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2021-642-E-AMS-Habitat for Humanity of Orange County-Community Climate Action Grant
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2021-642-E-AMS-Habitat for Humanity of Orange County-Community Climate Action Grant
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Last modified
11/4/2021 1:45:30 PM
Creation date
11/4/2021 1:44:24 PM
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Template:
Contract
Date
11/3/2021
Contract Starting Date
11/3/2021
Contract Ending Date
11/4/2021
Contract Document Type
Agreement - Performance
Amount
$95,000.00
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832083 10-03-18 <br />3 <br />11 <br />12 <br />13 <br />14 <br />15 <br />Yes No <br />Yes No <br />a <br />b <br />13a <br />13b <br />Yes Noa <br />b <br />c <br />16 <br />17 <br />a <br />b <br />Yes No <br /> <br />Schedule G (Form 990 or 990-EZ) 2018 <br />Schedule G (Form 990 or 990-EZ) 2018 Page <br />Does the organization conduct gaming activities with nonmembers? <br />Is the organization a grantor, beneficiary or trustee of a trust, or a member of a partnership or other entity formed <br />to administer charitable gaming? <br />~~~~~~~~~~~~~~~~~~~~~~~~~~~ <br />~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ <br />Indicate the percentage of gaming activity conducted in: <br />The organization's facility <br />An outside facility <br />~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~% <br />%~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ <br />Enter the name and address of the person who prepares the organization's gaming/special events books and records: <br />Name | <br />Address | <br />Does the organization have a contract with a third party from whom the organization receives gaming revenue? <br />If "Yes," enter the amount of gaming revenue received by the organization | <br />~~~~~~ <br />$and the amount <br />of gaming revenue retained by the third party | $ <br />If "Yes," enter name and address of the third party: <br />Name | <br />Address | <br />Gaming manager information: <br />Name | <br />Gaming manager compensation | <br />Description of services provided | <br />$ <br />Director/officer Employee Independent contractor <br />Mandatory distributions: <br />Is the organization required under state law to make charitable distributions from the gaming proceeds to <br />retain the state gaming license?~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ <br />Enter the amount of distributions required under state law to be distributed to other exempt organizations or spent in the <br />organization's own exempt activities during the tax year |$ <br />Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, <br />15b, 15c, 16, and 17b, as applicable. Also provide any additional information. See instructions. <br />Part IV Supplemental Information. <br /> <br /> <br /> <br /> <br /> <br />NC, INC.58-1603427 <br />HABITAT FOR HUMANITY, ORANGE COUNTY <br />DocuSign Envelope ID: 0E2E518B-BEF7-4AF0-8D07-FCD05F094BD6
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