize
the Finance Manager to revise the 2012 budget to reflect the 2012 re-estimates for accounts
that are included in the proposed 2013 budget per the attached list. This will help staff
manage their budgets through the end of the year.
P\council files\agendas\2010\2010 budget adjustments
Attachment 1: 2012 Budget Adjustments
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2012 Budget Adjustments
Adjustments needed to achieve 2012 re-estimate numbers:
Adjustments needed to account
for 2012 Internal IT charges:
101-701-000-4025 12,730 M Ericson wages
101-101-000-4580 (110)
101-102-000-4580 1,470
101-000-000-3616 (100,000) Reduce Ambulance admin fee
101-116-000-4580 (360)
606-411-000-4950 (100,000) paid to General Fund
101-201-000-4580 (610)
101-301-000-4580 (2,270)
101-000-000-3301 106,000 Building permit fees
101-401-000-4580 6,390
101-000-000-3302 5,000
101-411-000-4580 (460)
101-000-000-3303 97,500
101-501-000-4580 (1,440)
101-000-000-3304 37,000
101-601-000-4580 (680)
101-000-000-3681 119,500
101-701-000-4580 (710)
206-603-299-4580 (740)
101-000-000-3524 (24,580) Police State Aid – actual amount
601-508-000-4580 (100)
101-000-000-3526 (57,300) MSA State Aid – actual amount
602-611-001-4580 610
604-512-000-4580 (150)
101-000-000-3613 30,000 Motor vehicle fees
605-706-000-4580 (10)
606-403-000-4580 (830)
101-000-000-3631 (185,000) Engineering charges
15,390 Net effect on General Fund
(1,220)
Attachment 1
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Agenda Item G5
AGENDA REPORT
TO: James Antonen, City Manager
FROM: Gayle Bauman, Finance Manager
SUBJECT: Approve Closure of Open Space Land Acquisition Fund
DATE: September 24, 2012 for October 8, 2012 council meeting
INTRODUCTION
The Open Space Land Acquisition Fund needs to be closed.
DISCUSSION
The Open Space Land Acquisition Fund was established in 1994 with the proceeds from a
$5,000,000 bond issue. On November 2, 1993, the $5,000,000 Open Space Referendum for
the purchase of underdeveloped land was approved. The parcels of open space considered for
acquisition were part of the Open Space Committee’s recommendations that were presented to
the City Council in 1992. The twelve-member committee located 66 parcels of open space in
the city and rated each parcel with a list of special characteristics. Nineteen pieces of property
made it to the top of the 1992 list. Acquisition of many of these parcels occurred during 1994-
1996.
Over the years, various miscellaneous grants and aids have been receipted to this fund which is
why the fund still has a positive fund balance. The original $5,000,000 has been fully spent and
the fund should be closed.
RECOMMENDATION
It is recommended that the Council authorize the following: (1) a transfer of $37,333.88 from the
Open Space Land Acquisition Fund to the Park Development Fund to close the fund, and (2) the
appropriate budget changes.
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Agenda Item G6
AGENDA REPORT
TO: James Antonen, City Manager
FROM: Gayle Bauman, Finance Manager
SUBJECT: Approval of Annual Maplewood Historical Society Payment
DATE: September 24, 2012 for October 8, 2012 council meeting
INTRODUCTION
On September 11, 2001 the City Council approved a motion to include a $2,000
payment to the Maplewood Historical Society in the city’s budget each year. This
annual payment has been incorporated in the 2012 Budget.
This year’s payment of $2,000 needs to be authorized.
RECOMMENDATION
Council authorization is needed annually to make the $2,000 payment because it is not
a required payment. Staff is asking the council to approve the payment for 2012.
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Item G7
AGENDA REPORT
TO: James Antonen, City Manager
FROM: Karen Guilfoile, Citizen Services Director
DATE: October 3, 2012
SUBJECT: Approval of a Temporary Gambling Permit and Fee Waiver – Friends of the
Mississippi River
Introduction
An application has been submitted for a temporary gambling permit on behalf of the
Friends of the Mississippi River for their participation in The Fish Creek Affair at the
Maplewood Community Center, located at 2100 White Bear Avenue. The event will be
held on November 3, 2012 from 6:00 p.m. to 9:30 p.m.
The organizer of the fundraiser is requesting the fees for the lawful gambling temporary
permit be waived.
In order for the State of Minnesota to issue a temporary gambling permit, approval of
the following resolution from the City is required:
RESOLUTION
BE IT HEREBY RESOLVED, by the City Council of Maplewood, Minnesota, that the
temporary premises permit for lawful gambling is approved for Friends of the Mississippi
at the Maplewood Community Center, 2100 White Bear Avenue, Maplewood.
FURTHERMORE, that the Maplewood City Council waives any objection to the
timeliness of application for said permit as governed by Minnesota Statute §349.213.
FURTHERMORE, that the Maplewood City Council requests that the Gambling Control
Division of the Minnesota Department of Gaming approve said permit application as
being in compliance with Minnesota Statute §349.213.
NOW, THEREFORE, be it further resolved that this Resolution by the City Council of
Maplewood, Minnesota, be forwarded to the Gambling Control Division for their
approval.
Recommendation
Approve the above resolution for a temporary gambling permit. Also, approve the fees
be waived for a temporary gambling permit.
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ITEM G8
AGENDA REPORT
TO: Jim Antonen, City Manager
FROM: Karen Guilfoile, City Clerk
DATE: October 2, 2012
SUBJECT: Approval of Resolution Certifying Election Judges for the November 6, 2012 General
State and Federal Election
RESOLUTION ACCEPTING ELECTION JUDGES
RESOLVED, that the City Council of Maplewood, Minnesota, accepts the following list of
Election Judges for the 2012 General Election to be held on Tuesday, November 6, 2012.
Ahl, Chuck
Ahrens, Fran
Aikens, Meridith
Allen, Jim
Anderson, Elsie
Anderson, Nancy
Anderson, Suzanne
Ansari, Ahsan
Arnold, Ajla
Aurandt, Robert
Bartelt, Joan
Bedor, David
Beggs, Regan
Behr, Jeanette
Behr, Nancy
Belland, Jaime
Berry, Robert (Bud)
Bierbaum, Al
Bjorklund, Diane
Bolden, Donita
Bolduan, Kay
Booher, Michele
Bork, Anna
Bortz, Albert
Bortz, Jeanne
Brandon, Richard
Brandon, Virginia
Bruner, Deborah
Bryan, Betty
Bunkowske, Bernice
Campbell, Lilia
Campbell, Thomas
Carle, Jeanette
Carson, Helen
Casserly, Debra
Christianson, Margorie
Combe, Edward
Connelly, Thomas
Coyle, Jim
Coyle, Rose
Cude, Carol
Cude, Larry
D'Arcio, India
DeBernardi, Nancy
Demko, Fred
DeZelar, Phil
Dickson, Helen Jean
Dittli, Albin
Dougherty, Tom
Droeger, Diane
Duellman, Audrey
Dunham, Bob
Eickhoff, Carolyn
Erickson, Elizabeth
Ewald, Jeanne
Fernholz, Jean
Finch, Michael
Finch, Roberta
Fitzgerald, Delores
Fosburgh, Anne
Fowler, Cynthia
Franzen, Nick
Freer, Mary Jo
Friedlein, Charlene
Friedlein, Richard
Fuller, Mary Katherine
Gaboury, Shirley
Galligher, Patricia
Garrison, Carolyn Ann
Garvey, Terrence
Gebauer, Victor
Gerlach, Barbara
Gerten, John
Gerten, Judy
Glissendorf, Sue
Golaski, Diane
Grace, Joanne
Granse, Barbara
Gravink, Barb
Gudknecht, Jamie
Gustafson, Dianne
Guthrie, Rosie
Hafner, Michael
Hahn , Vonna
Hanson, Joan
Hart, Barbara
Heininger, Gordon
Hervig, Cindy
Hinnenkamp, Gary
Hitzman, Harold
Hulet, Jeanette
Hulet, Robert
Huth, Patricia
Huth, Raymond
Inhofer, Mary Claire
Jagoe, Carole
Jahn, David
Jensen, Robert
Johannessen, Judith
Johansen, Kathleen
Johnson, Warren
Jones, Shirley
Jurmu, Joyce
Kapfer, Deb
Karner, Ann
Kipka, Judy
Kirchoff, Harold
Kliethermes, Jami
Knutson, Lois
Kramer, Dennis
Krebsbach, Jean
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Kreger, Jason
Kwapick, Jackie
Labossiere, Donna
Lackner, Marvella
Lampe, Charlotte
Larson, Michelle
Lauren, Lorraine
LaValle, Faylene
Lawrence, Donna
Layer, Stephanie
Layer, Tom
Leiter, Barbara
Leonard, Claudette
Lincowski, Steve
Lincowski, Vi
Liptak, Marianne
Lockwood, Jackie
Loipersbeck, Darlene
Loipersbeck, Jules
Mahowald, Valerie
Mahre, Jeri
Mammenga II, Donald
Manthey, John
Maskrey, Thomas
Mathey, Alana
McCann, John
McCarthy, Peggy
McCauley, Judy
Mechelke, Mary Lou
Meister-Westermann, Jean
Millette, James
Moran, Joyce
Moreno, Marlene
Mortenson, Karen
Muenchow, Mike
Myster, Thomas
Nelson, Percy
Nettleton, Janet
Newcomb, Mary
Nichol, Jane
Nichols, Miranda
Nissen, Helen
Norberg, Ann
Noyes, Douglas
O'Brien, D. William (Bill)
Olson, Anita
Olson, Lois
Olson, Norman
Olson, Sandy
Oslund, Kathryn
Parent, Dian
Pedersen, Bernard
Peper, Marilyn
Pophem, Michael
Putz, Shelly
Renslow, Rita
Rieper, Allan
Rodriguez, Vincent
Rubbert, Shirley
Rudeen, Elaine
Sagert, Chris
Saltz, Rosalie
Sandberg, Janet
Sands, Warren
Satriano, Pauline
Sauer, Elmer
Sauer, Kathleen
Sawyer, Sharon
Scharnott, Thomas
Scheuble, RoJean
Scheunemann, Marjorie
Schluender, Cynthia
Schneider, Mary Ann
Schramel, Betty
Schramel, Jim
Schultz, Louise
Seidel, Gloria
Shankar, Ananth
Shores, Teresa
Skaar, Delaney
Skaar, Steven
Skaar, Susan
Spangler, Bob
Stafki, Tim
Stenson, Karen
Storm, Mary
Stout, Carrie
Strack, Joan
Taylor, Lori
Thomas, Jeff
Thomforde, Faith
Tourville, Michael
Trippler, Dale
Tschida, Micki
Urbanski, Carolyn
Urbanski, Holly
Urbanski, William
VanBlaricom, Beulah
Vanek, Mary
Wasmundt, Gayle
Weinberg, Vicki
Wessel, Warren
Whitcomb, Larry
Witschen, Delores
Wolfgram, Dorothy
Wood, Susan
Yorkovich, Cindy
Young, Linda
Zawacki, James
Zian, Helen
Zipko, Leroy
Recommendation of the approved list of election judges is requested. Approval of this Resolution
does not qualify individuals to serve as election judges. Appointments will be made from this list to fill
the needed positions but not everyone on this list will be appointed. Additionally, individuals that have
not completed the required election judge training and completed the paperwork required by the city will
not be permitted to work unless they have met these requirements.
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Item G9
AGENDA REPORT
TO: City Manager, Jim Antonen
FROM: IT Director, Mychal Fowlds
SUBJECT: Authorization to Enter into a Service Agreement with The Active Network
DATE: October 8, 2012
Introduction
Since 2005 we have been utilizing the software package Recware Safari to manage almost all aspects of
membership and programming for the Maplewood Community Center and Parks and Recreation
Department. This software is now being retired by our vendor therefore requiring us to move forward with
a replacement application.
Background
As stated above, staff has been utilizing a software package from The Active Network for quite some time.
This application, Safari, is being retired on October 31, 2013 meaning that at that time we will no longer be
able to receive support. As this application is required by staff to manage all aspects of membership,
program enrollment, POS systems, etc. we require support and therefore began the search for a suitable
replacement.
Staff reviewed a number of applications searching for an application that was able to fill the unique needs
of the various departments that currently use Safari. Staff found many applications that could fill portions of
our needs (for example many applications can manage memberships but may not handle league
scheduling) but only 1 application was found that not only met but exceeded our current functionality and
that was a proven solution in the industry. This application is ActiveNet provided by The Active Network.
The Active Network is retiring Safari because it is an outdated client/server application. In its place they
created ActiveNet which is a web-based solution hosted by The Active Network. Choosing an application
that is offered by our current vendor is advantageous to the City in that the look and feel of the new
application is very similar to our existing program meaning that it will be much more familiar to staff. Other
reasons staff is recommending this application is that we are allowed unlimited users, staff has increased
mobility with a web-based application and we are allowed access to modules that will make us more
efficient than ever.
Budget Impact
The only direct costs of signing this agreement is $2,500 for onsite training which will be paid for by the
Maplewood Community Center. On-going costs are based on a per transaction model. The Active
Network collects a small percentage of each transaction which is dependent on whether or not a patron
pays by cash, check or credit card and whether or not they are doing so in person or online. Staff
estimates that we will break even moving forward with this model taking into consideration that we will no
longer pay yearly maintenance fees or credit card processing fees, both of which combined equal an
estimated $45,000 per year. In addition, because we are current customers we are able to take advantage
of a program that is crediting us $16,400 worth of implementation costs if we exercise an agreement by
October 31st.
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Attachment
1. The Active Network Software as a Service Agreement
Recommendation
It is recommended that authorization be given to enter into a 3 year service agreement with The Active
Network.
Action Required
Submit to City Council for review and approval.
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AGENDA REPORT
TO: James Antonen, City Manager
FROM: Michael Thompson, City Engineer/ Public Works Director
SSUUBBJJEECCTT:: Approval of Permitted Facilities Agreement with BP Products North
America, Inc., Maplewood Mall Sidewalk Improvements, City Project 11-09
DATE: October 1, 2012
INTRODUCTION
The council will consider approving a Permitted Facilities Agreement with BP Products North America,
Inc. This easement was requested by OP 2 Maplewood, LLC, the mall owner, and the City of
Maplewood. This agreement is necessary for the completion of the Maplewood Mall Sidewalk
Improvements.
BACKGROUND
Simon Properties, owner of the Maplewood Mall, has completed major renovation of the mall’s interior
and exterior. The improvements are a substantial investment into one of the city’s major taxpayers and
certainly are a good reflection on the economic health of the Mall area. Included with the improvements
to the Maplewood Mall area is the pedestrian improvements, led by the city, which includes
construction of additional sidewalks around the ring road of the Mall and other roadways adjacent to the
site. The contract was awarded to Urban Companies, LLC on April 25, 2011.
The new sidewalk provides a full connection along Southlawn Drive which will connect into the
proposed sidewalk adjacent to the new Park and Ride once completed. Also, the sidewalk connects
Southlawn Drive to White Bear Avenue via the mall ring road and adjacent property through a public-
private partnership. The owners donated easements while the City built and will maintain the sidewalk
improvements. This project greatly improves pedestrian access to the mall area.
Work on the sidewalk improvements is mostly complete with the exception being the locations where
BP Products North America, Inc. owns the property. The Permitted Facilities Agreement would grant
the necessary easements to the City so that the sidewalk construction could be completed in these
missing links.
BUDGET IMPACT
There is no impact to the overall project budget.
RECOMMENDATION
It is recommended that the city council approve the Permitted Facilities Agreement with BP Products
North America, Inc for the Maplewood Mall Sidewalk Improvements, City Project 11-09 and direct the
mayor and city manager to sign the agreement signifying city council approval. Minor revisions as
approved by the City Attorney are authorized as needed for the agreement.
Attachments:
1. Permitted Facilities Agreement
2. Location Map
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PROJECT LOCATION MAPMAPLEWOOD MALL SIDEWALKIMPROVEMENTSCITY OF MAPLEWOOD PROJECT NO. 11-09EXHIBIT 1PROJECTLOCATIONAgenda Item G10 Attachment 2Packet Page Number 58 of 224
AGENDA REPORT
TO: Jim Antonen, City Manager
FROM: Michael Thompson, Director of Public Works/City Engineer
SUBJECT: Approval of Cost-Participation Agreement with Ramsey-Washington Metro
Watershed District, TH 36/English Street Interchange Improvements, City
Project 09-08
DATE: October 1, 2012
INTRODUCTION
The council will consider approval of a cost participation agreement with the Ramsey-Washington Metro
Watershed District (RWMWD) as part of construction of the Highway 36/ English Street Interchange
Improvements. The cost participation agreement was reflected in the budget summary to council at the
March 26, 2012 regular council meeting. The agreement is for the cost participation and maintenance of
stormwater treatment improvements at the Highway 36/61 interchange constructed as part of the Highway
36/English Street Interchange Improvements.
BACKGROUND / DISCUSSION
The TH 36 / English Street Interchange Improvements project will remove the last at-grade intersection
along TH 36 between the eastern Ramsey County line and I-35W in Roseville. The proposed interchange
will be a full access diamond interchange generally constructed at the existing English Street location.
Access ramps to and from English Street will be provided for both eastbound and westbound traffic along
TH 36. English Street will be bridged over TH 36 and modifications will be made to TH 36 between TH 61
and Hazelwood Street to accommodate the proposed English Street Bridge and interchange.
As part of this project, storm drainage improvements are proposed which include new storm sewer within
the reconstructed roadways, filtration basins, and Ramsey-Washington Metro Watershed District
(RWMWD) water quality improvements within the TH 36 / TH 61 interchange loops. The RWMWD
Improvements are included in the plans and specification for the overall project and the proposed
agreement would allow construction of said improvements within the project. The City would invoice
RWMWD for the RWMWD related costs as part of this partnership project.
BUDGET
The City is the conduit in receiving federal funding of $295,329 for the Stormwater Treatment
Improvements solicited by RWMWD. This pays for a portion of the RWMWD improvements with the
remainder paid to the City by RWMWD through this agreement. The agreement stipulates that RWMWD
shall pay the City a lump sum amount of $257,660 for indirect costs (design and construction
administration services) plus 80% of the actual bid pricing for the RWMWD Stormwater Treatment
Improvements up front. This helps with the City’s cash flow.
At the end of the project, the City would then make a final invoice to RWMWD for the remaining 20% of the
Stormwater Treatment Improvements.
Agenda Item G11
Packet Page Number 59 of 224
RECOMMENDATION
It is recommended that the City Council approve the attached cost participation agreement with the
Ramsey-Washington Metro Watershed District as part of City Project 09-08, and direct the mayor and city
manager to sign the agreement signifying city council approval. Minor revisions as approved by the City
Attorney are authorized as needed for the agreement.
Attachments
1. Ramsey-Washington Metro Watershed District Cost Participation Agreement
2. Location Map
Agenda Item G11
Packet Page Number 60 of 224
AGREEMENT FOR COST PARTICIPATION IN THE
CONSTRUCTION OF THE HIGHWAY 36/ENGLISH STREET
INTERCHANGE IMPROVEMENTS, CITY OF MAPLEWOOD
PROJECT 09-08
THIS AGREEMENT made and entered in this _____ day of
______________, 2012 by and between the Ramsey-Washington Metro
Watershed District, (hereinafter “Watershed”), and the City of Maplewood,
(hereinafter “City”) for the cost participation and maintenance of stormwater
treatment improvements at the Highway 36/61 interchange (hereinafter
“Stormwater Treatment Improvements”) constructed as a part of the Highway
36/English Street Interchange Improvements, City of Maplewood Project 09-08
(hereinafter “Interchange Improvements”); and
WHEREAS, the Watershed and the City have agreed that there is a need
for, and it is in the public’s best interest to construct the Stormwater Treatment
Improvements; and
WHEREAS, the Watershed has received federal funding (S.P. 138-010-012)
to pay for a portion of the construction costs of the Stormwater Treatment
Improvements; and
WHEREAS, the City has received federal funding (S.P. 138-010-018) to pay
for a portion of the construction costs of the Interchange Improvements; and
WHEREAS, the Watershed and the City have agreed that it is beneficial to
construct the Stormwater Treatment Improvements together with the Interchange
Improvements; and
WHEREAS, the Watershed and City wish to establish responsibilities for the
design, construction, and ongoing maintenance of the Stormwater Treatment
Improvements;
NOW, THEREFORE, IT IS AGREED AS FOLLOWS:
Agenda Item G11
Attachment 1
Packet Page Number 61 of 224
1. The Watershed shall prepare the necessary plans and specifications and
obtain all necessary MnDOT approvals for the construction and ongoing
maintenance of the Stormwater Treatment Improvements.
2. The City shall prepare the necessary plans and specifications and obtain
all necessary MnDOT approvals for the Interchange Improvements.
3. The plans and specifications for the Stormwater Treatment
Improvements shall be combined with the plans for the Interchange
Improvements (hereinafter “Bid Package”) for the purposes of bidding
and construction.
4. The City shall be responsible for the advertisement, bidding, and award
of a construction contract for the Bid Package.
5. The City shall be responsible for the overall construction administration
and inspection of the Bid Package. These construction administration
and inspection services may be provided by City staff, MnDOT and/or
consultant engineering staff.
6. The Watershed shall provide additional construction inspection services
for the Stormwater Treatment Improvements. The level of these
inspection efforts shall be as deemed necessary by the Watershed to
verify that the improvements meet the intent of the Watershed’s plans
and specifications.
7. The City will receive the federal funding for the Stormwater Treatment
Improvements directly from MnDOT. The total amount of the federal
funding is $295,329.
Agenda Item G11
Attachment 1
Packet Page Number 62 of 224
8. The Watershed shall pay the City a lump sum amount of $257,660 for
indirect costs (design and construction administration services) for the
Stormwater Treatment Improvements.
9. The Watershed shall pay the City for the actual construction cost of the
Stormwater Treatment Improvements less the federal funding that has
been allocated for the improvements. Based on an estimated
construction cost for the Stormwater Treatment Improvements of
$570,000, the estimated Watershed construction cost is $274,671
($570,000 - $295,329).
10. The City shall invoice the Watershed for the $257,660 lump sum amount
plus 80% of the actual bid price for the Stormwater Treatment
Improvements less the federal funding amount upon the award of the
construction contract for the Bid Package. The Watershed shall
reimburse the City within 60 days of receipt of invoice.
11. The City shall invoice the Watershed for the actual final construction cost
for the Stormwater Treatment Improvements less the federal funding
amount and the construction amount billed at contract award upon the
completion of the Stormwater Treatment Improvements to the
satisfaction of the Watershed.
12. Watershed shall be solely responsible for the maintenance of the
Stormwater Treatment Improvements in perpetuity.
13. The Watershed agrees to defend, indemnify and hold the City harmless
from any and all claims, causes of action, lawsuits, judgments, charges,
demands, costs and expenses including, but not limited to, interest,
attorneys’ fees, costs and expenses connected therewith, arising out of
or resulting from the failure of the Watershed to satisfy the provisions of
Agenda Item G11
Attachment 1
Packet Page Number 63 of 224
this agreement or for damages caused to third parties as a result of the
manner in which the Watershed performs or fails to perform duties
imposed upon the Watershed by the terms of this agreement. Nothing
herein shall constitute a waiver by any part of any limitations of liability
provided by the Minnesota Statutes Chapter 466 or other applicable law.
IN WITNESS WHEREOF, the parties hereto have caused this agreement to
be executed by their respective duly authorized representatives on this _______
day of ___________, 2012.
CITY OF MAPLEWOOD RAMSEY WASHINGTON METRO
WATERSHED DISTRICT
_______________________________ _______________________________
Mayor – Will Rossbach Board President – Roger Lake
_______________________________ _______________________________
City Manager – James Antonen Administrator – Clifton Aichinger
Date___________________________ Date___________________________
_______________________________ _______________________________
Approved as to form by Legal Counsel Approved as to form by Legal Counsel
Date___________________________ Date___________________________
Agenda Item G11
Attachment 1
Packet Page Number 64 of 224
Agenda Item G11
Attachment 2
Packet Page Number 65 of 224
Item G12
MEMORANDUM
TO: Jim Antonen, City Manager
FROM: Karen Guilfoile, City Clerk
RE: Annual Renewal of Currency Exchange License – EZ Cash Maplewood, LLC
DATE: October 1, 2012
Introduction
EZ Cash Maplewood, LLC, a currency exchange licensee, made application with the State to
renew its currency exchange license to operate at 3035 White Bear Avenue.
Background
Minnesota Statutes Chapter 53A.04 requires the Department of Commerce to submit any
application for licensure as a currency exchange to the governing body of the municipality in
which the currency exchange conducts business. The law further requires the governing body
of the municipality to render a decision regarding the renewal of the license within 60 days.
After consulting with Chief Thomalla, there is nothing on record that would prohibit council from
renewing the annual currency exchange license. They are a good member of the business
community.
Recommendation
It is recommended that council approve the annual renewal license for EZ Cash Maplewood,
LLC.
Packet Page Number 66 of 224
Agenda Item I1
AGENDA REPORT
To: James W. Antonen, City Manager
From: H. Alan Kantrud, City Attorney
Gayle Bauman, Finance Director
Subject: Resolution Approving Extension of Electric Franchise Fee and
Declaration of Intent to Raise Fees by Ordinance
Date: October 3, 2012
INTRODUCTION
The City Council has approved first reading of the new Ordinance adopting the new rates for the
franchise fee with Xcel. This is the second reading.
Proposed Fee Increase
As part of the City’s budgeting process for 2013 the staff requested an increase in the electric
franchise fee.
Current and proposed monthly charges are as follows:
Current Rates Proposed Rates
Residential, Street Lighting & Muni Pumping $0.75 $1.25
Small Commercial & Industrial - Non-Demand $1.50 $2.50
Small Commercial & Industrial – Demand $9.00 $15.00
Large Commercial & Industrial $67.50 $112.50
Public Street Lighting $0.75 $1.25
MuniPumping-N/D $0.75 $1.25
MuniPumping-Demand $0.75 $1.25
The rate increase will generate annual revenues of approximately $475,000.00. This additional
revenue is required as additional revenue for the Street Light Utility Fund and was called for in
the City’s CIP on page 141. The City Council approved a bond sale in May 2012 for the burial
of the overhead power lines adjacent to Frost Avenue as part of the Gladstone Area
Improvement projects. These increased revenues will assist in paying the bond’s annual
payments.
The Proposed Ordinance calls for the new rates to take effect on January 1, 2013 and is
attached as Attachment 1. Staff has included a repealer section that will repeal the prior existing
Ordinance and rates so no conflict will occur with the rates.
RECOMMENDATION
Staff recommends the Council approve the 2nd reading of the ordinance setting franchise fees.
Attachments:
1. Proposed Ordinance setting franchise fees
Packet Page Number 67 of 224
Agenda Item I1
Attachment 1
1
ORDINANCE NO. _______
AN ORDINANCE IMPLEMENTING AN ELECTRIC SERVICE FRANCHISE FEE ON
NORTHERN STATES POWER COMPANY, A MINNESOTA CORPORATION, D/B/A XCEL
ENERGY, ITS SUCCESSORS AND ASSIGNS, FOR PROVIDING ELECTRIC SERVICE WITHIN
THE CITY OF MAPLEWOOD.
THE CITY COUNCIL OF THE CITY OF MAPLEWOOD DOES ORDAIN:
SECTION 1. The City of Maplewood Municipal Code is hereby amended to include reference to the
following Special Ordinance.
Subdivision 1. Purpose. The Maplewood City Council has determined that it is in the best interest
of the City to impose a franchise fee on those public utility companies that provide electric services within
the City of Maplewood.
(a) Pursuant to City Ordinance a Franchise Agreement between the City of Maplewood and
Northern States Power Company, a Minnesota corporation, d/b/a Xcel Energy, its successors
and assigns, the City has the right to impose a franchise fee on Northern States Power
Company, a Minnesota corporation, d/b/a Xcel Energy, its successors and assigns, in an
amount and fee design as set forth in Section 9 of the Northern States Power Company
Franchise and in the fee schedule attached hereto as Schedule A.
Subdivision 2. Franchise Fee Statement. A franchise fee is hereby imposed on Northern
States Power Company, a Minnesota Corporation, d/b/a Xcel Energy, its successors and assigns, under its
electric franchise in accordance with the schedule attached here to and made a part of this Ordinance,
commencing with the Xcel Energy January, 2013 billing month.
This fee is an account-based fee on each premise and not a meter-based fee. In the event that an
entity covered by this ordinance has more than one meter at a single premise, but only one account, only
one fee shall be assessed to that account. If a premise has two or more meters being billed at different
rates, the Company may have an account for each rate classification, which will result in more than one
franchise fee assessment for electric service to that premise. If the Company combines the rate
classifications into a single account, the franchise fee assessed to the account will be the largest franchise
fee applicable to a single rate classification for energy delivered to that premise. In the event any entities
covered by this ordinance have more than one premise, each premise (address) shall be subject to the
appropriate fee. In the event a question arises as to the proper fee amount for any premise, the
Company’s manner of billing for energy used at all similar premises in the city will control.
Subdivision 3. Payment. The said franchise fee shall be payable to the City in accordance
with the terms set forth in Section 9.4 of the Franchise.
Subdivision 4. Surcharge. The City recognizes that the Minnesota Public Utilities
Commission allows the utility company to add a surcharge to customer rates to reimburse such utility
company for the cost of the fee and that Xcel Energy will surcharge its customers in the City the amount of
the fee.
Packet Page Number 68 of 224
Agenda Item I1
Attachment 1
2
Subdivision 5. Record Support for Payment. Xcel Energy shall make each payment when
due and, if required by the City, shall provide at the time of each payment a statement summarizing how the
franchise fee payment was determined, including information showing any adjustments to the total
surcharge billed in the period for which the payment is being made to account for any uncollectibles,
refunds or error corrections.
Subdivision 6. Enforcement. Any dispute, including enforcement of a default regarding
this ordinance will be resolved in accordance with Section 2.5 of the Franchise Agreement.
Subdivision 7. Effective Date of Franchise Fee. The effective date of this Ordinance shall be
after its publication and sixty (60) days after the sending of written notice enclosing a copy of this adopted
Ordinance to Xcel Energy by certified mail. Collection of the fee shall commence as provided above.
Subdivision 8. Repeal of Prior Franchise Ordinance. Upon the effective collection date for the
new fees pursuant to this Ordinance any existing, prior, Ordinance and fees schedules shall be repealed so
as not to conflict with this Ordinance and fee schedule. Passage of this Ordinance shall constitute intent to
adopt the revised rates.
Passed and approved: _____________________, 2012.
__________________________________
Mayor
Attest:
_____________________________________
City Clerk
SEAL
Packet Page Number 69 of 224
Agenda Item I1
Attachment 1
3
SCHEDULE A
Franchise Fee Rates:
Electric Utility
The franchise fee shall be in an amount determined by applying the following schedule per customer
premise/per month based on metered service to retail customers within the City:
Rate Classification Electric Franchise Fee Amount Per Premise
Residential $ 1.25
Small C&I Non-Demand $ 2.50
Small C&I Demand $ 15.00
Large C&I $ 112.50
Public Street Lighting $ 1.25
Municipal Pumping Non-Demand $ 1.25
Municipal Pumping Demand $ 1.25
Franchise fees are to be collected by the Utility at the rate listed below, and submitted to the City on a
quarterly basis as follows:
January – March collections due by April 30.
April – June collections due by July 31.
July – September collections due by October 31.
October – December collections due by January 31.
Packet Page Number 70 of 224
Agenda Item J1
AGENDA REPORT
TO: James Antonen, City Manager
FROM: Charles Ahl, Assistant City Manager
Sarah Burlingame, Senior Administrative Assistant
DATE: October 2, 2012
SUBJECT: 2013 Review of Requests – Charitable Gambling
INTRODUCTION
Each year the Maplewood City Council solicits requests for charitable gambling funds. Every year the
requests for funds have exceeded the available funds. That is the case this year. The city received 28
applications with $88,810 in requests. The amount of funds available is $30,000. Applicants have been
notified that the applications are being presented to the Council during the October 8th regular meeting.
They were invited to attend in order to answer questions from the Council, if any, but no individu al
presentations are anticipated.
BACKGROUND
The City Council recently reviewed and updated the policy on the award criteria. The policy was
established to allow the city an opportunity to review requests on an annual basis to determine their merit
and overall community benefit while still allowing time to include requests in the upcoming budget
process. A copy of the updated policy is attached.
The following is a list of the organizations and groups who have submitted donation requests. Staff has
also attached a copy of the complete applications so that you will have a better understanding of the
individual requests. In addition, at the back of the staff report and applications is a spreadsheet whereby
each Council member can note their recommendations for funding. Also attached are the score sheets
from the previous 3 years for your reference.
Organization
Amount
Requested
Organization
Amount
Requested
180 Degrees, Inc. $5,000.00 Maplewood Police Explorers $8,000.00
Ashland Productions $1,500.00 Maplewood Police Reserves $5,000.00
Boy Scout Troop 461 $3,000.00 Maplewood Youth Scholarship Fund $3,500.00
CHILD Inc. $200.00 Mothers And More, Twin Cities East #299 $700.00
Dispute Resolution Center $2,000.00 Northern Lights Service Unit, Girl Scouts $3,500.00
District 622 Education Foundation $5,000.00 Ramsey County Fair $3,500.00
District 622 Fusion Drumline $1,600.00 Second Chance Animal Rescue $1,000.00
Friends of Maplewood Nature $1,200.00 Simon Youth Foundation - Maplewood Mall $600.00
Friends of Ramsey County Libraries $2,500.00 St. Jerome School $1,400.00
Hmong American Education Fund $5,090.00 The Salvation Army $3,000.00
Maple Tree Monastery Childcare Center $1,600.00 Tubman Family Alliance $2,000.00
Maplewood AARP TaxAides $1,500.00 Venture Crew 613 $1,060.00
Maplewood Area Historical Society $18,360.00 Walker at Hazel Ridge Senior Community $5,000.00
Maplewood Fire Fighters Flower Fund $1,000.00 Weaver Elementary PTA $1,000.00
RECOMMENDATION
The City Council should review the requests and fill out the provided score sheet. Staff will collect the score
sheets and total the final suggested award amounts. The suggested award amounts will be brought before
the Council at the next meeting for approval.
Attachments:
1. City Charitable gambling policy
2. Previous 3 years final score sheets
3. Summary of 2013 Charitable Gambling Requests
4. Charitable Gambling applications
5. 2013 Charitable Gambling Requests - score sheet
Packet Page Number 71 of 224
Updated 07.02.12
CITY OF MAPLEWOOD
CITY COUNCIL POLICIES ON AWARDS OF
CHARITABLE GAMBLING TAX FUNDS
1. All licensed charitable gambling organizations within the City are required to contribute 10
percent (10%) of net profits derived from lawful gambling activity in the City to the
Charitable Gambling Tax Fund. These funds are dispersed by the City Council for lawful
expenditures.
2. All applications must be complete and submitted by the application deadline established by
the City Manager.
3. The City of Maplewood grants funds from the Charitable Gambling Tax Fund to support
activities and services that benefit Maplewood residents. The first priority in the granting of
funds will be given to the City of Maplewood domiciled organizations. The second priority
or consideration will be given to funding requests from other organizations which are used
primarily for the benefit of Maplewood residents. Funds shall be distributed for projects,
equipment, or activities that are based in the community and which primarily benefit
Maplewood residents and will be looked upon more favorably than requests for salaries or
general operating costs.
4. In general, requests from organized athletic groups will not be funded. Funding for these
programs should be from participating families or community auxiliary groups. There are so
many athletic organizations within the community that the City of Maplewood is not capable
of funding their financial requests or fairly determining appropriate recipients.
5. The amount of Charitable Gambling Tax Funds awarded to any request is determined by a
City Council vote. A request must receive 3 or more votes for funding in order to receive
Charitable Gambling Tax Funds.
6. All funds granted are required to be expended for the requested project within one year of the
date of the award letter. However, payment will not be made until after January 1 of the
award year. Grant recipients shall submit a letter to the City Manager requesting payment of
the grant award as well as provide specific information on how the funds were used (receipts
or other proof of expenditure) for the proposed purpose.
7. No employee or department of the City of Maplewood shall solicit a donation from a
licensed charitable organization without City Manager approval. If there is a financial need
for a specific program that was not funded in the City budget, staff may submit a request to
the City Manager for the use of Charitable Gambling Tax Funds.
8. The allocation of Charitable Gambling Tax Funds is an annual award. The receipt of funds
does not in any way guarantee or commit the City of Maplewood to funding in any
subsequent year. Each year’s funding requires a new, separate application.
Agenda Item J1
Attachment 1
Packet Page Number 72 of 224
Name of Organization Requested
Amo nt
DL KJ EH JN WR Proposed
A ardAmerican Red Cross – TC Chapter $2,500 $2,000 $1,500 $2,500 $500 $0 $1,300
Ashland Productions $12,000 $500 $2,000 $0 $2,500 $0 $1,000
City of Maplewood Scholarship Fund $2,000 $1,000 $1,000 $0 $750 $0 $550
Dispute Resolution Center $3,000 $1,500 $2,000 $0 $750 $1,000 $1,050
Friends of Maplewood Nature $7,200 $2,000 $2,500 $0 $2,500 $4,000 $2,200
Heritage Theatre Company $9,400 $500 $1,400 $0 $500 $0 $480
Maplewood Area Historical Society $16,250 $1,000 $3,500 $0 $4,500 $6,200 $3,040
Maplewood Community Center $10,000 $2,000 $3,000 $8,500 $3,750 $0 $3,450
Maplewood Firefighters Flower Fund $1,000 $500 $500 $1,000 $500 $1,000 $700
Maplewood Police Explorers $8,000 $1,500 $2,000 $8,000 $3,250 $3,150 $3,580
Maplewood Police Reserves $5,000 $3,000 $2,500 $5,000 $2,750 $5,000 $3,650
Poj Koob Yawm Ntxwy (PKYN)$10,000 $3,000 $600 $0 $500 $0 $820
Ramsey County Fair $4,650 $3,500 $2,000 $0 $1,250 $4,650 $2,280
St. Paul Composite Squadron Civilian Air Patrol $2,000 $1,500 $500 $0 $500 $0 $500
St. Paul Educational Foundation, Inc. $5,000 $1,000 $0 $0 $0 $0 $0*
Walker at Hazel Ridge $6,500 $500 $0 $0 $500 $0 $200
Fund Reserves $0 $0 $0 $0 $0 $0 $200
TOTAL AMOUNT OF REQUESTS $104,500 $25,000 $25,000 $25,000 $25,000 $25,000 $25,000
An estimated $25,000 is available revenue from proceeds of the 10% Charitable Gambling Tax.
Any reduction in available funds will result in a proportional reduction of the award amount.
* Removed from consideration due to past practice of zeroing out any applicant that gets a zero allocation from four or more
members of the City Council.
Agenda Item J1
Attachment 2
Packet Page Number 73 of 224
2011 Charitable Gambling Funds Score Sheet
Name of Organization Requested
Amount WR KJ JL MK JN Proposed
Award
American Red Cross - TC Area Chapter $2,500 $0 $1,000 $2,500 $0 $500 $800
Ashland Productions $5,000 $2,500 $1,000 $0 $0 $1,200 $940
Austin Otto - Boy Scout Troop 461 $6,500 $0 $500 $0 $1,000 $1,200 $540
Dispute Resolution Center $3,000 $0 $2,000 $2,000 $0 $1,250 $1,050
District 622 ADD/ADHD Support Group $1,600 $0 $0 $1,600 $0 $400 $400
District 622 Fusion Drumline $12,650 $0 $1,500 $3,000 $0 $0 $900
Friends of Maplewood Nature $3,000 $1,500 $3,000 $2,000 $1,000 $2,500 $2,000
Maple Tree Monastery Childcare Center $3,335 $0 $0 $2,000 $0 $2,000 $800
Maplewood Area Historical Society $16,551 $6,000 $2,500 $2,000 $5,500 $4,000 $4,000
Maplewood Mall - Simon Youth Foundation $5,000 $0 $1,000 $0 $0 $500 $300
Maplewood Police Explorers $8,000 $6,000 $1,500 $1,500 $5,000 $2,200 $3,240
Maplewood Police Reserves $5,000 $3,500 $3,500 $1,500 $5,000 $2,200 $3,140
Maplewood Youth Scholarship Fund $2,000 $2,000 $1,000 $900 $0 $1,100 $1,000
North St. Paul Area Food Shelf $1,000 $0 $500 $1,000 $1,000 $1,000 $700
Presentation Cub Scout Pack 461 $1,000 $0 $0 $0 $1,000 $350 $270
Ramsey County Fair $4,500 $3,500 $1,500 $0 $4,500 $1,800 $2,260
Saint Paul Composite Squadron Civilian Air Patrol $3,552 $0 $0 $0 $0 $800 *$0
St. Paul Ski Club $5,000 $0 $0 $0 $0 $0 *$0
Tubman Family Alliance $12,000 $0 $2,500 $5,000 $0 $2,000 $1,900
Fund Reserves $0 $2,000 $0 $1,000 $0 $760
TOTAL AMOUNT OF REQUESTS $101,188 $25,000 $25,000 $25,000 $25,000 $25,000 $25,000
An estimated $25,000 is available revenue from proceeds of the 10% Charitable Gambling Tax.
Any reduction in available funds will result in a proportional reduction of the award amount.
* Applicant recieves $0 if applicant did not recieve 2 or more votes for fund allocations
Agenda Item J1
Attachment 2
Packet Page Number 74 of 224
2012 Charitable Gambling Funds Score Sheet
Organization Amount
Requested WR KJ JL MK JN Proposed
Award
American Red Cross - TC Area Chapter $2,500.00 $1,000 $1,000 $1,000 $0 $0 $600
Boy Scout Troop 461 $2,500.00 $500 $1,000 $1,500 $2,500 $750 $1,250
Dispute Resolution Center $3,000.00 $1,000 $1,500 $2,000 $1,000 $1,000 $1,300
District 622 ADD/ADHD Support Group $600.00 $300 $200 $600 $0 $400 $300
District 622 Education Foundation $2,500.00 $1,500 $1,800 $1,000 $0 $1,125 $1,085
Friends of Ramsey County Libraries $4,500.00 $2,700 $2,000 $1,000 $500 $2,250 $1,690
Maple Tree Monastery Childcare Center $3,176.50 $0 $800 $0 $0 $1,125 $385
Maplewood Area Historical Society $7,614.00 $5,000 $3,200 $1,000 $7,614 $5,600 $4,483
Maplewood Mall - Simon Youth Foundation $500.00 $0 $500 $500 $0 $400 $280
Maplewood Police Explorers $8,000.00 $5,750 $3,000 $2,000 $8,000 $6,000 $4,950
Maplewood Police Reserves $5,000.00 $3,750 $5,000 $2,000 $5,000 $3,750 $3,900
Maplewood Youth Scholarship Fund $3,000.00 $2,000 $1,800 $3,000 $0 $2,000 $1,760
North St. Paul Area Food Shelf $1,000.00 $500 $1,000 $1,000 $1,000 $1,000 $900
Ramsey County Fair $3,200.00 $3,000 $2,200 $500 $3,200 $1,600 $2,100
Second Chance Animal Rescue $2,000.00 $0 $1,000 $1,000 $0 $1,250 $650
Tubman Family Alliance $3,500.00 $3,000 $1,500 $2,000 $1,000 $1,500 $1,800
Weaver Elementary PTA $500.00 $0 $500 $500 $0 $250 $250
Fund Reserves $0 $2,000 $9,400 $186 $0 $2,317
TOTAL AMOUNT OF REQUESTS $53,091 $30,000 $30,000 $30,000 $30,000 $30,000 $30,000
An estimated $30,000 is available revenue from proceeds of the 10% Charitable Gambling Tax.
Any reduction in available funds will result in a proportional reduction of the award amount.
Agenda Item J1
Attachment 2
Packet Page Number 75 of 224
Agenda Item J1
Attachment 3
2013 Charitable Gambling Requests
Name of Organization/Contact Info Reason for Request Amount
Requested
Amount of
Award
180 Degrees, Inc.
Scott Beutel
(612)813-5520
236 Clifton Ave. South,
Minneapolis MN 55403-3466
Funds will support direct program costs for staff, activities and materials
for program participants at St. Paul’s East Side site. Funds will also go
towards transportation for additional Maplewood participants.
$5,000
622 Education Foundation
Carole Anderson
(651)484-5560
2878 Meadowlark Lane
Maplewood MN 55109
Fund to go towards Angel Fund, grant program that provides
assistance to public school students whose educations are at
risk due to their family’s financial situations. Grants help them to
fully participate in school.
$5,000
Ashland Productions, Inc.
Laurel Hannula
(651)274-8020
2100 White Bear Ave.
Maplewood, MN 55109
Funds to go towards purchase of wireless microphones. $1,500
Child Inc.
Keli George
(612)308-5136
2576 E. 7th Ave.
North St. Paul MN 55109
Funds used to provide support group supplies and educational
materials for awareness and prevention trainings. $200
Dispute Resolution Center
Jeanne Zimmer
(651)292-6067
91 E. Arch St.
St. Paul MN 55130
Funds to provide free and low-cost mediation and facilitation services to
Maplewood individuals and organizations. Also to provide community
education and training opportunities.
$2,000
Friends of Maplewood Nature
James Beardsley
2659 East 7th St.
Maplewood MN 55119
Funds to go towards a replacement iMac computer with interactive
screen for the Watershed Kiosk and an iPad for interactive use for
school groups.
$2,050
Friends of Ramsey County Libraries
Susan Gerhz
(651)486-2213
Fund to help purchase museum quality literacy-building
equipment in the preschool area of the Ramsey County Library
in Maplewood.
$2,500 Packet Page Number 76 of 224
Agenda Item J1
Attachment 3
4570 Victoria Street
Shoreview MN 55126
Hmong American Education Fund
Chue T. Vang
(651)592-1576
2168 Clark Street
Maplewood MN 55117
Funds to go towards purchasing office equipment and supplies as well
as go toward scholarships for students. $5,090
ISD 622 – Fusion Drumline
Jeanine Brannon
(651)490-5064
2927 Walter Street
Maplewood MN 55109
Funds to purchase long range PA system. $1,600
Maple Tree Monastery Childcare Center
Jennie Schlauch
(651)770-0766
2625 Benet Rd.
Maplewood MN 55109
Funds to go towards replacing infant highchairs. $1,600
Maplewood AARP Tax Aides
James Hartmann
(651)739-1885
1895 Upper Afton Road
St. Paul MN 55128
Funds to go towards thank you lunch/dinner for volunteers and
incidental office supplies not reimbursed by the IRS. $1,500
Maplewood Area Historical Society
Lois Behm
(651)770-8941
3030 Bartelmy Lane N.
Maplewood MN 55109
• Finish interior of milk house for dairy exhibit - $2000
• Fees for arch/consult. prelim. renovation of barn basement - $3500
• Engineering plans for overflow parking - $2000
• Stain deck, install gutters and repair doors on restroom entry - $1500
• New carpet in dining and living room of house - $3560
• New flooring in kitchen - $2800
• Repair upper deck of house - $3000
$18,360
Maplewood Fire Fighters Flower Fund
Dick Peterson
(651)777-9182
1375 Price Ave.
Maplewood MN 55109
Funds to help support efforts in giving a gift to members and
their families in times of need (death, sickness, surgeries, and
birth)
$1,000
Maplewood Mall - Simon Youth
Foundation
Heather Haigh
Assist with expenses to put on events throughout the year to
raise funds for local scholarships for high school students who
are active in the community
$600 Packet Page Number 77 of 224
Agenda Item J1
Attachment 3
(651)770-3863
3001 White Bear Ave. Suite 1072
Maplewood MN 55109
Maplewood Police Explorers
David Thomalla
(651)249-2602
1830 County Road B E
Maplewood MN 55109
Funds used to subsidize dollars budgeted to send the Police
Explorers to the annual state conference, a competition in
Duluth and national conferences. Funds will help purchase
uniforms and needed equipment.
$8,000
Maplewood Police Reserves
Dave Kvam
(651)249-2603
1830 County Road B E
Maplewood MN 55109
Funds will be used to provide reserve officers with uniforms and
equipment they use when volunteering services to the City of
Maplewood including: uniform and vehicle items, specialty
products and services related to the bike patrol program and
maintaining and equipping the supply trailer.
$5,000
Maplewood Youth Scholarship Program
Audra Robbins
(651)249-2125
1830 County Road B East
Maplewood MN 55109
Funds to assist Maplewood residents under the age of 18 who want to
participate in recreation programs but cannot afford the fees. $3,500
Mothers And More Twin Cities East #299
Hilary Ballard
(651)330-6590
477 Sterling St. S.
Maplewood MN 55119
Funds to go towards booking speakers for business meetings and to
purchase special insurance in order to have communication booths at
city events, walking in parades or certain fundraising events.
$700
Northern Lights Service Unit, Girl Scouts
Kathy Montz
kathynlgs@q.com
1887 Myrtle Street
Maplewood MN 55109
Funds to provide financial assistance for Girl Scouts to attend an
overnight cookie rally regardless of family’s financial situation. $3,500
Ramsey County Fair
Joe Fox
(651)777-6514
1821 Myrtle St.
Maplewood MN 55109
Funds to pay for ribbons and premiums for 4H club members
and other adults that participate in bringing exhibits to the far.
The funds will also help promote the 100th anniversary of the
Ramsey Co. Fair.
$3,500
Second Chance Animal Rescue
Nancy Minion
(651)578-9451
2681 Mallard Drive
Funds to help cover vet expenses for rescued animals. $1,000 Packet Page Number 78 of 224
Agenda Item J1
Attachment 3
Woodbury MN 55125
St. Jerome School
Shari Jacobus
(651)788-7068
384 Roselawn Ave. E
Maplewood MN 55117
Fun used to paint gym walls & ceiling, purchase & install in
vents, and safety mats behind the basketball hoops. $1,400
The Salvation Army
Mallory Birch
(651)746-3529
2445 Prior Ave.
Roseville, MN 55113
Fund to purchase commercial stand-up refrigerator for the food
shelf that opened in June 2012 to serve only Maplewood
Residents
$3,000
Tubman
Janet Golden
(651)789-6750
1725 Monastery Way
Maplewood MN 55109
Fund to purchase clothing rack, hangers and materials to construct a
secure changing room area for Harriet’s Closet. $2,000
Venture Crew 613
Dennis M. Sederberg
(651)771-1204
1574 Ross Avenue
Saint Paul MN 55106-4231
Funds to go towards scouting events and activities for youth (Boy Scout
Registration, Ultimate Frisbee Weekend, Venturing Shindig Weekend,
Backpacking on Border Route Trail)
$1,060
Walker at Hazel Ridge
(651)779-9779
Lauren Bednar
2730 Hazelwood Street
Maplewood MN 55109
Funds to go towards community events. $5,000
Weaver Elementary PTA
Cathy Seiford
(651)400-0228
2626 Keller Parkway
Maplewood MN 55109-1930
Funds to cover some of cost for t-shirts for an anti-bully campaign kick-
off event. $1,000
An estimated $30,000 is available revenue from proceeds of the 10% Charitable Gambling Tax.
Any reduction in available funds will result in a proportional reduction of the award amount.
Packet Page Number 79 of 224
Updated 070212
oa1dWCityofMaplewoodeceo
Application for Charitable Gambling Tax F nds
oPleasetypeorprintneatlySEP2n2Qi2 d3s
Applicant Information y
Name of organization requesting funds 180 Degrees Inc
Contact Person Scott Beutel Contact Phone 61 2 813 5520
Email Address scottb@180degrees org
MailingAddress236 Clifton Ave South Minneapolis MN 554033466
Type of organization making request please select one
City County School District 0 NonProfit Attach proof of IRS 501c3 status
Other Specify
How does your organization serveimpact the citizens of Maplewood
180 Degrees provides mentoring programs for atrisk youth who
are involved with the justice system and have mental health
issues Please see attached for additional information
How many residents of Maplewood does your organization serveimpactGive an estimated
In 2012 11 Maplewood youth participated in our mentoring
program In the past 5 years 46 Maplewood youth participated
Request Information
Amount of Request 5 0 0 0
In detail explain how the funds requested will be utllized be specific attach additional pages ifnecessary
Funds will be used to support direct proqram costs for 180
Degrees individual and youth mentoring programs Costs include
staff activities and materials for program participants to our
site on Saint Pauls East Side Funds will also be used to
provide transportation for additional Maplewood participants
Please see attached for additional information
Often applicants are not awarded the full amount requested can your organization utilize a partial
award X Yes No How would a partial award be utilized
A partial award would we used to support our mentorinq proqram
for atrisk youth at a scaled down level from the full amount
requested
By completing and signing this form the organization confirms that the requested Charitable Gambling
Tax Funds will be spent for a lawful purpose This request is a onetime request for funds to be awarded
in the next fiscal year and the applicant understands requests for future funding will require a new
separate application
sarah walker Chief Admin Officer 9202012
Signature Title Date
Sarah Walker
Print Name
J
Agenda Item J1
Attachment 4
Packet Page Number 80 of 224
CITY OF MAPLEWOOD
CITY COUNCIL POLICIES ON AWARDS OF
CHARITABLE GAMBLING TAX FUNDS
1 All licensed charitable gambling organizations within the City are required to contribute l0
percent 0 of net profits derived from lawful gambling activity in the City to the
Charitable Gambling Tax Fund These funds are dispersed by the City Council for lawful
expenditures
2 All applications must be complete and submitted by the application deadline established by
the City Manager
3 The City of Maplewood grants funds from the Charitable Gambling Tax Fund to support
activities and services that benefit Maplewood residents The first priority in the granting of
funds will be given to the City of Maplewood domiciled organizations The second priority
or consideration will be given to funding requests from other organizations which are used
primarily for the benefit of Maplewood residents Funds shall be distributed for projects
equipment or activities that are based in the community and which primarily benefit
Maplewood residents and will be looked upon more favorably than requests for salaries or
general operating costs
4 In general requests from organized athletic groups will not be funded Funding for these
programs should be from participating families or community auxiliary groups There are so
many athletic organizations within the community that the City of Maplewood is not capable
of funding their financial requests or fairly determining appropriate recipients
5 The amount of Charitable Gambling Tax Funds awarded to any request is determined by a
City Council vote A request must receive 3 or more votes for funding in order to receive
Charitable Gambling Tax Funds
6 All funds granted are required to be expended for the requested project within one year of the
date of the award letter However payment will not be made until after January 1 of the
award year Grant recipients shall submit a letter to the City Manager reguesting payment of
the grant award as well as provide specific information on how the funds were used receipts
or other proof of expenditure for the proposed purpose
7 No employee or department of the City of Maplewood shall solicit a donation from a
licensed charitable organization without City Manager approvaL If there is a financial need
for a specific program that was not funded in the City budget staff may submit a request to
the City Manager for the use of Charitable Gambling Tax Funds
8 The allocation of Charitable Gambling Tax Funds is an annual award The receipt of funds
does not in any way guarantee or commit the City of Maplewood to funding in any
subsequent year Each years funding requires a new separate application
Updated 070212
Agenda Item J1
Attachment 4
Packet Page Number 81 of 224
o
inerral Revenue Service Department of the Treasury
P O Box 2508
Cincinnati OH 452Q1
Date April 12 2002 Person to Contact
Stephanie Swartzbaugh 3107594
Customer Service Specialist
180 Degrees Inc Toll Free Telephone Number
236 Clifton Ave soo am to sso pm esr
Minneapolis MN 554033466 8778295500
Fax Number
5132633756
Federal Identification Number
237153536
Dear Sir or Madam
Thank you for submitting your restated Articles of Incorporation The changes indicated do not adversely
effect the exempt status of your organization
Our records indicate that a determination letter issued in May 1972 granted your organization exemption from
federal income tax under section 501c3 of the Internal Revenue Code That letter is still in effect
Based on information subsequently submitted we classified your organization as one thai is nat a private
foundation within the meaning of section 509a of the Code because it is an organization described in
sections 509a1 and 170b1Avi
This classification was based on the assumption that your organizations operations would continue as stated
in the appfication If your organizations sources of support or its character method of operations or
purposes have changed please 1et us know so we can consider the effect of the change on the exempt
status and foundation status of your organization
Your organization is required to file Form 990 Return of Organization Exempt from income Tax only if its
gross receipts each year are normally more than 2500 If a return is required it must be filed by the 15th
day of the fifth month after the end of the organizations annual accounting period The law imposes a
penakty of 20 a day up to a maximum af 10000 when a return is filed late unless there is reasonable
cause for the delay
All exempt organizations unless specificakly excluded are liable for taxes under the ederal lnsurance
Contributions Act social security taxes on remuneration of 100 or more paid to each employee during a
calendar year Your organization is not liable for the tax imposed under the Federal Unemployment Tax Act
FUTA
Organizations that are not private foundations are not subject to the excise taxes under Chapter 42 of the
Code However these organizations are not automatically exempt from other federal excise taxes
Donors may deduct contributinns to your organization as provided in section 170 of the Code Bequests
legacies devises transfers or gifts to your organization or for its use are deductible for federal estate and
gift tax purposes if they meet the applicable provisions of sections 2055 2106 and 2522 of the Code
i
Agenda Item J1
Attachment 4
Packet Page Number 82 of 224
2
180 Degrees Inc
237153536
Your organization is not required to file federal income tax retums unless it is subject to the tax on unrelatedbusinessincomeundersection511oftheCodeIfyourorganizationissubjecttothistaxitmust file an
income tax return on the Form 990T Exempt Organization Business Income 7ax Return In this letter we
are not determining whether any of your organizations present or proposed activites are unrelated trade or
business as defined in section 513 of the Code
The law requires you to make your organizations annual return available for public inspection without charge
far three years after the due date of the return If your organization had a copy of its appfication forrecognitionofexemptiononJufy151987itisalso required to make available for pubiic inspection a copy oftheexemptionapplicationanysupparting documents and the exemption letter to any individual who requestssuchdocumentsinpersonorinwritingYou can charge only a reasonable fee for reproduction and actual
postage casts for the copied materials The law does not require you to provide copies of public inspectiondocumentsthatarewidelyavailabfesuchas by posting them on the fnternet Warld Wide Web You mey
be liable fflr a pealty of 20 a day for each day you da not make these documents available for public
inspection up to a maximum of 10000 in the case of an annual retum
Because this letter could help resolve any questions about your organizations exempt status and foundation
status you should keep it with the organizations permanent records
If you have any questions please call us at the telephone number shown in the heading of this letter
This letter affirms your organizations exempt status
Sincerely
John E Ricketts Director TEtGE
Gustomer Account Services
Agenda Item J1
Attachment 4
Packet Page Number 83 of 224
City of Maplewood
Application for Charitable Gambling Funds
Addendum and Additional Information from 180 Degrees Inc
Addendums to Questions
How does your organization serveimpact the citizens of Maplewood
180 Degrees provides mentoring programs for atrisk youth who are involved with the justice system
and have mental health issues including residents of Maplewood The program has two main elements
individual mentoring and group mentoring Our individual mentoring program pairs clients with trained
volunteers to help them form a positive and supportive relationship with an adult Group mentoring
participants engage in a professionally facilitated program with peers based on the Girls Circle or Boys
Council models The program serves youth who generally have no other options for mentoring services
due to past behaviors serving a unique need for a highrisk population
Our individual mentoring program pairs atrisk youth with trained volunteer mentors in oneonone
relationships Mentors from a wide variety of backgrounds and communities are paired with mentees
for initial 6 month terms The pairs spend 3 hours a week doing activities and forming a positive
supportive relationship Many mentees get to experience new activities like going to a Twins or Vikings
game that they would not otherwise have the opportunity to do Mentors and mentees engage in pro
social activities include ones to encourage civic engagement
Many of the mentees lack positive adult role models in their lives and this mentoring relationship helps
to fill that need This mentoring program is an early intervention program designed to keep at risk
youth from becoming entrenched in the juvenile justice system Mentoring these clients is a way to help
get them back on track before they engage in even riskier behaviors or criminal activities
After mentors are recruited 180 Degrees provides them with initial training as well as ongoing quarterly
trainings In order to reach a wide variety of clients we have Hmong and Spanish speaking mentors and
actively recruit mentors who speak other languages as well as English Mentors come from a variety of
racial and ethnic backgrounds intluding the African American and Latino communities
7he second component of 180 Degrees mentoring program is facilitated youth groups These groups
follow the Girls Circle wwwgirlscirclecom and Boys Council wwwboyscouncilcom curriculum that is
implemented by trained staff inembers The group programs meet one to two times per week for three
hours a session Each of the two groups typically has 12 participants The curriculum that is used is
focused on helping participants develop resilienty prosocial behaviors increase connections and a
sense of competency These programs have been developed and tested to work with our target
populations as a way of helping reduce risk of further contact with the juvenile justice system and
involvement in more serious trouble
1
Agenda Item J1
Attachment 4
Packet Page Number 84 of 224
How many residents of Maplewood does your organization serveimpactGive an estimated
In 2012 11 Maplewood youth have participated in our mentoring program Since 2008 this program has
served 46 youth who were Maplewood residents In addition to program participants family members
are directly impacted by the mentoring program We are seeking to increase the number of Maplewood
residents that our program serves and are seeking additional support to accomplish that goal The youth
served by our program have few if any other options for servites 180 Degrees fills a unique niche for a
highrisk group of clients
More broadly the mentoring program and its positive outcomes for participants impact the broader
community including students schools their neighbors and other contacts Specifically quantifying
these results is difficult but it does not make the community level impacts less important
We anticipate continuing to serve growing numbers of youth from Maplewood through this unique
program As Maplewood continues to grow we see an increasing need for our mentoring program
among a diverse range of Maplewood youth A grant from this fund would increase our ability to serve
highneed Maplewood residents in need of this programs unique service
180 Degrees mentoring program primarily serves kids in the Juvenile Delinquenty Unit who are on
probation for lowlevel offenses We also serve clients referred to the program by Ramsey County
Childrens Mental Health Collaborative RCCMHC and Child Protection Many clients have dual case
management and are involved in multiple government systems We use WRAP Wellness Recovery
Action Plan approach and train mentors around mental health and juvenile delinquency so we can
serve the dual populations instead of only having one focus A vast majority of our clients come from
disadvantaged highrisk backgrounds Many have already had serious issues with school or contact with
the juvenile justice system The clients we are serving are tough cases and 180s program is often the
only mentoring program available to them
Nearly all of the programs participants come from low income families For the programs most recent
reporting period Quarters 1 2 2012 45 out of 92 participants came from families with incomes less
than 14157 per year An additional 24 participants for a total of 69 out of 92 were from families with
incomes under 19123 A majority of clients are from racial and ethnic minority groups 76 of our
2012 clients were from communities of color 16 speak English as a second language
All of our clients referred to the program from RCCMHC have serious mental health diagnoses most
have prior justice system involvement Almost all of the kids referred to the program by the Juvenile
Dequincy Unit also have serious mental health diagnoses The clients this program serves have few if
any alternatives for this type of inentoring Other mentoring programs even ones that work with atrisk
youth arent equipped to deal with the level of clients our program serves This lack of other options
makes preserving this program all the more critical for the clients we serve their families and our
communities
2
Agenda Item J1
Attachment 4
Packet Page Number 85 of 224
Ad d i t i on a I 0 rs a n i z a t i o n a I I n fo r m a t i o n
Overview of 180 Degrees Juvenile Programs
In 2001 after 30 years of successful operation 180 Degrees began providing an array of programs and
services for adolescents and young adults ages 917 involved with or at risk of involvement with the
juvenile justice system in Ramsey and Dakota County
180 Degrees currently serves between 1500 and 2000 youth and tamilies per year 78 of whom are
from racial minority groups and almost all of whom are lowincome 180 Degrees youth services have
expanded rapidly to include a variety of services that promote positive outcomes from youth while
reducing reliance on detention and outofhome placement These programs include ourjuvenile
delinquency unit juvenile reentry residential groups home and shelter detention and outofhome
placement alternatives and our juvenile mentoring programs
In many cases 180 Degrees serves youth who have exhausted all other options for avoiding the juvenile
justice system and whom other programs and agencies will not accept More information about all of
our programs can be found at our website www180degreesorg
3
Agenda Item J1
Attachment 4
Packet Page Number 86 of 224
Updared OZ0212
City of Maplewood iv
Application for Charitable Gambling Tax Funds
Pease type or print neatly SEP 18 1011
n a
Applicant tnformation
Name of organization requesting funds Ashland Productions Inc
Contact Person Laurel Hannula Contact Phone 65 2748020
Email Address lhannula@ashlandproductions org
Mailing Address 2100 White Bear Avenue
Maplewood MN 55109
Type of organization making request please select one
City County School District 0 NonProfit Attach proof of IRS 501c3 status
Other Specify
How does your organization serveimpact the citizens of Maplewood
Ashland Productions is a community theater organization which
provides opportunities for children and youth K12 and adults
of all ages to learn and grow through theater arts
How many residents of Maplewood does your organization serveimpactGive an estimated
4000
Re4uest Information
Amount of Request 15 0 0 0 0
In detail explaln how the funds equested will be utilized be specific attach additional pages ifnecessary
These funds would be used for purchase of wireless microphones Shure microlavalier omni
mics and related items Clear staticfree sound projection is a basic need in live theater
performances especially those featuring children and an intrinsic part of the total theatrical
artistic experience In addition the audio amplification of shows aids in the ability of all
patrons including those with minor hearing impairments to comfortably hear and enjoy the
shows Wireless mics are semidurable items which need replacing with agebreakage
Often applicants are not awarded the full amount requested can your organization utilize a partial
award X Yes No How would a partial award be utilized
Since multiple mic units are used partial fundinq would allow
Ashland to acquire at least some of the units which is still
very helpful in supporting our overall sound requirements
By completing and signing this form the organization confirms that the requested Charitable Gambling
Tax Funds will be spent for a lawful purpose This request is a onetime request for funds to be awarded
in the next fiscal year and the applicant understands requests for future funding will require a new
separate application
n lC f
Signature Title Da e
l Y C r c JJG
Print Name
Agenda Item J1
Attachment 4
Packet Page Number 87 of 224
o
ea
City of Maplewood
Application for Charitable Gambling Tac Funds sFV 2 i 7o2
Pease type or prirrt neatly
Anolicant kdomtion Q MaP
Name of organiation requesting funds BoY Scout Troop 461
ConfactPerson Charles Rnapp CondPhone G51 4857772
Email Adess ckna pBSgmail com
Mailing Address 1725 Kennard St
Maplewood MN 55109
Type of organaation makiig request please select one
City County SCh001 DistriCt Q NonProSt ARa Pronf of IRS 501c3 stetus
other Specify
How does ywrr orglss8on sevebmpact 1he eHizens of Mrewood
Troop 461 scouts are donors to local food shelves Bell Ringers
Rainbow Foods Second Harvest Volunteers planters of shrubs
native plant at an Aug 2012 Joy Park Eagle Scout Project
How many residenis of Maplewood dces your oganlzatlort seneRipactGive estimed
Troop 461 directly serves 42 registered scouts that influence
their respective schools and neighborhoods with service
Reauestlnfomafan
Amount of Request 3 000 00
In detaii explain how tle funds requesbed wiil be u61Qed Re enc a etadeeaorwaeert1
Bov Scout Troop 461 would like to Uurchase 6 used aluminum
canoes 450 00 each to be available for use bv Troon 461 and
other Bov Scouts Girl Scouts Cub Sconts and Venturing Crews
in and around Maplewood at NO COST we would also like to
purchase new and replacement Coleman camp stoves and propane
lanterns to be used on campouts and High Adventure trips
pten ap ae not awarded the tuU amouM requested c your organaation utile a partial
award Yes No Haw wouW a parfi award be uliled
Troon 461 would reduce their wish liet of canoes andor camnina
ecruipment and adiust to any amount awarded and be thrilled and
qrateful with anv financial support available
By competing and signing this foim the organization confirms fh the iequested Charihable Gam6fing
Tar Funds wi7l be spent for a lawlu purpose This request is a onetime request for funds to be awarded
in the nert fiscal year and the applicarrt underds requests for future fundb9 wii requiie a new
separate application
ti T461 Committee Chair September 21 2012
Signature Title Date
Charles Kna p
Print Name
Agenda Item J1
Attachment 4
Packet Page Number 88 of 224
Boy Scout Troop 461 is sponsored by the Mens Club of Presentation and has been
proudly developing youth for over 50 years Troop 461 currently has 42 registered
scouts with a variety of baclSgrounds from the following schools Presenration
Maplewood Middle Saint Jeromes john Glenn Middte Maternity of MarySt Andrew
Skyview Middle AFSA HillMurray Farnsworth Aerospace Academy CretinDerham
Hall Saint Agnes Nortfi High and BenildeSt Margaret Troop 461 was honored in
April 2012 with the Pope Paul VI Catholic Quality Unit Award recognizing unit service
religious activities emblems youth adult leadership
In addition to Monday night troop meetings the boys stay active on monthly weekend
campouts from September through May and attend a weeklong summer camp at
Tomahawk Scout Reservation in Wisconsin every june 39 boys enjoyed a week of
gorgeous weather at summer camp in 2012and earned 87 merit badges at Tomahawk
Weekend campouu take the boys to locations such as Phillippo Scout Camp in Cannon
Falls Stearns Scout Camp in Annandale Rum River Scout Camp in Ramsey William
OBrien State Park Moose Lake Srate Park Frontenac State Park Afton State Park
Wild River State Park etc
Troop 461 also takes an annual High Adventure trip for older scouts every July The
201 I High Adventure took I I members white water rafting and kayaking on a 2900 mile
trek to the Salmon River in Idaho The 2012 High Adventure took 23 members 5
vehicles I troop trailer 2 canoe traiers and I canoes to the BWCA through entry
point 23 out of Ely on a weeklong canoe trip out of Williams Hall outfitter on Moose
Lake
Troop 461 was thrilled to replace our 21 year old troop trailer this summer with the
purchase of a brand new 6x 12 foot enclosed cargo trailer We couldnt have done it
without donations from the Presentation Mens Club Knights of Columbus Council
4374 Saint Paul East Park Lions Club City of Maplewood Charitable Gambling Fund
George Mary Fontaine along with proceeds from troop fundraisers Christmas
wreath sales Palm Sunday Pancake 8reakfast aluminum cart recycling @ Party Time
Liquor on Larpenteur Ave and the troop hot dog stand The hot dog stand in North St
Paul runs every Friday night from une I thru September 14 where the boys sell hot
dogs brats chicken sandwiches pop water at the History Cruze Car Show
Kevin Otto
coutmaster
BSA Troop 461
TRUSTWORTHY LOYAL HELPFUL FRIENDLY COURTEOUS KIND
OBEDIENT CHEERFUL THRIFTY BRAVE CLEAN REVERENT
Agenda Item J1
Attachment 4
Packet Page Number 89 of 224
iIINNFSnTA Department of Revenue Sales and Use Tax
Certificate of Exempt Status sT1
Exempt Organizations
Presentation Of The
Blessed Virgin Mary Church
172 KE1vI1ARD ST
MAPLEWOOD MN 55109
Certificate number ES 21382
a 17se 81 5
Date Reissued 022497
The organization above is exempt from sales and use tax under Minnesota law on
purchases rentals and leases of inerchandise and services to be used exclusively in the
performance of charitable religious or educational functions For senior citizen groups
the merchandise must be used for pleasure recreation or other nonprofit functions of the
group his exemption does not appIy to purchases of ineals lodging motor
vehicld or waste collection and duposal serices MS 297A2 subdl6
Commissioner of Revenue
by
P R Blaisdell Supervisor
aies and Use Tax Livision
Questions Calf the MN Department of Revenue at 612 2966181 or tollfree 1800673777 TDD
users call the Minnesota Relay Service at 612 297533 or 1800627329 Ask for 612 2966181
Agenda Item J1
Attachment 4
Packet Page Number 90 of 224
Lra ooziz
City of Maplewood
Application for Charitable Gambling Tax Funds SEP 17 2ot1
Please type or print neaty C
o
Aoolicant Information gpe
Name of organization requesting funds CHILD Inc
Contact Person Keli George Contact Phone 612 3085136
Email Address ke 1 igeorge3@gmai 1 com
MailingAddress 2Jlo E 1h AV2
N St Paul MN 551 U9
Type of organization making request please select one
City County School District Q NonProft Attach proolof IRS 501c3 status
Other Specify
How does you organization serveimpact the citizens of Maplewood
Educates community on child abuse prevention and awareness
Free support groups to children who have been abused
Coordinates services with other organizations to help families
How many residents of Maplewood does your organization serveAmpactGive en estimated
Our organization helps make Maplewood a safer place for
children which impacts the entire community
Request Information
Amount of Request 2 0 0 0 0
In detail explain how the funds requested will be utilized be speciic a anacn addinonapages irnecessary
FllndS wi11 be used t0 Provid2 SllAOYt qYOUD SUDq1i2S arid
educational materials for awareness and prevention traininqs
Support groups are provided free of charge to all abused
children Trainings are provided for a variety of groups
including but not limited to work place scout groups charter
and public schools professionals working with children parent
Often applicants are not awarded the full amount requested can your organiZation utilize a partial
award X Yes No How would a partial award be utiized
Supplies for support qrouos and educational materials for
awareness and prevention traininqs
By competing and signing fhis form the organizaion confirms that the requested Charitable Gambling
Tax Funds wil be spent for a lawul purpose This request is a onetime request for funds to be awarded
in the next fisca year and the applicant understands requests for future funding wil require a new
separae application
1 rxecufi e Drer qiotz
Signature Title Date
Kel Cerqe
Print Name
Agenda Item J1
Attachment 4
Packet Page Number 91 of 224
INTERNAL REVENLTE SERVICE i DEPATMENT OF THE TREASURYPOBOX2508
CINCINNATI OH 45201
MAI 2 4 ZOO Employer ldentification Number
Date 411983306
DLN
17053057776055
CHILDREN HURT IN LEGAL DECISIONS Contact Per on
PO BOX 782 DANIEL D D2AG00 ID 31467
STILLWATER MN 550820000 Contact Telphone Number
877 8295500
Public Charity Status
170 b 1 A vi
Dear Applicanb
Our letter dated APRIL 2001 statedyou would be exempt from Federal
income tax under section 501c3 of the Internal Revenue Code and you wouldbetreatedasapubliccharityratherthanasaprivatefoundationduringanadvancerulingperiod
Based on the information you submitted you are cassified as a public charityundertheCodesectiorilistedintheheadingofthisletterSinceyour
exempt status was not znder consideration you continue tq be classified as
an organization exempt from Federal income tax under section 501c3 of the
Code i
I
Publication 557 Tax St3tllS O our Organizatioirovicies detailed
inioltnation abottt yoti rights and responsibilities as an empt crgarizatior
You may request a copyfby calling the tollfree nmber foforms
800 8293676 Information is also available onour Intrnet Web Site at
wwwirsgov
If you have general qlrestions about exempt organilationslpleasecall our
tollfree number shown in the heading between 830 am 530 pm Eastern
time j
Please keep this letter in your pennanent recordsJ
Sincerelyyours
4
Lois G Ler er
DirectorExempt Organizations
Rulings and Agreements
I
i
I LetteY 1050 DOCG
I
i
I
i i
i
Agenda Item J1
Attachment 4
Packet Page Number 92 of 224
IV
SEP 2 0 1012
i r oy
Se tember 18 2012 Map
Dispute Resolution p
Center
James Antonen City Manager
9 casc Arh streec City of Maplewood
st Pau MN 55130 1830 East County Road B
651292 6067 Maplewood MN 55109
fax 651 292 6065
Dear Mr Antonen
Board of Directors On behalf of the Dispute Resolution Center DRC it is a pleasure to
provide the enclosed application to the City of Maplewood for the
Charitable Gambling Tax Fund Program for 2013 Also enclosed is
Donna E Evans
an invoice for the Award of Funds for 2012
Metric Gites Funding from the City of Maplewood has helped ensure access to free
and lowcost alternative dispute resolution services by all individuals
Karen Hollaus families and organizations in Maplewood
Colleen Luna
DRC has continued its emphasis on diversifying those served notably
Kimberly Nightingale by working with the staff of CommonBond Communities to develop
and internal conflictresolution program for residents DRC provided
Marcell Walker a 30hour Basic Mediation Skills Training at Concordia Arms for 16
Barbara Williams CommonBond staff inembers during the first four months of 2012 to
help them be able to resolve resident conflicts
Saynmoukda Vongsay
Thank you for your consideration of this application Please contact
me at 6512926067 or dredremnor if I may provide additional
information
Jeanne Zimmer
Executive Director
Very truly yours
ne F Zimmer
Executive Director
encl
Agenda Item J1
Attachment 4
Packet Page Number 93 of 224
Updated 070212
City of Maplewood
Application for Charitable Gambling Tax Funds
Pease type or print neatly
Applicant Information
Name of organization requesting funds Dispute Resolution Center DRC
Contact Person Jeanne Zimmer Contact Phone 65 12926067
Email Address dre@dremn org
MailingAddress91 E Arch Street
Saint Paul MN 55130
Type of organization making request pease seect one
City County School District NonProfit Aftach proof of IRS 501c3 status
Other Specify
How does your organization serveimpact the citizens of Maplewood
DRC provides conflictresolution services to Maplewood
residents businesses and agencies resulting in less
consumption of city services such as police nuisance calls
How many residents of Maplewood does your organization serveimpactGive an estimated
Over the years DRC has served from 26 300 Maplewood
residents annually responding to community needs
Request Information
Amount of Request 2 0 0 0
In detail explain how the funds requested will be utilized be specific attach additional pages if necessary
DRC will provide free and lowcost mediation and facilitation
services to Maplewood individuals and organizations Community
education and training opportunities will be available For
example earlier this year DRC worked with CommonBond
Communities to train and support staff to resolve resident
conflicts in their 48 family and 165 senior housing units
Often apel are not awarded the full amount requested can your organization utilize a partial
award X Yes No How would a partial award be utilized
Support in any amount will allow DRC to continue to offer free
and lowcost conflictresolution services in Maplewood
including mediation and restorative justice processes
By competing and signing this form the organizafion confirms that the requested Charitabe Gambling
Tax Funds will be spent for a lawfu purpose This request is a onetime request for funds to be awarded
in the next fiscal year and the applicant understands requests for future funding will require a new
se arate application
Execu ive Director September 17 2012
Sig a ure Title Date
anne F Zimmer
Print Name
Agenda Item J1
Attachment 4
Packet Page Number 94 of 224
Dispute Resolution Center
Request for Maplewood Charitable Gambling Tax Funds
The Dispute Resolution Center DRC is a notforprofit community mediation program founded
in 1982 to provide mediation facilitation training and referral services in the East Metro area of
the Twin Cities The oldest communitybased conflict resolution resource in the State of
Minnesota DRC is the East Metros only provider of a full range of free and lowcost alternative
dispute resolution services
DRC is able to provide free and lowcost services to Maplewood residents businesses and
organizations through the generous support of the Maplewood Charitable Gambling Tax Fund
Program Referrals come from neighborhood groups block clubs schools social service
providers city administrations courts and police departments and probation offices
As a resource to city staff DRC provides an alternative to the many hours spent attending to
disputes involving neighbors including ordinance violations trees parking pets noise and
intercultural conflicts
Mediation strengthens and builds community relationships by providing opportunities for
community members to resolve differences respectfully and learn selfsufficiency in handling
future conflicts DRC supports Maplewood residents and City staff in resolving matters that
might otherwise escalate into violence or result in costly litigation Since 1999 DRC has assisted
over 650 residents of Maplewood in resolving conflicts related to their relationships as
neighbors employers and employees landlords and tenants and families
As a community resource DRC provides affordable accessible opportunities for neighbors
families community groups government agencies and businesses to resolve conflict No one is
ever denied services for inability to pay A majority of the individuals served by DRC are people
with lower incomes
The highquality services provided by DRC are consistent with the mission of promoting the
constructive resolution of conflict through open communication and shared decisionmaking
Studies have demonstrated that agreements reached in mediation are more likely to be adhered to
than those settlements imposed by a third party Participants report greater satisfaction with their
agreements and believe that the process improved their relationships with other parties and
opened the door to improved communication In the long run this creates more peaceful stable
and less violent communities and requires less police and municipal intervention and fewer
dollars when disputes arise
DRC services are available through the generous efforts of approximately 150 community
volunteers including residents of Maplewood who are recruited and trained by DRC
Volunteers must relate well to participants both to earn their trust as well as to understand their
language and culture DRC volunteers contribute approximately 3500 hours of service as
facilitators mediators trainers and board members each year
DRC also offers community education opportunities designed to teach effective conflict
resolution skills and invites residents of Maplewood to complete the 30hour Basic Mediation
Skills Training and apprenticeship to become volunteer mediators
Agenda Item J1
Attachment 4
Packet Page Number 95 of 224
i
I
INTERiIAL REVIIQIIE SERVICE DEPARTMENT OF TF TREASIIFty
P O BOX 2508
CINCINNATI OH 45201
2 j 2103 nployer ldentification Number
Date 411441352
r DLN
17053186748083
DISPUTE RESOLIITION CENTER Contact Person
974 W 7TH ST I PAIIL D RERR ID 31104
ST PAIIL MN 551023250 i Contact Telephone Number
877 8295500
I Public Charity Status
I70b I A vi
j
Dear Appli ant i
our Zetter dated 1983 stated you wouZd be exempt from Federal
income tax under section 5o1c3 of the Internal Revenue Code and you would
be treated as a public charity during an advance ruling period
Based on or records and on the infozmation you submitted we are pleased to
confirm that you are exempt under section 5o1c3 of the Code and you are
classif ied as a public charity under the Code section listed in the heading of
this letter
i
Publicatiori 557 TaxExempt Status for Your Organization provides detailed
informatioz about your rights and responsibilities as an ecempt organization
You may re est a copy by calling the tollfree number for forms
800 8293676 Information is alsolavailable on our Internet Web Site at
wwwirsgo
i
If you havegeneral questions about exempt organizations please call our
tollfree number shown in the heading between 800 am 630 pm Eastern
t ime i
i
Please keep this letter in your permaient records
Sincerely yours
I O
ILois G Lerner
Director Exempt Organizations
I Rulings and Agreements
I Letter 1050 DOCG
i I
i
Agenda Item J1
Attachment 4
Packet Page Number 96 of 224
Updated oyoziz
City of Maplewood
Application for Charitable Gambling Tax Funds PCe
Please type or print neatly SEP 1 R 112
Aoolicant Information n oa0
Name of organization requesting funds 622 EDUCATION FOUNDATION INC f Mape
Contact Person Carole Anderson Contact Phone 65114845560
Email Address Carole48@comcastnet
Mailing Address 2878 Meadowlark Lane
Maplewood MN 55109
Type of organization making request pleose select one
City County School District NonProfit Attach proof of IRS SOlc3 status
Other Specify
How does your organization serveimpact the citizens of Maplewood
The 622 Education Foundation provides assistance to public school students whose educations are at risk due
to their families financial situations With our aide they are able to fully participate in school Wilder
Research 200810 documented that Maplewoods population is 1330 povertv and that in 2011 4220 of
students received freereduced rates and 257 are homeless attachmentA We concentrate efforts
thrnugj the Ange Fr1 rn aal the edcation opportnities for all students espgcially the verv poorest of
the poor This effort in the short term raises selfesteem and success for students and in the long term will
assist them in achieving greater educational potentia attachment BJ
How many residents of Maplewood does your organization serveimpact Give an estimated
Direct impact is approximately 850 Maplewood students per year family impact is approximately 750 This
includes students receiving Angel Fund and Innovative Grant benefits
Reauest Information
Amount of Request 500000
In detail Explain hOW th2 fUdS CqUe5t0d Will b2 Utiliz2Cl be specific attach additional pages if necessary
The Angel Fund is a grant provided to each school in the amount of 2 per year per student in that building
and administered through the schools Principal and Social Worker It may be used to rrovide needed warm
clothing health assistance food or school materials and other necessities attachment B2 and B3
Innovative Grents are provided to district teachers to enhance learning4oortunities for students beyond
those that can be funded through the school district funds All students in the district may be impacted
attachment C
Often applicants are not awarded the full amount requested can your organization utilize a partial
award Yes No How would a partial award by utilized
The amount of the qerpupil Anel Fund would be reduced and the Innovative Grants would be limited
By compleing and signing this form the organization confirms that the requested Charitable GamblingTax Funds will be
spent for a lawful purpose This request is a onetime request for funds to be awarded in he next fiscal year and the
applicant understands requests for fuure funding will require a new separate application
i Cl Ht i v 7id
Signature Title Date
Ca t f i il1 cC S C
Print Name
Agenda Item J1
Attachment 4
Packet Page Number 97 of 224
I
EDUCATION
FOUNDATION
a step beyond
September 18 2012
No St PaulMaplewood0akdale
P O Box 9979
Maplewood MN 55109
Phone 6517487595
City Manager James Antonenwww622educationfounda5oncom
City of Maplewood
BOARD OF DIRECTORS 1830 E County Road B
Maplewood MN 551092702
COPRESIDENT
Lynn Berens RE City of Maplewood Charitable Gambling Grant Applications
COPRESIDENT
Chris DuFresne Dear Mr Antonen
VICEPRESIDENT
Mike Cavallaro Enclosed please find an Application for Charitable Gambling Tax Funds
SECRETARY submitted by the 622 Education Foundation The 622 Education
Shannon Horstman Foundation is a nonprofit organization which benefits Maplewood
students enrolled in the ISD 622 School District I have been a member
TREASURER ofthat Board for 17 years because I support its mission to enhanceAngieLaska
learning to even the educational baseline for all students and to assist
PASTPRESIDENT the neediest of school children in our community
Larry McCabe
DRECTORS Please direct any questions concerning to enclosed submission to me at
carote Anderson carole48@comcastnet or 6514845560 Thank you for considering
Marylee Abrams our application
Amy Cobom Sincerely
Debra Dempsey
Stan Karwoski i1o
David Lameyer Carole Anderson
Betti Marx enclosure
Pat Myckleby
Patty Phillips
Doug Ronsberg
Mary Kay Straka
Agenda Item J1
Attachment 4
Packet Page Number 98 of 224
IA F MI1I1dES
iar RECgTi ri R oNr
TTt2PdEY IE3L II JfySt3J QAma9 srti ssitna 32egistratao
SuT t2o0 BfNtEa Tor
445 MirrESOTa Srxcrr
SrPauII SSIOI213C F77ERAL EIN 11TL
b517571311
651 296140 TT4
wvwagstatennus Folt t Exaa 61302019
SECTIOlT ONE EOUIRED INFORMATION FOR IiIITYAI REGISRATI011 INUAL REPUZTIN I
1 LegallVame of O3gartiZQttOYl 622 EDUCATION FOUPdDATiON wc
If annual reportin is this a new name since the organizations last fiiin Yes No
If so please state former name
2 List all names under which the organization soticits contributiors
622 EDUCATION FO i
3 l2ailingAcdress ofCgazizrtion Physiccrlldcrss cf ganizctio
PO BOX 9979 2520 E 2TH 4Vt
titAPLEWOOD MN 51G9 NOF2TN ST PAU l411 55109
ContuctPerson CHR DU EYI1fXIZ CHRIS@CHRSSDUFRFSiECOM
Tel Ar ssss2o27 Fcrz No
5 Complete the folloiirg for the inost recent twelvemonth accoiniing year lYhile this informalioyz
shozrlc reflect the nancicls on 1hz IRS Form 990 this section is rerec to be completed even ij an
IRS Form 990 is attcrchec Befoe completing this seciion please tefe to the Instrzrctions
IICOMF sr 3ear Ea soizo
Contributions froj tie ubic 795
Govenment Grants Q
Other revenue 8257
TCDIAL RT 7s2s
EXPENSES
Arrount spent for prorm or charitable prposes a7L8
Managemeniaeneral expense sasa
Fundraising exense s
TOA EX s7s
EXCESS or DEFICIT s375
TOTAL Assets zoso2
TOTAL Liabilities 8
END O YEAl2 CT1 BAIAIVCETT WRTi Assets minus Liabilities 9758
For tfce Lise nly R 2 5i3 75 N eostcard 39i EZ 3 FS SIG
Sr att9t
bI 3 Upn request this material catz be nade availabtv in alernate formats
Agenda Item J1
Attachment 4
Packet Page Number 99 of 224
w
o Does the organiatic3 s the set of a piafessional tundraise rztsi soficitor or corsuliant
Yes 0 No
If so provide name and address of any outsicle professioral finclraier emaloyed by the organizatin
and state the totI amount of compensation each outsid iundtaise received from ttie f ling
organization during the year ittacda sherAule if ra3ore thai oee
Name
Address
City State Zip Compensation
7 Does this professional findraiser solicit or consult in Minnesota Yes No
8 Month ancl day accointing year ends sse
9 Has the orbanizatior inclided tie filing fee late fee if any and atl attacments required by tn
instructions Yes No
SECTIT WO 1ZEQJIRED Ft IIITAL IEGI5AIOt L
1 Address of reistred agent in the State of Iinnesota or the address of the persan who has custody of
the organizations baoks and records if not kept at the oraniztians oftic
Name
Street and Nunber
City State Zip Telephone
2 ye of legal entity tash the creating document
Nonprofit corporation Trust Unincorpqrated associatian
3 Ptace anti date the organization uas incoiporated
state date
4 Is lhe rganization exept fram federa income taxes
Yes ttac a copy of the TRS dtermination letterj Status Ic
No Date oranization submitted Form l 023 lo the IPeS
5 If tke ral3izatioi is ot exempt frorri eera iicome taxes c s isal agent state thti fiscal
agents nane address and federal EII
6 Has th organization been denied the riQht to solicit cortributions
a By any government agency
V
Yes tin if yes attacl explanation
b By any coiirt Yes iZfl Ifyes attach eYplanation
Agenda Item J1
Attachment 4
Packet Page Number 100 of 224
7 Explain in detail te charitable puoses ofthe organizta inlciisa rjs acaivities
8 Please mTk a1S iens that escribe the oranizations charitabl mission
Ars Cuiture Human Services CivicLobbying International f Halth
Environment Mental Health Education Religious 4her
Or List he NTEE ccdes that describe l arganizations purose
9 Which of ihe abfle to 6st describes the erganizations pimay purpss
l 2
0 Check one o more methods of solicitation the organization anicipates ising
Telephone appeals Grant n Sveep Cther
Direct mail Internet ivledia
11 State the total contributions the organization received durinp the accourtitg year last ended
12 Attal a list of organizaions officers directars trustees an chief execitiv officer inaluding their
titles addresses and totai annual compensation paid to each Attacheci
I
I
TION IREE EJ FOi lINI IfJZTilTG i1
L o iUST coiaipfete aaesddo 6
l las the organizations accounting year changed since the last report was filed Yes I10
fyes provide the new yearend date
2 Attaci an explanation if there ias been any change in the organizations tax status vith the Interna
Revenue Service a significant change in the purpases of the organiztion or i the organizations right I
to solicit funds has been denied suspencted revokPd or enjoined br any state agency or coui i any
state or if there are proceedings pending None Attached
3
Agenda Item J1
Attachment 4
Packet Page Number 101 of 224
3 List the i highest paid drectors officers ard einp3oyees of r organizatian and its relaTed
rnirationsj who receive toTal compensation of 5i oi mcre indicaira their ti2les an total
compensation paid to ach Total compensation includes salaris fees bnuseY fringe Pneits
severance paymenls and deferred compnsatio7 paid by the organization and all relatd organizations
Ariated trganizatian is an orDanization thai controls is controlied by a is under common contro
with another corporation Contral can exist hrugh stock ovnership or membrship interests the
aiEthflrity to appaint members or the ability to ciirect the policies and management c3f other corporatiors
See tllinn Stat 3I7Ad1 l subd i8 ue to chzzges in tie Iasv or annu rats after tst
Ol the compnsatio repcrting th i DOfl and otl eoanestion dnes s ta
rrt rorted on W2 bo 5 andor orm 1fl99 1IC bo 7 issued by h mrgniais a
it relael taations
ltameIitle ornpensation
eferre
ringe InefiComensaion
dE
2
3
4
5
4 Attal a list of organizations board of directors Attached
Inclided in IRS Reriirn
5 Attach a GAAP audit if total revenue exceeds 750000 ttached
Audit not included under the Faod ShelY Exemption excluding from totai revenue the valtie of
food donated to a nonprofit food shelf for redistribution at no cost Audit not reqiired
b Minnesota law requires that an organization file a copy of any IRS orr 990N ePostcard 94J 990
EZ oi 990PF informaiional rtun that was filed with the IRS Has the organization inctuded yith this
annual report copy of ali 9RS Farm 99N ePostcard 99 99tiZ or 990PF inforrnationa returns
that it tiled svith t iRS excludin Scheduie 8 or any other donor list required by the IRSj
0 Yes Na Not required to file a reurn tiith IRS or fites with Naiional
Chapter
IV 3j asvJirg S to ehe crhov cuPstrort care nttesting thcrt the IRS irrfcrnrtzanal Yetzarr2 jalecl
tivith this qffice is un excct copy inclucing crli schedules cnd attachments of te IRS inforrzationcl retann
lec tiitl Ihe InS ercizrcing Sehclzale B ot crnv other donor list the IPS nrn reqare
a
I
i
Agenda Item J1
Attachment 4
Packet Page Number 102 of 224
Short Form OMB No 15451150
Fo 990EZ Return of Organization Exempt From Income Tax i OUndersection501c527or4947axioftheIntemalReverxieCode
except blacic lung tenefit trust or private fomdation
Sponsaing organatans of donor advised funds organizations that operate one a more hospital facilfties
and certain controlling organizations as defined in section 512b13 must file Form 990 see instructas
All other organizations with gross receipts less than 200000 and total assets less than 500000
Depar6nent oF the Treasury at the end of the year may e this fortn
Memai Revene Senice The organation may have to use a copy of this retum to satisfy state reporting repui2ments
A For the 2010 calendar year or tau yr beginning Jul 1 2010 and ending June 30 20 11
B Cnecic if appicabie C Name of organization D Employer identification number
Address cnarye 622 Education Foundation Inc 411854041
Name cnange Number and street or PO box rf mail is not delivered to street address Roo sude E Telephone numher
ne PO Box 9979 6517487595
Temanffied
City or town state or country arxl ZIP a F Group Exemption
i Maplewood MN 55109 Number
G Accounting Method Cash Accrual Other specify H Check if the organization is not
I Website www622educationfoundationorg required to attach Schedule B
J Taxexempt status check only one 501c3 501c insert no 0 4947a1 or 527 Form 990 990EZ or 990P
K Check if the organization is not a section 509a3 supporting organization and its gross receipts are normally not more than 50000 A
Form 990EZ or Form 990 return is not required though Form 990N epostcard may be required see instructions But if the organization chooses
to file a retum be sure to file a complete retum
L Add lines 5b 6c and 7b to line 9 to determine gross receipts If gross receipts are 200000 or more or if total assets Part II
line 25 column B below are 500000 or more file Form 990 instead of Form 990EZ
Revenue Expenses and Changes in Net Assets or Fund Balances see the instructions for Part I
Check if the organization used Schedule O to respond to any question in this Part 1
1 Contributions gifts grants and similar amounts received 1 9583
2 Program service revenue including government fces and contracts 2 0
3 Membership dues and assessments 3 0
4 Investment income 4 2095
5a Gross amount from sale of assets other than inventory 5a
b Less cost or other basis and sales expenses 5b
c Gain or loss from sale of assets other than inventory Subtract line 5b from line 5a 5c
6 Gaming and fundraising events
a Gross income from gaming attach Schedule G if greater than
15000 6a 0
b Gross income from fundraising events not including 265s2 of contributions
from fundraising events reported on line 1 attach Schedule G if the
sum of such gross income and contributions exceeds 15000 4620
c Less direct expenses from gaming and fundraising events 6c ia92
d Net income or loss from gaming and fundraising events add lines 6a and 6b and subtract
line 6c 6d 10352
7a Gross sales of inventory less returns and allowances 7a
b Less cost of goods sold 7b
c Gross profit or loss from sales of inventory Subtract line 7b from line 7a 7c
8 Other revenue describe in Schedule O 8
9 Total revenue Add lines 1 2 3 4 5c 6d 7c and 8 9 71326
10 Grants and similar amounts paid list in Schedule O 10 472s5
11 Benefits paid to or for members 11
y 12 Salaries other compensation and employee benefits 12
m
13 Professional fees and other payments to independent contractors 13 7a73
a 14 Occupancy rent utilities and maintenance 14
W 15 Printing publications postage and shipping 15 72i6
16 Other expenses describe in Schedule O 16 1977
17 Total eupenses Add lines 10 through 16 17 57951
y 18 Excess or deficit for the year Subtract line 17 from line 9 18 3375
19 Net assets or fund balances at beginning of year from line 27 column A must agree with
Q endofyear figure reported on prior years retum g 184206
Z20 Other changes in net assets or fund balances exptain in Schedule O 20 0
21 Net assets or fund balances at end of ear Combine lines 18 throu h 20 21 197581
For Paperwork Reduction Act Notice see the separate instructions Cat No 106421 Form 990EZ 2010
Agenda Item J1
Attachment 4
Packet Page Number 103 of 224
Form 990EZ 2010 Page 2
Balance Sheets see the instructions for Part II
Check if the organization used Schedule O to respond to any question in this Part II
U Beginning of year End of year
22 Cash savings and investments 187723 22 206028
23 Land and buildings 0 23 0
24 Other assets describe in Schedule O 0 24 0
25 Total assets 187723 25 206027
26 Total liabilities describe in Schedule O 3517 26 8447
27 Net assets or fund balances line 27 of column B must agree with line 21 184206 27 197581
Statemerrt of Program Service Accomplishmerrts see the instructions for Part III Expenses
Check if the organization used Schedule O to respond to any question in this Part III Required fw seccion
What is the organizations primary exempt purpose 5ocKs and soica
orgations and section
Describe what was achieved in carrying out the organizations exempt purposes In a clear and concise manner describe asaaitrusts optionai
the services provided the number of persons benefited and other relevant information for each program title tor otners
Grants If this amount includes forei n rants check here 28a
29
Grants If this amount includes foreign grants check here 29a
30
Grants If this amount includes foreign grants check here 30a
31 Other program services describe in Schedule O
Grants If this amount includes forei n rants check here 31a
32 Total program service expenses add lines 28a through 31 a
List of Officers Directors Trustees and Key Employees List each one even if not compensated see the instructions for Part IV
Check if the organization used Schedule O to respond to any question in this Part IV
b Tdle and average c Compensatron d Carrtributions to e Expense
a Name and address hours per week If not paid employee benefit plans 8 account and
devoted to position enter 0 deferred compensation other allowances
Form 990EZ 200
Agenda Item J1
Attachment 4
Packet Page Number 104 of 224
Form 990EZ 2010 Page 3
Other Information Note the statement requirements in the instructions for Part V
Check if the organization used Schedule O to respond to any question in this Part V
Yes No
33 Did the organization engage in any activity not previously reported to the IRS If Yes provide a detailed
description of each activity in Schedule O
Were any significant changes made to the organizing or governing documents If Yes attach a conformed
copy of the amended documents if they reflect a change to the organizations name Otherwise explain the
change on Schedule O see instructions 34
35 If the organization had income from business activities such as those reported on lines 2 6a and 7a among others but
not reported on Form 990T explain in Schedule 0 why the organization did not report the income on Form 990T I
a Did the organization have unrelated business gross income of 1000 or more or was it a section 501c4
501c5 or 501c6 organization subject to section 6033e notice reporting and proxy tax requirements
b If Yes has it filed a tax retum on Form 990T for this year see instructions 35b
36 Did the organization undergo a liquidation dissolution termination or significant disposition of net assets
during the year If Yes complete applicable parts of Schedule N
37a Enter amount of political expenditures direct or indirect as described in the instructions 37a
b Did the organization file Form 1120POL for this year 37b
38a Did the organization borrow from or make any loans to any officer director trustee or key employee or were
any such loans made in a prior year and still outstanding at the end of the tax year covered by this retum 3ga
b If Yes complete Schedule L Part II and enter the total amount involved 38b
39 Section 501c7 organizations Enter
a Initiation fees and capital contributions included on line 9 39a
b Gross receipts included on line 9 for public use of club facilities 39b
40a Section 501c3 organizations Enter amount of tax imposed on the organization during the year under
section 4911 section 4912 section 4955
b Section 501c3 and 501c4 organizations Did the organization engage in any section 4958 excess benefit
transaction during the year or did it engage in an excess benefit transaction in a prior year that has not been
reported on any of its prior Forms 990 or 990EZ If Yes complete Schedule L Part I 40b
c Section 501c3 and 501c4 organizations Enter amount of tax imposed on
organization managers or disqualified persons during the year under sections 4912
4955 and 4958
d Section 501c3 and 501c4 organizations Enter amount of tax on line 40c
reimbursed by the organization
e All organizations At any time during the tax year was the organization a party to a prohibited tax shelter
transaction If Yes complete Form 8886T 40
41 List the states with which a copy of this retum is filed
42a The organizations books are in care of Telephone no
Located at ZIP 4
b At any time during the calendar year did the organization have an interest in or a signature or other authority
over a financial account in a foreign country such as a bank account securities account or other financial Yes No
account 42b
If Yes enter the name of the foreign country
See the instructions for exceptions and filing requirements for Form TD F 90221 Report of Foreign Bank
and Financial Accounts
c At any time during the calendar year did the organization maintain an office outside of the US 42c
If Yes enter the name of the foreign country
43 Section 4947a1 nonexempt charitable trusts filing Form 990EZ in lieu of Form 1041Check here
and enter the amount of taxexempt interest received or accrued during the tax year 43
Yes No
44a Did the organization maintain any donor advised funds during the year If Yes Form 990 must be
completed instead of Form 990EZ 44a
b Did the organization operate one or more hospital facilities during the year If Yes Form 990 must be
completed instead of Form 990EZ 44b
c Did the organization receive any payments for indoor tanning services during the year 44c
d if Yes to line 44c has the organization filed a Form 720 to report these payments If No provide an
explanation in ScheduJe O 44d
Form 990EZ 200
Agenda Item J1
Attachment 4
Packet Page Number 105 of 224
Form 990EZ 2010 Page 4
Yes No
45 Is any related organization a controlled entity of the organization within the meaning of section 512b13 45
a Did the organization receive any payment from or engage in any transaction with a controlled entity within the
meaning of section 512b13 If Yes Form 990 and Schedule R may need to be completed instead of
Form 990EZ see instructions 45a
4g Did the organization engage directty or indirectly in political campaign activities on behalf of or in opposition
to candidates for public office If Yes complete Schedule C Part I 46
Section 501c3 organizations and section 4947a1 nonexempt charitable trusts only All section
501c3 organizations and section 4947a1 nonexempt charitable trusts must answer questions 4749b
and 52 and complete the tables for lines 50 and 51
Check if the organization used Schedule O to respond to any question in this Part VI
Yes No
47 Did the organization engage in lobbying activities If Yes complete Schedule C Part II 47
48 Is the organization a school as described in section 170b1Aii If Yes complete Schedule E 48
49a Did the organization make any transfers to an exempt noncharitable related organization 49a
b If Yes was the related organization a section 527 organiiation 49b
50 Complete this table for the organizations five highest compensated employees other than officers directors trustees and key
employees who each received more than 100000 of compensation from the organization If there is none enter None
b Title and average c Compensation d Conttrbutions to e Expense
a Name and address of each employee paid more hours per week emploYee benefit plans 8 accout and
than 100000 devoted to position d P other albwances
f Tota number of other employees paid over 100000
51 Complete this table for the organizations five highest compensated independent contractors who each received more than
100000 of compensation from the organization If there is none enter None
a Name and address of each independent contracta paid more than 10000 b Type of service c Compensation
d Total number of other independent contractors each receiving over 100000
52 Did the organization complete Schedule A Note All section 501c3 organizations and 4947a1
nonexempt charitable trusts must attach a completed Schedule A Yes No
Under penalties of peryury I declare that I have examined this return including accompanying schedules and statements and to the best ot my knowledge and belief it is
true correct and complete Declaration of preparer other than officer is based on all information of which preparer has any knowledge
Sign
Here Signature of officer Date
Type or print name and title
Paid ntlType preparers name Preparers signate Date
Check if
Preparer
Use Only Firtns name Firms EIN
FiRns address Phone no
May the IRS discuss this retum with the preparer shown above See instructions Yes No
Fo 990EZ zoio
Agenda Item J1
Attachment 4
Packet Page Number 106 of 224
Attachment B
622 Education Foundation
Angel Fund Guidelines
PURPOSE
In 1998 the Angel Fund was created to assist students whose families are in financial
need This year the Foundation is providing 100 per registered student based on
enrollment as of September 30 In January another 100 may be sent to each
building The January funding is made possible by a member of our community
Use of the money is at the discretion of the principal or social worker within the
guidelines explained below No student names are given to the Foundation however a
list of ways in which the money is spent and the number of students impacted is
required by May 30 of this year Please use the charts below as your guidelines and if
the Board of Directors feels the uses do not meet our requirements Angel Funds for
next year will be withheld
The lists below are intended to give you a broad overlook of what the Foundation
considers appropriate and inappropriate based on our guidelines If you have a
concern or question please check with us by email to our Administrative Coordinator
Sue Jennings at csjenninqcomcastnet
Examples of appropriate Anqel Fund usaqe include
Boots and outerwear Clothin Health Office snacks breakfast lunch
Lice treatment su lies Birth certificate fees An er rou artici ation
Re lace lost inhaler lost books School su lies G m uniform
Bus cards s ecial taxi costs E e lasses alarm clocks Cub and Tar et ift cards for famil
Lunch debts Graduation ca own Medications harmac su lies
Examples of inappropriate Anqel Fund usape include
Scholarshi s to
Dee Porta e Youn Authors Science Field Tri s
Basketball after school rou Field tri for Home Livin class COMET
Tri to Branson for Show Choir ISD 622 Comm Ed Drawin class
Field Trips to
Bakken Sleddin A le Orchard Animal Farm
State Ca ital C stal Caves Colle es
Items that can be funded elsewhere PTO Booster Clubs Curriculum Dept etc
Social Studies AtlasesMa s FACS Sewin ba s Choir shirts sweats
Thank ou ifts Communi Ed 8 Hour Activities Athletic fees and uniforms
Yearbooks Drivers Ed assistance Many of the items listed in the
chart above
Agenda Item J1
Attachment 4
Packet Page Number 107 of 224
Attachment B2
Angel Fund Expense Record Summary 20102011
Report completed by each school administrator
ITEM Expeaditure students
served
Medical supplies 8
Food in school snacks preschool 100
brealasts etc
PE Uniforms 9
Winter coats 112
Boots 95
School clothing 211
Food cards from Rainbow or Cub 105
Food Stores for families
School supplies pencils paper 277
calculators etc
Scholarship assistance for 31
s ecialized hi otential classes
Cab fare medical emergencies 6
Bike repair for Adaptive PE 3
students
Medications including head lice 122
sham o0
Hand sanitizer 49
Mints MCA testing 321
Sweatpants for health office Many
Lost books 4
Alarm clocks 15
College application fee 3
Commencement fees 26
Tennis shoes 21
Backpack program 26
Total expenditures for the Angel Fund in 201112 was
21186OQ
Agenda Item J1
Attachment 4
Packet Page Number 108 of 224
Attachment 63
Distribution of Anel Fund Checks Oct 1 2011
The chart below indicates in yellow the schools within the City of Maplewood The majority of students
in North High School are from Maplewood although the school is within the boundaries of No St Paul
Angel Fund dollars were disbursed to assist over 1300 students in Maplewood We do not identify
students who received Angel Fund assistance however statistics provided by each school indicate 825
Maplewood students were given aide in 201112
School of students
Carver 521
Castle 445
Cowern 452
Eagle Point 378
Oakdale 512
Richardson 462
Skyview Elementary 603
Weaver 477
Webster 389
TEEPGladstone preschool 188
MLAP Alternative high school 117
John Glenn Middle 786
Maplewood Middle 769
Skyview Middle 770
North High 1952
Tartan High 1772
TOTAL 10593
Agenda Item J1
Attachment 4
Packet Page Number 109 of 224
r
Attachment A
Statistics Related to Student Povertv and Homelessness
Maqlewood Homeless Students 201112
Source Ryan Strack Federal Programs Coordinator District Homeless Liaison
Weaver Elementary 13
John Glenn Middle School 20
Maplewood Middle School 10
North High School 26
Gladstone ESCE 8
Harmony Alternative School 14
Homeless Rank State of MN
Source Ryan Strack Federal Programs Coordinator District Homeless Liaison
Minneapolis Public Schools 80
Bemidji Public Schools 47
St Paul Public Schools 31
Duluth Public Schools 27
St Cloud Public Schools 24
No St PaulMpwdJOakdale 21
Osseo Public Schoots 18
Rochester Public Schools 17
Maqlewood Povertv Homelessness
Source Wilder Research Maplewood City Profile 2011
FreeReduced Lunch Students 4220
Homeless Students 257
Wilder Research Statistics show that Maplewood freereduced has increased from 33 in 2007
and that homelessness has increased from 047
Agenda Item J1
Attachment 4
Packet Page Number 110 of 224
Attachment C
INNOVATIVE GRANTS AWARDED FOR THE 201112 SCHOOL YEAR
Ereaders with Text John Glenn Middle Charles Christopherson 400
Audio Books School
Get Caught Reading Harmony ALC Whitney Gonzales 800
TartanWebster Tartan High School Mark Junod 2500
Reading Collaborative
The Hunger Games Maplewood Middle Krystal Stout 500
School
Healthy Living Walk North High School Jane Hinrichsen 925
Across America
Science Connections Weaver Elementary Laurie Fuchs 1200
German Language Richardson Elementary Gil Surine 200
Instruction for 6 7th
Graders
Singing in Science Skyview Middle School Jeanette Landin 800
Brain GymSMART Cowern Elementary Cindy Piersdorf 1000
Gym
Agenda Item J1
Attachment 4
Packet Page Number 111 of 224
y
District 622s Vision A community partnership where learning and citizenship come first
622 Education Foundation
Grant A licationspp
a step beyond
Included in this packet are
Guidelines for Grant Applications p 23
Application for Education Foundation Grant p 45
Please submit clear
typewritten applications for
ease and accuracy of reading by the
committee Thank you
Agenda Item J1
Attachment 4
Packet Page Number 112 of 224
District 622s Vision A community partnership where learning and citizenship come first
622 Education Foundation
Guidelines for GrantApplications
a step beyond
Purpose
The Education Foundation Grant is designed to encourage facilitate and recognize
innovative and creative approaches to the accomplishment of District 622s Vision
Pesons Eigibe to Appy fo Gants
Individuals or teams of individuals employed by the North St PaulMaplewoodOakdale Public
Schools who are involved in the instruction of students This includes teachers principals bus drivers
cooks custodians clerical education assistants paraprofessionals etc Persons not employed by ISD 622
including students and student arganizations may apply for grants with the approval of ISD 622s
Superintendent of Schools ar hisher designee principals dept managers etc
Eigibe Poposas
Projects designed to be completed within 12 months of being awarded
Projects that meet the selection criteria
Do NOT apply if your project is currently being funded andor is underway
Section Citeia
1 Education Foundation priorities include
a innovative teaching and
b extended dayyear educationalenrichment opportunities
2 Consideration is given to the degree to which the proposal
a reflects the Vision of District 622 see headline above
b is a creative or innovative approach to the accomplishment of the Districts Vision IT MUST
ADDRESS A NEW PROJECT AS OPPOSED TO ONE ACCOMPLISHED OR UNDER WAY
c includes sound evaluation procedures and
d is clear and logical including 1 specific objectives 2 a clear description of procedures or
methods and 3 evaluation procedures that measure accomplishment of the objectives
3 Grants cannot be used to pay staff salaries except for the cost of a subsHtute required to enable
fulfillment of the Grant Substitute costs must be included in the dollar amount of funding
requested by the Grant
4 Grants are not intended to enable staff to make a lane change
5 For a greater chance of success before applying for Technology grants please consult the
Technology department to assure your request meets District standards and requirements
6 Grant Application must be signed by appropriate supervisor administrator or committee p 5
Funding Aocations Complete the Education Foundation Grant Program Application
Education Foundation Grant Program Grants of up to 2000 may be awarded to individuals or
small groups who initiate programs or projects Grants of up to 5000 may be awarded to campus
initiated or districtwide initiated programs or projects Available funding is based upon
Education Foundation Board of Directors discretion
Send application to Sue Jennings Superintendents Office Education Center
Or FAX to 6517487413 by 400 PM on Thursday October 25 2012
2
Agenda Item J1
Attachment 4
Packet Page Number 113 of 224
a y
District 622s Vision A community partnership where learning and citizenship come first
Responsibiities of Gant Recipients
1 Use the award for the purpose intended
2 Complete the Grant within 12 months of being awarded
3 Submit the evaluation form including a summary of financial expenditures to the Education
Foundation co Superintendents office within 30 days of completion
4 Agree to share successful procedures with the 622 Education Foundation if requested
Guideines fo Competing the Appication
The project is appropriate if you can answer yes to the following questions
Is it important to student achievement ar personal development
Can it be done
Is it practical
Is it new for you Funding will not be allocated for something already completed or
in progress
Goa Statement
Tell what you hope to achieve What will be different or better if the project is successful
Keep the statement simple and straightforward
Promise only that which you can reasonably expect to achieve
Statement ofRationae Address
The problem or issue
The importance of the goal
How the project supports the goal
How your project relates to the districts educational plan
Objectives
Limit the number of objectives
Be specific state in measurable terms to the degree appropriate
nstuctiona Pocedues
Be specific
List steps
Relate to purpose and objectives
Estimate duration of project
Evauation
Relate to stated objectives
Indicate how you will know whether the project was successful
Gant Appication ReJection
Any Grant Application received after the deadline andor any Grant Application without appropriate
signatures will be returned to the writer
Questions Please call Grant Committee Chair Betti Marx 748741
3
Agenda Item J1
Attachment 4
Packet Page Number 114 of 224
y a
District 622s Vision A community partnership where learning and citizenship come first
622 Education Foundation
Education Foundation Grant Program Application
Due in Superintendents Office by 400 pm on Thursday October 25 2012
Name of Applicants
Where I we work
My our jobs
Project Title
Keep title short please
Please verify that thisroject is NEW and not inrogress or completed If not this proect
is not eliible for a Foundation r ant
Please write one or two sentences explaining how your grant proposal is new and innovative
Brief description of our project approximatel 50 words
Rationale Importance and relevance to Districts Vision
Objectives Stated in measurable terms to the degree possible
Description of procedures and methods ipplicable or activities which will be utilized
Goal Statement what will be different or better i the project is successful
4
Agenda Item J1
Attachment 4
Packet Page Number 115 of 224
District 622s Vision A comrnunity partnership where learning and citizenship come first
Describe how you will evaluate success of the project
IdentiU any schoolcommunitU partners involved in the proiect and their roles
Identiy otherfinancial resources applied for or received
Anticipated Date of Implementation Anticipated Date of Completion
BUDGET ITEMACTIVITYRESOURCFSERVICE BUDGET AMOUNT
Would additional expendable resources be needed
to continue for an additional year Yes No
Total Amount Requested
Date of review by School Based Committee
for mulriple campusdistrictwide requests PrincipalAdministrator Signatures
I verifu that this grant proposal zs nezo and
innovative and has not been done in tlzis school
Should my grant be chosen for funding I agree to allow a photograph s of myself and my grant
project to be sent to the local paper or to be used in district publications
Signed
A licant ma add a es if needed or transfer form to ones own com uter
Grant Applications Must be Received by 400 pm on Thursday Oct 25 2012
Send Application to Sue Jennings Superintendents Office Ed Center
Or FAX to 6517487413
5
Agenda Item J1
Attachment 4
Packet Page Number 116 of 224
Updated 070l2
City of Maplewood RECEIVED
Application for Charitable Gambling Tax Funds SEp y 0 7y
Please type or print neatly
Applicant Information
Name of organization requesting funds ISD 622 Fusion Drumline
ContactPerson Brannon ContactPhone 651 4905064
Email Address brann001Qumn edu
MailingAddress Walter Street
Maplewood Minnesota
Type of orgaoization making request please select one
City County Q School District 622 NonProfit Attach proof of IRS 501c3 stetus
Other Specify
How does your organization servmpact the citizens of Maplewood
The Fusion Drumline provides an opportunity for ISD622 students
to use their musical talents in a unique competitive
environment
How many residents of Maplewood does your organization serveimpactGive an estimated
200 25 members plus familyfriendsaudiences
Request Information
Amount of Request 1600
In detail BlPI8111 hOW 1h@ fi111dS 2GU@Sd WIII bE Ut1112Ed be specTc attach additional pages ilnecessary
We would like to use the funds to purchase a Lonq Ranqer PA
system The Lonq Ranqer PA system is a is a hiqhoutput
portable sound system designed for marching banddrumline
rehearsal The system consists of a wireless receiver that is
attached to two horned PA speakers A transmitter is used to
send the signal to the PA speakers The drumline will use the
Often applicants are not awarded the full amount requested can your organization utilize a partial
award X Yes No How would a paRial award be utilized
The partial amount would be used towards the purchase price of
the PA system Other fundraisinq efforts would be done to
raise money for the remaining balance
By completing and signing this form the organization confirms that the requested Charitabe Gambling
Tax Funds will be spent for aawful purpose This request is a onetime request for funds to be awarded
in the next fiscal year and the applicant understands requests for future funding will require a new
separate application
Zw tvicV C7 C I rl
Sigrture Title Date
I 13cYe scYrr
Print Name
Agenda Item J1
Attachment 4
Packet Page Number 117 of 224
portable PA system to practice music and drill Having a portable PA system
makes it easy to set up for rehearsal in a gym classroom or outside A unified
sense of time is required for any drumline to be successful at a competitive
level The instructors can use the powerful Long Ranger PA system to
broadcast a tempo beat to the students to help them stay in time during
rehearsal The portable PA system will be a valuable tool to the Fusion
Drumline and Marching Band for many years
Agenda Item J1
Attachment 4
Packet Page Number 118 of 224
F
City of Maplewood SFP 2 101p
c2
Application for Charitable Gambling Tax Funds s
Or
Information
Name of Organization requesting funds Friends of Maplewood Nature
Phone Number of Contact Person James Beardsley
Address
co Maplewood Nature Center
2659 E 7 St
Maplewood MN 55119
Email Address maplerosedoc@gmailcom
Check Type of Organization Making Request
City o County o School District
X Non Proof of IRS SOlc3 status is required
Other specify
Lawful Purpose Request
The above named organization requests lawful Charitable Gambling Tax Funds for the
following purpose
Explain expenditure attach additional sheets if necessary
Upgrade Nature Center Exhibit Technolov
Maplewood Nature Center receives almost 10000 visitors annually including people of
preschool elementary highschool and adult ages Families can walk into the visitor center and
explore and touch the skulls furs and puzzles and books However we are behind in
interactive technology the young people are used to When you see a three year old trying to
swipe the marker board as if it were an IPAD it is noted that we need to accommodate this
new generation Our request includes
1 Watershed Kiosk A small IMac computer with interactive screen is needed to continue
offering environment information about watershed in a computer The software with
games and interactive learning for children and adults is already opereting in the
Maplewood Nature Center building but the old computer is dying a slow death These
learning modules are considered the most popular exhibit in the building as it is a
brightly colored animated program and interactive while teaching the importance of
protecting the watershed areas around lakes rivers and storm sewers
The replacement touchscreen monitor and computer will cost approximately 1 20000
1 IPAD In addition an IPAD is needed for interactive use for school groups This unit could
be used on the trail for offsite presentations and events or in the nature center
J
Agenda Item J1
Attachment 4
Packet Page Number 119 of 224
building An IPAD can play a variety of nature applications including Bird Frog and
Insect song and identification
The cost of this IPAD unit would be approximately 85000
Justification Outline how the proposed project or use of the Charitable Gambling Tax Fund
meets guidelines established by City Council i
Watershed Kiosk This computer would last for many years and can be used by every visitor to I
Maplewood Nature Center It is interesting enough that children enjoy the interactive program
multiple times The computer could also be used to teach other environment topics such as
trees recycling and energy in an interactive manner
IPAD Children can page through photos and touch a photo to hear a song This will help them
recognize songs and sounds they hear out on the trails and woods and marshes Naturalists can
plug the IPAD into a projector and share on a screen with a class of up to 50 students The cost
would include the cost of a connecting cord several nature applications and a security frame
Benefits
These two pieces of technology will engage and educate students on how to take care of their
watershed familiarize them with native Minnesota animals and be a fun interactive tool for
them to use They can be used for walk in visitors and for the classes that come to the nature
center for field trips
By completing and signing this form the organization confirms that the requested Charitable
Gambling Tax Funds will be spent for a lawful purpose This request is a one time request for
funds to be awarded in the next fiscal year and the applicant understands requests for future
funding will require a new separate application
Signature tle AeJ Date
wl ZVbj 0 Q IrY70 d
PrintName TtL1 rt
Amount Requested 205000
Agenda Item J1
Attachment 4
Packet Page Number 120 of 224
7NZERNAL REVENUE SERVICE T3EPtTMENT F TiE REASURY
P O BC3 2 5 t 8
CINCINNATI OH 45201
Emplayer ldentiicatian Numberz
Date 1 2 0553 3 715
DLN
17l53256n44007
FRZENDS F MAPLEWOOD NATURE Contact Person
CENTER PRESERVES KAF2EN A HATEY II7 31641
2659 E SEVENTH ST Contact Telephone Number
hIAPLEVOOLD MN 55119 877 8295500
Accounting Period Ending
May 31
Public Charity Satus
SQ9 a 2
Form 990 Requiredc
Ys
Effective Date of Exemption
June 8 2006
Contributian De3uctibility
Yes
Advance Ruling Ending Date
May 31 2 O 11
Addendum Applies
No
Dear Applicant
ve are pleased o inform yau that upan zview of your applicatian for tax
exempt status we have determined that you are exempt from Federal income tax
under secCion 5t1c3 of the Internal Revenue Cade Gontributions ta you are
deciuctible uder sectian 170 of the Code You aze a2sa qualified to receive
ta deductible bequests devises transfers or gifts under sectaan 2055 21U6
or 2522 of the Code 8ecause this letter could help resolve any questions
regading your exempt status you should keep it in youz permanent records
Organizations exempt un8er sectian 501c3 of the Code are further classified
as eitheX public charities or private foundations During your advance ruling
period yrou will lae txeated as a public hazit Your advaa iuling pericad
begins with the effective date af youz exemptian and encls with advance ruling
endang date shnwn in the heading of the Ietter
Shcrtly before the end of your advarce ruling period we wi11 send you Fam
8734 Support Schedule for Advance Ruling Period You will have 90 days after
te end of your advance ruling period to returra the campleted fo nn We wil
thn notify you in writing about your public charity tatus
Please see enclasd Publication 4223PC Compliance Guide for 541c3 Ptahlic
Carities for seame helpfu2 inforn7ation abnut your responsibilities as an
exempt oranizaCion
If ata dictribute funds to other organizations your reaords must shQw whether
they are ekempt under section 5Clicy3 In cases where the recipient
Zetter 45 fi30CG
Agenda Item J1
Attachment 4
Packet Page Number 121 of 224
FRIENTS OF MAPLEWd4D NATURE
organization is not exempt under seetion 51ct3 you must have evidence he
funds will be used for section 501c3 purposes
Sincerely
Robert Choi
Director Exempt organizations
Rulings and Agreements
Enclosures Publiaation 4221PC
Statue Extension
I
i
Letter 1045 DtCG
Agenda Item J1
Attachment 4
Packet Page Number 122 of 224
rm 1023 Rev 62007fi Name E1tJ Page 1
Pubiic Charity Status Cortnued
e 509a4jan orgaliizaton trganized and operatd exclusiuely for testing tor pubiic safety
f 5Ja1 and 70b1Aivan organization operated far the benefit of a college or university hat is owrted or
operated by a govemmental unit
g 5Q9a1 and 170b1Avan organizaiion that receives a substantia6 pari f its financiaf suppok in he frrm
of contrbutions from publicly suppnrted nrganizatians from 2 governmental unit or trom the general pubic
E 5U9a2an nrganization that nnrmaliy receives nat more than onethird of its financial suport from gross 1
investment income and receives mare tha onethird of its financial support from contributions membership
is and gross receipts from aciivities related to its exempt functions subjeci ta certain exceptfons
i A pubiciy supported organizatlon but unsure if it is desribed in 5g or 5h The organizatian wouid iike the tRS tts
decide the carrect status
8f you checksd bcx g h or i in question 5 above you must request either an advance or a definitive ruling by
selecting one of the boxes below Reter to the instructons ta determine which type of ruling you are eligible to receive
a Request for Advance Ruling By checking this box and signing the cansent pursuant to sectian 6501c4 of
the Code you request an advance ruling and agree to extend the statute of limitatians on the assessrnent of
excise tax under section 4940 ot the Code The tax will apply oniy if you do nat establish public support status
a the end o the 5year advance rufing period The sseSSmaM priod ruifi be exfended 1or the 5dvance ruling
years tt 8 years 4 manths and 15 days beyond fhe end pf the first yer Yau have ths gi1t ta refuse or limit
the ectension to a mrtualfy agreedupon period of tlme or issues Publication 1035 Fiending the Ta
Assessment Period provides a more cietailed explanatio of your rights and the consequences of the choices
you make You may abtain Publication 135 free of charge fram the IRS web site at wvvwifsgcv or by calirng
toifree 18008293676 Signing this consent will not deprive you af any appeal rights ta which you woufd
athenvise be entEtled if you decide not to extend the statute of limitatians you are nat eligible for an advance
ruing
arisent xing Period afLimitations Upn Assessment of Taxllnder Sectron4940af the lnteinaf RevenueCode
or Urganization
lrC tQi 5L
fSi atue oi Ofiicer Ckrector 7rustee or niher fype or print name ot signer Oata
a rizeci afticiatp PrY
Type or pirtt tiHa or autaority o1 sisnej
For R Ue Only r q w
OT
1R5 pirectcr Escempt Organizations 7ate
b Request far Definitive Ruling Check this box if yosa have completed oe tax year oT at leasi 8ufi manins ana
you are requesting a dfinitive ruling To confirrn your pulic support status answr line 6bi if ytsu checked trx
g in line 5 above Answer line 6bii if you checked box h in line 5 above If yau checked box i in line 5 aboue
answer both iines 8b and ii
i a Enter 2 af line 8 column e an Part IXA Staternent of Revenuss and Exrenses
b Attach a Ast showing the name and amount contributed by each person campany or organiation whose
gifts totaled more than the 2lo amourrt i the answer is Nae chec this box
iij a For pach year amounts ara included on lines 1 2 and 9 of Part XA Statement of Reuenue and
Expenses attach a list showng the name of and amount received from each disqualified person If the
answer is tJane check this box
b For ech year arnounts are inc4uded on ine 9 of Part IXA Statement of Reveues and Expensss attaeh
a list showing the name of and amaunt received frpm each payer other than a disquaEified person whase
payments were mare than the larger of 1 1 of line 1Ci Part IXA Siatement of Revenues and
Expenses or 2 SbOtJO If the answer is None aheck this box
7 Di you receive any unusual grants during any of the years shown an Part IXA Statement of Yes Na
Rerenues and Expenses if Yes attach a list including fhe name ot the contributor the date and
amunt of the grant a briet description ot he grant and xplain why it is unusuai
Fprm UZ Ree e2046
Agenda Item J1
Attachment 4
Packet Page Number 123 of 224
eceiv
City of Maplewood EP I 2 11
0
A lication for Charitable Gamblin Tax Funds
oa
pP g
Name of Organization requesting funds Friends of the Ramsey County Libraries
Contact Person Sue Gehrz Executive Director Phone 651 4862213
Address 4570 N Victoria Street Shoreview MN 55126
Email Address sgehrz@rclreadsorg
Check Type of Organization Making Request
City County School District
X Nonproftt Proofof IRS 501 c3 status is required Attached
Other specify
How does your organization serveimpact the citizens of Maplewood
The Maplewood branch library is the second busiest in the Ramsey County Library
system serving a diverse population in suburban Ramsey and Washington counties as
well as the northeast portion of the city of St Paul The project for which support is
requested specifically serves preschool children and young families According to the
2010 US Census the City of Maplewood has a population of 2437 children under the
age of five with 84 of them living below the poverty level Nearly 15 of Maplewood
households speak a language other than English The library serves all children equally
and gives each child who comes into the building as full an experience as possible This
is especially important for families with limited educational resources in the home Last
year programs at the Maplewood Library averaged 345 children per month
How many residents of Maplewood does your organization serveimpact
In 2011 the library in Maplewood had almost 400000 visitors and records show that
19088 Maplewood residents borrowed 246175 materials from that library
Request Information
Amount of Request 2500
In detail explain how the funds requested will be utilized
Purpose of request To help fund museum quality literacybuilding equipment in the
preschool area of the Ramsey County Library in Maplewood 3025 Southlawn Drive
Need When the library in Maplewood was designed a separate 16 x 16 space within
the childrens area was included to be used for Story times and other programs for
children The popularity of these programs with children parents and caregivers greatly
exceeded expectations and this space quickly became too small to accommodate the
demand The childrens programs needed to be moved into the large Community Room
1
v
Agenda Item J1
Attachment 4
Packet Page Number 124 of 224
The small space originally designed for programs is currently open with very limited
visibility by library staff Having open space in the toddlerpreschool area promotes
excessive physical activity ie running around misbehaving making noise and does not
foster literacybuilding interaction either with peers or adults Major public libraries in
the country have learned that preschool children benefit from being in an environment
that is divided into smaller nooks and spaces Children use different parts of their brain
when working on literacybuilding activities than when engaging in physical activities
Public libraries are a major resource for the development of early literacy skills and the
physical environments need to support that purpose
Project In 201 1 the Friends of the Ramsey County Libraries RCL applied for and
was awarded 1690 from the City of Maplewood Charitable Gambling Tax Funds to
purchase a piece of equipment dedicated to early literacy development in the preschool
area in the Maplewood Library In January 2012 the Board of Directors of the Friends
of RCL donated an additional 13000 to help design and create this project In early
2012 Ramsey County Library staff in Maplewood applied for funding from the
Minnesota Childrens Museum for a Smart Play Spot that will leverage the funds from
the city and the Friends to greatly expand the scope of the project
Our partnership with the Minnesota Childrens Museum the City of Maplewood local
civic organizations and area businesses will enable the installation of a40000 Smart
Play Spot in the Ramsey County Library in Maplewood located adjacent to the
Maplewood Mall The Childrens Museum is funding 20000 and the Friends are
required to match this amount We have already raised 14690 and are seeking funding
partners for the remaining 5310
We have accepted the preliminary project design with many interactive features for
preschool children including a bus large maple tree stump with animal costumes a
garden a farmers market two window telescopes and a flexible building that can be
made to look like different types of stores clinics etc Installation is scheduled for the
week of November 26 2012
Upon completion this redesigned space will help toddlers increase their attention span
and learn in a calming but intellectually stimulating environment Reducing physical
activity and noise by preschoolers will benefit all users of that library
Often applicants are not awarded the full amount requested Can your
organization utilize a partial award X Yes How would a partial award be
utilized
This Smart Play Spot project has many separate components Any funds granted would
be used to help fulfill the 20000 match required by the Childrens Museum
By completing and signing this form the organization confirms that the requested
Charitable Gambling Tax Funds will be spent for a lawful purpose This request is a
2
Agenda Item J1
Attachment 4
Packet Page Number 125 of 224
one time request for funds to be awarded in the next fiscal year and the applicant
understands quests for future funding will require a new separate application
I
Signature L U u Title Executive Director
Date 9122012 Print Name Susan L Gehrz
Attachments
IRS letter confirming 501 c 3 status
Copy of fundraising flyer being sent to prospective funding partners
Minnesota Childrens Museum Smart Play SpoP brochure
3
Agenda Item J1
Attachment 4
Packet Page Number 126 of 224
Internal Reverue Service Department of the Treasury
District
Director
Person to Contact EOTPA
FRIENDS OF THE SUBURBAN RAMSEY Telephone Number 18Q08291040COUNTYLIBRARIES
RAMSEY COUNTY PUBLIC LIBRARY
4570 N VICTORIA Refer Reply to 962423
SHOREVIEW MN 55126
Date October 15 1996
RE EXEMPT STATUS
EIN 411597085
This is in response to the letter dated October 15 1996 regarding yourstatusasanorganizationexemptfromFederalincometax
Our records indicate that a ruling letter was issued in August 1992grantingyourorganizationanexemptionfromFederalincometaxunder theprovisionsofSection501c3oftheInternalRevenueCodeof 1954
Our records also indicate that your organization is not a privatefoundationbutonethatisdescribedinSection509a2oftheInternalRevenueCode
Contributions made to you are deductible by donors in computing theirtaxablPincomeinthemannerandtotheextetprovidedinSectin1n FtieriernalevenueCvde
If your gross receipts each year are normally 25OG000 or more you arerequiredtofileForm990ReturnofOrganizationsExemptfromIncomeTaxbythefifteenthdayofthefifthmonthaftertheendofyourannualaccountingperiod
You are not required to file Federal income tax returns unless you aresubjectto the tax on unrelated business income under Section 511 of theCodeIfyouaresubjecttothistaxyoumustfileanincometaxreturnonF990T
If any question arises with respect to your status for Federal income taxpurposesyoumayusethisletterasevidenceofvourexemption
ii1S 1S a avSG 1c22
i nrerc1 v vniircii
Q
Bobby E Scott
District Director
Your advance ruling period ends on December 31 1996
Agenda Item J1
Attachment 4
Packet Page Number 127 of 224
III I F R I E N D S 4570 North Victoria Street
Shoreview MN 55126
oF rHe Phone 6514862213
RAMSEY COUNTY LIBRARIES Fax 651
Partnership Opportunity to Support Early Literacy
MEETS
Coming in November 2012 STANDqRDS
New interactive playFul environments for preschool children
are designed around the six skills that build literacy
Love of Books Using Books
Learning Words Telling Stories
Knowing Letters Hearing Sounds
Help the Friends raise 20000 to meet the matching grant offered by the Minnesota Childrens
Museum to create and install a40000 Smart Play Spot in the preschool area in the Ramsey
County Library in Maplewood
Museumquality installation will include
A hideaway tree trunk with animal puppets costumes sounds
A play bus with books interactive pieces 8 bus driver costume
A farmers market with play fruits veggies money more
A service building that can easily become a post office store fire station or office
An urban garden to practice planting harvesting counting
Two window mounted telescopes for exploring nature outside
Much more
Donors will be acknowledged
Media Coverage of the new installation the last week in November
Taxdeductible donation letter
Acknowledgement in 6000 copies of the ExPlore Library Newsletter and on the web site
Name on permanent donor plaque at the library for gifts of at least
250 individuals
500 civic organizations
1000 businesses foundations
Recognition in materials from the Minnesota Childrens Museum
For more information contact Sue Gehrz at 651 4862213 or sqehrznrclrealsnrq
tf
i
r
Public Service Building Tree garden under construction
Agenda Item J1
Attachment 4
Packet Page Number 128 of 224
I LlDnry achun1103LyoW 1 11B111 1250 PM Pps 1
Maor unding provided by
7
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Additional fundiny provided by
Blandin Fouridation Hennepin County Library Foundation
ChildrensHospital JohnSandlamesLKnightFoundation
City ol St Paul Cullural STAR Minneapolis Foundalion
GeneralMillzFoundation
In partnership wilh
DakotaCountyLibrarySystem GrendRapidsPublicLibrary w k
DetroitLakesEarlyChldhoodlnitiative HennepinCountyLibrarySystem
DuluthPublicLibrary IronwoodDevelopmentCorporetion
DuluthChildrensMuseum SamlPaulPubLcLbraryyslem t QQ
ElkRiverAreaEarlyChildhoodCoalition WorthingtonEarlyChildhoodlndiative 7 1
ElkRiverEarlyChildhoodFamilyEducalion WorlhinglonEarlyChildhoodFamilyEducation j Ch Q
ElkRiverCommunityEdutation Museum
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Agenda Item J1
Attachment 4
Packet Page Number 129 of 224
Llrryrpfiufgii76ypull I1ptt t26pPM Pge2
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Y
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CREATIVE LITERACY ENVIRONMENTS
Environmentsaredesignedaroundthesixpreliterecy SETTING THE TAGE FOR RAPID GROWTH
SPARK A LOVE OF READING
skillsdefinedbythePublicLibraryAssociationandthe Buildingonthesuccessolthefirstthreeenvironments OvertheneatthreeyearstheMuseumwilldeelopand
In2010MinnesotaChildrensMuseumincollaboretion AssociationforLibraryServicetoChildren fundedbythelnstituteofMuseumandLibraryServices installllmoreenvironmentslnadditionanappropriation
withDakotaCountyHennepinCountyandSaintPaul IMLStheMuseumwillcontinuetocomplemenithebest IromthetateofMinnesotaArtsBCulturalHeritageFund
Publiclibrariestranslormedthechildrensareasol
LoveBooks
Print motivation be interested in and enjoy books elements oi childrens museum learning emironments will support a tour of the recenily deeloped Storyland A
threelibrariesintoimmersiveinteractiveearlyliteracy withcommunitypartnershipstoadvancechildrens TripThroughChildhoodFavorifesexhibiltoatleasininesites
environments UseBooks literacydevelopmentandexpandtheprojectto TheMuseumssiteselectionprocessensuresaccesstolow
Prinlawarenessnokiceprintknowhowfohandlea GreaterMinnesota income o ulationswherechildrenfacethe reatestTheinstallationoftheseexhibitsmarkedthefirstphaseofabookfollowthewordsonapage
P P 9
multiyear strategic plan to extend the Museums learning educational disparity in school readiness
Learn Words
environmentsintocommunitylowtionssuchaslibraries
VocabularyknowthenamesofthingsPlaylulenvironmentsencouragechildrensliteracy
developmentthroughhandsonmultisensoryactivities TellStories
thaiincludedramaticplaystorytellingandplayingwith Narrativeskillunderstandandtellstoriesdescribe
IettersandsoundsClearmessagesalsoinspireadultswith thingsandevents
ideas and information on how to promote a love ol reading Know Lelters
andbuildpreliteracyskillsinyoungchildren Letterknowledgerecognizethedifferencesinletters a
know letter names and sounds recognize letters
everywhere
Hear Sounds y
Phonological awareness hear and play with the smaller 1 i L
soundsinwords t
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CURRENT AND FUTURE STATEWIDE REArp COMIIETEDSIlFS
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i
Agenda Item J1
Attachment 4
Packet Page Number 130 of 224
Updated 070212
C@1 V
City of Maplewood
Application for Charitable Gambling Tax Funds SEP r pp
Please type or print neaty
o
Applicant Information p
Name of organization requesting funds Hmong American Education Fund
Contact Person Chue T Vang Contact Phone 6 5 5 92 15 76
Email Address scholarshipscthehaef org
MailingAddress Mailing Address PO Box 17468 St Paul MN 55117
Operation Address2168 Clark St Maplewood MN 55117
Type of organization making request please select one
City County School District 0 NonProfit Aftach proof of RS 501c3 status
Other Specify
How does your organization serveimpact the citizens of Maplewood
We award scholarships to HmongAmerican students from
Maplewood Ramsey county state of MN for education We also
offer free academic coachingmentoring services for students
How many residents of Maplewood does your organization serveimpactGive an estimated
10 to 30 students with real and significant impact
Request Information
Amount of Request 5 0 9 0 0 0
In detail explain how the funds requested will be utilized be specific attach additional pages ifnecessary
We are reauestinq the followinq eauipments for prociramminq
computer 1200 program tables 340 computer desk 350
program chairs 500 fireproof filing cabinets 400 office
supplies for programs and meetings 300 Scholarship 1 program
cost 1000 Scholarship 2 program cost 1000 Total 5090
Also please see detail attached table
Often applicants are not awarded the full amount requested can your organization utilize a partial
award X Yes No How would a partial award be utilized
A partial award would mean that well prioritize the funds for
program cost and a computer second None of the funds will be
used for fundraising salary or general operations
By completing and signing this form the organization confirms that the requested Charitable Gambling
Tax Funds will be spent for aawful purpose This request is a onetime request for funds to be awarded
in the next fiscal year and the applicant understands requests for future funding will require a new
separate application
cvang PresidentCEO September 18 2012
Signature Title Date
Chue T Vang
Print Name
Agenda Item J1
Attachment 4
Packet Page Number 131 of 224
o
HAEF
Hmong American Education fund
Proposed Budget Request
Item Pro osed Current Situation Pro osed Amount
Computer Printer to keep No organizational computer 1200
track of students volunteers just using personal computer
Program meeting tables 4 No meeting tables 340
Computer desk 1 No desk 350
Chairs 20 No meeting chairs 500
Fireproof cabinet files for No cabinet files student and 400
student records 3 volunteer paper filing
Office supplies for programs Been using own funds to 300
meetings urchase supplies
HAEF Scholarship 1 program 1000
cost for female student
HAEF Scholarship 2 program 1000
cost for male student
Total Proposed 509000
HAEF PO Box 17468 Saint Paul MN 551 17 651 5921576 scholarshipscthehaeforg wwwthehaefor
Agenda Item J1
Attachment 4
Packet Page Number 132 of 224
INTERNAL REVENUE SBRVICB DEPARTMENT OF THE TRASURY
P O BOX 2508
CINCINNATI OH 45201
Date B pOIZ g451082638dentification Nwnber
DLN
17053364348021
THE HMONGAMaRICAN EDUCATION FUND Contact Pereon
PO BOX 17468 DALE T SCHABSR ID 31175
ST PAVL MN 55117 Contact Telephone Number
877 8295500
Accounting Period Endinq
December 31
Public Charity Status
170 b 1 A vi
Form 990 Required
Yes
Sffective Date of Exemption
March 2 2011
Contribution Deductibility
Yes
Addendum Applies I
NO
Dear Applicant
we are pleaeed to inform you that upon review of your application for tax
exempt statue we have determined that you are exempt from Federal income tax
under section 501c3 of the Internal Revenue Code Contributione to you are
deductible under section 10 of the Code You are also qualified to receive
tax deductible bequests deviaea tranefers or gifta under section 2055 2106
or 2522 of the Code secause this letter could help resolve any questions
regarding your exempt status you should keep it in your permanent recorda
Organizations exempt under aection 501c3 of the Code are further clasaified
as either public charities or private foundations We deCermined that you are
a public charity under the Code sections liated in the heading of thia
letter
P1eaSe 3ee enclosed PubliCatiOn 4221PC COmpliance GUide fOr 501c3 Pllb11C
Charities for cme helpul inormation about your responsibilities as an
exempt organization
Sincerely
Lois G Lerner
Director Exempt Organizations
Enclosure Publication 4221PC
Letter 947 DOCG
Agenda Item J1
Attachment 4
Packet Page Number 133 of 224
Updated 07 021
City of Maplewood ceiv
Application for Charitable Gambling Tax Funds
Please type or pnnt neatly SEP n 4 2pi2
c gAoplicantInformationyMap
Name of organization requesting funds q rG Q1QZ lj1CCAj
Contact Person ehy aG
EmailAddress Q ContactPhone s77Q7cJSla0c3ari
Maili ng Add ress o2LS BCYIGf J fYtereod mv So I
Type of organization making request please select one
City County School District X NonProfit Attach proof of IRS 5o1c3 status
OtherSpecify
How does your organization serveimpact the citizens of Maplewood
We provide quality care for children ages 6 weeks to 5 years We offer care free of charge to clients residing at Hill
House Shelter We recently had a child from the St Paul Park site attend Maple Tree for 3 months The Maplewood
site should be opening to families this fall and we stand ready to help them as needed We also serve children who
are receiving county funding for childcare The county payments are not equal to our current tuition so we subsidize
the remaining amount
How many residents of Maplewood does your organization servempactGive an estimated At this time 17
of our children reside at Maplewood addresses
Requestlnformation
Amount of Request 160000
In detail explain how the funds requested will be utilized @e specific attacn additionapages dnecessary
We serve up to 16 infants at Maple Tree We would very much like to replace our high chairs At 200 apiece and
the need for 8 units we are requesting 1600 We would be most grateful for any amount that could be earmarked
for this project
Often applica are not awarded the full amount requested can your organization utilize a partial
award Yes No How would a partial award be utilized We would purchase as
many units as possible andor choose a lowerpriced product
By completinq and sipninp this form the orpanization confirms that the requested Charitable Gamblinp
Tax Funds will be spent for a lawful purpose This request is a onetime request for funds to be awarded
in the next fiscal year and the applicant understands requests for future funding will iequire a new
separate application
Signature trLctC Title iYGClaY Date 8
U
Print name Cln t Lt tcL
J
Agenda Item J1
Attachment 4
Packet Page Number 134 of 224
Jennie Schlauch neco
Jtichlauch2 aoLcom
r
y Maple Tree
Childcare Center
Maple Tree Rod
lll1CCltC Z11CY faplewood Mh j109
G5177007GG
I i ax sro
wwwstpaulsrtouastery orQ
Agenda Item J1
Attachment 4
Packet Page Number 135 of 224
MINNESOTA Departixient of Revenue Sales and Use Ta
Certificate of Exempt Status sT1
Exempt Organizations
Sisters Of St Benedict
Maple Tree ChildCare
1695 No Century Ave
Maplewood Minn I09
Certificate nurnber ES 28921
Date Issued OS0683
Date Reissued 082697
The organization above is etempt from sales and use tax under Minnesota law on
purchases rentals and leases of inerchandise and services to be used exclusively in the
performance of charitabie religious or educational functions For senior citizen groupsthemerchandisemustbeusedforpleasurerecreationorothernonprofitfunctionsofthe
group This exemprion does not apply to purchases of ineals lodging wastecollectionanddisposalservicesortopurchasesorleasesofmotorvehicles MS
297A25 subdl6
Commissioner of Revenue
by
f f
I
g e sofPRP
Sales and Use Tax Division
Questions Call the MN Department of Revenue at 612 2966181 or tollfree t800673777 TDD
users call the Minnesota Relay Service at 612 2975353 or 18006273529 Ask for 612 2966181
Agenda Item J1
Attachment 4
Packet Page Number 136 of 224
usiness Filing Details Page 2 of 2
01291992 Nonprofit Corporation Domestic Restated Articles
03041999 Nonprofit Corporation Domestic Business Name
03041999 Nonprofit Corporation Domestic Restated Articles
OS312009 Registered Oce andor Agent Nonprofit Corporation Domestic
Office of the MN Secretary of State System Requirements Additional MBLS Information
Home Page
httpwwwsosstatemnus The MBLS application works with the Terms Conditions
following web browsers httpwwwsosstatemnusind
pagei66
Microsoft Internet Contact Us
Explorer version httpwwwsosstatemnusind
Mozilla Firefox version page42
35 Frequently Asked Questions
Apple Safari version 3 FAQ
Google Chrome httpwwwsosstatemnusind
pagei2
Copyright 2011 Secretary of State of Minnesota All rights reserved
hYhlcrnrtal enc etata mn ncRnoinPCCRaarhTlatailc7fiitoirlaF9RnhAFif4Pn R777n7
Agenda Item J1
Attachment 4
Packet Page Number 137 of 224
usiness Filing Details Page 1 of 2
Home Search BusinessSearch Filings BusinessFilings
Search Business Filings
Back to Search Results
Business Record Detals
File Amendment or Renewal BusinessAmendmentsfilingGuidae398dOba6d
a886001ec94ffe7fl
Order Copies
Order a Certificate BusinessCertificatesbusinessMasterGuidae398dOb
a886001 ec94ffe7froutefilingproductld083dd338fad3e
001 ec94ffe7foriginalFilingG uid6227e16468d5e011a886001 ec94ffe7 fl
Minnesota Business Name
Maple Tree Monastery Childcare Center
Business Type MN Statute
Nonprofit Corporation Domestic 317A
File Number Home Jurisdiction
1 G546 Minnesota
Filing Date Status
09061991 Active In Good Standing
Renewal Due Date Registered Office Address
72312012 2625 Benet Road
Maplewood MN 55109
USA
Registered Agents President
Optional None provided Jeron Osterfeld
2675 Benet Road
Maplewood MN 55109
USA
Filing History Renewal History
Filing History
09061991 Original Filing Nonprofit Corporation Domestic
09061991 Nonprofit Corporation Domestic Business Name
httnUmhlcnrtal cnc ctatP mn ncRncinPCCCPamhTPtailcfilinaCTnicaai9R1OhaEd4e011 8222n12
Agenda Item J1
Attachment 4
Packet Page Number 138 of 224
gL1RCH IN THE US 1227 SAI1VI PAUL AND MINNEAPOLIS STP
Seculai Institute of Pontifical Richardson FBP Vocation Dir James Voeller Main Street Lodge Assisted Liuing 909 Main St
ID and men founded in Ita1y in EBP John Mary Kaspari EBP Pio King NE 55413 Tel 6123622450 Fax 6123622449
FBP Seraphim Wirth FBP Maximilian Web wwwcatholiceldercareorg Units 50 Lay
Connolly FBP Totai in Residence 8 Total Staff 1 Staff 20 Total Staff 20Ibtal Assisted 64
HpU5ES AND CENTERS OF WeST Sr PntJ Community o Christ the Redeemer Catholic Eldercre By Day 11 6123622405 Fax
110 Crusader Ave W 55118 Tel 6514516114 6123622401 Web wwvcatholiceldercareorg
PIRIrUAITY Assisted 80 Lay Staff 16 Staff 10
i Ceater St Pau1s Monstery Fazt 6514530810 Email info@ccredeemerorg Catholic Eldercare Inc I101 on Main Apartments
Ave 55109 Tel 651777 Web wwkccredeemerorg Dr James C Kolar 1101 Main St NE 55413 Tel 6123788814 FaacnteuPresaF6517735124Email6123784725Webwww1101onmaincomUnits
ogtpaulsmonasteryorg Web 45
pnqeteryorg ctor HIimoski Dir Q CAMPS AND COMMTJNITl CENTERS Riuer lage East Assisted Liuing 2919 Randolph
MCGRecoe Cathdic Youth Camps Inc St NE 55418 Tel 6126052500 Fac 612605
pRford St 55104 11 6516410008 Administrative Offices 2131 Fairview Ave N 2404 Web wwvcatholiceldercazeorg Units 71
i Emeil loyolasrr@comcastnet 200 Roseville 55113 Tel 6516361645 Email Staff 25 Total Assisted S0
ypintualitycenterorg Tom Allen oce@cycamporg Web wwwcycamporg Camp Cristo Rey Corporate Internship Progrrrt 1in
llavid Rothstein Spiritual Dia location 19590 520th Ln 55760 1 218426 Citees 2924 4th Ave S 55408 Tel 612545
n gpiritual Dir Barbaza Leonazd 3353 Fax 2184264675 Natalie King Exec Dir g03 Stephen J Schulz Exec Dir Rev David
y VanderVort MA Spiritual Rev Robert C Nygaard Pres Bd Dirs Retired Haschka SJ Pres
Joanne Dehmer SSND MA John Breon Chm Vice Pres Bd Dirs Ibtal The Islander Foundation 1 De La Salle Dr 55401
Elizabeth Kerwin CSJ Spiritual Assisted 650 1bta1 Staff 20 I1 6126767603 David MedernachIteas
8 Queen Anne Communities 2627 Queen Ave 55411
19H8 Summit Ave 55105 Tel 651 R NEWMt1N CENTERS Tel 6125290503 Fax 6125295860 Rev Khanh
Fat 6516961190 Email M1tateaPOLtS Newman Center at St Lawrence 1203 Hai Nguyen Pres
olcom Web wwwdhmnaorg 5th St SE 55414 Tel 6123317941 Fau 612 g place for Newba Oce 120 S 6th St Ste
a the Heart of Mary 6 Total in 3g1771 Email parish@umncatholicorg Web 1150 55402 Tel 6123172895 8774402229
Ibtal Staff 1 wwwumncatholicorg Revs Patrick Johnson 7 Crisis Line Fax 6123172899 Email
t King Retreat Center 1952 621 CSP James Brucz CSP Robert J ODonnell safeplace@safeplacefornewbornscom Web
05313 Tel 7636821394 Fax 763 Total Staff 3 wwwsafeplacefornewbornscom PO Box 16550
Saint Paul 55116 Laure L Krupp Exec Dirmailchristtheking@kingshousecom
S MISCELLANEOUS LISTINGSgshousecomRevsAloysius Sagrado Corazon de Jesus 2645 lst Ave S 55408
OLI RaYmond R Kirtz OMI 51 Pnu Catholic Community Foundation One Tel 6128747169 Fac 6128700408 Email
OMI Dir James Deegan OMI Water St W Ste 200 Saint Paul 55107 Tel sagradocorazonl@msnnet Rev Lawrence E
j prybis OMI Bus Mgr Lon 6513890300 Fac 6513890650 Email info@ccf Hubbard Pres Bradley Capouch Vice Pres
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Web Hugo Artola Sec Armando Blas Garcia IYeas
OMI Priests 7 Brothers 1 1bta1 ycatholiccommunityfoundationorg Dr Society oF St Vincent De Pul Arehdioeesan
g Lay Staff 31 Total Staff 39 Mlou Eldred Pres Council 2939 12th Ave S 55407 Tel 612722
ojQ Nari Retreat nd Conerence Christian Brothers Youth Home 1983 1540 Lincoln 7882 Fax 6127220667 Ed Koerner Dir
7 County 2 Blvd 55026 I1 651 Ave 55105 Tel 6516990736 Bro Michael Lee qin Cities Catholic Alumni Club Q958 PO Box
g 6513453457 Email derson FSC Dir Mr Bob Pazadise Pres 581321 554581321 Tel 6516031412 Cazl
etreats@yahoocom Web Brothers 1 Bed Capacity 5 Total Assisted 4 Berstrom Club Pres Members 75
treatsorg Sr Rose Elsbernd FSPA tal Staff 1 Youth and Family Center Iria 1986 4405 E Lake
ed Annually 4598 Friends oF Catholic Urban Schools FOCUS 375 N St 55406 Tel 6127229612 Sisters Martha
lesuit Retreat House 1948 8243 pord St 55104 Tel 6516461797 Faac 651 Merriman CSJ Dir Betty Wurm CSJ Dir
e17 N 550429546 Tel 651777 6471797 Web wwKfocustwincitiesorg Thomas Counseling Center 1bta1 Assisted 35 ibtal Staff
6517771312 Revs Edward 5 McCarver Dir 2
Asst Patrick M McCorkell SJ Growing in Faith Cpital Campaign 226 Summit gpsTtNGS Regina Foundation 1175 Nininger Rd
1bta1 in Residence 2 Ibtal Staff 10 Ave 55102 Tel 651290161 Fax 6512901609 55033 Tel 6514804104 Fax 651480421
Cxo2c Christian Brothers Retreat St Marys Health Clirzics 1992 1884 Randolph Email kochendorferp@reginamedicalorg Web
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25 5t Croix Tr N 55047 Tel 651 pe 551051700 I1 6516907020 Fac 651 KHkreginamedicalorg Mark D Wilson Pres
Fex 6514335756 Email dunrovin@ 6907075 Email bdickie@stmarysclinicsorg Web CEO Pam KochendorFer Corp Sec
m Web wwwdunrovinorg Jerome vstmaryshealthclinicsorg Barbara L Dickie Regina Healthcare Inc 1175 Nininger Rd 55033
Total in Residence 6 1bta1 Staff 2 Exec Dir Neighborhbood Clinics 9 Park Nicollet Tel 6514804104 Fas 6514804212 Email
d65 Cluilcs 11 Patients Assisted Annually 11417 kochendorferp@reginamedicalorg Web
rzciscan Retreats 1956 16385 Saint Total Staff 8 LaY Staflfi Sisters 2 wwwseginamedicalorg Mr Stewart W Laird
55372 Tel 9524472182 Fax 952 Minnesota Catholic Caiference 475 University Ave PresChair Pam Kochendorfer Corp Sec
mait directoi@anciscanretreatsnet W Ste B 55103 Tel 6512278777 Fas 651 INVER GROVE HEIGHTS Catholic Finnce Corporation
franciscanretreatsnet Revs Steven 2272675 Email info@mnccorg eb 2000 5826 Blackshire Path 55076 Tl 651389
OFMConv Guardian James Van wwwmnccorg Christopher Leifeld Exec Dir Dr 1070 Faz 6513891071 Email ino@
MConv Assoc Dir Howazd Hansen Peter A Noll Dir Educ Alexandra Fitzsimmons catholicfinanceorg Web wwwcatholicfinanceorg
Staff Bro Bob Roddy OEMCone Esq Policy Dir The MCC is a Minnesota Michael P Schaefer Exec Dir Amanda Ellefson
Priests 3 Brothers 1 Lay Staff 6 Corporation the purpose of which is to promote Mgr Office Operations
ple Served 1700 the general welfaze of the people of the State of LEwooD The HillMurray Foundation 2625
Minnesota All Catholic Bishops of the State of Lenteur Ave E 55109 Tel 6517771376
HOMES FOR DISABLED Minnesota constitute Ex Officio the Board af Joseph M Peschges Pres
Kouse of Minnesta Inc I1975 1846 Directors 1bta1 Staff 5 Mple q Monastery Childcare Cenler 2625
e 55104 Tel 6516446650 Fax 651 Minnesota Catholic Education Association 4 genet Rd 55109 Tel 6517700766 Emai1
Bed Capacity 6 Sta 19 Mentally University Ave 551031996 11 6512278777 jschlauch2@aolcom Sisters Carol Rennie OSB
Adults 6 Ibtal Assisted 6 Fax 6512272675 Email pnoll@mnccorg Web prioress St Paul Monastery Jeron Osterfeld
61564611D4 Fax 6156461104 Den wwwmnccorg Dr Peter Noll Ezec Dir gd Pres Religious 4 Lay Staff 3 Bd Members 7
Admin Natiuity o Our Lord Endowment Fand 1900 tal Assisted 74 Total Staff 23
o llinnesota Irzc 17 1975 1846 Wellesley Ave 55105 11 6516965401 Faa Ta Encounter Christ o the Archdiocese o St Paul
fi5104 Tel 6516442411 Fax 651646 6516965458 Email info@nativitymnorg Web Minnepolis Minnesota bLC I1vin Cities TEC
ed Capacity 6 Staff 19 Mentally wwwnativitymnorg Laura Barr Admin Total 125 Kennard St Ste 201 55109 Tel 651281 I
Adults 6 Total Assisted Annually 6 Assisted 5000 Total Staff Finance Council 7 0085 Fac 8666002748 Email retreats@
6156461104 Fax 6166461104 Den Oblate Media and Commanication Corporation 104 twincitiestecorg Web wwwtwincitiestecarg Lisa i
Admin N Mississippi River Blvd 55104 Tel 651645 Vang Admin Angela Hunstiger Devel Officer i
dV Guild Incorporated 1990 130 S 3560 Re Louis Lougen Pres Oblates of Mary Nate Lamasgt Prog Dir Ibtal Assiated 2500
St Ste 90 Saint Paul 56107 Tel 651 Immaculate US Province Ibtal Staff 3
Fc 6514502221 Email info@ Sisters of St Joseph of Carondelet Ministries NEW G First Auenue Properties of Nem Prague
ratedorg Web Foundation St Paul Province 1884 Randolph 215 Main St E 56071 Tel 9527583920 David
corporatedorg Formed by the Guild Ave 55105 I1 6516907026 Fax 6516907039 B ByZek Pres
lie Women Guild Incorporated provides Email ioneill@csjstpaulorg Web pssso Benedictine Senior Living at Steeple Pointe
uf recovery oriented behavioral health wwwministriesfoundationcom Sr Irene ONeill 625 Central Ave 55369 Tel 7634254440 Fac
aer4ices for individuals with serious and CSJ Exec Dir 7633910747 Email bob6ieguidry0r
t mental illness Total Assisted Annually WomanWell 1784 La Crosse Ave 551194808 Tel bhshealthorg Roberta Guidry Resident Svcs
tal Staff 121 6517397953 Fau 6517397475 Email seeking@ Ain Bedrooms 59 Lay Staff 37 Ibtal Assisted
WomanWellorg Web wwwwamanwellorg Sr
100
QCIATIONS OF THE FAITHFUL Delmarie Gibney FSPA Dir Sisters 2 Bed
1he Companions of Christ 1992 2137 Capacity 14 Lay Staff 2 Total Staff 4 Total S FDQ s Z Quadran Av65073nTe1 651
Ave 55104 Tel 6516425933 Email Assisted 3000 4332753 Bruce A Fahey Admin Michele L
mPanionsofchristorg Web MINNEAPOLIS Catholic Eldercre Inc 1982 817
Fyey Admin I
PanionsOfChristorg Rev Jon Vander Main St NE 55413 Tel 6123791370 F STILLWATER St Croix Ualley Faith Fomation 218 E
4PrIbtal in Residence 11 6123622486 Email mshasky@ Willard St 55082 Tel 6513791274 Bob Collett i
Brothers o Pece Queen of Peace catholiceldercareorg
Web
1289 Lafond Ave 551042035 Tel 651 wwwcatholiceldercareorg Dan Johnson Pres Interim Dir
F 6516469083 Email franciscan@ CEO Total Assisted 439 Ibtal Staff 350 WEST Sr PnuL NET Ministries Inc 110 Crusader
fpeaceorg Web Skitled Nursing Facility I1 6123791370 Fac Ave W 551184427 11 6514506833 Fac G51
thersofpeaceorg Bros Paul ODonneli 6123792486 Web wvmcatholiceldercazeorg 4509984 Email ministryCnetusaorg Web
L TUardian Overall Anthon Sweere FBP Sisters 5 Bed Capacity 150 Lay Staff 220 Total wwwnetusaorg Mr Mark Berchem Exec Dir
Katzmarek FBP Vicar Conrad Staff 225 Total Assisted 375 1bta1 Staff 30
Agenda Item J1
Attachment 4
Packet Page Number 139 of 224
in your group exemption by consulting the Official Catholic Direcfory the official
subordinate listing approved by you or by contacting you directly IRS does not verify
the inclusion of subordinate organizations under your group exemption See IRS
Publication 4573 Group Exemption for additional information about group exemptions
Each subordinate organization covered in a group exemption should have its own EIN
Each subordinate organization must use its own EIN not the EIN of the central
organization in all filings with IRS
If you have any questions please call us at the telephone number shown in the heading
of this letter
Sincerely
2
Cindy Thomas
Manager Exempt Organizations
Determinations
Agenda Item J1
Attachment 4
Packet Page Number 140 of 224
I
I
I
Internai Revenue Service Department of the Treasury
PO Box 2508
Cincinnati OH 45201
Date June 27 2012 Person to Contact
Roger Meyer ID 0110429
Toll Free Telephone Number
8778295500
United States Conference of Catholic Employer ldentification Number
Bishops 530196617
3211 4 Street NE Group Exemption Number
Washington DC 200171194 0928
Dear SirMadam
This responds to your June 26 2012 request for information regarding the status of
your group tax exemption
Our recods indicate that you were issued a determination letter in March 1946 that you
are currently exempt from federat income tax under section 501c3 of the Internal
Revenue Code and are not a private foundation within the meaning of section 509a of
the Code because you are described in sections 509a1 and 170b1Ai
With your request you provided a copy of the Ocial Catholic Directory for 2012 which
includes the names and addresses of the agencies and instrumentalities and the
educational charitable and religious institutions operated by the Roman Catholic
Church in the United States its territories and possessions that are subordinate
organizations under your group tax exemption Your request indicated that each
subordinate organization is a nonprofit organization that no part of the net earnings
thereof inures to the benefit of any individual and that no substantial part of their
activities is for promotion of legislon You have futher represented that none of your
subordinate organizations is a private foundation under section 509a although all
subordinates do not all share the same subclassification under section 509a Based
on your representations the subordinate organizations in the Official Catholic Directory
for 2012 are recognized as exempt under section 501c3 of the Code under GEN
0928
Donors may deduct contributions to you and your subordinate organizations as provided
in section 170 of the Code Bequests legacies devises transfers or gifts to them or
for their use are deductible for federal estate and gifts tax purposes if they meet the
applicable provisions of section 2055 2106 and 2522 of the Code
Subordinate organizations under a group exemption do not receive individual exemption
letters Most subordinate organizations are not separately listed in Publication 78 or the
EO Business Master File Donors may verify that a subordinate organization is included
Agenda Item J1
Attachment 4
Packet Page Number 141 of 224
eiv
City of Maplewood SEP 19
Application for Charitable Gambting Taz Fnads
y MaP
ADDlicaat Information
Name of organization requesting fands Maplewood AARP TaxAides
Contact Person James Hartmann Contact Phone 6517391885
Email Address rcedcmaiiiiailcom
Mailing Address 1895 Upper Afton Road
St Paul MN 55128
Type of organnxtion malng recraest Non Profit SOlc3 verification letter attached
How dces yoar organization servewpact the citizens of Maplewood
We eleclronically file Federal Minnesota tax returns Minnesota Properly Tax and Rent
Credits at no chazge to the client Federal refunds from these sites were more than 800000
Minnesota credits were not available yet at ttus time The applicant is confident we helpl bring
more than 51000000 back into the community
Hov mn rESidents of Maplevood does yonr organizetion serveunpact
The Majority of the 2433 Federal Minnesota tax returns Minnesota Property Tax Refunds and
Rent Credits were for ZIP Codes 35149 and 53117 IItS seeurity provisions prevents elcser
definition
Reanest Information
Amonnt of Reqnes 1500
In detail ezpinin how the fids requested will be utilized
Ve really need a thank you gestiue lunch or dinner for the 30 or so volunteers that provide
accurate no cost returns to Seniors and Low Income Maplevvood residents TherE is nd for
incidental office supplies that IItS will not reimbuise
Often applicants are uot xwarded e fall amonnt reqnested can yonr orgnnicatioa ntilize
a partil award Yes How would a partial award be ntilrred
hen wE really nexxi something vve rlig into our own pockets Iecognition lucleons are pot
luck Dont invite spouses and friends to a meal
I
IS dt iovfl Y
5IqI
J
Agenda Item J1
Attachment 4
Packet Page Number 142 of 224
Milo Thompson
1794 Onacrest Curve
Maplewood MN 55117
18 September 2012
City Manager Jim Antonen
City Of Maplewood
1830 East County Road B
Maplewood MN 55109
Sir
Enclosed an application for Charitable Gambling Taac Funds for thoughtful
consideration by our Maplewood City Council
Thank you for forwarding this to our Council
Respectfully
i
Agenda Item J1
Attachment 4
Packet Page Number 143 of 224
r
Intemal Revenue Service Department of the Treasury
P O Box 2508
Cincinnati OH 45201
Date Aoril 17 2002 Person to Contact
Linda A Hill 3101768
Customer Service Representative
Toll Free Telephone Number
AARP Foundation aoo n o ew Pm esT
301 E St NW Ste A1 350 8778295500
Washington DC 200490001 Fax Number
5132633756
Federal IdeMcation Number
520794300
Dear Sir or Madam
This letter is in response to your telephone request for a copy of your organizations determination letter
This letter will take the place of the copy you requested
Our records indicate that a determination letter issued in May 1963 granted your organization exemption from
federal income tax under section 501c3 of the Intemal Revenue Code That letter is stili in effect
Based on information subsequently submitted we Gassified your organization as one that is not a private
foundation within the meaning of section 509a of the Code because it is an organization described in
ection 509a2
This classification was based on the assumption that your orgaizations operations would continue as stated
in the application If your organizations sources of support or its character method of operations or
purposes have changed please let us know so we can consider the effect of ihe change on the exempt
status and foundation status of your organization
Your organization is required to file Form 990 Retum of Organization Exempt from Income Tax only if its
gross receipts each year are nortnalty more than 25000 If a retum is required it must be filed by the 15th
day of the fiRh month after the end of the organizations annual aunting period The law impos a
penalty of 20 a day up to a maximum of 10000 when a retum is filed late unless there is reasonable
cause for the delay
All exempt organizatios unless specfically exGuded are liable for taxes under the Federal Insurance
ConUibutions Act social securiry taxes on remuneration of 100 or more paid to each employee during a
calendar year Your organiza6on is not liable for the tax imposed under the Federal Unemployment Tax Act
FUTA
Organizations that are not private foundafions are not subject to the excise taxes under Chapter 42 of the
Code However these organizations are not automatically exempt from other federal excise taxes
Donors may deduct contributions to your organization as provided in section 170 of the Code Bequests
legacies devises transfers or gifts to your organization or for its use are deductible for federal estate and
ift tax purposes if they meet the applicable provisions of sections 2055 2106 and 2522 of the Code
y
Agenda Item J1
Attachment 4
Packet Page Number 144 of 224
s
2
AARP Foundation
520794300
Your organization is not required to fli e federai income tax retums unless it is subject to the tax on unrelated
business income under section 511 of the Code If your wganization is subjed to this tax it must file an
income tax retum the Form 990T Exempt Organization Business income Tax Retum In this letter we
are not determining whether any of your organizatiorts presertt or proposed activities are unrelated trade or
business as deined in section 513 of the Code
The law requires you to make your organizations annual retum available for public inspedion without charge
for three years after the due date of the retum If your organization had a copy of its apptication for
ecognition of exemption on July 15 1987 it is also required to make available for public inspection a oopy of
the exemption application any supporting documents and the exemption letter to any individual who requests
such documents in person or in writing You can charge only a neasonable fee for reproduction and actual
postage costs for the copied materias The law does not require you to provide copies of public inspection
documents that are widely available such as by posting them on the Intemet World Wide Web You may
be tiable for a penaity of 20 a day for each day you do not make these documents available for public
1 inspection up to a maximum of 10000 in the case of an annual retum
Because this letter could help resoNe any questions about yau organizations exempt status and foundation
status you should keep it with the organizations pertnanerrt crds
If you have any questions please qt us at the telephone number shown in the heading of this letter
This letter affirms your organizations exempt status
Sircrely
C
John E Ridcetts Director TEGE
Customer Account Services
s
Agenda Item J1
Attachment 4
Packet Page Number 145 of 224
upam woxz
City of Maplewood
Application for Charitable Gambling Tax Funds SE I g ppy
Please type or pnnt neatly
Aoulicant Information Lf Map
Name of organization requesting funds Maplewood Area Historical Society
Contact Person Lois Behm Contact Phone 651 7708941
Email Address Behm3030cbitstreamnet
Mailing Address 3030 BaRelmy Lane N Society Mail to P 0 Box 9372 No St Paul
Mlewood MN
City County School District No NonProfit Attach proof of 501c3 status
Other specify
How does your organization servefimpact the citizens of Maplewood
We orovide historical exhibils talks and walkinq lours about Maolewoods historv and the BruenWo Dairv Farm We oromote
preservation and interpreta6on of Maplewood historic sites such as the Gladstone Savanna and Fish Creek Bluffs We offer the
Bruentrup Heritaae Farm as a venue for private rentals such as weddinas We preserve historic records objeds and photos
relevant to Malewood orovide research for the public and educabonal 0000rNnibes for the whole familv
How many residents of Maplewood does your organization serveimpact Give an estimated
We es6mate there were more than 2 400 visitors to the Farm in 2011 and at least another 100 attended our outreach proqrams
We estimate 756 were from Maolewood for a total in excess of 1 800
Request Information
Amount of Request 18 360 00
In detail explain how the funds requested will be utilized be speafic and attach additional pages if necessary
1 Finish interior of milk house for dairv exhibit 2000
2 Fees for architect and consultant for preliminarv renovatlon of bam basement for Gimatecontrolled intemretive space 3500
3 Create engineerinq plans for an overflow oarkina area 2000
4 Stain deck install additional autters and repair doors on reshoom entrv 1500
5 Install new carpetina in dining room and livinq room of house 3560
6 Install new floorina in kitchen of house 2800
7 Reoair uooer deck of house 3000
Often applicants are not awarded the full amount requested can your organization utilize a partial
award X Yes No How would a partial award be utilized
We would either select a oroiect that most Goselv matches the amount awarded or we would use Societv funds to suolement
the partial award or we would afiallv comolete a oroiect and finish the remainder in a future vear
By compieting and signing this form the organization con6rms that the requested Charitable Gambling
Tax Funds will be spent for a lawful purpose This request is a onetime request for funds to be awarded
in the next fiscal year and the applicant understands requests for future funding will require a new
separate application
eiG4 Treasurer 91812
nature Title Date
Lois N Behm
Print Name
Agenda Item J1
Attachment 4
Packet Page Number 146 of 224
INTERNAL REVENUE SERVICE DEPARTMENT OF THE TREASURY
P O BOX 2508
CINCINNATI OH 45201
Date MAY V7 OOZ Employer ldentification Number
411893632
DLN
17053082773002
MAPLEWOOD AREA HISTORICAL SOCIETY Contact Person
2170 E COUNTY RD D LARRY W BOTHE ID 31462
MAPLEWOOD NA7 551091003 Contact Telephone Number
877 8295500
Our Letter Dated
February 1999
Addendum Applies
no
Dear Applicant
This modifies our letter of the above date in which we stated that you
would be treated as an organization that is not a private foundation until the
expiration of your advance ruling period
Your exempt status under section 501a of the Internal Revenue Code as an
organization described in section 501c3 is still in effect Based on the
information you subitted we have determined that you are not a private
foundation within the meaning of section 509a of the Code because you are an
organization of the type described in section 509a1 and 170b1Avi
Grantors and contributors may rely on this determination unless the
Internal Revenue Service publishes notice to the contrary However if you
lose your section 5o9ai status a grantor or contributor may not rely on
this determination if he or she was in part responsible for or was aware of
the act or failure to act orlthe substantial or material change on the part of
the organization that resulted in your loss of such status or if he or she
acquired knowledge that the Internal Revenue Service had given notice that yo
would no longer be classified as a aection 509a1 organization
You are required to make your annual information return Form 990 or
Form 990EZ available for public inspection for three years after the later
of the due date of the return or the date the return is filed You are also
required to make available for public inspection your exemption application
any supporting documents and your exemption letter Copies of these
documents are aiso required to be provided to any individual upon written or in
person request without charge other than reasonable feea or copying and
postage You may fulfill this requirement by placing these documents on the
Internet Penaltiea may be imposed for failure to comply with these
requirements Additional information is available in Publication 557
TaxExempt 5tatus for Your Organization or you may call our toll free
number shown above
If we have indicated in the heading of this letter that an addendum
applies the addendum enclosed is an integral part of this letter
Letter 1050 DOCG
Agenda Item J1
Attachment 4
Packet Page Number 147 of 224
2
MAPLEWOOD AREA HISTORICAL SOCIETY
Because this letter could help resolve any questions about your private
foundation status please keep it in your permanent records
If you have any questione please contact the person whose name and
telephone number are shown above
Sincerely yours
Steven T Miller
Director Exempt Organizations
Letter 1050 DOCG
Agenda Item J1
Attachment 4
Packet Page Number 148 of 224
Updated 070212
City of Maplewood a
Application for Charitable Gambling Tax Funds SEP 1 4 ZZPeasetypeorprintneatly a
0
Aplicant Information pe
Name of organization requesting funds r i j L t L c 1 rt Q fr 2 iZ
ContactPersoncX i r ContactPhone 3i 7y il
Email Address
Mailing Address 7 1 i J N yjc p c j P
Type of organization making request please select one
City County School District NonProfit Attach proof of IRS 501c3 status
Other Specify
ow daes your organizatian serveimpat the citizens of lufapfewood
How many residents of Maplewood does your organization serveimpactGive an estimated
Pzquest Information
Amount of Request ry c
In detail explalll hOw the fullds PequeSted wlll be Utlllzed be specific attach additional pages if necessary
Often applicants are not awarded the full amount requested can your organization utilize a partial
award C Yes No How would a partial award be utilized
ey completing and signing this form the rganization confirms that the requested Charitable Gambling
Tax Funds will be spent for a lawful purpnse This request is a onetime request for funds to be awarded
in the next fiscal year and the applicant uncerstands requests for future funding will require a new
separate application
z p Qr c G yz
Signature Title Date
aa R e s
Print Name
I
J
Agenda Item J1
Attachment 4
Packet Page Number 149 of 224
Lawful Purpose Request
The Maplewood Firefighters Flower Fund is requesting monies from Charitable
Gambling Tax Funds in order to continue to support our efforts in giving a gift to our
members and their families in a time of need
Gifts are donated to members and their families in the events of death sickness
surgeries and births The following guidelines are used by the Maplewood Firefighters
Flower Fund in determining which recipients should receive a gift
1 In the event of a death flowers a plant or a memorial will be sent in the
amount of 5000 for the following
a Current firefighter
b Retired and honorary firefighter
c Spouse of the above a or b
d Children of the above a or b not their spouses if married
e Parents of firefighters not inlaws
f Employees of the fire department
g Firefighters of departments in bordering cities
h Retired chiefs of departments in bordering cities
2 In the event of sickness andor surgery flowers or a plant in the amount of
3500 will be sent to the following
a Current firefighter
b Spouse of the above a
3 In the event of a birth a2500 gift certificate from Target will be given to the
baby of the following
a Current firefighter
Justification
This request of monies from the Charitable Gambling Fund will be used to benefit the
firefighters and their families in their time of need The fund is used to show a small
token of our appreciation for the many hours that firefighters contribute to the city to help
protect and serve the citizens of Maplewood It is an opportunity to offer gratitude for
the wark that they do In the event that no monies are received a collection will be taken
from the firefighters to fund the account for future recipients Firefighters will essentially
be funding their own gifts should they ever be a recipient The fund is managed by a
retired member who is responsible for all ordering purchasing and tracking of gifts and
monies within the fund
Agenda Item J1
Attachment 4
Packet Page Number 150 of 224
Updated 070212
City of Maplewood ceivApplication for Charitable Gambling Tax Funds
Pease type or print neatly SEP 6 2012
a
Aplicant Information n
Name of organization requesting funds Maplewood Pol ice Explorers L
Contact Person Davi d Thoma 11 a Contact Phone 651 2492602
EmailAddress davidthomallaCcimaplewoodmnus
Mailing Address 1830 County Road B East
Maplewood MN 55109
Type of organization making request please select one
X City County School District NonProfit Attach proof of IRS 501c3 sfatus
Other Specify
How does your organization serveimpact the citizens of Maplewood
The Police Explorers volunteer their time and assist in several Citysponsore
activities such as National Night Out the Ramsey County Fair graduations
at Aldrich Arena and activities on t e 4t o u y
How many residents of Maplewood does your organization serveimpactGive an estimated
Pote 38000
Request Information
Amount of Request 8 000
In detail explain how the funds 1equested wlll be utilized be specific attach additional pages ifnecessary
The funds will be utilized to subsidize dollars budgeted to se the Police
Explorers to the annual state conference a competition in Duluth and
national conferences They will also be used to help purchase unifo a
needed equipment
See attached
Often applicants are not awarded the full amount requested can your organization utilize a partial
award X Yes No How would a partial award be utilized
Same as above
By completing and signing this form the organization confirms that the requested Charitable Gambling
Tax Funds will be spent for a lawful purpose This request is a onetime request for funds to be awarded
in the next fiscal year and the applicant understands requests for future funding will require a new
eltttian
tvl Chief of Police 9512
igna re Title Date
David J Thomalla
Print Name
J
Agenda Item J1
Attachment 4
Packet Page Number 151 of 224
City of Maplewood
Application for Charitable Gambling Tax Funds
Name of Organization Requesting Funds Maplewood Police Explorers Page 2
In detail explain how the funds requested will be utilized continued The Police
Explorers are a group of highschoolaged students who participate in activities and
learn about law enforcement as a career Their Advisors are Maplewood police officers
who have taken an interest in teaching these students about law enforcement
As part of their activities the Police Explorers attend conferences and participate in
competitions with Police Explorer groups sponsored by other law enforcement
agencies By participating in these competitions it offers the Police Explorers an
opportunity to obtain scholarships for college
By sponsoring the Police Explorers it is our hope that these students will become
interested in careers in law enforcement and become our police officers of the future
Agenda Item J1
Attachment 4
Packet Page Number 152 of 224
Updated 070212
City of Maplewood Qeceiv
Application for Charitable Gambling Tax Funds
Please type or print neatly
Applicant Information fu7
Name of organization requesting funds Maplewood Police Reserves
Contact Person Davi d Kvam Contact Phone 2 4 9 2 6 0 3
Email Address dave kvam@ci maplewood mn us
Mailing Address 1830 County Road B East Maplewood MN 55109
Type of organization making request pease select one
City County School District NonProfit Attach proof of IRS 501c3 status
Other Specify
How does your organization serveimpact the citizens of Maplewood
See attached explanation
How many residents of Maplewood does your organization serveimpactGive an estimated
Indirectly the reserves impact every resident and many
visitors Directly they impact thousands each year
Request Information
Amount of Request 5 0 0 0
In detail explain how the funds requested will be utilized be specific attach additional pages if necessary
Awarded funds would purchase uniforms and eauipment used bv
reserve officers to perform their tasks Outside of uniforms
some of the equipment they use maintain include a trailer
housing traffic direction other materials used during
details 3 vehicles with equipment and several bicycles used
for patrol of parks etc
Often ap licants are not awarded the full amount requested can your organization utilize a partial
award Yes No How would a partial award be utilized
A partial award would be used for the same thinas as a full
award the difference being the reserves would need to further
prioritize items with fewer dollars
By completing and signing this form the organization confirms that the requested Charitable Gambling
Tax Funds will be spent for a lawful purpose This request is a onetime request for funds to be awarded
in the next fisca year and the applicant understands requests for future funding will require a new
separate application
C Deputy Chief 8172012
ignature Title Date
David Kvam
Print Name
Jy
Agenda Item J1
Attachment 4
Packet Page Number 153 of 224
How does your organization serveimpact the citizens of Maplewood
Police reserve officers volunteer between 8000 10000 hours per year in service to the
community Some of the services which reserve officers provide include traffic control and
security at events occurring in Maplewood such as the Ramsey County Fair graduations at
Aldrich Arena 4 of July celebration Bruentrup Heritage Farm celebrations and the spring
fall city cleanup opportunities
Reserve officers also patrol the city independently and in conjunction with sworn officers several
days per week During their patrols reserve officers transport arrestees those requiring
detoxification and others in need of courtesy rides They respond to calls for public assistance
and other nonenforcement requests They also perform weekly property checks for residents
who have reported to the police department that they will be out of town In addition to those
regular duties reserve officers make themselves available for emergency needs such as securing
crime scenes and directing traffic at major accidents or incidents Their assistance frees sworn
officers to perform other tasks Without the help of our reserve officers either valuable resources
would be tapped to handle the tasks they perform or those things would simply remain undone
Agenda Item J1
Attachment 4
Packet Page Number 154 of 224
Updated 070212
City of Mapiewood
Application for Charitable Gambling Tax Funds
Please type or print neatly SEP 21 2011
Applicant Information y ooa
faPi
Name of organization requesting funds City of Maplewood
Contact Person Audra Robb ins Contact Phone 6 5 2 4 9 212 5
Email Address audra robbins@ci maplewood mn us
Mailing Address 1830 County Road B East
Maplewood MN 55109
Type of organization making request please select one
X City County School District NonProfit Attach proof of IRS 501 c3 status
Other Specify
How does your organization serveimpact the citizens of Maplewood
The Youth Scholarshi Program serves Maplewood residents under
age 18 who demonstrate financial need and may not otherwise
have the opportunity to participate in recreation programs
How many residents of Maplewood does your organization serveimpactGive an estimated
We serve around 6000 youth through our recreation programs and
sports leagues per year
Re4uest Information
Amount of Request 3 5 0 0 0 0
In detail explain how the funds requested will be utilized be specific attach additional pages ifnecessary
We use these funds to assist Maplewood residents under the aqe
of 18 who want to participate in our programs but cannot afford
the fees These are youth who would otherwise not participate
in our recreation activities Families that can demonstrate a
need are asked to pay one third of the programs cost and the
scholarship covers the remainder of the fee
Often ap licants are not awarded the full amount requested can your organization utilize a partial
award Yes No How would a partial award be utilized
We would offer scholarships to our youth participants until our
funding ran out
By competing and signing this form the organization confirms that the requested Charitabe Gambling
Tax nds wi be spent for aawful purpose This request is a onetime request for funds to be awarded
in t ext fi al r and the applicant understands requests for future funding will require a new
sep ra e ap lic t n
Recreation Manager September 18 2012
Sig at re Title Date
Audra Robbins
Print Name
Agenda Item J1
Attachment 4
Packet Page Number 155 of 224
Updaled 070212
City of Maplewood RECEIVED
Application for Charitable Gambling Tax Funds
Please type or print neatly SEr 1 o t2
Aoalicant Information yFyy
Name of organization requesting funds Mothers and More Twin Cities East 299
Contact Person Hilary Ballard Contact Phone 65 3306590
Email Address mothersandmoretceyahoo com
MailingAddress477 Sterling St S
Maplewood MN 55119
Type of organization making request please select one
City County School District Q NonProfit Attach proof o IRS 501c3 status
Other Specify
How does your organization servmpact the citizens of Maplewood7
Mothers More TCE is an organization dedicated to improving
the lives of mothers through support advocacy and education
We address mothers needs as individuals and members of society
How many residenis of Maplewood does your organization servmpactGive an estimated
We invite all mothers who seek support and tools to promote the
value of all the work mothers do We currently have 32 members
Reauest Information
Amount of Request 700
In detail explain how the funds requested will be utilized be specirc a attecn addirionai payes inecessary
We have business meetincrs twice a month Ouite often we book
speakers from the community who provide information on specific
topics related to our mission There is a cost to some of
them We also must purchase special insurance in order to have
communication booths at city events walking in parades or
certain fund raising event
Often applicants are not awarded the full amount requested can your organization utilize a partial
award X Yes No How would a partial award be utilized
MembershiAS are 45 annuallv Speakers can charqe as much as
200 Insurance certificates for one event can be 150 We
will be qood stewards of any award
By completing and signing this form the organization confirms that the requested Charita6le Gambling
Tax Funds will be spent for a lawful purpose This request is a onetime request for funds to be awarded
in the next fiscal year and the applicant understands requests for future funding will require a new
separate application
Coleader 92012
ture Title Date
Hilary Ballard
Print Name
S
Agenda Item J1
Attachment 4
Packet Page Number 156 of 224
mothers
az MURE
September 20 2012
Dear city council members
This past year we partnered with Tubman Family Alliance of Maplewood in a campaign
called Power of the Purse We created Power of a Purse in 2009 to spotlight mothers economic
issues in part by collecting new and gently used purses for mothers in need A purse symbolizes a
womans economic power and many families rely on a mothers income Mothers More believes
that no matter where a woman rests on the social ladder there is power in her purse when she is
able to provide for herself and her children With help from other businesses the Twin citles East
chapter raised 738 purses for Tubmans HameYs Closet which serves women with tough financial
circumstances An Open House held during the campaign featured a speaker who emphasized the
need for mothers to plan for their own purses financial stability throughout life
Mothers More believes together mothers are powerful A mother is more than any single
role she plays at any given point in her lifedme She is entitled to fully explore and develop her
identity as she chooses as a woman a citizen a parent or an employee All the work mothers do
whether paid or unpaid has social and economic value Careving work is real work with real
social and economic value All women deserve recognition and support for their right to choose if
and how to combine parenting and paid employment All mothers all children and all families are
unique We respeM the wisdom of each mother to decide how to care for her children her family
and herself Mothers have the right to fulfill their caregiving responsibiliaes without incurring
social and economic penalries The transitions women make into and through motherhood are
challenging and can be difficult
We invite you to check our national and local websites for more information Thank you for
reviewing our application
Sincereiy
Hil Ballar
Mothers and More TCE Chapter 299
mothersandmoretce@yahoocom
Local wwwmothersandmoretceorg
National wwwmotherandmoreorg
5
Agenda Item J1
Attachment 4
Packet Page Number 157 of 224
Intemal Revenue Service
P O Box 2508
Cincinnati OH 45201
Date May 37 2000 Person to Contact
Andrea Switser 3100972
Customer Service Representative
Mothers More Toll Free Telephone Number
Joanne Brundage 800 am to 80pm EST
P O Box 31 8778295500
Elmhurst IL 60126 Fax Number
5132633756
Federal identification Number
363564589
Dear Sir or Madam
This letter is in response to your fax dated May 30 2000 including a copy of the ArtiGes of Amendment filed
May 3 2000 with the State of Illinois changing the name of the organization from FEMALE to the name
shown above We have updated our records to reflect this change
Our records indicate that a detertnination letter issued in August 1994 granted your organization exemption
from federal income tax under section 501c3 of the Intemal Revenue Code That letter is still in effect
Based on infortnation subsequently submitted we Gassified your organization as one that is not a private
foundation within the meaning of section 509a of the Code because it is an organization described in
section 509a2
This classification was based on the assumption that your organizations opera6ons would continue as stated
in the application If your organizations sources of support or its character method of operations or
purposes have changed please let us know so we can consider the effect of the change on the exempt
status and foundation status of your organization
Your organization is required to file Form 990 Retum of Organization Exempt from Income Tax only if its
gross receipts each year are normally more than 25000 If a retum is required it must be filed by the 15th
day of the fifth month after the end of the organizations annual accounting period The law imposes a
penalty of 20 a day up to a maximum of 10000 when a retum is filed late unless there is reasonable
cause for the delay
All exempt organizations unless specifically excluded are liable for taxes under the Federal Insurance
Contributions Act social security taxes on remuneraUon of 100 or more paid to each employee during a
calendar year Your organization is not liable for the tax imposed under the Federal Unemployment Tax Act
FUTA
Organizations that are not private foundations are not subject to the excise taxes under Chapter 42 of the
Code However these organizations are not automatically exempt from other federal excise taxes
Donors may deduct contributions to your organization as provided in section 170 of the Code Bequests
legacies devises transfers or gifts to your organization or for its use are dedudible for federal estate and
gift tax purposes if they meet the applicable provisions of sec6ons 2055 2106 and 2522 of the Code
Agenda Item J1
Attachment 4
Packet Page Number 158 of 224
2
Mothers More
363564589
Your organization is not required to file federal income tax retums unless it is subject to the tax on unrelated
business income under section 511 of the Code If your organization is subject to this tax it must file an
income tax retum on the Form 990T Exempt Organization Business Income Tax Retum In this letter we
are not determining whether any of your organizations present or proposed activities are unrelated trade or
business as defined in section 513 of the Code
The law requires you to make your organizations annual retum available for public inspection without charge
for three years after the due date of the retum You are also required to make available for public inspection
a copy of your organizations exemption application any supporting documents and the exemption letter to
any individual who requests such documents in person or in writing You can charge only a reasonable fee
for reprodution and actual postage costs for the copied materials The law does not require you to provide
copies of public inspection documents that are widely available such as by posting them on the Intemet
World Wide Web You may be liable for a penalty of 20 a day for each day you do not make these
documents available for public inspection up to a maximum of 10000 in the case of an annual retum
Because this letter could help resolve any questions about your organizations exempt status and foundation
status you should keep it with the organizations permanent records
If you have any questions please call us at the telephone number shown in the heading of this letter
This letter affirms your organizations exempt status
Sincerely
i
John E Ricketts
Director TEGE CAS
Opent of the Teasury
Agenda Item J1
Attachment 4
Packet Page Number 159 of 224
fECENED
City Of Maplewood sEr 1 a 1z
Application for Charitable Gambling Tax Funds
Aaalicant information
Name of Organization requesting funds Northern Lihts Service Unit Girl Scouts
Contact Person Kathv Montz
Email Address kathvnls@q com
Mailing Address 1887 Mvrtle Street Maplewood MN 55109
Type of organization making request
City County School District NonProfit See attached Exhibit A
Other Specify
How does your organization serveimpact the citizens of Maplewood
The Northern Lights Service Unit of Girl Scouts of Minnesota and Wisconsin River Valleys helps girls ages 518
to grow strong in mind body and spirit in an allgirl environment By offering safe opportunities for girls to
learn necessary life skills and build selfesteem we enable young women to develop into citizens with
courage confidence and character
How many residents of Maplewood does your organization serveimpact e estimated u
The Northern Lights Service Unit services approximately 550 girls and adult volunteers in the North St Paul
Maplewood Oakdale area with 180 girls ad adult volunteers living in Maplewood
Reauest Information
Amount of Request 5350000
In detail explain how the funds requested wiil be utilized bes adsesreessarvl
Please see the reverse of this page
Often applicants are not awarded the full amount requested can your organization utilize a partial award
X Yes No How would a partial award be utilized
A partial award would reduce the amount of assistance available per girladuit volunteer or reduce the
number of girlsadult volunteers able to attend
By completing and signing this form the organization confirms that the requested Charitable Gambling Tax Funds will be
spent for a lawful purpose This request is a onetime request for funds to be awarded in the next fiscal year and the
appicant understands requests for future funding will require a new separate application
y q rlBwfCOCeVxtIacp I J d IZ
Signature Titie Date
Kathy Montz
Print Name
Agenda Item J1
Attachment 4
Packet Page Number 160 of 224
In detail explain how the funds requested will be utilized
The Northern Lights Service Unit is planning an overnight cookie rally this year as recommended
by Girl Scouts USA see attached Exhibit B1 National Cookie Sleepover Exhibit B2 Cookie
Rally Sleepover The cookie sale is the main fund raising event for many troops and girls This
sale provides funds for camps activities and events within the troop service unit and council
With about 380 girls and about 190 adults in the Northern Lights Service Unit we chose the Boy
Scout Base Camp near Fort Snelling for this event as this Scout facility is ideal in space and
provides active learning activities for a wide age range in the Metropolitan area The Boy Scout
Base Camp has a variety of activities led by experienced trained staff and will give our giris
opportunities for experiences many would never try as well as giving us a large enough location
to bring all of us together see attached Exhibit C1 Home page from Base Camp website
Exhibit C2 Welcome to Base Camp Exhibit C3 Base Camp Facility Permit Application The
Maplewood Charitable Gambling Tax Funds will provide important financial assistance to
reduce the cost of 25 per girl and enable all girls to attend this event regardless of family
financial situation see attached Exhibit D1 Financial Demographics from ISD 622 Exhibit D2
Scholarships for Membership The attached documents give more details on the Girl Scout
recommendation for a sleepover our planned event the Boy Scout Base Camp facility and our
service unit need
Agenda Item J1
Attachment 4
Packet Page Number 161 of 224
A
MINNESOA REVENUE ST3
Cetiflate of Exemptlor
Purohaser Complete this certificate and glve k to tha seiler
SNlsr tl this certificate is not fully completed you must charge sales tax Keep this certiticate as part of your records
Ths is a blanket certificate unless one of the boxes below is checketl antl remains in force as long as the purchaser coMinues
making purchases a unLil otherwise cancelled by the purchaser
Check if ths certificate is for a single purchase antl enter the reWted irrvaicepurchase order M
If y0U af B Gonif8Ct0 8ntl 112Ve 0 purChaSing Bgefit BgrCfineft Wlih 8n Cxmpt Og3nIZ0t40n ChCCk SlIB b0 t0 TONe mUttiplOpurchasesforaspecificjobEntertheexempentiTynameantlspecAicproJecc
Exempt entity name ProjeK Oescnptron
Namc of ph
Girl Scouts oi Minnesota and Wisoonsin River Valleys Inc
sumess axwsa ciy sun ra mte
400 Rob St S Saint Paul MN 55107
arcnasers raM o rn1noe Sna o asu cwnvr or se
8339372 MN USA
i no inA D nurtme FN Dme3 hcenee numbeStpfe usec W num0er
enOpr one of IM Onown Adte ol 4sue numDe Y
Nlme o 484e frOm whpm p Mt 0CBS kesing a rBMng
Seier aCpreas Cn
V
Stata iW wue
7ype of businew Circle the number that descibes your business
OS Accwnmodation antl foptl services 11 trensportation ana warehousing
02 Agricuiwrai forestry fishing hunting 12 Utllihes
03 ConsVUCtion 13 Wnolesaie trade
yg 04 Finance andmsurance 14 Busine9s services
b OS Information pubishing and commurncauons 15 Protessionai serntes
06 Manufactudg 6 EduCaton anC healthtare services
S 0 Mming 17 NonpwfR organization
OS Rea estate 18 Caovernmenf
09 Rentai arxt easing 14 Not a business exQlaln
10 Retail trade 20 Other eqain
Rsason for exemptlon Circle the letter that IcleMifies the reason for the exemption
A Federat govemment aaDaunent WUStrial productiONmBnufxturing
6 Specifc government exemvtion trom rst an backl 1 Drceet px permn x
F MPU exemption is no langecvallQ
m C Tribagovernmentnamei repealedMarch82008
0 Poteign Ciplomat l Orect ma1
ES 20007 M OShOf entet number hom DackECharitableorg8nzaiCnp Pa4e
F Reugwos or educationai organization N Percentage exempton
G Resale Advertising entcr peromtage7
H AgncUlWra1 prOdufiOn r U6litie mter cercentege
I derlare that the mformation on this certficate i5 corcect antl complete to Uie best of my knowledge antl belief PENALTY If you
a try to evatle paying saies tax by usmg an exempUOn ceruhcate tor items or servCes that will De usetl for purposes othgr than
i those being caimeA you may be fined 5100 unde Minnesota law for each transacon for w1Kh lhe certiRCate is usedJ
Sinawn ol aIDOnxaa purcnaser
v
Prmi rnK nere Ue Date
Brenda Dege CantroSler 81242010
5w No 210003u aer Forms and ac sheets are availabie an our webstte at wwwtaxesstatemnus
Agenda Item J1
Attachment 4
Packet Page Number 162 of 224
XFINITY Connect httpwebmailcomcastnetzimbrahprintmessageid849900t
hJT
XFINITY Connect cdowns9243comcast
Font Size
National Cookie Sleepover
From Tammy Freese TammyFreese@girlscoutsrvorg Tu Sep 18 2012 0304 PM
Subject National Cookie Sleepover
To cdowns9243@comcastnet cdowns9243@comcastnet
Hi Christina
Here is the information from our troop cookie manager guidebook
Hundreds of thousands of Girl Scouts across the nation will be participating in cookie sleepover parties on January 12 2013
River Valleys troops andor service units are encouraged to hold their own sleepover to get girls excited about the Cookie
Program Part of the sleepover will include a 3D video from Little Brownie Bakers thats all about cookies Connect with your
service unit cookie manager to learn if the sleepover is a troop or service unit event Check GirlScoutsRVorg for more
information
Other useful information for your scholarship purposes
River Valleys will have the Party in a Bag kits with 3D glasses cookies a sleepover patch that troops can purchase for each
giri The cost will be 5girl which includes those items and the ticket to part 2 of the cookie event after the cookie program
concludes event TBD We have options for service units to order the kit or troops may order the kit for each girl
participating We will also include one DVD of the Sleepover video per troop with the kit order along with program materials
for the girls to earn the Cookie Business BadgeLeaf for their Girl Scout Grade Level Troops would need to purchase the
Cookie Business BadgelLeaf on their own
I hope this information wili help you As I mentioned on the phone we will have more information coming out very shoRly
Many thanks
Tammy
Tammy Freese
Product Program Manager
Girl Scouts of Minnesota and Wisconsin River Valleys
8008450787 exL 1411
1 of 1 9I182012 1009 AM
Agenda Item J1
Attachment 4
Packet Page Number 163 of 224
e xlf a
yr WHAT COOKIE RALLY SLEEP OVER
wFiEiv January i2 is 2uis
s
TIME 800 pm 700 am
WHERE Boy Scout Base Camp
7Q1 Rlmingtn Rnarl
t s Fort Snelling MN 55111
c t
1
Hundreds of thousands of GirlScouts across the nation will be participating in
cookie sleepover parties on January 12 2013
We will be staying at Boy Scout base camp in the historic Fort Snelling building
All ages of girls will have the opportunity to climb on the indoor rock climbing wall
and shoot archery High school girls can try the space shuttle simulator and girls
12 years or older can use the indoor ropes course Pictures of the activities can
be found at
httpwwwexplorebasecamporsHomeaspx
DiZ2a oiu iciiiviauc Vviii uc iBiVcu fvY a iiaCn aviiG VJiiii a SilvJ9ii vFa iu fiivVic
Come out as a troop and be a part of this event of epic proponions
NEEDED to Participate A signed waiver for each Girl Scout is due at checkin
Form can be found at the link below Look for the participant waiver in the
general forms section This must be signed by a parent or guardian
httpwwwexplorebasecamporFormsaspx
PRICES
2500 per registered Girl Scout
800 per adult
DEADLINE December 13 2012 NO LATER
IRrina tn Ilaramhar laarlPrc maatino rlrn nff nr mail rinr tn nPPmber 1 QZ
Hny questions contaci Christina uowns 65i7489243
1410 Kohlman Avenue
Maplewood MN 55109
cdowns9243@comcastnet
Agenda Item J1
Attachment 4
Packet Page Number 164 of 224
Base Camp Inspiring Active Learning X b 1 Page 1 of 2I
ry 7 on1c os ase
ww xore6secanPor
r
1 rv
sssaa w iiii rr
Home Events Scouts School Corporate Community Ab
Home
Welcome
Welcome to Base Camp the Northern Star Councils newest program facility
located at Fort Snelling Minnesota It offers a unique yearround
environment where visitors can engage in team building rock climbing
ropes courses and archery
But its aiso convenientiy ciose to Minneapolis and St Paul creating a oneof
akind interactive experience in an urban setting Light rail is just blocks
away
Base Camp is open yearround to everyone in the community Since opening
in 2010 hundreds of groups have come through our doors including
Scouts after school evening and weekend programming
Schools educational programs and field trips
Community Groups and Nonprofits retreats partnerships and
facility rental
Corporate Groups facility rental and team building programs
Click on the links above for more details about these programs
The absolute best way to learn more about Base Camp is to come take a
tour Call us today at 6512549135 and we look forward to seeing you
soon
Coming Events
Click here to go to Coming Events
Program Features
NASA Space Shuttle Simulator
Click to lau
Indoor Rock Climbing
The Progr
Outdoor Rock Climbing Ice Climbing and High Ropes Course upCOmiflg f
SCOUt VC1
http www explorebasecamp org 9 192012
Agenda Item J1
Attachment 4
Packet Page Number 165 of 224
Base Camp Inspiring Active Learning Page 2 of 2
Archery com m un ity
profit busin
14000 Acres of Wilderness Land
About Base Camp
2012 Pr
Connect
Located in the centuryold Cavalry Drili Hall near Fort Snelling Minnesota
Base Camp is owned and operated by the Northern Star Council Boy Scouts
of America Our mission is to be available to and serve all youth of the 70IN OUR
greater Twin Cities metro area through school field trips lockins retreats occasional E
summer camps and community group use We have special outreach
programs for underserved populations Ask us for details LIKE US O
we grow an
Privacy Statement Terms Of Use
httpwwwexplorebasecamporg 9192012
Agenda Item J1
Attachment 4
Packet Page Number 166 of 224
Ix1 C 2
t
r
BASECAMP
INSPIRING ACIVE LEARNING
NORTHERN STAR COUNCIL
BOY SCOUTS OF AMERICA
WELCOME TO BASE CAMP WHERE SCOUTING
ADVENTURE BEGINS
Get Your Fall Base Climbing Archery ComboGreat for Packs
Groups of up to 24 participants may choose to split a
Camp LockIn on climbing reservation with archery Each participant
the Calendar Now will spend 1hour climbing 1hour doing archery
116 participantsl climb block80Sperson
1724 participants
Fall and early winter at Base rt 2 climb blocks 160
Camp are great times for a 5person
Pack Troop or Crew LockIn
De osit 50 is due atAunitlockinisapopularP
program that fills up fast time of reservation
Balance is due upon
Our LockIn program runs
arrival at camp 1
from 8PM8AM on any
Friday orSaturday night AV81IaIIe fOY TIOOpS at1CI V211tUP@ CY@WS YEaP
Your group picks 2 Base Round Base Camps Indoor High Ropes Course
Camp activities that run The indoor High Ropes Course at Base Camp is one of a kind This
until midnight You can activity is great for teamwork trust building and overcoming personal
choose from climbing obstacles The ropes course is available for youth who are at least 12
archery ice climbing 12 years old The ropes course can accommodate up to 12 participants in a
up ropes course 12 up 2hour period
space shuttle simulator or
120 per 2hour block when
staffed by a Base Camp
team building games Many Guide maximum of 12
units pairthese activities participants
with crafts games or 180 per 2hour block for
climbing ropes course 1
advancement lead by adults maximum of 12 participants
Deposit 50 is due at time of i7
Lockin fees are 25 per w
reservation Balance is due upon
outh 8 er adult We yYparrivalatcamp H
require a minimum of 20
participants for every lockin
f
To schedule your visit to Base Camp
but you can pair up with r y complete a facility permit available at
w
other units The fee t wwwexplorebasecamporgFormsaspx
includes the two staffed r Y
activities and a pizza Questions Please call 6127670042 or
lemonade snack at 10PM email basecam @nsbsaorpg
ExploreBaseCamporg
Agenda Item J1
Attachment 4
Packet Page Number 167 of 224
ixh f CJ3
ENorthernStarCouncilBoyScoutsofAmericaJL
Phone i 6323i72G i
FAX 7632317202
BASE CAMP FAILTY PER1IT APPLlGATION basecamptlnsbsaora
OY SGQUT GROUPS NNOY SCOUT GROUPS
Council BCamp District NonProfit Yes No if yes ST3 is required
Pack Troop Crew Youth Related Yes No
Unit use 4digit code Schooi QiBusiness Giri Scouts
BASECAMP District
GovMi101ndividual Other
Group Name Northern Lights East Girl ScoutsCouncil
Dates Requesting January 1213th
6atesj Requesting
Estimated Participants Est Participants 150
Reservation and rental application form for Base Camp facility
This form must be completed and returned to either council office with payment at time of reservation
vEv NAME Girl 5cout cookie raiiy sleep over
RESERVATION CONTACT Precamp contact for payment reservation confirmation and questions BSA Policy requires at least two adult leaders on
all trips The adult leader in charge must be at least 21 years old Coed Venturing crews must have both male and female leadership Please note A fax
number is preferred for retuming confirmation paperwork
Leader Name Christina Downs 21 Email cdowns9243@comcastnet
Phone Day 517489243 call 1st pNcne Eve 6512611558 cell call 2nd
Address 1410 Kohlman Ave i Maplewood State MN Z 55109
Asst Leader Name oan Dragos 21 Email Jodragos@aolcom
Phone Day Phone Eve Fax
Address City State Zip
DATES
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Dates January 12th 2013 Arrival Time 8 pm Departure Time 700 am
ATTENDANCE estimate Total Participants 100170 Note a perperson fee is charged and activities have a minimum and maximum
requirement
Male Youth Female Youth Male Adults Female Adults Notes Can get exact s closer to event
Activities for aqes 12 onlv ClassroomActivity Spaces Rental Options
Activi Staffinq Needeed Saace Ca aci Rentals based on availability
Indoor Climbing Wall Yes No Main Activity Field NA LockIn check 2 activities
0 Ice Climbing Tower Yes No Comer Classroom 30 Whole Building Rental
Ropes Course 0 Yes No 0 Conference Room 10 Fort Snelling Rendezvous Grds
Outdoor Ropes Course Yes No Resource Room 10 I Other
Space Shuttle Simulator Yes No Library 14
Team Building Games Yes No Amphitheatre 150
Archery Yes No Center Court 400 To do activities
Bikes list on 2ntl page Yes No Other independently and without
Resources list on 2 pagel Yes No staff you must be
Northern Star Certified
PAGE 7
ConFrmation of reservation iequest wi be nade via emai fax or phone srsrzo2
Agenda Item J1
Attachment 4
Packet Page Number 168 of 224
Northern Star Council Boy Scouts of America
Fione 7632317201
FAX 7632317202
basecampnsbsaorqBASECAMPFACILlTYPERMlTAPPLIGATION
RESOURCES NEEDED NOTES eg bikes robotics kits etc
Tables Bikes 5 per We are being supplied with a 3D movie by the Giri Scout
councii for this cookie event We want to be able to
Chairs Robotics kits show it to all the girls Will know table and Chair
Projector amounts as time gets closer
SCJUT REQUlREMENTS
At least one participating adult must be certified in Youth Protection Training for all scouting activities Available online at
rvsurirc takes 20 minutes
Name of Adult Chfistina Downs Expiration Date 04172013
ReauEr Traininq for Cub Scout OverniphCamina
At least one participating adult must have completed Basic Adult Leader Outdoor Orientation BALOO
Name of Adult Expiration Date
Required Traininq for Shootinp Ranqes and Climbinq Towers
See the Camp Usage Policy for required trainings Certification must be presented at camp prior to use of these facilities
Available online at D Itl rcrtrSatSCiOlCeSIF5t
AUTHORIZATION By signing below you confirm that
We have read and agree to abide bythe policies outlined on this application
and in the Nortern Star Council Camp Usaqe Policies document
We have a copy have reviewed and will abide by all policies in the Guide to Safe Scoutinq No 34416D
The Camp Leader will verify all transportation requirements as outlined above are followed
The Camp Leader will subt a atdance roster upon CheckIn
The Camp Leader will pav all remaininq fees perperson fees additional charges and any damages at Check0ut
by unit check personal check or credit card
Leaders
Name Christina Downs Signature L2 ZLG z 7iDate 09182012
Name Signature Date
NONSCOUT WAIVER 8 REQUIREMENTS
NonScout groups may be required to fill out additional requirements and fill out waiver forms
HOW DID YOU HEAR ABOUT US
I am also a boy scout advancement coordinator My son has stayed at base camp before
i
FEES oce use only
Reservation Approved Date by NSC Campinq Service
Fees Paid Pre Date Invoice Balance
RemarksJDescription of BslarcE
Notes
AGE 2
Conimation of reservation request wi be made via emai fax or phone 532012
Agenda Item J1
Attachment 4
Packet Page Number 169 of 224
x3 D1Z
Financial Demographics from ISD 622 d f l 1
Figure 1 Maplewood City Profile 20082010 Figure 2 Oakdale City Prole 20082010
Source Wilder Research Source Wilder Research
IVlaplewooq Oakdaie
Percent in poverty 1330 Percent in poverty 660
Median household income 51557 Median household income 66269
Households paying 30 or more of Households paying 30 or more of
income for monthly housing costs 3770 income for monthly housing costs 3260
Ci6ii c i J11VV viaii vrc iivi oiu vwiii vau 7ZIlj
FreeReduced Rates Homeless Student Rates Mobility Rates
cvm nni n doi 1d RQo
SY08 3320 080 1394
SY09 3590 132 1381
SY10 3940 188 1245
SY11 4220 257 1377
Ryan Strack
Federal Programs Coordinator
District Homeiess Liaison
School District 622 North St PaulMaplewoodOakdale
rstrack@isd622org
p 6517487696 f 6517487697
This message contains information that may be confidential and privileged Unless you are the addressee or authorized to
receive for the addressee you may not use copy or disclose to anyone the message or any information contained in the
message If you have received the message in error please advise the sender by reply email and delete the message
X G Z
Scholarships for Membership
Last year 33 girls and 48 adults used grants to pay for membership So a total of 81 people used
membership grants
Maylee Vue
Membership Specialist
Girl Scouts of Minnesota and Wisconsin River Valleys
Direct 6512511225
Toll Free 8008450787 ext 1225
Agenda Item J1
Attachment 4
Packet Page Number 170 of 224
Updated 070212
City of Maplewood ev
Application for Charitable Gambling Tax Funds Auc 21 20f2
Please fype or print neatly n
y
Applicant Information A9ap
Name of organization requesting funds jS D U1 Y
Contact Person o a Contact Phon
Email Address FO CCC Q C1 tt Q
Mailing Address l j y se Sj
Y e wP o s 5 i o
Type of organization making request please select one
City County School District NonProfit Attach proofof IRS 501c3 status
Other Specify
How does your organization serveimpact the citizens of Maplewood
How many residents of Maplewood does your organization serveimpactGive an estimated
t w t Yt fia r v2 sT li io rS ol v v v
c s a 7 ddx soo od a
Request Information
Amount of Request S a p o
In detail explain how the funds requested will be utilized be specific attach additional p ges if necessary
Ct i n Y Y i 6 h 5 et G Q j rt o y a ti7 Y aC C
Cc L C 6 h i i S 4 i fj u
s o U b r ca c v v a
d G c 7S c7 l c JrGir2 i ft lj 11J dJ GS
L i J fa s a e od j rl y i vo s v v u 1r s T
a ve Y Qs 7 sa yys i r Qe wa ol
Often applicants are not awarded the full amount requested can your organization utilize a partial
award Yes No How would a pa ial award be utilized
S CC S U N C S v l2 d S rd tic
lo l S a a v t j
By completing and signing this form the organization confirms that the requested Charitable Gambling
Tax Funds will be spent for a lawful purpcse This request is a onetime request for funds to be awarded
in the next fisca year and the applicant understands requests for future funding will require a new
se rate application
S Pc Y V L fQ a o i l vQ
ignature Title ate
O e 1
Print Name
Agenda Item J1
Attachment 4
Packet Page Number 171 of 224
Updated 070212
City of Maplewood
Application for Charitable Gambling Tax Funds
Please type or print neatly AU 6 1011
Applicant Information y ooaM
Name of organization requesting funds eC ctiaNc qirrla es ue
Contact Person ltJ jiOs Contact Phone 6 S ST 8 YS
Email Address hor1 iQ CCIy
Mailing Address Z YIaaid lJivc
lbu i ti sz
Type of organization making request please select one
City County SChool District Non Attach proof of RS 501c3 status
Other Specify
How does your organization serveimpact the citizens of Maplewood
SPC czac7rc
How many residents of Maplewood does your organization serveimpactGive an estimated
iiS i5 iIof aa tr Caa c5fe ouC 7o f
ncic o ou r Srv e S
ReQUest Information
Amount of Request vU
In detail explaln how the funds equeSted will be utilized be specific attach additional pages if necessary
Se c aacLi
Often applicants are not awarded the full amount requested can your organization utilize a partial
award Yes No How would a partial award be utilized
1
sa7e a 1 wl tous i tdi qo uads vcT
r G or 7 c aaiYa lS
By completing and signing this form the organization confirms that the requested Charitable Gambling
Tax Funds will be spent for a lawful purpose This request is a onetime request for funds to be awarded
in the next fiscal year and the applicant understands requests for future funding will require a new
separate application
w
O
Signature Title Date
cFIC isor
Print Nam
i
J
Agenda Item J1
Attachment 4
Packet Page Number 172 of 224
Supplemental page for Application for Charitable Gambling Tax Funds
Second Chance Animal Rescue
How does your organization serveimpact the citizens of Maplewood
Second Chance rescues stray dogs and cats from Hillcrest Animal Hospital which is the
impound facility for the City of Maplewood and is located in Maplewood We provide a
much needed service to the citizens and the City of Maplewood by taking impounded
dogs and cats into our program before they are put to sleep euthanized There is a
State fiveday animal holding requirement of strays and after that if the owner doesnt
reclaim them they can be euthanized Second Chance goes in and takes as many
animals as it has foster homes available prior to the animals being euthanized This
saves the City money by not having to pay for euthanasia and it helps the citizens in two
ways
1 if their dog or cat is lost and not reclaimed by the legal holding period there is a
good chance the animal is placed into a rescue organization rather than put to sleep
2 Second Chance adopts out many animals to the residents of Maplewood as new
family members and 3 Second Chance also utilizes the veterinary services of Hillcrest
Animal Hospital for medical work on some of the rescued dogs and cats
Explain how the funds requested will be utilized
Second Chance Animal Rescue is an all volunteer nonprofit 501c3 animal rescue
organization that incorporated in 1994 to rescue dogs and cats out of animal control
facilities and various other situations We do not have a shelter but instead hold
animals in volunteer foster homes until adoptive homes are found All animals taken
into our program go to a veterinarian where they are health checked heartworm or
FeLVFIV checked spayed or neutered vaccinated and dewormed Many animals
require additional vet care because of being strays on the streets they may have ear
infections be matted injured etc We provide the care Being a nonprofit we count on
donations to help pay our vet expenses In 2011 those expenses exceeded 100000
We are not able to recoup all of those expenses in adoption fees To date we have
rescued over 8600 animals and placed them into permanent adoptive homes If we
were granted funds from the Maplewood Charitable Gambling Fund they would be
used to help offset our veterinary expenses
Please view our website for more information about Second Chance Animal Rescue
wwwsecondchancerescueorq
Agenda Item J1
Attachment 4
Packet Page Number 173 of 224
ZNTERNAL REVENUE SERVICE DEPARTMENT OF THE TREASURY
DISTRICT DZRECTOR
P O HOX 2508
CINCINNATI OA 45201
Employer ldentification Number
Date j A J q 411780387
DLN
17053044746009
SECOND CHANCE ANIMAL RESCUE Contact Peraon
PO BOX 10533 MR LEWIS ID 31037
WHITE BEAR LAKE hIN 551100533 Contact Telephone Number
877 8295500
Our Letter Dated
October 1995
Addendum Applies
No
Dear Applicant
This modifies our letter of the above date in which we stated that you
would be treated as an organization that is not a private foundation until the
expiration of your advance ruling period
Your exempt status under eection 501a of the Internal Revenue Code ae an
organization described in aection 501c3 ie atill in effect Based on the
information you aubmitted we have determined that you are not a private
foundation within the meaning of section 509al of the Code because you are an
organization of the type described in section 509a2
Grantors and contributora may rely on this determination unless the
Internal Revenue Service publiahes notice to the contrary However if you
lose your aection 509a2 etatus a grantor or contributor may not rely on
this determination if he or ahe was in part responaible for or was aware of
the act or failure to act or the eubstantial or material change on the part of
the organization that reeulted in your loss of such status or if he or she
acquired knowledge that the Intemal Revenue Service had given notice that you
would no longer be classified as a section 509a2 organization
If we have indicated in the heading of thia letter that an addendum
applies the addendum enclosed is an integral part of this letter
Because this letter could help resolve any questions about your private
foundation status please keep it in your permanent recorda
If you have any guestions please contact the person whose name and
telephone number are shown above
Sincerely yours
F
Dietrict Director
Letter 1050 DOCG
Agenda Item J1
Attachment 4
Packet Page Number 174 of 224
C Second Chance
Animal Rescue
is a nonprofit 501c3 allvolunteer FOS@C Cdl2 N2@CS
yr
organization dedicated to rescuing caring for
Most dogs and cats are rescued from animalandadoptinghomelessdogsandcatsWe
control impound facilities and we have limited
educate the public on respect for all animal information on them We need foster parents to
life including the importance of spaying and provide a temporary home get to know the
neutering dogs and cats in order to reduce the rescued animal and provide information for
number of healthy animals euthanized prospective adopters
i
C Besides adult animals needing care pregnant
y animals need fostering through the delivery and
The mission of Second Chance Animal Rescue
several weeks after birth in order to properly
is to rovide homeless do s and cats with a
wean and socialize the puppieskittens We
p g C Adoption Service request that you have a separate room away
Second Chance at life and companionship Our from other animals for the foster animal to
organization goes beyond the confines of shelter Adoption days are advertised in local newspapers deliver and raise her litter
walls to build an extensive network of caring and are held at area pet supply stores Our animals
knowledgeable experienced and talented available for adoption can be seen on our web site Litters of puppies and kittens need fostering
individuals focused on at wwwsecondchancerescueorg also There may or may not be a mother with the
litter
quality animal care and services Our experienced adoption counselors provide
animal welfare education you with a careful honest assessment of each If you would like to become a foster care
animals health temperament and behavior volunteer for an orpositivepeopleanimalrelationships ganization that strives to save
cooperative rescue efforts The animal you adopt will have been vaccinated as many animals lives as possible and give them
heartworm or feline leukemiaFIV tested a Second Chance at life please call us
dewormed and spayed or neutered You will also
C Lifesaving receive a permanent ID tag a free initial
veterinarian examination for your animal and our
We value the life of each animal we encounter continuing support
We work cooperatively with animal control We want you to experience a rewarding lifetime
impound facilities and private rescue efforts to relationship with your new companion
save as many animals as possible
We provide homeless dogs and cats with the FOSt@Y CdY2 e r
quality care and positive human contact they
deserve We also provide any necessary
We place all Second Chance dogs and cats in ttemporaryfosterhomesuntiltheyareadoptedveterinarianandgroomingservices
e do not have a shelter
Our foster volunteers provide love and care in
their homes so the animals reestablish a positive a
bond with people We encourage our foster care
providers to begin training animals using positive
reinforcement techniques
r
Agenda Item J1
Attachment 4
Packet Page Number 175 of 224
Make a Lasting Imprint
Please check areas in which you are interested
s in volunteering
Dog Foster Care Cat Foster Care
r Transporting Animals Fundraising
Er a Special Events Public Relations
b a
Contributions
Your gift is accepted with sincere gratitude
Monetary gifts go directly toward animal care
E and are tax deductible
i Co
We are in need of
Y a Monetary Gifts
Kitten Food dry and canned
ToysTreatsDog RawhidesKongs
x Dog CollarsNylon Buckle
Gift Cards at local pet supply stores
Ask your employer about matching gifts f
4 llabJPleaseaddmetoSecondChancesmailinglistrt
Name r fF Y
r
Y
Address
SECOND CHANCE ANIMAZ RESCUE r
ctyAnonprofit501c3allvolunteerorganization
vr wStateZip
wwwsecondchancerescueorg Phone
6517715662 Emai
PO Box 10533
Make checks payable to Second Chance and mail to
White Bear Lake MN 551100533
SECOND CHANCE ANIMAL RESCUE
PO Box 10533
White Bear Lake MN 551100533 a
b
Agenda Item J1
Attachment 4
Packet Page Number 176 of 224
Updated 070212
City of Maplewood
Application for haritable Gambling Tax Funds
Au ns 2ot2Pleasetypeor print neatly
C o
Aplicant Information yMapeyo
C r
Name of organization requesting fund J ia 1r1
Contact Person 7 j Lifct Phone I 7 7U
Email Address Tha cn a SVvl
Mailing Address O V C Z 4M
YV1L r z S s C
s ttTypeoforganizationmaking request please select one
City County School District NonProfit Attach proof of IRS 501c3 status
Other Specify
How does you organization serv impat the citizens of Maplewood
l ii h a 1 y 2 C 1 t 111 Q YlV 1lZr
V i1
How many r sidents of Maple ood does our organization serveimpactGive an estimated
r i
J i l
Gl k
Request Information
Amount of Request
In detail explain ho the funds reCl@St@d WIII b@ UtIIIZ@d be specific attach additional pages if necessary
5 t Ct C
i
G
ul Gik ci rnuZa
Often applicants are not awarded the full amount requested can your organization utilize a partial
award Yes No How would a partial award be utilized
cc tiu rc l i c SS St i j aiiryl
h lo
ey completing and signing this form the organization confirms that the requested Charitable Gambling
Tax Funds will be spent for a lawful purpcasfl This request is a onetime request for funds to be awarded
in the next fiscal year d the applicant understands requests for future funding will require a new
separte applica ion
r
i L l O
Sig ature Title at
Ei vl i 4J c
Print Name
Agenda Item J1
Attachment 4
Packet Page Number 177 of 224
Fom W9 Request for Taxpayer Give form to the
Rev November 2005 Identification Number and Certification requester bo not
Department o the Treasury send to the IRS
Intemal Revenue Service
N Name as shown on your income tax relum
Simon Youth Foundation Inc
ro
Business name iF different from above
c0
o N
Q O IndividuaV Fxempt from backup
Check appropriate box Sole ptoprietor Corporaion Partnership Other wilhholding
r3N Address number street and apt or suite no Requesters name and addresa optionale
a 225 West Washington Street
c City state and ZIP code
U
Indianapolis Indiana 46204
N
list accouni num6ers here optionaq
Taxpa er ldentificatian Number TIN
Enter your TIN in the appropriate box The TIN provided must match the name given on Une 1 to aunid Sacial aeouriiy nvmber
backup withholding For individuals this is your social security number SSN However for a resident
alien sole praprietor or disregarded entity see the Part I instructions on page 3 For other entities it is
your employer identitication number EIN If you do not have a number see Now to gei a TlNon page 3 or
Note If the account is in more than one name see the chart on page 4 for guidelines on whose Empioyer idendficabon numher
number to enter 3 5 2 0 3 5 2 6 9
Certification
Under penalties of perjury I certify that
1 TFis number shawn on this form is my correct taxpayer identification number or I am waiting for a number to be issued to me and
2 I am not subjeci to backup withholding because a t am exempt from backup wlEhholding or b I have not been notified by the Intemal
Revenue Service iRS that I am subject to backup withholding as a result of a failure to report a11 Interest or dividends or c the IRS has
notified me tttat I am no longer subject to backup withholding and
3 I am a US person ncludErtg a US resident alien
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 ta report all interest and dlvldends 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 on page 4
Sign Slgnaturs at
Ffere us person oaee
Purpose of Form An individual who is a citizen or resident of the United
A person who is required to fife an information return with the Staes
IRS must obtain your correct taxpayer identification number A partnership corporation cmpany or association
TlIV to report for example Income pald to you real estaie created or organized in the United States or under the faws
transactions mortgage interest you paid acquisition or of the United States or
abandonment of secured property cancellation of debt or Any estate other than a foreign estate or trust See
coniributlons you made to an IRA Regulations sections 30177016a and 7a for additional
US person Use Form W9 only if you are a US perspn inormation
including a resident alien to provide your correct TIN to the Specia rules for partnerships Partnerships that conduct a
person requesting it the requester and when applicable to trade or business in the United States are generaAy required
1 Certify that the TIN you are giving is correct or you are to pay a wlthholding tax on any foreign partners share of
waiting for a number to ba issued income from such buslness Furthar in certain cases where a
2 Certiy that you are not subject to backup withholding or Form W9 has not been received a partnership is required to
3 Claim exemption from backup withholding if you are a Presume that a partner is a foreign person and pay the
US exempt payee
withholding tax Therefore if you are a US person that is a
In 3 above if applicable you are also certifying that as a UnitedFom W 9 t the partnership to n the
US person your allocable share of any partnership income establish your US status and avoid withholding on yourfromaUStradeorbusinessisnotsubjecttotheshareofpartnershfpincome
withholding tax on foreign partners share of effeckively
connected income The person who gives Form W9 to the partnership for
Note If a requester gives you a form other than Form W9 to Purposes of establishing its 11S status and avoiding
withholding on its allocable share of net income from therequestyourTINyoumustusetherequestersformifitispartnershipconductingatradaorbusinessintheUnitedsubstantiallysimilartothisFormW9Statesisintha foflowing cases
or federal tax purposes you are considered a person if you The US owner of a disregarded entity and not the entityare
Cat No 10231X Form 9 Rev 1120Q5
Agenda Item J1
Attachment 4
Packet Page Number 178 of 224
Updaced 070212
City of Maplewood
Application for Charitable Gambling Tax Funds
Please type or print neatly SEP 1 21011
Anolicant Information o0
Name of organization requesting funds St Jerome School
LMap
ContactPerson Jacobus ContactPhone 65 7887068
Email Address sj ac123@aol com
Mailing Address 384 Roselawn Avenue East
Maplewood Minnesota 55117
Type of organization making request please select one
City County School District Q Non Attach proof of IRS 501c3 status
Other Specify
How does your organization serveimpact the citizens of Maplewood7
Please see attached sheet
How many residents of Maplewood does you organization serveimpactlGive an estimated
The church and school combine serve approximately 500700
residentsincluding members of the parish and nonmembers
Request Infortnation
Amount of Request 1400 00
In detail explain how the funds requested will be utilized ne specro a anacn addtonei pages inecessary
The funds will be used to paint the qym walls ceilinq
purchase and install new vents and purchase and install new
safety mats behind the basketball hoops Not only will this
benefit the school but the gym is the area used for the free
community pancake breakfast community Zumba community
theatrical performances and free Easter egg hunt and activities
Often applicants are not awarcled the full amount requested can your organization utilize a partiat
award X Yes No How would a partial award be utilized
Any partial award will first be applied to paintinq the qvm and
then a plied to the remainina items If a partial award is not
enouqh to cover paint we will raise additional funds to paint
By completing and signing this form the organization confirms that the requested Charitable Gambling
Tax Funds will be spent for a lawful purpose This request is a onetime request for funds to be awarded
in the next fiscal year and the applicant understands requests for future funding will require a new
se lication
I
d 24 q CYloaC l j 1 2c l a
Signatu Title Date
Sf QCdrJVS
Print Name
Agenda Item J1
Attachment 4
Packet Page Number 179 of 224
St Jerome School
Application for Charitable Gambling Tax Funds
St Jerome School and Parish are located in the City of Maplewood and its members students
and families are very active in the Maplewood Community Listed below are some of the
servicesactivities we provide in and for the community
l Annual RakeAThon Each fall the students faculty and parents of St Jerome go out
into the neighborhood surrounding St Jerome and rake and dispose of leaves in the yards
of elderly and disabled community members This is done at no cost to those residents
2 Annual Pancake Breakfast Each year the Mens club from the Parish put on a pancake
breakfast This breakfast is free of charge to anyone who wants to attend and all
members of the community are invited
3 Annual Fall Festival and Boova Each fall there is a festival held in the parking lot of St
Jerome While some activities cost a nominal fee there are many events such as the
classic car show which are at no charge This event is open to the community
4 Annual Bread Collection Each year the students at St Jerome collect 100s of loaves of
bread This bread is then donated to the Dorothy Day Center
5 Food Shelf Collection St Jerome Parish continuously collects nonperishable food items
for community food shelves
6 Campbells Food Labels St Jerome School collects Campbells Food Labels These
labels are turned in and Campbells donates money and food to food shelves across the
United States
7 Annual Community Collection Each year the students at St Jerome pick a local charity
to support In 2012 the students and families collected new and gently used baby items
for low income families with small children
8 Zumba Zumba classes are held twice a week in the gym of the school These classes are
open to the public
9 Theatrical Performances St Jerome puts on an annual play which is open to the public
2012s play was Alice in Wonderland
Agenda Item J1
Attachment 4
Packet Page Number 180 of 224
10 Annual Easter Egg Hunt and Activities Each year St Jerome holds a free Easter Egg
Hunt and Easter crafts for those in the community All are welcome and there is no
charge
11 School Scholarships St Jerome School provides need based scholarships for students
Many of the students who receive these scholarships are residents of Maplewood
12 Free School Supplies and Uniforms St Jerome School provides free school supplies and
free uniforms to students in need Many of the students who receive these items are
residents of Maplewood
13 Free Lenten Season Dinner St Jerome provides a free good will offering dinner during
Lenten for Parish members and the community
14 Annual Fish Frv Each year St Jerome holds an all you can eat fish fry There is a cost
for the dinner however no one is turned away based on inability to pay
15 Feed Mv Starving Children Each year the 7th and 8th grade students volunteer at Feed
My Starving Children where they prepare meals which are shipped all over the world
16 Kids Korner Dav CarePreschool We offer day care and preschool to the community at
a reasonable rate
For many decades St Jerome has been an integral part of the Maplewood community St
Jerome prides itself in the opportunity to give back to Maplewood and its residents We
appreciate your consideration in providing a portion of the Charitable Gambling Tax Funds to St
Jerome
Agenda Item J1
Attachment 4
Packet Page Number 181 of 224
N
Jesus Christ is the same yesterday today and forever Heb 138
Archdiocese of
Saint Paul and Minneapalis
3
a
August 4 2009
Reverend Cletus B Basekela
Church of St Jerome
380 Roselawn Avenue East
Maplewood MN 551172033
Dear Father Basekela
The Church of St Jerome Maplewood Minnesota a Minnesota religious parishcorporationisataxexemptorganizationundertheprovisionsofSection501c3oftheInternalRevenueCodebyreasonofaGroupRulingissuedtotheUnitedStatesConferenceofCatholicBishops by the Internal Revenue Service on July 28 2009 whichisthelatest annual update in a series that began with the original determination of March251946Acopyofthe2009GroupRulingisenclosedThe Group Exemption Numberis0928
The Group Ruling provides that any organizations listed in the Official CatholicDirectoryfor2009asbeinganagency instrumentality and educational charitable andreligiousinstitutionsoperatedsupervisedorcontrolledbyor in connection with theRomanCatholicChurchintheUnitedStatesaretaxexempt
The Church of St Jerome Maplewood Minnesota is listed in the Official CatholicDirectory for 2009 A copy of the page from the directory showing that listing isenclosed
If you have any questions about the tax exempt status please contact me
Thank you
est j
e i zim er
Ch r for Civil A irs
i
i
I
I
22G SvNtMtT AvExuE ST PAUL MINNESOTA SS102217 TEL 651 2914405 Fnx 651 2901629 j
Agenda Item J1
Attachment 4
Packet Page Number 182 of 224
trttrrtia Revetre Servce Depertmettt t the Traseury
R O ax 2508
Glndnnatt ON 452Q1
tlate J Z Person tO CarttaCt
Roger tyer
7qli Fr Telehote Number
enszsoo
Urted SittCes Corfsrence oi Cafhoc 8ishaps Employer ldentMcaan Numbe
11 4 StfOet NE 53if 96617
Washington DC 2tU17119 Group Exemtio tmter
0928
DBar Sir or Madarn
In a nlng dated Marn 25 18 vre hald that ttte agenCes and fnstrumeMalCties and all edccalbnal
be and re6ous irstihsions operatied supervised or cormold by ar ln connecction wth the
Rarrfan Cathdic Church In tte Urutd Stafes its territories or possessbrxs appearng in The 1at
CafloJic trsckry 19d6 are ertttsd to exarrrUan rom Fecsra income uc urer the pravtsfons of
section 1416 the tremat Rvenue Cccle a i939 wtuch crrespands to 5echon 5U1cj3 pf the
1986 Code 7hls rtiling has been pdated annfaily io cover the organizations added bo or deieted
fttxn the Ltirectary
7he Cciat Catholfc Dtnecroryfor 2fl09 shows tie narries srd addressas af a ageries and
nsbmeMaliss and a educationai charitable and reEinus institutions operated by the Ranan
GatttoliC Ghurch in the United States is teritaiss atxt possessions irt existence at the time ttte
tirectory was pubished IE s understoad ttat each of thase is a nonQroirt ortanizaon that no part
ef fhe net eamigs thereof inures si the bertfit 4 arry tcfivitltrai tttt ra sntiat p8R of heir
actvities s for prqmotlon of legsiation and that nane are piwaie foundatlons urxier sec 5t9a of
the Cods
Based vrt at1 iMamaon sWmitfed we conGude thet the agencles ard tnsintmeMalies and
educaarral dtaritabe arx religEats instittcts operated sttpervtsetl Qr corrrotled ry vr in
conrction witti the Rornan Catholfc Church in thQ United Sfes its 9rrtoies or possessions
pearing 77re C7ffa Cellc Dtavyw 20t9 are exerrt rom Ftieral ucoms rier
sectlon 5f c3 af tle oris
Donors may deduct contribuUons to the agenciss stumerrtalts arx irstitutlons reertd o above
as Rrovided by secon 174 a the CQde Bequests gacres viss transfers or gifls to them or f
ttir use are dechtdlbie far edera esta and ift tax purposes if dy meet the appiicable provksiarRs
of setfions 2Q5 2106 and 2522 of tfre Code
Seginning Janty f1984 mles5 speclcliy exceped You and your suborsdinales mcast pay tac
uruder the Federal Insurance Cortraberfions Act IGA fa each empbyee who ls paid 103 or more In
a ealerdar year as indexed for inflatlon You and your sordiss ara nat tiate for the fac urr
the Federai Urtempbymeni 1ac Act FliTAj
Agenda Item J1
Attachment 4
Packet Page Number 183 of 224
The cociditions eonceming the reteron a your gr exernpon as set tci In cw prevbus
determinatan lefter dated Aut 17 1983 remain in fiui force and effed
Illif@
c w ft
Nfarager Cerrt Lanizatians
Determirsaons
Agenda Item J1
Attachment 4
Packet Page Number 184 of 224
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Agenda Item J1
Attachment 4
Packet Page Number 185 of 224
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Agenda Item J1
Attachment 4
Packet Page Number 186 of 224
CATIiOLIC CFNRCH IN TFiE US 1219 SAIlVT PAUL AND NQNNFAPOLIS STP
55102I1 6512921913 Students 178 Rea 812 1stAve NW 55112 Email sgutowskiCstpiusxwblorg Students 201
39S1 Ttetttse 1926 Mexged See Lumen Christi SchoolGrades K8 845 Znd Ave NW 5b112 WOODBURY WA9HINCTON Co Sut A3tstosE o
Catholic Community St Paul for recorda 11 651331522 Laylac6ers 25 Studenta 392 W000euftY 1998 Revs Thomas J Wallcer Brian
35ST htotHas Mo Rev Joseph E Weise SJ CatechesislRefigious Program11 6516331540 T Lynch Deacon Rip Riordan
Dearnn Thomas Dzik Faz 6516337404 SWdents 405 Mailing Address 4125 Woodbury Dr 551299627
1079 Summit Ave 551052243 Tel 6512277669 Nofrr ST PAUL RAMSEY CO ST PETER 1888 Tel 6517141058 Fax 6517149257
Faz 6512270847 CEM Itee Daniel F Griffith SchwlGradea KB T1 6517683000 Lay
Schoolt Thomas More Catholic School Grades 2600 N Margaret St North Saint aul 55109 Tel Teachers 43 Studentv 599
K8 1065 SummitAve 55105 Te1 6512244836 6517778304 Fax 6517770497 CatechesisReligious ProgramTe1 6517683011
Fax 6512240097 Emaili wituckid@ihm SchooGradesPteK8 LayIaehets26Students Students 2274
etlukesoig Web wwwihmstlukesorg Patrick 400
Loftou Prin Hagdischuno fibrarian Siaters CatechesisReligiousProgramI16517771 gOPOLTTAiV MINNEAPOLIB
2 Iay Teache 23 Students 338 Ibtal SCBff 39 StUdCat9 200 HENNEPIN COUNPY
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mietvas@lukeaetsarg StudenCs 123 1GuxtArt ANGets 1885 CEM1 Revs William F Gillespie OP In Etes Revs CA Kilroy OP
365r Tttofvs It tNostte 1954 Rev Joaeph Martiq Stanley Maslowaki Sr Dorothy Mrock Joseph P Gillespie OP0 loseph E Bidwill OP
Mthony Mdrade Deawn Richard ivtooie OSF Deacon Teriy Been Jose M Santiago dP Cletus J Wesseis OP Dan
Office 2119 Stillwater Avep55L19 11 651738 gxsc 8280 4th St N 55128ef 651732223 H Ostiek OP Bro Kevin W Carroll OP
0677 Fax 6517386492 Webwwwetthomaseporg Faz 6517382453 EmaiJ gagiazdienangelsorg AfITg dress Parish Center 283633rd Ave
CatechesisRetigious PrognmStudents 108 Web wwwguardianangelsorg S 55406 11 6127243643 Fair 6127229726
37T VNCSrrr uB Peuc 18883CEMI Rev Joseph preschooEmail sdwuznik@guazdianangelsorg Email info@saintalbertthegreatorg Web
Rlolwsou Deawn Isaokao Yang LayIbachers 8 Students 130 wK
Centec 651 Prginia St 56103 Tel 6514886137 CatchesisReligrous ProgramS6udents550 s 283332nd Ave S 55406Ii 6127243644
Fax 651 L 1939 Rev Robert H Hart Faz 6127245057
Res 239 Selby Ave SainE Paul 55102 Deacon Glenn Skuta CatechesisReligtous ProgramStudents 23
CatechesisReligiores ProgramStudents 63 Church 6133 15th St N 55128II 6b1732646 2Ay SeHns 1916 Polish Rev George J Kovalik
Faz 6615012230 Web wwwtcennyorg s 435 4th St NE 55413 Zlel 6123794996OUTSIDEMETROPOLETANSTPACTLgey2633HarvesterAveNMaplewood55119SeePopeJohnPaulIICathalicSchoolMinneapolisCOIACEGROYEWA3HINCTONCOC1urscHoeSr1GradesK83613515thStN55128
ftl7n 1966 Rev William Deziel OSC Deacons Tel 651b012220 Fau 6515012258 Ted under Elementary Schools ConsoGdated Parochial
Jack Nicklay Steve Xnop Zarembski Prin dan Wein orta Librarian La
O the Institutaon section
8694 BOth St S 55016I1 651469fb96 Fex g y CaechesisReligious PogramSee St Boniface
Iachers 23 Studentv 390 neapolis for details Tel 612379271 Fax651595364Emuilatritas@saintritasorgWebpgmmlt65150122046126761532wwwsaintritasorggryFaithFormationCaroleZempelgTpxNE7884ClosedSeeChurchofStCateehesisReligwusProgramtudents648pyQUthMinStudents461
Lrrrce Caxea Rnus Co Sr Jo oe Lrrre goSvuyE gusev Co Q Joaeph Hien
Ctxnn 1851 CEMI Rev David 4V Kohner 1CotePUS Cwusrr 1939 Rev Francis L Fried
curoN 1922 Rev Jemes RHimmelsbach
Suzanne Laddusire Du Peatoral Ministry Deacon Michael Humbert
s 5d9 W 54th St 554191818 Il 612824
Office 380 Little Canada Rd 55117 LL 651d84 d787 Faic 6128248232 Web
2708 Fax 651440b67 Email info@atjohaaflcotg
Oce 2131 N Fairview Ave 551235499 Il Wannunciationorg
Web wwwatjohnsoflcorg
6516398888 Fa 6516398288 Email SchbotGrndes K8 525 W 54th St 554191818
PreschaolLay Teachera 3 Students 35 corpua@mninternet Web t 6I28234394 Faz6128240998 Laylachers
SchoolGrades PreK8 2621 McMenemy St achurchofcorpuechristiorg 25 Studentis 942
55117 Tel 6514843038 Fax 6514811355 Mary CatechesisReligwua Programtudents 209 CatechesisReligious ProgramTel 618249993
Kay Rowan Prin IayIachers 19 Stndents 240 2T RcE oLIDt 1939 Rev RobertJ Fitzpatrick 266 gEudentv 85
CatechesisReligious ProgramIt 651t840048 Office 2048 N Hamline Ave 55I13 T1 651646 gT pxHOt7tr oF Pnua U849 Rev Glen T
Fes 651283233 Jean Conant Winter DRE 9389 Fax 6516464187 Web saintroseoflimanet Jenson
StudenGv 243 SchoolGrades PmSchoolB 2072 Hamline Ave ge gp4 Secoad St NE 55413 Sl 612379
MettroMet WASHINGTON CO Sr June oPr LxE N 55113 Tl 6516463832 Fair fi51647643T 2324 Fas 6123792325 Email
1939 Fiev Ralph W Talbot Jr Greg PizzolaW Prin Sisters 1 Lay 1achess 29 ethonychrchmsncom Web wwwstanthony
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Faa 6514fr4167 Deb MePherson DRE Student9 der EiemenEarpSchools Consofidated Parochial
SchooGradea K8 600 Mahtomedi Ave 55115 152 located in ttle Tnstitution section
Tr165142G2562 Fac 6516633662 Sally Hermea SxoxEVtEw RutseY Co ST ODLIA 1960 Revs jSoN 1890 Reds Ftichael OConnell Timo
Phillip J Rask Nels H Gjengdahl Deacon Ramon t L NoriisPrinIayIachers21Students223
G uardoCatechesiaReligiousProgram3tudents350 Rhs i723 Bryant Ave N 55411 TeL 612529
Mrtew000 Retser Co 3495 N Victoria St 65126 Tel 6514846681 Fa ggq Faa6125297618
1HOLY REDEEMERSARl7 Pee 1880 Italian 6514840780 Web wwwstodiliaorg SckoolGradesK8 1726 DupontAve N 55411
Merged See St Peter North St Paul Grades K8 Tel 6514843364 Fax 651 6125213609 Fezc6125223862 LeyItiachers
251 Jeaoats 1940 Rev Cletu9 Beseela 4153395 Mr Robert Grose Prin Lucinda Gorman 2g Studeuts 250
1894 MeMenemy Rd 66ll7 Li6rarian Lay 1achers 35 Studeate 612 Catechesis Religioua ProgramLL 6125217454
Church 380 Roselawn Ave E 5511711 653771 CatechesisReligiara ProgmmI1 6514842777 Faz 6125293343 StudenTs 98
12DS Fax 6517713628 EmaiL SnPenny Dunn OSF DRE Stvdents 907 Sr Auskix 1937 Potish Ree C00rge
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SchoolGredes PreK8 384 E Roselawn Ave 1Sr Josst 1942 Reve Michael Geagan Peter Chutch Oce 4050 UpWn Ave N b5412 L1
b5117 II 651718494 Faz 651713466 Patti B Deacon Jerry Scherkenbach 6125299561 Fax 6125298787 Email saa
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CatechesisReligiois ProgramStudents48 SchoolGrades K8 1138 Seminole Ave 55118 Schools Cousolidated P3rcelual located in the
PRE3EKCATTON oFTtrE BIF3SED VIRGM MnttY 1ti1 65i4578550 Fax 6514570780 Web www InsYitsstiansecfiou
1946 Rev Msrk A Huberty Deacon dames stjos8phwsporg Lay echers bl Students 680 Catechesis Religious Program Conaolidated
Saumweber CatechesisReligious ProgramTr16514578841 y at OurLadyof Viatory 5155 Emeraon Ave
Oce 125 Kennard St 6510911 6517778116 BYne Bouer DRE Studeats 197 N Minneapblis MN 55430 Students 16
Fas 651777843 Web ZT McsiaE 1868 Rev Kenneth L OfIotto 8Tt Bastuca oF ST hLuiv CaCnrnxt 1907
wwwpesenWtionotmaryorg Church Office 337 E Huriey Ave 55118 11 Rcv John M Bauer Deacons Del Fergusan Roger
SchooGradea K8 1695 Kennard St 55109 6514572334 Faa 6514511668 Caclsoa
71 6517775877 Eai 6517778283 LayIachera 5c1wo1Gradea K8 Te 65145T2510 Fax 651 Mailing Addreas PO Bo 50010 554050010
12 Students 175 4575049 Sieteta 1 LayIachera 11 Studenta 93 Ree88 N 17thSt554031295I1 6123331381
CatechesiaReligious ProgramFax 651777 CatechesislReligiotuProgram116614570172 Fax 8i23337230 Emeii bsm@maryorg Web
8743 Students 200 Students 33 wwwmaryorg
MENDOTA Dticor Co ST PEtvs 1840 Narive K B g MSe Co CatuhesislReligious ProgramFeL 6123173473
AmericanFrench CEM1 Rev doseph G Gall 1ST Meitx oF THS LnKE 1881 CEI1 Reo Rodger Students 728
a Bauman In Ftea Rev Roger P Pierre 9Sr BoxrnnCL 1858 German Rev John F
Mailing Address Rea PO Bo 60679 551b0 Res 4590 Bald Eagle Av 5b110 Tel 651429 Brandea Pazochial Admin Retired
11 6514524550 Faz 6514560646 Email 7771 Fas 651299539 Em1 cont9a3ur@stmarys Office Church Etes 629 Secood St NE 55413
church@stpeteremendotaorg Web wblorg Webwwwstmaryewblorg I1 8123792761 Fax 6126761532 Email
wwwetpetersmendotaorg SchoolGrndee PreK8 4690 Beld Eagle Ave boniface1858Cusfamilynet Weti wwwatboniface
Center 1405 Hwy 13 55150 55110 IayIachers 24 Students 405 mimeapolisorg
See Faithfiil Shepherd Catholic Scuinl Eagan CasebhesisReligious ProgrnmIL 65i29SQOl See Pope John Paul II Catholic School Minneapolis
under Elemeatary Schoole Coneolidated Parochia Helen Welter DRE Karlene Feidt DRE under Elementary Schools Conaolidated Parochial
located in the Institution section Studenta 371 locaEed in Fhe Institution eedion
CatechesisReligrous Program11 651524550 2ST Ptus X1954 Rev John J Mitchell Deacon CatechesislXeligious ProgmmThis is e shared
Fas 65f4560646 Kathy Raible DRE Studentv Thomas L Semlak program with St Clement Minneapolis 21 612
189 Mailing Addrese 3878 Highland Ave 55110 I1 3792451 Studente 59
New BacHror7 RnedsEY Go Sr JoeutrtSAensr 6514296337 Fax 6514295339 Email 10Sr Bxncer 1915 Very Rev Anthony M
1906 Polish 10Ehf1 Revs MicbaEl CSkluza parishstpiuszwblorg Web wwavetpiuswbLorg Criscitelli TORDeamn Richacd Heineman In
cel Sean R Magnusoq Deacons Thoma4 Quayie SchoolGrades PreSchool8 1b1 65I4299359 Res Rev Patrick Foley TOR
Rndaey Palmer Peter DHeilly Fax 6514299359 Email kgroettum@epxhf Ree 38ll Emerson Ave N 55412 Tel 612529
Parish Cenler35 2nd Ave NW 55112 11 wblorg Web wwwspxhfwblotg K Groettum 7779 Fac 612529451 Email sbrigid2@junocom
6516338333 Fai 651633404 Email Prio iaylkachers 23 Students 261 SchoolGrades K 5140 Fremont Ave N
atjohnny6@pclinkcom Web wwwsgbhnnybcom CatechesisReligiava ProgrmTeL 6517623634 554303497 Tel 6125297781 Fax 6125293343
Agenda Item J1
Attachment 4
Packet Page Number 187 of 224
Updated 070212
City of Maplewood
Application for Charitable Gambling Tax Funds Qecei
Pease type or print neatly
Aqplicant Information AUG L IU12
C o
Name of organization requesting funds The Salvation Army ape
Contact Person Mallory Birch Contact Phone 65 7463529
Email Address mallory birch@usc salvationarmy org
MailingAddress Twin Cities Social Services
2445 Prior Avenue Roseville MN 55113
Type of organization making request pease select one
City County School District NonProfit Attach proof of RS 501c3 status
Other Specify
How does your organization serveimpact the citizens of Maplewood
The Lakewood Social Services office provides basic needs such
as food clothing transportation and emergency financial
assistance to residents of Maplewood and Northern Ramsey County
How many residents of Maplewood does your organization serveimpactGive an estimated
Approximately 150 Maplewood families per month are now served
through the food shelf and other basic need services
Request Information
Amount of Request 3 0 0 0
In detail explain how the funds requeSted will be utilized be specific attach additional pages ifnecessary
The Salvation Army will use these funds to purchase a
commercial standup refrigerator for the food shelf The food
shelf opened in June of 2012 and serves only Maplewood
residents At this time the food shelf does not have a
refrigerator and is not able to distribute items such as milk
eggs cheese and other perishables to food shelf participants
Often applicants are not awarded the full amount requested can your organization utilize a partial
award X Yes No How would a partial award be utilized
Any amount received would cto towards the purchase of the
refriqerator This is an urqent need and we would secure the
remaining funding needed to make the purchase
By completing and signing this form the organization confirms that the requested Charitable Gambling
Tax Funds will be spent for a lawful purpose This request is a onetime request for funds to be awarded
in the next fiscal year and the applicant understands requests for future funding will require a new
separate application
Program Coordinator August 16 2012
Si nature Title Date
allory Birch LSW
Print Name
J
Agenda Item J1
Attachment 4
Packet Page Number 188 of 224
CITY OF MAPLEWOOD
CITY COUNCIL POLICIES ON AWARDS OF
CHARITABLE GAMBLING TAX FUNDS
1 All licensed charitable gambling organizations within the City are required to contribute 10
percent 10 of net profits derived from lawful gambling activity in the City to the
Charitable Gambling Tax Fund These funds are dispersed by the City Council for lawful
expenditures
2 All applications must be complete and submitted by the application deadline established by
the City Manager
3 The City of Maplewood grants funds from the Charitable Gambling Tax Fund to support
activities and services that benefit Maplewood residents The first priority in the granting of
funds will be given to the City of Maplewood domiciled organizations The second priority
or consideration will be given to funding requests from other organizations which are used
primarily for the benefit of Maplewood residents Funds shall be distributed for projects
equipment or activities that are based in the community and which primarily benefit
Maplewood residents and will be looked upon more favorably than requests for salaries or
general operating costs
4 In general requests from organized athletic groups will not be funded Funding for these
programs should be from participating families or community auxiliary groups There are so
many athletic organizations within the community that the City of Maplewood is not capable
of funding their financial requests or fairly determining appropriate recipients
5 The amount of Charitable Gambling Tax Funds awarded to any request is determined by a
City Council vote A request must receive 3 or more votes for funding in order to receive
Charitable Gambling Tax Funds
6 All funds granted are required to be expended for the requested project within one year of the
date of the award letter However payment will not be made until after January 1 of the
award year Grant recipients shall submit a letter to the City Manager requesting payment of
the grant award as well as provide specific information on how the funds were used receipts
or other proof of expenditure for the proposed purpose
7 No employee or department of the City of Maplewood shall solicit a donation from a
licensed charitable organization without City Manager approval If there is a financial need
for a specific program that was not funded in the City budget staff may submit a request to
the City Manager for the use of Charitable Gambling Tax Funds
8 The allocation of Charitable Gambling Tax Funds is an annual award The receipt of funds
does not in any way guarantee or commit the City of Maplewood to funding in any
subsequent year Each years funding requires a new separate application
Updated 070212
Agenda Item J1
Attachment 4
Packet Page Number 189 of 224
eva nnanr f iia Tatir
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Perar ta Cntact Tona Iorris
To1 ree Telpnore Nutttber I
Dear Taxpayer
iIS SS 1R teSDOtl52 t0 SFpUT AfJf e I a Ul I f2aU5t Fp i nfnrmti nn
regarding yrtr taxexempt staus
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section 5tl1EcC3 of tFe Inrnal Retnue Code in a daterminaton
ltter issued in June 133
uur records aiso inaicaie cha you arE no a privae ouniazion wihnhemeanirgofsection519CaoftheCodbecauseyaUaredescribednseciiot0aC1and17QhEACi
Dat may deduct corttributians o you s Qrvieed in secic 17 cfiricvucncuc51c3C1E5QVlSr5rransfersOCglf5ay0UO
for yaur use are deductiUle rflr Federal estate and gft ta aurposes
if they meet the aPlicable ureifsions or sacions 20 2Go 2d
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PIGS rFi l0 OUP LFDS1 WLIW1tSgOVED i 71 GCtTlilOCl fEgfiig IfIingrequireensSpecifica3lysectiero033CjflfheCade
provides tha failure to file ar arnual n return for three
corsecutive ears results in revocation nf taexempt status as of IthfilngduedateorthethzrdfnrorganizaionsreqiredtoI
fie t1e wi1 Pubiish a Iist uf gaiatQts whose aeeTY I
stats was revaked under sectiQr 03t3 of he Code an our wesie
beeinning in early 21I i
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Agenda Item J1
Attachment 4
Packet Page Number 190 of 224
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SALlATION ARMY
IORTiERt DIVTSIC
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If ynu have ny questons pease call us a he e7ephne nimr
sho4Jn in Lne heatiing af this letter
Sincerely Joiirs
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4 Martin porafirnS Manacr
Accounts hlnagement Oprations
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1
Agenda Item J1
Attachment 4
Packet Page Number 191 of 224
Updated 070212
cziu
City of Maplewood
Application for Charitable Gambling Tax Funds SFP 9 t 1m1
c
Applicant Information
Name of organization requesting funds Tubman
Contact Person Janet Golden Director of Sustainability Services Contact Phone 651 7896750
Email Address JGoldentubmanorq
Mailing Address Harriet Tubman Center East
1725 Monastery Way
Maplewood MN 55109
Type of organization making request please select one
C City C County School District X NonProft Attach prooof IRS 501c3 status
I Otherspecify
How does your organization serveimpact the citizens of Maplewood
Tubman is a multiservice agency with 40 years of experience providing family crisis and support services formed
from the merger of Chrysalis A Center for Women founded in 1974 Harriet Tubman Center founded in 1976
Family Violence Network founded in 1982 and ElderCare Rights Alliance ECRA founded in 1972 Built on a
history of innovation creating efficiencies and building partnerships Tubman is a pioneer in bestpractice models of
mental and chemical health services for women and family violence and elder abuse prevention and intervention As
the States largest provider of domestic violence services Tubman provides 20 of all Minnesota shelter beds for
women and children experiencing family violence This fall we will relocate our east metro shelter services to Harriet
Tubman Center East in Maplewood and expand public and multidisciplinary partnership spaces at that site
Tubman offers a full complement of services including family violence shelter and transitional housing legal services
including Orders for Protection mental and chemical health assessment treatment and support caregiver Support
and elder care resources parenting education and child care youth programming and inschool violence prevention
education resource counseling fnancial literacy and job readiness education and community education and
professional training 46 of Tubman clients live in the Twin Cities east metro area
Tubman has a longstanding connection with the City of Maplewood and its citizens The City was an essential
partner in Tubman securing a2 million state bond appropriation to renovate Harriet Tubman Center East Tubman
works with the Maplewood Police Department and City Prosecutor when providing criminal advocacy services to
victims of domestic violence and provides related training Maplewood Police Chief David Thomalla is a member of a
collaborative group convened by Tubman to identify criminal justice system issues plan collaborative solutions and
design a joint suburban Ramsey and Washington County domestic abuse service center to be housed at Harriet
Tubman Center East Tubman also provides violence prevention and healthy relationship education to students at
area schools including North St Paul High School Oakland Junior High and Next Step Transition Center
Tubman staff provide a variety of community education and professional training presentations to individuals living or
working in Maplewood Some examples during the last year include
Presentation on domestic violence and Tubman services at the Maplewood Citizens Academy
Training on domestic violence and Orders for Protection for teachers and staff at North St Paul High School
Elder Abuse Intervention and Prevention at the Maplewood CouRhouse
Health Care DecisionMaking at CommonBonds Century Trails senior housing community
Advice and education to nursing home Resident Councils and Family Councils at Maplewood Care Center
and Ramsey County Care Center
Tabman Application to Maplewood 1
v
Agenda Item J1
Attachment 4
Packet Page Number 192 of 224
Updated 070212
How many residents of Maplewood does your organization serveimpact Give an estimated
From July 1 2011 to June 30 2012 Tubman served over 560 Maplewood residents
22 received emergency shelter and a broad range of related supportive services
98 received legal services including criminal antl civil advocacy for victims of domestic violence and legal
representation and advice
8 received mental or chemical health counseling services
42 attended community education or training for seniors family members and formal or informal caregivers
172 participated in youth violence prevention and healthy relationship programs
16 received assistance with financial housing antl job search goals
11 participated in support groups for adults youth and children
65 attentled presentations on domestic violence Orders for Protection or elder abuse
196 received resources referrals advocacy and support by phone
Request Information
Amount of Request 2000
In detail explain how the funds requested will be utilized be specific and attach pages if necessary
Tubman requests funds to purchase cloth racks hangers antl materials to construct a secure changing room area
for HarrieYs Closet located at Harriet Tubman Center East in Maplewood HarrieYs Closet provides professional
clothing for work and school for women and men This program is staffed by community volunteers New and like
new clothing antl accessories are donated by national and local retailers and individuals
We envision HarrieYs Closet to be a warm safe environment where a client can come to get the professional clothing
and other accessories that they need Our goal is for the client to leave HarrieYs Closet feeling accomplished and
more confitlent in themselves With the help of our volunteers our shoppers can navigate the closet putting together
outfits that would be appropriate for different meetings and interviews Ultimately we see opportunities for Tubmans
JobsEducationTraining JET program and HarrieYs Closet to work together to prepare clients in shelter transitional
and the community not only to obtain educational opportunities and employment but also to sustain them
In addition to serving Tubman clients HarrieYs Closet will be open to Maplewood residents antl other community
members starting in November 2012 offering winter apparel for women and a limited number of inens items Clients
can access HarrieYs Closet either by appointment or during general open hours
Tubman will provide information to social service providers and Maplewood resitlents about how to receive clothing
from Harriets Closet through our contact with churches and places of worship other shelters serving women
children and men senior centers and partner agencies including the East Metro Womens Council and
CommonBond We will provide information to be inclutled in newsletters websites and other publications as well as
providing flyers and notices to libraries community bulletin boards food shelves and other community programs
Items to be purchasetl include
Quantity Description CostlUnit Total
3 Double Bar racks 9950 29850
4 Rolling Racks 6950 27800
3 3Levelroundracks 12900 38700
6 Caster replacements 100 600
10 sets Size Dividers 300 3000
8 sets Hangers skirt pants 4550 36400
8 sets Hangers coats shirts 2800 22400
Tubman Application to Maplewood 2
Agenda Item J1
Attachment 4
Packet Page Number 193 of 224
Updated 070212
Space Divider 20000 20000
1 Handheld Clothes Steamer 5000 5000
1 Steam Iron 3000 3000
1 Ironing Board 5000 5000
Brochures and Flyers 8250 8250
Total 200000
Often applicants are not awarded the full amount requested can your organization utilize a partial award
X Yes No How would a partial award be utilized
If Tubman received a partial award we would use funds first to purchase clothing racks and hangers Any remaining
funds would be used to purchase other items listed above
By complefing and signing this form the organization confirms fhat the requested Charifable Gambling Tax Funds
will be spent for a lawful purpose This request is a one time request for funds to be awarded in the nexf fiscal year
and fhe applicant understands requests for fufure funding will require a new separate application
Executive Director Se tember 20 2012
i ature Title Date
Beverly C Dusso
Print Name
Tubman Application to Maplewood 3
Agenda Item J1
Attachment 4
Packet Page Number 194 of 224
aE
SEP 2 x 1t
n
September 20 2012 MaP
James W Antonen City Manager
Maplewood City Hall
1830 East County Road B Tubman Center West
Maplewood MN 55109 3111 First Ave So
Minneapolis MN
55408
Dear Mr Antonen
6128253333
On behalf of the struggling families and victims of domestic violence we
serve I thank you and the City of Maplewood for your longstanding Tubman Center East
commitment to our organization Your support and partnership are truly 1725 Monastery Way
Maplewood MNappreciated55109
6oard oY Directors
OFFICERS Tubman respectfully requests 2000 to purchase equipment for 6517708544
Eric L Lipman Harriets Closet located at Harriet Tubman Center East Harrietscnar
Bradley S Wood Closet which provides professional clothing for work and school for Chrysalis Center
Chair Elect 4432 Chicago Ave SoRobertSchneeweiscommunitymembersandTubmanclientsisstaffedbyvolunteersand
Minnea ois MNvecnastockedwithdonationsfromnationalandlocalretailersandindividuals
P
Ann M Senne 55407
Secretary
Ron Anderson 6128710118
Treasurer Tubman highly values our longstanding connection with the City of
Kathteen M Schmidtkofer Maplewood and its residents including working with the MaplewoodPastChair
Beverly C Dusso Police Department and City Prosecutor when providing criminal
Presiden
advocacy services to victims of domestic violence and providing
DIRECTORS violence prevention education in area schools Tubman currently servesNormaAdams
Sheita D Arrington over 560 Maplewood residents each year and expects that number to
Laurie Bakken
Tommie Braddock 111CTeaSe 111 2013
John R Buzza n N I
Charles M Byme
j
CotleenMCarey The enclosed application describes our project and how it will benefit
Michael Crusham
residents of Maplewood Thank you for all the many ways MaplewoodRobert0Erickson
Tammie L Follet supports Tubman I hope you will agree that our Harriets Closet isJeanAFreeman
Jim Gitroy deserving of the Citys support If you have any questions please k
CharlesM Gray contact me directly or Janet Golden at j Tontubmanorg or 651789SheronDHorris
Witliam M Hutton 6750 y
Seamus Hyland
Mary KaulHoCtinger aje
Melissa Kuchenmeister Thank ou for considerin our re uest and all ou do for theThomasJLatlyygqy a
sona c aso community We look forward to hearing from you soon
Jay R Lindgren G
Deborah Lynch t
Catherine Manning Since ly t1
Harry D Melander
Sheila C Morgan
iRichardMNiemiec
Debra Page
Grant Piller
Dan Seeman Ili Ii I I I i
Kate wisser e rly C Dusso II
I
ADVISORY BOARD Ii i i
Sharon Sayles Betton
ii I
Marvin Borman V
Josie R Johnson
Diane Robinson
Sharon G Ryan
Penny Winton
Agenda Item J1
Attachment 4
Packet Page Number 195 of 224
fy j Dapartmeuf of the 1rzasur
7J Incrnal Rccnac Srnlcc
PO Box 2508 In reply refer to 0248i58532
Cincinnati OH 45201 Dec 24 20U9 ITR 4168C ED
41i240D48 DOD000 00
OOOZ0085
BODC TE
TUBMAN i
3111 FIRST AVE SOUTH
MINNEAPOLIS MN 554U8
i
D10196
Employer ldentitication Number 41124DD48
Person ta Cnntact Mr Lafollette
Tall Free Teiephone Number 1877829
Dear iaxpayer
This is in response to yaur Dec 15 2009 requestfor information
regarding y4ur taxexemp status
Our records indicate that your organization was recognized as exempt
under section 50Ic33 of the Internal Revenue Cnde in a
deterrtination letter issued in December 1974
Our recards also indicate that you are not a private foundation within
the meanzng of saction 509a of the Code because you are described in
sectianCs 509a1 and 170b1Atvi
Donors may deduct contributions to you as provided in section 170 of
the Code Bequests legacies devises transfers or gifts ta yau or
for your use are deductib3e fior Federal estate and gift tax purposes
if they meet the appJicable provisions of sectians 2f55 2106 nd
252Z af the Code
Beginning with the orgaflizations sixth taxable year and all
succeedins years it must meet one af the public support tests under
section 170Cb1Avi or section 509Ca2 as reported on Schedu3e
A of the Form 99D If your organization does not maet the public
support test far two consecutive years it is required to file Form
99QPF Return of Private Fnundatian for the second tax year that the
organizatinn failed ta meet the support test and will be reclassified
as a private foundation
if you have any questsons please call us aC the te7ephone number
shorn in the heading of th3s letter
Sinsreiy vQUrs
1
k
Michele P4 Suliivan Oper Mgr
Accounts Management Operations I i
i
Agenda Item J1
Attachment 4
Packet Page Number 196 of 224
Updated 070212
City of Maplewood eCe1v
Application for Charitable Gambling Tax Funds SEP n 2012
Please type or print neatly
0
Applicant Information yOfMapeyo
Name of organization requesting funds Venture Crew 613
Contact Person Dennis M Sederberg Contact Phone 651 7711204
Email Address dsederberg@net zero net
Mailing Address 1574 Ross Avenue
Saint Paul MN 551064231
Type of organization making request please select one
City County School District NonProfit Attach proof of IRS 501c3 status
DOtherSpecify Venture Crew registered with Boy Scouts of America
How does your organization serveimpact the citizens of Maplewood
Serves the youth of Maplewood who wish to take park in scouting
activities and builds confidence and independence
How many residents of Maplewood does your organization serveimpactGive an estimated
We currently have 5 youths registered
Request Information
Amount of Request 1060 00
n detail eXplaln hOW the futldS equeSt2d Will be ltlllZed be specific attach additional pages ifnecessary
See Attached Document i
Often ap licants are not awarded the full amount requested can your organization utilize a partial
award Yes No How would a partial award be utilized
A partial award would be used to defray the costs of the
previously mentioned activities
By compfeting and signing this form the organization confirms that the requested Charitable Gambling
Tax Funds will be spent for a lawful purpose This request is a onetime request for funds to be awarded
in the next fisca year and the applicant understands requests for future funding will require a new
separate application
Associate Advisor 9102012
Signature Title Date
Dennis M Sederberg
Print Name
V
Agenda Item J1
Attachment 4
Packet Page Number 197 of 224
Requested Funds Utilization Detail
1 Boy Scout registration for 2013 6 youth 6 adults
20000
2 Ultimate Frisbee Weekend April 26 28 2013 8 people
at 3500 per person is 28000 Per person cost is 8
food 2 transportation and 25 event fee
3 Venturing Shindig Weekend May 1719 2013 6
people at 3000 per person is 18000 Per person
cost is 8 food 2 transportation and 20 event fee
4 Backpacking on Border Route Trail August 1723 2013
5 people at 8000 per person is 40000 Per person
cost is 35 food 25 transportation and 20 camping
fees
Agenda Item J1
Attachment 4
Packet Page Number 198 of 224
Updated 070212
City of Maplewood
Application for Charitable Gambling Tax Funds
Pease type or print neatly SEP j 7 1012
C
lic nt Information y
p
Name of organization requesting fund Tl i
Contact Person i Contact Phone J
Email Address
Mailing Address
L
Type of organization making request nlease select one
City County School District NonProfit Attach proof of IRS 501c3 status
Other Specify
How cloes your organization serveimat th citizens uf Maplwoc
i t
How many residents of Maplewood does your organization serveimpactGive an estimated
i
Request Information
Amount of Request
In detail explain how the funds requested will be utilized be specific attach additional pages ifnecessary
l
Often ap licants are not awarded the full amount requested can your organization utilize a partial
avyard Yes No How would a partial award be utilized
r r
By completing and signing this form the organization confirms that the requested Charitable Gambling
Tax Funds will be spent for a lawful purpase This request is a onetime request for funds to be awarded
in the next fiscal year and the applicant understands requests for future funding will require a new
separate application
i
Sy n ture itle Da e
l
Gt
Pr nt Name
I
V
Agenda Item J1
Attachment 4
Packet Page Number 199 of 224
How does vour oraanization serveimnact the cRizens of Maolewood7
Hazel Ridge prides itself on community involvement We host a number of activities throughout
the year such as informative speakers musical performances meals and exercise classes all of which
are complimentary to the community We also work with the local xhools for Earth Day where
members of the National Honor Society at North High come and help our residents clean up our
surroundings as well as Hazelwood Park We participate in National Night Out in an effort to get to
know our neighbors and our community to help keep Mapiewood safe Our residents are also strongly
involved in charity work as we have a womans craft group that meets once a week to make yarn doils
The dolis will eventualiy be boxed up and sent oversees as part of the Operation Christmas Child charity
to help underprivleged children in Africa Some of the dolls will also be donated to the Iocal fire and
police stations for officers to hand out to children during crisis situations in hopes they will bring some
comfort We also have a few residents who volunteer their time at elementary schools in the area to
help children with their reading skilis
How manv residents of Maolewood does vour oraanization serveimoact
In addition to our 80 residents that we serve our community outreach has brought in over 150
community members this spring and summer alone with the different activities we have offered
In detail exolain how the funds reauested will be utilized
If we were awarded any amount of money we would put it towards our activtties department
so we may continue to host activities for the community The speakers and musiwl performances that
we bring in always come at a cost so some of the funds would be used to cover those fees For example
this fall we are hosting For the Love of Nature a three part speaker series We had Kate Crowley and
Mike Link speak on 824 describing their 1500 mile journey walking around Lake Superior On 914 we
have Mike Roberts speakfng about his experience as the last keeper at Split Rock Lighthouse in the late
1960s Our last presentation is on 921 with Ooug Ohman a photographer and writer from MN who is
speaking about his trip down the Mississippi from the Twin Cities to the lowa Boarder We sent out over
5000 invitations to seniors in the community to enjoy this complimentary event where they can hear
an informative program and enjoy refreshments However the total cost with printing postage speaker
fees food and supplies will be about 5000 We expect to have 4050 nonresidents at each progrem
We feel it is important to conect with the community and offer complimentary evenu for
seniors as many are isolated in their homes and dont have ways to connect with other seniors Many of
our residents and regular visitors are from the Maplewood and surrounding areas and have known each
other since elementary schooi tt is wonderful that these friendships have been maintained throughout
the years and that people can be reconnected after several years apart
Agenda Item J1
Attachment 4
Packet Page Number 200 of 224
Jd
wAi
iiSOTA Department f Ievenue Salos and uso
Piicae of cmpt 5tats Sr
Exempt organizations
arra
Walker Senior Housing Corporation IV ES 33749
3737 Bryant Ave So Darluwd
y
Minneapol is MN SS409 ttay 14 199s
Date Re MarGh 7 1994
Dae Reissued ApriT13 1994
The organization above is exempt from sales and tise tax under Minnesotalav on purchase9 rentals and leases
of inerchandise and services to be used exclusivel in the performanceof charitable religious or educational
funcdona For aanioratizen groupc tliamerhandiso must ba uced in th3plQasura reereation or othar nonprofit
funetion9 of the giioup fiiIsxemptlan doei not apply to purchases ol rnels lodgtng motor vetitcies or waste
collection and disposi seryices MS 297A25 sabd 16
Commissioner of Revenue
bY
L
P R Blaisdell Supervsor r 4
TaxpayerInformationDivision h
I ou hw ony auslons coll th MN Dparirrhf olRvnu at 61 sl or fofr 1E046379777
a
I
Agenda Item J1
Attachment 4
Packet Page Number 201 of 224
Updated 070212
City of Maplewood
Application for Charitable Gambling Tax Funds
Please type or print neatly p
Apqlicant Information
Name of organization requesting funds Weaver Association of Parents Teachex
Contact Person Cathy Seiford Contact Phone 65j 4000228
Email Address cathy@seiford com
Mailing Address 2626 Keller Parkway Maplewood MN 551091930
Type of organization making request please select one
City County SChool DistriCt Non Attach proof of IRS 501c3 status
Other Specify
Ilow does your oganization serveimpact the citizens ef Maplewood
We are a nonprofit ParentTeacher organization PTA at Weaver
Elementary Our mission is to Enhance the educational
environment of our children
How many residents of Maplewood does your organization serveimpactGive an estimated
500 students roughly 300 families
Request Information
Amount of Request 1 0 0 0
In detail explain how the funds requested will be utilized be specific attach additional pages ifnecessary
Weaver Elementary will be implementinq a new antibullyinq
proQram this year Olweus As part of the kickoff event for
students the coordinators ordered No Bully Zone tshirts for
each student Total cost was 2380 We received roughly
1380 in donations are are requesting funds for the balance of
this expenditure
Often applicants are not awarded the full amount requested can your organization utilize a partial
award X Yes No How would a partial award be utilized
Partial award will qo toward this expenditure Balance of
proect cost would then be funded by Weaver APT reserve funds
By completing and signing this form the organization confirms that the requested Charitable Gambling
Tax Funds will be spent for a lawful purpose This request is a onetime request for funds to be awarded
in the next fiscal year and the applicant understands requests for future funding will require a new
separate applican r
r fst tl Z
Signature Title Date
1 i rc
Print Name
Agenda Item J1
Attachment 4
Packet Page Number 202 of 224
Front of shirt
Elementy
1 yn
F
Ve Stand uP
Back of shirts
Weaver Elementary
No
Bull v
zone
Stnnd up Spenk out
Agenda Item J1
Attachment 4
Packet Page Number 203 of 224
INTERNAL REVENUE SERVICE DEPARTMENT OF THE TREASURY
P 0 BOX 2508
CINCINNATI OH 45201
Employer ldentification Number
Date OCT 312008 411911075
DLN
17053233333038
WEAVER ELEMENTARY ASSOCIATION OF Contact Person
PARENTS AND TEACHERS NANCY L HEAGNEY ID 31306
2135 BIRMINGHAM ST Contact Telephone Number
MAPLEWOOD MN 55109 977 8295500
Accounting Period Ending
August 31
Public Charity Status
170 b 1 A vi
Form 990 Required
Yes
Effective Date of Exemption
August 4 2008
Contribution Deductibility
Yes
Addendum Applies
No
Dear Applicant
We are pleased to inform you that upon review of your application for tax
exempt status we have determined that you are exempt from Federal income tax
under section 501c3 of the Internal Revenue Code Contributions to you are
deductible under section 170 of the Code You are also qualified to receive
tax deductible bequests devises transfers or gifts under section 2055 2106
or 2522 of the Code Because this letter could help resolve any questions
regarding your exempt status you should keep it in your permanent records
Organizations exempt under section 501c3 of the Code are further classified
as either public charities or private foundations We determined that you are
a public charity under the Code sections listed in the heading of this
letter
Please see enclosed Publication 4221PC Compliance Guide for 501c3 Public
Charities for some helpful information about your responsibilities as an
exempt organization
Letter 947 DOCG
Agenda Item J1
Attachment 4
Packet Page Number 204 of 224
Agenda Item J1
Attachment 5
Organization Amount Requested WR KJ JL MK BC Proposed
Award
180 Degrees, Inc.$5,000.00
Ashland Productions $1,500.00
Boy Scout Troop 461 $3,000.00
CHILD Inc.$200.00
Dispute Resolution Center $2,000.00
District 622 Education Foundation $5,000.00
District 622 Fusion Drumline $1,600.00
Friends of Maplewood Nature $1,200.00
Friends of Ramsey County Libraries $2,500.00
Hmong American Education Fund $5,090.00
Maple Tree Monastery Childcare Center $1,600.00
Maplewood AARP TaxAides $1,500.00
Maplewood Area Historical Society $18,360.00
Maplewood Fire Fighters Flower Fund $1,000.00
Maplewood Police Explorers $8,000.00
Maplewood Police Reserves $5,000.00
Maplewood Youth Scholarship Fund $3,500.00
Mothers And More, Twin Cities East #299 $700.00
Northern Lights Service Unit, Girl Scouts $3,500.00
Ramsey County Fair $3,500.00
Second Chance Animal Rescue $1,000.00
Simon Youth Foundation - Maplewood Mall $600.00
St. Jerome School $1,400.00
The Salvation Army $3,000.00
Tubman Family Alliance $2,000.00
Venture Crew 613 $1,060.00
Walker at Hazel Ridge Senior Community $5,000.00
Weaver Elementary PTA $1,000.00
Fund Reserves
TOTAL AMOUNT OF REQUESTS $88,810
An estimated $30,000 is available revenue from proceeds of the 10% Charitable Gambling Tax.
Any reduction in available funds will result in a proportional reduction of the award amount.
2013 Charitable Gambling Funds Score Sheet
Packet Page Number 205 of 224
Agenda Item J2
AGENDA REPORT
TO: James Antonen, City Manager
FROM: Gayle Bauman, Finance Manager
Chuck Ahl, Assistant City Manager
SUBJECT: Consider Resolution Adopting 2013 Rates for Utilities
DATE: October 1, 2012 for October 8, 2012 council meeting
INTRODUCTION
During preparation of the annual budget, staff reviews revenues produced by the current rates
to determine if they are sufficient to cover operating, capital and infrastructure costs. The
programs that were reviewed were Sanitary Sewer, Environmental Utility, North St. Paul Water
Surcharge, St. Paul Water Surcharge and Recycling. Based on current information, it was
determined the North St. Paul Water Surcharge did not warrant a fee increase at this time but
the remaining programs did.
DISCUSSION
The attached statements identify the expense and revenue categories, as well as the cash
balances for the following programs.
Sanitary Sewer – the proposed 2013 Budget includes an increase in sanitary sewer utility
rates of 4%. This fund is needed to finance the Metropolitan Council sewage treatment
charges to Maplewood that will be 63% of the operating expenses for the Sanitary Sewer
Fund in 2013. The sewage treatment charges for 2013 are anticipated to be $2,632,340.
Other operating expenses (including depreciation), are anticipated to be $1,533,950 in 2013.
Present 2013
St. Paul Billing District:
Rate per 100 cubic feet $2.82 $2.94
Minimum Charge (per quarter) $15.86 $16.50
North St. Paul, Roseville, Little Canada and
Woodbury Billing Districts:
Rate per 1,000 gals. $ 3.77 $3.92
Minimum Charge (per quarter) $15.86 $16.50
Environmental Utility – a 10% increase is being proposed to offset the demands on city
resources for storm water treatment and increasing operating costs. This is the amount used
during the preparation of the 2013-2017 Capital Improvement Plan (CIP) document. As staff
projects expenses into future years, the pressures to expand this program are significant.
Annual increases of 10% are proposed in the CIP for the next five years to help fund
improvements and increased operating expenses.
Packet Page Number 206 of 224
The anticipated operating expenses in 2013 for the Environmental Utility Fund (EUF) are
$1,740,520. The largest expense is the Storm Sewer program which accounts for $1,191,050
of this expense, including depreciation in the amount of $480,700. The net income for 2013 is
projected to be $472,450. This will provide for an operating balance to help achieve the goal
of self-sufficiency. We are not projecting a need for increased bonding in 2013 to cover
projects in the 2013-2017 CIP Plan.
The 10% proposed increase will raise the quarterly rates on a single-family home from $18.84
($6.28 per month) to $20.73 ($6.91 per month); a $0.63 per month increase.
St. Paul Water Surcharge - this fund is needed to finance the unassessable water system
improvements that would otherwise have to be financed by property taxes. The proposed
2013 Budget includes an increase in the water surcharge for the St. Paul Water Service
District from 4.4% of the St. Paul Water charge to 6.5% of the St. Paul Water charge. The
increase would be approximately $1.05 per quarter.
Recycling – the proposed budget for 2013 includes a 15% increase in recycling fees. The
fees are proposed to increase to $2.56 per month for multi-family units and $7.68 per quarter
for single-family residents. The 15% increase will result in additional revenue of approximately
$62,000. These revenues are needed to offset the costs of recycling.
Summary of Monthly Fees
Monthly Charge Monthly
2012 2013 Increase
Sanitary Sewer 15.04 15.68 0.64
Environmental Utility 6.28 6.91 0.63
Water Surcharge – St. Paul .73 1.08 0.35
Water Surcharge – N. St. Paul 1.20 1.20 0.00
Recycling 2.22 2.56 0.34
TOTAL MONTHLY INCREASE 1.96
RECOMMENDATION
Staff recommends approval of the attached resolution authorizing the above rates for 2013.
P:\Council Files\Agendas\2012\101 Fees - Utility Rates 2013 New.Doc
Attachment 1: Resolution for 2013 Utility Rates
Attachment 2: Statements of Revenues, Expenses and Changes in Net Assets
Packet Page Number 207 of 224
RESOLUTION
ADOPTION OF THE 2013 RATES FOR UTILITIES:
SANITARY SEWER
ENVIRONMENTAL UTILITY (STORM WATER)
WATER SURCHARGE (ST PAUL)
RECYCLING
WHEREAS, the City of Maplewood has established utility rates, and
WHEREAS, city staff has reviewed the utility rates.
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF
MAPLEWOOD, MINNESOTA, that:
1. The updated sanitary sewer rates with a 4% increase shall become
effective beginning January 1, 2013, with fees set as follows:
St. Paul Billing District: Rate per 100 cubic feet $2.94
Minimum Charge (per quarter) $16.50
North St. Paul, Roseville, Little Canada and
Woodbury Billing Districts: Rate per 1,000 gals. $3.92
Minimum Charge (per quarter) $16.50
2. The updated Environmental Utility Fund rates with a 10% increase shall
become effective beginning January 1, 2013, with quarterly rates set at
$20.73 ($6.91 per month).
3. The updated water surcharge rates for the St. Paul Water District shall
become effective beginning January 1, 2013, with fees set as follows:
6.5% of the St. Paul water charge.
4. The updated recycling fees with a 15% increase shall become effective
beginning January 1, 2013, with fees set as follows:
$2.56 per account per month for multi-family units
$7.68 per account per quarter for single-family residents
5. The updated utility rates are approved for all related services received on
or after January 1, 2013.
6. The rates shown will be reviewed by staff on an annual basis with
recommendations for revisions brought to the city council for
consideration.
Attachment 1
Packet Page Number 208 of 224
2012
ACCT 2010 2011 ORIGINAL 2012
NO. ACTUAL ACTUAL BUDGET RE‐EST. 2013
Operating revenues:
3305 Sewer permits 5,344 3,724 4,300 4,300 4,300
3651 Sewer billings 4,440,773 4,787,123 4,645,750 4,645,750 4,831,580
Total revenues 4,446,117 4,790,847 4,650,050 4,650,050 4,835,880
Operating expenses:
Personnel services 458,683 484,003 509,070 509,070 474,270
Commodities 14,521 21,798 38,530 38,530 38,610
Contractual services 212,669 210,527 260,940 260,940 258,530
4485 Billing 40,306 40,389 36,110 40,120 45,500
4510 Sewage treatment 2,570,600 2,600,258 2,460,130 2,460,130 2,632,340
4950 Administration 323,960 323,960 323,960 323,960 335,630
4795 Depreciation 362,365 362,869 367,970 367,970 381,410
Total expenses 3,983,104 4,043,805 3,996,710 4,000,720 4,166,290
Operating income (loss)463,013 747,042 653,340 649,330 669,590
Nonoperating revenues (expenses):
Special assessments 24 39 ‐ ‐ ‐
Investment earnings 645 3,188 3,330 5,300 6,000
Miscellaneous revenues 6,854 18,651 ‐ ‐ ‐
Miscellaneous expenses (5,222) (4,381) ‐ ‐ ‐
Gain/(loss) on disposal of property ‐ (224,098) ‐ ‐ ‐
Investment management fees (2,319) (4,945) (670) (4,000) (4,500)
Total nonoperating revenues (expenses)(18) (211,546) 2,660 1,300 1,500
Net income (loss) before contributions
and transfers 462,995 535,495 656,000 650,630 671,090
Transfers in (out):
Public Improvement Projects fund (net) (112,152) (321,555) (406,900) (465,000) (50,000)
Debt Service (184,400) (269,150) (266,930) (266,930) (264,710)
Sewer Lift Station projects ‐ (169,541) ‐ (195,785) (250,000)
Capital contributions 330,845 1,094,166 ‐ ‐ ‐
Change in net assets 497,288 869,415 (17,830) (277,085) 106,380
Net assets ‐ January 1 12,384,407 12,881,695 12,172,055 13,751,110 13,474,025
Net assets ‐ December 31 12,881,695 13,751,110 12,154,225 13,474,025 13,580,405
CITY OF MAPLEWOOD
SANITARY SEWER FUND (601)
STATEMENT OF REVENUES, EXPENSES AND CHANGES IN NET ASSETS
Attachment 2
Packet Page Number 209 of 224
2012
2010 2011 ORIGINAL 2012
ACTUAL ACTUAL BUDGET RE‐EST. 2013
Net income (loss) before contributions
and transfers 462,995 535,495 656,000 650,630 671,090
Add depreciation 362,365 362,869 367,970 367,970 381,410
Change in current assets 153,253 (33,184) ‐ ‐ ‐
Change in current liabilities 765 (10,492) ‐ ‐ ‐
Sale of fixed assets/non‐cash activity ‐ 225,390 ‐ ‐ ‐
Transfers in (out)(296,552) (760,246) (673,830) (927,715) (564,710)
Net increase (decrease) in cash 682,827 319,833 350,140 90,885 487,790
Cash balance ‐ January 1 291,970 974,797 665,157 1,294,630 1,385,515
Cash balance ‐ December 31 974,797 1,294,630 1,015,297 1,385,515 1,873,305
STATEMENT OF CASH FLOWS
Packet Page Number 210 of 224
2012
ACCT 2010 2011 ORIGINAL 2012
NO. ACTUAL ACTUAL BUDGET RE‐EST. 2013
Operating revenues:
3651 Environmental utility charges 1,736,452 1,899,240 2,011,520 2,011,520 2,212,670
Total revenues 1,736,452 1,899,240 2,011,520 2,011,520 2,212,670
Operating expenses:
Nature center 69,710 67,233 73,170 73,170 78,290
Planning ‐ ‐ 285,590 285,590 288,560
Storm sewer maintenance 714,820 741,272 527,880 527,880 527,780
Street sweeping 179,474 183,193 197,810 197,810 182,620
4485 Billing 40,716 40,389 40,000 41,000 46,200
4950 Administration 69,400 92,300 122,760 122,760 136,370
4795 Depreciation 438,285 480,700 438,290 438,290 480,700
Total expenses 1,512,404 1,605,087 1,685,500 1,686,500 1,740,520
Operating income (loss)224,047 294,153 326,020 325,020 472,150
Nonoperating revenues (expenses):
Special assessments 31,084 ‐ ‐ ‐ ‐
Investment earnings 438 1,545 2,610 2,610 1,150
Miscellaneous income ‐ 542 ‐ ‐ ‐
Gain/(loss) on disposal of property (30,653) (30,884) ‐ ‐ ‐
Investment management fees (1,766) (2,397) (1,950) (1,950) (850)
Total nonoperating revenues (expenses)(896) (31,195) 660 660 300
Net income (loss) before contributions
and transfers 223,151 262,958 326,680 325,680 472,450
Transfers in (out):
Public Improvement Projects fund (net) (397,298) (1,936,980) (396,200) (550,000) (100,000)
Amount to be bonded for ‐ 1,910,200 ‐ ‐ ‐
Debt Service (174,650) (193,050) (301,460) (301,460) (399,690)
Storm Cleanup ‐ (100,000) ‐ (200,000) ‐
City Dump Remediation ‐ (29,000) (50,000) (100,000) ‐
Fire Training Facility (15,000) (235,000) ‐ ‐ ‐
Park Development ‐ (25,000) (100,000) (100,000) ‐
Capital contributions 1,342,559 2,607,468 ‐ ‐ ‐
Change in net assets 978,762 2,261,596 (520,980) (925,780) (27,240)
Net assets ‐ January 1 17,902,765 18,881,528 18,343,248 21,143,124 20,217,344
Net assets ‐ December 31 18,881,528 21,143,124 17,822,268 20,217,344 20,190,104
CITY OF MAPLEWOOD
ENVIRONMENTAL UTILITY FUND (604)
STATEMENT OF REVENUES, EXPENSES AND CHANGES IN NET ASSETS
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2012
2010 2011 ORIGINAL 2012
ACTUAL ACTUAL BUDGET RE‐EST. 2013
Net income (loss) before contributions
and transfers 223,151 262,958 326,680 325,680 472,450
Add depreciation 438,285 480,700 438,290 438,290 480,700
Change in current assets (41,121) (20,247) ‐ ‐ ‐
Change in current liabilities (12,965) 5,027 ‐ ‐ ‐
Sale of fixed assets/non‐cash activity 30,653 30,884 ‐ ‐ ‐
Transfers in (out)(586,948) (608,830) (847,660) (1,251,460) (499,690)
Net increase (decrease) in cash 51,056 150,493 (82,690) (487,490) 453,460
Cash balance ‐ January 1 151,092 202,149 143,869 352,641 (134,849)
Cash balance ‐ December 31 202,149 352,641 61,179 (134,849) 318,611
STATEMENT OF CASH FLOWS
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2012
ACCT 2010 2011 ORIGINAL 2012
NO. ACTUAL ACTUAL BUDGET RE‐EST. 2013
Miscellaneous Revenue:
3651 Utility billings 50,569 170,087 181,500 181,500 268,130
3801 Investment earnings (194) 358 500 700 280
3808 Water availability charges 36,960 19,230 36,960 36,960 36,960
Total revenues 87,335 189,675 218,960 219,160 305,370
Expenditures:
Capital projects 35,102 17,024 ‐ ‐ ‐
4485 Fees for utility billing (3,756) 876 1,760 900 5,280
4930 Investment management fees ‐ 556 400 600 20
Total expenditures 31,346 18,456 2,160 1,500 5,300
Excess (deficit) of revenue
over expenditures 55,990 171,220 216,800 217,660 300,070
Other financing sources (uses):
Transfers in (out)
Public Improvement Projects 212,000 (40,463) (423,500) (300,000) (30,000)
Debt service funds (33,460) (49,320) (46,080) (46,080) (45,760)
Net increase (decrease) in fund balance 234,530 81,437 (252,780) (128,420) 224,310
Fund balance ‐ January 1 (159,251) 75,278 139,278 156,715 28,295
Fund balance ‐ December 31 75,278 156,715 (113,502) 28,295 252,605
CITY OF MAPLEWOOD
WATER AVAILABILITY CHARGE FUND ‐ ST. PAUL WATER DISTRICT (407)
STATEMENT OF REVENUES, EXPENDITURES, AND CHANGES IN FUND BALANCE
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2012
ACCT 2010 2011 ORIGINAL 2012
NO. ACTUAL ACTUAL BUDGET RE‐EST. 2013
Operating revenues:
3534 County ‐ other grants 73,475 77,683 73,480 73,480 77,680
3781 Recycling charges 394,433 411,610 414,150 414,150 476,270
3782 Trash fees ‐ ‐ ‐ ‐ 85,000
Total revenues 467,908 489,293 487,630 487,630 638,950
Operating expenses:
Personnel services 64,673 77,093 81,230 81,230 88,830
Commodities 2,282 11,960 10,400 10,400 4,500
Contractual services 399,246 459,952 513,880 513,880 422,690
4950 Administration 39,330 49,290 49,290 49,290 49,580
Total expenses 505,530 598,294 654,800 654,800 565,600
Operating income (loss)(37,622) (109,002) (167,170) (167,170) 73,350
Nonoperating revenues (expenses):
3801 Investment earnings 584 1,223 1,360 1,600 1,300
3809 Miscellaneous 6,442 2,588 ‐ ‐ ‐
4930 Investment management fees (2,352) (1,897) (1,020) (1,200) (970)
Total nonoperating revenues (expenses)4,674 1,913 340 400 330
Net income (loss) before contributions
and transfers (32,948) (107,089) (166,830) (166,770) 73,680
Transfers in (out):
Debt Service (2012A Bonds)‐ ‐ ‐ ‐ (77,960)
Change in net assets (32,948) (107,089) (166,830) (166,770) (4,280)
Net assets ‐ January 1 531,507 498,559 321,519 391,471 224,701
Net assets ‐ December 31 498,559 391,471 154,689 224,701 220,421
CITY OF MAPLEWOOD
RECYCLING PROGRAM FUND (605)
STATEMENT OF REVENUES, EXPENSES AND CHANGES IN NET ASSETS
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2012
2010 2011 ORIGINAL 2012
ACTUAL ACTUAL BUDGET RE‐EST. 2013
Net income (loss) before contributions
and transfers (32,948) (107,089) (166,830) (166,770) 73,680
Change in current assets 7,321 (3,250) ‐ ‐ ‐
Change in current liabilities (44,154) 30,019 ‐ ‐ ‐
Transfers in (out)‐ ‐ ‐ ‐ (77,960)
Net increase (decrease) in cash (69,781) (80,320) (166,830) (166,770) (4,280)
Cash balance ‐ January 1 517,515 447,734 270,694 367,414 200,644
Cash balance ‐ December 31 447,734 367,414 103,864 200,644 196,364
STATEMENT OF CASH FLOWS
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MEMORANDUM
TO: James Antonen, City Manager
FROM: Tom Ekstrand, Senior Planner
Chuck Ahl, Assistant City Manager
SUBJECT: Consider Recommendation of No Further Action on Reinforced-Turf
Parking Surfaces for Residential Parking Needs
DATE: October 1, 2012
INTRODUCTION
On July 23, 2012, the city council approved an ordinance amendment to allow
reinforced-turf parking lots as a limited-use option for temporary, over-flow parking lots.
The city council also directed staff to study allowing reinforced-turf parking as an option
for residential parking needs.
Request
Consider whether the city ordinance should allow reinforced-turf as a parking surface for
residential use.
The residential parking ordinance is in the back of this memorandum in the Reference
section.
BACKGROUND
The recently amended turf-parking ordinance applies to non-residential parking
circumstances and reads as follows:
Sec. 44-17. Off-Street Parking.
(e) All parking lots and associated driveways shall have a surface of bituminous material
or concrete and striped parking spaces. The city council may permit the alternative
parking method of reinforced-turf parking when it would meet the following criteria:
When the need for overflow parking is infrequent or limited to occasional parking
events.
Where there is already hard-surfaced parking that provides for handicap-accessible
parking needs.
Where the turf parking lot would meet setback and screening requirements.
Where the parking need is seasonal (non winter) so snow plowing is not needed.
Where there would be an environmental benefit due to storm water management or
meeting shoreland/wetland/flood plain ordinance impact needs.
Agenda Item J3
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Where the turf-parking plan meets the approval of the city engineer from the
standpoint of using proven construction materials engineered for durability and
aesthetics.
Where the turf-parking plan meets the approval of the police and fire chief from the
standpoint of meeting public safety requirements.
This parking surface alternative shall not apply to single and double dwelling residential
properties which are governed under Section 44-17 (j), the residential parking ordinance
apply.
DISCUSSION
On September 18, 2012, the planning commission considered whether the city council
should amend the residential parking ordinance to allow reinforced-turf parking surfaces.
Staff had recommended that the ordinance should remain as is and that the city should
continue to require hard surfaced driveways and parking areas for residential needs.
Staff’s reasons were to preserve neighborhood aesthetics and also that there could be
possible difficulties with code enforcement.
Regarding aesthetics, turf parking areas could become tall-grass problems and,
consequently, may appear just to be unmaintained areas. Side yard setbacks could also
easily be infringed upon if the actual parking turf-parking area was unclear. We may not
know exactly where a turf parking edge stops.
The planning commission was not convinced that enforcement was much of a potential
problem. Staff concurs with them following that discussion. Likely, there would not be a
great desire by residents to install reinforced-turf parking pads. If so, the city could track
such installations through the driveway permit process. Any illegal parking on grass
would be enforced as it currently is.
Conclusion
The planning commission moved to continue requiring hard-surfaced driveways and
parking pads for residential parking needs and not allow reinforced-turf. Their
recommendation intended to keep neighborhoods looking neat, maintained and orderly
and avoid the potential that turf parking areas could become unkempt.
RECOMMENDATION
Take no action on amending the residential parking ordinance to allow reinforced-turf
parking surfaces.
If the city council would like staff to revise the residential parking ordinance to include
allowing reinforced-turf parking surfaces, staff will do so for review by the planning
commission.
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REFERENCE
(j) Off-street parking in residential areas shall be in accordance with the
following:
(1) Purpose. The purpose of this subsection is to control, through
nuisance and zoning regulations, certain land uses and activities that
have a direct and detrimental effect on the character of the city's
residential neighborhoods. As such, the city council finds that, in order to
accommodate the off-street parking needs of residents while protecting
the interests of the public, regulations and performance standards are
desirable and necessary for off-street parking areas in residential zoning
districts.
(2) Findings. To the purposes listed in subsection (j)(1) of this section,
the city council finds that the use and possession of vehicles are an
important factor in the lives of many residents of the city. The city council
also finds that the number of vehicles, the improper storage of vehicles
and the parking of and storage of excessive numbers of vehicles can be a
nuisance and can affect the neighborhood character as well as the public
health, safety and welfare, property values and the reasonable use and
enjoyment of neighboring properties. The city council further finds that the
establishment of the regulations in this subsection furthers the goals in
the city comprehensive plan relative to the establishment and
enhancement of residential neighborhoods and similar goals. In making
these findings, the city council accepts the recommendations of city staff
and planning commission that have studied the experiences of other
suburban cities that have reviewed and regulated off-street parking in
residential areas. The city council establishes the regulations in this
subsection as a means to balance the interests of the owners of vehicles,
nearby residents and the public.
(3) Goals. Goals in adopting this subsection include the following:
a. Preserving neighborhood character, public health, safety and
welfare and property values.
b. Allowing all residents a reasonable use of and a chance to enjoy
their property.
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c. Minimizing the nuisances and the adverse effects of off-street
vehicle parking through careful site design standards.
d. Requiring the owners and builders of residential driveways
and parking areas to design and build them to reasonable
standards.
e. Avoiding nuisances and potential damage to adjacent
properties from off-street vehicle parking and parking areas
through design standards and setback requirements.
(4) Off-street parking standards for single-family and two-family
dwellings. The following standards shall apply to off-street parking for
single-family and two-family residential properties in the RE-40, RE-30,
RE-20, F, R-1, R-1S and R-2 zoning districts:
a. Vehicle parking in the front yard setback area (the area
between the front of the residential structure and the street
right-of-way line) of single-family and two-family residences
shall only be on a hard-surface driveway or on improved
and designated parking areas. Such a hard surface shall
include bituminous, concrete, brick, gravel or crushed rock
or another hard surface approved by city staff.
b. The city prohibits vehicle parking or storage in the front
yard on grass, unimproved areas or areas without a hard
surface.
c. Driveways and parking areas shall be at least five feet from
a side property line, and parking areas shall not be in the
street right-of-way or on other public property.
d. No owner or operator shall park a vehicle that would block
a sidewalk.
e. All vehicles parked or stored outside on a residential
property shall not be abandoned, as defined in section 18-
67, shall have a current license and registration and shall
be in operable condition. Also see sections 18-67 and 18-
68
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f. The total area in the front yard setback area of a single
dwelling lot improved for parking and driveway purposes
shall not exceed 40 percent of the front yard setback area.
The total area in the front yard setback area of a duplex or
double dwelling lot improved for parking and driveway
purposes shall not exceed 50 percent of the front yard
setback area.
g.
The city may approve an increase in front yard driveway
coverage, a different driveway setback or a different
driveway surface for a single or double dwelling by
administrative review of minor construction plans as
outlined in section 2-285. The city may approve an
increase in front yard driveway coverage, a different
driveway setback or a different driveway surface where
such approval would meet the standards required by code
for unique circumstances and where the above standards
do not fit or where they would create a hardship for the
property owner. As part of such an approval, the city may
require the property owner or applicant to add screening
next to or around the parking area or driveway. The city
may require such screening to help hide the parking area
and vehicles from the view of adjacent residential
properties or from the view from the public street. The
property owner or applicant may use a privacy fence,
additional landscaping or other means to meet the
screening requirement. City staff shall approve and inspect
all such screening.
p:ord\turf parking ordinance Amendment Residential Parking Provisions CC Report 10 12 te
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September 18, 2012
Planning Commission Meeting Minutes
1
DRAFT
MINUTES OF THE MAPLEWOOD PLANNING COMMISSION
1830 COUNTY ROAD B EAST, MAPLEWOOD, MINNESOTA
TUESDAY, SEPTEMBER 18, 2012
1. CALL TO ORDER
A meeting of the Commission was held in the City Hall Council Chambers and was called to order
at 7:00 p.m. by Chairperson Fischer.
2. ROLL CALL
Paul Arbuckle, Commissioner Present at 7:01 p.m.
Al Bierbaum, Commissioner Present
Joseph Boeser, Commissioner Present at 7:07 p.m.
Tushar Desai, Commissioner Present
Larry Durand, Commissioner Present
Lorraine Fischer, Chairperson Present
Dale Trippler, Commissioner Present
Stephen Wensman, Commissioner Absent
Staff Present: Tom Ekstrand, Senior Planner
3. APPROVAL OF AGENDA
Staff added 10. b. Update on RSI Recycling Project.
Commissioner Trippler moved to approve the agenda as amended.
Seconded by Commissioner Desai. Ayes – All
The motion passed.
4. APPROVAL OF MINUTES
Commissioner Trippler moved to approve the August 21, 2012, PC minutes as submitted.
Seconded by Commissioner Bierbaum. Ayes – All
The motion passed.
5. PUBLIC HEARING
None.
6. NEW BUSINESS
a. Ordinance Revision – Reinforced Turf Parking Ordinance for Residential
Properties
i. Senior Planner, Tom Ekstrand gave the report and answered questions of the
commission.
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September 18, 2012
Planning Commission Meeting Minutes
2
The following were comments and questions raised by the commission during the
discussion:
Are there any other cities that allow the Reinforced Turf Parking Ordinance for Residential
Properties?
Is it expensive or relatively inexpensive to install reinforced turf parking? It should be simple to
know who has approval for reinforced turf parking and have a spread sheet of the addresses to
monitor.
It looks like grass and people driving by don’t know the difference. It should not be allowed in
residential. If people want to have parking spaces they should pave it or put gravel down.
If someone wants to use this reinforced turf parking do they have to go through an application
process for approval? If there is no permit the city won’t know who is using the system.
Are there requirements where RV’s and boats can park temporarily? Temporary parking spots
rather than parking on the grass is preferred. A commission member stated it causes more
problems than solutions.
A concern is the potential of oil drip contamination going direction into the ground.
Have there been any requests for this type of system yet?
Commissioner Bierbaum moved to deny the reinforced turf parking for residential use.
Seconded by Commissioner Durand. Ayes – Chairperson Fischer,
Commissioner’s Bierbaum,
Boeser, Desai, Durand,
& Trippler
Nay – Commissioner Arbuckle
The motion passed.
b. Resolution of Appreciation for Gary Pearson
Commissioner Trippler moved to approve the resolution of appreciation for Gary Pearson.
Seconded by Commissioner Boeser. Ayes – All
The motion passed.
This goes to the city council on September 24, 2012.
7. UNFINISHED BUSINESS
None.
8. VISITOR PRESENTATIONS
None.
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September 18, 2012
Planning Commission Meeting Minutes
3
9. COMMISSION PRESENTATIONS
a. Commission report for the city council meeting of August 27, 2012. Commissioner Durand
was scheduled to attend. The items reviewed were the wetland setback variance for 1978
Kennard Street and the RSI Recycling conditional use permit. The city council approved the
wetland setback variance. The city council tabled RSI Recycling with conditions. After the
councils review, RSI Recycling withdrew their application for the location in the old Wipers
Recycling building. Staff is waiting to find out what the plan is for RSI Recycling to possibly
move to another location in Maplewood.
b. Commission report for the city council meeting of September 10, 2012. Commissioner
Bierbaum was scheduled however, there were no planning commission items to review at the
meeting.
c. Upcoming city council meeting of September 24, 2012. Commissioner Fischer is scheduled to
attend. The resolution of appreciation for Gary Pearson will be presented at this meeting.
There will also be a joint meeting at 5:15 p.m. that evening with the city council and the
boards and commissions regarding the Gladstone area.
10. STAFF PRESENTATIONS
a. Update about improvements at the Gladstone Savanna and Public Safety
Training Center
i. Senior Planner, Tom Ekstrand gave a brief update on both projects.
b. Update on the RSI Recycling Project
i. Staff had given the update under commission presentations.
11. ADJOURNMENT
Chairperson Fischer adjourned the meeting at 7:40 p.m.
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Agenda Item L1
AGENDA REPORT
TO: James Antonen, City Manager
FROM: Charles Ahl, Assistant City Manager
Shann Finwall, Environmental Planner
DATE: October 3, 2012 for the October 8 City Council Meeting
SUBJECT: Response to Council Member Cardinal’s Questions Submitted at the September 24,
2012 Council Meeting
INTRODUCTION / BACKGROUND
At the September 24th City Council meeting, Council Member Cardinal submitted the following questions to be
answered on the October 8th Council Meeting. The questions and staff responses are as follows:
1. Question: Are the trash rates you have reported good for the next year or only the next 3 months?
Staff response: Sec. 30-68(c) of the City’s solid waste management ordinance states that the City’s
contract hauler shall propose new base rates each year by September 1 for the upcoming calendar
year based on the price indicators and adjustment formulas specified in the contract (CPI, and fuel).
The City shall review and may approve or disapprove the new base rates by November 1 each year.
To date, Allied Waste Services, the City’s contracted hauler, has not proposed new base rates for
2013 and therefore the base rates will remain the same until at least the end of 2013.
The contract does allow for Allied Waste Services to adjust the disposal costs based on the change in
actual tipping fees. The tipping fee is the cost charged to the contractor to dispose of trash at the
Resource Recovery Technologies facility in Newport. According to the contract, Allied would have to
notify the City as soon as the tipping fees for the next year are known, approximately in November
each year.
2. Question: You previously stated that Allied would buy new trucks and they would use bio-diesel – will
they actually use bio-diesel?
Staff response: Allied Waste Services has purchased two new automated collection trucks to service
the new residential single hauler system. The trucks run on B2 biodiesel fuels and have the latest in
technology exhaust scrubbers.
RECOMMENDATION
This is an informational item for the City Council. No action is required.
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