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RES 2023-0057 - Agmt with Jet Award Foundation & Trust for the Johnny Rodgers Foundation & Trust Scholarships - 2023 City Clerk Office Use Only: Publication Date(if appli able): 2 02 1:6-1 RESOLUTION NO. Agenda Date: I ) (/, Department: '/igt=I. Submitter: C...•v�J�� l /�e/ CITY OF OMAHA LEGISLATIVE CHAMBER Omaha, Nebraska RESOLVED BY THE CITY COUNCIL OF THE CITY OF OMAHA: WHEREAS, the Jet Award Foundation & Trust, a Nebraska non-profit corporation, has signed an agreement with the City of Omaha, which is attached hereto, to provide specified services; and, WHEREAS, pursuant to such agreement the Jet Award Foundation & Trust shall operate the Johnny Rodgers Foundation &Trust Scholarships, during the period of January 1, 2023 to December 31, 2023; and, WHEREAS, the Mayor recommends approval of the agreement in the amount of fifty thousand dollars ($50,000) to the Jet Award Foundation & Trust for financial support of such activities; and, WHEREAS, funding for the agreement is budgeted in the amount of fifty thousand dollars ($50,000) from 2022 Community Services, Keno/Lottery Proceeds Fund 12118, Organization 126086; and, WHEREAS, it is in the best interest of the citizens of the City of Omaha to approve the agreement; and, NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF OMAHA: THAT, as recommended by the Mayor, the agreement between the City of Omaha and the Jet Award Foundation & Trust in the amount of fifty thousand dollars ($50,000) to operate the Johnny Rodgers Foundation & Trust Scholarships from January 1, 2023 to December 31, 2023, and incorporated herein by this reference, and funding of such project, is hereby approved. FURTHER THAT, the Finance Director is authorized to provide payment of fifty thousand dollars ($50,000) from 2023 Community Services, Keno/Lottery Proceeds Fund 12118, Organization 126086; and in accordance with the contract terms. APPROVED A ITO FORM: )44 CITY ORNEY DATE RESOLUTION NO.'102-50051 JAN Adopted: Attest: AL DEPUTYCitY Clerk Approved: A IL— Mayor AGREEMENT ; 3 This Agreement is made and entered into this I I day of()K nu f e ;by and between the City of Omaha, a Nebraska municipal corporation (hereinafter referred to a `City") and the Jet Award Foundation & Trust, 11711 Arbor Street, Suite 300, Omaha, NE 68144 (hereinafter referred to as "Contractor"). WHEREAS, the City of Omaha, in furtherance of its statutory authority to promote public health, welfare,and safety to its citizens and residents, wishes to contract with the Contractor,as described below, to obtain the Contractor's services in the implementation of this Grant Award; and, WHERAS, the City has set-aside funding from the 2023 Community Service allocation for the implementation of this Grant Award. NOW, THEREFORE, in consideration of the mutual covenants and agreements herein contained, the City and the Contractor mutually undertake and agree as follows: I. DUTIES OF THE CONTRACTOR The Contractor agrees to do the following, along with all other obligations expressed or implied in this Agreement: A. The Contractor will provide the services and duties as stated more fully in the Jet Award Foundation&Trust 2023 Community Services Application,and any future approved budget modifications. The Contractor will operate the Johnny Rodgers Foundation&Trust Scholarships to low-income and first-generation students entering the career and technical trades programs at Metropolitan Community College(MCC). Jet Award Foundation &Trust Item Computation Cost Scholarship $2,000/scholarship x 25 scholarships $50,000 Grant Award Amount: $50,000 B. The Contractor will be responsible for all aspects of the project including day-to-day management of the Program. The identity of the chief executive of the Contractor and any changes thereof shall be provided to the City. C. The Contractor shall maintain an accounting system that accurately tracks income and expenditures associated with this Grant Award separate from other agency funds. D. The Contractor agrees to comply with the financial and administrative requirements set forth in the City of Omaha Grants Management Handbook. E. The Contractor understands and agrees that funds may be frozen if the Contractor does not respond in a timely fashion to requests to address audit findings and financial or programmatic monitoring findings. F. The Contractor shall allow the City to have access to the Contractor's records and program site for the purpose of financial and/or program audits,as may be required in the sole discretion of the City or its authorized designee. The Contractor shall retain all documents for a minimum of three years following the completion of this Grant Award. G. The Contractor will implement and enforce, as to its employees, a drug-free workplace policy substantiality similar to the City of Omaha's policy which is on file with the Human Resources Department. H. The Contractor will provide an executed W-9 Verification form. I. The Contractor is required and hereby agrees to use a federal immigration verification system to determine the work eligibility status of new employees physically performing services within the State of Nebraska. A federal immigration verification system means the electronic verification of the work authorization program authorized by the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.C. 1324a,known as the E-Verify Program, or an equivalent federal program designated by the United States Department of Homeland Security or other federal agency authorized to verify the work eligibility status of a newly hired employee. If the Contractor is an individual or sole proprietorship, the following applies: 1. The Contractor must complete the United States Citizenship Attestation Form, available on the Department of Administrative Services website at www.das.state.ne.us. 2. If the Contractor indicates on such attestation form that he or she is a qualified alien,the Contractor agrees to provide the US Citizenship and Immigration Services documentation required to verify the Contractor's lawful presence in the United States using the Systematic Alien Verification for Entitlements (SAVE)Program. 3. The Contractor understands and agrees that lawful presence in the United States is required and the Contractor may be disqualified or the contract terminated if such lawful presence cannot be verified as required by Neb. Rev. Stat. §4-108. J. The Contractor must ensure that all individuals coming into contact with minors are suitable, as defined by the Grant Award Special Condition(included herein)prior to interaction with participating minors. This requirement applies regardless of an individual's employment. The Contractor may not permit any covered individual to interact with any participating minor in the course of activities under the award,unless the Contractor has made written determination of the suitability of that individual to interact with participating minors as outlined in the Grant Award Special Condition. - 2 - II. TERM This Agreement shall become effective on January 1, 2023 and shall terminate on December 31, 2023. Either party may immediately terminate this Agreement upon mailing prior written notice thereof to the other party;provided,that in the event of such early te,iiilnation,the Contractor shall immediately return to the City all unexpended funds advanced to the Contractor under this Grant Award. In the event the Contractor requires an extension to the terms of this Grant Award, requests must be submitted in writing to the City's Grant Manager no later than 45 days prior to the end of the Award term. In the event of an extension approval, the Agreement shall automatically be extended to the end of the approved extension. III. COMPENSATION The City shall compensate the Contractor in an amount not to exceed, under any circumstances, $50,000 ("Maximum Compensation"). Following the execution of this Agreement, the Contractor must submit quarterly reimbursement requests by the due by dates outlined under IV. Reporting Requirements. Quarterly Reimbursement Requests must detail funds expended during the quarter, along with clear, concise, and detailed backup documentation supporting all expenses. Quarterly Reimbursement Requests are required even if no funds were expended during the time period. All requests for reimbursement shall be submitted electronically to the City of Omaha, Mayor's Office, Grant Manager. Originals shall be retained in the Contractors records and made available upon request for audit purposes. Any tangible equipment purchased by the Contractor with funds pursuant to this Agreement shall be the property of the Contractor. IV. REPORTING REQUIREMENTS The Contractor shall comply with all reporting, data collection and evaluation requirements, as prescribed below and as outlined in the City of Omaha Grants Management Handbook. All reports for reimbursement shall be submitted electronically to the City of Omaha, Mayor's Office, Grant Manager. Originals shall be retained in the Contractors records and made available upon request for audit purposes. A. Quarterly Report Filing Schedule: Programmatic performance reports, and fiscal expense and reimbursement requests are due quarterly as identified below during the term of this Grant Award. B. Close Out Reporting: Grant Awards will only be closed out once all final documentation has been received from the Contractor and approved by the City. Final programmatic performance reports, - 3 - and fiscal expense and reimbursement requests are due by the deadline identified below. Reporting Schedule Reporting Programmatic Report &Fiscal Reimbursement Request Period Due by Date Delinquent After January—March 4/30/23 4/30/23 April—June 7/30/23 7/30/23 July— September 10/30/23 10/30/23 October—December 1/30/24 1/30/24 Final Close Out C. Grant Award Adjustment: Grant Award funds must be used for the purposes identified in the Contractor's 2023 Community Services Application. The Contractor shall not undertake any work or activities that are not described in the Application, and that uses staff, equipment, or other goods or services paid for with Grant Award funds,without prior written approval from the City's Grant Manager. The Contractor must submit an adjustment request to the City when any of the following will occur: the focus of the Contractor's funded Project changes; there is a change in the start or end date of the funded project; a new project director or fiscal officer is assigned to the Project by the Contractor; or a budget modification is requested by the Contractor to transfer dollars between budget line items. No budget revisions are to be made by the Contractor without prior written approval from the City's Grant Manager. V. INDEMNITY To the extent allowed by law,the Contractor covenants and agrees to indemnify and hold harmless the City of Omaha, their officers, agents and employees, their successors and assigns, individually or collectively, from and against all liability for any fines, claims, suits, demands, actions or causes of action of any kind and nature asserted by the Contractor or by anyone else,for personal injury or death,or property damage in any way arising out of or resulting from the acts of the Contractor's employees or agents pursuant to this Agreement, and the Contractor further agrees to pay all expenses in defending against any claims made against the city of Omaha provided, however, that the Contractor shall not be liable for any injury, damage or loss occasioned by the sole negligence or willful misconduct of the City,its agents or employees. The Contractor, and the City of Omaha shall give prompt and timely written notice of any claim made or suit instituted which, in any way, directly or indirectly, contingently or otherwise, affects or might affect the other parties. VI. EQUAL EMPLOYMENT OPPORTUNITY CLAUSE During the performance of this contract, the contractor agrees as follows: - 4 - 1. The Contractor shall not discriminate against any employee applicant for employment because of race, religion, color, sex, age, sexual orientation, gender identity, disability or national origin. The Contractor shall ensure that applicants are employed and that employees are treated during employment without regard to their race, religion, color, sex, age, sexual orientation, gender identity, disability or national origin. As used herein, the word "treated" shall mean and include, without limitation, the following: recruited, whether by advertising or by other means; compensated; selected for training, including apprenticeship;promoted;upgraded;demoted;downgraded;transferred;laid off;and terminated. The Contractor agrees to and shall post in conspicuous places, available to employees and applicants for employment, notices to be provided by the contracting officers setting forth the provisions of this nondiscrimination clause. 2. The Contractor shall, in all solicitations or advertisements for employees placed by or on behalf of the Contractor, state that all qualified applicants will receive consideration for employment without regard to race, religion, color, sex, sexual orientation, gender identity or national origin, age, disability. 3. The Contractor shall send to each representative of workers with which he has a collective bargaining agreement or other contract or understanding a notice advising the labor union or worker's representative of the Contractor's commitments under the equal employment opportunity clause of the City and shall post copies of the notice in conspicuous places available to employees and applicants for employment. 4. The Contractor shall furnish to the Human Rights and Relations Director all federal forms containing the information and reports required by the Federal Government for federal contracts under federal rules and regulations, including the information required by section 10-192 to 10-194, inclusive, and shall permit reasonable access to his records. Records accessible to the Human Rights and Relations Director shall be those which are related to paragraphs (1) through (7) of this subsection and only after reasonable notice is given the contractor. The purpose of this provision is to provide for investigation to ascertain compliance with the program provided for herein. 5. The Contractor shall take such actions with respect to any subcontractor as the City may direct as a means of enforcing the provisions of paragraphs (1)through(7) herein, including penalties and sanctions for noncompliance; however, in the event the Contractor becomes involved in or is threatened with litigation as the result of such directions by the City, the City will enter into such litigation as is necessary to protect the interests of the City and to effectuate these provisions of this division; and in the case of contracts receiving federal assistance, the Contractor or the City may request the United States to enter into such litigation to protect the interests of the United States. 6. The Contractor shall file and shall cause his subcontractors, if any to file compliance reports with the Contractor in the same form and to the same extent as required by the Federal Government for federal contracts under federal rules and regulations. Such compliance reports shall be filed with the Human Rights and Relations Director. Compliance reports filed at such times as directed shall contain information as to the employment practices, policies, programs and statistics of the Contractor and his subcontractors. - 5 - 7. The Contractor shall include the provisions of paragraphs (1) through (7) of this section, "Equal employment opportunity clause," and section 10-193 in every subcontract or purchase order so that such provisions will be binding upon each subcontractor or vendor. VII. DEBARMENT OR SUSPENSION BY ANY FEDERAL AGENCY Office of Management and Budget (OMB) guidelines require that any individual or entity that has been placed on the Excluded Parties List System(EPLS -available for review through www.sam.gov)may not be a participant in a Federal Agency transaction that is a covered transaction or act as a principal of a person participating in one of those covered transactions. These guidelines apply to covered transactions under a grant award from any Federal agency for which a recipient expects to receive reimbursement for expenditures incurred or an advance on future expenditures. The Contractor providing goods and/or services to the City of Omaha,by acceptance and execution of this Agreement agrees, that neither it nor its principals is presently debarred, suspended, proposed for debarment,declared ineligible,or voluntarily excluded from participation in this transaction by any Federal department or agency. Contractor further agrees,by accepting and executing this Grant Award,that it will include this clause without modification in all lower tier transactions, solicitations, proposals, contracts, and subcontracts. Where the Contractor or any lower tier participant is unable to certify this statement, it shall attach an explanation to this Agreement. VIII. INDEPENDENT CONTRACTOR It is understood and agreed by and between the parties that any and all acts that the Contractor or its employees, agents, contractors or servants perform pursuant to the terms of this Agreement shall be undertaken as independent contractors and not as employees of the City. Neither Contractor nor any of its employees or agents shall be construed to be the employee or agent of the City for any purpose whatsoever. Contractor shall not be entitled to any benefits of the City. The City shall not provide any insurance coverage to the Contractor or its respective employees including,but not limited to workers' compensation insurance. Contractor and the City shall each pay all wages, salaries and other amounts due to its respective employees and shall be responsible for all reports, obligations, and payments pertaining to social security taxation, income tax withholding, workers' compensation, unemployment compensation, group insurance coverage,collective bargaining agreements or any other such similar matters. Contractor shall have no authority to bind the City or by or with any contract or agreement, nor to impose any liability upon the City. All acts and contracts of the Contractor shall be in its own name and not in the name of the City, unless otherwise provided herein. - 6 - IX. CAPTIONS Captions used in this contract are for convenience and are not used in the construction of this contract. X. APPLICABLE LAW Parties to this contract shall conform to all existing and applicable city ordinances,resolutions,state laws, federal laws, and all existing and applicable rules and regulations. Nebraska law will govern the terms and the performance under this contract. XI. CONFLICT OF INTEREST A. No elected official nor any officer or employee of the City shall, during their tenure and one year thereafter, have a financial interest, direct or indirect, in this Grant Award or in any funds transferred hereunder. Any violation of this section shall render the Agreement voidable by the City or the Contractor. B. The Contractor covenants that it presently has no interest and shall not acquire any interest, direct or indirect, which would conflict with the performance required to be performed under this Agreement; it further covenants that, in the performance of this Grant Award, no person having any such interest shall be employed. XII. WARRANTY AS TO COMMISSIONS The Contractor warrants that it has not employed any person to solicit or secure the Agreement upon any agreement for commission, percentage,brokerage, or contingent fee. XIII. MERGER This Agreement shall not be merged into any other oral or written contract, lease or deed of any type. This is the complete and full agreement of the parties. - 7 - XIV. MODIFICATION This Agreement contains the entire agreement of the parties. No representations were made or relied upon by either party other than those that are expressly set forth herein. No agent, employee or other representative of either party is empowered to alter any of the terms hereof unless done in writing and signed by an authorized officer of the respective parties. XV. ASSIGNMENT Neither party may assign its rights under this Agreement without the express prior written consent of the other party. XVI. CONTRACT DOCUMENTS The Contractor is responsible for review of and compliance with each of the terms of this Grant Award. The parties agree that this Agreement shall include, as if fully set forth herein, the contractor's 2023 Community Services Application; FFATA Reporting Form; and Audit Certification which are attached hereto. - 8 - XVII. AUTHORIZED REPRESENTATIVE In further consideration of the mutual covenants herein contained, the parties hereto expressly agree that for purposes of notice, including legal service of process, during the term of this Agreement and for the period of any applicable statute of limitations thereafter, the following named individuals shall be the authorized representatives of the parties: (a) CITY OF OMAHA Jean Stothert,Mayor Office of the Mayor 1819 Farnam Street, Suite 300 Omaha,Nebraska 68183 Contact: Amber Parker, Grant Manager Phone: (402)444-5211 (b) CONTRACTOR Jet Award Foundation&Trust Johnny Rodgers, Executive Director 11711 Arbor Street, Suite 300 Omaha,Nebraska 68144 Phone: (402) 306-0291 EXECUTED this ) day of n tit 3 CITY OF OMAHA,NEBRASKA JET A FO ATION Jean Stothert,Mayor Dat Johnn Rodg , Exe utiv 'rector Date ATTEST: 404' 19 ill w, E_��abdli Bull 'Citytit ate ►61; T Y APPROVE AS TO FORM: r— it/e72-bc,2_'(- Assistant City Attorney Date - 9 - r:\\H ,' '',., AUDIT CERTIFICATION Grantee Name: - I HP.. Jr A wig i-lb Feu/✓4SR77ot) 47-R, i Grantee Address: )►7ii A RQo.t S;., / �MilNfl, fi �r5/y.Contact Name and Title: ,1),Lh5 n.b r7Ky Vice. P, ,, _//7- ; Phone#: yt;l—3;6-1-/_33 Fiscal Period End Grant#(s): i I Tax iD r: 9J-?.23v/7 g I Date: 1a./31 iFor fiscal years beginning on or after December 26,2014.If you are a non-Federal entity that expended$750,000 or more in • Federal funds(from all sources including pass-through subawards)in your organization's fiscal year(12-month turnaround reporting period),then you are required to arrange for a single organization-wide audit conducted in accordance with the provisions of Title 2 C.F.R.Subpart F(,5 200.500 et sect.) • For fiscal years beginning before December 26,2014.if you arc a non-Federal entity(other than a for-proftrcommercial entity) Ithat expended$500,000 or more in Federal funds(from all sources including pass-through subawards)in your organization's fiscal i year(12-month turnaround reporting period),then you are required to arrange for a single organization-wide audit conducted in accordance with the provisions of Office of Management and Budget(OMB)Circular A-133 Compliance Supplement 2014. j If you are a non-Federal entity that expended less than the applicable audit threshold a year in Federal awards,you are exempt from Federal audit requirements for that year.However,you must keep records that are available for review or audit by appropriate I officials including the Federal agency,pass-through entity,and U.S.Government Accountability Office(GAO). Please complete the appropriate section below and submit the completed and signed form and required documentation within 60 days after the end of your fiscal year to: Grant Administrator.City of Omaha Office of the Mayor 1819 Farnam Street. Suite 300,Omaha.Nebraska 68 1 8 3-0300 Section A:Organization subject to the requirements of OMB Circular.A-133 Please check one of the following and provide all appropriate documents: I hereby certify that for the fiscal year ended (date): 1.The auditor's report on financial data states that the audited information is fairly stated in all material respects; and 2. l'he administration of our federal projects has been audited in accordance with OMB Circular A-133 and there were • no material instances of noncompliance with federal laws and regulations or reportable conditions;and 3.There were no findings of noncompliance in the audit report that are specifically related to the subrecipient award(s);and 4 4. Management has addressed the resolution of previous-year findings from prior audit reports if related to the subrecipient award(s). Auditor's report filed on (date). Enclosed is a copy of the audit report. • • We have completed our OMB Circular A-133 audit for the fiscal year ended (date),and material noncompliance • issues and/or reportable conditions were noted. Enclosed is a copy of the audit report and our response. We have not completed our OMB Circular A-133 audit for the fiscal year ended (date). • We expect the audit to be completed by (date). Within thirty(30)days of completion of the A-133 audit we will • provide a new Audit Certification along with the audit report and response(if applicable). • • • • 10/(11/15 City of Omaha.Nebraska Page I of Policies K Procedures Supporting,Documentation—Audit Certification Section B:Organization subject to the requirements of Uniform Guidance: Title 2 C.F.R.200 Subpart F Please check one of the following and provide all appropriate documents: I hereby certify that for the fiscal year ended (date): 1.The auditor's report on financial data states that the audited information is fairly stated in all material respects;and 2.The administration of our federal projects has been audited in accordance with the Uniform Guidance:Title 2 C.F.R 200 Subpart F and there were no material instances of noncom pliance with federal laws and regulations or reportable conditions;and 3.There were no findings of noncompliance in the audit report that are specifically related to the subrecipient award(s);and 4. Management has addressed the resolution of previous-year findings from prior audit reports if related to the subrecipient award(s). Auditor's report filed on (date). Enclosed is a copy of the audit report. We have completed our A-133 audit for the fiscal year ended (date),and material noncompliance issues and/or reportable conditions were noted.Enclosed is a copy of the audit report and our response. We have not completed our A-133 audit for the fiscal year ended (date). • We expect the audit to be completed by (date). Within thirty(30)days of completion of the A-I33 audit we will provide a new Audit Certification along with the audit report and response(if applicable). Section C:Organization NOT subject to the requirements of OMB Circular A-133 or Title 2 C.ER. 200 Subpart F Our organization is not subject to the requirements of OMB Circular A-133 or Title 2 C.F.R. Subpart F because we(please check one of the following): Did not expend above the minimum threshold in federal funds during the fiscal year(complete federal funds expenditure chart below). Are a for-profit organization. Are exempt for other reasons(explain): Federal Grantor Pass-through Grantor Program Name CFDA Number Expenditures • • Total Federal Expenditures.fin.this Fiscal Year 6Cf/ • �G} Failure to st nit this or a similar statement,or failure to submit a completed single audit package as required by the • required d c ate may result in suspe ion of funding and may affect eligibility for future funding. • • /15/61 • Uri737- 64;z • Autiot•ized Signature Printed Name Title • • 10/01/15 City of Omaha.Nebraska Page 2 of Policies&Procedures Supporting Documentation—audit Certification -,•'-'-:;:'ZiN City of Omaha Federal Funding Accountability and Transparency Act (FFATA) Reporting Form Business/Agency Information Legal Name Physical Address Address I 17)i R AZ01, ST kf-Br i Om,CI H fi, ivls: 10 s'ii-/y 1 Mailing Address " City. State i j!--.• I Zipcode C9.1,}A,14,q Congressional District / Business/Agency Data Universal Numbering System (DUNS)Number Iii)yei Business/Agency Annual Gross Revenue from Prior Fiscal Year Exceed 80% or 6N—o7 More in Federal Funds Yes / Business/Agency ---,- Annual Gross Revenue from Prior Fiscal Year Equal or Exceed ' . $25 million in Federal Funds , Yes 1\ro.. ,. . -7.-2'.',:r.'...)' •,:,,, ,-,, --,,------: f-_,,- i-.:',.;-:'..-.....,'.--,-..,3 -:',::,,:',,,-,-- bc)---y., ')',-..:, -', :-.-.;7- (---.1,:c.---; -,T-_17-7 T7-1:-_- _I:CALI-7) ,...:',a Business/Agency's Five(5)Highest Compensated Officers Only complete if'YES'was selected for both annual gross revenue boxes. Name Compensation 1--- . .. , . . . . . ,-. , . .; ,-..,.:. • - - ..... - Comments: ,• •Signature of Authorized Official • - Date ! //-30--,.2.2_[Typed/Printed Name I 11/30/15 cit, or Omaha.Nebraska Page 1 01.2 ' Federal Financial Act Transparency Form Typed/Printed Title ti ce Prat Ci0i11-7T/ C) Typed/Printed Email f l 67:,ail.c.G•,Yi -_ - -- --- �i✓enn�, percv M0_r)c�s-c�c:t�-c��s -� • 11/30,15 City of Omaha,Nebraska Page 2 of 2 Federal Financial Act Transparency Form Form Ww9 Request for Taxpayer (Rev.October 201t3) identification Number and Certification 'u Form to the Department of theTreaswy requuestth Do not Internal Revenue&rvi,e le Go to svwvelm gov/FotrnW9 for Ineenzetlens and the latest Information. send tO B IRS. Internal 1 Name(aa shown on your income fax return).Nacre Is required on this lbw do not team this line blank THE JET AWARD FOUNDATION&TRUST 2 Business m eneldlsagarried entity name,If different thorn above 0, 3 Gf g pr en phiate her for federal hoc ciasificalon of the person whose nave ix Exemptions on fine 1.Check only one of the 4 Exem (codes apply only to '' s. ce Instructions ortain a not haividuais;see ❑ proprietor or ❑ c Corporation s Corporation ❑ partnership ❑rrustrestate °3)' ;single-member tle c Exempt payee code Cif any) ��`"T ❑ United GabBty company.Enter the tax d for the tax( corporation,&S co/potation,Pptne I.o z Note:Check the appropriate box inter l!C c� man of the starmember miner. Do not check Exemption from FATCA reporting 11C if the U.0 Is classified as a sir dfdegarded from the owner unless the owner of the t_t-G Is R.E o another ll,-C that is not ceded tom the owner for U.S federal tax purposes.Otherwise,a code o is dlsr�rderi from the owner ahead check the appropriate box for the tax dxs t rlon of It wmneer mher t1C that Ig eo7+3 n, El other(see Instructions)► 501(C)(3)-PUBLIC CHARITY 4►>emea�es eotriweuteusi rD 6 Address(number,meet,and apt.or suite no)See instructions. Requester's name end address(optional} Ift 11711 Arbor St,Suite 240 ea 6 tits,state,and 71P code Omaha,NE 68144 4 7 list account mothers)hem(optima) Part I Taxpayer Identification Number(TIN) Enter your TIN In the appropriate cial The TIN provided must match the name given on line 1 to avoid I so srarxnttynumber backup withholding.For individuals,this is generally your social security number(SSN).However,for a resident after),sole proprietor,or disregarded entity,see the Instructions for Part 1,later.For other entitles it le_yert employer identification number(tIN).If you do not have a number see How to get a 71N,later.- or -dote:lithe account is in mom than one name,see the instructions for fate 1.Also see What Name and J Employer Identification number'Number To Give the Requester for guidelines on whose number to enter. ( 8 1 -I2121-r 810I119181 Part II Certification 1 !! II Under penalties of perjury,I certify that 1.The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me);and 2.1 am not subject to backup withholding because:(a)I am exempt from backup withholding,or(lj I have not been notified by the Internal Revenue Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that!am no longer subject to backup witthhokifng;and a.I am a U.S.citizen or other U.S.person(defined below);and 4.The FATCA code(s)entered on this form(d any)indicating that I am exempt from FATCA reporting Is correct. Certification Instructions,You must cross out item 2 above if you have bearnot fled by the IRS that you are currently subject to backup withholding because you have failed to report all lrtterest and dividends on your tax return,.For real estate trz ons Item 2 does not acquisition or abandonment of secured property,cancellation of debt,contn'butiuns to an individual retirement Apply.For mo).andaneinterestecal,pa other than interest and d vi ou are not required to sign the non,hart you must provide arrangement S emt _and o dY paYmeer. Y��t TIN.See the instructions for Part II,[star. of Here liSign I sperson► Date► 1 General instru ins 1099-DIV(dividends,Including those from stocks or mutual • Section references are to the Internal Revenue Code unless otherwise noted. •Form 1099-MISC(various types of Income,prizes awards,or gross proceeds) Future developments.Far the latest Information about developments related to Farm W-9 and Its Instructions,such as legislation enacted= •> Form 1099�B{stoke[or mutual fund sales and certain other . after they were published,go to www.irs.gov/ForeiVeatr sactlans by brokers) •Form 1099 8(proceeds from real estate transactions) Purpose of Form -Form 1099-K(merchant card and third party network transactions) An intRvedual or entity(Feted W-9 requester)who is required to fife an •Form 1098(home mortgage interest),1098-E(student loan interest). information return with the IRS rust obtain your correct taxpayer - 1098-T(tuition) identification number(TIN)which may be yoursoclal security number •Farm 1099-C(canceled debt) (SSN),Individual taxpayer ideth'flcatkeh number(ITIN),adoption taxpayer Identification number(A11N),or employer identification number •Font 1099-A(acquisition or abandonment of secured properly) (EIN),to report on an information return the amount paid to you,or other Use Form W-9 only If you are a U.S_person(including a resident amount reportable on an Information return_Examples of information alien),to provide your correct TIN. returns include,but are not limited to,the following. #you do not return Form P1-9 to the requester will,a 11N,you might •Form 1099-TNT(interest earned or paid) be subject to badwwp withholding.See What is backup withholding, Wen Oat No.10231x Form W-9(fiev.10-2018) 2023 Community Services Program Grant Application Cover Sheet ORGANIZATION CONTACT INFORMATION Organization Name Jet Award Foundation and Trust Program Name: Johnny Rodgers Foundation and Trust Address 1711 Arbor St. Suite 300 City Omaha State NE Zip 68144 Head of Organization Mr. Johnny Rodgers Phone: 402-306-0291 Email info a,thejetaward.com Primary Contact Person Mr. Denny Drake Phone: 402-306-4332 Email Denny.perfonnancesolutions@gmail.com Financial Point of Contact Mr. Denny Drake Phone: 402-306-4332 Email Denny.perfonnancesolutions@gmail.corn Is the organization an IRS 501(c)(3) not-for-profit? X Yes ❑ No If no, is your organization a public agency/unit of government? n Yes ❑ No Employer Identification Number(EIN): 81-2280198 EXECUTIVE SUMMARY Briefly state the need or issue addressed by the request. State the purpose of this funding request, including information about the population served and geographic area(s) that will benefit from this proposal. The Jet Award's mission is to raise funds to provide scholarships opportunities to individuals that would otherwise not have that educational opportunity. The Jet Award Foundation & Trust Scholarships are matched by Metropolitan Community College and assist low-income and first-generation students entering the career and technical trades programs at Metropolitan Community College (MCC). Funding from the 2023 Community Services Program Grant will allow more scholarships to be awarded to deserving students. Community Service funds are being requested for: ❑ A new program within the organization X Expansion of an established program ❑ Continuation of a public service provision BUDGET OVERVIEW Total grant funding requested: $50,000 Annual cost of the program: $475,000 Annual organization budget: $900,000 2/03/22 City of Omaha—2023 Community Services Program Page 1 of 2 Grant Cover Sheet&Application 03 } , = . - la { � 3 65 \ /411 ` rb ` 2 z n. - o 0 3 2 a co co 3co = � � ® P n \ } o C2 g Wl \ § I co o. ` \ ( 0 Z \ 7 : R, % \ ° S 104 ? k Cr ƒ n. k / ) \ m « ƒ 0 -, ) w co ID , 0 m - z — > - \ � � a \ _ < lb q \ ] {f $ \ 0 ) k 0 n • St / o Ca \ J \ - • cu 3 , a o / i } R o q { g \ / 2 1 / o in. 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