Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
COM 0122.005 2000-2002
. • Stephen K Yamashuo ~-y Hury A Takahashi Mayor Director r~',~ f '~;~YQ~~''" COUNTY Of ~H~k1K~l'I DEPARTMENT OF FINANCE 23 Aupuni Saeex. Room 118 • Hilo, Hrwati %7201252 (808) %I-1231 • Fu (808) %I-8248 HAWAII COUNTY NONPROFIT GRANTS (FY 2001-02) HUMAN SERVICES NONPROFIT GRANTS REVIEW COMMITTEE FISCAL YEAR ENDING: ]tine 30, 2002 DATE OF APPLICATION. •=Y ~fi1~~ JOOI GRANT APPLICATION FOR. ~OtS~N~I] MrtD~NPaIYI S,6r!/iets (hems 77W) Legal Name of Organization: a/S ~x'r~ /~Jt-'Ip~.~7lA`i swl Mailing Address: i.~~ b+X ~lo2.e trt»~dtcM- Hi Po~Y3 Facdrty/Site Address: 63 i2}9 kA/Wi+drf6 ita.~v /fitrr/riC,sytArsri ir2i~ ,r~ac.~-~~ Dvector/Srte Manager. ~SA41• A~OGLL.MI~- Orgenuetion President: Contact Person (Grant Wnter): /!Il/r~tGL /Y/•0 Amount of Request for Couuty Fuadt: S Fri Oa Total Annual Budget of Orgaruzation S 4V i • 00 Has the applicant applied for any other funds from the County of Hawaii this fiscal yeafl ? Yes Souroe/Depenment: ® No Ageucy/Program(s)• ? Social Servicea ? Youth Programs ? Elderly Progrema Check Categonea: ? Culture and Arts ? Education ~ Other 111f~w17~'t SGW~~LtS Briefly, define the program for which fundhsg L belog requested: Funding is being requested to support West Hawaii Mediation Services. WHMS provides quality mediation aid conciliation services to individttaLs in the districts of Hariiakua, North and Sottth Kohale, North and South Kona, and Kau. The services are - cost effective, partnering public and private funding with trainod vohurteers from the community who provide mediation services. No• ~ z~ - S _ P11eNo. 6VD -I lfsEDc Ref. 1bt FEB I. QUALIFYING STANDARDS FOR APPLICANTS An applicant must meet all of the followtng standards. ® Be chartered or otherwise authonzed to do business m the Snte for channble purposes sad exempted 5om the federal income tax by the Internal Revenue Service ® Have a govcrtttng board whose members serve without compeneaton sad have no contltct of interest between then regular occupatom and the eavtcea provided. ® Have bylsws or pohctes which describe the meaner in which btuineee is conducted, iacludmg tnensgement, audit, fiscal pohcrea end procedures, pohcrea on nepotem, and pohcia on management of potmtnl conflict of mteren. ® Have at lent one year's expenence wish the sernce or activity for which the appropnstoa n Bought or can otherwise demomtrate to the satufictoa of the County eufficteot experts to atrcceafirlly carry out the saints or activity ® Be licensed and accredited m accordance with epphcsble requvemean of Federal, State and County lawn. II. GRANT CONDITIONS The applicant agrees to comply wath the following tame and conditions prior to receiving a grant award. A. Comply wath applicable Federal and Snte laws prohtbrtng diacriminatiea agawt e~ person on the beau of race, color, natoaal origin, religion, creed, sex, age. or haadreap. B Agree not to use any public foods for purposes of entettammeat or paquieita. C. Comply with such other requuemwn ee the Duector of Ftname may prescribe to ensure edherome by the nonprofit organtaatioa wath Federal, State, and Comty Lws, sad esubhahed standards Sur fiscal end Program marugemeat D. Allow the Director of Finance, the commttteee of the council and then ataffi, end the Leguhurve Auditor sccas to records, reports, file, sad other related documenn m order that the program, management, sad fiscal practices of the nonprofit orgatuzaton may be monitored sad evelwted to assure the proper and effective expenditure of public funds. III. RECORDS AND REPORTS A. The epplicaat shall follow generally accepted accomtag procedures and practice sad shall raainhm boob, mcords, dacumean end otter evidence which sufficimUy snd propaiy accotmt for the mtpeadituro of County foods. The boob, records and docummn shall be subject at all reasonable limas to rmpecnoq reviews, or tudin by the County expending agency, the Direetor of Forme, sod the Legie4tive Auditor. or by their iapresentatves B The County expending agency, Director of Ftnence, or County Council may request pctodic wnttea reports on the rue of County fiinds. C The nonprofit organimtian shall suborn a find written report b the LegisWtve Auditor within sixty (60) days aftra June 30 of the focal year. The report shall imlude m explanation of the public beoefin derived from the awarding of Use grmt, a listing of other fiutding sauroa and emamb obtained dtuiog the grant penod, sod a complete accamtmg of all expendrturee supported by Canty of Hawaii grant fiinds {per Chapter 2, Article 25, Becton 2-142(d), Hawaii County Code, amended August, 1999}. -2: rv. QUARTERLY ALLOCATION Under no crrctrmeterraa shell grant lands be d[ebutsed m e lump sum payment Grant funds w[ll be dteburaed to Grmteea only through a quarterly allocation process. The dtsburemmt of grant fins can be formuLted on m equal quarterly apporuonmmt buu V. GRIEVANCE PROCEDURE The applicant will adopt and mamtam s gnevance procedure to assure proper eccouatmg for my concern end complamu about ru program or semcee that may arse from ib member, employees, clime err from other member of the public. VI. DISCLOSURE OF WFORMATION All mfotmanon, data or other material provided to the County by virtue of thu apphcanoa shall be subject to the Uwform Information Precticee Act (UIPA), Chapter 92F, Hawur Revved Sumter. All such material is deemed goverommt record and shall be open to the public sad may be provided to other public and/or private fitadmg wuroes VII. CONTTNiTF.D ELIGIBII.I7'Y Any appllpnt or reclphxt whe withholds or omlb say materW heb or dellbentsly mYreprnenb each heb to the Comty of HawaB shall: (1) tT~+-a+•r•~y be disgtul[5ad from comide[auon for Nonprofit Gant funding; OR (2) be m nohmon of the trams of the Grant Agreeaiem of County funds is which pee a grant agreement can be tetmmated by the County a~ the recipient or provider may be !able w rermbure all or a portion of any funds received therein. VIII. ACKNOWLEDGEMENT BJI~ /suMO .~Epi~rioyt , tic (Legal Name oFOrgenrunon) hereby agrees to admmuter the lU1GST t ~~K/~ S~?tGt.1 (Program Title) m accordance with the regulation, policies end procedures prescn'bed by the Hawah County Finane Dtpvmimt. Dutdbunon of gtwt fiends u Lmited W grantees whtc6 arc m compliance with County regulation, policra and procedurd. The County taerves the nght to withhold grmt distribution at any time the grantee is not m complimce. It u the policy of the County of Haww end for those who do busmw with the Canty to provide equal employment opportuniba to all person mgerdlaa of ice, physical dwbilitia, wlor, religion, sex. age, or natronl ongm u mandated by the Federal Civil Righb Acts, u amended, a~ soy other fitderal err state laws relating to egnl employment oppmvmities. IX. AMENDMENTS TO THE APPLICATION/EVALUATION The applipnt usurer that it will mbmn W the Human Services Nonprofit Grwu Review Comm[troe (HSNPGRC) for poor rrnea sad approval a written request end jntrficatroa far any changes. additram, a debtiaos to say poroon(s) of the grant appGption or a duly executed Grant Agreement of Carroty Ftu[da. The tippliant will cooperate and assist m any effort uaderblr® by the HSNPGRC to evehule, mapect a otherwise monitor the effectivmeu, feubility, and/or cat efficiency of any anti all pnctica, polieias and procedma err aetrvities puruent m ilia application army grmt deargmtion or allopuon received u a result of tbu application. -3- r X. AUTHORITY AND CAPACITY OF APPLICANT The epphcant certifies that tt hes the authonty and cepactty to develop end submit thte apphcanon, and to fully admuuster the programG) Pursuant to thu apphcanoa. UNSIGNED PROPOSALS WII..L NOT BE ACCEPTED! ~,~,o ( Ue~.t 1 ~~t'~I~D 1 Signature of Pres~~ / Date Signature of Executive DuectodMaaager Dtue -4= County of Hawaii, Grant Appliptbn FY 2001-2002, Wt~t Hawaii hledlatlon Services NARRATIVE QUESTIONS PROGRAMISERVICL DESCRIPl70N A. Overvkw~ 1. Describe the prognm for whh:h fimdhq b 6dK requested. The fiords arc requested to support the West Hawsii Medratim Services (WFA!<S) which serves the districts of Hamakua, North and South Kabala, North acct 3aulh Kaos, and Kau WHMS has mediated dispYa bdween parties countywide in ardor to aooommodde 5milia. 2 What tmique or etpriAnat eervke wt~ 6e prevWedY West Hawaii Mediadm Services provides quality medidim and omalidim sQVica fir individuals and organianms in west H¦wtii. Medistim is a confidential problem-solving grooms in whiff trained neutrals assist parties in oommunicatmg what's important in the diepcrte, creating utd negotiating optima, acct aa8iog agreemerns Chet ere fiur, realistic end durable. WHMS handles the following types of disputes: naghbar/neighbor, Small Cla®s (landlord/tmmt, omsmoerhnercbent, claims involving property damages, bsd debts), community issue (rod maintenance, aooesa, commmity covenents), ®d femay issues (parent/teea, pre and poet divorce). WHMS utilizm trained volumeer medidors, ell members of aQ Hawaii Canty oammmtity. WHMS is unique in offering a publidp ivate partnership in two arms, a) finding end b) provisim of scvia~. a) Funding. WHMS receives finding from the State of Hawaii Judiciry through a Purchase of Service cmtract. This contract requves the recipiems to seaere a 15% cash matdt. WHMS also reoelva fiords from the Hawaii ]udice Fomddim m additim to the Hawaii Canty grmts. We also charge en admhmiatrdive fee far medietim service hued upm ability to pay. b) Provisim of service WHMS uses trained commorrity members to deliver progr® services. m additim to self refrrals, we roceive 73% percent of case referrals from public agencies such u the court and leg•I systems (Dcstrid Court, Family Court, Cnatit Court, Praxvting Altamey's Office, Hawau Canty Pdice Deparmrent) u well as referrals from other public entitres such u the Department of Eduadiao, Department of Human Scvioes and the Cocmty of Hawaii. Private mdividuala who voluntetr they time to assist othere fit their community mediate all of thex case 3. What specidc outcomes arc to be aehhwedY The desced outcome is to provide en aceesvble, effective process that edtrcate0. empaiwas cod auists perttciperrts m 5ndmg peaceful, doable resolutims fir s®ple ad complex dispturs. 4. Her w~lll the proposed program empaver partictpaeWetleab to become aeli solrieh:ut sad tee0lbte soeLl chaajeT The savior provided by WHMS empowers both clients and volunteer medidars m the following ways: Clientc- The prooav of medietim, m which a trained neutral assiab the parties involved in a dispute m cammrmiamrg end negotiating they own agreement, is based m the principle of empowerment. Portia who are in the dispute have the mad infirmadm about the dispute end potential agreement poen'bilitiaa, the moat respms'bitity in resolving the dispute end the mad inveeinreat in fmd'trtg a radurim the will be durable. 1 . ~ County of Hawall, Grant Applicatbn FY 2001-2002, West Hawali MediaHOn Services in addition to tiasrsting psrties in resolving arrmt disputes, the process provides the partiresa en apportuniry to gam new skills in oommuniwnen end negotiatim. Thtye skills hopefully will be used m the futrae should additional dispuoea ooar. Mediatars- The skills in commumotien, negotietien and problem solving acquued by the framed voltmteer mediators are inatrmnernel m providing quality servioet to clients. Thry are also beneficial to the vohmteer mediators, allowing them to suooessfWly prevent and resolve disputes m then own persenal and profeaaional tivm B. PrebkmlNeed 1. What h the probkedeeed the propoacd Program d dWped to eveetT The program provider aernoes tlrst addrmsm the following needs: Affordable, eocenrble problem-solving praotea met repaQS rdeuenships • A viable option to the lnrmal legal and oast eyst® for individuals with diapttea • A cast effective resotr« for the o®muniry and the court and legal syatent 2. Who is the terser popelaNoe cad what are the apcel6c eeedsT The target populKiae is individuals and arganiraeens of Hawaii County that have a anent dispute with another party and Sor wham the mediation probem 18 more accessible, more affordable and/or more appropriate than the formal legal «trt syst®. Altltoug6 WHMS chegea an administngive fee, no ace is re fined errvi« because of financial hvdship. The mediafien proems also woks in aenjtmctim with the cart and legal cyst®, assisting parchvm rewlvieg specific issues aaaide of the cartroem 3. What fy the geegraphkal area(s) W be nerved, faelgty aed boon of opentloeT Hamakua, North Kabala, South Kabala, North Kone, South Kane, end Kau districts ere the geographical aroaa sQVed. The offi« Srcihty is located at 67-1279 Kawainee Raad, Parke Squae IR217, Kamuela, Hawaii %743. Ot6« hags of operation ere Monday-Friday, 9:00 A.M. to 5:00 P.M Mediations are omducted at times oenvenimt to all partim C. CdlaboretloelCaordlaatloa 1. What apalPie eseaaerea wfL 6e Wren b eoWboratdeoordleate wNh other Commaefly reaoarees to achieve maximum program eflldesry aed coat eltleeth~eeamT WHMS «Ilabantes and caerdinatea with relisrring agmaes sucL u Ctamty Police, Praeewdog Attorney's Ot~oe, District, Family and Circuit Carta, Department of Human Sernoea, acct with private agencieal«llaboratiens such as the Family Support Servitxis, Family Cart l.dncatien programs, Salvaden Army and Domestic Violen« hrtaagenry Team. We also provide autrea~ acct informatim to servi« clubs sudr es Rotary, and to other argenicatims who requpt in(ormatien. WHMS oollabaratea with community arganiutiaos and businesses to secure ccofidentisl mxtmg r«m0. at no drarge, in whrrh to cenduct the mediation sessiens. This makes the mediatien proems mare geographically aooeasrble to climb and as well a, cost eHixeve. Our team of trained volunteers, members of the West Hawaii community, sre key to maxmtum progr® delivery and oast efTectiveness. 2. How will these aseasrres rede« or eliminate cry existfag dupliutloe of aervieea W yaor desipah hrtet R'aPT 2 County of Hawaii, Grant Applicatbn FY 2001-2002, West Hawaii Mediation Services Walt Hawaii Madtatim Scvices provides the mly community-based mediatim saviors fa the Hemakter, North Kabala, Sou@t Kabala, NaYh Kma, Smth Kona end Kau d,stnds of Hswaii Canty. D. Gab and Objectives: i. What arc the major gaab/beaehmarks of the propmed pragnmt The goal is to provide quality dispute resolunm services, mcludasg mediatim, facilitatiay canciliatim, oommunity edtrwtim end treating. WHMS alas treated volunteers who apply, are aderviewedbehscted and who must suooassfWly camplcte trainatg and apprasdcwhip to modiste far the program. A nominal fee is charged far training to Dover casts. The training rs progressive, and advanced traiaatg is offsad mly after completing apprersticeship with prerequisite case types. 'Ihe progrmr uses a oo•medrrte madd mediators) to handle cases. WHMS requaas that earls modiator participate m an annual RefrmhQ Training Corinna The gaaatlUtlve gab for the 2001-2002 prognm year an as fdlows: • Caseload - To provide modiatim savroas to 522 individuals (direct clients) at PY 2001-2002 increase of 20X) • New cases - to open 246 cases (sn mama of 10%) • Mediator pod -1) to cmvert 50°h of the inactive mediator pool to the active mediates pod; 2) to increase the mm~bar of advanosd mediators (Dtvoroe, Civil Rights, ®dlor Special Edrrptim) by 25X • To have 90% of charts rxeiving medianm services feel that they brne~5ted from the program's servioes. • To continue the mediator support system WHMS has added individuals saved to quantitative goals because the number of cases involving mare complta issues and muhiple seasims has increased. Locking at typal of cases as well as individuals served will abo make the clierrt satieftuiim paemhge mere meamisgtul. 2. What speeiftc obJectivealactioo step an phased for ach goalt The speci5c actin steps plamwd far eacdr goal are v follows• • Caseload - to provide mediatim, oancilianm and/or facilitatim srrvixs to 522 individuals (daect clients): to opra 246 canes Quarterly newsldtera to all caastitumts Routine press nleeses explaining sarnoas, traarmgs, mtd gatherings Ongoing ermomo®ast m Chanel 14, public eocem televisim On the web site of Five Maintain Medical Cammrmity, health and oommmity ea•vices site Included in the Heslma Island Rrsavae Guide Establishing a Speakers Burew for lonl civic, community, educatim groups Program staff will maattaat retinal relatlmships with Praeavting Attorney's Office, Canty Police Department, District, Faintly and Circuit Casts • Mediate pool - To convert 50% of the inactive mediator pool to the ae~ve mediate pool Mediator support staff poaitim (resew this pasinm) Newsldters - distribrrted quarterly Basic Tninimg - to be held aaee a year Refreshc Training - to beheld ma a year Mentaring Program -apprenticeship of 5 madiatims comediatad with a senie medrate. This will assist mediators in reentry as well ss supporting the quality aanaattce program • Medrete pool - To inoreax the n>®bc of advanced mediators (Divorce, Civil Rights aod/a Spacial Eduatim) by 25% Pro®am staff will dissanmate the traatmg calendar m the frent psge of eecL mewslerta Divorce Training - to beheld mce a year 3 County of Hawaii, Grant Applkatbn FY 2001-2002, West Hawaii Mediation Services , • Nindy percent (90'/e) of clients receivmg medietim services will f«l that they bme5ted fran the scvico pronded. Program stiff will first assess that the climb' needs cat be and by the mediatim preoma. Progrw staff will msurc that mly trained mediataro. Medistas must sttooenfully camplese 20 hats of Basic Traming to mediate basic disputes and ao addihmal 20 hours of Divorce Mediatim Trainutg to mediate divesoe and Lenity disputes. It is now mandatory that esdt mediator ocmplete the Refresher Tnatatg nice a year to be m the sdive mediator list Program staff will ensure m-going mediates competency is mmitored. The program uses a co- mediates model essigniog two medutara to eakfi case. Apprentice medutess co-mediate fes 5 sessims with a eenkes mmtes/medietor. Earb mediates does a wnttm ewluatim of the process efts earh mediatim The Quality Assurance Committee revrewa this infiarmetien. Program stiff solicits feedback from all clients receiving program sdvicae thratgh telepitene acct written survey follow-up. 'I>us mfarmetim is also reviewed by the Qualiy Asskcmoe Committee. • To continue the mediates support syst®. To xaae renewed fuodmg for apart-tinte pasitim fes 2001-2002 who will identify treating, mmitoring end support needs which will reduce attritim and meseaee the np.city to reapmd to inaze.aing and/or tit®giog oammtmity needs. 3. What it the tlmellae (start sad end daha) for eaeY aeflw atepT 'Ihe program provides yea rotmd mediatien services, so program evaluahen including medirtar manitesing and ctimt feadbadk Doane throughart the year. The timeline is as follows. January 2001 Newdette Mardi 2001 Victim lMmder Training April 2001 Newsletter, Refresher Traating and Speakers Bureau July 2001 Newsldta, Back Training Odottkr 2001 Newsletter and Divesx Trainutg Decmber 2001 Special Eduntim Madietim Training 4. What afgoltkaat ctkotteutered oateome(a) svlB the prst`ram achiever Nindy percent (90°/.) of clients receiving medtatim services will feel that they benefited from the services provided. WHMS is dimt-omtaedm that tae med;atim programs provide a ewtoe that avisb the dimta in nd mly resolving then dispute, but at learning bdta ways to menage disputes m the !mitre. m same caxs, dtspuhaob who have gene through mediatim Itlke me prooewa so enact that they choax to take madiuim training and bearome mediators 1b®xlves. E. Servke lkllvery 1. What methoddo~y wi116e tared fa the propaaed Program's delivery of aervleea2 WHMS urns the following definitims. • Mediatim - a oonfidmtial, voltmtwy process in whidt trained nartrals assist parties in diapttea, to oommuniate and negotiate what the parties feel is a LQ and durable sgre®mt. Agr+eematta, if reached, are put m writing, with copies given to bath parties. A copy of a meduted agretmmt is also sent to the court, ifappliable. • Case - a cox is opened when the parties involved in a dispute agree to partidpate in a medtatim (exceptim - a cox is opmad when referred b3' m agency with admmistrahve and es legal authesrry over the parties i.e. Ceuta) • Intake - m interview is oondudad try staff to identify the key tastres of the disputes and to determine if the cox is appropriate for mediatien. 4 County of Hawaii, Grant Application FY 2001-2002, West Hawaii Mediatbn Services • Facilitation - a meHiod of appraarhing meetiAg managesnmt using a neutral party to assist in agenda development and meeting process 'Ihe facilitator cancartrste solely m the proaas and leaves content to the perticipmb at the mexting • Conciliatim - m agreement that is rechad before mediatim as a roult of interventim by Lrtake Staff. • Mediator - m individual who successfully camplexe training and epprmtio~ship. • Mortar - a senior mediator who has satisliad time and aseload citeris. • Apprenfice - a trained but inescpQimced mediator. Mediadm servioes: 'Ihe mediation process begins when a prospective client mrrtacts the program. Program staff elicit pestinent informanm abort the dispute with the party to determine if the process is appropriate tar the dispuue. If the issue presented seem appropriate for medietim, program stiff contacts the other party (ie) m the dispute, conveys the request far madiatim and explains the mediatim proces. If the party is willing to participate m a mediatron, pragrran stiff will elicit pirthimt infarmahan about the dispsrte Gom that party as well. Both parties m the dispute: are told that the process is conSdential. Bath partie are den uiformed of the administrative fee for savior. If the parties have a fmmcial hardship, services are provided without ohsrge. After the intake process, program staff schedule the madiatim sessim, mudiing the type of dispute with the two mediators' expertise and experience. In cede to insure m ®partral process, a mexlietor is not assigned to a case m whidS the mediator knows the parties. Some disputes, for example Smell Claims, can be roolved m me session. Others, such as domestic cisea, requne multiple sesiasb. F. Evslsatfoo: 1. Wbat proeem svgl be ored to evaluate the program sad servka? WHMS evaluates ib services in the following ways: • Client ssdsfactim -client are surveyed after roceiving mediatien service to dedamine if thry was satisSad with the process end the eeviae thry received. • Madiatar campetenry -Only individuals who successfully complete both the tramirsg and apprmtrcediip proxss are allowed to mediate:. After apprerrtioeahip, mediators arc reqused to attend a Refresher Training armiialy. • Service provisim - WHMS staff martibins ongoing cammunicatim with referrtl sauroe to ensure that canmunity needs arc being met. Faedbsclc is elicited from referral eaooas, whidi is heipfiil m plmning • WHtdS is mmitared end evaluated annually by the Hawaii State ]udic~ary, Curter far Ahernative Dispute Resolutim. 7tie activities ere mmitarod and evaluated through giierterly repcrb and m annual site visit. WHMS is also monkored and evaluated quataiy by the FLwari ]ustioe Fosmdatim 2. Haar srlll tbb prroeeas messun the osteome speeltkd !d Ihm D (1-1)T 'Ibe mediefim services provided are by then nature outcome based 7}ie disputers and imues addraeed arc identi5ed by the clients, and the pmtie th®selve ddermine if m agroemmt is readied. 1be mediators who volunteer far the pr+ogr~s do so to achieve persanl growth by aoquQing vahrabk sIa7L and to give time and magy to then community 5 County of Hawaii, Grant Application FY 2001-2002, West Hawaii Mediation Services G. Program Fees: 1. Does your orpetratbe charge a membership fee for service partldpaeb? No 2. Does the proposed prasram charge partlcipasb a fee for xrvke provided by the orpobatloeT An admmidrative fee of 520.00 per party per s~vsim rs assessed far serviae far basic cars. M administrative fee of S50.00 per party per sessim is assessed far divorce and real esbte eta 7Lerc is no rhvge far taut aeav. Climb who have a finaruial hardship are not refused servioea. If a ctimt can afford a partial fee, that is assessed. If the client oa'md afford any part of the fee,lhrystill rooeive services. H. Viability: 1. What b your JustNleatioe or rotbeak far the e:pesditerc of poblk 1Lods for the prapoaed pragnmT 'fine requ~vt is far S20,521 m Cainty funding. Althargh WHMS does receive funding from the Hawaii State Judiciary, that mmry is targeted to assist in reducing the caseload of the taut tau other large is to prevent disprrta from fvuling theQ way into the legal syat®. WHMS provides a needed service far FLwaii rasidmts prwided by volunseaa from the Hawaii community. true aootmunity bLVed medidim serviaes. Medidim not mly bme5b the clients who receive the service but also the vohmtee mediators who utilize oammmicabm and negotiatim skillsvm theeQ primal mtd profesatmd liven to prevent and/or resolve disputes. 2. What arc the 1Laxial and programoutle plans b aadale the proposed program beyond the upeomiag Beal year! 'Ihe West Hawaii Meduum Services have been providing quality medretim servixa to the Hawau amtmtmity since 19Eg, and it is anticrpated that the progruns will aintmue past the upoanetg 1isa1 year. 71te programm rcdrzes that ling-term surnval is oontmgmt upm both providing quality service and a fimdmg strategy tint iaoarporates diversi5ad funding souram. L Budget: See attached eompkted bsslget tables. ORGANIZATION/AGENCY INFORMATION A. BoardMDireeton 1. Has the orpelratbo's Bard of Dlrectorc received formal troinhrg wfthle the pad Mo (2) tLal years? All Hoard members restive arieobtim and a Board of Diroctar's Manual when thry join the Board. 2. What arc the primary role sad rcspoesibllity of your orgae6atloe's Eucutlve DlrectorT 'Ilia Exeartive Dueciar, undo the daedim of the Board of Duectors, is respmsrble fro • Plmoiog and implementing scvieas • Opesatims of WHMS • Pcsamel manegemmt • Fuanas, reard keepbrg, ®d report produdim • Public Itelstfms~ammunity relations, referrals source relatims, print end electrmrc media 3. What arc the primary role aed responslbllMles of your orgaebatloo's Board of DlrectoraT 6 County of Hawaii, Grant Appl'ICation FY 2001-2002, West Hawaii Mediation Servkxs The primary roles and respmsbrlrties of the Board of Directors are as follows: • To adapt rules and reguldrms for the conduct of meetings and of the Carpaatim • To appoint a approve the appointment of committee • To define the dufin of ot5cers and committees • To employ and define the dunes of agerHS and employers • To delegate duties • To establish general pohcres for the Carpaaron, and to manage the business and affeus of the Capaatien All Board members are ragpanable to assrst the Carpaatim with anmral and other fund-raising efforts. OtBoes of the Corpaatim are Prcside+rt, Via President, Sevday and TreaaaQ. Eedr dueaor ie also actively involved in Board Committees (a &et is included witfi the Board of Direda's Roster). B. Past performaaee: 1. Horv effeetlve has the oryaelaatloe base V aehhevles pragnm scab V the pad 2 }heal yeanT a. Qsotltadve doh a eemhen served: Caseload - to open 246 uses - WHMS opened 224 cagrs in the bst 5sca1 year. Mediator pool -to convert 5096 ofthe saacbve mediator to active medistar sblus. When WHMS berme en mdepmdent orgarizdim from the YMCA m July 1999, them wQe 8 active and 3 inactive mediators. By Decesnber ]999, the Curter had SS active sd 22 inactive mediators, a 687.5/0vmaax in active mediatQS. We arre+rtly have 55 alive art of 93 inactive mediators, The October 2000 Dwane Training generated 10 mere divots madiston. h. QaalkaHrc date shorrles semher and perceetase of prtlclpaeb achhwfns meannbk osuooerea WHMS surveys cheob to ddamme sansSdien with the services received end to obtain anecdotal quahbtive infarmatim far mmitaing medida competency. The percentage of climb respmding the they benefited from the service far the FY2000 was 89Ya C. Piaaoebl: 1. Have yoer orsaebatloe's eorreet prosnm opentloes rcmahed the sure u bet yearT Whet major prosnm or MaeeLl ehaesa wls be Interred nest yerr! a. In luiy 1999 WHMS formally disengaged tram the YMCA end reapplied far SOl(cx3) status (originally granted 1988, expired d YMCA 1998, granted .gear in February 2000} since Jniy 1999 WHMS hag bean belling the mediatims fie half of the island of Hawaii. b. WJIINS applied far and received arratha me year of fimdmg from the Hewsii hretice Farmdatim fa volurrteQ /mediator support. The monies received src supporting, in part, mQeaging the afa8' boas from 52 to 68 haaa per welt. The additimal hogs aro devoted to volunteer / medidor support fimdims. Hopefidly, with renewed finding, the Mediator Support Coardmatar pasitim can fit maintained. This person has aagided WHMS in wadinating medida treiaing efforts, finding new coarmmity lacatiaag for madiatims, maintaining the dabbese far the volunteara, and assisting in the prodectim of the newsletter. These efforts have helped to reduce attrrtim and inQeased err capacity to rnspmd to inaeesmg ard/a charging commrmrty Heads. 2. What b the slats of all of the orgasbatbn's major coetncb or agrcemeob for the eomhq yearT The aarent Judiciay caotnd ends m burs 2001. Prior to the date, in Fetnsy 2001, WHMS will respond to the RFP far cmtinued fimdiog. WHMS has sewgaed eanltecb far RICO ®d for 7 County of Hawafl, Grant Application FY 2001-2002, West Hawaii Mediation Services , condo aswciatim medianms. We are in process of securing contracts with the Departmerrt of Educs6m and the DepnAmart of Labe. 3. How does the proposed program lit into your organlratJoo's loo` nose >inanelal plant Providing quality medietim sernoes is the missim of WHMS. All 5nancial planning is dedicated to rnhance the quality of services offcad and to reach as many members of the oommmiity who could benefit from those serviora D. Monitoring 1. Doring the put 2 Mnl yeah, wkat fioaodal and/or administrative monltoriq kas yo.r progam received from soy and all fodksg sonroaT County of Hawaii Human Service Commissim 808. %1.8225 Judidary, CADR Elizabdh Kart 808.522.6464 Hawaii lusda Fouodatim Prier S. Adler 808.537.3886 E. Akokol, Tobacco and Drag-Free Workplace Pdida and Lformotbo: 1. Hav does your organtvation addrm akokol, tobacco, and other drag preventJoe InformntJon disseminative as purl of your workplace and/or program environoxntT 'Ibere is no ~okiog allowed in WHMS. Staff members are enmmaged to adopt a henNhy liteatyle, whiefi includes «aase, good nutrifim end the awarareas of the effects of tobacco, alcohol and/or drug use. 8 ]s:~ ~ ~ o s ~j N N M N ` ~ ~ ~ ~ W 8 N N N N FW FW W LL ~ O O V 4R r ~ O ~ ~ N O C ~ m ~ ~ o ~ ~ 9 N N ~ ~ a W j E IY ~ s r M ~ ~ ~ g 3 ~W: ~~a~ W a- m ~ mp ~ 8 J: O r ~ ~ ~a ~ C ~ o LL W 9 t ~ ~ ~ ~ ° W ~ a ~ _ ~ ~ ~ ~ s ooo¦y¦a 1W- a O A ¦ z C ~ ~ ~ N ~ r N ~ ~ ~jj~~~~ A~A MN YIMM N J ~ ~ ~ N : J d ~ mm F LL 3 (((Q(((Q,,,~~~= W ~oi~G m Wmmj N Y g O: ~ ~ ~ Wv ~ ~ ~ ~ ~ ~ ~ s e ~ W d ~ ,s N t9 W F ` ~ o~~ ~~p~~~ ~p~p~ 8Q~ NMN MN MN ~ NNN N _ `QQQ~~ ~ N M M M Tj ~ a mJm F ~ 3 ~F~ ~o- N m0 g a N J " s $ ~ - ~ o $ $ `s ~ ~ a ~ ~ ~ r N N Y 0 m W~ F ~"p~~p ~ g~~g ~ ~ y ~ M N Q m ~iQ¢~Q¢~ijj~~ ~ gg~~ o S W~ ~ N M M ~ ~ ~ w ~ E ~ ~ IoW z LL ' ~ w g Z~ ~ Z ~ ~ ~ ~ a ~ c e E~ ~ L° ~ ~S $$~F •n==s o O e- psi: s~ ~ a~- ~ ~LLtddF~a< .2E F .s 1~ Om0 ~N[9 V If1 r ~ ~ ~ ~ ~ W~ F e M ~ ii v,~m~• NCD PI r Ief N M N r g r O W~ ~~m~g N~M~l~ ~ ~ a a~ _ ~~C~ mJ W_ 2 ~ m ~ ~~4 ~ _ ~ ~g J LL = O m ~~~~oo _ ~t-r-r~ 8 ~ ASS b ~ ~ ~ E ~O 3 m~ 8 NC r _O 0 ~ ~m ~~s 0 ~ N N n~ ~~N~ N M N `4QQ~~~~ ~ ~ M M M N ~~if N N m O J ~ ~ x ~W m 3 g~~ 8 s ~ ~ x y4g~ ~ ~d ~ ~ ~ 7 c g ~~xLL~ Ea ~ ~ ~ ~~E~ o x $ 's 8 N N r 7 C W L C~ LO ~ _W 7 8 ~ J C 3 8~ s ~ ~ a_ n ~ Z• O~ 'S C ~ ~ N r S N N~ O gR K N Y Q N m W ~ ~ ~ ~ ~ M ~~[000 •J x ~ m~ ~ ~ ~ ~ ~ ~ a~ - _ ~ ~ ~ LL a cg - SUPPORTING DOCUMENTS CHECKLI T In summary of the rules and regulations to seek a grant of County funds, please submit the following documents or items in the order listed below 1. ? One (1) ORIGIIVAL grant application-completed, with appropriate signatures affixed, and dated. 2. Five (S) copies, double-sided, of the completed grant application. 3. Attach to the ORIGINAL Brant application only, the followmg• ~ Orgam7ation/agency flow chart ~ List of current Board of Directors and Officers to include. Dates of expiration of terms of office ? Addresses and phone numbers of board numbers Regular meeting schedule of Board of Directors i/ Using Staff Information Sheet I~st names of all agency staff. For all administrative staff involved in the program for which the funding is being rcauested. include: Job descnphon S• Resume 4. Attach to the ORIGINAL ergot applicatioa and cools. ONE (1) of each of the followmg• FIIYANCLAL QUESTIONNAIRE -Must be completed and signed by organizatron's comptroller, accountant or bookkeeper and signed by the Executive Director. N~ ANNUAL FINANCIAL STATEMENTS -Agency's past two (2) years' annual financial statements: 1. Prepared by a qualified accountant and approved/signed by the Executive Director; OR 2 Prepared and signed by a Cert~fled Public Accountant (CPA). ? CURRENT AUD1T -All nonprofit orgamutions must have an audit prepared by an independent CPA at least every three (3) years. IRS FORM 990 - Most curtent document for fiscaUcalendar yev. ? INFERNAL REVENUE SERVICE (IIiS) LETTER -Verifying agency's tax-exempt status for nonprofit organisations. LIABILITY INSURANCE CERTIFICATE - Currcpt and valid. to include the County of Hawaii as additional insured with a general liability of Sl million and 550,000 for each occurrence. ? ARTTCI.ES OF INCORPORATION - Wined and dated. BY-L.AWS -Must contain specific clauses regarding nepotism and conflict of interest. By-laws must be siaped gad dated. r'~[Y u• N~4 ~V Stephrn K Yuneahrro ~ ' ~ ~ Harty A Tekahuhr Mayor Director CiOUl~ 1 I O~ ~![341a1 DEPARTMENT OF FINANCE 25 Aupum Strew, Room 1 I S • Hilo, Hawaii %720-4252 (808) %1-8234 • Fu (808) %1-8248 HAWAII COUNTY NONPROFIT GRANTS (Fl' 2001-02) FINANCIAL QUESTIONNAIRE Please include as en attachment an explanation for all "NO" answers to questions #1 thru #11 below: Yes No ? ® 1. Has the agency operated continuously for the peat three (3) years? ® ? 2. Hss the agency operated wtth a positive cash flow for the peat three (3) years? ® ? 3. Does your Board of Drrnctors approve a detailed cash flow budget before the begiming of each fiscal year'1 ® ? 4. Do your Board meeting auroras show that quarterly 5nancial statements ere approved? © ? 5. Is your equtty balance at least ZO% of your Total Liability balance? ® ? 6 Is your Total Cttrrmt Asset balance larger than your Total Current Liability baLace7 ? 7. Are bank reconciliations and accounting performed by someone other than the chock signatory? ® ? 8. Are you fiilly insured for the agency's vehiclels) wad bwldmg(s)7 ® ? 9. Is your Workers' CompensaUOn at least 2% of payroll? ® ? 10. Are you curre~ (non-delinquent) on all payroll and payroll to payments? ® ? l 1. Ice the agency free of any pending lttigation, lima or judgments? ? ® 12. Within the past 12 months, has the agency applied for vendor or beak credit and was denied credit? If yea, please explain. As the grant applicant, I cernJy that the agency has satLsfactonly responded to each ojthe abmr quesnons and explained as needed / herby certify that roes fnjonnadon is trove and correct to the ben ojtny btmv/erlge. Agency: ~0-/I'fi~'11 iJJf~.~T.YYt SbtdlCts ~~5,,"[ PI•f SSif ~ b),. /~ly$ /JM1rIl<L4~id lKSu.YNk `D~ccy7rL (6, s+~.~i~ry~ rnet Naao/rab ~ - B~oia.. thre Certified by: (SO>•~4 As gt~Nl~ Pnae Name or Fxeeuhve pnebr S~.nve Drs County of Hawall, Grant Applkation FY 2001-2002, West Hawaii Mediation Servkes FINANCIAL QUESTIONNAIRE -ATTACHMENT 1 West Hawaii Mediat,on Service was originally incorporated in 1988. >n 1996 WHMS joined the YMCA ttnd was run through that progrtan until 1999. Io July of 1999 WHMS split from the YMCA, started the applica<iao proaav for rm own s01(cx3) status, tmd begtm pnw,amg mediehan servioty far wort H¦waii. 9 BIG ISLAND MEDIATION, INC. (A Hawau Nonprofit Corporation) Doinst Business As: West Hawaii Mediation Services AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2000 Carbonaro Certified Public Accountants / Member AICPA CP S & Managtmrnt Group HSCPA INDEPENDENT AUDITOR'S REPORT To the Board of Dnectots Big Island Mediation, Inc. Kamuela, Hawaii 96743 We have audited the accompanying statement of financial position of Big Island Mediation, Inc. (a Hawaii non-profit corporation) as of June 30, 2000, and the related statements of activity and changes in net assets, and cash flows for the year then endod. These financial statements are the responsibility of Big Island Mediation, Inc.'s management. Our responsibility is to express an opinion on these financial statements based on our audit. We conducted our audit in accordance with generally accepted auditing standards. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatement. An audit includes examtning, on a test basis, evidence supporting the amounts and disclosures in the financial statements. An audit also includes assessing the accounting principles used and significant estimates made by management, as well as evaluating the overall financial statement presentation. We believe that our audit provides a reasonable basis for out opinion. In our opinion, the financial statements referred to above present fairly, in all material respects, the financial position of Big Island Mediation, Inc. as of June 30, 2000, and the changes in its net assets and its cash flows for the year then ended in conformity with generally accepted accounting principles. G s Makawao, Hawaii October 5, 2000 1043 Makawao Avenue, Suite 205 •Makawao, Hawaii 9b768 • Phone: (808) 572-2978 fax. {808) 572-8007 BIG ISLAND MEDIATION, INC. Balance Sheet June 30, 2000 ASSETS CURRENT ASSETS Cash: Checking -American Savmgs Bank S 10,503 Petty Cash 50 Total Cash 10,553 OTHER CURRENT ASSETS Accounts Receivable 125 Prepaid Insurance 614 Total Other Current Assets 739 Total Current Assets 11,292 PROPERTY AND EQUIPMENT (Note 2) Furniture & Equipmrnt 3,937 Less Accumulated IkpreccaUon (1,090) Net Fixed Assets 2,847 TOTAL ASSETS S 14,139 LIABILITIES AND NET ASSETS CURRENT LIABILITIES Capitalized Lease Payable S 1,302 Accrued Exprnaes 1,968 Total Current Liabilities 3,270 NET ASSETS Unrestricted 10,869 TOTAL L.IABILTIIES AND NET ASSETS S 14,139 The accompanying notes and Auditaa' report ace an integral part of these fiaaocial ataaemeats. Page 2 BIG ISLAND MEDIATION, INC. Statement of Actlvlty and Changa In Net Assets For the Year Ended June 30, 2000 Temponsrily PcAnanently PUBLIC SUPPORT AND REVENUE Unrestncted Rcatitcted Restricted ToW ludic~ary Funding S 45,687 S 45,687 Donated Mediator Services (Notc 4) 23,112 ~ 23,112 Donated and Other Income 10,414 10,414 Hawaii Justice Foundation 9,450 9,450 In-Kind Donation of Spece (Nou 4) 6,345 6,345 Ttatning Income 2,297 2,297 Donated Fund Assets 2,278 2,278 Administrative Fees 1,720 1,720 Interest Ittcar~e 72 72 Total 101,375 - - 101,375 Net Assets Released from Restrichotu - - - - Total Pubhc Support snd Revenue 101,375 - - 101,375 EXPENSES Payroll and Related Coats 32,830 32,830 Donated Services Expeoae (Nou 4) 23,112 23,112 Outside Services 10,534 10,534 Donated Space (Nou 4) 6,345 6,345 Rent 3,979 3,979 Telephone 3,243 3,243 Insurance 2,529 2,529 Pnnttng and Postage ],963 1,963 Supplus 1,698 1,698 Deproctation 1,090 1,090 Travel 990 990 Tra~nmg - Staff and Mediatoro 838 838 Dues and Publications 635 635 Jamtonal Coats 256 256 Bank fees 187 187 Interest Expense 174 174 Education 103 103 Total Expenses 90,506 - - 90,506 EXCESS REVENUE OVER EXPENSES 10,869 - - 10,869 NET ASSETS, BEGINNING OF YEAR - - - - NET ASSETS, END OF YEAR S 10,869 S - S - S 10,869 The aerntrtpmying noses and Auditors' repot are m integral part of tlfeae fiaancral atatenrmta. n--_ ~ BIG ISLAND MEDIATION, INC. Statement of Cuh Flows For the Year Ended June 30, 2000 CASH FLOWS FROM OPERATING ACTMTIES Govemmrnt and Foundation Grants S 55,138 Donations 10,414 Other Cuh Receipts 3,892 Interest Received 72 Cash Paid to Employees and Vendors (58,ti06) - Net Cash Provided by Operating Actinties (Note S) 10,910 CASH FLOWS FROM INVESTING ACIMTIFS Cash Used to Purchase Copier (1,659) CASH FLOWS FROM FINANCWG ACTIVITIES Cash Received to Finance Copter Purchase (Note 6) 1,659 Cash Paid on Principal of Copter Lease Payable (Note 6) (357) Net Cash Provided by Financing Activities 1,302 Net Increase m Cash for the Year 10,553 CASH BALANCE, BEGINNING OF YEAR _ CASH BALANCE, END OF YEAR S 10,553 e~ The accompanying soles and Auditoe' report are an integral part of these financial atatemena. Page 4 BIG ISLAND MEDIATION, INC. Notes to the Financial Statements June 30, 2000 Note 1. ORGANIZATION Big Island Mediation, Inc., dba as West Hawaii Mediation Services is a non-profit organization incorporated under the laws of the State of Hawaii on' June 17, 1999. Big Island Mediation, Inc. is a community-based organization that provides, teaches and facilitates alternative dispute resolution. It helps people of all ages, in situations ranging from family and neighborhood to business end government, deal with their differences in non-adversarial, expeditious and affordable ways promoting respect, communication and peace. Note 2. SUbIIvIARY OF SIGNIFICANT ACCOUNTING POLICIES Method of Accounting• The Organization uses the accrual method of accounting for fmancial statement reporting according to generally accepted accounting principles. Under this method of accounting, revenue is recognized when earned rather than when received and expenses are recognized when incurred rather than when paid. Property and Equipment: The Organization capitalizes all furniture and equipment with a useful life greater than one year. Property and equipment are stated at cost or, if donated, at the approximate fair value at the date of donation. Depreciation is computed using the straight-line method over the assets' estimated useful lives which range from 3 to 5 years. Revenue Recognition: Contn'butions received are recorded as unrestricted, temporarily restricted, or permanently restricted support, depending on the existence and/or nature of any donor restrictions. Unconditional promises to give due in the next year are reflected as current promises to give and are recorded at their net realizable value. Grants and other contributions of cash ere reported as temporarily restricted support if they are received with donor stipulations that limit the use of the donated assets. When the donor restriction expires, that is, when a stipulated time restriction ends or purpose restriction is accomplished, temporarily restricted net assets are reclassified to unrestricted net assets and reported in the statement of activities as net assets released from restrictions. Cash and Cash Equivalents.• For the purpose of the statement of cash flows, cash is defined as demand deposits and savings accounts. Income Taxes: Big Island Mediation, Inc. is exempt from Federal income taxes under Section 501(cx3) of the Internal Revenue Code and also from State of Hawaii income taxes under Sections 416-19 and 416-20 of the Hawaii Revised Statutes. Estimates: The preparation of financial statements in conformity with generally accepted accounting prmciples requires management to make estimates and assumptions that afl'ect certain reported amounts and disclosures. Accordingly, actual results could differ from those estimates. Page 5 BIG ISLAND MEDIATION, INC. Notes to the Financial Statements June 30, 2000 Note 3. CONCENTRATIONS The Judiciary, State of Hawaii has contracted with Mediation Centers of Hawaii to provide active dispute resolution for the State in all counties. In order to carry out the performance of this contract in Hawaii, Mediation Crnters of Hawaii has contracted with Big Island Mediation, Inc. to provide active mediation services from the Hamakua Coast to the Kau area of the Big Island. The Agrncy has also received a significant grant contract from the Hawaii Justice Foundation. These contracts represrnts the largest revenue source earned by Big Island Mediation, Inc. The contracts were rrnewed for the subsequent 5sca1 year rnding June 30, 2001. The Organization received approxunately 54% of its funding from these two funding sources. The Organization's continuing operations depend significantly on these contracts. Note 4. DONATED MEDIATOR SERVICES Contributions of donated services that create or enhance non-financial assets or that require specialized skills, are provided by individuals possessing those skills, and would typically need to be purchased if not provided by donation, are recorded at Uteir fair values in the period received. Over 40 volunteer mediators provided substantially all of the mediation services used to fulfill the Judiciary contract and the Hawaii Justice Foundation grant. The value of these services, which totals about 523,112, is reflected as a non-cash revrnue item and expense item. The volunteer mediator value was calculated by multiplying 577.8 hoots by 540 per hour. in addition there were 141 mediation sessions performed at donated locations throughout West Hawaii. The value of this space in fidfilling the Agency's mission is 56,345. Page 6 BIG ISLAND MEDIATION, INC. Notes to the Financial Statements June 30, 2000 Note 5. RECONCILIATION OF EXCESS REVENUE OVER EXPENSES WITH NET CASH PROVIDED BY OPERATING ACITVII~S Excess Revenues over Expenses S 10,869 Add Depreciation 1,090 FNIV of Donated Fixed Assets • 2,278 Adjustment to Reconcile: Increase in Accounts Receivable (125) Increase in Prepaid Insurance (614) Increase in Accrued Expenses 1,968 Net Cash Uaed by Operating Activities S 10.910 * Non-Cash financing activities. Note 6 COPIER LEASE PAYABLE On October 15, 1999, the Agency entered into a lease purchase for a copier. The purchase agreement calls for 60 payments of 553.30 which includes principal, interest snd sales taxes. The buyout option at the end of the lease is S 1.00. I'+Se ~ Return of Organization Exempt from Income Tax 01''"° 11-0017 Y Under actlon 501(c) of the Irdemel Revenw Code (except black luny bene0t trust 1999 a.P.`xenl a h Trweuy a pdveb foundetlOn) M uNon 49d7(sX1) nonexempt charlhtle trust Thk Fain Is Open inarrr nr.«.. servbr Note: Tire orpen(ratlon may lleve ro use a o! tlds rofum ro satfaty sbhe roporbrp requnmenb. to PubNe Inspectlon A For Ure 19!! cekndar er /N to ar rlod be nN Jul 1 1899 and endl Jun 30 2000 B CFackif• C rlrn.aagne.oen D e.~reywra«aene.erewe« fMw un fTexerase«w wsr±.r 5t Island Hedtatton Inc dba west xawatt Hedtatton Services 99-0343488 X NeW neRn w°~ Ngieer i xbM PA e« Y mee Y n« Irerrrd b reerr eee) na«Nwxb Trberww n~iw rwrnem eµab P.O. Box 7020 808 885-5525 nexn care cep. Te.n «fwny suq aP . s F Chsdf ? d exemption :w~i rieperMq~ Kamuela HI 96743 epplaatan rs penGrq G Type of orpenrution ~ X Exempt under sattron 501(c) 3 ~Unsart number) a ~ sedron 4947(e)(1) nonexempt chenbble trust Note: Sectlbnbn 801(X!1 axe~~! orpenlndo+rs and I917('a~'1) rwnexampt dtar/bbN Wstr Aluat afbcf a campAelad SCIraaYeY A (Form ~4 H (e) Is tlxs a group rohan filed for alfihetes7 Yes No I If edha bin m H u dsdod Tes; sntsr laur.dpt {?pq exerrphan an6a (GEp ~ (b) If Yes; enbr dr number d aKhale la stedr the rolum b filed ~ J Atcantrrtp method Cash X Attrwl c Is Ibis a rob rebxn filed M iashon caartl a Nr Yes X NO 07rer K Check here ? d tM orpenrratan's prow receipts are normally rat more then S25,Ot>0 The orpenwtion need not fib a rekrn wrth Crc IRS, but d rt racerved a Form 990 packece m the mall, d should file a return wNnul fironcuel data Sores stabs reeuln a compleb nWm. Nola: Form 990~EZ me W used rurafraa wfOr ron Nss tlrarr 100 000 and rots/ assets lass tlrerr 000 of end o! er P Revenue E nses and Chan rK In Net Assets a Fund Balances sea rnstrudroro 1 Cordrrbuurxrs, Or1b, prenb, and similar erralnls recewed e drsct plblx; support 1 a 22 142 . b Indnsct public support 1 b c Govenxnerx oontrrbrArana (gronb) 1c 45 687. d ToW (add hoes 1e Urouph lc) (eltach sGrdWa of corrtrrtxrrors) (cash S 65, 551. rancesh S 2.278.) L-Id Stmt . td 67 829. 2 Program sernce revenue inclulrnp povemmenl fees end contracts (ham Part VII, hoe 93) 2 4 017 hkmbarshrp duet arxt asssssmems 9 4 Interest an sawrrgt arxl lemporsry cash rrtvesfinenb 1 72 . 5 Drvrdards and rnterest from securrtias 5 8a Gross rolls 8a b Less rental expenses . 8b c Net rental infxmx a (loss) (subtract hoe tib from hoe 6e) . 8f: 7 Other rrrvestment rncane (desenbe ? 7 8a Gross enarxrt ham sale of esseb other W Seturtiss p9) Otter e than rrxrontory a• v b Less• cost a other basis and sobs expenses 8b w c Gun a (loss) (albdi schedule) 8c i d Nel grin a pces) (combine hoe column (A) and (El)) 8d 0 9 Specel events end achvrles (attach schedule) a Grass revenue (rat includrrrp S of contributions rsPOrted on Irre fa) . . fe b Less direct expenses other then hndrmsrnp ezperles !b c Net income a pose) from special evenb (subtract hoe 9b trom hna 9a) . 9c 10s Gross sales of rnventary, less returns and albrvances 10e b Less cost of goods sold tOb c Grins prom a puss) from sale d rnaardory (adadi sdaduk) (suMrsd hd 1[a Iran hoe 1 W) 10c 11 Other revsnw (from Part VII, has 10. . . . . 11 12 7oW meow add lines 1d 2 3 4 3 & 7 Bd 9c lOc and 11 12 71 918. s 1! Program ssrvxxs (from hoe 44, column p~) 1S 48 671. x UI Menepemant and general (from has 44, column (L7) 14 12 378 . P s 15 Fundrarsuq (ham Irre 44, colum (D)) 1S 0. N s 16 Paymams ro affilebs (atterh schedule) . le s s 17 ToW ex nses sdd Imes 16 and 44 tolum . . . 17 61 049 . a 18 Excess a (dsfia0 to Oe year (subtract hoe 17 from bne 12) 18 10 869 . i s 19 Net asseb a firxl Wlsncas et bepxvxnp o! year (from Inc 73, colfarn (A)) 1f 0. T T 20 Other cherrpes m rot essab or find balarxxrs (albeh sxpleretan) 20 s 21 Net asssb a hod balances el end of err trornbire Ilres 18 19 and 21 10 869 . BM For Paperwork ReducBon Act Notlp, see seperab Instructlore. Tt~ofot annee Form 990 (1999) Ftxm 990 1999 et Island MedLtton [nc (dal west Nawatt eedUtton Services) 99-0343488 Pa 2 Statement of Fundlond Exptnstes Alt aganasbona mtmt cornp~ete cohsrut py. Cdtsrea n,o (p~ ere requkad for stoegan 501(e)(~ end (4) aryenirstlom antl sac0on 4947(a)(1) nottaxempt UmritaWa treats but apOpyf -for o0rn, Do not wtc/ude aAtanb reported txt IMe (B) Program hlertagenant 6b, BD, 9e, ltlb, for 16 d Pen 1 ~ ToW acmes end portent (0) Fundraaing 22 Ornrb and tt9outlae (tdfach scM6ds) (cash f nan•tash f ) ~ 23 Sptcdre stusWee b rndrvdrmb (spseh eth) Z3 2e Bsafib Ddd b a for msmbst (attach seh) 24 PS Oomproslandolhars,dirsdors,sk 2S 13 313. 9 985. 3 28. 0. 20 Other salaries and wsges 26 19 517. 14 637. 4 880. 0. 27 Penswn plan contrrbubtxts 27 2f1 OIMr employee tanafib 2! 29 Payrdl taxes . . 29 30 Profasswxrel hurdnarrtp less a0 31 Aaauntrnq fees !1 ffi Lepal Mss a2 33 Supplies 1 698. 1 273. 425. 0. 34 Teleptans !1 3 243. 2 432. 811. 0. 35 Posbpe and atuppinp . !S 36 Otxvpaney !fi 4 235. 3 176. 1 059. 0. 37 Egwprnent renal and mamtanana 37 39 Prrnbnq and publresbans 39 2 598. 2 107. 491. 0. 39 Travel 99 990. 742. 246. 0. 10 Owdsrsncu, erontenbom, and moetirrR 10 41 Interest 41 174. 130. 44. 0. 42 Ospncudlort dspMiort ak (eeach scbduM) 4? 1 090. 817. 273. 0 . 43 OtMapenat(Itrrnmke 43e bOutside Services_______ 43b 10 534. 10 534. 0. 0 c Insurance____________ 43c 2 529. 1 897. 632. 0. d TralningStaff & Medtator_s 49d 838. 838. 0. 0. e Tsea Ouw Ex eras Stmt 47e 290. 103. 187. 0 M ~ bl ~-h"'tsm.~.~' M 61 049. 48 671. 12 378. 0. Reportlrq of Jolyd Costs - Dd you report rn cdumn (B) (program servrcaa) any )ant tosb Irarrt a txtmbrnsd educsbansl earrrpargn and tUndraarrtp sdrt.btian7 . . ~ ? Yes X? lro I} 'Yes,' enter the agyttpete amont of these Ianl costs f ; (10 the amount allocated b program services f , (IIO the amount allocated b management end general f ;end (w) the amount alltouled to tundra I Statement of Pro ram Service Accom Ilshments whet rs the orgenrzatran's pnmery exempt pttrpasat ? Fact l1 fate d1 sputa resolution _ Froa.nsavlaExpww All argsnwhans must desenM then exempt purpaaa achievematb in a eNSr and canaa_p menrt~r~. Sfa fhe numWr of t'sottgpp "'d clients served publr awed, etc. Di aduevements yet en riot maewraDla. (aecbott 5o1(c) a (4) n• r in0 izabons a secLort 49s e 1 naasem t e t~er~table tnnb must abo ankr the amount d na a auoce ors to aU~s ~ a~srs°u a Mest xawet t M_dtatton serrtces (MMMSLprovtded a Court nedtatton ?rojra~ for 14s court ordered and court referred cases as an elternattre to lttt ¦tton to the court s stew. 7hts Included an Adult Dtverston .1----------•Y--------------------- ro rr, where ftrrt rice offender could choose to aedtete and have th~tr use dirtseed. If aedtett en tern ire eet_ 3_l__________~__________ (Onnts and alloabora f 0 36 560 . b NHMS also handled 78 non_court mediation and facilitation cases duringtheyear__ The fees ranked from f0 to f50per person per s_esslonL depending on abil_itY to~ay__76_.9% of the cases that_mediated resulted 1n agreement____ -(Orrtb antl albutiorts f 0 ) 8 189 . c WHMS offered Communlty,TralninB and Norksho~s to v_ertous cosunlt~and professional Lroups toyrovtde ba _tc skills 1n.eEtatton }or everyday ltvtnj _Dt}}_rent versions of the Qr~a~ were off_red_ eo Ntlor the}reienueten t~ehe}!ouy~ atandl~and tie fe~~ wire dte~ounted to non•proftt~ end co~unt~ jreups_ -(OreMS end ellocatlans f 0.) 1 625 . d 11HMS offers training to professional and volunteer mediators to handle a varlety_ of cases_ Fees are charBeti to cover the cost of~rov__idingt_h_e_professto_nal trainer and other costs The fees charjed durtn(the dear }or the baste tretntnj were S375per student_ Is and albatans 0 2 297 e OUar somas , band a0oallara f 1 Total al m Setvke nsas sltouW tW lino e4 txthrrst em ttan ? 48 671 . OAA 7~otm tatttss Farm 990 (1999) Form 990 (1999) efa Island Nedfatlon,Inc.(dG Hest Xawaft Nedtatton Services) 99-0343488 Page9 Balmnu Sheets (See mstructans) NoM: WMn rsgxrad, affachM scfredul~s and amourks lnffun ffe dsscnpfan W colurm sfxxrFd W for andofryrr amounts only 13epmmrp of year End ofyaar 45 Cash -non-interest-bsanng 0 . 4S 10 553 . 46 Sewrgs aril temporary ash investments 46 47a Accounts recervade 47a 125 . b Less allowance far doubHul accounts . . 47b 47c 125 . 4Sa Pledges reservable 4ea , b Less. allowance for doubtful accents 4Sb 48c 49 Grants raprvade 49 50 Recervabks from officers, dxedors, trustees, and kty ertplayees i (adach schedule) 50 i 51 ¦ Otter rotes 6 loans racervade (attach schedule) 51 • s bless: allowance for doubthd actanh 51 b 51 c 52 Imentores for sale or use 52 53 Preped expenses and deferred charges 5! 614 . 5A Invesments - secunbas (attach schedule) 54 55a Investments -lard, buddmgs, 6 equpmanl bests 55a b Lau, atnmulated depreciation (attach schedule) 55b 55c 56 Investirents -other (attach schedule) 5fi 57a Land, buildings, aril equipment• bssrs 57¦ 3 937 . b Lass: amxrxrlaled depraciatian (attach sctedlde) 57b 1 090. 57c 2 847. 56 OCer assets (dasaibe ' ) 5S 59 Total asaeb sdd boss 45 dx must I Ins 74 0 . S9 14 139 . 60 Accounts psyads and accred exparws . 0 . W 1 968 . 61 Grants payabe . 61 • 6Z Deferred revenue . . . f12 63 Loans from officers, detectors, trustees, and May employees (attach schedule) . ff9 t W a Tsx-exempt bond ledhties (attach schedule) 64a i b Mortgages aril other rates payable (ettsch schedule) 64b i 6S t)t)erlisMlites(descnbe ~ See Line 65 Stmt ) !5 1 302. 66 Tobl IIadIItMs add boas 60 th h fi5 0. K 3 270 . Orpanhatlons that follow SFAS 117, cMck hen ? aril complete boss 67 though 69 and boss 73 aril 74 f7 Unrestricted . Q 10 869. 46 Temporarily restricted 1)6 q Parmansrdly restratsd N R Oryantratlons that do not follow SFAS 117, check fen ? ~ and complete hoes 7011rouph 74 70 Capital stock, trust pnroipal, or current Itxids 70 T Pad-in or Capital surplus, or lend, balding, and equpnent hod 71 72 Retained earmrps, eridowrrienl, accumulated irxpnie, or oiler finds 72 79 Tohl ml asseb or land balanas (add boas 67 dxaugh ffl a lines 70 though 72, column (A) must equal fine 19 and wlumn ~ must equal fine 21) 0 . 73 10 869 . 74 TMaI Ilabllttln and net assefaMund balanws add Mnes 66 and 0 . 74 14 139 . Form 990 is availabb for pudic ingestion and, 1a soma people, serves as the pnmary or ails sours of inlormetion about a partiaYar orgenuutan How ttr public perarvss an orpsmubon m such pws may be determined by the inlormatan presented on ds rekm. Therc}ore, please make sue the retim is complete end accureh and lolly dasades, in Part III, fhs orgaro¢atian's programs and ecroonplishrnmks BM nxnolw awwe Form 990 1 61 Island 1ledlatton Inc (dba 5kst Nwatt tledlatton Services 99-0343488 Pa 4 Reconcllistlon of Revenue per AudHed Reconclllatlon of Expanses per Audited Flnsnelal Ststements with Revenue Financial Statements with Expenses per Return (See Instructltx5s.) per Return a Tdd memm, llaro. and atlur auDPat a Tohl expansas and losses par par audad fironcW Yalanrres ? a 101 375. sodded financial sWemenh ? a 90 506 . b Amwnb mcluded on Ilne a but b Artarnb mcluded on hoe a lxA not not m Ime 12, Farm 990 on Ime 17, Form 990 (1) Net unroalwd (1) Donetsd sarv- pams an Kes and use mvestrnerds S of facrlfibs S 29 457 . of lserbtrs f 29 457. hoe t4 iam 99o f ~ ~a 0~ f ~ hn~, Farm990~ . S (s) Other (Wanly). (4) Other (speary): -------•s --------'f AMdd~h ~ntsonlmes(1) ? b 29 457. ~ Nh" ~ jaon.hnas(1) ? h 29 457. c une a mrnua Ime b ? e 71 918. c one • moos kne h ? e 61 049 . d Amounts included on line 12, d Amounts naluded on hoe 17, Farm 990 but not on boa a: Farm 990 but rat on biro a: (1) Irwestmant expenses not (1) Investment Imel 6b, ~ inclupeASd aril ne Form 990 S 6b, Farm 990 S (4 OHrer (Weary) R) Other (spedry) --------s --------'S Add anwlm~ on ones (1) and f=) ? d Add emanb on hoes ) and fA ? d • Total revenue par Imo 12, Fenn • Total azpansta per Una 17, Fonn 990 rro c ks lino ? a 71 918. 990 iM c IW Ilrls . ? • 61 049 . List of ONicers Directors Trustees and K m 1o ees 1st aaeh rxx even N not can • see InsWCtans. T10e and aappea Mores (G~ ComparwUon (C) Cantr~utioru to (q Expanse (A) Name and address Per waNc~dsvotsd 01 not paid, employee Wnafit aetount and dher to position enter-0.) plans and deNrred dlowaraas snsafion Desha_Nard_ec_chla_________ P08 7020 Kamuela HI 96743 Exec Dir 40 13 313. 0, p, _Luke A_1_tken POB 6535 Kamuela HI 96743 President 1 0. 0. 0. Dee Chapon_____________ POB 10 Haws HI 96719 Vice Pres 1 0. 0. 0. ]udlth Kautz 64-5097 Mhtte Rd Kamuela NI 96743 Secretor 1 0. 0. 0. Barbara Hodgson 68-111 N Pukaua Pl Kamuela HI 96743 Treasurer 1 0. 0. 0. GeorBe_Erro_r____________ 75-665 Hua•'a1 St Katlua-Kona HI 96740 Di rector 1 0. 0, 0. Curtis Kirker P.0. Box 6751 Kamuela HI 96743 Director 1 0. 0. 0. _Mati_ida_ Tompson POB 9654 Kamuela HI 96743 Dl rector 1 0. 0. 0. Susan Evans is-ioOONenr St aZa9Kalua-Kona Mi9a74 Director 1 0. 0. 0. Sea Lot of Officer Etc Statement 0. 0. 0. 7S Drd arty olfiter, duaclar, hrwtaa, ar key employes racsne appropab eortpansstim of moro then s100,000 horn your ar0anrtafbn and dl related orpanwbona, of wMeh mas Men 150,000 vies DrWdad by 111a rotated dryanrrahonf7 . ? Q Yes ®No If 'Yes' sltarh aUbdi~ls -see irobuc0ors B/iA it9=_rala ttnoms Farm (1999) Form990 1 et Islandrredlatton inc dbaHestNawttnedtattonServtces 99-0343488 P 5 Other Information rnatiurdrorts. yK ~ Tfi Did the apenwtan engage m any actrvrty rat prevausty reported a the IRS) If Yes,' attach a detailed desorption of each actmb . . 76 X 77 were any dyrtpes made m the ogen¢rrq « gowrrurp doasnarNs Ixd not reported a the IRS) 77 X If Yes,' attach a cardorrrred copy of the charges 7aa Dd the organruUOn have welatad txsureu arms income of 51,000 or nave duruq ttx year covered M tlx: retumT 7oa X b If Yes,' Free rt filed a tax reWrn on Form 980.7 for fhrs year) 79b 79 Was there a hqurdaUOn, drssoluUon, termrnehon, or subslanUel contracUan durrrq Vrs year) I} Yes; attach a sUlemeM 79 X 80 a Is the organwtan rotated (WMr then 6y essociaUOn vnth a statevnde or nationrnds orpanveUon) Itrouph wmnan memlxrshrp, goverrnng s, trustees, officers, ek, to arty other exempt or ransxempt ogenwUoni~ COa X DlfYes,'eMerihenameoftheogenwtan? Hedlation Centers of Hawaii _ - _____________________,andchedrwhetherdrs~exempta ~ranexempl. 01 a Enter tlta amount of pdrUgl experddures, dried a rndrred, as descrttxad m the rrrstruetlons 91 ¦ 0 . b Drd the organwtion file Fonn 1120•POL fo the year) Q1 b X S2 a Drd the orgqaanwtion reterw donated semces or the use of materiels, equrpmeM, o faaldres al m charge or sl substantially less than fan rental value? B2a X b If Yes; you may rrdrula the value of three Hems here Do rot include this amours as revenue rn Parl I o as an expense m Part II (See msfrrxirans for reporUrrp rn Part III) alb 29 457 . 93a Did the organwlron comply with the gable rntpedan requramerds for returns and exemption apphcatans7 e3a X b Did the orgsnrzabon comply wrth the disclosure requvements relating a qud pro quo contirlxdrorrs7 tpb X a4a Did the orpanwtion sohat any contirlatiorrs or pills that were not tax dsdrx:trbN1 e4a X b If Yes,' did the arpenwtlon include wdh every sohGtatan an express statement that such caWibuUOns or gills were not tax deduChbls 946 ffi 501(c)(4), (5), or oparxzatlars a Were su6staMraly all dues nondaducUble by members? , a5a b Did the ogeniratan make ony rn-house lobbyrrp experdrturss of 1;2,000 or Isu7 . e5b If 'Yes' was aM:wered a erlFrr ~e or &5b, do not complete 86c through l~ih below unleu Ore orgenrzatan received a waiver for proxy tax owed for the pray yesr. c Dues, assessments, and sxnilar artatxtts horn members e5c d Sedron 162(e) lobbying and pobbul expendrtues 05d a Aggregste rardaducUble artauM of Sedan Gp33(e)(1)W dws roUcas e5a 1 Taxable amount of lobbyrrq and pohtrcal expandrtuas Orris 05d lea awe) ~1 q Does the ogenwtion elect a pay the Section G033(a) lax on the artauM m 85fi ~ h If Sedron 6033(e)(1)W dues notices were sent, does the orgenw6on agree to sdd the amours rn 85f a its reasonable eshmete of dues albceble a nondedudrbls lobbyaq aril polrUCal expendrtues for UM alloanrq tax year) e5h 66 501(c)(n orpanaaports. Enter: a InrtieUon teas and uprtel cantrrbubom rncludsd on Irrre 12 e6a b Grins rexrpts, included on brie 12, for gable use of club facdrUes ebb 87 50I(c)(1?) avpanaaMars. Eller. • Grins rrtcome hom members or shareholders 97a berms rrtconre from other sources. (Do rat net amounts due or peril a ottrev sources against amens: due or recervad hom them.) alb M At any time durng the year, dd the orpanwUon own a 50% or praetor interest rn a tsxable alion or parUrsrsMp, o an entity dsregerdad as separate hom the organwtion under Repulatians Sections 301.77 and 301.770137 It Yes; complete Part IX X 99a 50I (c)(3) opsnashorts Eller Amount of fax imposed on the ogenwUOn durrrg the year uder. Sedan 4911 ? 0 . ;Section 4912 ? 0 . ,Sedan 4955 ? 0 . b 50I (c)(.0 and 50I (c)(4) orpan@atlaro. Drd the oganaetion erpape rn ary Sedan 4958 excess benefit trarrseciron dump tM year o d r11 bacorna aware of an exceu benefit Vansadion hom a poor year) If Yes; attach a sfalemaM explarnerp each tiarrsacUOn . e9b X c EnUr Amount of tax imposed on the opsnwtron managers err drsquahfied persons durrrp the year urxkr Sedans 4912, 4955, aril 4958 ~ 0 . d£ntar Amount of tax on Irne t19c, slaw, rermtxrsed by the arganwlan ? 0 , 90a Lrst the :fetes wrdr which a copy of this ratan a fibd ? None Re ui red b Number of employees employed m the pay paired fhsl includes March 12, 1999 (see instructions) 90b _ _ - - 3 91 Tlxbooksarsmcareof? Desha Nardecchla__________ TelapMrtanumber? LOB~_885_5525______ Loubtlst? PO Box 7020~_Karnuela HI_ LP+4? 96743 -r-1 ---------?LJ 92 Batten 4947(y(I) nonexempt efiaritabN trusts 6lirrp Form 990 n lieu or Farm 7041- r+trdc here aril enter the arraud of tax-exempt interest received or aooued during the tax war f)2 eAA Form 990 (1999) ,~oros ulm9e Form 990 1999 et Island nedUt+on Inc (dba Meet xewN xedleNOn Serv+cee) 99-0343488 P 6 Anal sis of Income-Producin Activities ee rntrucbor+e. Unrelated buekisst +ricoma Exch+ded aeNan 512 513 a 514 Enlar grow amorists u+less W pq (f,7 (D1 Ra4ted~etempt otherwise rnreated. Buunns Nde Amaed aG Arrqunt hnchorr rncorrre 9~3 Program sarvia revenue aTratnin Income 2 297. bA ministrative Fees 1 720 c d • f fdedreare/Mkdicab payments y fee a mntrecu from porerrvrent epasie . 91 Memberstep dose aryl aseessrrienls ss trdrst an seanpr a Isroasn ush immriu 1 a 72 . 96 Dmdends 6 interest han secudies 97 Nk radii iroma a pins) hen red sstsk: a debtfirronced property b rot debt•finriced Property 9a Net mW iritare a poq) from pen Prop 99 Other investment income 700 Gam a (loss) hom ssles of assets other then rnventery 101 Nit Irimme a post) fran spenel eranb , 102 ors pas « trs>,«n rrr a rrwao~y 103 Other revenue: a b e d • 101 SLbtotY (add mluneu (B), (D), erd (q) 4 1 105 To41(add hne 104, column tD), end (Fa) . ~ 4. 0 9 . Nob; 10.4 ra hne Id Pert / should die amaisf on /hr 1? Part 1. 1 Relatlonsh of Activities to the Accom lishment of Exem Pu see a rntruckons UrM No. Explain how eaeh ectivhy for which rr+come is reported rn cokarx+ (E) of Part VII antribuled importan0y to the accomplmM+enl ~ of 1M aparo:ation's exempt puposas (other 0»n by prwrdrrq tubs for suth Dwposss)• 93aFees were c ar ed to train ro essiona an vo unteer me iators to fact state a varlet of mediation cases. The fees cover the cost o the ro essiona trainer and ma aria s. 93 Administrative fees were Char ed toindividuals to non-court mediation cases. The fee char ed for basic mediations was s15 er ersan er hour but was waived incases of financial hardshi . Information Re ardin Taxable Subsidiaries and Disrc aided Entities ee inthuctiam. N/A W 0~ (Cl 0» Name, address, and EIN of corporebon, Paantepr N Natue of acbvdres Total Endof-year parhxrship, a diueperded eM+ly ownrnhp intsat rriconte assets .y«. any % Please w ol, ~,"`.~8'r~T:rBM~nam d'"ppw.rhn m. p.prv M•~lunwbUP f>~~J h~W1.xY Sign ? ~ ? Herc siPw. a amr. o.r rye « rnir ~ rd tin. Paid r,.n..r. Pis' n.a r sv.o.wrs sew ° rtn Prc• eipnie'• ? 11/02/00 pe~ 166-62-3837 parcr's r~ti John D Carbonaro CPA a P. C. Use ? 1043 Makawao Ave. Ste 205 EIN 99-0303190 Only .,,s Makawao HI 71P+4 ? 96768 BM tt>Erma +arnns Fain 980 (1999) o.v.a~wa a rr rwewy x~w nrwn¦ awvlar schedule A Organization Exempt Under 1999 ~On"~ SeGtiOn 501(t~ eeu.m _c,,,,i,,,r,aw, r~,esr rv ((EEscept PrHate Foundatlon) and Settlon 501(e1501(11501 ~501(n~ or SeNon 1917 axl) ae no ~s~saoa Nonexempt Charitable Trust Supplementary n orm wparab Instructlons~ ? Must be com fed the strove o mtraUons and attatMd to their Form 890 or 890iZ. xrir ar M GPntreec^ Empb~.r tlrnYevam a,.ne.r B1 Island Mediation Inc. dba Nest NaNai1 Mediation Services 99-0343488 Compensation of the Five Highest Pald Employees Other Than Officers, Directors, and Trustees (See ~rotruehons List each one If there acs norr, enbr 7YOne.) (a) Neme and adddress of each (b) Title and avera0e (c) Compensation (dl~lybpnb~pp,y~~ ~ ~ t ern S50 ~Od00~f e d filed Wr i~hon Beni i Marsd D~ sym allowances None--------------------- Total number of olfw empbyees pad owr 000. ' None Compensation of the Five Highest Pald Independent Contractors for fessit>rtal Servltxs (See rtxbuctiorw. List each one (wMUxr mdmdwls or firms). If errs aro nar, enter Tlone.) (a) Neme and address of each uxlsperdent conbatlor ped more then 550,000 (b) Type o1 sarvx;e (c) Comparaation None Total amber of oBMrs recaMrp owr 5500001or Iservioee ? None BM Fa Paperwork Reductlon Ad Noep, see the Instructlons for Form 890 and Form se0i2. 9clydN A farm 990)1999 iLl/a101 OUOeM Schedule A orm 990 1999 B1 Island aedlatton, Inc (dba Mest xawatt aedtatlon Services) 99-0343488 P 2 ®Statements About Activities Y•s No 1 Duruq the year, has Ote organization attempted to influence national, state, or local legislation, including any attempt to mfiuerx;e public opinion on a lepislatrve matter or referendums ~ X It 'Yes; enter the total expenses paid or incurred m connectwn wdh the lobbying ectlvliKS ~ S Orparnzatlons that made an election under section 501(h) by filup Form 57613 must complete Part VI-A Other orgamzatons checMrq'Yes,' must complete Part VI-B •M attach a statement plump a detailed descnptlon of the lobbyuq admhes 2 During the year, has the organization, either dvedly or indxectly, engaged in arty of the following acts with any of ds trustees, dvectors, ottlcers, creators, key employees, or members of then families, or with any taxable organzaton with wtuch any such person is affiliated as an o icer, duedar, trustee, malorily owner, or principal txnefic~ary • Sale, exchange, or leasing of property pa X b Lending of money or other extension of credil~ 2b X c Furnishing of goods, services, or facilitles~ yc X d Payment of compensation (or payment or reimbursement of expenses if more than 51,000) SeE Pt V, Fm 990 2d X e Transfer of any part of Its income or assets 2e X If the answer to any question 1s 'Yes,' attach a detected statement ezplalninp the transactions 3 Does the organization make grants for scholarships, lellowshlps, student loans, etc 3 X 4a Do you have a section 403(b) annuity plan for your employees 4a X b Attach a statement to explain how the orpanu:ation determines that individuals or organizations receiving grants or loans from d in firiherance of its charitable r rams uah b receive menh ee nKtructlons -Reason for Non•Private Foundation Status (see msvudwns ) The organzaton 1s not a private fourxfahon because it is (please check only On• applluble box) 5 A church, canvenlan of churches, or association of chlrctes Section 170(b)(1)(A)(Q 6 A school Section 170(b)(1)(A)(u) (Also complete Part V, papa 4 ) 7 A hospital or a cooperative taspdal sernce orparxz•twn Section 170(b)(1)(A)Qu) 8 A federal, state, or local government or governmental unit Section 170(b)(1)(Axv) 9 A medltal research apan¢atlon operated m conlunctlon w11h a hospilal Section 170(b)(1XA)(nQ Enter the hoepltal's name, illy, andstah? 10 ? An organization operated for the benefit of a college or university owned or operated by a povernmenUl un11 Section 170(b)(1)(A)pv) (Also complete the Support Sch•dul• in Part IV•A ) 11 a X? An organization that normally receives a substantial part of its suppod hom a governmental and or hom the general public Section 170(b)(1)(A)(w) (Also complete the Support StMdul• in Part IV•A ) 11 b ? A community trust Section 170(b)(1)(A)(w) (Also complete the Support Schedule m Part IV•A ) 12 ? An organization that normally receives (1) mor• than 331/3% of ds support hom conVibutions, membershp fees, and grass receipts hom activities related b ds charitable, etc, functions - sublact to certain exceptions, and no mon Uran 331!3% of its support hom gross investment income and unrelated business taxable income (less sedan 511 tax)) hom businesses acquned by the organzaton after June 30, 1975 See sedan 509(a)(~ (Also complete the Suppott ScMduN m Parl IV-A ) 13 ? An organizaton that rs not controlled by any disqualified pparsons (other than foundation managers) aril supports organu:atlons described 1n (1) Ixles 5 through l2 above, or sedan 501(c)(4), (5), or (6), d they meet tlx test of sedan 509(a)(~ (See section 509(a)[d) ) Prowde the followuq information about the supported organzations (See instructions ) (a) Name(s) of supported orpanlzahon(s) N horn ~ ~r 11 n An oroanwtion orpan¢ed aril operated to test for public safety Section 509(a)(4) (Sce uushulctlons ) BM ~eatwox rzae9s Schedub A (Form 990) 1999 SctxWule A am 1999 al Island Medtatton Inc (dba Mest aawNt nedLtton SerW ces) 99-0343488 P 3 Support Stheduk (ContpkN onN it you checked a hox on fms 10,11, or 12.) ure ashmelbodoFaccowrWgp, role: You may we Bre eaksftNf ut tla vetrucManc Aar eanMSr6rp Irom fhs eccru~al b Ihs carte mrtllod of acmun6rg. Caktsdar er(ar8salyear a (p~ td~ beplnrdnp el ) . ~ 1 1997 1996 1995 T(Wal 15 ann~d co InVlbuborls Ira~xs~ . Ses~lm~i 28. . 16 hlernbersfa tees received . 17 satl a performed, a IttmlWnO d felilUes M aro alb tlM n n« a bdrrs utssleYd b tla t 1 e Oros Irmlr hem irsassC dlsidanls, smr~eabns,lhet leelr (Sedlen IXsXS)L hsaUe hr~ana (Im Sedkn SI t Yes) Iran hulhtellei bl th al'n• reason Mlr Jena 1915 19 IM Irtoarte ham ursaleYd btahtaes attheYe not Induced In Ihr 1t 20 Tu rewxMS levld br dle apantrabon"t hvle6t and arQBww wk b rt a expended on ds hehelf zt The vahw of ssrvtces a hedrbes furtietrd b 9rs oryarloabon M a porarmlenbl wt wd)atrl clrrae. Do not tncltde the vahee of serltioes a fatddres haNetlsd b tlx 22 06Mr tncanr. AtASdI a sctrsdtM. Do not Include at dal u~wbhom sale of 2! Total of Itrtee 15 22 24 Lne 23 mires Ihr 17 25 Enter 1 % of lele 23 . 26 fkpantratlorrs dsscAbed on Imes 10 or 11: a Enter 2% o} amaxd to column (e), Irna 24 ? 26a b Attach a list (wtseh is not open to public rrlspecbon) slwwtnp Mls name of and amount cadnbuled by each person (o8rr Than • povemmental unit or publKly suppeed arpan¢atwn) wlass brat Oodle for 1995 ttraph 1998 exceeded Uta smount shovrn m terse 26s. Enter the sun o} all these excess amouds ? 266 c Total support br Setilon 509(a)(1) test. Enter tens 24, column (e) . . ? 26c d Add. Anauda from tolurn (s) for hoes 18 19 ZZ 28b ? 26d • Public support (Itne 26c minus Iuns 26d total) . ~ 26e 1 Puhllt w rce Inc 26e numeret dlvlded Ilne 26c denominato ~ 25t ~ 27 Oryentotlaus desalted on Nrre 12: a For amanb rnduxfsd m hoes 15, 16, end 17 thst ware recewed from a 'dtsgwhfied person; sttaeh a het b show Uue nsma of, and btsl arttounts reprved in each year from, each'drsgwldied person' Enter the sum of such amounts fu each year (1~ (1997)------------ (1~-----~------ X995)------------- bFa arty arttouslt truNudsd m bns 17 that wes recatwsd from a rardusgwhfied person, attach a Itst b show Uus name of, and amount reterwtd for each year, Itrt was nave 8tsn IFre lerper of (I) the amount on tens 25 for Ste year a f5,D00. Onelude m the Int orpanwborus descnlted m hoes 5 Mrough 11, as well as rrdmdwls.) ARer camptdinp the dtffsreruce between ill amont ravened and the larger amoud descnbed un (1) a enter the sum of these ddlerences (rtes excess amourutt) for each year. (1~ (1997)------------ (1996)---------~-- (1~------------- cAdd Amounh from column (e) tar hrtes• 15 16 17 20 21 ~ 27c d Add• Lme 27a brat and hoe 27b brat ~ 27d e Ptbla support Noe 27c total rrxnra hoe 27d tofaq . . ? 27e t Total support fa seobon 509(a)(2) test: Eller artausA on hoe 23, Iplum (s) ~ 27f q PubBc suppoA perpmaq (Ilne 27e (numerator) ullvlded by llm 271(Mnominaloru ~ 27 % h Investment Income rcen Inc 18 column • numereto dltdded Ilrue 271 denominrio ? 27h % 26 Unusual Grant: Fa an apenwtan desrntxd m hoe 10, 11, or 12 that retasuvsd arty unuswl grants dulrq 19951hrpuph 1998, attach a Int (~wwhhrdt is rat open b public truspcciton) for each year stgwuq the rrrrte of Bus cordrtbtdor, the date and amoud of tTx pant, artl a Wrs+desarphon of tM nelws of the Orard. Do not include these pools In hrr 15. (See inshrxiibru.) t y~ am SCM.MrAe A am 1999 et Island Medtatton Inc. (dbe Mast Harat+ IkdleNon SerW Ces) 99-0343488 P 4 Prtvata Scho Qlxstionndtt (SM ~rrbucbons.) (To be campNMd Ordy by sdaols tltal checked tM box on IMre 61n Pal IV) N /A Yes No 29 Does the aganwtron have a rac+ely na+disttimmatay pokey tarord students by statement m +ts charier, bylaws, other gowrnirp msbument, or m a resduhon of its govarmrq body? 49 30 Does the aganwbon include a statement of its rec~aly nondiscrimmatary pohry toward students m all ds brochures, csulooues and otl+er wnttsn commumcadons with the publK deahrp with stdent adnussioru, programs, and u laishps7 30 31 Has the organ¢atwn publicized ds ranalb nond~scrnrnnstory pohcY ttxouph newspappeer or broedgsl media dung the perrod of solxatebon for studenh, a unrq the rpisbalan pared rf d F+ss ra solicdatan program, m a way tl+at makes @+e policy known to ell parts of Urc general wrtrrxisy d serves? . . . . . 31 If 'Yes; please desuibe; d No; pease explain. (If you need mac spsx, alhch a separate statement ) 32 Does d+s organwbon maintain the lollowmg. e Rscads rndreebrq ffxe racial conposi4on of the student body, faculty, and admirnstrahw staff? 32a b ~doc+srant~ng~7 t acholarshps and other financml assistance era awarded on a roaaly 32b c Caoros of dl utebquss, brxhres, annou+oemeMS, and other wrrlten rcsWrs to the DubIK deNxp w student admisswr+s, Programs, and schdarshps7 . 32c dCopies of all material used by the organ¢abon a on ds behalf to solxat conbibuha+s7 . 92d If you answered 7Vo' to any of the above, please explain (If you need mace space, atheh a separols stalemeMJ 33 Does the orgsnwhon diunminete by race m any way rnth respect lo: a Students' ngt+ls or prmleges7 33a b Admissior+s polx:ies7 . . . . 33b c Employment of tacvty a edmmnfrabve stafR . 93c d Sefgkrateps a odor fuw+eul ass+star+ca7 . . 33d e Eduut+aul policies? 33s 1 Ilse of fae+I+bes7 331 g ABdebc programs? . . . 33 hQC+er extraarr+a>lar adw+lros7 33h If you answerad'Yas' to any of the above, please explain (If you need more space, attach a separate statement) 34a Does the orgenwtxm rexrve arty finaneul aid a assistance hom a gowrnmantal egar+ry7 31• b Fka the aganwtanh right to such ad ever bean revolad a suspended? 31b If you er+swsred 'Yes' b edher 34s or b, please explain usnq an atlecfred statement. 3S Does CN a~aMzabon csr6N Nrt It has complied wiM tl+s eppheabk raqutromaMs of seclwrn 4 Ol through 4.06 of lieu Proc 75.50 1976.2 C.B. 587 town recut nadisrnmwbon7 tf No ' aUact+ an • Iwbon... ld BAA ~aaa +vsass orrr+ Sdkdrte A orm 1999 st Island nedtatton Inc. dW Mast Newelf 1ledtatton Services 99-0343488 P 5 Lobbying ExpendRums by Electlnp Public Charities Instncbdrrc.) (To be compbted ONy by an el bb agartiratbn Ntat flbd Fam 5 N/A Cheek here ? a d the aganzattdn bslortps b an affihatad group. Check here ? b d u cMcked'a' above and Lmted cronNOl' rovrsbns a I . Limits on Lobbying Expenditures l• ro) Affiha group To be campbted (the term 'experdrtues' means artgtstls gab a rrlcurred.) totals for all abctrrtp or nwbats 36 Total lobbyrrlg expendilures b mfluenee publrc oprrntNt (Waasroola klbbyut~ !e 37 Total lotttyrrtp expendrlures to mflteertce a Isgnlatrw body (deed lobbyrrt~ !7 3e Total bbbyrrrp axpandrtureKS (add hoes 36 and 37) !e 39 Oetx exempt purpose axpendrtures !e 40 ToW exempt purpose experdtuas (add hrtes 38 end 39j 40 41 Lobbyrrq nontaxable arnanl Enbr the amount ham the follovnrtp table - N tM amount on Nrte 40 Is - TM b~An9 nontaxabb amount Is - Not over t500,0g0 10% of the amount on Ens 40 Oren SSOg,000 dt nil over i1,000,0~ itog,OgD qa Is% d tlr eecas orn 35gD,001 IMr it,ao0.000 bt nil ewr il.sogooo snsooo plus lox a tla exwe ear it,ooooM 4t Uar it,sgo,000 bt not ow i17,Oggo00 i71S,0g0 pus 5% d the aaess as 51,50gg01 Over S17,OOg,Ogo S7,ooo,000 . 42 Grassroots nontaxable entouil (enter 25% of hoe 41) 42 4! Subtract hoe 42 fiom hoe 36 Eller -0• d hoe 42 is rtgre than hoe 36 43 44 Subtract Imo 41 from has 38 Enter -0• d hoe 41 ra more than hna 38 41 Cautlon: 1/ tlrero rs an amount ar either line 43 a hoe 44 must BN Form 4710. 4 -Year Averaging Period Under Section 501(h) (Some organrtatrons that made a section 1 electnxt do riot Mw W compbb all of the fiw columns below See the instructions fa boss 46 through 50 ) Lobbying Expendkures During 4 -Year Awraging Mrltd Clalendar year (a) (b) (c) (e) 6:glnd~~~ ~ 1999 1998 1997 1996 Total 4S Lobbylrtp rgrdaxebla amaat . 46 dhnp trout 1 d Ilne / s 47 Total bbbytrq az rddures 48 GrassrooB non• taxalte tsmotnl 49 Gresuaots tat' amoud 150% d hoe e 50 Grassroots bbbYrrq ex ndrWas Lobbying Activity by Noneledln~Public Chalitles (For ropoArrq only by ttrganrrabortt Ntat rwl anrplsb Part VI•N (Bee rnstnx:ttonsJ Durnlg the year, did Nte apenaatron atlempt t0 mlluerlce rottortaf, sUte a lapl Iagrslabon, trteludtnp arty attempt to influence public oDrnron on a bgrslatrve molter a rsfererdun, Wouph the use of• Yss No Mwurrt ¦ VoWMeers X b Pad staff or merurgemenl pnCluda rnmpensatron m expenses reported on hoes c Nvough h.) X c Msdy sdvar6senNnb . X 0 . d Mailings to members, Ipislatas, a the Ptblrc X e Publrcabons, a published a broadcast statemerds X 1 Grants to other aparuratxtrss for lobbyirtp purposes X N Direct corrtecl rvrth legislators, then staffs, gowrmtxtt officals, a a Ispislatrw body . . X h Ralkas, dttmastrations, samtttars, rnrrverttats, speeches, lechaen;, a any other means X I Total lobbyrrip ezpsrdihres (add Imes c tf?oWh h) 0. If 'Yes' to cry of the alxsva, also attach a sbtameM omrq a dahiled daaiogon of Nie lobbfarq sctrvrttss BAA teer,orm ivmfs Schedule A (Form 99~ 1999 Seted~la A Orm 1999 at Island Ikdlatton Inc. (dW Mest aaratl IkWlatlon Services 99-0343488 P 6 Intormatlon Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organlzatlons (Sea utstrucbar) 51 Did the raportxq a bon dxaetly a irdeedy erpaps m arty of the folwMnrq Meth erry other apanizsbon described m section 501(c) of the Coda (othx than section 501(c)(~ orpanizstaru) a in ueUon 527, relabrq to poliUCSI apamzaGans? a Transfers hom the reporbnp apemzabon to a nortehenbbb exempt apemzatan of. Yes No (gCash 51 a X t1nOVisr aueh . a X b Other transactrons: Q)Salas a exchsnpes of assets Mnth a rancFrtnbde exempt orpenuabon b X ppPurchases of cruets from a rarahsnfads exenpt apamzatan b X Qignerdal of bcrhbas, egwpmrlt. a otltr aunts b I X Or)Fieimbwsanent arrargrnerds b X (hLoarcc a lore glmrardeas . . b X (vgPerbrtnann of serwtss a membership a hxdrnsirq sobabbons b X c Shenrq of faeddies, egwpmmt, madmp In1s, other nsab, a pad employees . c X d If the answer b anryry of the above n'Yes; ~omylab Cr tollowi acFpdWe Column (b);hould al m slaw tea fax rkat veluq of Hre goads other as!{ats, a services aM n .by vp n ~ ~ ~ f the a n¢atran regnwiG leas prn fair ttrraat velw m a ransseborr a(bs r err ms raw ( Cu Wher assets a aervaea (rtaQcwvad: Lrt e~ ra. Anaun) involved Name of ronehsribblaaxampl apanizstion DaalpElon of tnnaMs, trsrsd9als, nd sMnnp xrsnpsnenD 52a Is the orpanwtan dveclly a mdnecUy affibated wtb, a related to, ana a more tax exempt ayanwtrorx desuibed m sedan 5111(c) of the Coda (other Uren section 501(c)(~) a m section 5277 ~ Q Yes ® No b If 'Yes ' co lab the follows schedule: Name of aapamzabon Type of ap)an~abon Descrpbon oclnbbonsfap BM tra~aa tsrmvs ScMdJa A (Form 99th 1999 Bp Island Mediation, Inc (dba West Hawau Mediation Services) 99-0343488 1 Form 990, Pape 2, Part II, Lme 43 Other Expenses stmt (A) (8) (C) (D) Total Program Management Fundraismp Other expenses ptemize) services and eneral Bank Fees 187. 0. 187. 0. Education 103. 103. 0. 0. Total 290. 103. 187. 0. Form 990, Paps 3, Part IV, Lme 65 Other Llabilitles Statement Beginning End of Line 65.Other Llabllities: of Year Year Capitalized Lease Payable 1.302. Total 1, 302 . Forrn 990, Psge 4, Part V Llst of Officers, Etc. Statement (N (C) (D) Name and address Title and Compensation Contnbuhons Expense average hours per (H not psW, to employee account week devoted errtsr-0-) benefit plans and other to position and deferred alklwarxes compensation Dav1d Rodman 7r•{N! WlY1 bIlYK-KOM.NI ![7 D1 rector 1 0. 0. 0. Gae Milson POS36315lMefkoloe.XI9673a DifeCtOr 1 0. 0. 0. Total 0. ~ INTERNAL REVENUE SERVICE DEPARTMENT OF THE TREASURY P. 0. BOX 2508 CINCINNATI, OH 45201 Employer Identification Number: Date: ~ ~5 ~ 99-0343488 DLN: 17053307032009 8IG ISLAND MEDIATION INC Contact Person: C/0 WEST HAWAII MEDIATION SERVICES EDNA DIAZ ID# 95121 PO BOX 7020 Contact Telephone Number: KAMUELA, HI 96743 (877) 829-5500 Accounting Period Ending: June 30 Foundation Status Classification: 170(b)(1)(A)(vi) Advance Ruling Period Begins: June 17, 1999 Advance Ruling Period Ends: June 30, 2003 _ Addendum Applies: No Dear Applicant: Based on information you supplied, and assuming your operations will be as stated in your application for recognition of exemption, we have determined you are exempt from federal income tax under section 501(a) of the Internal Revenue ode as an organization described in section 501(c)(3). Accordingly, during an advance ruling period you will be treated as a publicly supported organization, and not as a private foundation. This advance ruling period begins and ends on the dates shown above. Within 90 days after the end of your advance ruling period, you must >end us the information needed to determine whether you have met the require- ments of the applicable support test during the advance ruling period. If you establish that you have been a publicly supported organization, we will classi- Fy you as a section 509(a)(1) or 508(a)(2) organization as long as you continue to meet the requirements of the applicable support test. If you do not meet :he public support requirements during the advance ruling period, we will ;lassify you as a private foundation for future periods. Also, if we classify iou as a private foundation, we wi71 treat you as a private foundation from your beginning date for purposes of section 507(d) and 4940. Grantors and contributors may rely on our determination that you are not a private foundation until 90 days after the end of your advance ruling period. [f you send us the required information within the 90 days, grantors and :ontributors may continue to rely on the advance determination until we make + final determination of your foundation status. If we publish a notice in the Internal Revenue Bulletin stating that we +i11 no longer treat you as a publicly supported organization, grantors and :ontributors may not rely on this determination after the date we publish the iotice. In addition, if you lose your status as a publicly supported organi- •ation, and a grantor or contributor was responsible for, or was aware of, the ict or failure to act, that resulted in your loss of such status, that person Letter 1045 (DO/CG) -2- BIG ISLAND MEDIATION INC nay not rely on this determination from the date of the act or failure to act. 41so, if a grantor or contributor learned that we had given notice that you Mould be removed from classification as a publicly supported organization, then that person may not rely on this determination as of the date he or she acquired such knowledge. If you change your sources of support, your purposes, character, or method ~f operation, please let us know so we can consider the effect of the change on dour exempt status and foundation status. If you amend your organizational document or bylaws, please send us a copy of the amended document or bylaws. 41so, let us know all changes in your name or address. As of January 1, 1984, you are liable for social security taxes under the Federal Insurance Contributions Act on amounts of S100 or more you pay to each of your employees during a calendar year. You are not liable for the tax imposed under the Federal Unemployment Tax Act (FUTA). Organizations that are not private foundations are not subject to the pri- ~ate foundation excise taxes under Chapter 42 of the Internal Revenue Code. however, you are not automatically exempt from other federal excise taxes. If iou have any questions about excise, employment, or other federal taxes, please let us know. Donors may deduct contributions to you as provided in section 170 of the Internal Revenue Code. Bequests, legacies, devises, transfers, or gifts to you ~r for your use are deductible for Federal estate and gift tax purposes if they neet the applicable provisions of sections 2055, 2106, and 2522 of the Code. Donors may deduct contributions to you only to the extent that their :ontributions are gifts, with no consideration received. Ticket purchases and similar payments in conjunction with fundraising events may not necessarily qualify as deductible contributions, depending on the circumstances. Revenue 2uling 87-246, published in Cumulative Bulletin 1887-2, on page 104, gives guidelines regarding when taxpayers may deduct payments for admission to, or ether participation in, fundraising activities for charity. You are not required to file Form 990, Return of Organization Exempt From Income Tax, if your gross receipts each year are normally $25,000 or less. If iou receive a Form 980 package in the mail, simply attach the label provided, :heck the box in the heading to indicate that your annual gross receipts are formally 525,000 or less, and sign the return. Because you will be treated as s public charity for return filing purposes during your entire advance ruling period, you should file Form 990 for each year in your advance ruling period :hat you exceed the 525,000 filing threshold even if your sources of support io not satisfy the public support test specified in the heading of this letter. If a return is required, it must be filed by the 15th day of the fifth nonth after the end of your annual accounting period. A penalty of 520 a day is charged when a return is filed late, unless there is reasonable cause for :he delay. However, the maximum penalty cfiarged cannot exceed 510,000 or Letter 1045 (DO/CG) -3- BIG ISLAND MEDIATION INC 5 percent of your gross receipts for the year, whichever is less. For organizations with gross receipts exceeding $1,000,000 in any year, the penalty is $100 per day per return, unless there is reasonable cause for the delay. The maximum penalty for an organization with gross receipts exceeding $1,000,000 shalt not exceed 550,000. This penalty may also be charged if a return is not complete. So, please be sure your return is complete before you file it. You are not required to file federal income tax returns unless you are subject to the tax on unrelated business income under section 511 of the Code. If you are subject to this tax, you must file an income tax return on Form 990-T, Exempt Organization Business Income Tax Return. In this letter we are not determining whether any of your present or proposed activities are unre- lated trade or business as defined in section 513 of the Code. The law requires you to make your annual return available for public inspection without charge for three years after the due date of the return. You are also required to make available for public inspection a copy of your exemption application, any supporting documents and this exemption letter to any individual who requests such documents in person or in writing. You can charge only a reasonable fee for reproduction and actual postage costs for the copied materials. The law does not require you to provide copies of public inspection documents that are made widely available, such as by posting them ~n the Internet (World Wide Web). You may be liable for a penalty of $20 a day for each day you do not make these documents available for public inspection (up to a maximum of $10,000 in the case of an annual return). You need an employer identification number even if you have no employees. [f an employer identification number was not entered on your application, we Nell assign a number to you and advise you of it. Please use that number on X11 returns you file and in all correspondence with the Internal Revenue iervice. If we said in the heading of this letter that an addendum applies, the addendum enclosed is an integral part of this letter. Because this letter could help us resolve any questions about your exempt status and foundation status, you should keep it in your permanent records. If you have any questions, please contact the person whose name and elephone number are shown in the heading of this letter. Sincerely yours, Steven T. Miller Director, Exempt Organizations Letter 1045 (DO/CG) ...,,...n.+ Otltl Os Yb Y6O P. O2 Etu 99.0343488 rem 872-~i Consent t~ixtng Period of Umltation Upon O1e /tl , Assessment of Tax Undo Staation 4540 of the Internal Revenue Cade re tre tA.a t~ Fenn tOtls. lub,~e .°r~r~iiw ::~rw~ (Sr Irotrudbru on nws? ~id.~ ~ fir' Under sarroan 86O11eM4) of the Intrrul Revenw Cod., rid u pert a e request rued wRh Form 7023 that the trgenltetlon r,rrtsd below be treated M a ptblkJy wpported a9anu!etlon under seCUOn 17OQ~)I~rNlvp a seetla, StA(a)(~ durtrp en advance Mng period, 13 t 4 Z~I p~,p~McDi~ p~ T Frrr ~ a . ~eiw a m~tl.e Intrrnl Revrtus or o:..$.47t..~o,~G2.+..KA~r?wx.~.a... F.~1.......9.1e7.4.~......... end n,e ~.artn rywr swt ob s ewe Il~a w)reesd Exert~l OrpatMtasG0~n3) oomem end egne that tttc period b essessirg tax pmpoeed undr section ,t)+o a the code) ror any a C,e 5 taz years In the advenee ruNng perbd rdl extend B yeah, a months, and 16 days beyond the end a er Rret tax yar. However. If a r,otlee a aetldency In tax la sny a these years is sent to the aryanlntton before ttw period exptes, dto nme for making sn asaessmant wls be firthor c.tended by the number a days the asrssn,r,t is proMblted, pue 80 deye. Endk,g date a tYSt taz yer ..~N,W 9 9......... NrM b oryeniradon lee shover M orgentdng dee,rrws) Date 1316 ~tt,lAUp /~Jea~ryo~, T,uc. °a~oP~oooo Oilier a buetr having euaradty b egn r rr~~m• ene tltle RCl It. CAIn,A~ neon ? r etc artterree Fa IRS use only /~~^~'~°1'°° DYepar~~' ~Canrn~.`+?/(_ Plum and Exempt OrgWretlatsl Diw a ~t~t~t~ ~ ~ ~ S ftttlY w ..r w....,,.. per rr.rr.. r.e. 7 r w er +..rc, ACORN CERTIFICATE OF LIABILITY INSURANC~9rH 1 °'06, ' ~w.xN:ea THIS CERTIFIGTE IS ISSUED AS A MATTER OF INFO YATION ONLY AND CONFERS NO RHiHTS UPON THE CERTIFIGTE tatanabe Insurance Services HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR L00 Pauahl Street, Suite 202 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. silo HI 96720-30G6 INSURERS AFFORDING COVERAGE Phone:80B-935-8116 Fax:808-935-8816 IMWRERA First Fire i Gaual Ins. INwnex s West Hawaii Mediation Services Hiq Ialand anon, dba NwReaa P. O. Hox 7 INwIULO, Kamuela HI 96763 ~ Iwunex e :OVERAGES rNe rouau av Iwuuwcc wno YtLOW NAVI arax osuED t01XE Iwwao NAYao AWVI ?an rxe roLILV vEluoo INauna YorvarNfraYOOw AMY aeouwrrurt. 7EIIY o! DONa710N 0/ AY1' eDNYMCT ON or1Ya oocuYaNr YfRN AEwucr 1b MnaeN tw L,famlun wr fe eaum OR YAY ?a1RA1N, Tw pUMIMl Alro110m tM 711! IDUClf pfCIMlL waw M 1YalaCr YD Au ne 7GY; eaeLUapa AMD COMa110re a alal roLMIEL AOGIIEDAYE LYYrf OIOWN YAY IIAV! bM IRDIIrJO fR vAe CI.AYIa TY?! W INa11MNCa roLICY NDYaG DA Y W YYIDDIYY LYYrt Dd1l11AL lYRRT GCN OCCU1wNee al 000 000 A X' corYENGALO[xwlLLUrurr CPX,7027166 07/01/00 07/01/01 n11EOAr?aElMwft,.l f 50 000 ewYa YAOe ?X omlx Yu Ear IA•r ar YwArol f 5 000 iEIta01ML a ADV INJURY f D ' ceNwuAaDRwAn f 2 000 000 aaxL AoaRE^wre uert Avruu vaw. vROOUCrs • wYVAx Aao t 0 ,OlJL1, I I •Iq LOG AIRDYOfai LIAfn17Y I coYweD aMOI[ LIY1T f ANY Auro 1!• K~JeYYI ALL OYYMED AVIOf i fwoar auuRr f fC11FWLFD AYYOf o~rq NIRED AVTOa ~ lODRr INJURY NOM.OYRND AY70a i I rRO ~I10AYAa[ i OARAG[ LYWUiY ~ I 1 ADTO ONLY • G ACGDINf i ANY ADiO i I ~ orNG nux G ACC f AUiO OMLY A00 f EIC!laLWalrY ~ GGI CCCDMaNC! f occuR ~ cwra rAOa AooReoAre f f DenuctlaLE ~ f ~ RETEIrilal f I s YARI{W COYIaNGl10Y AMD I I I I RY Y I R EJIVLOYW LWILRY I EL GGI ACCIDelr f lL DgEAlE•G [YR f !L aaGa! • roucr UYR f only DfaCRI?nOM OF OVEIIAYNN1aM1OCA710NW ~~urCLYaIOYf ADDfD l7lNDORalYENnlvEGAL ?ROVIaOw The certificate holder named below i• an additional Insured rmdar the policy to the extant sat forth is the policy provisions. Location: 65-1279 Kawaihae Rosd, Hamuela, HI (250 Sq Ft) CERTIFICATE HOLDER N Aoa+lowLUauRSO.INwReaLemR: CANCELLATION PARlQiCH mN)I1LD ANY Or TN! AWYE DE>ICmatD rouau K CAMCaLLaD a00R! TII! e?wA wne YNUeor, rN[ ewmo IwURall f1mL uwAwx r0 YAIL 30 an YIIIYrIetl Nonce m rNC curvN:Are NoLOU NAren ro rNe LlR. our rAaua TO 00 f0 mYUi Parker Ranch IYroaE MO OtLNYT10N OII LY1mL17Y OF ANY NY1D UvOM YN! mmmmL m AaaNT{ OR Attn: Property Manager REVRUeNUmru. P O Bo: 909 Kamnela HI 96753-0909 Ann A. Kikuta N~ ACORD 259 (7117) an sU aBAlmlIIORATION 1903 1NaLSaEs IoaLYalca . Ise,I NarrruW Wr IY~q Fr - i06.0 SPATE OF HAMfN DEPARTMENT OF OaBENCE AID COlltlBlEJt AFFNR6 6ohnM OdBYW ~ BmNwa BaaMaNt OMrist Qs Tnr Copy 1010 RIdISW 81s.t LYBnp AddiMP P.O Bn. ~0, FIOr10kk Iraal BEE10 APPLJCATION FOR REGISTRATION OF TRADE NA ~ 0 (sEE REVERSE SIDE wR c+ENERAL INFORl11AT10N AID WSTRUCIIONS) J~ 3 01999 PLEASE TYPE OR PRIME LEGIBLY W BLACK INf ZU APPLICMRS HALE Bi Island Medution, Inc Il HIUMAII MNttt Aeee.s: P.O. Box 6751 cq, Kamuela se.r HI 2p Cads %743 z Clsdc one Raprhalo^ r IX) Nar OR ( ] Rrrrr 3. SrWS d appbsd: (CISGr on) J Sar PripNlorfK) CaPa~ I ) ~~P I ) ~ /r.oalMlon ? r apptiord r a oorporabon or pstrsrdtlp, W aWe or oanlry d InmryontYoMumsYU~ -~-lo~••~~ i I s Trad. rrn r WEST HAWAII MEDUTION SERVICES (TAr loan r not b M uud b taprrr rr rrrn d. naw mryoi.Eon a parYrntYp.) & APpfaid r (deck my~ IX I OdP~ d ~ OR I 1 AriQra pna b aAOm nrna aw ata~ud by anorta~ 7. Ur.rs d ralnrs for atid~ rs bad. ns~r Y MFq uad COD1mUnll?' mCd1at10R tiMV ICYB I oertry, older its psndtls .al farts r Sadlon rB2~S, Maaa1 Rs~AaW 80WAU, rrQ CHECK ONE I . ] 1 an tls eppN~l OR ~I am M Preclderlt (dliot held) d M aPPford ronr0 h rie kseOoMp appNalbr6 sM M rs errrw.e rtsds h rr applutlan rs true and mnr! b yr 6eM d ny rwardpe and 6e1ef. Thb aooluYm mist be cadlled by tlr appfoem N an IndlAtliW, a W an dLoer r • oorporatbn, a M • General wm. t • o..rMiY+. SlVSkn meat a h tldc ink. ~P~wne+?w. uBE aLq '130 i $ C.ftlirsr d R.pYatlv~ Na CERTIFlCATE OF REGISTRATION OF TRADE NAME In aooadarw wllh tlr provrlorr d Cheplar X82 d the Haasil Rwred SOetWe, thr CartllYeale d RaprtrMbn r Wued b CND ('1~ .ppllarK tha u.a d Br wid TRI1D^ tlrotDllgttt jlr tar IM trm d YwKa>~n ~~a997--~ Ju` l g DEPARTMENT OF COMMERCE AHD CONSUMER AFFAIRS STATE OF HAWAII JUL 019 9 REOISIRATION OF A TRADE NAME YVITII DYacbr d CIKmMIa snd AdGIYs THE DEPIJiiMiNT DOit NDT GRANT M OYYNERBFip OF TFf TRADE NAME Iw ~1 FORM X-1 8JO8 STATE OF HAWAII DEPARTMENT OF COMMERCE AND CONSUMER AFFAIR8 BuWnNS Rpfstntbn Dfvlsfon 7070 Richards Street Malllnp Address: P.O. Box 10, Honolulu, Howell 98870 o~~~o~~~ APPLICATION FOR RESERVATION OF NAME I..~,.,~.,.,...~.,...~.,~..~.,~..x"~.w..M..en...., MI~1 2 0 IA68 0;1 .m . PLEASE TYPE OR PR/NrLEIiIBLYIN BLACK/NK ~ ~ Pore ciwk anwd a prapa~d bwlrrr rdy lyp (drdc arty ar). ®CpPam, ? PWwYip (nrr.utrnll.d) ? LLC ? LLP w+aab, waon n+wua warn FM1xwL7u, uw» IrA+mu~, nub 1 NnmedApplbnt Wm Curtis Kicker 1 AddiwdAppllarrt P.O Box 6751, Kamuela, HI 96743-6471 a srb.dkgnnll~a+r~r Penan bbndrp b o~pritre ~ rrw donr~tle buYr~ anny ? b Foralyn brwbar wbV bbndlrp b any an ny brYrr b tlr SV1~ d HaMal ? c P«son b arpnnbs • }oralpn brMr ~^RY and 4indrN b M n~rY doaimnb b barnW Gukr~ b tlY~ SYI~ ? d FonNp~ bWnr nnYN autliortred b tanarl bu~krr b tli Slab end bWdbp b drops IY mb ? a Ed~Wq domrlk buWrr arrMy bbrdYy b drrp~ w am e w~ b b. n..~Y.a Big Island Mediafan, Inc. 5 Fa Carpontlarr, nrr ~ rar~ad br (drdi orr} ? ProM © Norpidll 8 Fa Pu6rrWp~, nbna `rrrvW for (drdt orrY ? Clbrr~ ? Lln~ 4 Wm Curtis Kicker /J lr~.n.,al ey Wwt(,~(.41J 14r.. (SEE INSTRUCTIONS ON REVERSE 81DE) (D~pnbwd Ur Only) Har 2 01999 ~.l Rarrvatlan d baYrr my nrrr, r raQrrYd, hr~by appard br • prlod d 710 dna b ~a al 72nD rridnlyt SEP 171999 DIRECTOR OF COMME~R~C~E )AND CONSUMER AFFNRB By L ~ _ STATE OF HAWAII Department of Commerce and Consumer Affairs Business Registration Division Post Office Box 40 Honolulu, Hawaii 96810 Telephone (808) 586-2727 MEMORANDUM tune 24, 1999 File No. D2/TN• 5/20/99 CURTIS KIItKER P O BOX 6751 KAMLIELA HI 96743 RE BIG ISLAND MEDIATION, INC -Articles of Incorporation BIG ISLAND MEDIATION -Trade Name Application Enclosed please find your two file-stamped copies of the Articles of Incorporation for BIG ISLAND MEDIATION,INC I am also returning the Trade Name Application and S50 00 check submitted for BIG ISLAND MEDIATION, which did not have to be filed. The S50 00 check you submitted with the initial Articles of Incorporation filing, has been applied to the dowment The two additional SS0.00 checks you submitted were not necxssary and are returned to you Beyst Wishes,A- Karen Azuma V Business Registration Assistant As of October 1, 1984, the law provides that your initial registration is valid for otily one year. It will be yow responsibility to re-register your name at the end of that period m any time during the i the expiration date. If you renew yow registration in a timely manner, yow renewed registration will be valid for ten yeah. Please cote that the Deparirttent doa not send out notices to remind you of the expiration date. Therefore, it is vour rappnsibility to remember to ro-register. If you forget when the expiation date is, you tray call (808) 586-2727 or come to the Business Registration Division (1010 Richards St Honohilu) to inquire. If you do forgo to re-register the name, be aware fiat anyone may now apply for a rume that hu expued. So. to avoid future problems. please remember to re-reeistcr vour trade name. trademark or service mark. Note• Blank forms are enclosed for renewal. NonralundabM Flllnp Fee -150.00 DOMESTIC NONPROFIT SuWnB Orlplnd and One Trw Copy State d Hawall DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS D ~ ~ ~ ~ M R O Buslnaaa Raplatratlon gNabn U l5 1010 RlchaNs 9tnat Mallln0 Address P.O Box 40, Hondulu, HI 88810 .~'1 ~ 719A9 ARTICLES OF INCORPORATION 9 : o I Atrvt, (Saglon 4158.34, Hewal RavlsW Sblutas) ~ d ~5~ H~W~ AIn~ ~ PLEASE TYPE OR PRINT LEGIBLY IN BLACK INK TM utwarel0tre, aaskxp to loan a nonprofit corpontbn utWar ttr hwa d tlta Stw d 4iawaN, wrmy as baorts: 1 Tha rots d the corparatbn shNl W BiR Island Mediation, Inc. II The address d the oorpnratton'a olfira 4 (proWds street sddreaap 65-1229A Opeb Road, Suite #13 [Camuela, HI %743 m Tha parlod d ks dura0on Ia parpstwl Iv Sectbn 7 The purpaae(e) far whkh tlts wrpontlon b or0an~sd. To organize, secure funding for, train staff and volunteers for ,and to provide conflict•'dispute resolution services, on a non-profit basis, on the Island of Hawaii. and the tnnsactlon d any or all lawful actlvltMs for whkh nonprdk corptrcatlons tn.y ba Incotporalad under Chapter 4158, Hawall RavWd Statues. Sectbn 2. And M lurthenrtce d ssW purpose. the torpotatbn sMN have ell pttwsn, rl0hta, prH8e0ea and IttamtMtles. and shall be subJed to all d the IyblOtlea coniartsd ar knpoeed by law upon carporatlana d thk name. and etrll be subJad and hsva all the benellts d ell 0srrersl laws wtlh respect to wporatbne. D3•t a6r lrrl te.v ras as (c.rlacrienl Bland Medlatlon - iroc4s d Intpporatlon tune 1 s. 199a ~ 1 of F Section 3. The corporation shall be organized and operated exclusively for charitable or educational purposes within the meaning of the U.S. Internal Revenue Code of 1954, as the same now is or may from time to time be amended, and the objects and purposes of the corporation, and its powers in connection therewith, are as follows: (a) To engage in charitable and educational activities of any and all kinds; and to accept and receive property of any and all kinds by, devise, trust agreement, bequest or otherwise; and in particular to promote the civil goal of peaceful resolution of community disputes through the orderly mediation of such disputes by trained mediators; to mediate and resolve disputes between persons that might otherwise be resolved only through resort to the judicial system: to advance the civic cause of justice by voluntary mediation of neighborhood disputes; and to do any act or thing incidental to or connected with the foregoing purposes or in advancement thereof, but not for the pecuniary profit or financial gain of its members, directors or officers, except as permitted under Section 415-8, Hawaii Revised Statutes. (b) To engage in fund-raising activities of all kinds where the purpose and use of the funds so obtained are to further the purposes of the corporation; (c) To receive and administer funds in furtherance of the charitable and educational objectives and purposes and works mentioned above, as dictated by the general powers conferred by the laws of the State of Hawaii but only such laws as will implement the above stated purposes; and in addition, but limited to the furtherance of the above stated purposes, to take, receive and hold by bequest, devise, gift, grant, purchase, lease, or otherwise, either absolutely or jointly with any other person, persons, or corporation, any property, real, personal, tangible, or intangible, or any undivided interest therein, without limitation as to amount or value, to alter, improve, sell, convey, or otherwise dispose of any such property and to invest, relnvest, or deal with the principal or the income therefrom; (d) To enter into, make, perform and carry out contracts of every kind for charitable or educational purposes, without limit as to amount, with any person, firm, association, or corporation or other group or organization, including particularly contracts for the borrowing of money and for the employment of administrators and investment or other counsel as the Board of Directors may deem necessary; to draw, make, accept, endorse, discount, execute, and issue bonds, debentures, or other obligations for any of the objects or purposes of the corporation; and to secure the same by mortgages, pledges, deeds of trust or otherwise; (e) From time to time, if in the furtherance of charitable or educational purposes, to apply foz, purchase, acquire, transfer, or otherwise exercise, carry out and enjoy any benefit, right privilege, prerogative. or power conferred by acquired under, or granted by any state, ordinance, order, license, power, authority, or franchise, commission, right or privilege, which any government or authority or governmental agency or corporation or other public body may be empowered to enact, make or grant; Big Island Mediation - Articles of Incorporation June 15, 1999 Page 2 of 6 (f) In accordance with the laws of the State of Hawaii, made and applicable to corporations formed thereunder, the corporation shall be entitled to and shall have power: (I) to have succession by its corporate name in perpetuity; (ii) to sue and be used in any court; (iii) to make and use a common seal; (iv) to hold, purchase, and convey such property as the aforementioned purposes of the corporation shall allow, without limit as to amount, and to mortgage, pledge, and hypothecate the same to secure any debt of the corporation; (v) to appoint such subordinate officers and agents ae the business of the corporation shall require; and (vi) to make by-laws not in conflict with law or these articles of incorporation; (g) To exercise and possess any and all rights, privileges, powers and immunities which now or hereafter may be secured by law to charitable corporations and which are reasonably incidental to the furtherance of the objects and purposes above set forth. Section 4. in all events and under all circumstances, including but not limited to reorganization, dissolution, or amendment of the Articles of Incorporation of the corporation: (a) No substantial part of the activities of the corporation shall consist of carrying on political propaganda, or otherwise attempting to influence legislation; nor shall it participate in, or intervene in (including the publishing or distribution of statements), any political campaign; nor shall it engage in any transactions defined at the time as "prohibited" under the Internal Revenue Laws of the United States; nor shall amounts be accumulated out of income of the corporation in amount or duration, or be used or invested in such manner or for purposes or functions, such that the same would constitute grounds for denial of income tax exemption under the Internal Revenue Laws of the United States; (b) The corporation shall never be operated for the primary purpose of carrying on any trade or business for profit; and neither the whole nor any part or portion of the assets, income or earnings of the corporation shall be used, nor shall the corporation ever be organized or operated, for objects or purposes which are not permitted to be carried on (i) by a corporation exempt from federal income tax under Section 501 (C)(3) of the U.S. Internal Revenue Code of 1954, as amended, or (ii) by a corporation, contributions to which are deductible under Section 170(c) (2) of the U.S. Internal Revenue Code of 1954, as amended; and no compensation or payment shall ever be paid or made to any member, officer or director of, or donor to, the corporation except as a reasonable allowance for actual expenditure or for services actually rendered in the furtherance of the purposes set forth in Section 3; and big Island Mediation - Articles of Incorporation June 15, 1999 Pege 3 of 6 (c) Neither the whole nor any part or portion of the assets, income or earnings, current or accumulated, of the corporation shall ever be used for dividends or be otherwise withdrawn or distributed to or divided among any member, director or officer of the corporation or any donor, whether upon liquidation or dissolution of the corporation or otherwise, provided further, that neither the whole nor any part of portion of such assets, income or earnings shall ever be used for, accrue to, or inure to the benefit of any private individual within the meaning of the tax exemption requirements of the laws both of the United States and the State of Hawaii, except as provided in Section 4 (b) hereof. Section 5. The corporation shall be a membership corporation. The corporation is not organized for profit and will not issue any stock, and no part of its income or assets or earnings shall be used for dividends, or otherwise withdrawn or distributed to any of its members, directors, or officers except as expressly permitted in Section 4 paragraphs (b) and (c) hereof. The corporation is organized and shall be conducted exclusively for charitable and educational purposes. Section 6. There shall be a Board of Directors of the corporation of not less than three nor more than fifteen persons, each of whom shall be a member of the corporation and a majority of whom shall be a member of corporation and majority of whom shall be residents of the State of Hawaii. The Board of Directors shall be constituted and its members elected and appointed as the by-laws shall prescribe. The direction and management of the affairs of the corporation and a majority of whom shall be vested in the Board of Directors; SUBJECT, ALWAYS, HOWEVER, to the provisions of applicable law, the articles of incorporation and the by-laws. There may be an executive committee and such other committees of the Hoard of Directors as the by-laws may provide. Section 7. (a) The board of Directors annually shall appoint from among the members of the corporation a President, one or more Vice Presidents, a Secretary and a treasurer, and from time to time, such other officers as the conduct of the affairs of the corporation may require. One person may hold more than one office. (b) The officers and subordinate officers shall have such powers and duties and will be elected or appointed and removed as provided by the by-laws. (c) The names of the initial officers of the corporation shall hold office until their successors shall be duly elected or appointed. Big Island Medletion - Articles of Incorporation June 15, 1999 Page ~ of 6 Section 8. The membership of the corporation shall consist of the officers and directors named herein, together with such other members, whether as successors to the original members or as additional members, as shall be admitted to membership in the manner prescribed in the by-laws or otherwise, rules and regulations creating, governing, or terminating memberships or classifications of memberships and relating to qualifications, duties, obligations and privileges; and the action or decisions of the Board of Directors with respect thereto shall be final. No membership shall be assignable nor pass to any personal representative, heir or devisee of any member. Associate or other non-voting memberships may be provided for by the bylaws. Section 9. The by-laws of the corporation may be adopted by the directors within thirty (30) days after the effective date of this incorporation, and thereafter may be adopted, amended or repealed by the vote of a majority of the voting members of the corporation present, or represented by proxy and constituting a quorum at any meeting of the voting membership duly called and held, the notice of which shall have stated that a purpose of the meeting was to consider the adoption, amendment, or repeal of the by-laws. Section 10. The property of the corporation shall alone be liable for the payment of its debts and liabilities and the private property of the members, directors, and officers shall not be subject to the payment of the corporate debts to any extent whatever. Section 11. In the event of liquidation or dissolution of the corporation, whether voluntarily or involuntarily or by operation of law, the remaining assets of the corporation shall be distributed in such manner as the Board of Directors or a majority of them deem best suited to further the objects and purposes for which the corporation was established, but in any event such distribution shall only be to such organization or organization as may then by exempt from income tax under Section 501 (c) (3) of the U.S. Internal Revenue Code of 1954, as amended. Section 12. These articles shall be subject to amendments from time to time as provided by law, except that no such amendment shall be made which would change the corporation's name or the objects and purposes of this corporation to include objects and purposes which would not be exclusively charitable and educational, or which would permit the net earnings of the corporation to inure to the benefit of any member, donor or private individual, or which would permit any substantial part of the activities of the corporation to be the carrying on of political propaganda, or otherwise attempting to influence legislation, or which would permit the corporation to participate in, or intervene in (including the publishing and distributing of statements) any political campaign on behalf of any candidate for public office. Sig island Mediation - Articles of Incorporation June 15, 1999 Page 5 of 6 V 3 The numbw d dkecbrs ahaq rax IM Iai than three (3) and Ma number d dkactars constRUtlna tM InWI Bond o1 D1auaK Is _ TM faliowlrtq an dra tames end rasldettcw street WNeaaa d dta mNW diteotan pl[Cf~ (must bs /ndMatialsJ Rea!-nee Street ~'re=~- ( •.nh.r. dtv afe~. n a~del 1 Wm Curtis Kirker P.O. Box 6751, Kamuela, HI 96743-6471 p ,Marcia Carmen 75-655 Hua'ai Street, Kailw~-Kons, HI 96740 3 Judith Kautz P.O. Box 6853, Kamuela, HI 96743-6853 w TM officers d the oorporatlon shall corakt d a Jxasldent, vlca precklent, serfstery and treasurer TM idbwtrp an the Hama end nsldena street addresses of the Intrkl ofiltxrs. QQI~p (mwf G MtlMaUak) Resldenee Street Addna fnumDer. street dN. erase. zlo a~dal Rs.aent ~Nm Curtis Kirker P.O. Box 6751, Kamuela, HI 96743-6741 vico-Prosklent Marcia Carmen 75-655 Hua'ai Street, Kailua-Kona, HI 96740 ~~a,y Judith Kautz P.O. Box 6853. Kamuela, HI 96'43-6853 Treasurer Ba?bara Hodgson 68-111 West Pulwua, Kamuela, HI 96743 vn (X J Tha axporatbn ha membsn. ( J The corpondon ha rq members VIII Tlr eorporaeon k nonprotlt In nature, and shall not authoriza or taus shares d stock. No dlvgends shall W J>•tl end m part d dN intxrrre or Prdfi d tM COrporatkM slWl tN dlatrlbuW b b memwrs. dYeebn, ar oAkers, appt far tervlces acbrfiy rantlend a tla carporatkxr, Ws ceNfy undo fha perafilee d Sectlon s15B•158. HawaN Revised Stsbrta, that we hsve red the stave statemerw end that the ame an true end eorreti Wrtrtaa our hands this /~'t/n day d ~.Lr~ , 1BQQ Wm Curtis Kirker Judith Kautz (TypelAint Nama d Inco+ponfi>~ (TypdPrint Nsma d Incorporabr) u~~ Q..~ ~ (s+anatu~ ollnaarporaror) (clan. Inaarcartor) (Starr h tYSCk Nk) (Stan h Oradr Inland Medraoorr ?rtlckr d Irroorporatlon June 15. 1999 Pale 6 d 6 •r-- BIG ISLANDS MEDIATION, INC BY- LAWS APPROVED BY THE BOARD OF DIRECTORS AUGUST 18, 1999 AMENDED JUNE 2, 2000 ARTICLE 1: NAME AND PURPOSE Section 1. Name and Purpose. The name of the corporation shall be Big Island Mediation, Inc. dba West Hawaii Mediation Services; hereinafter referred to as the Corporation. The Corporation is a voluntary agency dedicated to promoting the use of alternative dispute resolution through mediation; to assisting groups in consensus decision-making through meeting facilitation; to educating the public on the benefits of alternative dispute resolution, thereby relieving the burden on the court system; and to providing training in mediation and meeting facilitation skills. Section 2. Additional Purposes To do any act or thing incidental to or connected with the foregoing purposes or in advancement thereof, but not for pecuniary profit or financial gain of its members, Directors, officers, staff or volunteers, except es permitted under SS 416-21, Hawaii Revised Statutes. ARTICLE II: MEMBERS Section 1 Members. Members of this Corporation ere the active mediators and volunteers. Member of the Corporation elect the Board of Directors." Section 2. Directors. The voting members of the Corporation shall be those presently serving on the Soard of Directors. Each Director shall be entitled to one vote for each matter submitted to a vote. ARTICLE III: BOARD OF DIRECTORS Section 1 Number There shall be a Board of Directors of the Corporation to consist of not less than three (3) persons. The number of Directors greater than three (3) shall be fixed as is from time to time determined by the Board of Directots and governed by the Articles of Incorporation and any amendments thereof. The Board of Director fixes the maximum number of Directors at 15 (fifteen). fiction 2. Term, The term of office for a Director shall be three years. Approximately one third of the board will be up for election each year. Any individual may serve two consecutive terms, a total of six years; after two consecutive terms, an individual must retire from the $oard for at least one year before being eligible to serve again Section 3 Selection and Qualifications of Directors. Once each fiscal year the Board of Directors will solicit names of interested, qualified individuals to serve on the Board of 1 Directors from the membership. The names of the nominees will be placed before the members of the Corporation at the next Annual Meeting. Additional nominees may be submitted by the members at that time. The membership will vote for new members to the board at the annual meeting. Nominees receiving the highest number of votes will be deemed elected. Section 4. Resi¢nation. Any Director may resign at any time by giving wntten notice of such resignation to the Board of Directors. Section 5. Vacancy. Any vacancy on the Board of Directors may be filled by an affirmative vote of a majority of the remaining Board of Directors then serving. Section 6. Compensation. Directors shall not receive any stated salary for their services as a Director, but by resolution of the Board may be reimbursed for expenses incurred in attending meetings of the Boazd or in performing official functions of the Corporation. The Board of Directors shall have power in its discretion to contract for and pay to Directors rendering unusual or exceptional services to the corporation special compensation appropriate to the value of such services, to the extent that such compensation is not restricted or prohibited by the Section 4941(d) of the Internal Revenue Code and its Regulations as they now exist or as they may hereafter be amended. Section 7. Powers. All of the corporate powers of the Corporation whether set forth generally, specifically, or by implication in its Articles of Incorporation or in these By- laws, shall be vested in and exercised by the Board of Directors. In addition to powers specified elsewhere in these By-laws and without limiting the generality of any powers of the Board granted by law, the Board of Directors shall also possess the power: a. To adopt policies governing the general organization, program, and conduct of the CorporaUOn. b To elect the President of the Corporation and any additional officers provided in these By-laws or authorized by the Board of Directors. c. To appoint and remove an Executive Director, who may approve and remove alt employees and shall be responsible for general supervision over the business affairs and activities of the Corporation and see to the proper observance of all By-laws and any action or orders of the Board of Directors. d. To prescribe personnel standards and practices and establish compensation of all positions. e To appoint standing and special committees and chairpersons thereof and to establish or authorize the establishment of other committees. 2 f To appoint an Advisory Board. This Board is chaired by the President of the Board of Directors of the Corporation. g To define the jurisdictton, duties and powers of all committees except as otherwise providcd in the By-laws. h To approve the Corporations budget and make and authorize expenditures necessary for the conduct of the affairs of the Corporation. i. To have an annual review or audit as required by law, grant, or contracts conducted by an independent auditing firm. j. To perform such other duties as may be necessary for the conduct of business of the Corporation. ARTICLE IV: PRINCIPAL OFFICE. MEETING OF DIRECTORS Section 1 Principle Office. The principle office of the Corporation shall be maintained at such place in the State of Hawaii as the Board of Directors from time to time shall determine. Such offices to be in the charge of an Executive Director as mey be appointed by the Board of Directors. Section 2. Placc of meeting. The place of meeting shall be stated in the call for the meeting. Section 3. Reg~ar Meetings. The Board of Directors may establish regular meetings to be held in such places and at such times es it, from time to time by vote determine, and when any such meeting or further notice thereof shall be so determined no further notice thereof shall be required. SecUOn 4. Annual Meeting. The fast meeting following the beginning of the fiscal year shall be designated the annual meeting of the corporation. The annual meeting of the corporation shall be set by the Board of Directors. An annual meeting shall be held in each fiscal year. At such meeting, the Board of Directors shall elect the officers of the Corporation fdr the ensuing year. Section S. Special Meetingg. Special meetings of the Board of Directors may be called at any time by the President or by any two Directors. ,section 6. Notice. Except as provided in Section 3 of this Article IV, notice of each meeting of Directors of Corporation, stating the authority for the call of the meeting and the place, day and hour thereof shall be given to each Director by the Secretary or by the person or persons calling the mceting at least one (1) day before the date set for such meeting. Such notice may be given in person, by phone, fax, a-mail, or phone message. 3 Sectton 7 Ouorum. At all meetings of the Board of Directors a majority of the Directors shall be necessary and sufficient to constitute a quorum for the transaction of business and the act of a majority of the Directors present at any meeting at which there is a quonun shall be the act of the Board of Directors, except as may be otherwise specifically provided by statute or by these By-laws. If at any meeting there is less than a quorum present, a majority of those present may adjourn the meeting without further notice to any absent Director and may convene or reconvene the meeting when a quorum shall be present. Section 8. Adioumment. In the absence of quorum at the date, time and place of a meeting duly called and held, the presiding officer or a majority of the Directors present may adjourn the meeting from time to time without further notice and may convene or reconvene the meeting when a quorum shall be present. Section 9. Rules of Order. In any meetings under these Bylaws, Roberts Rules of Order, latest edition, shall be used as a guide to govern procedure, at the discretion of the chairperson of the meeting Section ]0. Action by Directors. Without a Meetin¢. Any action required or permitted under Section 415B-16, Hawaii Revised statutes, as amended, to be taken at a meeting of the Board of Directors, may be taken without a meeting if a consent in writing, setting forth the action so taken, is signed by a majority of the Directors then serving. ARTICLE V: OFFICERS Section 1.Officers. The officers of the Corporation shall be a President, a Vice- President, aSecretary, and a Treasurer, and any other officers determined and appointed by the Board of Directors from time to time. The officer must be a Director of the Corporation Two offices may be held by the same individual; however, not less than three different individuals must hold positions as officers. Section 2. Election and Term of Officers. The officers of the Corporation shall be elected at the annual meeting of the Board of Directors by majority vote of the Directors present. Each officer shall hold office until his or her successor shall have been duly elected and qualified. Section 3. Subordinate Officers 8c A¢ents. The Board of Directors may appoint or employ such subordinate officers, including Assistant Treasurers and Assistant Secretaries, agents and employees es may be deemed proper, who shall hold their positions at the pleasure of the Board of Directors and who shall have such powers and duties as may be assigned to them by the Board of Directors. The authority to employ agents and employees and fix their powers and duties may be delegated by the Board of Directors. Any officer of the Corporation may also be a subordinate officer, agent, or employee. 4 Section 4. Bonds. Any officer may be required by the Board of Directors to give a swety company bond for the faithful discharge of his or her duties in such sum as the Board of Directors may require and such bonds shall be deposited as the Board may direct. Section 5. Removal. Any officer elected by the Board of Directors may be rtmoved by the Board of Directors whenever in its judgment the best interests of the Corporation would be served thereby, but such removal shall be without prejudice to the contract rights, if any, of the officer so removed. Section 6 Vacancies. In case any office of the Corporation becomes vacant by death, resignation, retirement, disqualification, or any other cause, the majority of the Board of Directors may elect a successor. Section 7. President: Powers 8c Duties. The President when present shall preside at all meetings of the Board of Directors. Subject to the control of the Board of Directors, the President shall exercise general supervision and direction over the management and conduct of the affairs of the Corporation and shall also have such other powers and duties as are given to him or her elsewhere by law or in these By-laws and as may be assigned to time from time to time by the Board of Directors. Section 8 Vice-President: Powers 8c Duties. In the absence of the President or in event of his or her inability or refusal to act, the Vice-President shall perform the duties of the President, and when so acting, shall have all the powers of and be subject to all the restrictions upon the president. The Vice-President shall assist the President in the performance of his or her duties and shall perform such other duties as from time to time may be assigned to him or her by the President or by the Board of Directors. Section 9. Treasurer: Powers 8c Duties. The Treaswer, except as the Board of Directors may otherwise order and direct from time to time and subject to the control at all time, (1) shall have charge of the financial affairs of the Corporetion and have the care and custody of its moneys, funds, valuable papers and documents; (2) shall keep full and accwate books of account of the Corporation transactions, which books shall be and remain the property of the Corporation; (3) shall deposit to the credit of the CorporaUOn all moneys and funds of the Corporation in such bank or banks or other depositories as the Board of Directors shall designate; (4) shall pay out and disburse funds so deposited rn the general course of business and under the authority of the Board of Directors; (5) shall receive all moneys and funds and sign all receipts and vouchers and enforce for collection or deposit all notes, check, drafts and similar commercial instruments payable to the Corporation, and in the absence of specific instructions from the Board of Directors, may delegate this authority to any agent or employee of the Corporation, (6) shall make and render to the proper municipal, state, federal, and other governmental officials all exhibits, retains and reports required by law, (7) shall make and render to the Board of Directors such reports and financial statements as it may request; (8) shall, 5 upon request, present end exhibit to the Members of the Corporation and to the Board of Directors all the books, accounts, records and evidence therefore kept by him or her; and, (9) shall have such other powers and duties as may be incidental to the office of Treasurer elsewhere given to him or her by law or in these By-laws and as may be assigned to him or her from time to time by the Board of Directors. Seaton ]0. Secretary: Powers 8c Duties. The Secretary (1) shall attend and keep the minutes of all meetings of the Board of Directors, and when requested, shall attend and keep the minutes (of the Board of Directors and) of any committee, in books provided for that purpose; (2) shall attend to the giving of all notices as provided by these By- laws; (3) shall keep a record, containing the names, alphabetically arranged, of ell persons who are members of the Board of Directors of the Corporation, showing their places of residence, phone numbers, fax numbers and a-mail addresses, and date of election, and such book shall be open for inspection as prescribed by law; (4) shall when so authorized or ordered by the Board of Directors, he or she may affix the seal of the Corporation, if any, to any contracts or agreements; and (5) shall have such other powers and duties as may be incidental to the office of Secretary or elsewhere given to him or her by law or in these By-laws as may be assigned to him or her from time to time by the Board of Directors. Section 11 Secretary Pro Tem. If the Secretary shall not be present at any meeting, the presiding officer shall appoint a Secretary Pro Tem. He or she shall keep the mtnutes of such meeting and record them in the books provided for that purpose Section 12 Assistants: Powers & Duties. Such Assistant Secretaries and Assistant Treasurers as may be appointed or elected shall have an exercise such powers and shall perform such duties as may be prescribed in these By-laws or as may be determined from time to time by the Member of the Board of Directors. Section 13. Absence of Treasurer or Secretary. In the absence of the Treasurer or in his or her inability to act, or if that office is vacant, the duties thereof shall be performed by such Assistant Treasurer as may have been designated by the Board of Directors, otherwise by the Secretary. In the absence of the Secretary or in his or her inability to act, or if that office is vacant, the duties there of shall be performed by such Assistant Secretary as may have been designated by the Board of Directors, otherwise by the Treasurer Section 14 Execution of Instruments• Authorized Signatures. All checks, drafts, notes, bonds, acceptances, deeds, leases, contracts, and all other instruments shall be signed by such person or persons as shall be provided by general or special resolution of the Board of Directors, and in the absence of any such general or special resolution applicable to any such instrument, then such instrument shall be signed by an officer of Corporation and countersigned by another officer of the Corporation or the Executive Director. 6 ARTICLE VI: INDEMNIFICATION Section 1.Insurance. The Corporation shall have the power to purchase and maintain insurance on behalf of any director, officer, executive board mtmber, advisory board member or commice member of the Corporation, against any liability asserted against or incurred by such person's status as such, whether, or not the Corporation would have the power to indemnify the person against liability under this Article. ARTICLE VII: COMMITTEES Section 1. Standinn Committees. There shall be such standing committees es the Board of Directors shall from time to time deem proper for carrying on the activities of the Corporation or for the conduct of its business or affairs, the duties, jurisdiction and powers of which shall be defined by the Board of Directors. The chairperson of each standing committee will be nominated from members of the Board of Directors and confirmed by the Board of Directors. Section 2. Scecial Committces. There shall be such special committees as the Board of Directors shall from time to time deem proper for the efficient conduct of its affairs. The duties, time limit, jurisdiction and powers of which shall be defined and amended, as required, by the Board of Directors. The chairperson and members of the committee may be persons other than members of the Board of Directors Section 3. Advisory Board. There may be an Advisory Board having none or exercising any power or acts of the Corporation. This Board may serve in an advisory capacity in assisting the Corporation with fund-raising, community relations, publicity and other activities deemed desirable for the support and operation of the Corporation. The members will be nominated by the board or executive director and confirmed by the board of directors. The president of the Corporation will chair the Advisory Board. Section 4. Committee. Each chairperson shall appoint the members who will serve on his or her committee. Section 5. Reportin¢. The chairperson of every cormiee and the Advisory Board shall report all activity to the Board of Directors on a regular basis. Section 6. Vacancies. Vacancies in the membership of any committee and the Advisory board may be filled by appointments made in the same manner as provided in the case of the original appointments. Section 7. Qgotum. Unless otherwise provided resolution of the Board of Directors designating a committee, a majority of the whole committee shall constitute a quorum and the act of a majority of the members present at a meeting at which a quorum is present shell be the act of the committee. 7 Section 8. Rules of Order. Each committee and Advisory Board may adopt rules for its own government not inconsistent with these By-laws or with rules adopted by the Board of Directors. ARTICLE VIII: FISCAL YEAR, CONTRACTS, CHECKS, DEPOSITS AND FUNDS Section 1. Fiscal Year. The fiscal year of the Corporation shall be such es may from time to time be established by the Board of Directors. Section 2. Contracts. The Board of Directors may authorize any officer or officers, agent or agents of the Corporation, in addition to the officers so authorized by these By- laws, to enter into any contract or execute and deliver any instrument in the name of end on behalf of the Corporation, and such authority may be general or confined to specific instances. Section 3. Checks. Drafts. etc. All checks, drafts or orders for the payment of money, notes or other evidences of indebtedness issued in the name of the Corporation, shall be signed by such officer or officers, agent or agents of the Corporation and in such manner as shall from time to time be determined by resolution of the Board of Directors. In the absence of such determination by the Board of Directors, such instruments shall be signed by an officer of Corporation and countersigned by another officer of the Corporation or the Executive Director. Section 4. Deposits. All funds of the Corporation shall be deposited from time to time to the credit of the Corporation in such banks, trust companies or other depositories as the Board of Directors may select. Section 5 Gifts. The Board of Directors may accept on behalf of the Corporation any contnbution, gift, bequest or devise for the general purposes or for any special purpose of the Corporation. ARTICLE IX. PROHIBITION AGAINST SHARING IN CORPORATE EARNINGS AND PROHIBITED POWERS Section 1. Prohibition Against Sharing in Comorate Earnings. No Member, Director, Officer, or employee of or member of a committee of or person connected with the Corporation, or any other private individual shall receive at any time any of the net earnings or pecuniary profit from the operations of the Corporations provided, that this shall not prevent the payment to any such person of such reasonable compensation for services rendered to or for the Corporation in effecting any of its purposes as shall be fixed by the Board of Directors; and no such person or persons shall be entitled to share to the distribution of any of the corporate assets upon the dissolution or winding up of the affairs of the Corporation, whether voluntary or involuntary, the assets of the Corporation, after all debts have been satisfied, then remaining in the hands of the 8 Board of Directors shall be distributed, transferred, conveyed, delivered, and paid over, in such amounts as the Board of Directors may determine or as may be determined by a court of competent jurisdiction upon application of the Board of Directors, exclusively to organizations which would then qualify under the provisions of Section 501(c) (3) of the Internal Revenue Code and its regulations as they now exist or as they may hereafter be amended. Section 2. Prohibited Powers. Notwithstanding any other provisions of these by-laws, no Members, Directors, Officer, employee or representative of this Corporation shall have the power to take any action or carry on any activity by or on behalf of the Corporation not permitted to be taken or carried on by a non-profit Corporation under the provisions of Section 41621, Hawaii Revised Statutes, as amended. ARTICLE X: BOOKS AND RECORDS, SEAL Section 1. Books and Records. The Corporation shall keep correct and complete books and records of account and shall also keep minutes of the proceedings of its Board of Directors and committees having any of the authority of the Board of Directors, and shall keep at the registered or principal office a record giving the name and address of each Director. All books and records of the Corporation may be inspected by any Director or Regular Member, or his or her agent or his or her attorney for any proper purpose at any reasonable time. fiction 2. Seal. The Corporation may have a seal of such form as the Board of Directors may from time to time determine, which seal shall be in the custody of the secretary. The Board of Directors may change the form of the seal or the inscription thereon at pleasure. ARTICLE XI: AMENDMENTS TO BY-LAWS Section 1 Amendment. These By-laws may be altered, amended, added to or repealed by an affirmative vote of not less than a majority of ell Directors of the Corporation if notice of the proposed amendments shall have been given in the call for such meeting. ARTICLE XII: BOARD POLICY MANUAL The Board of Directors shall have full power to create a Board Policy Manual containing policies considered necessary for the governing and well being of the organization. These policies must be consistent with the Bylaws. 9 JqN-31-2001 09:4T RM WE3THgWgIIMEDIqT ION 000 BB3 3323 P. 11 ~r sr W ~ ~k M JiML ~ wN~M r ~Mt1r a~w~ i~f rMra 16~ , i pR rew