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Home My WebLink AboutCOM 0667.003 1998-2000 HAWAII COUNTY NONPROFIT GRANTS FY (2000-2001) Program Title: Residential and Support Services; Ka Home Pulama, Domiciliary Home THE ARC OF HILO 1099 Waianuenue Avenue Comm. No, 667 003 Hilo, Hawaii 96720 Ftile No. !4-f~M Ref. To: t~SE6G Ref. Date_fE8 2 3 ~nnn JHSV OG ~4b Stephen K. Yamashiro V6;. A Harry A- Takahashi .Mayor ::I Uircrtv , mr~p;, ,.,.r j S. K. Schulte ~rE •o P~/ De u! OF H 'P y ~nur~tp of ~ab~aii DEPARTMENT OF FINANCE 'S ~4u ouni Sheet Room lle Hilo, Hawaii 967?0-i?5? ~ti081 °b L9'_3A . Fax (80819618238 HAWAII COUNTY NONPKOFIT GRANTS (FY 2000-01) HUMAN SERVICES NONPROFIT GRANTS REVIEW COMMITTEE (HSNPGRC) FISCAL YEAR ENDING:June 30, 2001 DATE OF APPLICATION: J a n u a r y 2 9, 2 0 0 0 GRANT APPLICATION FOR: Rssidential & Support Services; Ka Home Pulama (Program l'iue) Domiciliary Home Legal Name of Organization: THE ARC O F H I L C Mailing Address: 1C99 Waianuenue Avenue Hilc, Hawaii 96720 Facility/Site Address: 139 Anau Raad Hilo, Hawaii 96720 Director/Site Manager: Phone: Organization President Robert E. Cooper, Executive Phone: (800) 935-8534 Director Contact Person (Grant Writer) R o b e r t E. C o o p e r Phone: (B 0 8) 9 3 5- 8 5 3 4 Amount of request for County funds: $ 7 8 . 8 7 4 , 0 0 Total annual budget of organization: $ 4 8 4, 9 8 9. O D Has the applicant applied for any other funds from the County of Hawaii this fiscal ye.tr? Yes Source/Department: ~ No Agency/Program(s): ~ Social Services ~ Youth Programs Elderly Programs Check Category (ies) ~ Culture and Arts ~ Education 6 Other Housing for persons with mental retardation (MR) and/or developmental disabilities (DD) Brien ,define the program for which funding is being requested: This Department of Health licensed Domiciliary Home provides supported living options for persons with MR and/or DD, Each individual receives basic living skills care, positive behavior support, education and training t? prevent institutionalization and also allows them to remain in their ?wn community. 1 I. QUALIFYING STANDARDS FOR APPLICANTS An applicant must meet all of the following standards: Be chartered or otherwise authorized to do business in the State for charitable purposes and ~~!t exempted from the Federal income tax by the In[emal revenue Service. VY Have a governing board whose members serve without compensation and have no conflict of interest between their regular occupations and the services provided. Have bylaws or policies which describe the manner in which business is conducted, including management, audit, fiscal policies and procedures, policies on nepotism, and policies on ' !t management of potential conflict of interest. W Have at least one year's experience with the service or activity for which the appropriation is sought or can othetwise demonstrate to the satisfaction of the County sufficient expertise to ' `!t successfully carry out the service or activity. xN Be licensed and accredited in accordance with applicable requirements of Federal, State and County taws. II. GRANT CONDITIONS The applicant agrees [o comply with the following terms & conditions prior to receiving a gran[ award. A. Comply with applicable Federal and State laws prohibiting discrimination against any person on [he basis of race, color, national origin, religion, creed, sex, age, or handicap. B. Agree not to use any public funds for purposes of entertainment or perquisites. C. Comply with such other requirements as the Director of Finance may prescribe to ensure adherence by the nonprofit organization with Federal, State, and County laws, and established standards for fiscal and program management. D. Allow the Director of Finance, the committees of the council and their staffs, and the Legislative Auditor access to records, reports, files, and other related documents m order that the program, management, and fiscal practices of the nonprofit organization may be monitored and evaluated to assure the proper and effective expenditure of public funds. III. RECORDS AND REPORTS A. The applicant shall follow generally accepted accounting procedures and practices and shall maintain books, records, documents, and other evidence, which sufficiently and properly account for the expenditure of County funds. The books, records and documents shall be subject at all reasonable times to inspection, reviews, or audits by the County expending agency, [he Director of Finance, and the Legislative Auditor, or by their representatives. B. The County expending agency, Director of Finance, or County Council may request periodic written reports on the use of County funds. C. The nonprofit organization shall submit a final written report to the Legislative Auditor within sixty (60) days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant and a listing of other funding sources and amounts obtained during the award period. 2 N, QUARTERLY ALLOCATION Under no circumstances shall grant funds be disbursed in a lump sum payment. Grant funds will be disbursed [o Grantees only through a quarterly allocation process. The disbursement of grant funds can be formulated on an equal quarterly apportionment basis. V. GRIEVANCE PROCEDURE The applicant will adopt and maintain a grievance procedure to assure proper accounting for any corcems and complaints about its programs or services that may arise from its members, employees, clients or from other members of the public. VI. DISCLOSURE OF INFORMATION All information, data, or any other material provided to the County by virtue of this application shall be subject to the Uniform Information Practices Act (UIPA), ch. 92 F, Hawaii Revised Statutes. All such material is deemed government record and shall be open to the public and may be provided to other public and,'or private funding sources. VII. CONTINUED ELIGIBILITY Any applicant or recipient who withholds or omits any material facts or deliberately misrepresents such facts to the County of Hawaii shall: I) Immediately be disqualified from consideration for NonproEt Grant funding; OR Z) be in violation of the terms of the Grant Agreement of County funds in which case a grant agreement can be terminated by the County and the recipient or provider may be liable to reimburse all or a portion of any funds received therein. VIII. ACI{NOWLEDGMENT THE ARC OF HILO (Legal Name of Organization) Residential &5upport Services hereby agrees to administer the Ka Home Pulama, Domiciliary Hnme (Program Title) in accordance with the regulations, policies and procedures prescribed by the Hawaii County Finance Department. Distribution of grant funds is limited to grantees, which are in compliance with County regulations, policies and procedures. The County reserves the right to withhold Brant distributions at any time the grantee is not in compliance. It is the policy of the County of Hawaii and far those who do business with the County to provide equal employment opportunities to all persons regardless of race, physical disabilities, color, religion, sex, age, or national origin as mandated by the Federal Civil Righu Acts, as amended, and any other federal or state Laws relating to equal employment opportunities. IX. AMENDMENTS TO THE APPLICATION/EVALUATION The applicant assures that it will submit to the HSNPGRC for prior review and approval, a written request and justification for any changes, additions, or deletions to any pottion(s) of the grant application or a duly executed Grant Agreement of County Funds. The applicant will cooperate and assist in any effort • undertaken by the HSNPGRC to evaluate, inspect or otherwise monitor the effectiveness, feasibility, and/or cos[ ef£ciency of any and all practices, policies and procedures or activities pursuant to this application or any gran[ designation or allocation received as a result of this application. ' X. AUTHORITY AND CAPACITY OF APPLICANT The applicant certifies that it has the authority and capacity to develop and submit this application, and to fully administer the program(s) pursuant to this application. UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! ~J~~~ ~ i~3~ l~ Signature of PresidendChairperson/W . H~ 0 R A C E F A R R Date d~~~/a ~ 3 00 Signature of Executive DirectodManaser ROBERT E COOPER to 4 A. OVERVIEW 1. Describe the Program for which funding is being requested. Funding will provide housing for five individuals with mental retardation and/or developmental disabilities who are medically fragile and have challenging behaviors. The home is a licensed Department of Health, Developmental Disabilities Division (DOH-DDD) Domiciliary Home. The home receives no funding from the DOH-DDD and all staffing and administration costs come from each tenant's Social Security Insurance, Level of Care payments which do not cover the total required staffing and administration costs of the program. Level of Care payments pay for each tenant's rent, utilities, clothing, food, recreation, leisure activities, transportation and other survival needs. 2. What unique or significant service will be provided? The facility provides a natural, community-based home for our tenants and prevents them from being institutionalized. Our agency's mission is to improve the quality of life for persons with mental retardation and/or developmental disabilities (MR/DD), which includes their right to live, work and play in the least restrictive, individually appropriate environment, in the community of their choice, (all of our tenants have lived in East Hawaii most of their lives). Our specific objectives are to increase mobility (walking or being able to ride the bus, depending on each person's condition); making choices; use of leisure time; self care; communication training; social skills; home management; long term supported employment; etc. We also provide positive behavioral support training to those individuals that have challenging behaviors that have acting out behaviors, and those that may cause harm to themselves or others in the community. We also coordinate all special needs for our tenants, i.e., doctor and dentist appointments, special diets, and etc., to maintain the optimum health of each of our tenants. 3. What specific outcomes are to be achieved? Each tenant has an Individual Service Plan developed by the case manager at the DOH-DDD. We then meet as a team with tenant, case manager, parent/guardian, staff and other concerned parties to develop an Individual Habilitation Plan (IHP) for each client/tenant that quantifiably delineates particular domains (training, educational areas to be addressed). A task analysis for each training area is then developed and training is conducted by our Living Skills Instructors. The outcomes are to promote and enhance each person's ability to live to their fullest capacity, towards total self-sufficiency. 4. How will the proposed program empower participants/clients to become self-sufficient and facilitate positive social change? Our program empowers our clients/tenants toward self-sufficiency by living in a natural home setting, in our community, which allows them to participate in the community as active members rather than in an institutional setting. Each tenant has an IHP, which they help create, to overcome deficit areas, so they can fully participate in our community. The IHPs are programs that educate and 1 train our folks in areas that they need assistance in and to increase their self- sufficiency, which in turn facilitates positive social change in each tenant and in turn positively impacts our community. We work with them in many areas, some twenty areas, that enhance their abilities to participate in our community to their fullest potential. This includes: positive behavioral training, reading, writing, cooking, shopping, Special Olympics and other leisure activities, just to name a few areas, that increase personal abilities and enhance the quality of each individual's life. B. PROBLEM/NEED 1. What is the problem/need the proposed program is designed to meet? Because of the lack of affordable housing, especially for our population, our home must continue to operate. There is a lack of foster and care homes in our community and most of the care and foster homes will not accommodate the tenants with whom we work because of their medical and behavioral problems. Also, foster and care homes do not provide habilitation and educational programs for their tenants. We are the only agency supported domiciliary home in East Hawaii and if the home is forced to close, our tenant might face reinstitutionalization, which would cost the State and County much more money to provide the same services our tenants now enjoy. 2. Who are the target population and what are their specific needs? We serve people with mental retardation and/or developmental disabilities who are referred by the Department of Health, Developmental Disabilities Division and meet specific criteria: A level of disability that occurs before the age of 22, which has a severe and chronic effect on achieving individual independence. It is recognized that the level of impairment is attributable to mental or physical impairment or a combination of impairments, which can include autism, cerebral palsy, mental retardation and other disabilities that substantially impair the functional ability of the individual in their major life activities. Their needs are individual and include some of these areas: self-care, receptive and expressive language skills, learning, mobility, self-direction, the capacity for independent living, and economic self-sufficiency. Some of our folks have medical needs, since they are medically fragile, blind or exhibiting behavioral difficulties. There is also a need for home management skills training, the use of transportation, and making choices, as documented in their IHP. 3. What is the geographical area to be served, facility and hours of operation? Because we are one of three domiciliary homes on the Big Island, (the other two are located in Kona and Mountain View, the home in Mountain View is operated by a private family), we take referrals from the entire county. We operate twenty- four hours a day, seven days a week, fifty-two weeks out of the year. Our home is located at 139 Amau Road in the Kaumana section of Hilo. C. COLLABORATION/COORDINATION 2 1. What specific measures will be taken to collaborate/coordinate with other community resources to achieve maximum program efficiency and cost effectiveness? Our home has been serving our population since 1981and we have a long history of collaboration with the community and community organizations such as: the State of Hawaii, Department of Health, Developmental Disabilities Division; Department of Human Services; Department of Transportation, in cooperation with the Federal Transit Administration for the Transportation of the Elderly and Handicapped; U.S. Department of Housing and Urban Development; East Hawaii Special Olympics; the Center for Independent Living; Hawaii County Economic Opportunity Council; State of Hawaii, Department of Adult Services; the Social Security Administration; Protection and Advocacy Agency of Hawaii; County Housing; Kona Krafts; Brantley Center; Public Nursing; Department of Health, Mental Health Division; churches and other community organizations. The DOH, DD Division, once funded group homes, such as ours, but stopped funding these operations in 1994. Our cost effectiveness is assisted by utilizing the above named organizations, with their input, assistance and monitoring, as well as internally monitoring. Also we have annual outside CPA audits and audits by the State Hospital and Medical Facilities Administration and the State DOH, DD Division. 2. How will these measures reduce or eliminate any existing duplication of services to your designated target group? Because we are the only agency serving this population, and because of our close communication with the above named organizations, we believe there is no duplication of services. In fact, we need more habilitative housing options in our community to meet the needs of our ever-growing MR/DD population. We are also in constant contact with the other domiciliary homes on the island and provide for them the DOH-DDD licensing required 40 hours of Hawaii Visions for Persons with Developmental Disabilities training. D. GOALS AND OBJECTIVES 1. What are the major goals/benchmarks of the proposed program? The goal of our agency is to improve the quality of life for people with mental retardation and/or developmental disabilities as mentioned earlier. We work in, at least, twenty varied educational domains such as: self care, receptive and expressive language, mobility, self direction, capacity for independent living, economic self sufficiency, social skills, making choices, transportation and other areas which will improve each tenants quality of life. 2. What specific objectives/action steps are planned for each goal? When a tenant is referred to our program and meets the necessary criteria for placement, an interdisciplinary team (ID Team) is set up which includes the DOH-DDD case manager, family/guardian, tenant, agency staff, nurses, physicians and other concerned parties. We assess the tenants' needs, utilizing 3 the State DOH-DDD approved pyramid scales, psychological testing and other assessment tools to determine what educational areas in which the tenant has deficits. The team and tenant then decide which areas he/she would like to work on. Alf of our tenants attend day programs where training also takes place. We then draw-up an IHP that delineates specific areas/goals to be worked on. These goals then are broken down into specific accomplishable objectives. A task analysis for each objective is taught by our Living Skills Instructor, in the home and in natural community settings. We track the progress on data sheets, case notes, quarterly reviews and are monitored by the DOH-DDD at least annually. 3. What is the time line (start and end dates) for each step? The IHP, with its goals, objectives and task analysis is put into place within thirty days of admission into the home. The programs are worked on and evaluated, at least, weekly, with quarterly reviews and as each tenant progresses, accomplishes a certain objective, a new objective is put into place with the input of staff, tenant and the ID Team. Depending on the abilities of each tenant, program objectives are met, according to their abilities. Anew IHP is drawn up each year, at a minimum, or more frequently depending on the accomplishments of each tenant. ' In summary, an IHP is drawn up upon admission, checked weekly, monthly and quarterly, and each year a new plan is implemented depending on the objectives met by the tenant that year. 4. What significant client-centered outcomes will the program achieve? Include in your answer how many participants/clients will: a) Attain at least one personal program outcome; or b) Show measurable progress towards you program goals Our program is tenant/client centered and is set up to improve the quality of life for each person to achieve self-sufficiency. Each tenant works at their own pace, on goals and objectives that will enable them to overcome personal deficits. They work on, at a minimum, five objectives in their IHP. The outcomes depend on the abilities of each tenant and they are expected to attain competence in three of the objective areas each year. Tracking of objective accomplishments is measured by task analysis, case notes, reassessments and 'real life' observational tests that measure competency. There are five tenants in the home and each has met his/her minimum goals and objectives each year. If they are unable to do so, then we re-evaluate the IHPs and draft new programs that are more appropriate to the tenant. In the past, we have had tenants accomplish their goals, so that they were able to move into less restrictive environments, including moving into our independent living apartment complex, Hale Ulu Hoi. These tenants are now self-sufficient, employed and, with very little support, are active community members. E. SERVICE DELIVERY 1. What methodology will be used in the proposed program's delivery of services? 4 The Arc of Hilo's philosophy, principles, practices and procedures regarding people with mental retardation and/or developmental disabilities are based on the recognition of individual human rights, to live, work and play in the least restrictive and individually appropriate environment, that ensures dignity and respect, choice, decision making, developing ones full potential and being a participating member of the community. Our goals are that individuals have the right to a comprehensive and integrated Individual Habilitation Program, positive behavioral supports and other services designed to maximize development and foster integration into the community. The agency ensures partnerships with individuals, families and the community and assesses needs, provides needed support and develops resources. The particulars of how these services are delivered are explained under Goals and Objectives (D) in this proposal narrative. F. EVALUATION 1. What process will be used to evaluate the program and services? The agency's innovative person•centered approach utilizes multi-component strategies that deliver educational programs and supports tailored to meet the , specific needs of our clients/tenants. Service goals and objectives are met and evaluated in the following ways: each tenant, when admitted to our program, has an IHP developed (as explained in item D, 1-4). This tenant centered plan is tailored to meet specific needs. The IHP has prioritized goals and objectives, outcomes and time lines for completion. Each tenant plan has a task analysis for each objective. Objectives are worked on each day and accomplishments are recorded on their task chart (i.e. a marking of a 5 indicates that the tenant is independent and doing the task, a 3 indicates that the tenant needs modeling, a 1, the tenant is unable to do the task, etc.). Observations are made in case notes and after a determined period of time, the task is re-evaluated. The over all plan is monitored, at least monthly, then we have quarterly assessments and an annual review with the interdisciplinary team -tenant, staff, case manager, family and other concerned parties. At this time, the IHP is reevaluated and/or a new plan developed. The administrator monitors the program with the staff and the ID Team. We are monitored by the DOH-DDD, and the DOH Hospital and Medical Facilities Branch on programs and the condition of the facility. We also survey the families and tenants of the program, on their satisfaction of the program and tenant progress annually. 2. How will this process measure the outcomes specified in Item D, 1-4? The tenants each have two charts, one covering admission documents, their habilitation program, monthly summaries, various psychological and other assessments, social service interactions, legal documents, policies and procedures, grievance procedures, client rights, and etc. The other chart is their medical chart which contains emergency medical information, physician visits (each three months for checkups, at least), nutrition regime, medical history, physicals, dental information, vision and audiological services, physician orders, progress notes, psychological assessments, psychiatric information, medical lab 5 reports, medication taken and noted, weight and vitals information. This and the IHP, recreation and leisure activities are all charted and evaluated weekly, monthly, quarterly and annually or as each tenant's needs dictate. This information is covered in Item D, 1-4 and Item F, 1. To summarize, the tenants have complete charts covering admission, legal, medical and all other necessary information to facilitate a complete and active treatment program. Goals and objectives with start and end dates are recorded in the habilitation charts and case notes and outcomes, problems/solutions recorded daily, weekly, monthly with quarterly reevaluations and annually new programs are developed. G. PROGRAM FEES 1. Does your organization charge a membership fee for service participants? No, we charge no membership fees. 2. Does the proposed program charge participants a fee for services provided by your organization? No. The funds we do receive come from each tenant's Social Security, Level of Care payments. This attempts to cover their rent, utilities, food, clothing, transportation and the staffing required by our license, to maintain each individual in the home. The money we receive does not cover the necessary staffing. At best, it covers one staff position for the year, ie, 40 hours per week, 52 weeks per year. It does not cover the other required staff member at 40 hours per week and the relief workers we need in case the primary care giver (Living Skills Instructor) becomes sick, goes on vacation, etc. H. VIABILITY 1. What is your justification or rationale for the expenditure of public funds for the proposed program? The DOH-DDD cut alt funding for group homes in 1994. There is no funding at all for our domiciliary home, except the U.S. Department of Housing and Urban Development (HUD), subsidy for rent. This amounts to the tenants paying one- third of their Social Security income for rent and HUD subsidizes the remaining amount. HUD only covers the cost for facility operation and not for the necessary and required staffing needed for our tenant's services in the home. We do receive Social Security, Level of Care payments, but this amount barely covers the cost of one staff member for the year, excluding benefits. We need two full time staff members and a relief worker just to maintain the bare requirements. 2. What are your financial and programmatic plans to sustain the proposed program beyond the upcoming fiscal year? We continue to ask the DOH-DDD for funding domiciliary homes, yet the DOH- DDD itself has undergone major funding cuts as with other state agencies. We are working with the other Associations for Retarded Citizens (ARCS) on the Federal and State levels, to educate our legislators on the need for housing options for our population and the consequences of not funding our much needed programs. 6 The ARC of Hilo does request funding from the Hawaii Island United Way each year. The amount we receive is very small. We also do fund raisers, which generate small amounts of money, but we have many programs that our agency runs, that are also need money. We continue networking with other agencies on the State and County levels, forming coalitions that focus on funding and enhancing program needs for our community. We will continue doing this in order to maintain our home and other programs. The ARC of Hilo has been providing living options in our domiciliary (we used to have three homes) and our apartment complexes since 1981. We are constantly working on other funding options to maintain our programs. I. BUDGET See attached Budget tables and other financial information. ORGANIZATION/AGENCY INFORMATION A. BOARD OF DIRECTORS 1. Has the organization's Board of Directors received formal training within the past two (2) fiscal years? Yes, see attached letter of verification 2. What are the primary role and responsibilities of you organization's Executive Director? The Executive Director's function is to serve as the Administration Officer of The ARC of Hilo. He plans, organizes, directs and coordinates all staff, programs and activities of The ARC of Hilo to assure that objectives are attained. He is the principal resource professional to the Board of Directors, association membership and the general public. The Executive Director recommends and participates in the formulation of new policies and policy revisions and is a leader in obtaining forward-looking programming and opportunity development for the developmentally disabled in our community. 3. What are the primary role and responsibilities of your organization's Board of Directors? (Clarify role of executive officers vs. general membership.) The agency's Board of Directors consists of fourteen members, nominated and then elected by our ARC general membership. The Board has four executive officers the president, vice president, secretary, and the treasurer. The president oversees board meetings and directs the Board. In his absence, the vice president takes on these duties. The treasurer receives information concerning financial matters from our Controller, who oversees financial matters. The treasurer advises and reports to the Board. The secretary records discussions that take place at the board meetings. The general membership is made up of concerned community members and they attend, at least, annual membership meetings to discuss agency concerns and elect officers. 7 The responsibilities of the board include being legally responsible for all activities of the agency and to determine agency policy in human resources, planning, finance, community relations and organizational operations. The board's president, along with the other executive officers, set up various committees, to oversee the various operations of the agency. Briefly, the board's executives and board members responsibilities include recruiting board members, hire and oversee the accountability of the Executive Director, deal with personnel policies and volunteers, review the agency's mission and philosophy, agency planning, evaluations, ensuring financial accountability, overseeing budget development, raising funds, managing and maintaining properties and investments, coordinating public relations, community cooperation, ensure the agency's programs and services, address community and client's needs, ensure that the agency's administrative systems are adequate and appropriate and legal structures are appropriate and that the agency meets all applicable legal requirements. B. PAST PERFORMANCE 1. How effective has your organization been in achieving program goals in the past two (2) fiscal years? Include the following information: A) Quantitive data on numbers served; and B) Qualitative data showing number and percent of participants achieving measurable outcomes. Our agency, during the past two fiscal years, and for many years, has met our program goals. We are licensed to serve five (5) individuals with mental retardation and/or developmental disabilities in the home. DOH-DDD licensing requirements are that we can only take referrals from the them. We continue to be licensed to serve five individuals. All of our tenants have IHPs in place and, as mentioned in the other parts of this proposal (Items D, E, and F), each plan has delineated goals and objectives. Because this program deals with a natural home living situation, it is important to mention besides programming issues, that these tenants choose to live in our home, because it is "their home". One tenant has lived there since 1983. We deal with the quality of life, which can only be measured by personal interviews, and each tenants satisfaction, which is evaluated by our monitors, and at our quarterly and annual ID meetings. Each tenant has five (5) educational and training domains to achieve progress in. Each day they participate in their training programs and their achievements are measured on their individual task analysis sheet. Because of confidentiality issues, names cannot be mentioned, but Tenant No. 1 has met 75aJo of her objectives. Tenant No. 2 has met 65~/o of her objectives. Tenant No. 3 has met 80% of his objectives and Tenant No. 4 is meeting over 55°Jo of his objectives. These percentages are averaged. C. FINANCIAL 1. Has your organization's current program operations remained the same as last year? What major program or financial changes will be incurred next year? 8 We expect the current program to continue in operation as it has this last year. We are hopeful that we will not have to change any of the programming because of financial constraints. It will all depend on funds received. 2. What is the status of your organization's major contracts or agreements for the coming year (employment agreements, office leases, primary grant revenue/supplier, etc.)? Our major contracts such as grant revenues, leases, etc., are expected to be the same or similar in the coming year. We are finding that the State programs are changing in that they want them to be funded by the monies going to the clients and allowing them to choose which providers they want. This will make us have to compete with others offering similar services. 3. How does the proposed program fit into your organization's long-range financial plan? The Ka Home Pulama Domiciliary Home program trains our clients in living skills including personal care, food preparation, shopping and transportation, and prepares them for independent living in our apartments or the community. In the future, we hope that the home can be used to provide Medicare waiver services for habilitation training, personal care and respite services, and that billings from these services can help to provide financial supports for the operation of the home. D. MONITORING 1. During the past two (2) fiscal years, what financial and/or administrative monitoring has your organization received from any and all funding sources? Please list all monitoring sources, contact names and phone numbers. Each year, we are monitored by the DOH-DDD for program compliance. The contact there is Salod Luke. Her phone number is (808) 453-6261. The DOH, Hospital and Medical Facilities Branch also monitor us for facility and program medical compliance. The contact there is Mrs. Punahele and her phone number is (808) 586-4100. The U. S. Department of Housing and Urban Development (HUD) tracks our HUD subsidies. The contact is Carol Horiuchi and her phone number is (808) 522-8185, extension 247. Our outside CPA for our annual audits report is Anne Fukuhara and her number is (808) 982-7723. E. ALCOHOL. TOBACCO. AND DRUG FREE WORKPLACE POLICIES AND INFORMATION 1. How does your organization address alcohol, tobacco, and other drug prevention information dissemination as part of your workplace and/or program environment? The ARC of Hilo has very clear policies and procedures regarding alcohol, tobacco and drug prevention. There are designated smoking areas away from where our tenants/clients gather. Along with our overall policy and procedures, information about alcohol, tobacco and drug use and their consequences are located in our employee handbook, which each employee reads and signs. Our 9 guidelines makes it clear that alcohol and illegal drug use of any type is not permitted. The organization does drug testing prior to the hiring of any employee and will do testing if an employee is suspected of using any illegal substance. There are disciplinary actions spelled out and employee assistance and counseling is offered by our agency if an employee tests positive to any illegal substance. We disseminate information about drug use in the form of memos and, as needed, provide staff meetings/training concerning the latest research regarding tobacco, alcohol and illegal drugs in our nation. 10 SUPPORTING DOCUMENTS 1. ORGANIZATION/AGENCY FLOW CHART 2. LIST OF CURRENT BOARD OF DIRECTORS 3. STAFF INFORMATION SHEET (Includes: Job descriptions and Resumes of Administrative Staff - 4. FINANCIAL QUESTIONNAIItE 5. ANNUAL FINANCIAL STATEMENTS , (Includes: Current Audit) 6. IltS FORM 990 7. INTERNAL REVENUE SERVICE (IRS) LETTER 8. LIABILITY INSURANCE CERTIFICATE 9. ARTICLES OF INCORPORATION 10. BY-LAWS Program Title: Residential and Support Services; Ka Home Pulama, Domiciliary Home ORGANIZAION/AGENCY FLOW CHART Program Title: Residential and Support Services; Ka Home Pulama, Domiciliary Home ~m~m ~'am n CAS ~ ~ cn «C ~ a~ _ incn~~ °m~QO A~~ A~ moo. ~ ~'vD o~~~o Cn~ cn HOC' tuc~DCa~- .3~ c cQ m ~ ~ to o~~ O ~ ~ ~ ~ ~ m o cn ~ ~ n ~ ~ TT ~ ~ ~ ~ W ~ < ~ Q O ~ 0 CDnQ ~p~~, y, . ~ r+ ~ cnmp~ m ~ ~ ~ ' o0 0 n ~ O ~ ~ 3= c ~ n ~ ~ ~ ~ ~ (~D o C7 y O u~oa ~v~o ocn m o m za m ~ o m~ om o ~ m , m ~ ~ 3 n o°-'o ~ C7 m ~ o ~ p n CD LIST OF CURRENT BOARD OF DIRECTORS Program Title: Residential and Support Services; Ka Home Pulama, Domiciliary Home THE ARC OFHILO BOARD OF DIRECTORS (All members of the Board of Directors are volunteers.) Board Member/Address Occupation Phone Number TERM EXP. WILLIAM HORACE FARR Data Processing Coordinator 959-0773 (H) PRESIDENT 961-8600 (1!U) 6/30 /o / 505 A Ainalako Road whfarr ote.net Hilo, Hawaii 96720 ELLEN F. AOKI Realtor 959-9098 (H) ~o/3o/O~ SECRETARY Grandparent of Disabled Adult 935-0399 (W) 1444 Mona Loop 961-2459 (F) Hilo, Hawaii 96720 eaoki(o~hgea.org PAUL ROSENDAHL Businessman 935-8223 (H) X0/30/00 TREASURER Parent of Disabled Adult 969-1763/961-3778 (W) 204 Waianuenue Avenue 961-6998 (F) Hilo, Hawaii 96720 PHRIPHR(a~INTERAC.NET NEIL BRAZIER Retired Businessman 982-6890 HCR 2 Box 6001 Parent of Disabled Adult theunioues@msn.com G/3p/o/ Keaau, Hawaii 96749 WINSTON CHING Retired Dispatcher 959-9291 (H) 26 Hanohano Street Parent of Disabled Adult cheddvnmichiko(a~aol.com /o/3o/p~ Hilo, Hawaii 96720 MIKE GLEASON Counselor 965-0622 (H) P. O. Box 1076 965-2150 (W) 6~ao~oD Pahoa, Hawaii 96778 mgleasona(~mailhost.k12.hi.us KATHY HIRAYAMA Businesswoman 934-7507 (H) 510 Kalanikoa Street 935-0933 (W) 6~3%/ Hilo, Hawaii 96720 hbeohana(a~aol.com DORIS IWAOKA Businesswoman 959-6761(H) 799 Komomala Drive Parent of Disabled Adult 967-7321 (W) r 3~%0 Hilo, Hawaii 96720 967-8429 (F) dOrpaf(Q74te. net MARSHA KAYANO Business Professor 959-9840 (H) 748 Kaiua Place Sister of Disabled Adult 974-7508/974-7327 (W) 6~3%~ Hilo, Hawaii 96720 kavanot~hawaii.edu THE ARC OFHILO BOARD OF DIRECTORS (All members of the Board of Directors are volunteers.) ANGIE MIYASHIRO Teacher 959-7619 (H) 379 Lama Street 974-4052 (W) 6/30/01 Hilo, Hawaii 96720 angle@intemac.net LOUISE NORTHWOOD Retired Businesswoman 934-0954 (H) 700 Akolea Road Hilo, Hawaii 96720 6/3°/00> LARRY TANIMOTO Businessman 885514 (H) P. O. Box 983 936-5039 (cell) 6~30/o a Kamuela, Hawaii 96743 CAREY UCHIDA Bookkeeper 935-0537 (H) 138 Kaikuono Place Parent of Disabled Adult 966-9939 (W) G ~30% / Hilo, Hawaii 96720 DENISE WALKER Businesswoman 966-6514 (H) , P. O. Box 4998 966-7481 (1IV) G/3o/off Hilo, Hawaii 96720 dwalker~aloha.net STAFF INFORMATION SHEET (INCLUDES: JOB DESCRIPTIONS AND RESUMES OF ADMII~IISTRATION STAFF) Program Title: Residential and Support Services; Ka Home Pulama, Domiciliary Home ..v - a. a.. ~ r,~ , iJ r, ~ THE ARC OF HILO Jos DESCRrnTIO~I Executive Director (Sept2mb?~, 1998) Purpose of the Position: 1ne LX?CU`Vc' D17e C`CI 1~ tl"'i2 Chlef Cperai.-Tl~ C`:: C-~", r2sUCr:clbl2 TOr OV2ra11 bL:Sin2~: ai::; pT'O>ras: :Wanda?m?nt 07 tll? pnVdt~, n0n-j,rJ_^_. _1'.,V,rS :'_Ce Or~dI• Zj2, o ~ ~ ser" _ SZdtIOn. ~'?!CDS, unJl?mcr.r= ar.4 ddminlST2T_ r^Qrdm~ i^.1.1i° 4v y - p - n k2? iTh its misslon, and in accordance oc:Th it= L'"- ~a:\~~ a_^C,~, pOll ~.e's deV210 TJ°C vV i'= bCdrN O?~_.'I-..~:Cr=. r"OV7G2_ l2dd e;'=1ii er~ar~izd-.or.-,vide ianrsn, and tare eff2cuve o2_ ~ ~vY_ - - p use cT a~ ^c~ resowces. Su~ervlses,za:~ ar,d DL:1!~: do 2TT2CUVe tedr~i. ~2VP_10ps anG m.dL'tTa1n- 3 .OL:Ild i'-=Cal OpeIatlOP, dnG ~'.ii'lGSg bd?2 TOr th2 a~enC•.'. R25pCnslble t0 ke°TJ t<r2 boar^ dbr23St Ot Ci ~di1~?S .Tl the d~BnC~% s 2.^, L7: 0I'r Lera LO ors Lu? u11dt pTOgrdmB a^-d =2":1C?5 '2_'1 all. ST3bl2 dnG r218Cdnt LO C11Znt n2°ds. Job Pespon=_ibilities: 1~2-^,JI':r~.~ ;O Tl ie bCar G, dr~d W1 t1^~1r! tl'.2 j1L1it.~-. Ot t'.2 .'SV-LaW_, p011C125 an4 DUG met, `~Y:2 '=X2C^.:t: •v? moire CTOr '_s r2sponslbl2 TO the BCa.TG :Or d-^.C !ldS COn ;in2Tt~urdT2 dUT.`lOIIV LO aCCOm x!1_1". `.~.2 GULies 32T IC rl"1 b?l0~\'. 1;1^x? Tnaa G?i2 ~at2 pOr'.70ns O_' :Ile 'e5r^,Onsib~iii-p CC. nsi=t2.^.T SOLiSId Op?rdII0r5, :'~~=th?^ 6VI`1li DrOpOrtiO ~ t . r ~ - - r~dt° du'.: ~Or.L"v iOr 1-12i* :'Gl ii ll--+.2: ;T. blit ii lit ^dy nOt r2::nG u::~h a.'1V ~OrUOr~. Oi i'llSi nor dCCCLL'Ztd blllTV TOr r2~~;lU. 1. ~2r~.. a. ?X2C'.it:'7e STaLT '.O +u?2 CCd1'C, OL :r2C`.OT: a:LG ii? C.')I'i1~1i ~2~, r2"JOI u;~~ On a?1d c ...i T2r::r?Ulig CTOgrams and ~2:': iC2~, CrOV.GLTI~ DdCKjr OLSLd LTli Cl-IIiaIlOn }Cr pC!1CV_ s2,.-r r?commending anal or assis~~ g t<'~e board ;1^ dev?loping peiic2s for the e_?cuv? and 2ccncmicai operation, cf th? ager~-y, and assun^:2 full r?spors~oilir? for imp12T-,encation of policies and pre rams. Ens-_:xe tlldt Board and committ?e members are orented to their roles and resporsibilides, are kept inYcrmed on a uIIl?ly' basis, that respect is shown for their perspediv?s, and that their time i= used productively. 3. Ens-~:r? cn-;eil-lg organizaticr.-wide s~ate,~ c and operational plz-uling with the inVCl'v2m2nL OT '~l'12 BOdrd and dpplOyUP_dte Std i:, W_"ll G1 lllCludes regLil d2 eVdlLidtlOn OT client outcomes, and the cor.~-rued quali v and rel2vanc2 of =ervic2s provided. :assume chief responsibility for public accourtabilir~ of the a~enc?, maiTlterance of agency fac~~ities, and meeting legal obLgations of the agency. Direc- all financial operations of the agency, iriciudirg budget development and moniTeri_ng, as well as adherence to accounting principles, government contrdc: mmpLanc2 and tax and other reporting re~.ur2ments. i. develop and maintain a stable, diverse funding base for the agency which employs a mix of fundi.*lg sources -government, sales and se: vice, United Way, foundation=, individuals and corporations. 7. Recruit, select, hire, train, supervise and evaluate employed staff. Authorize appointment, promotion, disdpline or release of employees. 8. Provide for optimum utilization of employees, ensuring that they are delegated appropriate responsibility and authority, that appropriate limitations of their au$ZOriry are defined, and that they are compensated cos~mensurate with their respons~ilities in keeping with a compensation plan approved by the Board. 9. Create a positive atmosphere "in house" so that staii, Board and other agenc;~ volunteers are enabi_ed to do their work iln a cooperative manner to z-ularce program and service, and that t!'~ey are provided oppor~anities for professional development anti g_pcvtl~. 10. Represent the agency to u4e 'treader commuxur~, developing and mairtair~n, gecd working relationships ovith appropriate public and private organizations. y RESUME OF ROBERT E. COOPER (Bobby) 486-B Akolea Road, Hilo, Hi 96720 Bus.Ph. (808) 961-3577 Fax (808) 961-9113 Married E-mail eleuhilo@gte.net Education: High School Punahou School 1949 College Washington State University 1 1/2 years Mech.Engineering San Jose State College BA in Business Administration 2/58 Military: United States Air Force. Four years. Discharged as a Staff Sergeant. Duties.....Senior Surgical Supervisor. Work Experience: The ARC of Hilo 1/1/00 until present Position: Executive Director Eleu Hilo, Inc. 1/1/97 until present Position: President. Started my own corporation to consult with others in various azeas. Offer services in business management to profits and non-profit corps. W.H. Shipman, Limited 1984 until 12/31/96 Position: President. Ran this private, family corporation. They are lazge land owners, involved in real estate developing and renting land to farmers. Blackfield Hawaii Corporation 1974 until 1984. Position: Senior Vice President of Development. Responsible for the development of real property from acquisition to sale, or to lease. Blackfield developed high rise condominiums, high rise office buildings, and shopping centers. Hawaii Housing Authority 1971 to 1974 Position: Development Administrator. Began a new program whereby the State government was involved in developing residential housing for people with low and moderate income. Leavers and Cooke, Inc. 1965 to 1971 Position: Project Manager. I was responsible for the project management of several single Family residential developments totaling about 3,000 units. Budgets were prepared, construction was coordinated, engineers and architects were consulted and marketing was done. Hawaiian Telephone Company 1961 to 1965 Position: Personnel Assistant. I worked in various positions in the Industrial Relations Department: In the employment office interviewing applicants, in salary administration for management people and in management development programs. i Other: I still paddle outrigger canoes competitively and have been the President of the Lanikai and later, the Kamehameha (Hilo) Canoe clubs, the Third Vice President of Hawaiian Canoe Racing Association, the Vice President and later Race Director of Moku O Hawaii Canoe Racing Association (Big Island). I was formerly the President of Junior Achievement for Hawaii Island, and am presently the chair of the Peanut Butter Ministry of the Methodist Church here in Hilo, (we feed homeless and street people and others who need a meal twice a week), and on the board of directors of the Hawaii Island Chamber of Commerce Controller/Human Resources Administrator Reports to: Executive Director General Responsibilities • Responsible for the overall accountability of the finance and human resources areas of The Arc of Hilo. Responsible for the accurate interpretation and implementation of policies of The Arc of Hilo related to these areas. • Continuously evaluates programs, policies and procedures in these areas relating to the effectiveness of results, relative costs, obsolescence, competitiveness and compliance with contractual and regulatory authorities. ~ecific Responsibilities • Develops, implements and maintains recordkeeping and reporting system fulfilling the needs of internal and regulatory requirements for The Arc of Hilo in accordance with its by-laws and policies developed by the Board of Directors. • Develops, implements and maintains human resource policies including job evaluations, performance appraisals, discipline, compensation and employee benefit programs for The Arc of Hilo in accordance with its by-laws and policies developed by the Board of Directors. • Provides the resources for managers to enforce human resource policies • Plans, organizes and directs the work of employees in the finance and human resource areas of The Arc of Hilo. Responsible for hiring, training development, promotions, transfers, discipline and termination of the staff employed in the finance and human resource areas. • Assists in the preparation of the annual budget of The Arc of Hilo and presentation to the Board of Directors. Provides the means and methods for areas to fulfill their responsibilities in preparation of budsets. Qualifications • Demonstrated management skills to select, hire, motivate and supervise employees in the accomplishment of determined tasks and goals. • Demonstrated accounting skills in accounting systems, recordkeeping, reporting, and personal computers. Demonstrated skills forecasting, budgeting and organization. • Demonstrated knowledge in human resource administration including problem solving decision making and ability to assist others identify problems and solutions. • Demonstrated administrative skills in evaluation, conceptualizing, designing, planning organizing and coordinating a variety of programs and projects to achieve desired results. • Proven communication skills, both oral and written, with ability to deal effectively with a variety of people. Evidence of negotiation skills. Dated: 12: U99 IDescs Pentad: 12/13/99 Ronald E. Penn P. O. Bos 363 Honomu, Hawaii 96728 Phone & Fav - (808) 963-6367 E-mail: Rep 1005i~aol.com Objective Business and/or financial manager/advisor for individual or business enterprise Summary of Qualifications Success in start-up, restructure and management of diverse units Rc functions Proven abilities in financial planning retirement and benefit consulting Highly skilled in research, analysis, organization, planning, negotiation, administration Professional Esoerience Financial Analysis and Planning • Developed and implemented financial controls (including project costing and budgeting systems) over occupancy expenses for over UO properties • Developed reporting and analytical process for S~QOOQ000 occupancy budget „ • Prepared financial analyses and recommendations on purchases and sales of company owned real estate, leases and subleases raneing from S2d,000 to S14,OOQ000 Real Estate Administration/Property Management • Negotiated purchases and sales of company owned real estate, leases & subleases including several major sales and leaseback transactions reducing annual occupancy expenses over 5,000,000 • Counseled and trained propem managers on structure of sales, purchases and leases; asset management; property management • Organized and managed homeowners/condominium associations with 8 to ~0 units Corporate Tax Alanagement • Instituted and managed corporate tax activities including the preparation of subsidiary and consolidated federal and state income tax returns • Developed tax strategies and tax planning techniques to reduce taxes paid • Directed preparation of sales/use, personaUreal estate propem• & payroll tax returns Financial PlanningBenefit Consulting • Counseled individuals in benefit choices through their employers and outside sources • Developed tracking and forecasting systems for individuals to achieve financial goals • Counseled individuals in setting tracking and achieving retirement and financial goals Small Business Management • Directed the management of public utility obtaining 53,OOQ000 financing for expansion of water treatment and distribution systems • Managed charitable organization's daily activities including fundraising, accounting, investments and assistance programs doubling size of programs in three years • Developed and implemented accounting, reporting and control systems J + Ronald E. Penn Page 2 Human Resources • Directed policy formulation for all human resource activities -compensation, benefits, employment, training and management development -covering 4,000 employees • Directed redesignlrevision of and managed pension, 401k, health and insurance plans • Designed and implemented executive compensation and stock plans for 75 top and 150 middle management exzcutives resulting in an integrated compensation package Public Accounting • Gained Big Six accounting experience in audit. management consulting and Lax preparation for a variety of small, medium and large sized clients Employment Historv 1998- Consultant for Previous Employer; Financial Planning & Consulting 1978-1998 Norwest Bank Colorado, NA 1970-1978 Affiliated Bankshares of Colorado, Ina (now Bank One Colorado, NA) 1969-1970 Grant Thornton, Certified Public Accountants 1963-1969 Ernst & Young, Certified Public Accountants 1961-1962 National State Bank (now Nonvest Bank Colorado); part-time in college Community Service Homeowners' Associations • Shadows Owners' Association, Inc., Breckenridge, Colorado • The Norman Condomurium Association. Inc., Denver, Colorado • Tenth & Emerson Townhouse Association, Inc., Denver, Colorado Public Utility • Blue River Water District ,Breckenridge, Colorado Charitable/Non Profit Organizations • Historic Hilo Preservation AssociationiFriends of the Palace Theatre, Hilo, Hawaii • Hilo Downtow[r Improvement Association, Hilo, Hawaii • The Alexander Foundation, a ~O1(c)(3) charitable organization, Denver, Colorado • Colorado Dance Festival, Denver, Colorado Professional Designations Certified Public Accountant Associate Financial Planner Education University of Colorado, Boulder. Colorado, Bachelor of Science (Business) Colorado Graduate School of Banking, University of Colorado, Boulder, Colorado College for Financial Planning, Denver, Colorado Other Achievements Instructor, Ameeican Institute of Banking, accounting and auditing Instructor, Graduate School of Banking, University of Colorado, Boulder, bank accounting The Arc x of Hilo 1099 LVninmternre Avenue HAWAII COUNTY NON-PROFIT GRANTS COMMITTEE (2000-O1) Hilo, Hawaii 96720 Phone: (30S) 935-8534 Faz: (303) 961-0148 This letter verifies that The Arc of Hi3o's Boazd of Directors have had formal Wit/r over 41 years of training in several azeas over the last two (2) fiscal yeazs, including: the law firm Service, the Arc of Hilo is Torkildson, Katz, Fonseca, Jaffe, Moore & Hetherington, Attorneys at Law; covimitted to securing for training in Responsibilities and Liabilities; a training course for Board of all people with mental Directors for non-profit corporations and Develo~g Your Board offered by non- profit management. retardation and other disabilities the opporfunity to choose and realize their goals of S~ erel~ where and haw they learn, live, work, and piny. Robert E. Cooper Executive Duector Formerly known as the Hilo Association for Retarded Citizens, Rainbow Crafts and Hilo Vocational Rehnbilitntion Center. The Arc of Hilo is qualified as a producing agency for people with severe disabilities u+rder - the provisions of Public Lnzv 92-28, The Javits- Wngner-O'Day Act. Am Affiliate of The Arc National Orgnni=noon. Y~~ A United Way Agency FINANCIAL QUESTIONNAIRE Program Title: Residential and Support Services; Ka Home Pulama, Domiciliary Home ' it of H~ ~JN,....... 45~~ Stephen K. Yamashiro ii,: Harry A. Ta kaha~h~ ,Na4ar ~ ~ Dne-tor `•sr p;, ,ei~ S. K. Schulte y ~Tf xa •~.~~r%~ n[ I,IV ~OF~ y ~uuutp of ~aknaii DEPARTMENT OF FINANCE '_5 Aupuni Streeq Room IIS Hdo, Hawau 96720-325 f503)961~y23! Fax 18081961-n238 HAWAII COUNTY NONPROFIT GRANTS (FY 2000-01) FINANCIAL QUESTIONNAIRE Please include as an attachment an explanation for all "NO" answers to questions #1 thru I t below: Yes No I . Has the agency operated continuously for the past three (3) years? C.S 2. Has the agency operated with a positive cash flow for the past (3) years? 3. Does your Board of Directors approve a detailed cash flow budget before the beginning of each fiscal year? C~ ~ 4. Do your Board meeting minutes show that quarterly financial statements are approved? C>t5 ~ 5. [s your equity balance a[ least 20% of your Total Liability balance? C~ ~ 6. [s your Total Current Asset balance larger than your Total Curren[ Liability balance? 7. Are bank reconciliations and accounting performed by someone other than the check signatory? 8. Are you fully insured for the agency's vehicle(s) and building(s)? 9. Is your Workers' Compensation at least 2% of payroll? C~ ~ 10. Are you current (not delinquent) on all payroll and payroll tax payments? I L Is the agency free of any pending litigation, liens orjudgments? 12. Within the past l2 months, has the agency applied for vendor or bank credit and was denied credit? If yes, please explain. As the grant applicant, I certify [hat the agency has satisfactorily responded to each of the above questions and explained as needed. !hereby certify that this information is true and correct to the best of my knowledge. Agency: THE ARC OF HILD Phone: (808) 935-7644 Prepared by: Ronald E. Penn, Controller 1/31/00 Prin[ Name/Tine i lure Datc Certified by: Robert E. Cooper, Executive 1/31/00 Print Name of 8zecutive Director D 1 r e c t o r ignature Date r, r m m rn °a ~ .n a m ~ . ~ O c < h c ~ a o~ ~ m o ? to y c 'Z z H ~ ~ r n n n H a r. V] O C 3 N G ~ G f. 7 ° fi _ d N W F ~ N ~ N W O Lfl Ul ~ ~ y ]J o o a o 0 0 ~ •:~j n G `f ~ O O O O O O D p O ~ ~ r. 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O O ~ ~ N N O1 m ~ lIl ` ~ n lD N J W O W 'Tl `..i ~ J O U'I 01 N O ~ ~ _ N O ~ O O ~ ~'j 3 _ t ~n m ~ oo Y r*i o Q ~ p~ N W ~ m N , Q n ~ 3 C n r ~ C~ + ~ LP ~ O ~D N ~ W O W n'1 ^ m J m Ul O~ N ~ ~ ~ ~ H ~ C] C n ~ 2 H Ll1 m J e~ O 3 H m n ~ m rn ~ D1 N W `C < m N COUNTY OF HAWAII HUMAN SERVICES NONPROFIT GRANTS (FY 2000-01) Staff Information Sheet Admin. Statf'of Othe Full Part Degree StatF Grant r Time Time Name BL Program start Position Title Field of Study Rahert Coc er BS-Bus. Adm X X X Execut've Dire t Ronald E. Penn BS-Business X X X Controller Trinidad Bayhayan X X Bookkee er Nora Galarse X X Bookkee er Colleen Madeira AA Educati n X X Livin Skills Inst. Ruth McCumiske X X Relief Josephine Kalauli X X Livin Skills Inst. -i -i .:.i ~ o ~ Q ~ P n (i O R O R W a N m ^ ~ z o c o b o o ~ ~ y o a ~ ~ o p ~ r y v, ~ O O A y C t m rY- ~ D DH H ~ ~ ~ ~ a D o z i., z .~b m ~ z ~ O N C " t` r ~FH : p ~ ~ w G --1 L1 A ~ w m m cn C y ~ ro ,z n H Q ~ ^ ~ r _ ' m ~ u' X e: ~ " ~ sn : ;a~ . o ~ ~ F ~ N O „„yi:f II O O H m ~ ~ = "~a; m ~ = - : " 5 cn r O N m -1 D - c N N ~ D ~ ~ p °C w Ov J F W 'C 0~ b ~ m p rn °o w ~_C~-. ~ o j N p II °o CJ. c ~ ~ rn rn o w ~ ~ O m:, ~ ~ ~ N ~ W J m O~ ~ to II ~9+ O Q r p F o 3 F w ~ o~ 7~ c 'A m 00 `;f O ~ ~ w ~ C Z ~ m ~ ~ w ~ ? ~ m c ~ C:7 x. - y -~`'f ~ TI G G 'z m w N ~ O1 m O N Oo R ~ ~ W O~ p N~ ~ O F l11 ~O O~ r~ c O ~ O ti 3 CJ ~G N Ol LII ~ ~f fTl lp W O~ p p l~'~; m U1 W ~ O C m O m c ,V~ h ~O Dt W -1 ~ ~ lp O lp ~ II ~ C ~ ~ "yf r D ~ `vr, a n _ o `YY%. ~ o ~ = H ~ ~ ~ ~ m II ~n ~ ».C , o o° ~ a 3 N m o G p m O1 j CO V 77 H N J N J Ol ~ ~ N C"] F F = 0 ;O~ F O F H P OO H G _Q II G O r w ;'Q J ~ O H a n ~ O° v rn u ~ x ~ m m w w o ~ m .'b ~ ~ 3 a p m rn ~ ~ m N m -'C J O1 V R N J - R F O F H F F ~ I I v `G z _ a _ z ~ y .•..-fir .O G : ' G ~ G Czi ~ G ~ G ~ G ~ _ ~G Z ~ r n n m C7 •'m O~~ N v z n cn -i n ~ o m x ;=-i;r ~ D .n c < n ro n o m n o ~ o m m ;=7 ~r r ? n n ? ? h Q n ~ ~-7 to Z '~D-' O is o ro m c n m m ? ~ ? n - rC' •O ~ Z 3 r• N f" ~ 'G rF c'F a N h H• "'-:7 C O -c m p n ~c f- ~ r~ ti m n m m n m '_n_ m y O '<p .fn C C H• ? 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N ~ O1 U1 ~ N '`O• ~p - S W m ~ O N -G ry,L O m tTl LIl m U1 - ~ 3 m ~ o o c a m y O m r = z ~ -o ' z = z z ~ z ~ z = z ~ z = - -t O =m-p : ; r cn 9_ . m r• v r. r.` n . ~ w r• to Z =i fi ~ ~ ~ 'A m ~ m F m ~ - r; p ~ ` _ -H - w m m - _ h ~ x d ~ H H - - Rl - 7 7 - . m m n co II J ~ R sr. ~ -awe ^a a, ~ ~ -m [n n y' ~ .rs •oil ~ ~ro~ ~ Vie' '~i to ^t t sr,~ -"dx .:Fn ~ ~ ~ _ - Fi - v r N J O N ~ ~ ~ ~ ~ ~ U1 ~ Ui ~ ~ G ~ ~ m \ \ - \ r .p ~ ~e 3 ~ C -m-I N Cl r N _ 4. O C J j ` 'n. G7 u," ~ - is ~p ~ to to -C 0^ rC` O - ~ - ~ m o 0 0~ r..'Zp ~ - ~ ~rn O r _ r V ~ = G ~ < ~ _ = ~ z w ~ ~ i iva~c _ ~ D ~ a n N ~ o o rn O1 _ ~ > ~ N a m ~ w w c Pr_', ~ n m m W F O O O ~ _ y , 0 4 3 ~ ~ ao m a v = _ < ~J ~ ~ ~ (n'_ C V ~y r O ~ - N ~ ~ ~ W m m O T ? C7 . F O1 O ~ c n ~ O N O - ~ N 3 ~ H O o r C H 1~ ~ n r•• ~ X _ ~ o, ~ ~ ~ o _ n 3 IV W W G ~ C fTl ~ W m m - (o r Ol O O ~ G 'G ANNUAL FINANCIAL STATEMENTS (INCLUDES CURRENT AUDIT) Program Title: Residential and Support Services; Ka Home Pulama, Domiciliary Home - The Arc of Hilo and Affiliate Financial Statements Tune 30, 1998 Ann Fukuhara Certified Public Accountant The Arc of Hilo Table of Contents Independent Auditor's Report 1 Financial Statements Combined Staremears of Fiaarcial Posirion 2 Combined Staremenu of Acrivities 3 Combined Sta[emeau of Funcrional EsFenses Combined Statemeau of Casa Fiows ~ Nees ro Financial Statements 6 - li , Schedule of Federal Awards 14 Notes to Federal Awards IS Report on Compliance and on Internal Control Over Financial Reporting Based on an Audit of Financial Statements Performed In Accordance with Governmeni.~udiiing Standards 16 - 17 Report on Compliance with Requiremenu Applicable to Each Major Program and on Internal Control Over Compliance in Accordance With OivIB Circular A-133 18 - 19 Combined Schedule of Findings and Questioned Costs 20 - 25 Corrective Action Plan 26 - 27 rianagement Letter 28 - 29 i Ann N. Fukuhara, CPA I~ n=::cz!ehua Avenue °.0. Baz 6691 Fiiio, Hawaii 96120 (508} 961-55;2 Fic f508) 9_x8539 c.:ai1: ati^so e,ne: Independent auditor's Repart The Board of Directors The Arc of Hilo I have audited the accompanying statement of financial position of The Arc of Hilo (a rp[ for profit orsanizatior.) and aft hate as of June 30, 1993, and the related statements of ac::vices and cash flows for the vent rhea ended. These financial statemens aze the responsibility of management. ~fy respcrs~oilirt is to express an opi,.icn or. These fmanciai statemens based on my audit. I conducted my audit in accordance with generally accepted auditing sandads and the satldazds applicable ro finarlciai audits contained in Covernmerr.auci n; Standards, issued by the Comptroller General of [he United States. Tnose s~anaards require that I plan and per."or^ the audit to obtain reascnabie arurance about whether the financial statemeas aze free of mate::zi misstatement. An audit 1n C1UdeS e :aminmg°-, On a test bas iS, eVICe.^.Ce Si1pDOC-ung [ne aTI:OURLS 2nC a1SC:pSULES m Che flnanClal SLdLeWe.^.CS. .'fin aUClt aISO :nC1llCC5 "eS5e55mg ille aCCv^LRC:A°_ pI1nC:PIES llSed 3L'd ;i?Q-~Tl'-IiCant eSISInaLeS made bV ,^.laP.aaemenC, aS Weli aS e`ra1L'anIlg t,:e OVe:all SL,aP.Cia! SL3CeT,ent DleSentaliCn. I believe that my await provides a reasorabie basis fer my opinion. L-I my opituon, the financial sratemens revered to abcve present fairly, in ai': materizl respecu, the ftttaycial position of The Arc of Hilo as of June 30, 1998, and she changes in is net asses and its cash Rows for the year rhea ended inconformity wiL`S generally accepted accounting principles. In accoraance with C-enera[ly Audir:'n3 Standards, I have also issued my reper*_ dated stay 20, 1999, on my consideration of Tae Arc oc Hilo'; internal control over financial repotting and my toss of its cospiiance with ce^ain provisions of taws, remlIations, contracs, and grans. The accompanying schedule of e~pe^.ditnres of federal awazds is presented cox the purposes of additional analysis as required by U.S. Once of Management and Budget Circnlaz A-133, dudits of Stctes, Loca! Governments, and ~Uon-Pro)=tr Organisations, and is not a required part of the basic financial statements. Such infornadon has been subjected to the auditing pr~edures applied in the aucai of 4`le basic financial statements and, in my opinion, is fairly stated, in all material respecu, in rela~~on to Lhe basic financial statements taken as a whole. An^. Fukuhara, CPA Ha.o, Ha'Nall May 20, 1999 1 fhe Arc of Hilo and Affiliate Statement of Financial Position As of June 30, 1993 (with comparative amounts for 1997) Temporarily Total ASSETS L`nrestricted Restricted 6/30;98 6/30197 Current Assets Cash and cash equivalens, notes Z & 13 S 788.345 S 2,851 S 791,196 S 588,Oj2 Invesc.-nents 94,799 94,799 74,113 Deposits -Escrow, note . 85,000 85,000 li5,000 Lease bonds 1,500 ' 1,5C0 1,500 .4ccourts receivable note 3 35,691 35,691 15,430 Grants and contracs receivables, note 4 112,726 112,726 163,193 Othe: receivable - 28,-.i2 Prepaid espeases 32.195 22,195 18.536 Tonal current asses 932,731 210,376 1,143,107 1,08-1,295 Note receivable, note 6 50,110 50,170 50,559 Property and equipment, net of 1, ~20,j47 1,720,547 1,695,086 accumulated depreciation of $1,039,007, note 7 Total assets 2 703.448 210,376 2,91_,824 $ 2.829.940 LI_~BILITIES A`tD NET ASSETS Current liabilities accounts payable 7j,697 7j,697 "x2,355 Accreted salaries & other liabilities 58,396 58,396 106,979 Notes payable 1.917 Cur-,ent portion of long term debt, note 3 15,037 li,037 Total current liabiities 149,130 0 149,130 181,251 Mortgase payable - Less current portion, note 8 1,779,128 1,779,128 1,808,074 Totallon;termliabilities 1,779,128 - 1,779,128 1,808,074 Net Assets tinrestricted, note 1 775,190 775,190 635,678 Temporarily restricted, note 1 210,376 ZI0,376 204,937 Total net asses 775,190 210,376 985,566 840,615 Total liabilities and net assets S 2,703,;48 $ 210,376 $ 2,9li,824 S 2,8 The accospanvin3 notes are an integral part of trese f~ancial statements. . ' The Arc of Hilo and Affiliate Statement of Activities For the Year Ended Tune 30, 1998 (with compararive totals for 1997) Temporarily Total Total Unrestricted Restricted 6!30198 6/30197 PLBLIC SUPPORT r1~`ID REVENUE: Puolic Suooort: State of Hawaii -Dept. of Health, note 11 S - S 108,460 5 108,460 S 5 i3,C42 Section 8 Housing Assistance 273,750 273,150 255,810 State of Hawaii -Dept. of Human Services, note 11 41?,074 1L,074 120,980 Donanons 19,164 19,164 26,937 Counc~ of Hawaii 29,000 ^-9,CC0 30,200 Private foundation 7,000 7,000 8,000 Hawaii Isiand United Way 17,945 i i,9»~ 17,4b0 Special events 9.•'86 9,'86 3.765 Total snooort 46,595 830,284 316.319 1.036,134 Revenue: Sales and services-64,127 - 464,127 471,''47 ReatalIncome 7~,i38 71,!38 73,399 Pro~rarn service revenue 60,390 60,:90 ~~'.787 Interest income 25,255 5,439 31,694 -2.377 Other income 2',^37 21,'37 10,!79 Totalreveaues 646,647 5,439 653.086 6~2 ?89 Net asses released from restrictions Satisfaction of propose and time- restrictions 830,284 (830,284) - - Total net asset released from restrictions 830,284 (830,284) - - TOT9L PL~LIC SUPPORT Ai`iD REVF,tYUES 1.533,526 5,439 1,528.565 1.678,473 EYPENSES ?.PtD LOSSES RehabiIitadon and training services 1,229,608 1,229,608 1,384,931 General and administrative 154,006 14,006 107,308 Loss on sale of asses 400 400 5,013 1,384,014 - 1,384,014 1,197.252 Change in net assets 139,5 L 5,439 14'.,951 181,221 Net asses, beninning of year 635,678 204,9.7 840,515 659,394 Net assets, end of year S 775,190 S 210,376 S 98,:66 S 840,615 The accomeanyin~ notes are an integral part of these financial statements. 3 The Arc of Hilo and Affiliate Statement of Functional Expenses For the Y ear Ended June 30, 1998 (with comparative totals for 1997) Rehabiliation General 1998 199 i & Training and Program Administrative Total Total Salarizs 5 588,604 S 80,042 S 668,6x6 S 593,893 Fnnae 74,065 U,042 Si,107 91,902 Employee benefits--'.5,267 8,325 53,592 46.149 Total personnel 101,936 101,409 809,345 131,944 Insurance ~'",670-.7,670 ^.",x90 Intzrestext?ense 164,385 2,924 151,309 110,361 Viisce!laneous expense 1,830 9,369 11,199 2,482 Professional fees 11,041 11,041 27,438 Outside services 6,249 6,249 Program 19,711 8,848 28,625 185,822 Printing & publication 697 2,270 2,967 1,274 Rzpairs and maintenance 13,994 862 13,856 59,400 SiGfftraining 1,189 1,189 918 Suoolies :6,152 =,242 39,394 38,407 Sales tax 20,300 20,300 18,514 Transporation & vehicles 18,884 1,621 20.505 20,057 Travel 524 2,082 ?,606 278 U~rilities and telephone 13,512 4,089 71,601 16,053 Tetal expenses before depreciation 1,105,850 154,006 1,259,856 1,316,438 Deorzciation 123,758 L3,758 115,801 Total Expenses $ 1,229,608 S 154,006 S 1,383,614 S 1,492,239 The accompanying notes are an integral part of tb~ese financial statements. 4 .F he Arc of Hilo and Affiliate Statement of Cash Flows For the Year Ended June 30, 1993 (with comparative amounts for 1997) 6x'30/93 6/30197 Cash Flows From Operating Activities: Cash received from program activi~ies 8 1,6_6,545 S 1,65,779 Cash paid to suppliers and employees (1.311,373) (1.358.847) Net cash provided by operating activities 315,172 260,932 Cash flows from investing activities Acquisition of equipment (148,130) (67,046) Preczzs from sales of assets & refundable deposits 0,000 (136,500) Net cash flows provided (used) by investing acrivties (98,120) (303,546) Cash flows from financing activities Rzpavment of dzbt (13.908) ("6,373) Net cash flows provided (used) by financing activifies i 13,908) (76.373) Ne*_ increase (decrease) in cash 20:,14^. (L^,987) , Cash & cash equivalnets at beginning of year 583.052 601,039 Cash & cash equivalneU at end of year 791.196 588.052 Reconciliation of change in net assets to cash provided by operating activities Inczase in net assets ?4'.,951 181,221 Adjustments to reconcile net assets to net cash provided by operating activities Depreciation L ; ,758 115, 801 (Ir_crzase) decrease in receivables 1 L ,066 (93,166) (Increase) decreasz in prepaid expenses 0 ,659) 6,255 Ir_creasz (decrease) in accounts payable 3,342 1,923 Increasz (decrease)in accrued liabilities (51,200) 56,932 Gain (loss) on sale of assets (400) 5,013 Donations restricted to endowment fund (20,686) (19,305) Investment income (3.742) ties cash provided by operating activities S 315,172 S 266.932 Tire accompanying notes are an intesral part of these financial statements. 5 .r The Arc of Hilo and Affiliate Notes to Combined Financial Statements June 30, 1993 1. Summar+ of si;nificant accounting policies nature of Activities The arc of Hilo (arcj is cos..'nittzd to providing residential, educational and vocational opportunities for people wirh mental retardation in the county of Hawaii. The association also conducts business under the resisrered jade names: Hilo Vocational Rehabilitation Center, Ka Home Pttla**ia and Hale Ulu Hci. Ln addition, one of the Association's residential facilities is administered LhSOllga an affiliated corporan_on, Hilo aRC Housing Corporation No. 1 (rousing Corporation). aRC exerts direct control over tae operations cf tae Housing Corporation, anc ti7e r,~~o cor:cratiets snare a common Beard of Directors. Basis of Presentation The accompanying financial statements are prpared on the ac:rual basis of accountins and in accordance with generally accepted accounting principles. tint assets and revenues, expenses, gains and losses are classic"_ed based on existence or absence of doper-imposed res~ ctions. accordingly, net asses of the arc of Hilo and changes therein are classified and rzpor*.ed as follows: Unres~icted net assets - Nzt asseu that are not subject to donor imposed stipulations. Temporarily restricted net asses - Nzt asset subject to donor imposed stipulations that may or will be net, eitaer by actions and or the passage of time. ~nen a resCiction z:.pires, temporarily restricted net asses are reclassined to unrestricted net assets and reported in the statement of activities as net assets released from res~ictions. Contributions Contributions are considered to be available for unrestricted use unless specifically restricted by the donor. Amouns received that zre designated fen future periods or restricted by the dor_or for specific purposes are reported as temporarily restricted or pernanently resuacted suppor that increases those net asset classes. When a remporar;+ restr~~ction expires, temporarily restricted net assets are reclassified to unrestricted net assets and reported in the statement of activities as net assets released from resL~ctions. 6 The Arc of Hilo and Affiliate Votes to Combined Financial Statements -continued June 30, 1993 Property and Depreciation Propert;~ is stated at cost or at fair m?,-kzt value established at tl!e time of donation. Depreciation is computed usL-tg the straight-line :azt`ed over the estimated useful lives of the properties. Leases Leases tl.zt trarsfzr substantially all of the benefiu and risk: of owr_ership are classified as capital leases. All other leases are shown as operating leases. Income tries T'r~e Association and z;"liate arz ciassined as a tax-exempt or_anizations under Section ~01(c)(3) of the U.S. Internal Revenue Code and are exempt from Federal and State income ;es. Donated Facilities The Arc of Hilo occupies land and a building !mOWn as Hilo Rehabilitation Czatzr leased from the Department of Social Services and Housing which is leased for annual rental of one dollar (Si.00) per year. In addition, land for the 3 HUD projects are !eased from the Deparm:7ent of Land and natural Resources fcr an annual lease payment of S1 each. do amcunu have beta reflected in the statements for the donated portion of the rent of these facilities inasmuch as no objective basis is available to measure the value of the use or such land and facilities. Functional Allocation of Expenses The costs of proviaing various programs and other activities have been summarized on a functional basis in the statement of activites. Accordingly, ce: tain tests have been allocated among the programs and supporting serrices benefited. Estimates T'ne preparation of fmarcial statements in conformity with generally accepted accounting principles requires management to make estimates and assumptions that affect certain reposed amounts and disclosures. Accordingly, actual results could differ from those estimates. Combined Financial Statements The financial stn*.emeats include the accounts of all of Arc's zi zliates. All sisnifica.*',[ intercompany transactions and accounts are eliminated. 7 s The Arc of Hilo and Affiliate tiotes to Combined Financial Statements -continued June 30, 1993 2. Cash Designated for Exclusive Use of HUD Projects Total Project No. 140-EH005 Replacement reserve 19,859 Residual receipts 6,719 Lease bond j00 Project No. 140-EH009 Replacement reserve 100,508 Residual receipts . X35 Lease bond 500 Project No. 140-EH053 ' Replacement reserve 33,6.8 Residual receipts 395 Other 500 Tenant Security 9,369 HL-D project checking accounts & petty cash 143,905 ~ 318.118 Under the HUD regulatory agreements, annual contributions of 536,588 are required to be made to the reserve replacement accounts for the three HL~ projects administered by ARC and its affiliate. The cumulative balances are mainrained in federally insured bank accounts. 3. Accounts receivable Accounts receivable 50,691 Less allowance for doubtful accounts (15.000) 5 35.691 8 The Arc of Hilo and Affiliate Notes to Combined Financial Statements -continued June 30, 199S 3. Accounts receivable -continued Sales and service revenues include yard service, laundry and janitorial wnich are provided to various government agencies and businesses. Services aze invoiced at Least monthly. 4. Grants Receivable Grants receivable are deemed to be fully collectible by management and comprse of the following amounts as of June 30, 1998: State of Hawaii -Department of Human Services 5'4,498 State of Hawaii -Department of Health 38?28 511".726 5. Deposits -Escrow On April 19, 199 i , the Arc of Hilo signed a deposit receipt offer and acceptance (DROA) for real property located at 48~ Laukapu Street, Hiio, Hawaii. The real propery is in the process of negotiations and is subject to approval of the seller. A deposit in the amount of 585,000 was tendered towards the purchase of the real property. This deposit is fully refundable should the sellers reject Lhe offer. 6. Note Receivable On March 12, 1996, the Arc of Hilo sold its residential facility located on Likeke Street, in Hilo, Hawaii for a total sales price of 5170,000. The buyer of the real property purchased the property by way of cash and a note for 551,000. In accordance with the montage note, the buyer will pay monthly payments will continue for a period of 59 months with the final payment due to the Arc of Hilo or_ Viazch 12, 2001. As of June 30, 1998 the balance due to the Arc of Hilo amount to 50,1'10. 9 • ~ ' ~ 1 The Arc of Hilo and Affiliate Notes to Combined Financial Statements -continued June 30, 1993 7. Property and Equipment HUD Project No. 140-EH005 Building ~ 20",691 Equipment ~ .~26 213,217 Accumulated depreciation (103.251) Net 109.966 HUD Project No. 140-EH009 Building 153,832 Equipment ~ .212 799.044 Accumulated depreciation (390.¢39) Net ^08,205 HUD Project No. 140-053 Building 1,232,'37 _ Eaui~meat '12 1,256,149 Accumulated depreciation 027.946) Net 928?03 ARC -Other Land 69,000 Acquisition costs - Builain; 79,904 Buildings 31,000 Vehicles 160,760 Equipment 114,'29 Leasehold improvements 36,061 491,144 Accumulated depreciation 21( 6.971) Net 2%4.173 Total ~1.i20.547 Fixed assets include 4 buildings. The 3 HUD projects aze built on leased Iand at 139 Amau Road, 1303 and 1305 Ululani Street, all in Hilo. 10 , The Arc of Hilo and Affiliate Notes to Combined Financial Statements -continued June 30, 199S S. Notes payable U. S. Department of HousLzg and Urban Development, Project No. 1--'.0-EH005. Interest at 9?5 0, monthly payment of $1,498 due ~Iay 2022, collateralized by a first mortgage on real property at 139 :~.-nau Road, Hilo 5 172,138 U . S. Deparffnent of Housing and Urban Development, Project No. 140-EH009. Interest at 9.250, monthly payment of 55,709 due September 2022, collateralized by a first mortgage on real propem at 1305 Lnulani Street, Hilo ' 601,390 U. S. De~arsnent cf Housing and Urban Development, Project No. 140-Eh053. Interest at 8.875"0, monthly pavmeat of 57,525 due December 2030, coLateralized by a first mortgage on real propem at 1303 Uiulani Street, Hilo 960.037 51.794.165 The following summarised the note maturities: Year ended June 30 1999 13,700 2000 15,200 2001 17,500 X002 19,800 2003 22,100 11 The Arc of Hilo and :affiliate "otes to Combined Financial Statements -continued June 30, I99S 9. Pension plan ARC and its affiliate have a defined cnne-ibution pension plan coverrg most of the full time personrei. Employee eIisibiiir: to paricipate is based on axe and length of service reauiremenrs. Employees can contribute up to 10 a of gross waees. ARC and affiiiare's annual cone-ibution to the plan is based on 4 0 of employee compensation. Pension expense for the year ended June 30, 1998 was 57,379. 10. Leases commitments ARC leases facilities in various locations. h occupies the Hiio Reaabilitadon Center on Waianuenue .venue thrcugh leases with the State of Hawaii, Depaz~nent of Social Services and Housing for the purpose of iu vocational rehabiLtarion activities. Tne association also has use of adjoining pazcels through a revocable per.,:it. The Iease term runs thseugh u:e year 2008 with an annual teat of S1 per year. ARC and the Housing Cororatien lease the land for the h'LID residential projecu from the Stare of Hawaii, Department of Land and Natural Resources. The terms for each of the three lease agreements runs through the year 2002 with annual teat of Si of each lease. 11. Contracts with State of Hawaii ARC is under subcon~act witiz the State of Hawaii to provide services for people with mental retardation and developmental disabilities on the Island of Hawaii. The contracu are for the period July 1, 1997 throueh June 30, 1998 and aze subject to renewal upon the availability of state and federal funds. Such contracts for the yeaz ended Tune 30, 1998 provided the followin; funds: 12 The Arc of Hilo and :affiliate Notes to Combined Financial Statements June 30, 199S 11. Contracts with State of Hawaii -continued Departmz^.t of Hzalth Adult Day Program ASO Log No. 98-088 5108.^^-60 Deparnnert of Human Services Vocational Rehabilitadcn DHS-96-vr-~ 160 120,978 (Includes 52,810 of Clow through federal funding) Medicaid Waiver Service DHS-98-CLTCB-6110 291.096 Total State Grants 5520.34 Under the terms of the contracu, Arc is obligated to return any unexpended funds at the end of the contract period. T:~,e return of any such unexpendzd `unds are recorded ir_ tLe year in winch the facts which require such return become :clown. 12. HUD rental subsidies In addition, housing assistance pavmenu are received from the Federal Department of Housing and Urban Development for housing provided by ARC for elderly and hanaicapped tznants of Ka Home Pulama, Hale UIu Hoi I and Hale Ulu Hoi II. This assistance is sumn!a_rized on the attached 5chedulz of Federal Awazds. 13. Concentration of Credit Risk The Arc of Hilo and affiliates maintain several bank accounts at various banks. Accounts at a financial institution are insured by the Federal Deposit Insurance Corporation (FDIC) up to 5100,000. Cash at one financial institnr.'on exceeded Federally insured limits. The amount in excess of the FDIC limit totaled 526,662 as of .Tune 30, 1998. li .1 fhe Arc of Hilo and Affiliate Schedule of Expenditures of Federal Awards Year Ended June 30, 1998 Federal Federal Grantor/Pass-Throu;h CFDA Federal C'rantor/Proaram or Cluster ti]te Number E.~cpenditures Department of Housin; and tirban Development Section 202 -Housing for elderly or handicaoned Project No. 140-EH005 1?.157 172,915 Project No. 140-EH009 14.157 661,390 Project No. 140-EH053 14.157 960,037 Section 8 -Lower income rental 1?.156 273,750 assistance program State of Hawaii, Department of Human Services Vocational Evaluation and 84.126 120,810 Trainins Total Expenditures of Federal Awards $ 2,188,902 The accompanying notes aze an inte,al part of these financial statemenu. 14 The Arc of Hilo and Affiliate Notes to Combined Financial Statements June 30, 1993 Note 1. Basis of Presentation The accompanying schedule of expenditures of federal awards includes the federal ,ant activity of T'ne Arc of Hilo and Affiliate and is presented on the accrual basis of accounting. The information in this schedule is presented in accordance with the requirements of OMB Circular A-133, Audirs of States, Local Governments and Non Profit Or;anizations. "Therefore, some amounts presented in this schedule may differ from amounts presented in, or used in the preparation of, the basic financial statements. rote 2. Loans Outstanding The Arc of Hilo and Affiliate had the foIlowing loan balances outstanding at June 30, 1998. These loan balances outstandin; aze also included in the federal expenditures presented in the , schedule. Program Titie Federal CFDA Amount Number Outstanding Section 202 Housin; For elderly or handicapped Project No. 140-EH005 14.1 i $ 1 12,915 Project No. 140-EH009 14.1 i 661,390 Project No. 140-EH053 14.17 960,037 Total loans: 51.794.342 1~ IRS FORM 990 Program Title: Residential and Support Services; Ka Home Pulama, Domiciliary Home Fbrm 990 Return of Organization Exempt From Income Tax oMenlo.,sas-oo47 Under section 50,(c) of the Internal Revenue Code (except black lung benefit 1997 trust or private foundation) or section a9a7(a)(1) nonexempt charitable trust This Form is bepanme,a nr Ine T,eaaury Open to Public Inmrnal aev<nue Service Note: The or anization ma have [o use a Co of this return to satin Stale repprtin requirements. Ins BCLIOn A For the ,997 calendar ear OR tax ear eriod he innin JU! v 1 , ,997 and endin June 3 0 , , 199 8 B Check iC Please C Name of organization, number and street, city, town, state, and ZIP code D Employer identification number Change of use RS he Arc of Hi1c o- atltlresa Iabelor ^ i 9~ G109568 minal rmuro PrtYP or ~ ~ E Slate registration number Final return See 1099 wdidRlie RUe A`?e IIll2 L N~A Specific F Check ? d exem pp amenaee remro Instrue- pticn a lication ( equired also for lions. ~ ~ Q HT 9 5 7 2 0 IS pending Slate reportlngl - G Type of organization Exempt under section 50t(c)( 3 ) G (insert number) OR ? section a9a7(a)(t) nonexempt charitable trust Note: Section SOt(c)(3) exempt organizations and 49a7(a)(1) nonexempt charitable trusts MUST attach a completed Schedule A (Form 990). H (a) Is this a group return (led for affiliates? Yes No 1 If either box in H Is checked "Yes,' enter four-digit group exemption no. IC liNI? (b) If "Yes," enter number of affiliates for which return is filed: ? J Accounting method: ~ Cash Accrual (C) Is This a seParale return Illetl by an organization covered by a group ruling? Yes [ Np Gthef (Specify) ? K Check here ? I rf the organization's gross receipts are normally not more than 525,000. The organization need not `file a return with the IRS; but if it received a Form 990 Package in the mail, it should file a return without `financial data. Some states require a complete return. Note: Form 990-EZ ma be used b or anizatlons with ross receipts less than $t 00,000 and total assets less than 5250,000 at end of year. ;PBit';t Revenue, Ex enses, and Chan es in Net Assets or Fund Balances (see Speclec !ns;rucucns on page t t.) 1 Contributions, gifts, grants, and similar amounts received: a Direct public support 1a 2 5 , 164 .I b Indirect public support 1b 17 , 94 5 . I ' C Government contributions(grants) 1C 692,858.!`-- d Total (add lines to through ,c) (attach schedule of contributors) (cash 5 nancasn 5 ) ld 736, 977. 2 Program service revenue including government fees and contracts (from Part VII, line 93)...... I 2 I S 63 , 319 . 3 Membership dues and assessments 3 4 Interest on savings and temporary cash investments j 4 j 3 0, 4 9 9. 5 Dividends and interest from securities 5 6a Gross rents 6a ~ - b Less: rental expenses . 6b C Net rental income or Qoss) (subtract line 6b frem line 6a) ~ 6C 7 Other investment income (describe ? ) ~ 7 ~ Revenue 8a Gross amount from sale of assets other (A) Securities (B) Other I`~' than inventory ~ fie 765.1-~ b Less: cost other basis & sales expenses . 16b 1 , 0 0 0 . . C Gain or (TOSS) (attach schedule) Sc - 2 3 5 . , d Net gain or (loss) (combine line 8c, columns (A) and (e)) 8d - 23 5 . 9 Special events and activities (attach schedule) a Gross revenue (not including $ 9 , 4 8 0' . of contributions reported on line ta) 9a 9 , 4 8 6 . b Less: direct expenses other than fundraising expenses......... 9b C Net income or (loss) from special events (subtract line 9b from line 9a) 9C 9 , 4 8 6 . 10a Gross sales of inventory, less returns and allowances.......... ~ 10a b Less: cast of goods sold 10b I C Gross proft or (loss) from sales of inventory (attach schedule) (subtract line tOb from line t0a).. lOC 11 Other revenue (from Part vll, line 103) 11 21, 2 31 . 12 Total revenue (add lines t d, 2, 3, a, 5, 6c, 7, 8d, 9c, , Oc, and ,1) 12 1 , 3 61 , 2 7 7 . 13 Program services (from line aa, column (B)) 13 1, 0 9 3 , 9 5 3 . 14 Management and general (from line aa, column (C)) 14 9 8 , 2 3 7 . Expenses 15 Fundraising (from line aa, column (D)) 15 16 Payments to affiliates (attach schedule) 16 17 Total expenses (add lines t6 and aa, column (A)) 17 ~ 1 , 19 2 , 19 0 . 16 Excess or (deficit) for the year (subtract line t 7 from line 12) 18 I 16 9 , 0 8 7 . Nat 19 Net assets or fund balances at beginning of year (from line 73, cclumn (A)) l9 906 , 168 . Assets QO Other changes in net assets or fund balances (attach explanation) 20 ~21 Net assets or fund balances at end of year (comb-ne lines t8 t9 and 20) 21 j 1 , 0 7 S , 2 S 5 .Net assets or fund balances at end of year (comb-ne lines t8 t9 and 20) 21 1 , 0 75 , 2 S 5 . Far Paperwork Reduction Act Notice, see page , of the separate instructions. can 7 99012 NrF Izesa GLD 4224 Form 990 (,997) Cop YrigM Forms Sol:ware Only, 1997 Nelcq FOrmAssLo tsps7 The Arc of Hi- 99-0109668 LI J Pace 2 Pal-b`.ll': JtatemBnt Gf Allorganlzalions must complete column (A). COlumns(6).(C), and (D)are,equireCforseclion SUl(cy])aVd le)organizOtlpns anE Functional Expenses section 4947(app nonexempt cnarilabie trusts but optional for olhers.(See Spealic lnstmcllons on page l5.) Do not include amounts reported on line (B) Program (C) Management (A) Total (D) rundraising 6b, Bb, 9b, tOb, or 16 of Part I. services and general 22 Grants and allocations (attach schedule) . no~- (nsh$ casn$ 1 22 23 Specific assistance to individuals (auaon son.;. 23 I 24 Benefits paid to or for menbers Wu,cn scn.) 24 I 25 Compensation of officers, directors, etc 25 I 26 Other salaries and wages 26 549, 148 571, 422. 75, 726.1 27 Pension plan contributions 27 28 Other employee benefits 28 9'. , 15 9 . 8 ? , i 8 5 . 6 , 9 7 29 Payroll taxes 29 44,'061.1 37,237. 7,424.. 30 Professional rundraising fees 30 , i 31 Accounting fees 31 32 Legal tees 32 ! 33 Supplies 331 39,394 . 39, 394 . I 34 Telephone 34 ~ I 35 Postage and shipping 35 I 36 Occupancy 36 I I I 37 Equipment rental and maintenance 37 ; ! I 38 Printing and publications 38 2 , 9 o' . 2 , 124. 8 4 3 .I 39 Travel 39 2, 6 0 6. 2, 5 3 6 7 0 .1 40 Conferences, conventions, and meetings... 40 'i i 41 Interest 41 1 8i, 905.1 75, 705.'. 6, 200. 42 Depreciation, depletion, etc. huacn soneeule) . 42 8 C , 4 9 i 8 0 , 4 91 . 43 Other expenses (itemize): a 43a I b 43b I I c 43c d 43d ' e See Sch. Attached 43e1 200,859 200,859.1 44 Total functional expenses!aea Imes zz tnrougn i I as)Orgganizations completing columns ~ I (B)-D),carry these totals to lines t3-t5.. 44 1, 192, 190.1 1, 093, 953.! 98, 237.; Reporting of Joint Costs. --Did you report in column (B) (Program services) any ;pint costs from a combined educational campaign and fundraising solicitation? ? ~ Yes ~ No If "Yes," enter (i) the aggregate amount of these joint costs $ ; (ii) amt. allocated to Prog. services $ iii the amount allocated to Mana ement and eneral $ ; and fix amt. allocated to Fundraisin $ P~€<fIF; Statement of Pro ram Service Accom lishments (See Specific Instructions on page 18.) What is the organization's primary exempt purpose?? See Stat emerit Program Service All or anizations must describe their exem t ur ose achievements in a clear and concise manner. State the number of clients Expenses g p p p (Required far SOgcg91 served, publications issued, etc. Discuss achievements that are not measurable. (Section 50t(c)(3) and (4) organizations and and(d)args.,anda9a7(aNt) a947(a)(1) nonexempt charitable trusts must also enter the amount of grants and allocations to others.) trusts; but optional for of tiers. a See statements (Grants and allocations $ 1 1 , 0 93 , 9 5 3 . b (Grants and allocations $ ) C Grants and allocations $ d Grants and allocations $ ) 8 Other program services (attach schedule) (Grants and allocations $ 1 ~ f Total of Program Service Expenses (should equal line 4a column (B) Program services) ? 1 , 0 93 , 9 53 . CTT 7 99012 NTF 12539 GLD 4224 Copyright Farms Sollware Oily, t 987 Nelco . ~ O I ° Form 990 (1997) The Arc of Hilo 99-0109668 - Page3 F73Lt. ~u Balance Sheets (See Specific Instructions on page 18.) Note: Where required, attached schedules and amounts within the description (A) (B) column should be for end-of-year amounts only. Beginning of year End of year 45 Cash non-interest-bearing 93 , 521. 45 I 46 Savings and temporary cash investments 3 6 , 5 0 7 . 46 6 94 , 3 i 3 . E 47a Accounts receivable ~ 47a 5 0 , 6 91 . b Less: allowance for doubtful accounts....... 47b 15 , 0 0 0 . 7 5 , 4 3 0 . 47C 3 5 , 6 91 . 48a Pledges receivable 483 b Less: allowance for dcubtfW accounts....... 48b 48C 49 Grants receivable i63,i92. 49 112,726. 50 Receivables from officers, directors, Vustees, and key employees (attach schedulel 50 513 Other notes and loans receivable (attach schedule) 513 50,170. b Less: allowance for doubttul accounts....... 51 b 5 G , 5 5 9 . 51C 5 0 , 17 0 . Assets 52 Inventorlestorsale or use ~ 52 j 53 Prepaid expenses and deferred charges 18 , 5 3 6 .153 ~ 2 2 , i 9 5 . 54 Investments securities (attach schedule) 7 ~ , 113 .154 94 , 7 9 9 . 55a Investments land, buildings, and equipment: basis X553 - b Less: accumulated depreciation (attach f schedule) S5b 155c 56 Investments other(attachschedule) 56 573 Land, buildings, and equipment: basis 573 1 , 5 04 , 0 2 6 . b Less: accumulated depreciation (attach schedule) 57b 711, 586. 724, 118. 57c 792, 440. 58 O,ner ? Reserves & Deposits I 272,610. 58 224,732. assets ltlescribe 59 Total assets add lines a5 throw h 56) must equal line 7a) i , 818 , 5 8 5 . 59 2 , 0 2 7 0 6 6 . 60 Accounts payable and accrued expenses 6 i .218. 60 117 , 6 8 2 . 61 Grants payable 61 62 Deferred revenue 62 63 Loans from officers, tlirectors, trustees, and key employees (attach Liabilities schedule) 63:: 643 Tax-exempt bond liabilities (attach schedule) 643 b Mortgages and other notes payable (attach schedule) 8 4 S , 0 9 i . 64b 8 3 4 , 12 9 . 65 Omer ? Deposits & Client trust I 6, 109. 65 lia bihties ldescribe 66 Total liabilities add lines 60 throw h 65 912 , 418. 66 9 51 , 811 . Organizations that follow SFAS 117, check here... ? ~ and complete lines 67 through 69 and lines 73 and 74. 67 Unrestricted 701, 231. 67 864 , 879 . 68 Temporarily restricted 2 0 4, 9 3 7. 68 210 , 3 7 6. 69 Permanently restricted 69 Nat Organizations that do not follow SFAS 117, check here... ? a and complete Assets lines 70 through 74. or Fund 70 Capital stock, Vust principal, or current funds 70 Balances 71 paid-in or capital surplus, or land, building, and equipment fund 71 72 Retained earnings, endowment, accumulated income, or other funds....... 72 73 Total net assets or fund balances (add lines 67 through 69 OR lines 70 through 72; column (A) must equal line 19 and column (B) must equal line 2t) 906, 168. 73 1, 075, 255. 74 Total liabilities and net assets /fund balances add lines 66 and 73 1 , 8 18 , 5 9 6 . 74 2 , 0 2 7 , 0 6 6 . Form 990 is available for public inspection and, for some people, serves as the primary or sole source of information about a particular organization. How the public perceives an organization in such cases may be determined by the information presented on its return. Therefore, please make sure the return is complete and accurate and fully describes, in Part III, the organization's programs and accomplishments. can 7 99034 NTF 126a0 GLD 4225 Copyright Forms Soltware Only, 1991 Nelco Form 990 tss7) The Arc o,_ Hilo 99-0109668 l~ ~ u Pae4 PaR IV-A Reconciliation of Revenue per Audited Part N-B Reconciliation of Expenses per Audited Financial Statements with Revenue per Financial Statements with Expenses per Return (See Specific Instructions, page 20.) Return a Total revenue, gains, and other support ~ - a Total expenses and losses per audited : ( per audited financial statements ? a 1 , 3 61 , 2 77 . rnancial statements . ? a 1 , 19 2, 19 0 . b Amounts included on line a but not on b Amounts included on line a but not line 12, Form 990: r - on line t7, Form 990: Net unrealized gains i (1) Donated services on investments $ & use of facilities.. $ I:- (2) Donated services ffk (2) Prior year adjust- & use of faclities . $ I menu reported on (3) Recoveries of prior sine 20, Form 990. $ year grants $ (3) Losses reported on (4) Other (specify): line 20, Form 990. S (4) Other (specify): See Att. $ Add amounts on lines (1) through (4) ? b ~ See At t . S ~ i Add amounts on lines (t) through (4)...? I b C Line a minus line b ? i c li , 3 61 , 2 7 7 . C Line a minus line b ? I C ~l , 19 2 , 19 0 . d Amounts included on line 12, ( d Amounts included cn line 17, Form 990 but not on line a: t ( Form 990 but not en line a: (1) Investment expenses € (1) Investment expenses not included on ~ not included on line 6b, Form 990 $ line 6b, Form 990. $ (2) Other (specify): ~ ~ (2) Other (specify): Add amounts on lines (t) and (2) ? ~ d Add amounts on lines (t) and (2)......? L, d 8 Total revenue per line t2, Form 990 ~ 8 Total expenses per line 17, Form 990 I linec luslinedl e1,~o_,2?7 linec luslinedl..................? e.1,192,19O. e{~~Gf!31: List Of Officers, Directors, Trustees, and Key Employees (ust each one even if not compensated; see Specific Instructions on page 20.) (B) ~ Itle and average (C) Compensation (D) Contributions to ~ (E) Expense (A) Name and address hours per week (if not paid, emolo ee benefit plans) account and other devoted to poslticn enter -0-.) 8 dyeferred comp. allowances ~I i i i See attached schedule 75 Did any offcer, director, trustee, or key employee receive aggregate compensation of more than $'100,000 from your organization and all related organizations, of which more than $10,000 was provided by the related organizations?.... ? a Yes ®No If "'les," attach Schedule See Specific Instructions on page 20. can 7 99034 NTC Sisal GLD 4225 Copyright Forms Soliware Only, 199] Nelco ~'JI~V Form 990 1997) The Arc o~ dilo 99-0109668 Pa e5 `PgR V[ Other Information (See Specific Instructions on page zt.) vas No 76 Did organization engage in any activity not previously reporteC to IRS? If "Yes," attach detailed description of each activity 76 X 77 Were any changes made in the organizing or governing documents but not reported to the IRS? 77 ~ X If "Yes," attach a conformed copy of the changes. it 784 Did the organization have unrelated business gross income of 51,000 or more during the year covered by this return? ~78a, ~ X rte---- b if "Yes," has it tiled a [ax return on Form 990-T for !his year? N / A 78b 79 Was there a IiGwdation, dissolution, termination, cr substantial contraction during the yearv If "Yes," attach a statement 79 I XX 804 Is the organization related (other than by assoc:anon wiln a statewide or nalio nwide organization) throug'n common membership, governing bodies, trustees, officers, etc., to any other exempt or nonexempt organization? r Soai I X b If "Yes," enter the name of the organization ? NSA and check whether it is ~ exempt OR nonexempt ~ 814 Enter the amount of political expenditures, direct or indirect, as desc-ibed in the i instructions for line 81 814 ~ 0 . ; ` b Did the organization file Farm 1120-POL tar this year? . N ~.A ~ Slb 824 Did the organization receive donated services or the use of materials, equipment, or facilities at no charge or at ~ substantially less than fair rental value? 82a X b If "Yes," you may indicate the value of these items here. Do not include this amount as revenue in Part I Or as an expense in Part II. (See instructions for reporting in Part IIL) B2b~ N / p ~ ~ is 634 Did the organization comply with the public mspec:ion requirements for returns and exemption applications? , i 834 X b Did the organization comply with the disclosure requirements relating to quid pro quo contributions? . i, 83b1 X 844 Did the organization solicit any contributions or gifts that were not tax deductible? ii 844! X b If "Yes," did the organization Include with every solicitation an express statement that such contributions or gifts were not l tax deductible? `1./A 184b...;.:., 85 501(C)(a), (5), or (6) organizations. a Were substantially all dues nondeductible M' members? N /A ~ 854 b Did the organizaton make only in-house lobbying expenditures of 52,000 or less? N/A '.85b If "Yes" was answered to either 85a or BSb, do not complete 85c through 85h heiow unless the organization received a waiver for proxy tax Owed for the prior year. C Dues, assessments, and similar amounts from members ~ 85C N J p : d Section 162(e) lobbying and political expenditures $5d t ~ i. B Aggregate nondeductible amount of section 6033(e)(1 )(A) dues notices 858 - f Taxable amount of lobbying and political expenditures (line 85d less 85e) 85f g Does the organization elect to pay the section 6033(e) tax on the amount in 85f? Nf A . 85 h If section 6033(e)(1)(A) dues notices were sent, does the organization agree to add the amount in 85f to its reasonable estimate of dues allocable to nondeductible lobbying and political expenditures for the following tax year? N./A . 85h 66 501(0)(7) organizations. Enter. a Initiation fees and capital contributions included on line 12 864 f b Gross receipts, included on line 12, for public use of club facilities 86b 87 501(c)(12) organizations. Enter: a Gross income from members or shareholders....... 874 b Gross income from other sources. (Do not net amounts due or paid to other sources ~ " € against amounts due or received from them.) ~87b t 88 At any time during the year, did the organization own a 50°'0 or greater interest in a taxable corporation or partnership? If"Yes,"complete Part IX 88 X 894 501(c)(3) organizations. Enter: Amount of tax imposed during the year under. E section as11 ? 0 . ;section 4912 ? 0 . ;section assn ? 0 . k b 501(c)(3) and 501(c)(a) organizations. Did the organzation engage in any section 4958 excess benefit transaction ~ during the year? If "Yes," attach a statement explaining each transaction 89b X C Enter: Amount of tax imposed on the organization managers or disqualified persons during the year under sections 4912. 4955, and a958 ? 0 . d Enter. Amount of tax in 89c, above, reimbursed by the organization ? 0 . 904 List the states with which a copy of this return is filed ? NSA b Number of employees employed in the pay period that includes March 12, 1997 (See instructions.) 90b 3 91 The books are in care of? The Az'C of Hilo Telephone no.?(808) 935-8534 Located ac?1099 Waianuenue Avenue, Hilo, Hawaii zlP+a? 96720 92 Section 49a7(a)(1) nonexempt charitable trusts tiling Form 990 in lieu of Form 1041 Check here ? and enter the amount of tax-exempt interest received or accrued durino the tax year ? 92 cnn 7 99056 NTF 12BA2 GLD 2877 Copyriy M1l Forms Software Only, 199] Nelco fo,,.f~ The Arc of u~ l0 99-010960'8 Page 6 Pat. Analysis of Income oducin Activities (See Sgecifc InstlucnonS Gage 25.) Ente- _r_x zmeunts unless otherwise Unrelaeed busieess income Excluded by secaon 512, 513, er 51a (c) indi _r A (B) (C) (D) Related or exempt Business Ameunt ExGuslon cotle Amount function income 93 =r-r. service revenue: code a I I b I j I c ~ I d i I e=_~ Sch. Attached ~ I SF„ 319. f w_..re,memcaidpavmems...... r ! I g~ rd cpntrans from govt. agencies I I 95 4'-•+-sh p dues anE assessments . l I TM~.t on savings one temporary ws h ~ 1 C ~ 3 a p 9 ~e.= vents . 9B - rias one .merest born securities.... l 97 L+atal income pr(Ipssl from real estate: I acr-!nanced Property I, p~sat-flnanmd property 98 V2ldl inCOTe Or (IPSSlfrpm perSpnal I I I I I r--~-y I 99 ~ nvestmem income I 1Q0 mac '1~p551lrom sales of assets ether I [:a nventory i~ I - 2.S 5 . ' I 485. 101 Lanme pr (loss)irom spedaf events... 102 r pis prollt/(lass? from sales of inventory 103 G-~ revenue: a I b i I i C d I li I e_s_ Sch. Attached ~ I i 2i, 231. 104 S:atal(adecolumns(eL(D),antl(E)) i I ~ •L l 499 . 593, 801. 105 Taz(add line too, columns (B), (D), and ('E)) ? E24 , 3 00 . Note: fLnc tC5 plus line td. Part I, should equal the amount on line 12, Part L) PartY01' Relationship of Activities to the Accomplishment of Exempt Purposes (see sgecisc Instructions on pg. z6.> Lme i Explain how each activity for which income is reported in column (E) of Part VII contributed importantly to the accomplisnrnent of the ~ ~ organizatlon'S exempt purposes (other than by providing funds for such purposes). 93 'Program SerVi Ce reVenUeS SUIJDOrtS the "'eSlae_^.t1a1, eCUCaL1OR 'and vxational o~acrtur.ities =cr clients with mental retardation. I The Arc o= Hilo crovides varicus oroarams such as the Adult I PYOCram Vocational evaluation ~raini ng and rehabilitiati on, Sheltered work activities. These procrams sueport the ach,_evement o~ nrovidina educatior_al, vccat_onal and reabilitation or clients I with mental retardatien. I 95 I ZRte"'est 1RCOii'e 1S Cer_VeC -rOm. '-iUD reauired reserves. These lamcunts contribute to The Arc c'_ Hilo's procrams as stated above. See attached schedule :Part IXi Information Re ardin Taxable Subsidiaries Com late this Part if "Yes" box on line 88 is checked.) Name, address, and employer identification Percentage of I Nature of Total End-of-year num r Of co OfdiiOD or artnershlp gwnefS fp business ddtivitles inCDme assets be rp p , Interest N/A ~ i i l I ~d I I ^rd I U Or penalties Ol Penury, tleCfar fh Il have examined this return,nclutling accPmpanying 5cnedules and slatemUtS, and fp [he best Of myy knC"'lpdge and Please Deliel, s tie, correct, an comp~tetDeclaratio preparer lot Der than oificeq is DOSed on all inlormauon of wh`lcnpey~a~a~r.hpos~any knowlCaae. Se Ge- ucuon U, one ete.l .J.r'[aae~~ ~s~~iSE Here ' ~ W 9~`'~`1 ' Acz2v~- G~ 8t r fgnature of officer Date T pe or Door name and titre. Pre arer's ~ p ~ - Date Dneck n sal- Preparer's SSN Paid sig attire' ~`u-u'~~""" 12 / 0 6 / 9 9 ~ `pfo~ea ? ~ - - Preparer'e r Ann Fukuhara, CPA EIN ? 94-32'9888 Firm's name (or yours Use Only if self-employed) ' P . O . Box '0 6 91 zIP . a? 9 0 721 and address Hiio, Hawaii CnA 7 990$6 NTF 12843 Gtr 1877 Copyrlg Dl Forma Soli ware Only, 199] Nelro Name: The Ar(' of Hilo IDNo:99-01090'58 Attachment to 1997 Form 990 ~ ~~~,~I _ ~`-J LJ~ U Form 990 t9s~ The Arc of Nilo 99-0109658 Pa e 6 Part VII Anal SiS Of Income-ProduCin ACtivitieS (See Specific Instructions on pa a 25.) Enter gross amounts unless otherwise Vnrelated business income excluded by section 512, 5t3, pr 5ta ; (E) indicated (A> ~ (B) ~ (C) (D) Related or exempt Business 93 Program service revenue: cotle Amount jExclusion code Amount fu ncaon income a j b c I d I eSee Sch. Attached ! I X63,319. f Medicare/Meblcaid paymenlS i 9 Fees antl conlrac[s from govt. agencies 94 Memhers hip dues and assessments I I 95 Inleresl on savings and temporary cash ]_c~ j 3 0 , 4 9 9 . I nves (ments . 91) plvldends and imeres[Irom securities.... 97 Net rental income or (loss)OOm real eslale a de bt-financed property I bnol debt-llnanced property i ' 98 Nn rental Income or ;loss) o-om personal I property . 99 Olher lnveslment income. j 1QQ Gain or (loss)trom sales of assets other 1 han inventory - G J S . 101 Net lncomeor(loss)7romspeciaievents... 9,486. 1Q2 Gross prollV(lossl from sales al invenlory 103 Other revenue: a b c I I d I eSee Sch. Attached i ' 21 231. 1Q4 Subtotal (add columns(aL(Dl,and(Ep I 0 . 30, 499. 593, 801 . 105 Total (add line t0a, columns (e), (D), and (E)) ? 6 2 4 , 3 0 0 . Nate: (Line i05 plus line id, Part I, should equal the amount on line '12, Part L) Pstt V{!f! Relationshi of Activities to the Accom lishment of Exem t PUr OSOS (See Specific Instructions on p . 26.) Line No. Explain how each activity for which income is reported in column (E) of Part VII contributed importantly to the accomplishment of the ~ organization's exempt purposes (other than by providing funds for such purposes). 93 Program service revenues sun orts the residential, education and vocational o portur.ities for clients with mental retardation. The Arc of Hilo rovides various pro rams such as the Adult Program, Vocational evaluation. trainin and rehabilitiation, Sheltered work activities. These pro rams support the achievement of rovidin educational, vocational and rehabilitation of clients with mental retardation. 95 Interest income is derived from HUD required reserves. These amounts contribute to The Arc of Hi1o's ro rams as stated above. See attached schedule Rart1X' Information Re ardin Taxable Subsidiaries Com lets this Part if "Yes" box on line 88 is checked. Name, address, and employer identification Percentage of Nature of Total End-of-year ownersnlp number of corporation or partnership interest business activities income assets N/A °r °r ^r Under penalties of perjury,IdeClare than have examined this return, including accompanying scM1etlUles and stalemMtS, and to the best p(m knowledge and Please belief, nis Vag con<c6 antl complete. peclaratlono(prepamrtolner thanptliceq~s ~azedon alliNOrmallonof whichprepares hasany know~edge.lSee General Instruction U, on page I0.) Sign j Here ' Si nature of officer Date ' T e pr riot name and title. Preparer's n 1 A, Date eheckuseu- Preparer'sSSN Paid signature (,(Mxt l C~ '_2/06/99 ployed? Name: The Arc of Hilo IDNO:99-0109668' Attachment to 1997 Form 990 Part I -Statement of Revenue, Expenses, and Changes in Net Assets Line 9, S ecial Events and Activities Bpwit?1 fivrrnu: (AI (B) (C) Other Totel Gross Receipts 9, 4 8 6. 9, 4 8 c' . Less: Contributions Gross Revenue 9,486. 9,48o'. Less: Direct Expenses Net Income or (loss) , 9, 4 8 6. 9, 4 8 6. Description of Events: lA) Fashion show and garage sale (8) icy I other Copyright 1997-98 Universal Taz Systems, Inc. ~f 1 of ~ \ L.I/ /r SCHEDULE A organization Exempt Under Secti,.. ~ 501(c)(3) OMB N0.7545-0047 (Form 990) (Except Private Foundation) and Section 507(e), 50t(f), 50t(k), 507(n), or Section 4947(a)(7) Nonexempt Charitable Trust Supplementary Information 1997 oepar~ment of the Treasury See separate instructions. mtmn,l aevenue service ? Must be com leted b the above or anizations and attached [o their Form 990 or 990-EZ Name of the organization Employer identification number The Arc of Hilo 99-01096'08 Part: C Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees (See instructions on page 1. list each one. It there are none, enter "None.") (a) Name and address of each employee paid more (b) rtle and average hours (d) contribwlons m (e) Expense than $50,000 per week devoted to position (c) Compensation oei~ re aecompe~asm ooI other allowances N/A I I Total number of other employees paid over ~ ~ ~ i - $50,000 ? . E~~rt 4E Compensation of the Five Highest Paid Independent Contractors for Professional Services (See instructions on page t. List each one (whether individuals or firms). If there are none, enter "None.") (a) Name and address of each independent contractor paid more than $50,000 (b) Type of service (c) Compensation N/A Total number of others receiving over $50,000 for rofessional services ? Far Paperwork Reduction Act Notice, see page t of the instructions for Form 990 and Form 990-EZ. Schedule A (Form 990) 7997 CAA 7 990A12 NTF 126dd GLD 3274 Copyright Forms Software Only, 1997 Nelco The Arc. of Hilo 99-O109E68 ~'il 11~~ Schedule A (Form 990) 1997 page 2 Fart`'.€€€= Statements About Activities vas Nq 1 During the year, has the organization attempted to influence national, state, or local legislation, including any attempt to influence public opinion on a legislative matter or referendum? 1 X If "Yes." enter total expenses paid or incurred in connection with ;he lobbying activities ? 5 Organizations that made an election under sectors 501(h) by 'fling Form 5768 must complete Pan VI-A. Other organizations checking "Yes," must complete Part VI-B AND attach a statement giving a detailed description of the !0bbying activities. 2 During the year, has the organization, either 'irectly or indirectly engaged in any of the following acts with any o` its trustees, directors, officers, creators key employees or members of their families, or with any taxable organization with which any such person Is affiliated as an cfficer, director. trustee, majority owner, or principal beneficiary: ) E E f I: a Sale, exchange, or leasing cf property? 2a I, ~ X b Lending of money ar other extension of credd? 2t) X C Furnishing of goods, services, or facilities? 12C X d Payment of compensation (or payment or reimbursement of expenses if more than 51,000)? 2d X e Transfer of any part of its income or assets? 29 X If the answer to any question is "Yes," attach a detailed statement explaining the transactions. I I 3 Does the organization make grants for scholarships, fellowships, student loans, etc.? 3 X 4 Attach a statement to explain how the organization determines that individuals or organizations receiving grants or loans from it in furtherance of its Charitable programs qualify to receive payments. (See instructions on page 2.) r ParilV Reason for Non-Private Foundation Status (see instructions on pages z through a.) The organization is not a private foundation because it is: (Please check only ONE applicable box.) 5 A church, convention of churches, or association of churches. Section 170(,b)(1)(A)(i). 6 A school. Section 170(b)(t)(A)(ii). (Also complete Part V, page a.) 7 A hospital or a cooperative hospital servlco organ¢ation. Section 170(b)(1)(A)(iii). 8 A Federal, state, or local government or governmental unit. Section 170(b)(t)(A)(v). 9 A medical research organization operated in conjunction with a hospital. Section 170(b)(1 )(A)(iii). Enter the hospital's name, city, and state ? 10 ~ An organization operated for the benefit of a college cr university owned or operated by a governmental unit. Section 170(b)(1 )(A)(iv). (Also complete the Support Schedule in Part N-A.) 11a ®An organization that normally receives a substantial part of its support from a governmental unit or from the general public. Section T70(b)(1)(A)(vi). (Also complete the Support Schedule in Part IV-A.) 11b 8 A community trust. Section 170(b)(1 )!A)(vi). (Also complete the Support Schedule in Part IV-A.) 12 An organization that normally receives: (1) more than 33 ti3%of its support from contributions, membership fees, and gross receipts from activities related to its charitable, etc., functions subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired b/ the organization after June 30, 1975. See section 509(a)(2). (Also complete the Support Schedule in Part IV-A.) 13 ~ An organization that is not controlled by any disqualified persons (other than foundation managers) and supports organizations described in: (1) lines 5 through 12 above; or (2) section 501(c)(a), (5), or (6), if ;hey meet the test of section 509(a)(2). (See section 509(a)(3).) Provide the following information about the supported or anizations. (See instructions on oa a a.) (a) Name(s) or supported organization(s) (b) Line number from above N/A 14 ~ An organization organized and operated tp test `or public safety Section 509(a)(a) (See ~nstruc[ions on page a ) Can 7 990A72 NrF tzsa5 GLD 3274 Copyright Forms Software Only, 1991 Nelco The Arc. of Hilo '~9-0109668 ~OL1 LJ Schedule A Form 990) 1997 Paqe 3 pal't'~(-A SuPpOft SCh BduIB (Complete only if you checked a box on line 70, 11, or 12.) Use cash method of accounting. Note: You may use the worksheet in the instructions for co nvertin from the accrual to the cash method of accountin . Glendar year for fiscal year beginning inl? (a) 1996 (b) 1995 (c) 1994 (d) 1993 ~ (e) Total 15 GI(ls, grants, and cantributlons received. coo not include unusual gams. see nne ze.l.......... 835, 557. 843, 947. 801, 891. 956, 850. 3, 438, 245. 16 Membership lees received 17 Gross receipts tram admisslpns, merchandise sold or services _ performed, or furnishing of f acillUes in any activity t hat Is not a business unrelated to the organinllon's chamable, etc., 575 799. 609, 976. 536, 323. 506, 355. 2, 228, 453. purpose . 16 craft m<ome from Interest i dlvitlentl5, amounts received tram aymentt on secunties loans Pse<tlen 512(ap5p, reins, royalll<s, and unrelaletl business ' taXa bee income (less section 511 taXlS) IrOm )O51nGSSGS dCQUhCd oy ~5eorganl:aupn aver June 9e' 31, 887. 13, 148. 8, 587.. 5, 733. 59, 40'0. 19 NBet Income from unrelaletl business actlvitles not Included In Ilne 18 20 Taz revenues leveed for the organization's benefit and either paid to it or expendetl on Its behalf 21 The value of services or lacilNies furnished to the organization by a governmental unit wit he Ul charge. Da naI Include the value of services or f acilllles generally lurnlshetl lO the public wllhoul charge . . 22 Other income. Attach aschedWe. Da not lnclutle gain or liossl from sale of capital assets 10 , 4 7 9. 9, 8 41 . 3, 5 0 3. 0. 2 3, 8 2 3. 23 rotalonmetlsihropghzz..... 1, 453, 722. 475, 912. 1, 350, 404. 1, 458, 953. 5, 749, 991. 24 unez4minuthne,7......... 877, 923. 866, 936. 814, OSi. 962, 588. 3, 52i, 528. 25 Enters%onfneza.......... 14,537.E 14,769. i3, 504. 14,690.;: 26 Organizations described in lines 10 or 11: 9 Enter 2 % of amount in column (e), line 2a ? 26a ~ 70 4 3 1 . b Attach a list (which is not oFen to public inspection) showing the name of and amount contributed by each person (other than a governmental unit or publicly supported organization) whose total gifts for 1993 i through 1996 exceeded the amount shown in line 26a. Enter the sum of all these excess amounts ? 26b C Total support for section 509(a)(1) test: Enter line 24, column (e) ? 26C ~ 3 , 5 21 ,~~5 2 8 . d Add: Amounts from col. (e) for lines: 18 5 9 , 4 6 0 . 19 22 23 , 823. 26b ? 26d 93 , 283 e Public support (line 26c minus line 26d tataq ? 269 3 , 4 3 8 , 2 4 5 . f Public support percents a (line 26e numerator) divided by line 26c (denominator)) ? 26f 97.54 27 Organizations described on line 12: 3 For amounts included in lines 15, 16, and 17 that were received from a "disqualified person,' attach a list to show the name of, and total amounts received in each year from, each "disqualifed person.' Enter the sum of such amounts for each year: (1996) 0. (1995) 0. (199a) 0. (1993) 0 . b For any amount included in Tine 17 that was received from a nondisqualified person, attach a list to show the name of, and amount received far each year, that was more than the larger of (1) the amount on line 25 for the year or (2) 55,000. (Include in the list organizations described in lines 5 through 11, as well as individuals.) After computing the difference between the amount received and the larger amount described in (1) or (2), enter the sum of these differences (the excess amounts) for each year. (1996) 0 . (1995) 0 . (1994) 0 . (1993) 0 . C Add: Amounts from col. (e) for lines: 15 16 17 20 21 ? 27C Aed:une ? 27d d 2ra rotal and line 27b total . 0 Public support (line 27c total minus line 27d total) ? 27B t Total support far section 509(a)(2) test: Enter amount on line 23, col. (e). ? 27f $ _ _ g Public support percentage (line 27e (numerator) divided by line 27f (denominator)) ? 27 h Investment income percents a (line 18, column (e) (numerator) divided by line 271 denominator ? 27h 28 Unusual Grants: For an organisation described in line 10, t 1, or 12 that receivetl any unusual grants during 1993 through '1996, attach a list (which is not open to public inspection) for each year showing the name of the contributor, the date and amount of the grant, and a brief de5cnpti0n of the nature of the grant. Do not inclutle these grants in line 15. (See instructions on page 4.) 0 cAA 7 990A34 NrF uses GLD 3275 Copyright Forms Software Only, 1997 Nelco The Arc of Hilo ~9-0109668 Schedule A Form 990) 1997 Pa e 4 .Part V Private School Questionnaire (sae instructions on page 4.) (To be completed ONLY by schools that checked the box on line 6 in Part IV) N ~A Yes Na 29 Does tha organization have a racially nondiscriminatory policy toward students by statement in its charter, bylaws, other governing instrument, or in a resolution of its governing body? 29 30 Does the organization include a statement of its racially nondiscriminatory policy toward students in all its brochures, catalogues, and other written communications with the public dealing with student admissions, programs, and scholarships7 30 31 Has the organization publicized its racially nondiscriminatory policy through newspaper or broadcast media during the ~ _ period of solicdalion for students, or during the registration period if it has no solicdation program, in a way that makes the policy known to all parts of the general community R serves? j 31 If "Yes,' please describe; if "No," please explain. (It you need more space, attach a separate statement.) f{[~ tE E 32 Does the organization maintain the following: a Records indicating the racial composition of the student body, faculty, and administrative staff? 32a b bas s ds documenting that scholarships and other financial assistance are awarded on a racially nondiscriminatory 32b I C Copies of all catalogues, brochures, announcements, and other written communications to the public dealing with student admissions, programs, and scholarships? 32C d Copies of ail material used by the organization or on its behalf to solicit contributions? 32d It ydu answered "Nc" to any of the above, please explain. (It you need more space, attach a separate statement.) € 33 Does the organization discriminate by race in any way wdh respect to: k a Students' rights or privileges? _ 33a I b Admissions pclicies? 33b C Employment of faculty or administrative staff? 33c d Schglarships or other f nancial assistance? 33d I e Educational policies? 3361 f use of facilities? 33f g Athteticprograms? 33 h Other extracurricular activities? 33h If you answered "Yes" to any of the above, please explain. (If you need more space, attach a separate statement) 34a Does the organization receive any financial aid or assistance from a governmental agency? 342 b Has the organization's right to such aid ever been revoked or suspended? 34b If you answered "Yes" to either 3aa or b, please explain using an attached statement. 35 Does the organization certify that it has complied with the applicable requirements of sections 4.01 through 4.05 of t Rev Proc 75-50 1975-2 C B 587 covering racial nondiscrimination? If "Ng," attach an explanation 135 , cnn 7 990A34 NTF t26d) GLD 3275 Copyright forms Sollware Only, 1997 Nelco The' Arc .of Hilo 9-Oi09568 Schedule A Farm 990 1997 Pa e 5 €Pait Vf-'A Lobbying Expenditures by Electing Public Charities (see instructions on page s.) (To be completed ONLY by an eligible organization that filed Form 5768) Check here ? a it the organization belongs to an affiliated group. Check here ? b If you checked "a" above and "limped control" provisions apply. (a) (b) Limits on Lobbying Expenditures Affiliated group To be completed tplals for ALL electing (The term "expenditures" means amours paiC Or incurred.) organizations 36 Total lobbying expenditures to influence public oplnion (grassrocts lobbymg) 36 I 37 Total lobbying expenditures to influence a legislative body (cirect lobbying).......... 37 1 38 Total lobbying expenditures (add lines 36 and 37) ~ 38 39 Other exempt purpose expenditures 39 40 Total exempt purpose expenditures (add lines 3H and 39) . 40 41 Lobbying nontaxable amount Enter the amount frcm the following table - - If the amount on line 40 is The lobbying nontaxable amount is Not over 5500,000 . 20 % of the amount on line a0 Over 5500,000 but not over $1,000,000... staa,ooa pms ~sv, of the excess aver ssao,ooo . Over $1,000,000 but not over $1,500,000. sns,aoo pms iav of the exeess over Et,9aa,aoo 4l Over $t,5D0,000 but not over $17,DDD,000 4225.000 pWS S%ol the excess over 51,600,0911 Over $17,000,000 31,000,000............. 42 Grassroots nontaxable amount (enter 25°6 of line a1) 42 , 43 Subtract line a2 from line 36. Enter -D- if line a21s more than line 36 43 4d Subtract line 41 from line 38. Enter -D- if line 4t is more than line 38 Caution: If there is an amount on either line a3 ur line aa, you must file Form a720. ~ t 4-Year Averaging Period Under Section 601(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. N /A See the instructions `or tines a5 through 50 on page 7.) Lobbying Expenditures During 4-Year Averaging Period Calendar year (or fiscal (a) ro) (c) (d) (e) year be innin in} ? 1997 1996 1995 1994 Total 45 Lobbying nontaxable amount . 46 Lobbyin ceiling amount (9150%< Of line 45(e)) ~ ` 47 Total lobbying expenditures 48 Grassroots nontaxable amount . 49 Grassroots ceiling amount ((150 of line 48(e)) . 50 Grassroots lobbying ex enditures FarE Yf-B Lobbying Activity by Nonelecting Public Charities (For reportin only by or anizations that did not complete Part VI-A) (See instructions on pa e 7.) During ;he year, did the organization attempt to influence national, state or local legislation, including any Yes No Amount attempt to influence public opinion on a legislative matter or referendum, through the use of: a Volunteers X b Paid staff or management (Include compensation in expenses reported on lines c through h.) X C Media advertisements X d Mailings to members, legislators, or the public X e Publications, or published or broadcast statements X t Grants to other organizations for lobbying purposes X g Direct contact with legislators, their staffs, government officials, pr a legislative body I X h Rallies, demonstrations, seminars, conventions, sFeeches, lectures, or any other means X i Total lobbying expenditures (add lines c through h) If "Ves" to any of the above also attach a statement ^iyinq a detailed description of 'he lobbying activities. CAA ~ 99~A56 NTF 12648 GLD 3276 Copyright Farms Software Only, 199] Nelco The Arc~of Hilo 3-0109668 Schedule A Farm 990) t997 Pa e 6 Pact.VlC Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations 51 Did the reporting organization directly or indirectly engage in any of the following with any other organization descnbed in section SOt(q of the Code (other than section SDt (c)(3) organizations) or in section 527, relating to political organizations? a Transfers from the reporting organization to a no nchantable exempt organization oC Yes No (i) Cash _ 51ai X (ii) Other assets a ii ~ X b Other transactions: (i) Sales of assets to a noncharitable exempt organization b i) X (ii) Purchases of assets from a noncharitable exempt organization b ii X (iii) Rental of facilities or equipment b iii ~ ~ X (iv) P.eimbursement arrangements b Iv I , X (v) Loans orloan guarantees b v X (vi) Performance of services or membership or fundraising solicitations b VI X C Sharing of factlities, equipment, mailing lists, other assets, or paid employees ~ C ~ X d If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the fair market value of the goods, other assets, or services given by the reporting organization. If the organization received less than fair market value in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received: (a) (b) (c) (d) Line no. Amount Involved Name of noncharitable exempt rrganization Description of transfers, transactons, & sharing arrangements N/A ; A I I I 528 Is the organization directy or indirectly affiliated with, or related to, one or more tax-exempt organizations described in section 501(c) of the Code (other than section 5Dt(c)(3)) or in section 527? ? ~ Yes ~ No t) If "Yes," complete the followin schedule: Name of organization Type of organization .Description of relationship N/A coq 7 990A56 NrF izsas GLD 3276 Gop yrighl forms Software O~iy, 199] Nemo NAME :'The Arc of Hilo ID N0:99-0109658 SUPPORTING SCHEDULE 1997 Form 990 Part I - Statement of Revenue, Expenses, and Changes in Net Assets Line 1 - Contributions, Gifts, Grants, and Similar Amounts Received. (List only money, securities, or property worth $5,000 or more.) Amount Date Contributors' Name aad Address Received Received Various donations 19,154. Atherton foundation 7,000. Total 26,164. The Arc of Hilo Federal ID No. 99-0109668 Statement Part III The Arc of Hilo's primary exempt purpose is to provide residential, educational, and vocational opportunities for disabled adults and adults with mental retardation. Statement Part III The Arc of Hilo's vocational rehabilitation and adult day program provided sheltered work and job placements for more than 150 disabled adults. In addition, residential support services subsidized housing served more than 100 disabled adults with mental retardation. Total program expenses "1,093,953. NAME:The FArc of Hilo ID N0:99-0109668 SUPPORTING SCHEDULE 1997 Form 990 Part II - Statement of Functional Expenses Depreciation, Depletion, etc. Current 179 Accum. Description Basis Method Life Depr. Exp. Depr. Property & Equip 1,504,025. SL Various 80,491. 711,586. Totals 1,504,026. 80,491. 711,586. 1997 Form 990 Part II - Statement of Functional expenses Line 43 - Other Expenses (B) Program (C) Mgmt. (D) Fund- Description (A) Total Services & General raising Insurance 39,907. 39,907. ~ Miscellaneous 10,898. 10,898. Professional fees 11,627. 11,627. Program 28,525. 28,625. Repairs and maintenance 6,608. 5,608. Staff training 1,189. 1,189. Sales tax 20,300. 20,300. Transportation & vehicle 20,505. 20,505. Utilities & telephone 61,200. 61,200. Totals 200,859. 200,859. • NAlME:The Arc of Hilo ID N0:99-0109658 SUPPORTING SCHEDULE 1997 Form 990 Part IV, Balance Sheets - Line 51 Other Notes and Loans Receivable Original Balance Date of Maturity Description Amount Due Note Date Mortgage receivable 51,000. 50,170. 03/12/96 Totals 51,000. 50,170. 1997 Form 990 Part IV, Balance Sheets - Line 54 Investments - Securities Market Description Cost Value Investments - Prudential 94,799. , Total 94,799. 1997 Form 990 Part IV, Balance Sheets - Line 57 Land, Buildings, and Equipment Cost/ Accumulated Book Description Basis Deprec. Value Property & Equipment 1,504,026. 711,586. 792,440. Totals 1,504,026. 711,586. 792,440. 1997 Form 990 Part IV, Balance Sheets - Line 58 Other Assets Description Amount Deposits held in escrow 85,000. Lease bonds 1,000. Interfund receivables 138,732. NAME:The Arc of Hilo ID N0:99-0109668 SUPPORTING SCHEDULE 1997 Form 990 Part IV, Balance Sheets - Line 58 Other Assets Description Amount (Cont.) Total 224,732. 1997 Form 990 Part IV, Balance Sheets - Line 64b Mortgages and Other Notes Payable Original Balance Date of Maturity Description Amount Due Note Date Mortgage - Housing Urban Develop 83x,129. Totals 834,129. NAME:The Arc of Hilo ID N0:99-0109668 SUPPORTING SCHEDULE 1997 Form 950 Part V - List of Officers, Directors-, and Trustees (D)Contri- (E) Expense (B)Title and (C)Compen- butions to account and average hours sation (if employee other (A) Name and Address per week not paid) bea. plans allowances Louis Pavao President 0. 0. 0. 632-B Kaumana Drive 2 Hrs/wk Glenn Hirata Vice President 0. 0. 0. 15-2712 Moi Street 2 Hrs/wk Hal Smith Treasurer 0. 0. 0. 2817 Maiko Street 2 Hrs/wk Doris Iwaoka Secretary 0. 0. 0. 799 Komomala Street 2 Hrs/wk Ellen Aoki Board Member 0. 0. 0. 1444 Mona Loon 1 Hr/wk Winston China Board Member 0. 0. 0. 25 Hanohano Street 1 Hr/Wk Phyllis Hayama Board Member 0. 0. 0. 345 Anela Street 1 H.r/Wk „ Laraine Kawasaki Board Member 0. 0. 480 Mohouli Street 1 Hr/wk Florence Kubota Board Member 0. 0. 0. 33 Manulele Street i Hr/wk Louise Northwood Board Member 0. 0. 0. 700 Akolea Street 1 Hr/wk Takashi Sasa'ti Board Member 0. 0. 0. 75 A Huaalari Street 1 Hr/wk Paul Roserdahl Board Member 0. 0. 0. 204 Wiaranueaue Ave 1 Hr/wk Richard Santos Executive Dir 39,890. 1,512. 0. 1099 Waiaruenue 40 hrs/wk NAME:The Arc of Hilo ID N0:99-0109668 SUPPORTING SCHEDULE 1997 Form 990 Part VII - Analysis of Income-Producing Activities Line 93 - Program Service Revenue Unrelated Excluded by sec. Business Income 512, 513, or 514 (e) Related (a) (c) or exempt Bus. (b) Excl. (d) function Description code Amount code Amount income Rehabilitation, vocation 563,319. and other programs for adults with disabilities Totals 563,319. 1997 Form 990 Part VII Analysis of Income-Producing Activities Line 103 - Other Revenue Unrelated Excluded by sec. Business Income 512, 513, or 514 (e) Related (a) (c) or exempt Bus. (b) Excl. (d) function Description code Amount code Amount income Other income from 21,231. operations Totals 21,231. 1997 Form 990 Part VIII Relationship of Activities to the Accomplishment of Exempt Purposes Line No. Explanation 100 The Arc of Hilo disposed of various equipment at a loss. 101 Net proceeds from a fashion show and a garage sale. Proceeds used for client excursions and travel. 103 Miscellaneous income from a vending machines, sales of Guava, and other income used for residential, educational and vocational training for clients who are mentally disabled. NAME:The Arc of Hilc ID N0:99-0109668 SUPPORTING SCHEDULE Schedule A (Form 990), Part IV Support Schedule Line 22 - Other Income (a) (b) (c) (d) (e) Description 1996 1995 1994 1993 Total Misc 10,479. 9,841. 3,503. 0. 23,823. Totals 10,479. 9,841. 3,503. 0. 23,823. INTERNAL REVENUE SERVICE (IRS) LETTER Program Title: Residential and Support Services; Ka Home Pulama, Domiciliary Home Internal Revenue Sarv' Department 5e Treasury District Dirac:ar Parson .o Contact: E~' T ?2C OF HILO Ta:epheneNu.^ber. (iiZ~3~ 72g_t235 1099 w~I<LVtiH`itTe A7`c i0, HI 96720-?096 FafarPaplyto: EOMP Coo rdiracar Date: c~7 i l 196 ~ cL`'u` 99-0109668 ~..~_rnal Revenue Code Section: . SOL(c)C031 •02_: Sir or Madam: .han'.t you Fcr sccmiCt_::g the _..'o-3tior, scow belcv of or. the 9aclosure. We have mzd9 it 3 pate o6 your _i1e. ~:1°_ Ch2n325 LRd iC3C9d d0 ROC 3d'?er521y 3=~eCC yOUC ?X2.^.pC ~Cd CI:S a!td C^C .^_X~^..^..:7 C:Oi. 1000?t i55Ue~ CO YOU COn_'_lcl°5 I!1 2PC000. ::9352 19t LLS ~n0~: 3CCLC 3R'J [l1 Ct_r9 C'.a::~2 tl.e C^a raCC2r, pC tC052, ii2 C.^.OC CC OOarc~iOR, ^ame Or aCdC9s5 OC ;JCCr Oro=R1=cC1CG. Lit S is a C__, __6^e.^.t COr ~..C2i :i Zo VCL'r 9X e.T.pC SCa C::S. _canic ycc .or your ccope_aticn. ~~SiRCereiy Your/~/s~,~~..~~ Cistrict Director I-aa Ch3Ra2d to^ To (Name) Hilo Association For Retarded (S E ~SOVE) Citizens .-y- c°/G~ D±o is icn "cC3s'__.. L^.~ustrizl Par;. _ _ ~Z Ce~zaia Circle "cc~~_c=_y ?3 r:<, CA SL755-7GC6 ~ Letttr 976(CG)(R2v. 1-87) Internal Revenue Ser ~ Department , Treasury Distrkt P.O. Hox 2350 Los Angeles, Callf. 90053 O~rector Person to Contact: LUCILLE BA_RR.~GAN P HILO ASSOCIATION FOR Talephone bomber- RETARDED CITIZENS (213) 894-2336 1099 WAIANUENUE AVENUE Refer Reply to HZLO, HI 96720-2096 EO(100593) Date: NOV 0 3 1993 RE: HILO ASSOCIATION FOR RETARDED CITIZENS EIN: 99-0109668 GENTLEMEN: This letter is in response to your request for a copy of the determination letter for the above-named organization. our records indicate that this organization was recognized to be exempt from Federal income tax in FEBRUARY 1955 as j described in Internal Revenue Code Section 501(C)(03). It is J further classified as an organization that is not a private foundation as defined in Section 509(a) of the code, because it is an organization described in Section 170(b)(1)(A)(i). The exempt status for the determination letter issued in FEBRUARY 1955, continues to be in effect. If you need further assistance, please contact our office at the above address or telephone number. Sincerely, Disclosure Assistant \~1(~~ LIABILITY INSURANCE CERTIFICATE Program Title: Residential and Support Services; Ka Home Pulama, Domiciliary Home ACORD GERTIF~C.' TE ©F I_:tABiItTY INSt•~~I~LE Dare imrvpliml - 01/31/2000 PRODUCER (808)935-6034 FAX (808)935-6312 ~TRiS~CERTtFfL'A'rFiS-ISSIIE riad Insuranc2 Agency, InG. I ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR c/o American Insurance Agency, Inc. I ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 900 Fort Street Mall, Suite 500 COMPANIES AFFORDING COVERAGE Honolulu, HI 96813-3105 ~GMPnNY Admiral Insurance Co. Attn: Duane Sugihara Ext: X34 A INSURED COMPANY The ARC of Hilo dba Hilo Rehab Center & Hilo ARC Housing Corp. ~1 & Hale Ulu Hoi III a ',,;vi;~ 1099 Waianuenue Avenue ~G•.+PaNV c Hilo. HI 96720 ^ObIPANV D I COVERAGES THIS IS -0 CERTIFY THAT THE PGL'CIES OF INSURANCE LISTED aELCW ~ :AYE SEEN ISSUED TO THE INSURED NAMED ABOVE FCR THE RGLICY PERIGD INCICATEC, NOTWITHSTANDING ANV RECUIREMENT TERM CR GCNCITICN OF ANV CONTRACT CR OTHER CCCUMENT''NITH RESPECT TC'NHICH THIS I CER i IFICATE .MAY aE =SSUEC OR MAY PERTAIN. THE INSURANCE AF~GRD EC 9V THE ~CLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EcCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN 3ECL'CEC EY PAID CLAIMS CO 'YPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR PATE iMMIpDIW) GATE (MMIDD/YY) '_IMITS G'cNERAI LIABILITY GENERAL AGGREGATE 5 1 OQD DDS X COMMERCIAL GENERAL!IABIL'TY ~RGCUCTS-OGMP`GP +GG 5 CL4IMS MADE X OCCUR 'ERSONAL3 ADV INJURY S 1 ~ DDD ~ DDD A A99AC07779 12,'D2.':999 D7'Ol/2001 1,000,DOO owNER's s coNrre;.ceGR•s artGT EACH occJRRENCE s ' , 000, 000 ~ ='RE OAMAC-E ;AOy one lire) 1EXC1Ud e0 `nEDE'(P(Anvaneoerscnl i EXCIUded AUTOMOBILE LIABILITY T!?!S ''surance CCCtnaGt Ij i;,Q,'.'B'.'J Oj+ an 1.5... COMEINED SINGLE'_IMIT ANV AUro nct IICel:Sed C'y '`~O State -P,7a3i1 3nG ~ 3CI Au owNEp AUTGS It3 e^UIaiIOn Cr .X2fil^Ct:0;1. IE 'r ~ ~ ~ EoclLV m~uav s y the .i,.ar:,~ i ~;-~c:,d SCFEDUL_] AUTOS i ,Per person) in;obrert, c,ain undzr ;his ccn.r~ct arG ,,c: coverod cy HIRED AUTOS ~ any guaranty and Gi the State vt Ha'.Y¢IL• 3CDILV MJURY S Per acctlenel NON-OWN`cp AUTOS TFlPD INSii-,,:,~!uS AGcI~lC`! MC. jSurplu5 Line crG':zr - ,A T~`h.,-~~. nROPERT`!DAMAGE S LIGen$•~ I._ GARAGE LIABILITY ~ V; ai2:1aIT;(iv .1 r.. :j L'1le 2~.^.. I"I D'1.^.I U~U, H~~ .`j i_„j~ AUTO CNLY~UAGGIOENT S ANY AUTO OTHER THAN AUTO GNLV UCH ACCIDENT 5 ~~AGGREGAi'c S EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM >GGREGATE S OTHER THAN UMBRELL>FORM S WORKERS COMPENSATION ANO TORY LIMITG DER EMPLOVERS'LIABILITY - E! EACH ACG:DENT S THE PROPRIETOR/ INCL EL DISEASE -POLICY LIMIT 5 PARTNERS/EX'cCUTIVE OFFIC'cRS ARE EXGL EL DISEASE - U EMPLOYEE 4 OTHER Professional Liability 51,000,000 Each Claim A Claims Made Form, A9gpL09571 12/02/1999 07/01/2001 51,000,000 Aggregate 12/02/1997 Retroactive Date DESCRIPTION OF OPERATIONSILOCATIONSNEMICLESISPECIAL ITEMS ertificate holder is additional insured in accordance with policy provisions as their interest may ppear. Grant: KHP Group Home .CERTIFICATE-HOLDER - GANOELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL _3Q_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, County of Hawaii Bl d.'K 0104715471-85341 ~BUT~FA,IJW'~R,~EJT~(O~tMALIL SUCH NOTICE SHALL IMPOSENO OBLIGATION OR LIABILTY 15 Aupuni Street REPRESENTATIVES. H110, HI 96720 AUTHORIZED REPRESENTATIVE By ACORII 25•S(1t9S}: ®A.COW7-GQRPOfYATIQrt-t9 General Agee} ARTICLES OF INCORPORATION Program Title: Residential and Support Services; Ka Home Pulama, Domiciliary Home Nonrefundable Filing Fee: 225.4.." /O• DOMESTIC NONPROFIT Submit Original antl One True Copy Name Change Amendment STATE OF HAW:.11 ( DEPARTMENT OF COMMERCE ANO CONSUMER AFFAIRS 1 ~ i~~ i~ II ~ Business Registration Division ~ ~ - ~ f ~it ~ - tpt0 Richards Sweet , l.~ Malting Adtlress: P. O. Bc>: a0, Honolulu, Hawar 96810 J Nntf ' vYtC ~I~L~Ipu,1J~1 UQ?•O `J~11.77J ARTICLES OF AMENDMENT TO CHANGE CORPORATE Ccmrerre 8 CaascRer A";irs (Section 415&38, Hawaii Revised Statutes) S't,iE C~ H:r:;,u The undersigned, duly authorized officers pf the corporation submitting these Articles of Amendment, certify as follows: 1. The present name of the corporation is: Hile Association Por Retarded Citiz°ns 2. The corporation's name is changed to: Tne Arc v` Hilo 3. If adoption of the amendment was by the members, complete the following: A. A meeting of the members was held on (Hoorn par Year) A quorum was present at the meeting, and at least two-thirds of the members present at the meeting voted to adopt the amendment. OR 8. The amendment was aCOpted by the written consent of all of the members of the corporator entitled to. vote. 4. If adoption of the amendment was by the board of directors, complete the following: A. A meeting of the directors was held on Ncv=tuber 8, 1 995 (MOnln pay - Yearl A quorum was presant at me meetir:y, anC a majority of the directors in office voted to aCOpt the amendment CR B. The amendment was adopted by the written consent of all of the Board of Directors. 5. If [he amendment was adopted by the Board of Cirectors, check one of the following: [ ] The corporation has no members. OR (X j There are no members entitled to vote. We certify under the penalties of 4158-158, Hawaii Revised Statutes, that we have read the above statements. and that the same are true and correct. Witness our hands this ~ Bth day of Ncvemher , tg g5 Cpuis H. Pavan President Glenn 5. H;rata, Vice President }~~/1~J~'f(~ ~~~/pa~''lP~rr~n'rj~N(~ame 8 Tile) (T rPnnl a Ll/e) ~ fS9nature o/OMCer) fS4natursol OH¢er) (See Reverse Side For I stfuctions) oz-z w. l olv _ • ti SS- - ~ _ - '..c 1?-;? - _ '-~-Iilo ARC Hilo Association ;='or Retarded Citizens 1099 Waianuenue Avenue Hilo, Hawaii 96720 ' 935-7644 ' August 9, 1994 To +rhom it concerns: 1 On August 2, 1994 a aotion eras passed by the the Board of Direetars of Hilo Association for Retarded Citizens dba Hilo Vocational Bahabilitation.Genter that, 'No part of the eet ineoee of the Hilo Association for 3etarded Citizens aay inure to the benefit of any shareholder ar individual. Louis H. pavan . (resident - _ . ! ~I ' ~ I Residential and Support Services Vo~tional Rehab[litation Services ~ 935-7644 935-8534 DEPARTt;ENT OF CUPIPIERCE AND CONSUf1ER AFFAIRS Business Registration Division P. 0. Box 40, Hcnolulu, Hawaii 96810 Date: Ma_*cn 23. 1988 Hi 1o Association to Eelc Retarded , Citizens 1099 tvaianuenue Avenue Hilo, HI 96720 Re: Hilo Association to He1o Retarded Citizens - Articles of Amendment The date of incorporation for the above corporation is Enclosed is the information srteet nor corporations. There were no duplicate copies of the Articles of Incorporation to return. Q The date of registration for the above partnership is There wen=_ no dupiicate conies of the document to return. Q Date of filinc of the abcve document is November 4, 1987. There were no duel_cate conies to return. Business Registration Division Documents Processing Branch 3 . c ram-o-~ crr,~.o~ ~-..-'^..Y ~ 1, FilinS Fac Lt0.00 ` _ - DOMESTIC NONPROFIT Alshonred CNenlc ST.50 - ~ ^ General Amendment STATE OF HAWAII ' ~OEPAATMENT OF COMMERCE ANO CONSUM EA AFFAIRS Business Regiatntian Division t0,0 R~ards Sucet Ma,Lng Redress P. 0. Bo: a0, Hawlulu, Nawar, %a~0 ~ AFtT1CLES OF AMENDMENT o° O _ (Section 4158-38, Hawaii Fievised Statutes) ~ _ ~l„1 c 1 1ii:::l~;ti c?t cH!U:'_4 c_:^~ _ - 4 C _ H " - ` It WN2 N'I >U~ ~ `lam - = ° Tb„g_'•3ndersigned. Culy auNarized officers of the corporation suhmitting these Articles of Amendment, 'J) ~ certity~ follows: n 1. Tye rar~ia of the cc, poracon is: „t ~,I.~ ~Y Hilo A.sscci ation to Heln Retareed Citizens 7'~ 2. The amendment adopted is attached. 3. !f adoption of the amendment was by the members. eamplete the following: A. A meeting of the members was held on NOVen.ICEr 8 1986 (MOn,n Day Year) A quorum was present at the meeting, and at least two-hird5 of the members present at the meeting voted to adapt the amendment. OR 9. The amenCmen[ was adopted by the written consent of all of +he members of the corporation entitled to vote. 4. ~ It adoption of U1e amendment was by the board of direC.ors, eamplete the fallowing: A. A meeting of Ne directors was held on (MOn,n Day reel A quorum was present at the meeting, and a majcrity of the directors present at the meeting voted to aCCpt the amendment. OR B. The amendment was adapted by the written consent of all of the board of directors. . 5. If the amendment was adopted by the Ward of direr;crs, check only one of the following: ( j The corporation has no members. OR ( J There are no members entitled to vote. We certify under the penalties Of 4158-IJB. Hawaii Revised Statutes, that we have read the above statements, and that the same are true and correct. Witness OUf hands this day Of 19~ LOUIS H. PAVAO, President t~'14RY W. FARL, Vice-President ~ frrPaP~n ,v a rus) frya«vnnr N.nw a ru.) tSQnamrs o/ Onrceq i (Spna,ure of Otlrcx) (sae Reverse Side Far Instructions) oz o na) 0~549~541 ~F.~i r i AA~VDED CHARTu2 OF HILO ASSOCLaTICN TO E-:FiP R..~'I:4RDED CITIZ~`IS ARTICLE I. NAME. Tne name of the corporation sha11 be "HIED ASSC'CLaTION FOR R_tTARDED CITZZ^IS". ARTICLE II. PRINCIPAL OFrICE. Tne locaticn of the principal office of the corporation sha11 beat 216 Kamehameha Avenue, Hilo, Hawaii °6720, or at such other Location in Hilo, Ci*_y and Ccanty of Haa,aii as the Board of Directors shall designate. ARTICLE III. PURPOSE AND PCW~S. The objects and purpose of the corporation are as follows: (a) T_o prevent the incidence and minimize t<he efforts of mental retardation and other ha.*idicapping conditions. (b) To assure the availability of residential alter- natives to enable mentally re*_arded and other handicapped persons to live and develop successfully wit'Un the coamimity. (c) To assure the availability of services to support, sustain and advocate for families and others who care for mentally retarded persons in the co~tIInunity. (d) To assure the availability of oppor*_unities for the developtent cf employment skills for the mentally retarded and other handicapped persons in the community. (e) To purchase, take on, lease, exchange, or other- wise acquire any lands, buildings and property, real or personal, which may be requisite for the purposes of, or conveniently used in connection with any of the objects of said corporations, and to sell, d~nise, mortgage, give in exchange or dispose of the same. i. ~ (f) To employ or have under contract such persons that are qualified for the job being it paid or not. (g) To invest and deal with the monies of the corporation, not immediately required, in such securities and in such manner as may from time to time be dete_*mined. (h) To Lrorrow, raise and give security for money by the issue of pranissory notes or other obligations or by mortgage of all ' or any part of the property of the corporation. _ (i) To solicit funds for the accomplishment of the above purposes. (j) To e.~pend any of the monies or properties of the corporation, wizether they be capital investments or income from G'me same, for the objet*_s or purposes of the corporation. (k) To do and perform all such acts and things and to carry on all such business as s:~a11 be proper, necessary, or convenient , for the furtherance of the objets and purposes aforesaid. ARTICLE IV. DD~EtATION. The duration of the corporation shall be perpetual. ARTICLE V. DiRE02C)RS. Lne business and affairs of the corporation sha11 be managed by a Board of Directors, consisting of not less than three (3), no more than eleven (11) persons, who sha11 be qualified, nominated, elected, and appointed, as is provided for in the By-laws. The Boazd of Directors sha11 have fu11 power to control and direct the business and affairs of the corporation, subject, however, to instructions by the members, and to any Limitations which may be se*_ forth in the (7iarter, or " in the By-Laws of t,4e corporation. ARTICLE VI. OFrIC~S. Tne Officers of the corporation shall consist of such officers as the President, Vice-President, Secretary and Treasurer, with -2- .r ~ such quzlifications, duties, and powers as are provided for in the By-Laws. ARTICLE VII. I~•tB~.SHIP. Members may be admitted and expelled in the manner provided for in the By-Laws from time to time. Tne By-Laws provide that these persons desiring to become members of the corporation sha11 submit their application to the Board of Directors of said corporation, and shall be admitted to membership upon approval of their application by the Boz<~-d of Directors. The proposed By-Laws further provide that memberships sha11 te_-ninate either upon the resigna*_ion of members, duly accepted by the Board of Directors, of by vote of two-thirds of the Boazd of Directors in fore of expulsion. ARTICLE VIII. BY-IAGiS. ine By-Laws may be amended by a majori*_y of the membership at any meeting of members duly called and held for the purpose of consider- ing the amendment or reveal of the By-laws. Tne By-L2ws of the Carroration sha11 not be amended to be inconsistent with the Regulatory Agreement between the Corporation and the Secretary of Housing and Urban Development so long as a mortgage on the Carporation's property is held by the Secretary of Housing and Urban Develcpment. ARTICLE NON-PROFIT. The corporation is not organized for profit and will.not issue any stoc'.c. No part of the Corporation's assets, income, or ea_nings will be used for dividends, 'or will otherwise be wi*_hdrawn or distributed to any of its mem~ers, directors or officers, except in return for services actually rendered to the corporation. ARTICLE X. DISSOLUTION. The corporation sha11 have the power to dissolve, and s'nall hive the power to distribute ail or any part of its properties either before or after dissolution, to any. other charitable corporation or trust having -3- objects and purposes similar to those of this corporation, as determined by the Board of Directors. PROVIDED, HGWEVTER, that any real or personal procerty in which the Secretary of Housing and Urban Development holds a mortgage or financing statement can be conveyed at any time to the Secretary of Housing and Urban Development. ARTICLE XI. AhIFi`1D[~'iYIS. _ This Charter may be amended with an affirmative vote of ' two-thirds (2/3) of the general membership present at a meeting called far that purpose; PROVIDED, HOWEVER, that so long as a mortgage on tt4e Corroration's property is held by the Secretary of Housing and Urban Development, these Articles may not be amended without the prior written approval of the said Secretary. ARTICLE XII. LIABILITY. The property of the corporation shall alone be liable for payment of its debts and liabilities. -4- T* 'r STATE OF HAWAII DEPARTMENT OF REGULATORY AGENCIES Honolulu I, MARY G. F. BITTERMAN, Director of Regulatory Agencies of the State of Hawaii, do hereby certify that according to the records of this Department, HILO ASSOCIATION TO HELP RETARDED CITIZENS was incorporated on June 22, 1954 as a nonprofit corporation; that it is still in existence; and that it has complied with all the provisions of Chapter 4I6 of the Hawaii Revised Statutes, regulating domestic nonprofit corporations. IN WITNESS WHEREOF, I have hereunto set my hand and affixed the seal of the Department of Regulatory Agencies, at Honolulu, this 21st day of July, 1981. `~O Direct of ~e alato y A ncies 1 ~ By Corporaci n am curities Adminis~ for • RECORDATION REQU EST Eu,y ~:'"r ~ rr DE?ARTMENTpF REGULATORY AGENCIES 3759 BUSINESS REGISTRATION DIVISION ~ THE OR1 CtVAL OF TEiE DOCUbtE~T ItE CORt;ED AS FO(.L17K•5: ISSUE RECEIPT T0: F sr,~- or anawtt arn¢ as HZLO ASSOCZ4;'IOT: TO HELP Se"TARDED BUREAU OF CpNVEYAY,(GEj CaILDRE.*; MAY 4 - 1911 ~e a ~ AFTER RECORDATION, RETURN T0. d~~-•••••~ ~ /j .c ....................U .1. ~cwc .17 DE?ARTMENT OF REGULATORY AGENCIES F~a.•,~ ~ ~n• - _ ~ Y BUSINESS REGISTRATION DIVISION a- P~~: RETURN BY: MESSENGER STATE OF HAWAII DEPARTMENT OF REGULATORY AGENCIES kONOLULU CERTIFICATE FOR FILING WITH THE REGISTRAR OF THE BUREAU OF CONVEYANCES OF THE STATE OF HAWAII AS REQUIRED BY SECTION 416.23, HAWAII REV ISED STATUTES I, the undersigned Oireeor of Regulatory Agences of the Swtz of Hawaii, do hereby certify that pursuant to an amendment to the ~ariei of Iacor, oSltSon of HILO dSSQC.T.ATIDl' TO ~~p EETA.RDED CHIIJS.-:. a Hawaii corporatran, ~e name of the said corporation was changed to HIT.A ASSOCIATIO'I TO fiELP RETARDED CITZZr`iS. Further, I do hereby certify that I have determned that sucl change in the name of said corporation ~s nor in confllc with the provisions of Secion 416 12, Hawa~. Revisae Statutes. IN WETNESS WHEREOF. I have hereunw set my hand ana affixed the seal of the Department of Reguiam•y Agencies. at Honolulu, this 2nd day of TT+9 ,1977. Dvecor of Requlato•y Agencies /'L 1~~ l l . Cor porauon ano SeCUr~t yes Admrnimator i Giurnge of Ci.rpurnC• one Flakes two oor yCu checko ae followai 17on-Yrofit Corport• n Dept, of R ~utory Agenclen Feo $5 'Pilo iri Duplicate Hureau of hunveynncee Fee $2 =.~";1F11 S'fATB OF IIAWAIT • ~ ~ ~ ~ .~IrAlION DI'FARITILNT OF Itl?CUI.A'1'ORY AGENCIES Justness RaglsCrntlon Ulvi ion 'FP )I ~I 42 ~IN r~~ lOlU Richards SCreet Flailing Address: Y.O. Hox 4U, Ilonolulu, Ilawali 96Q10 R.I OF Tn tha Flatter of the Amoadment of ) HAWAII Che Charter of Incorporation of ) t111u Aeuooiation to help liatardud ~ Clrildrsu ~ ) CERTIFICATE OF AMENDMEN'P The President and Saurotary, respectively, of Illlo Aeuociutlou to Iluln liuturdeJ Chlldreu, a Ilewnli non-proltt corporation, Jo hereby certify that 4t a spuciel meeting of Cho membore of ea id corporation duly celled anJ hell aL 32 ltalnbow Dr1Vu~ 11110 w on the yth day of Ilovembur ,196 , for the purpose of changing the name of Che Bald corporation, it waa voted by noC less then two-thirJe of the srembara present at the meetin~ to amend the Charter of IncorpoCatlon of sold corporation by Illlo Auoociatlon to Heip liaturJud deleting the name Childrun wherever it nppenue in the Charter of Tncorporntion, and f.naorting !n lieu thereof Cho name Milo Auuoolutlon to Ilulp Ratardad Citizurru L1I WITNESS NIIERliOP, the undorsigned have hereunto sot Chair hnuds thls_1lltlr i day of ~LU~til ,19 77 _ - luo;l,aip uAW,nu _ Pr~..l nt LIAI~i altullalrrliR STATE OF HAWAII ) Se~cetary County of tlawali ) rtich.~rd F~'aaU end Marti Si~wlalt~.r being first July sworn on on Ch Jepoee and say that they are tha YreaiJent and Secretary, Milo lie~sociation to Ilralp respectively, of Ilokardod Children Chut ae ouch officers they nrs duly authorized Co sign the foregoing Certificate of AmenJmunt; anJ that they Nava read the eeiJ Curtificate, know Cho contents thereof, and that the unma la true. 1t1CilAllD HA,,i,! U _ 'reaidf~')t Subscribed and ewurrr to bafore ma this 7~7Cc1`~ ~~~)C'rcY~~ liitltday of April ,19~~ r;.Ui.fl` I;i10:~:,1,1'a:li c'L.- .b Secretory X11 L tom- Y~ A. a~~~... ...~~~iiil~p,.,.2h tt . Notary Public, rd JuJlclal Circuit, SCate of Ilawrrll My comorieeton expires: 9/22/77 c- • I hereb~r approve the Eoragoing aarsudment Chla'?~~~'~Jay of~~,19 7~ . _ t,orporat on & Securities A mirrtetrator Directcr of Regulatory Agencies /i t • (tic n.c'_ 1 RECORDATION REQUESTED BYS ~ 1:~SI?lEu~ P.EG'i.,;'fRAiI0i1 DiV_SIG:1 7a- a 8909 '2,::.;~ ISSUE RECEIPT T0: c., • fiILO ASSOCIATION TO }1ELP RETARDED CHILDREN tecci;rd ?or , AFTER RECORDATION, RETURN T0: f ec.•• ~ '--_API' ~ s 1972 DEPARTifENT OF REGL".ATORY AGENCIES °1 ----~il~' o'ckck ~ • ' Ui DUSINESS REGISTRATION DIVISION I ;oco.dc~ in (icu oea_, t16E1t~~6~ ~atf17J RETURk7 DY: MESSENGER I STATE OF HAWAII DEYARTl•>Eil'T bF REGULATORY AGENCIES IIONGLULU CE:?TIPICATE FOR FILING_WITH TILE REGISTRAR OF TlU3 BUREAU OF CONVEYANCES OF T}lE STATE OF HAWAII AS REQUIRED d'! SEC'CION 41.6-23, IiA[dAII REVISED STATUTES 1, the undersigned Director of Regulatory Agencies of the State of Hawaii, do l~ereby'certify that pursuant to an amendment to the Charter of Incorporation of BIC ISLAND ASSOCIATION TO HELP RETARDED CHILDREN ~ a Ilaaaii corporation, the name of the said corporation was cfiangtd to HILO ASSOCIATION TO HELP RETARDED CHILDREN. Further, I do I~ereby certify that leave determined hat such change in the name of said corporation is not in conflict with the prrovlsiona of Section 41b-12,,Ilawaii. Revised Statutes. IN WITNESS WIUiREOF, I have hereuntn set my fiend and affixed the seal of the Department of Regulatory Agencies., st Honolulu, this 24th dsy of Aprll ' 1 X12 1 ~~r ~ C / `_i Diteetor of Regulatory Agencies fr c__- ~~.C%rya:ation 6 Securities Administrator mznge of oor~orate flamo llept, of Rel{ulatory Agencies Fao .j Eton-Profit Corporation Ili nu of Conveyances Fee ~t2 STATE OF l1AWAII .~III'AII'CMEN'1' UI' IIl]CUTA'fOITY AGL3ICIl.;i Dusineaa Iiegiatration lliviaion I lonolulu .u the Matter of the Amendment of ) the Charter of Incorporation of ) CER'fIFICAT6 OF AMENDMENT DIG ISLAND ASSOCIATION TO The President and Secretary, respectively, of RGLP IIETARDCD CHILDR>;N a IlawaiL non-profit corporation, do hereby certify that- at a special meeting of the members of said corporation duly called and held at WAILOA STA'P1; PARK on the day of _,7,~I~ , 19~_, for the purpose of changing the name of Cite said corporation, It was voted by not less [Iran two-tltirde of tl~e mesibere prevent at the meeting [o emend tha Clart r of Incorporation of said corporation by deleCing 13~G ~SL,ANI) the name ASSOCIATTON '.l'0 1113LI' Rli'1'ARDLD CHILDREN wherever it appears ~ln tha Charter of Incorporation, and inserting in lieu thereof, the name ]DLO ASSOCIATION '1'CL1L.P tarmalTnrn CIiTT.11RF.N IN WITNESS WNE[tEOF, the undersigned have hereunto eat their hands this 11th pday aE A~ril~ ~ 1~.~2,• _ ~~~1~ ICa-{~ STy Fr~e ident STATE OF IIAWALI ) Secretary __.__.Dorothy P. Kataoka and Gerhard Post being first duly sworn on oath depose and say Chet Chey are khe President and Secretary, IIILO ASSOCIA'L'ION TO III'LP respectively, of IIETARDED CIITLDREN ; Chat ae such office re they arc duly auChorized Co sign the foregoing Certificate of Amendmeut; and that they have read the said Certificate, know the contents thereof, and that the sam%%~lis true. < ~t (~e iden Subscribed end sworn to before me [Iris Secretary day of A-P,e~~- 1972_. No Car Fublic, Judicial Ci.rcult, C State of llawaii Nolml'„Publit,~ll~d Judldal Circull, 11y commloaion axpires: ~ Stale 6F Ilowvil My Comntlaion~iRpirer January 10, 197, I I~ereby approve ttie foregoi.r$ aryendm~nt this day of 19_ t ~ . llirector of Regulatory Aganciea RESOLUTION BE IT RESOLVED by the members of Big Island Association to help Retarded Children that the Charter of Incorporation of this corporation be amended as follows: (1) The name of the corporation shall be and is hereby changed from Sig Island Association to Help Retarded Children to The Hilo Association to help Retarded Children; and (2) Article I of the Charter of Incorporation shall be and is hereby accordingly amended to read as follows: I. The name of the corporation shall be THE HILO ASSOC71\TION TO HELP RETARDED CiiILDREN. Introduced by ~~l"?I ~.i! Seconded by ~°J _ , OC'1~'ICr OC Tllr '['RGASURL:Ii TLI[Ri'i'DRY 0[' IIAIJAIi 1 k2REDY CERTIFY Ihet Ihls is a wo end coned copy of the orlginel moaded Irl the Matter of the CeLltlon InlhleolAcoon: I?or Charter ~ of ~ T DIQ ISLAND ASSOCIATION TO IIELP ~ Imrc:a,giEuut woe RG1'ARDED CIIILURI3N Y m: v o~ucrutcl ~ cw,roru+n Huron Dot ,ii ~c d , / PC'['I'CIDN COR 'I'iIC CIIAIi'['L:R OLD IIJCOIiPUlln1'IDN UI~ DIG ISLAIJU ASSOCIATION 'i'O IIGLP 1[li'1?ARULD CNILUIiL•'N - 7 . ~ :l 1~~: ~,rr~ t..; ,.,t 1 • OE'FICE OF Ti. i TRF~lSURF:R • TF1IliTT0RY GE IIAUAII ' In tho Flattor of tho I'atition ) L'or Chartor 3 of ) • IlI6 ISLAlR) ASSOCIATI011 TO lL^uI1' RETARDED CSTLD:iI:il CHARTER 0>f I1TCOiiPURATI011 ICnotr yo,, that whoroas TA,DdSHT SUZUI(T, IWTSUIII )C, TSIiI1CAl1,1, SIfIG~:O OZP.KT, ALTGD GALGi1, TAlCAO UEIUtRA, IIF,1lRi',1tT N, ICOItAYASHI, SAOZO TALLllCI, CIR?IIICi[T TAIGI}L1SHI, lASUYUI:I OGATA, }IAFiUO 11AG1tTAFII, IIANUEL iGll)EIROS, AifOT YEE and J,U[S li, C.15~, all of vhom aro rosidonto of thu Cow,ty of Hnvaii, constitutln~ tlw ohartor mombore, diroctore, euul.officora of a voluntary association 1•ototm au 3TG ISL.IIFD ,lSSOCL1T10N TO li'~LP IIETARDP.,D CIITLDF2?;li, havo mado nltplication to mo ne Troaauror of tho Territory of Navaii, to grant a Chartor of IncotZioratiwt! 11011, TFiP:REE'OR.^, I, K.11( TAI I.Ea7, Trenruror of tho Torritory of }Imrnli, Ly nna vith tho emtoont of Lho Govornor of tho Torritory of 14ur<<11 and in tho o:corcico of all itot~or and auti.urity in tu~~nrioo on- nbling uio iu th:ts bohnl.f, do haroby conatituto tho mombora of tho uuid association, a ba,1y cot1tornto, alai do conl'u'r uhat thorn tho follovin~ Clturtor: ' x. Thu nmso of tho corporation oha11 bo °BI(i ISI„l1IA ,ISSOCLtTI0I1 TO 11ELT' It)V1'!u'lUl'sD CHII,D1lEi'l~r . IT, Tho locution of tho principal offico of tho oorporntfat ohnll bo ut 21G lGvnahamolut Avaro.o, Hilo, County'cutd Torritory of Navaii, or t,t ouch othor location in tho Torr.ttory of He,vaiJ. as tho Doard of Diroc- fora ulwll d~uiCnuto. wl.+ • -IJ• • I Y III. Thu ob~octs and purposes of the corporation are ae follawe; (n) To build, increase, improve, maintain and repair faci-- lltios within the County oP Siavaii for rho education, recreation and Caro of mentally retarded curd mentally dofiaiont childrmt; (b) To increase publio and parent understanding of chil- dren vho wro ulna oi• unable to develop their ubillLy to loai~t, are sloe or ttnablo to nurture mentally; (c) To Itolp motttally retarded and mentally dofioioltt• chil- dren develop to the ftil.loot degree and load happier, morn productive liven; (d) To resist in rho oharactor building of the community of the Cowtty of IDivnii in general, and of the children of the conw:w- nity in particular, by Providing proper rocreutional fncilitios for said conustutity; (o) To rondcr and iltntish sucL seaistanco as it may doom i'it mtd advicablo to minoro who nzro in nsod of assistwtco for the purpose of obtaining an oducction and to do all things that they may thi~ilc uucossary or advisable for the puri~oso of assisting minoro along oducatiottal linos curd for their moral, social and upiritual up- lift. • (f) To establioh and maintain a general systwn for the edu- cational, moral and ply~sical advmtcomouL• of rho cltilcix,;n of the Cowtty mid Territory of Haunii and to Inculcate mtd inapiro in said childrmi the highest ideals of ,lmoricctn citizenship end the gout privileges and advantagoo attuuding Aroorican citizenship mid its corresponding duties attd o'oligations. (g) To purchaoo, talco on, lease, oxchan„o, or othoiuiso acquire any lands, buildings and property, real or personal, which ~oay bu requisite for the purposes of, or convuniontly used in oon- noction with any of the objocte of said corporation, and to sell, domicu, ntortGage, give in ezaltango or dispose of tT•e a,wm3. (h) To hire and employ teachers, inetruotors, secretaries, ..a:. clerks, toanagors, atl'otio diroctoro, servants td aw rkmon, and to pay to them and Eo the other poreona, including mambox•s, in return for aorvicoo rendered to 6ho oorporation, salaries and o~agoe. (1) To invent and donl with the monlos of the.corporation, • not immedlatoly ruquix•od, in ouch oocuritiea and in such manner as may from limo to lima bo doterminod, (,1) To burrow, ratan atui give security for aionoy by the ioeuo of promissory notes or other obligations or by mortgage of all or ally part of the property of the corporation. (k) To acquire and roooivo charitable oontri}nxtione non- outing of'oaslr, oecuritios, or other properties; (1) To oxpond any of the monies or proportion of t},o co r-. poration, whothor they bo capital invoatmonta or inoomo from the some, for lho ob,)ocls or pux•;tosea of the corporation; To do and perform nll such e,ctu and thin~o and to Carry on all such businoao ue shall Lo proper, aeceaanry~ ox catveniout fur i the furtllerunco of the ob,)oote sold puri,osee aforesaid. TV. Tho duration of lho oorporation shall be porpetruxl. V. The corporation will oompleto ila organization with Li two months after the isuuanoe of the Ctuxrtar, Va. Tlto buolnoes and affairs of the corporation oltall bo munagod b~~ a Doard of Diroctox•s, consisting of not loos than throw (3), nor morn tluux olovou (11), poreona, rrho shall bo qualified, nomitwtod, oloctod, and appointed, no is provided for in the D~-dawn. 'Pha Lourd of Directors o1u~11 luxve full power to contrgl and direct the Lusinooe and affairs of the oorporation, aub~oet, howovar, to itv- • etructiona by the mo~abore, and to any limitations trhich may bo set forth in tlto Chuxtor, or in tlto Dy.-Laws of llto corporation. Tlic initial Dirootore of the oorporation and their busineoe and Noma M~ addroesoe shall be ao 'olloerei Name• Homo Addroeo Business Act.rlrees Dept; of Publ.lc Ilorls ~ananta K. Hr16ht _ Kattmana Drive,}{il.o owtEy of IR:vaii,lillo Janos lf. Cuao _ 205 Krtiulani St,ltilo 131 hluianuonuo Avo.ll}Slo-_ llol,t. of Public Hoalth Ilatcwni IC. Iahlluitlu 402 llainalcu Avo. tlillo Torr^of 1[auaii, Milo Dont. o:(' Public Inotructlon biitoahl OI;a.V~,__ 410 limtlulcoa St, ,Milo Tarr, of Ilnt~ali, I{ilo • T,aaeohi Stuu1;1 2G Ifina St., Ililu 216 Komohamoha l~yo,y_ }ills Shozo Tadalti _ 91 Laulcoua St_,1[ilo 0!1 Knnoclohua St. Milo A~_- Cl,ultichi Tulcahashi_ Kawn:u~ , llilor Ic.:uail _ lOd Kamehawohy Avo_, I(ilo_ YII, Tho Officora of the corporntion shall consist of ouch officers as oltall bo providod for in the 8y-Lava, with such qunlificutionn, dutioa, and potrore ao aro provided for in tho By-Law®. Tho initial Officora of tho corporation, together with thou homo curd intolnoos cddroooos aro ao followor Offia® Ilamo Home Adareso Bttni,tooe Adciroea 216 Kea;oi:wnoha Prosidctnt T T_udao_h_i 8nzuld _ ; 6 1{ina St,1il11o_ Av_u,_L411o__ ~ Du„t. of~Publio Vlco_Pz•ouldaut~_ Ilitoul,i Ol;a 410 I}anixJiua St,` Instn.~l[i1o Vico-Procidont Chultlchi:l'alachashl' Kawntavtr Ifilo 104~K.~m, .lvo. - _ izl ~.ieia,tuenua %ocretn,y ,7;u,es }I, Cttso Y ::05 K;.iu_lnni St. St•, liilo fl:~l I:nnoolohtta Trogsuror _ Shozo Tt,dala 91 Kaulona St, St L, }Iil.o VIII, Fleraboro may bo admitted and oxpoll.od in rho mnn;wr proviaea for in rho Ily-Lcuro from time to t1mo. T};e'l,ropoood By-Lave Provida that thooo porsono aooirin; to boaomo momboro of tho ootporation cLull oub- wit tholr application to tho Bonrd of Dirootoro of said corporation, and shall bo admitted to mombvrahip upon approvn;l of thou tti~hlicution by loo Hoard of Dirootora. Tho propoood 8y-Lnwo furthor proviso that • ,aerabershipo ohall tenainate oithor ui:on the rosig,tation o£ mombers, dxil.y acceptod by the Beard of Dirootora, of by vote of ttvo-thirdo of tiro Board of Dirootora in form of expttloion. ..g,. a ~ ` y ~ • 4 . 1 IX. Tho initial Dy-Letts of thv co1•pornti.on rshall bo adoptod by the incorporntorn at un initial meotin,,; of the incorporntorr. to bo held within tvo moutlto i'rom tho ivnuancv Of the Charter. Tho Charter ottull provido that thv D;>-L .vs may bo a;nvndod by a ma,jarity of tha mombor» ohlp at any moetln~ of mOI1lbOre duly callod and (told for the putgioov of conoideriug tho wnmubnont or xopoal of tiro Ify Latrn, X, Tha coi•}~oration iv noE orgctni~ad for profit and t;il.l nob ioeua any stool[, llo part of its aosoto, lncono, or oarniatgn will bo uo~d for dividondo; or trill o~herttino ba e~itluirntm or dietributod to any of its rwmbvre, oxca,,t in roturn for sorviova actually rondorad to tlto cor•- potation. %I, i~hv corporation shall have the potror to dir>uolvo, and ohall have rho potror to dietri.buto al.l or any part of its proportion olthor bnfoxa or nftar dissolution, to any othor chu~ltabl.a corporation or tl-unt having ob,lnctn nnil pur,,~oaou oimilar to thoao of this cot1,oration, au detorminod by tha llonrd o2' Dlroctorv. XlI, Tho prope:'rty of tho corpo'rntiwt shall alone bo linblo fo'. pey- wont of iCa debts and liabilities, IIi 11IT!L::C 11iQillti';OF, I havo horowtto svt my hn: 3 and atuvvd tha of.icinl oanl of tha Office o#' rho Treasurer of tho Torritory of Huuail to bo herowito afflxad this ~ ~;";ul _ auy of _ ~Tu;to lt)L:]. 45Z_~•_ . r.:ul T,tI Lzu Troantu•ar, Tvrritery of Ha,~:,;.i I heraLy o~ttuant to rho grnntirr„ of tha foro;;oln,; Cluu•tar of Y Ir>co.porutien t•h.lo .,_•2?nrl day of Jiu_~o•~,_, 195h. ~:y G;,vornor of tlty Toxritory of llatinll ..5,. d ~ W...... , . - , :-ICING PLE 8i11.? a._ , K°6tirhi~Q'(~~ wAV,mll ~ . t.,'; , ~ ' U1 '4(1 rMENT Ui' RCGIJLATOIIY AGEN1;lES (i~ilo in Duplicate) l1SINF:SS IIEGItiiIIAIION DIVISION 7Y,I;fl4r1) IowRlcunnosslllFEr hn~IHl+., Ili=di;,111ArIUlI MAILING AUI?RESS: -1'. O. BOX 4Q IIONOI-UL-U, II',WAII 9UU10 II11 I APPLICATION FOR REGISTRATION Of- hRADE NAME MIN U I~ Z7 111 OR (a nonprofit corporation) Ililo Auooolatiou to help Retarded Cititcenu 7d(ddlj4~f~6Ka ~,>I~(11dU(i11X3lYlU)f:xisting under tha laws of the State of ~IUWU-~_____ _ anddoinybusinessal 1099 1Yn,~}~IyyIIUO AVB.a II11Qs tli 9672___ in applying for Iha leyish alien of a ll ade nanro submits the lollowiny stalcnwnL lal That the Trade name is 11110_ VOOatloual $arabllitEttlOn Center ILINC- OUT INAPPLICABLE STATEMENT 1 Ibl Thal (TIC ai1111Ca11( IS (I1C (SOiC Flllll oriyinal propl iator, or 1 ul the aforesaid trade name; 9ik:IVYIiiHMM1(%a}IKydhX14?31~7118Gx1Cdii7GH9lAIX 1 Icl That Iha nature of the business in which d1e aforesaid uade name is to be used is rehnbilitation and voeaLional training oi' hundioapped peroonet unloa of geode Droduced in trulnLlg by cllent~ I cerlily, under the penalties set forth in Suction 4U2-3.6, Ilawaii Revised Statutes, that ILINE OUT INAPPLICABLE STATEMENT 1 l3Y%s~rY7f~1~111ih18tK$11 I rlamad in the loregoiny application, and (I am the YrOBldent of the applicant (olllca haldl Thal 1ho statements ntada in the applicatiun are true and correct to Thu bast of my knowludga a/n'd babe(, (Slpnar are) (Dare) This application must bo certified by the applicant, if an indivAlual, or by an oiliest, II a corporation, or by a general partner, it a partnership. (SEE nEVERSE SIDE FOR GENERAL INFORMATIONI (FOR DEPARTMENTAL USE ONLYI ~5G83 CERTIFICATE Of REGISTFIATION OF TIIAUE NAME In accordance wish U1e provisions of Chapter 462 0l the Hawaii Revised Sta lu les, This Cer ti licata of Reyislration is issued Io secure to the aforesaid applicant the exclusive use of the said TFiADE NAME Ihrouyhout the State of Hawaii for the farm of ten years Ilom the date harrul. ' IN WITNESS WHEREOF, 1 have hereunto set my hand and alfixerl rite seal of lire Department of Regulatory Agencies, at Ilonolulu, Slate of Hawaii, this__~ Jay of . o „ ;f, Director of Regulatory Agencies l , ..©y Rav, 12176 CorhOra lion end SecUlllles Admu1151ralor / , I t 1 L OF IIAiVAI~•,' l lliPAli'fMEN'1', 01' CO1N1\Ililtl'G AN'~ CUNSUM).rlt"AFFMats ~"'+Gi" ' 010 RICIIARDS STREET 1AILlNG ADDRESS: P. O. OOX 90, IIONOLULU, }IAWAII 90810 L FILING 310 UISHONOREU CHECK37,50 APPLICATION POR ItECLSTRA'I'ION OP 'f RAUL' NAME.,,. (FILE IN OVPIICATEI F~.1 4. i ~ Fill in only one of the four below: rd;: c', ; ,R.,.;,;.. _ SOLE PROPRIETOR Names - _ ~ .t.: ~,~i ~ :y • C s Address: Y dip Code or -air",. CORPORATION Names _llilo /tOaOCi.ItlUn Lo Ilclo Ret;Lrdod l:ltizrn•s ~ non-Irrofil Address: 1097 Ilalonucnue 11ve Milo III Zip Code 9o7'LlJ or formed under the laws o Ilawoii PARTNERSIIIP Name: Address: Zip Code or Formed under file laws of UNINCORPORATED Names ASSOC1AT10N Acldresss Zip Code 1. Trade name Is ka Ilu~..c 1'uluma lI. Appliegnt is (check one): ® Originator of name, or 0 Assignee (One to whom name was assigned by another) UI. Specific nature of business for which the trade name is being used: (lpor.alion of a carp I1Gni~~. I certify, under the penalties set forth in Section 482-0.5, Hawaii Revised Statutes, that Check Orle: 1 am file npplicant, or ® 1 em the President-lloerd of Directoru of the applicant -~O Ice held named In tho foregoing applicnlion, and that the statements made Bl the applicakion are true and correct to le best o ly kno1w/led6e and belief. ~u+o ~/~v LOUIS II. PAVl1l1 $ ~,3 S gnature Date 'Chas application must be certified by the applicant If an indlridunl, or by an officer if q corporation, or by a general partner If a partnership. (SEE REVERSE SIDE FOR GENL7RAL INFO~IMATION) (DEPARI'MENTAI, USE ONLY) ~ ~ CE[t'fIFICA'fE OF REGISTRATION OP TRADE NAME In accordance with the provisions of Chapter 482 of the Ilawaii Revised Statutes, this Certificate of Registration is issued to secure to the a[oresgid applicant the exclusive use of the said TRADE NAMC throughout the Slate of Hawaii [or the term of ten years from the dale hereof. DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS STATE OF IIAWAII , Dated: ~~.1!'1C, oZ ~ ~ -6rreetor of~ommerce an onstuner ~ arts Itev. G/82 , e~l~. .vr unyr tYtl- . GPAIifMGNT.OP CO1NMIii1C@ AND CONSUMER AFFAIRS i )LO RICIIAItDS STRL'G'1' AILINO ADDRESS: P. O. UOX 4U, HONOLULU, HAWAII 9G010 _ I FILINGSIO DISHONORED CHECK37.50 AYPLICA'1'ION FOR It1:GIS'rRA710N OF 'rIiA UE NAML7 (FILE IN DUFL~CATE) Fill in only one of the four below: . • - SOLE PROPRIETOR Namer ~:=~_K,: ~ Addressr °",',);~[1 Code ° . ~Af.l or p i. r CORPORATION Namet Ili to Assncinl-inn n Ilolp 12 -1~Ird Ci ~-f n~ (non-Irrofit) Address: ~ Zip Code 9G77U or Formed under the laws o ~iao-rvii ' PARTNERSHIP Nurne: Address: Zip Code or Formed under the Inws o UNINCORPORATEll Nnme: ASSOCIATION Addressr Zip Code L Trade name is _ Ilaln HLI 'In; II. Appllennt is (elleck one): ® Originator of name, or Q Assignee (One to whom name was assigned by another) III. Speelfic nature of business for wllletr the trade name Is belrlg used: Rentinn apartment unit.:: to diaal.llod uhv:;ically handic•Ipped or olderly I certify, under the penalties set forth in Seetion 482-3.5, Ilawaif Revised Statutes, that Chock One: Q I um the applicant, or Q I am the 'rce~idunt-~U~oard of Uirectora of the applicant (Office held named In the foregoing pplication, and that the statements made In the application are true and correct tot 9 best of m nowledge and belief. C-/~~ lu _ .5 z3J83 S gnatul•e Dete Tllis application must be certified by the applicant if an indlviduai, or by en officer 1[ a corporation, or by a general partner If a partnership. (SEE REVERSE' SIDE FOR OENERAL INFORMATION) (DEYAR'I'MENTAL USG ON[.Y) y7 CERTIFICATE OF REOISTRA'rION OF TRADE NAME ~yl 0 In accordance with the provisions of Chapter 482 of the 1lawai( Revised Slelutes, this Certificate of Registration is issued to secure to the aforesaid applicant the exclusive use o[ the said '!'BADE NAME' throughout the State of Hnweii for the term of ten years from the date hereof. , DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS (~STATE OF IIAW~yAIt Dated: ..y~.f-lNP oZ ~ 7 ~`~J .4,V~a~~-'~.,..... Director o onuneree an< orlsumer ~ al'-r s- liev. G/82 BY-LAWS Program Title: Residential and Support Services; Ka Home Pulama, Domiciliary Home ~r--~ '-'i RESTATED BY-LAWS OF The Arc of Hilo ARTICLE I. Section 1. The principal office of the corporation shall be at Hilo, County and State of Hawaii, or at such other location as the Boazd of Directors shall from time to time determine. The corporation may establish any other offices or places of business in or out of the State of Hawaii as the Board of Directors shall intermittently determine,. Section 2. The Corporation may have a corporate seal which may be in such form as the Boazd of Directors shall occasionally determine. ARTICLE II. Section 1. The corporation may or may not have members. AlI persons, either residents or citizens of the United States, are e$gible for membership in the Corporation. Section 2. The name of any person desiring to become a member of the Corporat=on shall be presented by any other member of the Corporaton to the Boazd of Directors. The application for membership shall be accepted by a majority vote of the members present, at which time the applicant will be considered to be a full member of the Corporation. Section 3. The Boazd of Directors may prescribe, at their own discretion, application fees for persons applying for membership. Section 4. The Board of Directors, at the;_* own discretion, may prescribe and set annual or semi-annual dues to be paid by all members. reviszd 4/97 1 ARTICLE III. Termination of Memberskin Section 1. Persons desiring to terminate membership may submit their resignations to the Boazd of Directors, and the membership shall be considered duly- terminated upon acceptance of the resignation by the Board of Directors. Section 2. The Board of Directors, for non-payment of duly assessed dues, or for other good cause, may expel any member from the Corporation upon a vote of two- thirds of the Board of Directors. ARTICLE IV. Meetings and Notices Section 1. The annual meeting of the members shall be held during the last quarter of each fiscal year at such time and place as the President shall direct, or at such other time and place as the Boazd of Directors shall de*,ermine, for the purpose of the election of Directors and the transaction of such other business as may lawfully come before the meeting. Section 2. Special Meetings. Special meetings of members may be called by the President upon his own motion, or upon the written request of one-third of the Directors, or upon the wrtten request of 25% of the members. Section 3. Notice of Vfeeting. Notice of annual or spec_aI meetings shall be mailed to each member at his address as recorded upon the minutes of the Corporation, at least ~ days before the date of said meeting, but such notice may be waived, by the consent of any member given in writing or noted upon the Secretary's i~finutes. Notice of every special meeting shall indicate briefly its' purpose. Section 4. Quorum. One-fourth (1/4) of all the members of the Corporation, or a total of nine (9) members, whichever shall be the lower, represented in person or by proxy, shall be necessary to constitute a quorum Section 5. Regulaz membership meetings may be held every quarter at the discretion of the President. revised 4/97 2 ARTICLE V. Board of Directors Section I. The Board of Directors shall consist of not less than seven (i~, nor more than seventeen (1' persons elected by the members at the annual meeting of the Corporaton, to hold office for staggered terms of three (3) years, and for not more than t.vo (Z) terns in succession. One-third (1/3) of the membership of the Board of Directors shall consist of either parents of handicapped persons or handicapped persons. Upon the initial appointment of the members of the Board, one-third (I/3) for a to of two (2) yeazs, and one-third (I/3) for a term of three (3) yeazs. A ce_*tificate of appointment indicating length of term shall be presented to each dsector. All appointments thereafter shaII be for a term of three years. The number of Directors consIItuting the Board of Directors shall be determined from time to time by resolution of the members or current Directors at any annual or special meeting. The terms of one-third (I/3) the Directors shall expire each year. A Director need not be a member of the Corporation_ In the event of death, resignation or disability of a Director, whe±her from siclv-~ess, or extend absence from the State of Hawau, or any other reason the President, with 4he approval of the remaining Directors, although less than a quorum, mac, they so wish, appoint a Director to fill tlhe vacancy for the unexpired te_*m. Section 2. The Boazd of Directors shall meet monthly at such places and at such t<rnes as the President shall dete.^nine. Any tcvo (2) Directors mav call a mee+dng of the Boazd of Directors by malting a written request to the Secretary not less than five ~,vorking days in advance of the meeting, such meetings to be held at the main office of tl':e Corooration. . Section 3. Any Director missing three (3) consecutive meetings in a yeaz without a valid excuse will be dropped from membership on the Boazd. Section 4. The Secretary shall give notice, orally or in writing, of each meeting of tl`~e Boazd of Directors to each Director at least five (5) working days before the meeting. No notice of a meeting need to be given to a Director who is at the time absent from the State of Hawaii. The presence of any Director at a meeting shall be the equivalent of a waiver of the requirement of the giving notice of said meeting to such Director. The failure to give notice shall not invalidate any action of a meeting of the Boazd of Directors if a quorum is present. ~~~,[5z~ s v~ 1 ARTICLE V. Board of Directors (continued) Section 4. The Board of Directors, by a majority vote of the quorum, shall exercise all the powers of the Corporation in the management, direction and maintenance of its business; it shall be authorized to sell, transfer, give or otherwise convey either by deed, bill of sale, mortgage, lease or otherwise, any or all of its prope_*ty; it shall have the power to direct and control the voting of shares of stock held by the Corporation in other Corporations; it shall appoint officers and may appoint managers, and other employees; it may dischazge officers, managers, and employees, for such cause as it may believe proper; it shall determine the compensation, if any, of aII of_~:cers, and may determine the compensation, if any, of managers and employees; it shaIl determine the compensation, it any, to be given to officers and directors for attending meetings; and may generally do and perform all things which are required for the proper management of the corporate business with the approval of a majority of the Directors present. , Section 5. The Boazd of Directors will set policies for alI programs that it admin,sters, taking into consideration tl'~e recommendation of the various standing committees. Section 6. Director of the Corporation may be a party to, or otherwise have interest in, any contract or transaction of the Corporation, provided that the facts aze made known to the Boazd of Directors before action is take.*~. The Director who has the personal interest may be counted in deter--iining a quorum but shall not vote on the var'ac~zlaz matter. Section 7. One-third (1/3) of the Boazd shall constitute a quorum. revised 1/97 ~ - ARTICLE VI. o t~~5 Section 1. The officers of this Corporation shall consist of a President, one or more Vice-Presidents, a Secretary, and a Treasurer, and such other officers as shall from time to time be appointed, such as asecond Vice-President, Assistant Treasurer, etc. All officers shall be elected by the Board of Directors and may be replaced at any time by the Board of Directors. All officers must be members of the Corporation. Any Director, however, may be appointed to office. One person may serve in more than one position, such as Secretary-Treasurer, if the Board of Directors so appoints. Section 2. The President shall preside at all meetings of the Directors and members and shall have general charge and control over the affairs of the Corporation subject to the Board of Directors. Section 3. The Vice-President shall perform such duties as may be assigned to him by the Boazd of Directors. In the case of tt~.e death, disability or absence of the President, he shall perform and be vested with till duties and powers of the President. Section 4. The Secretary shall keep a record of the minutes of the proceedings of meetings of members and directors, and shaIl o ve notice as required by these By-Laws of till such meetings duly called. He shall have custody of all books, records, the Corporate Seal, and papers of the Corporation, expect such as shalt be in the charge of the Treasurer, or of such other person authorized to have custody and possession thereof by a resolution of the Boazd of Directcrs. Section 5. The Treasurer shall oversee the work of the Bookkeeper/Accountant. AlI monies and valuables received or disbursed, shall be deposited in the name of and to the credit of the Corporation in such banks and depositories as the Boazd of Directors shat designate. (Separate accounts shall be maintained for monies and valuables received and disbursed in the name of the Corporation, but for the exclusive use of a program administered by said Corporation). Section 6. All checks, deeds, contracts, mortgages, leases, promissory notes, and other legal documents shall be signed by such officer or officers as may be authorized by the Boazd of Directors. The Boazd of Directors at their discre+3on may authorize the use of the facsimile signatures. reviszd ~:'9 i ~ ARTICLE VII Administration Section 1. The Board of Directors shall appoint an Chief Executive Officer (CEO), who shall be the Chief Administrator, under the direction of the President, to be responsible for implementing all Association policies, programs and activities, developed, formulated and approved by the Board of Directors. The CEO shall, in consultation with Officers and Committees, develop the overall program, and make recommendations for Boazd consideration. The CEO shall, work with Boazd members, committee chairpersons and other volunteer personnel towards strengthening of the Association as a whole, by making maximum use of the energies and proficiencies of both staff and members. The CEO shall, serve at the pleasure of the Boazd of Directors. The CEO shall, have the power, subject to rules and regulations of the Boazd of Directors, to designate, appoint or remove employees or persons on the staff of tl:e Association. ARTICLE III Advisory Board Section 1. An Advisory Boazd may be set up to consist of professionals in their field of expertise as recommended and approved by the Boazd of Directors, such Advisory Boazd shall have no administrative authority. revised 4/97 6 ARTICLE IX Standixg Committee The President will have the following Standing Committee: Section 1. A. Hilo Vocational Rehabilitation Center B. Commuruty Residential Project C. Ways & Means /Budget D. Membership E. Personnel F. Publicity G. Constitution & By-Laws H. Nomination Section 2. There shall be a minimum of three (3) members on each committee. Members of all committees aze to be appointed on a rotating basis. Section 3. The duties of each committee aze outlined in Appendix #1. Section 4. The Boazd or the President may establish additional committees as they from time to time deem necessary. ARTICLE X NomixatixQ Committee and Electiox Section 1. Nominating Committee -will consist of three (3) members. Section 2 Nominating Committee will make nominations at least three (3) months before the end of the fiscal year. Section 3. Election -last one-fourth (1/4) of the fiscal year. revised 4i 97 7 ARTICLE XI These By-Laws may be amended at each annual meeting by a majority of those present. THIS IS TO CERTIFY that the above By-Laws of THE ARC OF HILO were duly adopted by a vote representing a majority of the members at the meeting duly called and held at its office in HIlo, Hawaii on the 9th day of April , 1997. ~ ~ Doris Iwaoka, Secretary THIS LS TO CERTIFY that the above By-Laws of THE ARC OF HILO were duly amended by a majority of those members present at the annual meeting held Apri19,1997. ~ 1 Vim- '-w.,.4...~ Doris Iwaoka, SeQetary revised 4/97 8