HomeMy WebLinkAboutBPW-04-01-15-08 Indianapolis Wind SymphonyRESOLUTION NO. BPW- 04- 01 -15 -8
RESOLUTION OF THE CITY OF CARMEL BOARD OF PUBLIC WORKS AND SAFETY
ACKNOWLEDGING RECEIPT OF CONTRACT
WHEREAS, pursuant to Indiana Code 36- 1 -4 -7, the City of Carmel, Indiana ( "City "), is authorized to
enter into contracts; and
WHEREAS, pursuant to Indiana Code 36- 4 -5 -3, the City's mayor may enter into contracts on behalf of the
City; and
WHEREAS, pursuant to his authority under Indiana law, the City's mayor, the Honorable James C.
Brainard, has caused to be signed the City contract attached hereto as Exhibit A (the "Contract "); and
WHEREAS, Mayor Brainard now wishes to present the contract to the City's Board of Public Works and
Safety for it to be publicly acknowledged, filed in the Clerk- Treasurer's Office, and made available to the public for
review.
follows:
NOW, THEREFORE, BE IT RESOLVED by the City of Carmel Board of Public Works and Safety as
1. The foregoing Recitals are incorporated herein by this reference.
2. The receipt of the Contract is hereby acknowledged.
3. The Contract shall be promptly filed in the office of the Clerk- Treasurer and thereafter made available to
the public for review.
SO RESOLVED this
ISr
day of
. 2015.
CITY OF CARMEL, INDIANA
By and through its Board of Public Works and Safety
BY:
mes Brainard.
Date:
Mary Ann
Date:
rkey Member
s
Lori S. WI'atson.
. Date:
ATTEST:
Di na Cordray, IMCA, lerk - Treasurer
Date: `/- /- /j
S: \E BasslMy Documents \BPW -Resolutions12015 \INDIANA WIND SYMPHONY Acknowledge Arts Grant Program Agreement - 201S.docxy23, i5 12:38 PM
ARTS GRANT PROGRAM
AGREEMENT
This Grant Agreement (herein referred to as "Agreement ") entered into by and between the City
of Carmel (the "City ") and Twkie Zap je4.011 & ws vt Qf S opt y (the
"Grantee "), is executed pursuant to the terms and conditions set forth herein. In consideration of
those mutual undertakings and covenants, the parties agree as follows:
1. That on behalf of Grantee, a not - for - profit corporation, I, __TAA iei+ ejork
an authorized representative of Grantee, have applied for a City of Carmel
( "Grantor ") Arts Grant, said application attached hereto and made a part hereof as
Exhibit "A."
2. Grant Agreement. The City, after review and recommendation by the Mayor and by
the City Council, agrees to grant $ 12 , 0 0 0 . 0 0 to the Grantee for
the eligible costs of the project (the "Project ") or services as described in Exhibits
"A" and "B" of this Agreement. The funds shall be used exclusively in accordance
with the provisions contained in this Agreement.
3. Design and Implementation of Project. The Grantee agrees to use any and all grant
funds in accordance with the proposal contained within this agreement and any
documents attached to this Agreement, which are incorporated by reference.
4. Warranty of non - profit status. Grantee hereby represents and warrants that it is a
not - for - profit entity with a determination letter from the Internal Revenue Service
declaring that it is exempt from Federal income tax.
5. Payment of Grant Funds by the City. The payment of this Grant by the City to the
Grantee shall be made in accordance with the following conditions:
A. This Agreement must be fully executed and signed by both Grantee and Grantor.
B. Grantee has attached all the following information, which it represents and warrants
to be true and accurate, all which have been incorporated fully by reference:
1. An application and description of the proposed use of the grant funds (EXHIBIT
A);
2. A budget for the calendar or fiscal year for which the grant is requested
(EXHIBIT B);
3. Certified copies of incorporation as a not - for - profit corporation under state law
(EXHIBIT C);
4. A not - for - profit application or determination letter from the U.S. Internal Revenue
Service identifying that it is a not - for - profit corporation that is exempt from
Federal income tax (EXHIBIT D);
5. Any audits, reviews or compilations available describing the financial condition
of the Grantee, including most recent available IRS Form 990, and the attached
Affidavit (EXHIBIT E);
6. A list of the Grantee's board of directors and officers listed (EXHIBIT F);
7. A Year End Report from the previous year IF Grantee received an Arts Grant
from the City of Carmel in the previous calendar year, pursuant to paragraph 7
herein (EXHIBIT G).
C. Any other grant conditions that City requires to be met by Grantee, specifically:
6. Grantor's right to request audit or review. Grantee shall submit to an audit or
review by an independent Certified Public Accountant of funds at the City's request,
and shall make all books, accounting records and other documents available at all
reasonable times during the term of this Grant Agreement, and for a period of three
(3) years after final payment of funds under this Agreement, for the purpose of an
audit by the City of Carmel, the State of Indiana, or their designees.
7. Year end review. Grantee agrees to provide the City of Carmel a year -end report
( "Year End Report") for each year, describing how the grant was used and the impact
of the dollars received. This Grant award may not exceed one third (1/3) of Grantee's
combined contributed income, revenue of sales, and /or ticket revenue from the
2
previous year. If the Grant amount is in excess of sixty thousand dollars
($60,000.00), the Grantee agrees to provide, at Grantee's cost, a review or audit of the
grantee. Said review or audit shall be performed by a Certified Public Accountant
( "CPA ") who is neither an employee of Grantee nor a member of the Grantee's Board
of Directors, to be provided to the City of Carmel by March. 31 of the following year.
8. Funding Credit. Grantee agrees to credit the City of Carmel in the printed materials
associated with a funded program or project. The City of Carmel will supply, upon
request, Grantee with the graphics /logos necessary for compliance.
9. Statutory Authority of Grantee. The Grantee expressly represents and warrants to
the State that it is statutorily eligible to receive these monies and it expressly agrees to
repay all monies paid to it under this Grant, should a legal determination of its
ineligibility be made by any Court of competent jurisdiction.
10. Use of Grant Funds by Grantee. The funds received by the Grantee pursuant to this
Agreement shall be used only to implement the Project or provide the services in
conformance with the Budget and for no other purpose. If it is determined by the
City that misappropriation of funds have occurred, the Grantee must return all funds
received by Grantor and individuals who misuse Grant funds may also be subject to
civil and/or criminal liability under Indiana or Federal law.
11. Employment Eligibility Verification. The Grantee affirms under the penalties of
perjury that he /she /it does not knowingly employ an unauthorized alien.
The Grantee affirms under the penalties of perjury that he /she /it has enrolled and is
participating in the E- Verify program as defined in IC 22- 5 -1.7. The Grantee agrees
to provide documentation to the City that he /she /it has enrolled and is participating in
the E- Verify program.
The City may terminate for default if the Grantee fails to cure a breach of this
provision no later than thirty (30) days after being notified by the State.
12. Governing Law; Lawsuits. This Agreement is to be construed in accordance with
and governed by the laws of the State of Indiana, except for its conflict of laws
provisions. The parties agree that, in the event a lawsuit is filed hereunder, they
waive their right to a jury trial, agree to file any such lawsuit in an appropriate court
in Hamilton County, Indiana only, and agree that such court is the appropriate venue
for and has jurisdiction over same.
13. Relationship of Parties. The relationship of the parties hereto shall be as provided
for in this Agreement, and neither Grantee nor any of its compensated officers,
employees, contractors, subcontractors and /or agents are employees of City. The
3
Grant amount set forth herein shall be the full and maximum compensation and
monies required of City to be paid to Grantee under or pursuant to his Agreement.
14. Severability. If any term of this Agreement is invalid or unenforceable under any
statute, regulation, ordinance, executive order or other rule of law, such term shall be
deemed reformed or deleted, but only to the extent necessary to comply with same,
and the remaining provision of this Agreement shall remain in full force and effect.
15. Entire Agreement. This Agreement, together with any exhibits attached hereto or
referenced herein, constitutes the entire agreement between Grantee and City with
respect to the subject matter hereof, and supersedes all prior oral or written
representations and agreements regarding same. Notwithstanding any other term or
condition set forth herein, but subject to paragraph 15 hereof, to the extent any term
or condition contained in any exhibit attached to this Agreement or in any document
referenced herein conflicts with any term or condition contained in this Agreement,
the term or condition contained in this Agreement shall govern and prevail. This
Agreement may only be modified by written amendment executed by both parties
hereto, or their successors in interest.
IN WITNESS WHEROF, the parties hereto have made and executed this Agreement as follows:
-L n0410-0 Ct. 1'01,1 d "Grantee ")
/fr. L. 4 /La
PVName of Officer: el 0,4 7ch,- 10 1440.4,4 Title: fire_ S i de //14" Of
Date: �I/Yl /�
Date:
3/17/2015
CITY A F CARMEL ( "Grantor "'
By:
James Brainard, Mayor
Date: 3/17/2015
If you have any question concerning the City of Cannel's 2015 Arts Grant Program, grant writing, guidelines or application materials, contact:
Sharon Kibbe, City of Cannel, One Civic Square, Cannel, IN 46032, Phone: 317 -571 -2483, skibbe@carmel.in.gov.
4
2015 Arts Grant Application Request January 14, 2015
Exhibit "A"
Application and Description of the Proposed Use
of the Grant Funds
P.O. Box 78592, Indianapolis, IN 46268 3 www.IndianaWindSymphony.org
2015 Arts Grant Application Request January 14, 2015
Exhibit "A"
Application and Description of the Proposed Use of the Grant Funds
APPLICANT:
Name of organization: Indiana Wind Symphony
Address: P.O. Box 78592, Indianapolis, IN 46268
Telephone: 317- 748 -4802 Fax: 317- 862 -6452
Contact Person: Janice Schreibman, President of the Board of Directors
Email: janschreibman@att.net
APPLICATION AMOUT: $20,000.00
DESCRIPTION OF THE PROPOSED USE OF THE GRANT FUNDS:
The Indiana Wind Symphony (IWS) has entered the 17th season of performing as
Indiana's premier adult concert band under the musical direction of Dr. Charles
Conrad. Our performances delight audiences, intertwining the musical heritage of
the classic community band with the innovation of a contemporary wind ensemble
repertoire. As a resident ensemble of the Palladium at the Center for the
Performing Arts in Carmel, the IWS has achieved acclaim for several national and
global premier performances. Dr. Conrad, all IWS board members, and each highly
trained auditioned symphony musician make up a wholly volunteer organization
that works together to bring audiences the highest level of technical and musical
expertise.
The IWS is respectfully requesting a grant in the amount of $20,000 to offset
operational costs and initiatives for the Symphony's 2015 -2016 season, shaped by
our mission, to "present artistic performances of significant music for band and wind
ensemble to the Central Indiana community."
Grant dollars will be used to help us to fulfill our mission in the following ways:
I. Increased Targeted Marketing Campaign
$10,000
The IWS will direct additional funds to marketing in a concentrated and
strategic initiative to develop and expand our audience. A main source
of our operating income is generated from ticket sales and as such
audience development is a key component to the IWS' financial
sustainability. We also believe that the additional paid advertising will
create and improve brand awareness for the IWS and Palladium in the
greater Central Indiana community. As part of this effort we will
explore advertising with new media partners to reach new audiences.
P.O. Box 78592, Indianapolis, IN 46268 4 www.IndianaWindSymphony.org
2015 Arts Grant Application Request January 14, 2015
II. Guest Artists to Perform with the IWS in the 2015 -16 Season
$2,000
Our commitment to creating excellence in programming is evident at
each concert when you hear the ensemble perform at a level that far
exceeds the connotations of a hometown group of volunteer musicians.
To complement this high -level of artistic achievement, we wish to
continue our tradition of inviting guest artist to perform with us during
the 2015 -16 season. Not only will this take the performance to higher
musical level, it may prove a motivator for potential patrons to discover
the IWS at the Palladium, thereby growing our ticket revenue.
III. Education Outreach
$4,890
A focus of the IWS is to cultivate a passion for band performance in
young musicians. Funds from the City of Carmel would allow us to
accomplish this is two significant ways.
1. The IWS rehearses at Carmel High School. As part of this agreement,
the IWS will provide sectional support to the Carmel High School
band. This will support development of young musicians at a cost of
$200.00 per IWS musician for each session 2 musicians X 2 sessions
= $800.00
2. The IWS will host a local high school band to perform with the Wind
Symphony on a regular season concert. As part of this outreach, not
only will the students in the band have the opportunity to perform in
a world class venue, the IWS will offer each band member two tickets
for their family to attend, a tour the Palladium and the Feinstein
Archives, as well as a pre- concert reception. Approximate size of the
High School band = 80 members.
• 150 family tickets @ $20.00 per ticket ($3000.00)
• Cost of 2 Palladium staff members @ $15 per person for 3 hours each
($90)
• Pre - concert /reception for students $1000.00
IV. Audience /Donor Development Reception
$ 2,000
The IWS will host a reception for season ticket holders and major stake-
holders in an effort to cultivate concert patrons into individual and
corporate donors. Since becoming a resident ensemble at the Palladium,
the IWS has already enjoyed an expanded following from all over Central
Indiana. A main source of our operating income is generated from ticket
sales, but a revenue stream we hope to grow is from individual
donations. We hope to host another in a series of receptions to develop
deeper relations with our current audience members and donors,
increasing their experience of IWS performances at the Palladium,
cultivating a love of concert band genre of music and the value of having
P.O. Box 78592, Indianapolis, IN 46268 5 www.IndianaWindSymphony.org
2015 Arts Grant Application Request January 14, 2015
the arts as an integral part of our community. Support from the City of
Carmel will help offset: a pre or post- concert reception at a 2015 -16
season concert, event promotion and catering.
By:
Printed Name of Officer: O. nice S. Schreibman
Title: President of the Board of Directors
Date: , /31,2D/5-
V. Young professionals
$1110.00
The IWS will host a reception for young professionals. An initiative
was begun last concert season to reach out to young professionals. After
careful evaluation of the initiative, a decision to partner with existing
young professional groups was made. Partnering with existing young
professional groups will offer that group an event to promote their
gathering, as well as, introduce new audience members to both the IWS
and the Palladium, cultivating a relationship that fosters a love of concert
band genre of music and the value of having the arts as an integral part
of our community.
Support from the City of Carmel will help offset:
• A pre or post- concert reception at a 2015 -2016
concert
• Promote the event
• Catering
P.O. Box 78592, Indianapolis, IN 46268 6 www.IndianaWindSymphony.org
2015 Arts Grant Application Request January 14, 2015
Exhibit "B"
Budget for 2015
P.O. Box 78592, Indianapolis, IN 46268 7 www.IndianaWindSymphony.org
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Profit & Loss Budget Overview
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January 14, 2015
www.IndianaWindSymphony.org
2015 Arts Grant Application Request January 14, 2015
Exhibit "C"
Certified copies of incorporation as a not -for-
profit corporation
P.O. Box 78592, Indianapolis, IN 46268 9 www.IndianaWindSymphony.org
2015 Arts Grant Application Request January 14, 2015
STATE OF INDIANA
OFFICE OF THE SECRETARY OF STATE
CERTIFICATE OF INCORPORATION
OF
INDIANA WIND SYMPHONY, INC.
I, SUTI ANNT: CILOY, Secrot7y oc Stt of Tn4afla, h,-ohy ecrtif
Articles of Incor.poration of tha aLove corporation :have bee presente
:IL 7,-V office accot.;ipanie by the fees. orscrild 1-sy law; tat
fount:: such Articles coefor Lo la'; all ;i6 pruscri-bud by t pro-,risions .017'!
fne Indiana Nonprofit Corporation Act of 1991, as wiend:.-2-
rHEREFORF, I herehy is:-'u to such corporalion this Cartifico.to of
Incorporation, on further certify that its corporate existence uill bein
Octoer 23, 1997.
lo. '.7itucss ha-ve :iercunto set F7:y
har:d ar& riffie1 the seo.1 of the. Stat,a of
Indlana, ot the. City of in.dianzpolls,
Twelity-tidre. of C:cto:Jer , 1997.
_104 attiuu
SUE ANNE GILROY, Secretar f State,
P.O. Box 78592, Indianapolis, IN 46268 10 www.IndianaWindSymphony.org
2015 Arts Grant Application Request
ARTICLES OF INCORPORATION -^
State Form 4162 (68 / 6-95) Corporate Farm.No. 364-1 (October 1
Approved by State Board of Accounts 1995 APPROVED
I LED
INSTRUCTIONS: Use 812°x11" white paper for inserts. - IND.SECRETAKYQFS ATE
Present original and two (2) copies to address in upper right
corner of this form.
Please TYPE or PRINT
Upon completion of filing the Secretary of State will issue a
receipt.
January 14, 2015
SUE ANNEGRROY
SECRETARY OF STATE
CORPORATIONS DIVISION
302 W. Washington 51., Rm. 8018
Indianapolis, IN 46204
Telephone: (317) 232 -6576
Indiana Code 23- 17 -3 -2
FILING FEE: 330.00
For tax exempt status, Nonprofit Cotporatidns must qualify with both
the internal Revenue Service and the Indiana - Department of. Revenue.
ARTICLES OF INCORPORATION
The undersigned incorporator or incorporators, desiring to form a corporation (hereinafter referred to as the °Corporation) pursuant to the
provisions of the Indiana Nonprofit Corporation Act of 1991 (hereinafter referred to as the "Act"),. execute-thecfnllowing Articles of
Incorporation.
' , 'ARTICLE itNarne and P viapat Office A" w
Name of the Corporation: (the name must include the word "Corporation", 'Incorporated; "limited", "Company" or one of the abbreviators thereof):
Indiana Wind Symphony, Inc.
Principal Office: The address of the principal office of the Corporation is:
Post office address
410 Second Avenue, N.E.
City
Carmel
Indiana
ZIP code
46032
ARTICLEigRi tposei(optronaQ ,,a,,A:v t
The purposes for which the Corporation is formed are:
1. to provide to the general public opportunities to experience and listen to the finest wine
band music and literature through concerts, activities in schools, clinics and other
educational activities;
2. to provide a professional - semi - professional level musical forum for the study of literatu;
education and an opportunity for the musicians to work with other professional, semi -pro-
fessional musicians in developing their talents and thereby providing musical expression
available to the general public;
3. to represent as musical ambassadors the City of Indianapolis and the State of Indiana;
4. to promote band and wind band music and literature for local, state and national uses and
establish a musical library with wind band literature; and
S. other related musical and educational activities connected with these purposes.
5ARIiCLE_ill TYPeo` fCorP. ora (ion,(cheGr,only�orie):.",`t`.
The Corporation is a:
® public benefit corporation, which is organized for a public or charitable purpose;
❑ religious corporation, which is organized primarily or exclusively for religious purposes; or
❑ mutual benefit corporation (all others). _
ARTICLE v,,'Reg ite ed Agent'and Registered offiaLi
Registered Agent: The name and street address of the Corporation's Registered Agent and Registered Office for service of process are:
Name of Registered Agent
Lawrence E. Lawhead
Address of Registered Office (street or building)
8900 Keystone Crossing, Suite 940
City
Indianapolis
Indiana
ZIP code
46240 -4633
254ARTICLE,VMembershfp,
Indicate if Corporation will have members:
® Yes 0 No
P.O. Box 78592, Indianapolis, IN 46268 11 www.IndianaWindSymphony.org
2015 Arts Grant Application Request
Name(s) and address(es) of the incorporator(s) is/are as follows:
January 14, 2015
Name
Number and Street or Building
City
State
: ZIP code
Lawrence E. Lawhead
899$ Ceystone Crossing
4
Tndianapolis
Tndiana
i
4;240 -4644
ARTICLE VII Distribution pYAssets on Dtssolution`or Final,ligtiidabon,
Refer to Indiana Code 23- 17 -22 -5 for permitted activities following Dissolution.
1. To a person or entity described in Section 501(c)(3) of the Internal Revenue Code; or
2. If the dissolved corporation is not described in Section 501(c)(3) of the Internal
Revenue Code, to a foreign or domestic public benefit or religious corporation.
THIS DOCUMENT MUST BE SIGNED BY ALL INCORPORATORS.
Ir I (we)rit�reby verify, lent to penalties of perjury, that the facts contained herein are true. (Notarization not necessary)
Prid name
nte
Lawrence F. 'Laub earl
Signature
Printed name
Signature
Printed name
This instrument was prepared by: (name)
Lawrence E. Lawhead
Address
8900 Keystone Crossing, Suite 940
City
Indianapolis
State
Indiana
ZIP code
46240 -4633
P.O. Box 78592, Indianapolis, IN 46268 12 www.IndianaWindSymphony.org
2015 Arts Grant Application Request January 14, 2015
Exhibit "D"
Determination letter from the U.S. Internal
Revenue Service identifying that IWS is a not -for-
profit corporation that is exempt from Federal
income tax
P.O. Box 78592, Indianapolis, IN 46268 13 www.IndianaWindSymphony.org
2015 Arts Grant Application Request January 14, 2015
INTERNAL REVENUE SERVICE DEPARTMENT Of THE IREAmun,
DISTRICT DIRECTOR
.P. 0. BOX 2508
CINCINNATI, OH 45201
Employer Ideatificatic:n Number:
DateSEP 17 1999 35- 22029445
DL.N:
7,19225178
INDIANA WINO SYMPHONY INC - Contact Person:
910 SECOND AVE - GLORIA POLK - ID4 526,77,
CARMEL, IN 46032 Contact Telephone_ Number:
(:377) 82?-5F40
Accounting Period Ending:
December 31
Form 990 Required:
Yes
Addendum Applies: .
No
_Dear Applicant:
Eased on information 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 503(a:• of the Internal
Revenue Cade as an organization described in section 501(c)t).
We have further determined that you are not a private foundation within
the meaning of section 509(a :• of the Code, because you are on organization
described in sections 509(a)(1) and 170.(b)(1)(A)(vi).
If your sources of support, or your purposes, character, or method of
operation change, please let us know so we can con. <,ider the effect of the
change on your exempt status and foundation status. Is the case of an amend-
ment to your organizational document or bylaws, please send us a copy of the
amended document or bylaws. Also you should inform us of <:it changes in your
name or address.
As of January 1, 1984, you are liable for taxes under the Federal
Insurance Contributions Act (social. security taxes: on remuneration of $100
or more You nay t,• each of your ampinyean during a calendar year. - Von are
not liable for the tax impr.. ed under the.Federal Unemployment Tax Act CFUTA).
Since -you are not a private foundation, you are not subject to the excise
taxes under Chapter 42 of the Code. However, if you are involver in an excess
benefit transaction, that transaction might be subject to the excise taxes of
section 4755. Additionally, you are not automatically exempt: from other
federal excise taxes. If you have any questions about excise, employment, or -
other federal taxes, pleas_ contact your key district office. -
Grantors and contributors may rely on this determination unless the
Internal Revenue Servile pul•lishes notice to the contrary. ,However, if you
lose your section 509(a)(1) status, a grantor or contributor may not rely
on this determination if he or she was in part responsible f:.r, or was aware
of, the act or failure to a,_t, or the substantial or material change on the
part of the organization that resulted in your toss of such status, or if he or
she acquired knowledge that the Internal Revenue Service had given notice that
you would no longer be cla5.-t.ified as a section 509Ca)(1) organization.
..etter 917 (007C8)
P.O. Box 78592, Indianapolis, IN 46268 14 www.IndianaWindSymphony.org
2015 Arts Grant Application Request
ItNDIANA WIND SYMPHONY INC
January 14, 2015
•Su -T, Exempt Organization t- usiness 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 51.3 of the Code.
You need an employer identification number even if- you have no employees.
If an employer identification number was not entered on your application, a
number will he assigtied to you and you will be advised of it please use that
number on all returns' you file and in all correspondence with the Internal
Revenue Service.
If He. have Indicated in the heading of this letter' that an addendum
applies, the enclosed addendum is an integral part of this letter.
Because this letter could help resolve any questions ab.:.ut. your exempt
status and foundation status., you should keep it i,, your permanent records.
If you have any questions, please contact the person whose name and
telephone number are shown-in the heading of this letter. .
Sincerely yours,
District Director
P.O. Box 78592, Indianapolis, IN 46268 15 www.IndianaWindSymphony.org
2015 Arts Grant Application Request January 14, 2015
Exhibit "E"
Financial condition of the Grantee
P.O. Box 78592, Indianapolis, IN 46268 16 www.IndianaWindSymphony.org
STATE OF INDIANA )
) SS:
COUNTY OF 4 )
of
I,
Ai
my oath, state that pursuant to paragraph 7 of the City of Carmel Arts Grant Program Agreement,
, an authorized representative
C., ( "Grantee "), being first duly sworn upon
all income of Grantee, including a City of Carmel arts grant, if applicable, revenue of sales,
and/or ticket revenue, etc., in the Grantee's year ending in 2014 totaled $
Signature
Printed Name oWV6I.,
Subscribed and sworn to before me, the undersigned Notary Public, this /.S_ day of
;/ .qA✓ , 20 /S-
KASEY J CORBETT
Notary Public - Seal
State of Indiana
Marion County
My Commission Expires Oct 13, 2022
Signature - Notary Public �/� se/
■
/
Printed Name 4s �a �611z. Y �.
Resident of /W4", /0,4/ County, Indiana
My Commission Expires: WD //3 �� �-
2015 Arts Grant Application Request January 14, 2015
Indiana Wind Symphony, Inc.
Profit & Loss
December 2014
Ordinary Income /Expense
Income
Concert Income
Concert Honorarium
Program Ads
Season Ticket Sales
Ticket Sales
Total Concert Income
Dec 14 Jan - Dec 14
0.00 5,500.00
60.00 300.00
1,560.42 11,792.76
12,338.58 29,206.24
13,959.00 46,799.00
Contributions Income
Donation In Kind 1,451.93 9,376.83
Fundraising 0.00 14.63
Unrestricted 2,245.00 20,729.43
Total Contributions Income 3,696.93 30,120.89
Grants 0.00 11,135.00
Grants - Matching 0.00 4,050.00
Miscellaneous Income 0.00 225.00
Shirt and Photo Sale 0.00 180.00
Uncategorized Income 0.00 0.00
Total Income 17,655.93 92,509.89
Expense
Administrative Expenses
Development Director 140.00 4,943.75
Postage 0.00 92.00
Total Administrative Expenses 140.00 5,035.75
Advertising 0.00 493.17
Award Expense 0.00 187.00
Bank Service Charges
Credit card fees 365.01 1,067.42
Pay Pal fee 26.19 45.29
Bank Service Charges - Other 25.00 25.00
Total Bank Service Charges 416.20 1,137.71
Capital Expenditures
Equipment Purchase 165.86 658.53
Total Capital Expenditures 165.86 658.53
Concert Expenses
AudioNideo Recording 200.00 325.00
Concert Advertising 3,319.50 12,484.32
Concert Hall Rental 3,705.58 22,364.23
Facility Ticket Surcharge 1,482.50 5,016.00
Grant Expenses 0.00 3,882.63
Instrument Rental 0.00 125.00
Music 730.73 4,533.39
Other Concert Expenses 315.00 1,409.83
Other Paid Performers 250.00 2,280.00
Printing 1,129.89 4,981.99
Soloist/Guest Conductor 2,750.00 7,551.41
Sound 0.00 1,300.00
Transport Expense 100.00 584.89
Total Concert Expenses 13,983.20 66,838.69
Page 1
P.O. Box 78592, Indianapolis, IN 46268 18 www.IndianaWindSymphony.org
2015 Arts Grant Application Request January 14, 2015
Indiana Wind Symphony, Inc.
Profit & Loss
December 2014
Dues and Subscriptions
Festival Expense
Insurance
Liability Insurance
Total Insurance
Dec 14 Jan - Dec 14
0.00 425.00
659.20 1,151.37
0.00 500.50
0.00 500.50
Marketing 0.00 3,139.60
Miscellaneous 199.68 928.80
Office Supplies 0.00 30.57
Postage and Delivery 9.80 494.66
Printing and Reproduction 0.00 281.29
Rent 152.00 1,942.00
Shirt Sale Expense 0.00 564.00
Travel & Ent
Entertainment 0.00 1,100.00
Total Travel & Ent 0.00 1,100.00
Uncategorized Expenses 0.00 0.00
Web Site Expense 0.00 155.00
Total Expense 15,725.94 85,063.64
Net Ordinary Income 1,929.99 7,446.25
Net Income
1,929.99 7,446.25
Page 2
P.O. Box 78592, Indianapolis, IN 46268 19 www.IndianaWindSymphony.org
2015 Arts Grant Application Request
Fonn 990—EZ
Department of the Treasury
Internal Revenue Service
January 14, 2015
Short Form
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
► Do not enter Social Security numbers on this form as it may be made public.
► Information about Form 990-EZ and its instructions is at www.irs.gov/form990.
A For the 2013 calendar year, or tax year beginning
01/01
, 2013, and ending
12/31 , 20 13
B Check it applicable:
❑ Address change
❑ Name charge
❑ Initial return
❑ Terminated
❑ Amended return
Application pending
G Accounting Method: 0 Cash ❑ Accrual Other (specify) ►
C Name of organization
INDIANA WIND SYMPHONY INC
D Employer identification number
35- 2029445
Number and street (or P.O. box, if mail is not delivered to street address)
PO Box 78592
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Indianapolis, IN 46278
E Telephone number
317- 796 -8457
F Group Exemption
Number ►
I Website:► IndianaWindSymphony.orq
J Tax - exempt status (check only one) — Q 501(c)(3) ❑ 501(c) ( ) • (insert no.) ❑ 4947(a)(1) or 0527
K Form of organization: Q Corporation ❑ Trust ❑ Association ❑ Other
H Check ■ 0 if the organization is not
required to attach Schedule B
(Form 990, 990 -EZ, or 990 -PF).
L Add lines 5b, 6c, and 7b, to line 9 to determine gross receipts. If gross receipts are $200,000 or more, or if total assets
(Part II, column (B) below) are $500,000 or more, file Form 990 instead of Form 990 -EZ ► $
89,175
Part,I
Revenue, Expenses, and Changes in Net Assets or Fund Balances (see the instructions for Part I)
Check if the organization used Schedule 0 to respond to any question in this Part I
0
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 106421
Form 990-EZ (2013)
P.O. Box 78592, Indianapolis, IN 46268 20 www.IndianaWindSymphony.org
1 Contributions, gifts, grants, and similar amounts received
2 Program service revenue including government fees and contracts
3 Membership dues and assessments
4 Investment income
5a Gross amount from sale of assets other than inventory . .
b Less: cost or other basis and sales expenses
c Gain or (loss) from sale of assets other than inventory (Subtract line 5b from
6 Gaming and fundraising events
a Gross income from gaming (attach Schedule G if greater than
5a
0
1
40,268
2
48,822
3
0
4
0
[ _
0
5b
0
line 5a) . .
5c
$15,000)
16a I 0
Rever
b Gross income from fundraising events (not including $
0 of
contributions
from fundraising events reported on line 1) (attach Schedule G if the
sum of such gross income and contributions exceeds $15,000) .
c Less: direct expenses from gaming and fundraising events . . .
6b
85
l 6c ,
112
d Net income or (loss) from gaming and fundraising events (add lines 6a
and 6b and subtract
line 6c)
_
6d
-27
7a Gross sales of inventory, less returns and allowances
7a
0
b Less: cost of goods sold
7b
o
c Gross profit or (loss) from sales of inventory (Subtract line 7b from line 7a)
7c
0
8 Other revenue (describe in Schedule 0)
8
0
9 Total revenue. Add lines 1, 2, 3, 4, 5c, 6d, 7c, and 8 ►
9
89,063
10 Grants and similar amounts paid (list in Schedule 0)
10
o
11 Benefits paid to or for members
11
0
12 Salaries, other compensation, and employee benefits
12
0
13 Professional fees and other payments to independent contractors
13
4,357
;pe
14 Occupancy, rent, utilities, and maintenance
14
2,388
15 Printing, publications, postage, and shipping
15
364
16 Other expenses (describe in Schedule 0) See Schedule 0, Statement 1
16
77,255
17 Total expenses. Add lines 10 through 16 O.
17
84,364
Net Assets
18 Excess or (deficit) for the year (Subtract line 17 from line 9)
18
4,699
19 Net assets or fund balances at beginning of year (from line 27, column (A)) (must agree with
end -of -year figure reported on prior year's return)
19
4,029
20 Other changes in net assets or fund balances (explain in Schedule 0)
20
0
21 Net assets or fund balances at end of year. Combine lines 18 through 20 ®
21
8,728
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 106421
Form 990-EZ (2013)
P.O. Box 78592, Indianapolis, IN 46268 20 www.IndianaWindSymphony.org
2015 Arts Grant Application Request
Form 990 -EZ (2013)
January 14, 2015
iPart:'ll
Balance Sheets (see the instructions for Part II)
Check if the organization used Schedule 0 to respond to any question in this Part II
Page 2
22 Cash, savings, and investments
23 Land and buildings
24 Other assets (describe in Schedule 0)
(A) Beginning of year
(6) End of year
4,029
22
14,774
0
23
0
0
24
0
25 Total assets
26 Total liabilities (describe in Schedule 0) See Schedule 0, Statement 2
4,029
25
14,774
0
26
6,046
27 Net assets or fund balances (line 27 of column (B) must agree with line 21) . .
4,020
27
8,728
[Rart'YIIIy Statement of Program Service Accomplishments (see the instructions for Part III)
Check if the organization used Schedule 0 to respond to any question in this Part III ❑
Expenses
(Required for section
501)c)(3) and 501(c)(4)
organizations and section
4947(a)(1)trusts; optional
for others.)
What is the organization's primary exempt purpose? See Schedule 0, Statement 3
Describe the organization's program service accomplishments for each of its three largest program services,
as measured by expenses. In a clear and concise manner, describe the services provided, the number of
persons benefited, and other relevant information for each program title.
28 11 concerts presented at various venues of music for band and wind ensembles by a group of approximately_
70 volunteer musicians. Total audience for the year was approximately 25,000 patrons.
(Grants $ 0) If this amount includes foreign grants, check here . . . . ► ❑
28a
0
29
(Grants $ ) If this amount includes foreign grants, check here . . . . ■ ❑
29a
30
(Grants $ ) If this amount includes foreign grants, check here . . . . ► ❑
30a
31 Other program services (describe in Schedule 0)
31a
0
(Grants $ 0) If this amount includes foreign grants, check here . . Is ❑
32 Total program service expenses (add lines 28a through 31a) ►
32
0
List of Officers, Directors, Trustees, and Key Employees (list each one even if not compensated —see the instructions for Part (V)
Check if the organization used Schedule 0 to respond to any question in this Part IV
(_
(b) Average (c) Reportable (d) Health benefits,
(a) Name and title hours per week compensation contributions to employee (e) Estimated amount of
devoted to position (Forms W -2 /1099 -MISC) benefit plans, and other compensation
(it not paid, enter -0 -) deferred compensation
Denise Pierce 2 0 0 0
President of the Board
Thomas Howenstine 2 0 0 0
Treasurer of the Board
Charles Conrad 3 0 0 0
Music Director
Jan Schreibman 2 0 0 0
Secretary of the Board
Ed Engledow 2 0 0 0
Board of Directors Member
Flora Garrison 2 0 0 0
Board of Directors Member
Don Pou(sen 2 0 0 0
Board of Directors Member
Liz Leatherberry 2 0 0 0
Board of Directors Member
Jim Ittenbach 2 0 0 0
Board of Directors Member
Form 990 -EZ (2013)
P.O. Box 78592, Indianapolis, IN 46268 21 www.IndianaWindSymphony.org
Form 990 -EZ (2013)
P.O. Box 78592, Indianapolis, IN 46268 21 www.IndianaWindSymphony.org
2015 Arts Grant Application Request January 14, 2015
Form 990 -EZ (2013) Page 3
WERA Other Information (Note the Schedule A and personal benefit contract statement requirements in the
instructions for Part V) Check if the organization used Schedule 0 to respond to any question in this Part V ❑
Yes No
33 Did the organization engage in any significant activity not previously reported to the IRS? If "Yes," provide a
detailed description of each activity in Schedule 0 33 ✓
34 Were any significant changes made to the organizing or governing documents? If "Yes," attach a conformed
copy of the amended documents if they reflect a change to the organization's name. Otherwise, explain the
change on Schedule 0 (see instructions) 34 ✓
35a Did the organization have unrelated business gross income of $1,000 or more during the year from business
activities (such as those reported on lines 2, 6a, and 7a, among others)? 35a ✓
b If "Yes," to line 35a, has the organization filed a Form 990 -T for the year? If "No," provide an explanation in Schedule 0
c Was the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization subject to section 6033(e) notice,
reporting, and proxy tax requirements during the year? If "Yes," complete Schedule C, Part III 35c ✓
36 Did the organization undergo a liquidation, dissolution, termination, or significant disposition of net assets
during the year? If "Yes," complete applicable parts of Schedule N
35b
36
37a Enter amount of political expenditures, direct or indirect, as described in the instructions • 137a 1 0 r ' '`
b Did the organization file Form 1120 -POL for this year? 37b ✓
38a Did the organization borrow from, or make any loans to, any officer, director, trustee, or key employee or were
any such loans made in a prior year and still outstanding at the end of the tax year covered by this return? .
b If "Yes," complete Schedule L, Part II and enter the total amount involved . . . . 38b
39 Section 501(c)(7) organizations. Enter:
a Initiation fees and capital contributions included on line 9
b Gross receipts, included on line 9, for public use of club facilities
40a Section 501(c)(3) organizations. Enter amount of tax imposed on the organization during the year under:
section 4911 • p ; section 4912 ► 0 ; section 4955 B. 0
b Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in any section 4958 excess benefit
transaction during the year, or did it engage in an excess benefit transaction in a prior year that has not been
reported on any of its prior Forms 990 or 990 -EZ? If "Yes," complete Schedule L, Part I
39a
39b
c Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax imposed on
organization managers or disqualified persons during the year under sections 4912,
4955, and 4958 • 0
d Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax on line 40c
reimbursed by the organization • 0
e All organizations. At any time during the tax year, was the organization a party to a prohibited tax shelter
transaction? If "Yes," complete Form 8886 -T
41 List the states with which a copy of this return is filed ► IN
42a The organization's books are in care of • Thomas Howenstine Telephone no. • 317 -796 -8457
Located at • PO Box 78592, Indianapolis, IN 46278 ZIP + 4 ►
b At any time during the calendar year, did the organization have an interest in or a signature or other authority over
a financial account in a foreign country (such as a bank account, securities account, or other financial account)?
If "Yes," enter the name of the foreign country: •
See the instructions for exceptions and filing requirements for Form TD F 90 -22.1, Report of Foreign Bank
and Financial Accounts.
c At any time during the calendar year, did the organization maintain an office outside the U.S ?
If "Yes," enter the name of the foreign country: •
43 Section 4947(a)(1) nonexempt charitable trusts filing Form 990 -EZ in lieu of Form 1041 —Check here
and enter the amount of tax - exempt interest received or accrued during the tax year • 143
38a
40b
•
40e
46278
Yes
42b
No
42c
►❑
44a Did the organization maintain any donor advised funds during the year? If "Yes," Form 990 must be
completed instead of Form 990 -EZ
b Did the organization operate one or more hospital facilities during the year? If "Yes," Form 990 must be
completed instead of Form 990 -EZ
c Did the organization receive any payments for indoor tanning services during the year?
d If "Yes" to line 44c, has the organization filed a Form 720 to report these payments? If °No," provide an
explanation in Schedule 0
45a Did the organization have a controlled entity within the meaning of section 512(b)(13)?
45b Did the organization receive any payment from or engage in any transaction with a controlled entity within the
meaning of section 512(b)(13)? If "Yes," Form 990 and Schedule R may need to be completed instead of
Form 990 -EZ (see instructions)
Yes
0
44b
44c
45a
45b
Form 990 -EZ (2013)
P.O. Box 78592, Indianapolis, IN 46268 22 www.IndianaWindSymphony.org
2015 Arts Grant Application Request
Form 990 -EZ (2013)
January 14, 2015
46 Did the organization engage, directly or indirectly, in political campaign activities on behalf of or in opposition
to candidates for public office? If "Yes," complete Schedule C, Part I
Section 501(c)(3) organizations only
All section 501(c)(3) organizations must answer questions 47-49b and 52, and complete the tables for lines
50 and 51.
Check if the organization used Schedule 0 to respond to any question in this Part VI
Ye
sPage 4
No
46
✓.
47 Did the organization engage in lobbying activities or have a section 501(h) election in effect during the tax
year? If "Yes," complete Schedule C, Part 11
Yes
No
47
48 Is the organization a school as described in section 170(b)(1)(A)(i)? If "Yes," complete Schedule E .
49a Did the organization make any transfers to an exempt non - charitable related organization?
b If "Yes." was the related organization a section 527 organization'/
50 Complete this table for the organization's five highest compensated employees (other than officers, directors, trustees and key
employees) who each received more than $100,000 of compensation from the organization. If there is none, en er "None."
48
49a
49b
(a) Name and title of each employee
(b) Average
hours per week
devoted to position
(c) Reportable
compensation
(Forms w- 2/1099 -MISC)
(d) Health benefits,
contributions to employee
benefit plans, and deferred
compensation
(e) Estimated amount of
other compensation
None
Preparer's signature
Date
Check ❑ If
self- employed
TIN
Finn's name •
Firm's EIN ■
Firm's address N.
Phone no.
oral number or other employees paid over $100,000 . . . . •
51 Complete this table for the organization s five highest compensated independent contractors who each received more than
$100,000 of compensation from the organization. If there is none, enter "None."
(a) Name and business address of each independent contractor
(b) Type of service
(c) Compensation
None
d Total number of other independent contractors each receiving over $100,000 . . ►
52 Did the organization complete Schedule A? Note. All section 501(c)(3) organizations and 4947(a)(1)
nonexempt charitable trusts must attach a completed Schedule A ► ❑✓ Yes ❑ No
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is
true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign
Here
Signature of officer Date
k Tom Howenstine, Treasurer
Type or print name and title
Paid
Preparer
Use Only
Print/Type preparers name
Preparer's signature
Date
Check ❑ If
self- employed
TIN
Finn's name •
Firm's EIN ■
Firm's address N.
Phone no.
urn with the preparer shown above? See instructions
► ❑ Yes ❑ No
Form 990 -EZ (2013)
P.O. Box 78592, Indianapolis, IN 46268 23 www.IndianaWindSymphony.org
2015 Arts Grant Application Request
SCHEDULE A
(Form 990 or 990 -EZ)
Department of the Treasury
Internal Revenue Service
January 14, 2015
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990 -EZ.
0. Information about Schedule A (Form 990 or 990 -EZ) and its instructions is at www.irs.gov /form990.
Name of the organization
INDIANA WIND SYMPHONY INC
OMB No. 1545 -0047
2013
Employer identification number
35- 2029445
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1 ❑ A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).
2 ❑ A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)
3 ❑ A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).
4 ❑ A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the
hospital's name, city, and state:
5 ❑ An organization operated for the benefit of a college or university owned or operated by a governmental unit described in
section 170(b)(1)(A)(iv). (Complete Part II.)
6 ❑ A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).
7 ❑ An organization that normally receives a substantial part of its support from a govemmental unit or from the general public
described in section 170(b)(1)(A)(vi). (Complete Part II.)
8 ❑ A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)
9 0 An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross
receipts from activities related to its exempt functions — subject to certain exceptions, and (2) no more than 331/3% of its
support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part IIL)
10 ❑ An organization organized and operated exclusively to test for public safety. See section 509(a)(4).
11 ❑ An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the
purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section
509(a)(3). Check the box that describes the type of supporting organization and complete lines 11 e through 11h.
a ❑ Type I b ❑ Type II c ❑ Type III - Functionally integrated d ❑ Type III- Non - functionally integrated
e ❑ By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons
other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1)
or section 509(a)(2).
If the organization received a written determination from the IRS that it is a Type I, Type 11, or Type III supporting
organization, check this box ❑
g Since August 17, 2006, has the organization accepted any gift or contribution from any of the
following persons?
(i) A person who directly or indirectly controls, either alone or together with persons described in (11) and Yes I No
(iii) below, the goveming body of the supported organization?
(ii) A family member of a person described in (i) above?
(iii) A 35% controlled entity of a person described in (i) or (t) above?
h Provide the fo lowing information about the supported organization(s).
11 g(i)
11g(ii)
11g(iii)
(i) Name of supported
organization
(1) EIN
(iii) Type of organization
(described on lines 1 -9
above or IRC section
(see instructions))
(iv) Is the organization
in col. () listed in your
governing document?
(v) Did you notify
the organization in
col. (1) of your
support?
(vi) Is the
organization in col.
() organized in the
U.S.?
(vii) Amount of monetary
support
Yes
No
Yes
No
Yes
No
(A)
03)
(C)
(D)
(E)
Total
;
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990 -EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990 -EZ) 2013
P.O. Box 78592, Indianapolis, IN 46268 24 www.IndianaWindSymphony.org
2015 Arts Grant Application Request
Schedule A (Form 990 or 990 -EZ) 2013
latIM Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed o qualify under Part II.
If the organization fails to qualify under the tests listed below, please complete Part I.)
Section A. Public Support
January 14, 2015
Page 3
Calendar year (or fiscal year beginning in) ►
1 Gifts. grants, contributions, and membership fees
received. (Do not include any 'unusual grants. ")
2 Gross receipts from admissions, merchandise
sold or services performed, or facilities
fumished in any activity that is related to the
organization's tax - exempt purpose . . .
3 Gross receipts from activities that are not an
unrelated trade or business under section 513
4 Tax revenues levied for the
organization's benefit and either paid
to or expended on its behalf . . .
5 The value of services or facilities
furnished by a governmental unit to the
organization without charge
6 Total. Add lines 1 through 5 . . .
7a Amounts included on lines 1, 2, and 3
received from disqualified persons
b Amounts included on lines 2 and 3
received from other than disqualified
persons that exceed the greater of $5,000
or 1% of the amount on line 13 for the year
c Add lines 7a and 7b
8 Public support (Subtract line 7c from
line 6.)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
10,544
12,937
11,865
22,571
40,268
98,185
11,298
19,157
54,547
48,304
48,822
182,128
0
0
0
0
0
0
0
o
0
0
0
o
0
0
0
0
0
0
21,842
32,094
66,412
70,875
89,090
280,313
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
t `:'
M=
280,313
Section B. Total Support
Calendar year (or fiscal year beginning in) ►
9 Amounts from line 6
10a Gross income from interest, dividends,
payments received on securities loans, rents,
royalties and income from similar sources .
b Unrelated business taxable income (less
section 511 taxes) from businesses
acquired after June 30, 1975 _ .
c Add lines 10a and 10b
11 Net income from unrelated business
activities not included in line 10b, whether
or not the business is regularly carried on
12 Other income. Do not include gain or
loss from the sale of capital assets
(Explain in Part IV.)
13 Total support. (Add lines 9, 10c, 11,
and 12.)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
21,842
32,094
66,412
70,875
89,090
280,313
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
21,842
32,094
66,412
70,875
89,090
280,313
14 First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3)
organization, check this box and stop here ► D
Section C. Computation of Public Support Percentage
15 Public support percentage for 2013 (line 8, column (f) divided by line 13, column (f))
16 Public support percentage from 2012 Schedule A, Part 111, line 15
Section D. Computation of Investment Income Percentage
15
100 %
16
100 %
17 Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f)) . 17 0 %
18 Investment income percentage from 2012 Schedule A, Part 111, line 17 18 0 %
19a 33'x3% support tests -2013. If the organization did not check the box on line 14, and line 15 is more than 331/3 %, and line
17 is not more than 33'rr %, check this box and stop here. The organization qualifies as a publicly supported organization . ► 0
b 33'o% support tests -2012. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 331/3 %, and
line 18 is not more than 331/3 %, check this box and stop here. The organization qualifies as a publicly supported organization Is 0
20 Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions ► El
Schedule A (Form 990 or990 -EZ) 2013
P.O. Box 78592, Indianapolis, IN 46268 25 www.IndianaWindSymphony.org
2015 Arts Grant Application Request January 14, 2015
Schedule 0, Statement 3
Form: 990 -EZ
Page: 2
Line Number: Part III
Primary Exempt Purpose
INDIANA WIND SYMPHONY INC
35- 2029445
Primary Exempt Purpose
The presentation of artistic performances of significant music for band and wind ensemble to the Central Indiana community.
P.O. Box 78592, Indianapolis, IN 46268 26 www.IndianaWindSymphony.org
2015 Arts Grant Application Request January 14, 2015
* ** Form 990 Online Filers: Please fax completed and signed form to 866- 699 -3916
Form 8453 -E0
Department of the Treasury
Internal Revenue Service
Exempt Organization Declaration and Signature for
Electronic Filing
For calendar year 2013, or tax year beginning 01/01 , 2013, and ending
12131 20 13
For use with Forms 990, 990 -EZ, 990 -PF, 1120 -POL, and 8868
OMB No. 1545 -1879
2013
Name of exempt organization
INDIANA WIND SYMPHONY INC
Employer identification number
35- 2029445
Part ;1
Type of Retum and Return Information (Whole Dollars Only)
Check the box for the type of return being filed with Form 8453 -EO and enter the applicable amount, if any, from the retum. If you
check the box on line 1a, 2a, 3a, 4a, or 5a below and the amount on that line of the return being filed with this form was blank, then
leave line 1 b, 2b, 3b, 4b, or 5b, whichever is applicable, blank (do not enter -0 -). If you entered -0- on the return, then enter -0- on the
applicable line below. Do not complete more than one line in Part I.
la Form 990 check here P. ❑ b Total revenue, if any (Form 990, Part VIII, column (A), line 12) . . lb
2a Form 990 -EZ check here ' j b Total revenue, if any (Form 990 -EZ, line 9) 2b 89,063
3a Form 1120 -POL check here ► ❑ b Total tax (Form 1120 -POL, line 22) 3b
4a Form 990 -PF check here ® ❑ b Tax based on investment income (Form 990 -PF, Part VI, line 5) 4b
5a Form 8868 check here ► ❑ b Balance due (Form 8868, Part I, line 3c or Part II, line 8c) . . . 5b
Part ll
Declaration of Officer
6 ❑ I authorize the U.S. Treasury and its designated Financial Agent to initiate an Automated Clearing House (ACH) electronic funds
withdrawal (direct debit) entry to the financial institution account indicated in the tax preparation software for payment of the
organization's federal taxes owed on this return, and the financial institution to debit the entry to this account. To revoke a payment,
I must contact the U.S. Treasury Financial Agent at 1- 888 - 353 -4537 no later than 2 business days prior to the payment (settlement)
date. I also authorize the financial institutions involved in the processing of the electronic payment of taxes to receive confidential
information necessary to answer inquiries and resolve issues related to the payment.
❑ If a copy of this return is being filed with a state agency(ies) regulating charities as part of the IRS Fed /State program, I certify that I
executed the electronic disclosure consent contained within this return allowing disclosure by the IRS of this Form 990/990- EZ/990-
PF (as specifically identified in Part I above) to the selected state agency(ies).
Under penalties of perjury, I declare that I am an officer of the above named organization and that I have examined a copy of the
organization's 2013 electronic return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true,
correct, and complete. I further declare that the amount in Part I above is the amount shown on the copy of the organization's electronic
return. I consent to allow my intermediate service provider, transmitter, or electronic retum originator (ERO) to send the organization's retum
to the IRS and to receive from the IRS (a) an acknowledgement of receipt or reason for rejection of the transmission, (b) the reason for any
delay in processing the return or refund, and c) the date of any refund.
Sign
Here Signature of officer
Tom Howenstine, Treasurer
Date I Title
P-art,I II
Declaration of Electronic Return Originator (ERO) and Paid Preparer (see instructions)
I declare that I have reviewed the above organization's retum and that the entries on Form 8453 -EO are complete and correct to the best of
my knowledge. 111 am only a collector, I am not responsible for reviewing the retum and only declare that this form accurately reflects the data
on the return. The organization officer will have signed this form before I submit the return. I will give the officer a copy of all forms and
information to be filed with the IRS, and have followed all other requirements in Pub. 4163, Modernized a -File (MeF) Information for Authorized
IRS e-file Providers for Business Returns. If I am also the Paid Preparer, under penalties of perjury I declare that I have examined the above
organization's retum and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct, and
complete. This Paid Preparer declaration is based on all information of which I have any knowledge.
ERO's
ERO's signature
USe Firm's name (or
Only address and ZIP Vie.
Date
Check if
also paid
preparer
Check if
self -
employed ❑
ERO's SSN or PTIN
EIN
Phone no
Under penalties of perjury, I declare that I have examined the above return and accompanying schedules and statements, and to the best of my knowledge
and belief, they are true, correct, and complete. Declaration of preparer is based on all information of which the preparer has any knowledge.
Paid
Preparer
Use Only
Print/Type preparer's name
Peparer's signature
Date
Check ❑ if
self- employed
PTIN
Firm's name ►
Firm's address •
For Privacy Act and Paperwork Reduction Act Notice, see back of form. Cat. No. 366060
Firm's EIN •
Phone no.
Form 8453 -EO (2013)
P.O. Box 78592, Indianapolis, IN 46268 27 www.IndianaWindSymphony.org
2015 Arts Grant Application Request January 14, 2015
Exhibit "F"
List of the Grantee's board of directors and
officers
P.O. Box 78592, Indianapolis, IN 46268 28 www.IndianaWindSymphony.org
2015 Arts Grant Application Request January 14, 2015
President: Jan Schreibman
Jan is a music therapist specializing in pediatrics, traumatic brain injury, and high
risk maternity. She worked for Indiana University Health from 1999 to 2012 and
was instrumental in establishing the music therapy program for the healthcare
system. Jan currently is an adjunct professor of music therapy at IUPUI and is a
consulting music therapist with Positive Pathways. She has presented at music
therapy and nursing conferences nationwide. Jan earned her B.S. in music and
psychology from Indiana University/Purdue University Fort Wayne and her
equivalency and Master's Degree in music therapy from Western Michigan
University. She also performs in the flute section of the IWS.
Immediate Past President: Denise K Pierce (Effective December 20, 2013)
Denise is the President of DK Pierce & Associates, Inc., a strategic marketing
consulting firm located in Zionsville, IN, with satellite offices in six other states. Her
company provides product development and commercialization consulting to
Fortune 100 biopharmaceutical and medical device companies across the US and
globally. Denise obtained a Bachelor's Degree in Biology and secondary
concentration in Business Management from Fairleigh Dickinson University. Denise
also is a performing member of the IWS, in the flute section.
Treasurer: Thomas Howenstine
Tom is a retired Certified Public Accountant with over 30 years' experience in
public accounting and as a Chief Financial Officer (CFO) for a private corporation
and also for a division of a publicly held national corporation.
Secretary: vacant
Ed Engledow
Ed is Chairman of Engledow Group - an 80 year old Indianapolis based horticultural
services firm. While he does not play in IWS, he is a musician (trumpet) and is
involved in various initiatives promoting music education for youth.
Flora Garrison
Flora works for the Indiana Department of Workforce Development as a Grant
Accountant, managing Federal grant portfolios for the regional unemployment
offices across the state. She is a founding member of the IWS Board of Directors as
well as a playing member of the ensemble. She volunteers annually with the
Mozelle Sanders Dinner at Thanksgiving and with numerous organizations
throughout the remainder of the year. Flora holds an M.B.A. from Indiana Wesleyan
P.O. Box 78592, Indianapolis, IN 46268 29 www.IndianaWindSymphony.org
2015 Arts Grant Application Request
University.
Don Poulsen
January 14, 2015
Don serves as Vice President of Business Operations for Safis Solutions, a
regulatory compliance consulting organization for life science companies. Sixteen
of Don's nearly 30 years of experience in engineering have been within the
healthcare and life- science industries. Don earned two B.S. degrees, one in
Mathematics and the other in Chemical Engineering, from the University of New
Mexico. He earned his M.S. in Petroleum Engineering from the University of
Oklahoma. Don also performs with the IWS.
Liz Leatherberry
Liz serves in the role as Director of Bands for Zionsville West Middle School, and
obtained her Bachelor's Degree in music education from Butler University School of
Music. Liz provides the Indiana Wind Symphony with insights into outreach to
youth specific to music engagement. She also performs with the IWS, in the clarinet
section.
Jim Ittenbach
Jim Ittenbach launched Strategic Marketing & Research, Inc. (SMARI) in 1983, a
research consulting firm. Mr. Ittenbach, with broad based experiences in a variety
of businesses and industries, now serves as the company's cornerstone in
positioning SMARI as a provider of marketing consulting services; supported by
custom designed primary research. With a long history of serving on the board of a
variety of organizations, Jim currently serves on the IWS board as well as the Ball
State Miller College of Business Marketing Advisory Committee.
Ex- Officio: Charles Conrad, IWS Music Director
Charles P. Conrad is the founder and music director of the IWS since its inception in
1997.An Indianapolis native and current Carmel resident, Dr. Conrad has
committed his educational and performance career to the study and performance
of music in Indiana. He graduated from Arlington High School and attended the
Indiana University School of Music, where he received a Bachelor's degree in
Trumpet Performance. He earned the first Master's degree in Conducting ever
granted by Butler University and a Doctorate in Conducting from Ball State
University.
P.O. Box 78592, Indianapolis, IN 46268 30 www.IndianaWindSymphony.org
2015 Arts Grant Application Request January 14, 2015
Exhibit "G"
Year End Report from the City of Carmel Arts
Grant from 2013
P.O. Box 78592, Indianapolis, IN 46268 31 www.IndianaWindSymphony.org
2015 Arts Grant Application Request January 14, 2015
Exhibit "G"
Year End Report from the 2014 Cannel Arts Grant
Name of Organisation: Indiana Wind Symphony, Inc.
Grant award amount for 2014: 511,135.00
DESCRIPTION OF THE USE OF THE GRANT FUNDS:
A) Bring a major soloist to perform with the 1WS
For the September 27, 2014 concert, the 1WS had Kenneth sin to perform. He is a one of the
world's leading classical saxophonists. The cost to bring in Mlr.was 52.551.41. Below is the
program write up from the concert.
About the Soloist
A rangfh 't'!iq
4, widely sea:,, —vstl as ore of the
ssOchri lesslaq classical suoFhoaists. lie burst no
the sxnc in 19% dim winning the pons. tigio.ut how
York Attica International Maid, ti.trieh ro+.:l tJ in
an acclaimed debut rented et Corn ko Ilan. TIE
Arc< Avrud Ifire the Is at5(attl Altirta:e for
hilcellenee led to smother Carnegie Nail
rsirfbXntares items arc but tea of the multhude of
awards heat Tsc bra verified in leas tM :t Rol
decades. In thrd time, ha Iu sokiol far tortstty.
tr Ming ro fire rcorinee s In the lvr:ee5s. Ilk
ytpe:uzroxc ittrhxk , etlb entarnv With the Des
Moines Symphony, !Jailed 4:erx.y NIPly H.Atal, Slatxnia Army [land. to
, rmtmitu It and ofltsthal fSpet14. eta Thsittnd Philharmonic aehettr,, rand the
Hang. Kona 5iatmtkc'tn.
has a:rn an Kliw remti li)4 midst. Ile reltus d Ins first CD nt age V. tad
h tfxotpaFtsyy now it►tuLs twelve tele es,, with uutre is crrxsa As are
advocate for new music, 'fse tuts had moot chill 30 •s xks dedicated (V hita by
notable nre4eetToCIS from remind the atsrkd, iwJulia ; Amnia= Sohn Cbuthtm
an Walter Etxnteyb Leis Serrano Alatoon ntSwine Guy Loran- oetFrance and
Pits Swe,s g8HetCiunl,
Kenneth 'I hokls *loco front @K 17rtircrsir3,r of t6inn1s. Ch.^tr,RtsC1t- 1111X111.1
I "NIA). lemma IJtrisVr,Ity lfl \t. \I \t,. =.,i Artj Di:plantn*, and the Iton Ksts
Aerators} tin Performing Art:. ttc sans the !Teat suato)ltorritt tp reeco -c rte
presi*ius Artist Diploma from rift 11731131111 k'e(itmsity Sited of 1Ic^ti .
'Panay. Ts: is the Professor of tiauapbree:u the Unistrslty of knot. President.
Ekes of the lynx! Aztericss Saxophone Alliance. and Vice Presidsct of the
Irramui nst 1am)VII >IIt Committee.
As for laic ounleol 0411, the Sastrrs'wme knout ;whops snit' it better stn
;utyou "'rite tnrc magic of rstnsic is to tnlse a series of Sat bless ce is picot of
roper um: tins them ban rem caul IMIkt entities that nim7n is and kr:mdse.
An; ..Kenneth Ttie is the 'master es,g,ician; "
page 1
P.O. Box 78592, Indianapolis, IN 46268 32 www.IndianaWindSymphony.org
2015 Arts Grant Application Request January 14, 2015
Year End Report from the 2014 Carmel Arts Grant
B) Host the Second Annual Carmel Festival of Bands
The Festival of Bands has been scheduled for September 18 and 19, 2015. The Friday portion of
the Festival will consist of several of the bands performing across from Bub's Restaurant in the
heart of The Cannel Arts District. On Saturday the main concerts will be held on the Center for
the Performing Arts green spare, immediately following the Farmers Market, and will include
approximately 7 bands in addition to the Indiana Wind Symphony. The expenses to date are
S I,150.00. The additional funds will be used for payments to the other bands, travel expenses.
advertising, security, etc. The total budget for this event is 530,000.00. The difference ber,veen
the funding from the remainder of this grant, which is 57,434.00, will be covered by
sponsorships from Carmel and Indianapolis companies.
P.O. Box 78592, Indianapolis, IN 46268 33 www.IndianaWindSymphony.org
Company ID Number: 663014
To be accepted as a participant in E- Verify, you should only sign the Employer's Section
of the signature page. If you have any questions, contact E- Verify at 888 - 464 -4218.
Employer Indiana Wind Symphony, Inc.
Thomas Howenstine
Name (Please Type or Print)
Electronically Signed
Title
04/16/2013
Date
Signature
Department of Homeland Security — Verification Division
USCIS Verification Division
Name (Please Type or Print)
Electronically Signed
Title
.4/16/2013
Signature
Date
Information Required for the E- Verify Program
Information relating to your Company:
Company Name:Indiana Wind Symphony, Inc.
Company Facility Address: 10 2nd Ave N.E.
`Carmel, IN 46032
Company Alternate
Address:
P.O. Box 78592
Indianapolis, IN 46278
County or Parish:
HAMILTON
Employer Identification
Number: 135202944
Page 12 of 131E-Verify MOU for Employer 1 Revision Date 09/01/09 www.dhs.gov /E- Verify
Company ID Number: 663014
co,
IIIIIII
North American Industry
Classification Systems
Code: 711
Administrator:
Number of Emplo ees: 1 to 4
Number of Sites Verified
for:
1
re you verifying for more than 1 site? If yes, please provide the number of sites verified for
in each State:
INDIANA
1 site(s)
Information relating to the Program Administrator(s) for your Company on policy
questions or operational problems:
Name:
Telephone Number:
E-mail Address:
Name:
Telephone Number:
E-mail Address:
Denise 1: Pierce
(317) 418 - 7879
dkpierce@dkpierce.net
Thomas G Howenstine
(317) 796 - 8457
tomlhowen@aol.com
Fax Number:
Fax Number:
(217) 769 - 3506
Page 13 of 13 I E-Verify MOU for Employer l Revision Date 09/01/09 www.dhs.gov/E-Verify