210210 07/02/2012 CITY OF CARMEL, INDIANA VENDOR: Page 1 of 1
ONE CIVIC SQUARE CARMEL REPERTORY THEATER CHECK AMOUNT: $65,000.00
CARMEL, INDIANA 46032 484 E CARMEL DRIVE
Po Box 162 CHECK NUMBER: 210210
CARMEL, IN 46082
CHECK DATE: 7/2/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1401 4355100 062812LDC001 65000.00 GRANT FUNDING
Invoice 062812LDC00I from Carmel Repertory Theatre Page 1 of 1
Carmel Repertory Theatre
484 E Carmel Drive
Box 162
Carmel, IN 46032
City Of Carmel Invoice 062812LDC001
City Hall
1 Civic Square Invoice Date 06/28/2012
Carmel IN 46032
Due Date 06/28/2012
Item Description Unit Price Quantity Amount
Product City Grant 65000.00 1.00 65,000.00
Subtotal 65,000.00
Total 65,000.00
Amount Paid 0.00
Balance Due $65,000.00
http:/ /www.aynax.com/printlnvoice.php 7/2/2012
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D
AR TS G RA N TPROGRAM
AGREEMENT
This Grant Agreement (herein referred to as "Agreement entered into by and between The City
of Carmel (the City) and, (the Grantee), is executed pursuant to the
terms and conditions set forth herein. consideration of those mutual undertakings and
covenants, the parties agree as follows:
1. That on b half of Grantee, a not for -profit corporation, I,
1_Cc _fr �C� y n an authorized representative of Grantee, am
applying a City of Carmel "Grantor Arts Grant.
2. Purpose of this Grant Agre `The purpose of this Agreement is to enable the
City to award a grant of Dollars and oD Cents ($XXX,XXX,XXX) 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. A 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 (EXHIBIT E);
6. A list of the Grantee's board of directors and officers listed (EXHIBIT F).
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 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 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.
2
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 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 -7.3. The Grantee agrees
to provide documentation to the City that he /she /it has enrolled and is participating in
the E -Verify program. Additionally, the Grantee is not required to participate if the
Grantee is self employed and does not employ any employees.
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 officers, employees,
contractors, subcontractors and/or agents are employees of City. The 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
3
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:
"Grantee
Printed e of Officer: G �\S k)(� Title:
Date:
CITY OF CARMEL "Grantor"
By:
James Brainard, Mayor
Date:
ATTEST:
Date: I 0 -3�07 1
If you have any question concerning the City of Carmel's 2012 Arts Grant Program, grant writing, guidelines or application materials, contact:
Sharon Kibbe, City of Carmel, One Civic Square, Carmel, IN 46032, Phone: 317 -571 -2483, skibbeQcannel in.gov
4
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Carmel Repertory Theatre, Inc. -8-
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Si'�v� ++ts..�...aua+:.. a...P'w.aw+i..3 �w.3dP'rw ..11 °'L`= h1" 5 4 +i-�.i�' +fwawii+ rass
The Carmel Repertory Theatre, Inc. is requesting a grant of $180,000.00 to
f develop the Infrastructure of the Theatre group that Is based in the new
Carmel Fine Arts Center. This includes monies for the Rep as well as
AACT
Outcomes /Objectives
To develop the infrastructure to ensure long term growth and viability.
To become the primary organization to give Carmel residents the ability to
utilize the Arts infrastructure they have enthusiastically supported both
vocally and financially.
o To develop outreach programs that fill the void in arts education cuts in
local schools.
To expose the citizens of the City of Carmel the finest examples of live
performing arts.
To increase awareness in programs available.
To form strong community bonds between Carmel Repertory Theatre, Inc.
and local business leaders and Professionals.
a Develop relationships with other local performing arts groups.
To develop as a permanent home for AACTFest.
Evaluation
Evaluation of success will be measured in seven ways.
Successfully incorporate The Rep Programs into The Center for the
(s
Performing Arts Center.
Developing a Theatre program for area school children.
1 m Increase the number of audience members who participate in Carmel
Repertory Theatre, Inc. productions.
C Number of area volunteers who participate in Carmel Repertory Theatre,
l Inc. productions.
I Successfully developing relationships with all the other performing Arts
I groups utilizing the facilities to ensure the best outcome for all groups.
o Develop AACTFest Committee.
a Secure outside funding for AACTFest 2013.
i
EXHIBIT B
Estimated 2012 Budget Carmel Repertory Theatre
Jan -12 Feb -12 Mar -12 Apr -12 May -12 Jun -12 Jul -12 Aug S 1 2 O 1 2 N ov -1 Dec -12 2012 -2012
n?;4 •g.cw"S F. '?;f 3"h�s i :a t +_:I
Revenue r Y k, 4k� `r �c.,s w w: `a� �?ah 7 x s 3 t?aa'I E,"r�c.�irw`eE: ae i Y r L
Ticket Sales 15000 27500 50000 10000 50000 20000 172500,`
Concessions r0
Advertising 250 500 500 100 500 "'dc 1850
Sponsorships 500 1200 500 500 1200x,3900
Rental Income 200 200 200 200
W
Fundraisers 1000 10000 2000 �n13000
Grants 130000 20000
Individual Donations 2000 2000 2000 2000 2000 2000 2000 2000 2000 2000 2000 20002%1000
Corporate Donations 1000 1000 1000 1000 1000 1000 2000x;8000:3
Total Revenue 1 3200 18750 3200 1 162200 2000 13000 2000 54000 14200 360,0 52000, 45900:;.3'4050
Expenses
Payroll 1500 1500 1500 1500 1500 r 1500 1500 1500 1500 1500 1500 1500 r� '18000"
Payroll Taxes
Advertising /Promotion 2000 2000 2000 2000 2000 2000 2000 2000 2000 2000 2000 2000 24000,
Printing 1500 1500 1500 1500 1500 1500 1500 1500 1500 1500 1500 1500
Bank Fees 10 10 10 10 10 10 10 10 10 10 10 10 Y 'r120
Interest Expense
Credit Card Fees 100 100 100 100 100 100 100 100 100 100 100 100
Dues and Subscriptions 50 50 50 50 50 u.250�
Royalties 7000 300 5000 3000 3000
Warehouse 2500 2500 2500 2500 2500 2500 2500 2500 2500 2500 2500 2500f" ,30000;.
Venue Rent 15000 15000 1 1000 30000 15000 30000 15000 w;1,21;000:
Insurance 1271 1271 1271 1271
Office Supplies 50 50 50 50 50 50 50 50 50 50 50 50
Postage 300 300 300 300 300 300 300 300 300 300 300 300
Professional Fees 250 250 250 250 250 250 250 250 250 250 250 250 x;;3000.`
Repairs Maintenance 300 300 300 300 300 300 300 300 300 300 300 300' y3600
Laundry/Housekeeping 100 100 100 100 100 100 100 100 100 100 100 100
Utilities /Phone 1250 1250 1250 1250 1250 1250 1250 1250 1250 1250 1250 1250 Vic;' ;;15000'1
Theatrical Supplies 2000 10000 250 2000 250 5000 250 2000 250 1500 250 2000 25750"
Production Expense 10000 10000 1000 18000 10000 18000 10000
Misc. 100 100 100 100 100 100 100 100 100 100 100 100
Total Expense 13281 51960 10210 38581 15210 16960 11531 62960 35210 15781 58210 37010
f� w.Fi y f #.ixY 1� t.r,7�- i:+ss �bT.,
=,Profit, Loss 1008,1. r x. 3321,0 7010. s, 12361,9,, 13210 3960,. x -896US .210,1,0.., 1218,1, a wr =62 �'x� <7, 14 6
a 1 0 e,�. 88 ..u_.
'b ,SM 1 0'.x. <"Aw Ab Q) 40 r.�
EXgdiBi'd' C
Mate of Indiana
Office of the Secretary of State
CERTIFICATE OF INCORPORATION
of
CARMEL REPERTORY THEATRE, INC.
I, TODD ROKITA, Secretary of State of Indiana, hereby certify that Articles of Incorporation
of the above Non Profit Domestic Corporation have been presented to me at my office,
accompanied by the fees prescribed by law and that the documentation presented conforms to
law as prescribed by the provisions of the Indiana Nonprofit Corporation Act of 1991.
NOW, THEREFORE, with this document I certify that said transaction will become effective
Friday, April 24, 2009.
In Witness Whereof, I have caused to be
STA affixed my signature and the seal of the
,•e State of Indiana, at the City of Indianapolis,
`I b April 24, 2009.
s
a
®®gy�pp
b
s X1 0
0. TODD ROKITA,
SECRETARY OF STATE
e a
2009042700211/2009042704143
ARTICLES OF INCORPORATION FOR A NONPROFIT CORPORATION TODD ROKITA
SECRETARY OF STATE
State Form 4162 (R1011 -03) Corporate Form No. 3641 (October 1984) CORPORATIONS DIVISION
f i Approved by State Board of Accounts 1995 302 W. Washington St., Rm. Eo18
�••,?6ie Indianapolis, IN 46204.
Tel ephone �317) 232-6576
NOTES: 1. Norprofd corporations must qualify with the Internal Revenue Service and the Indiana Department of Indiana Code"23- 17 -3 =2
Revenue. It is strongly suggested you do not corrplete or file this form before contacting both agencies.
2. Article VIl must be completed appropriately. Please see (1) above. FILING FEES 530.00
p.
I'-
INSTRUCTIONS: 1. Use 8 112 "x 11 "white paper for attachments.
2 Present original and one (1) copy to the address in the upper right corner of this form.
3. Please type or print.
4. Please visit our office on the web at www.sos.in.gov
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''AcVq, execute the following Articles of
Incorporation.
Na me of the Corporation: (the name must inci ude the word Corporatior Incorporate Lmrte ompany' prone o the a revs ions therso
Carmel Repertory Theatre, Inc.
Principal Office: The address of the principal office of the Corporation is:
Post office address City ZIP code
484 E Carmel Drive #162 Indiana
Carmel 46032
11161 V
The purposes for which the Corporation is formed are:
Carmel Repertory Theatre, Inc.'s vision is to provide the best possible live theatrical performances for the citizens of the City of Carmel. Furthermore,
we are developing Carmel Repertory Theatre, Inc. to be the resident theatrical company for the new Carmel Performing Arts Center.
Carmel Repertory Theatre, Inc. has agreed upon the following list of core values /visions that we feel represent the needs and wants of the community:
Provide the best in live theatrical entertainment to include acting, dance, and music
Provide family based entertainment throughout the year for the City of Carmel
To be open in all aspects so that the area citizens can be involved
Provide open books for all financial dealings to ensure good stewardship of all finances
To this end, we have gathered an elite core group of individuals to lead Carmel's live dramatic Theatre into the next phase of development. Carmel
Repertory Theatre, Inc. embraces a collaborative effort and has been enthusiastically received by the local arts and educational community. We will
bring instant stability and long term commitment with these individuals.
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
rx mutual benefit corporation (all others).
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
Carmel
I hi
j Indicate if Corporation wil.' Have members:
ED Yes No
(Continued on A- reverse side)
e
Name(s) and address(es) of the incorporator(s) is/are as follows:
Name Number and Street or Building City State ZIP code
Larry Creviston 179 Aspen Way Carmel IN 46032
Carlo Nepomuceno 13871 Forum Meadows Dr Carmel IN 46033
Rachael Whitlock 842 Spruce Drive Carmel IN 46033
Refer to Indiana Code 23- 17 -22 -5 for permitted activities following Dissolution.
To a successive organization with the same general purpose, or then to the City of Carmel for
disbursement as they deem most beneficial.
Please note this section must be completed.
THIS DOCUMENT MUST BE SIGNED BYALL INCORPORATORS.
In witness whereof the undersigned incorporator(s) of said Corporation execute(s) this document, and verify(ies) subject to penalties of
perjury that the f q twined her In and true this day of 20
Signature Printed name
Larry Creviston
Signature'/ J Prig +P =^gyp
Carlo Nepomuceno
S;cnar!ir_ °nnre i nam
I nis insirur, .err was pr pareG Dy. v`.f4 el
State
I Z!: code
79 AsDei+ VVav Carmel i IN j 46032
INDIANA SECRETARY OF STATE
RECEIPT
Receipt Number: 1693840
Payment Entry Number 615310
INDIANA SECRETARY OF STATE
BUSINESS SERVICES DIVISION
302 West Washington Street, Room E018
Indianapolis, IN 46204
(317) 232 -6576
SUSAN CREVISTON
179 ASPEN WY
CARMEL, IN 46032
Receipt Date: 04/27/2009
Receipt Status: Closed
The following details your transaction(s) with the Secretary of State's Office
Payment Submitted:
Payor Payment Type Reference Comment Amount
SUSAN CREVISTON Check/ MO 2802 $30.00
Total Amount $30.00
Transactions posted to this receipt:
Entity Name Type of Filing Amount
CARMEL REPERTORY THEATRE, INC. Non Profit Domestic Corporation $30.00
Articles of Incorporation
Total Amount $30.00
Date Printed 04/27/2009 Prepared By LaDonna Price Page 1 of 1
3EC;RETARY OF J' TATS
STATE OF INDIANA
TODD ROKITA
SECRETARY OF STATE
Dear Entrepreneur.
The key to future economic prosperity and growth is a strong
Indiana business community. Congratulations on being a part
of our state's future!
Your business entity document (s) are filed and have been File your Business Entity
approved by the Indiana Secretary of State. For your records, Report online and enjoy the
a copy of your Certificate and receipt are included.
benefits of Service on Your
You are now well on your v. to establishing a business in Indiana Schedule...
and although you have filed the appropriate documents with the
Office of the Secretary of State, you will need to contact the following
agencies to complete your new business requirements: A recent online survey of 1,213
D Internal Revenue Service Registration: Business must obtain an Online Business Entity Report Filers.
revealed SOS customers are satisfied
Employer Identification Number. You may obtain this number by
telephone or by filing Form SS -4 with the IRS. Employer Identification with this online service:
Number (606) 292 -5467. IRS Information Number (800) 829 -1040.
Forms (800) 829 -3676. Or write: IRS, Cincinnati, OH 45999. 94 percent of online filers
completed the process in
less than IS minutes
Indiana Department of Revenue Contact the Indiana Department of
Revenue Taxpayer Services Division, Withholding -(317) 233 -4016, 94 percent said it was easy
Sales Tax (317) 233 -4015, Corporate Tax and General Information to file online
(317) 615 -2662. Or visit Room N -105 Indiana Government Center North,
300 North Senate Avenue Indianapolis, IN. 46204 (west of the State House).
\\.in.aovldor 95 percent said they would
file online again
Department of Workforce Deve %omen Businesses with employees have
various responsibilities. Learn about these by obtaining an Employer's Desk Guide
by contacting the DWD at (317) 232 -7436 or (800) 437 -9136. \\\\.in. -o\;d\\d Comments from satisfied users
Once a business entity has formed in the state of Indiana or received a Great job! Really makes this easy.
Certificate of Authority, it has an ongoing responsibility to file regular Business Thanks!
Entity Reports to the Secretary of State. These reports must be filed every year
by nonprofit organizations and every two years by for profit businesses during
the anniversary month of the organization's formation or Certificate of Authority. I have never had a report so easy
to file. I'm new at my job and this
I strive to make this process as easy and efficient as possible, so you can spend made me look good.
more time focu n on the vitality of your new business. Visit www.sos.IN.gov
today t rn abo ervice on Your Schedule! Good Luck! I think you have done an excellent job in
making this task very easy.
cerely,
*For more information
about an accesslndiana
subscription, please visit
www.subscribe.IN.gov.
Todd Rokita
Indiana Secretary of State
THE STATE HOUSE, 200 WEST WASHINGTON STREET, INDIANAPOLIS, IN 46204
(317) 232 -6576
EXHIBIT I)
Y 0 7 20 aWicyer Identification fir:
Dates 26
17053117016039
CAS RSPIRTMY TEXURE MIC Coantaat Person a
4684 B CNOM Day CMMM 162 JOW C xxon n* 31217
L7JSM, IN 86032 Contact Telephone Number:
(877) 029 -5590
Accounting Period a2dings
Dear 31
Public Charity status:
170 (b) (1) (A) .('vi)
Form 990 Bequireis
Yes
affective Date of Rxemption.
April 241, 2009
Contribution Deductibility:
Yeas
Addendum Applies:
Wo
Dear Agpliaanta
We are pleased to into= you that upon review of your application for tau
eft status we have determined that you are emap from Feral ianc:o n tax
under section 501(a) (3) of the Zntaernaal Revenue Code. Coutribatioms to you a�
deductible under Section 170 of the Code. You are aalaaao qualified to receive
taax deductible beoMte, devisee, transfers or gifts undez Section 2065, 2108
or 2522 of the Code. Because thla letter could help resolve nay question
regarding your eft statue,, you should keep it in your permanent records..
Osganiaaaticne eft undaer sedtioan 501(a) (3) of the Code are further elaselfied
as either public charities or private foundations. We determined that you ante
�L public charity um%r the Code section (s) lusted in this heading of thiO
letter.
Plea see one' sod Publication 4221 -PC, Compliance (tide for 501(c) (3) Public
p, Charities, for sow helpful ii4ormation about your responsibilities as an
E7 eft OrgaanISM& ei.
Letter 947 (DOMM
e e
r
e
c
t
V
Yeti 947 (I
Indiana Department of Revenue Check if: []Change of Address
NP -20 Indiana Nonprofit Organization's Annual Report El Amended Report
State Form 51062 For the Calendar Year or Fiscal Year Final Report: Indicate
(R4 t 3-11) Beginning Janua 2011 and Ending 2011 Date Closed
MM /DD /YYYY MM /DD /YYYY
Due on the 15th day of the 5th month following the end of the tax year.
NO FEE REQUIRED.
Name of Organization Telephone Nwl]ber
Carmel Reperto Theatre, Inc. 317- 767 -3973
Address County Indiana Taxpayer Identification Numbei
484 East Carmel Drive Box 162 Hamilton 0138403260
City State Zip Code Federal Identification Nwnber
Carmel 1 IN 46032 -2812 26- 4324639
Printed Name of Person to Contact Contact's Telephone Nwnber
Patricia A. Bigham 317 -409 -1029
If you are filing a federal return, attach a completed copy of Form 990, 990EL or 990PF.
Note: If your organization has unrelated business income of more than $1,000 as defined under Section 513 of the Internal Revenue Code, you
must also file Form IT 20NP.
Current Information
1. Have any changes not previously reported to the Department been made in your governing instruments, (e.g.) articles of incorporation,
bylaws, or other instruments of similar iunportance? If yes, attach a detailed description of changes.
2. Indicate number of years your organization has been in continuous existence. Three
3. Attach a schedule, listing the names, titles and addresses of your current officers.
4. Briefly describe the purpose or mission of your organization below.
Carmel Repertory Theatre, Inc. seeks to develop, engage, and challenge audiences and volunteers through the
expansion. of theatre education and performance for both artist and the greater Carmel community.
—kdecAatx, under the penalties perfur t l have examined this return, including all attachments, and to the best of my knowledge and belief, it
is true, co tpl t corre
Treasurer
Signature of Officer or Trustee Title Date
Patricia A. Bigham 317 -409 -1029
Name of Person(s) to Contact Daytime Telephone Number
Important: Please submit this completed forth and /or extension to:
Indiana Department of Revenue, Tax Administration
P.O. Box 7147
Indianapolis, IN 46207 -7147
Telephone: (317) 233 -4015
Extensions of Time to File
The Department recognizes the Internal Revenue Service application for automatic extension of time to file, Form 8868. Please forward a copy of
your federal extension, identified with your Nonprofit Taxpayer Identification Number (TID), to the Indiana Department of Revenue, Tax
Administration by the original due date to prevent cancellation ofyoursales tax exemption. Always indicate your Indiana Taxpayer Identification
number on your request for an extension of time to file.
Reports post marked within thirty (30) days after the federal extension due date, as requested on Federal Form 8868, will be considered as timely
filed. A copy of the federal extension must also be attached to the Indiana report. In the event that a federal extension is not needed, a taxpayer may
request in writing an Indiana extension of time to file from the: Indiana Department of Revenue, Tax Administration, P.O. Box 7147, Indianapolis,
IN 46207 -7147, (317) 233 -4015.
If Form NP -20 or extension is not timely filed, the taxpayer will be notified by the Department pursuant to I.C. 6- 2.5- 5- 21(d), to file Form NP -20. If
within sixty (60) days after receiving such notice the taxpayer does not file Form NP -20, die taxpayer's exemption from sales tax will be canceled.
IQ�116 II��I 611119161 II�II II��I II�II II�01 IIS91 �IIII 10111 �I�I 191
25411111594
s
NP -20A Indiana Department of Revenue
Eh State Form 51064 Nonprofit Application for
(R2 /10 -10) Sales Tax Exemption
NO FEE REQUIRED.
Part I
Full Name of Organization This Area for Department Use Onl
Carmel Repertory Theatre, Inc. Type
Street Address
484 E. Carmel Drive #162
City, State, Zip Code County
Carmel, In 46032 -2812 Hamilton Indiana Taxpayer Idenbfication Number Federal Identification Number
Date Incorporated I Enter the Month Your
or Formed: 2114/20091 Accounting Period Ends: 12/31/11 0138403260 26- 4324639
What is the predominant purpose of your organization?
to develop, engage, and challenge audiences and volunteers through the expansion of theatre edu
Part II
1. Indicate type of qualifying organization named in I.C. 6- 2.5 -5 -21 (Check only one box In A, B, or C).
.F A. Organized specifically as a:
(1) Church E3 (3) Monastery/Convent (5) Departmental Use Only El (7) Pension Trust
It (2) Hospital (4) Parochial School (6) Labor Union (8) Veteran's Group
B. Organized and operated for one of the following reasons:
(1) Religious I� (3) Scientific (5) Educational (7) VEBA
(2) Charitable JJ�J (4) Literary (6) Civic (8) Student Co- operative Housing
C. Organized and operated as one of the following entities:
(1) Fraternal (including fraternal (2) Departmental Use Only (4) Business Association
beneficiary societies) (3) Business League
2. Does your organization sell or rent personal property for more than 30 days in a calendar year? No Yes
3. Is this organization a local affiliate of a national or parent organization? No Yes —If so enter name and address of national or parent
organization.
4. Has this organization previously applied for Indiana exempt status? No Yes -If so, please indicate previous registration number.
0138403260
IMPORTANT Attach the following documents.
Copy of federal determination letter (ruling from the Internal Revenue Service) showing the section of the Internal Revenue Code exemption
�r from federal tax has been granted. To obtain a copy of federal determination letter or to apply for federal exemption, contact the IRS at:
1- 877 -829 -5500
Mail To:
Indiana Department of Revenue
Tax Administration
P.O. Box 7206
Indianapolis, IN 46207 -7206
(317) 232 -0129
I declare under the penalties of perjury that am authorized to sign this application on behalf of the above organization and 1 have examined this
application, including the accompanying statements, and to the best of my knowledge it is true, correct and complete.
t Name of Person(s) to Contact Daytime Telephone Number(s) Email Address
Patricia A. Bigham 317 409 -1029 crtbigham2 @gmail.com
Signatur Title Date Si ned
j 4 a Treasurer p2�,�� �o (cg,
Indiana De�rtrrtent of Revenue
Indiana Government Center Notttt IndWsepofis, Indiana 46204
Indlens Nonprofit Sala Tax Exemption Certffiaxtte
Forst NP-1 (Mis certificate may not be used to collect sales tax)
State Foam 5 1063
(4-03) TMD: 0138403260-
-L®C: 000
•Cotes VD: 1000072695291
Wood: 06/04/2010
MEN
CARKM REPERTORY TIEEATRE INCORPORATED
484 E CARM EL DR 162
CARMEIT IN 46032 -2812
Qagarisadon is only 40100111 from payment of sales tax on purchases for which t6e.orgaaiation.is granted exemption.
(Detach i ;e)
t Qualibin8 for sales tax exemption requires Ste completion and filing Or an appilotuion i'bnn peace by the Wiens Deparnnent of
Revenue. Tate tRAPOW tdendficatioat Plumber (M) above must be provided to ft miler Ifs are to be exempt from sales
WL 10 to tlttallly far Ww tax WOMOon, ta:ch Pmbaaee muse be used for PWPOM descrOwd in Information Bullelin k 10.
The TID must be used an Sales Tact Exam Codficate(ST- I o5) when malcing qualified purchases.
The fact that an organization is granted exemption fiem income tax by the federal governmeak or that it at one time wes granted such an
exemption by the State of Indiana, does not neeeesearily mean that a purchase made by a nonprofit organization is exempt from sales tax.
11041111mento ftr Stales Tau Raempt Pwvhmn by Notrproflt Organlzadons:
E
A. Purchases bye Nonprofit Organization for its Own Use:
I. In order to qualify for sales tax exemption on pure3sasoe a nonprofit organization, must satisfy the following
conditions:
(a) The organization must be named or described in IC. 6-- 2.5- 3- 2l(b). Organizations named or
deBMIW in this Code section are organized and operated exclusively for one or more of the
following purposes:
Civic Charitable Educational Fraternal
Literary Religious Scientific
(b) inchtded in the above general organizational categories ere the following specifically named
typos of nonprofit organizations:
Business Fraternities 1Nes Churches Convents
Labor Unions Licensed Hospitals
Monasteries Parochial Schools Pension Trusts
Shared Hospital Services Sororities Student Cooperative Housing
2. In orfr to qualify for Balsa tax exemption, purchases must be used for the same purposes for which the
noapmfit organlu lion is granted exemption.
3 Aw lk P*wte q/' &V m=Wkvdimyor,oroflcer of rice nonprofit organ ization,or
for eqy oLd w lrufdt+iattsr/ ae Rot ettlWe for 0molpfio Pumhases used for social purposes are never exempt.
D. Purchases by Nonprofit Organisation for Resale:
Purchases of tangible personal
property ptut:haeed for reesle by nonprofit organizations are eligible for sales tax exemption.
Vn{
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February 28, 2012
ti Larry Susan Creviston
Carmel Repertory Theater
Dear Larry Susan,
This letter is to inform you that the books of Carmel Repertory Theater have been thoroughly examined
and found to be in accordance with auditing and accounting standards. The tax return (form 990EZ)
was also examined and found to be accurate for filing. After examining both the books and the tax
return, It was proven that all activity was for the business related to the theater.
Sincerely,
JoEilen Ambuehl
Financial Auditor
Carmel Repertory Theater
t
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EXHIBIT E
Sikis h.
Carmel Repertory Theatre, Inc.
Financial statements
December 31, 2011
IM
Carmel
REPERTORY THEATRE
s ichxom
TABLE OF CONTENTS
INDEPENDENT ACCOUNTANTS' REVIEW REPORT 1
FINANCIAL STATEMENTS:
STATEMENT OF ASSETS AND
NET ASSETS MODIFIED CASH BASIS 2
STATEMENT OF REVENUE, EXPENSES, AND
CHANGES IN NET ASSETS MODIFIED CASH BASIS 3
NOTES TO FINANCIAL STATEMENTS 4 -6
Certified Public Accountants Advisors
kioc--v Members of American Institute of
Certified Public Accountants
8555 North River Road, Suite 300 Indianapolis, IN 46240
INDEPENDENT ACCOUNTANTS' REVIEW REPORT
To the Board of Directors of
Carmel Repertory Theatre, Inc.:
We have reviewed the accompanying statement of assets and net assets modified cash basis
of Carmel Repertory Theatre, Inc. (an Indiana nonprofit organization) as of December 31, 2011,
and the related statement of revenue, expenses and changes in net assets modified cash
basis for the year then ended. A review includes primarily applying analytical procedures to
management's financial data and making inquiries of Organization management. A review is
substantially less in scope than an audit, the objective of which is the expression of an opinion
regarding the financial statements as a whole. Accordingly, we do not express such an opinion.
Management is responsible for the preparation and fair presentation of the financial statements
in accordance with the modified cash basis of accounting and for designing, implementing, and
maintaining internal control relevant to the preparation and fair presentation of the financial
statements.
Our responsibility is to conduct the review in accordance with Statements on Standards for
Accounting and Review Services issued by the American Institute of Certified Public
Accountants. Those standards require us to perform procedures to obtain limited assurance
that there are no material modifications that should be made to the financial statements. We
believe that the results of our procedures provide a reasonable basis for our report.
Based on our review, we are not aware of any material modifications that should be made to the
accompanying financial statements in order for them to be in conformity with the modified cash
basis of accounting, as described in Note 1.
L c.P
Sikich LLP
Indianapolis, Indiana
March 29, 2012
317 842 -4466 [FAX] 317 577 -7724 www.sikich.com
Sikich LLP
CARMEL REPERTORY THEATRE, INC.
STATEMENT OF ASSETS AND NET ASSETS MODIFIED CASH BASIS
DECEMBER 31, 2011
ASSETS
CURRENT ASSETS:
Cash and cash equivalents 42,983
FIXED ASSETS:
Furniture and equipment 19,186
Accumulated depreciation (7,674)
Fixed Assets, net 11,512
54,495
LIABILITIES AND NET ASSETS
NET ASSETS
Unrestricted 54,495
See independent accountants' review report and accompanying notes to financial statements.
2
CARMEL REPERTORY THEATRE, INC.
STATEMENT OF REVENUE, EXPENSES AND
CHANGES IN NET ASSETS MODIFIED CASH BASIS
YEAR ENDED DECEMBER 31, 2011
REVENUE:
Contributions 37,425
Government grants 69,000
Program income 184,003
Special events 1,142
In -kind contributions 2,496
Interest income 8
Other income 725
Total Revenue 294,799
EXPENSES:
Facilities and equipment rental 131,819
Program expenses 73,504
Operations 32,236
Office expenses 1,155
Contracted services 10,167
Costumes 12,028
Travel and meetings 9,718
Depreciation 3,837
Total Expenses 274,464
CHANGE IN NET ASSETS 20,335
NET ASSETS, beginning of year 34,160
NET ASSETS, end of year 54,495
See independent accountants' review report and accompanying notes to financial statements.
R 3
CARMEL REPERTORY THEATRE, INC.
NOTES TO FINANCIAL STATEMENTS
DECEMBER 31, 2011
(VOTE 1 SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Nature of Business Carmel Repertory Theatre, Inc. (the "Organization was founded in 2009
and seeks to develop, engage and challenge audiences and volunteers through the expansion
of theatre education and performance for both artists and the greater Carmel community.
Basis of Accounting The Organization's policy is to prepare its financial statements on the
modified cash basis of accounting; consequently, certain revenues are recognized when
received rather than when earned and certain expenses and purchases of assets are
recognized when cash is disbursed rather than the obligation is incurred. These financial
statements are not intended to present the Organization's financial position and results of
operations in conformity with accounting principles generally accepted in the United States of
America.
Basis of Presentation The Organization is required to report information regarding its
financial position and activities according to three classes of net assets: unrestricted net assets,
temporarily restricted net assets, and permanently restricted net assets.
Net Assets The financial statements report amounts separately by class of net assets:
Unrestricted net assets Unrestricted amounts are those, which are currently available
by the Board for use in the Organization's activities.
Temporarily restricted net asset Temporarily restricted expendable amounts are
those, which are restricted by donors for specific purposes. As of December 31, 2011,
the Organization had no temporary restrictions on its net assets.
Permanently restricted net assets Permanently restricted amounts are those, which
are subject to donor imposed stipulations that require that they be maintained
permanently by the Organization. Generally, the donors of these assets permit the use
of all or part of the income learned on the related investments for general or specific
purposes. As of December 31, 2011, the Organization had no permanent restrictions on
its net assets.
Concentration of Credit Risk Financial instruments that potentially subject the Organization
to concentrations of credit risk consist principally of temporary cash investments. The
Organization places its temporary cash investments with financial institutions, which may at
times be in excess of the Federal Deposit Insurance Corporation (FDIC) limit of $250,000. At
December 31, 2011, the Organization had no significant concentrations of credit risk.
4
Carmel Repertory Theatre, Inc.
Notes to Financial Statements (continued)
Fixed Assets Furniture and equipment are recorded at cost or, if contributed, at the estimated
fair value at the date of the gift. The Organization capitalizes additions of fixed assets in excess
of $500 cost or fair value, if contributed. Depreciation of fixed assets is computed using the
straight -line method and based upon the estimated useful lives of the assets ranging from 5 to 7
years. Expenditures for fixed assets and for renewals or improvements which extend the
originally estimated economic life of the assets are capitalized. Expenditures for maintenance
and repairs are charged to expense when incurred. When an asset is retired or otherwise
disposed of, the cost and accumulated depreciation are removed from the accounts and any
gain or loss is included in the statement of revenue, expenses, and changes in net assets
modified cash basis.
Depreciation expense was $3,837 for the year ended December 31, 2011.
Contributed Materials and Services Contributed services are recognized as contributions if
the services (a) create or enhance non financial assets or (b) require specialized skills, are
performed by people with those skills and would otherwise be purchased by the Organization.
Contributions of tangible assets are recognized at fair value when received. The amounts
reflected in the accompanying financial statements as in -kind contributions are offset by like
amounts included in expenses or additions to fixed assets.
The Organization received contributed materials and professional services related to theatre
performances during the year ending December 31, 2011, with a fair market value on the dates
of the donations of $2,496.
Impairment of Long -Lived Assets The Organization evaluates long -lived assets for
impairment when circumstances indicate the carrying amount of an asset may not be
recoverable based on the undiscounted cash flows of the asset. If the carrying amount of an
asset may not be recoverable, a write -down to fair value is recorded. Fair values are determined
based on the discounted cash flows, quoted market values, or external appraisals, as
applicable. Long -lived assets are reviewed for impairment at the individual asset or the asset
group level for which the lowest level of independent cash flows can be identified. Management
has determined that no impairment existed for the year ended December 31, 2011.
Advertising Costs The Organization expenses advertising as incurred. There was no
advertising expense for the year ended December 31, 2011.
Management Estimates Management uses estimates and assumptions in preparing these
financial statements on the modified cash basis of accounting. Those estimates and
assumptions affect the reported amounts of assets and liabilities, the disclosure of contingent
assets and liabilities, and reported revenues, expenses, and other changes in net assets during
the reporting period. Actual results could differ from those estimates.
fl:
Income Taxes The Organization is exempt from federal income taxes under Section 501(c)(3)
of the U.S. Internal Revenue Code. No provision for federal income taxes has been made.
�r
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12
4i
5
Carmel Repertory Theatre, Inc.
Notes to Financial Statements (continued)
The Organization has adopted the provisions of Uncertain Tax Positions Disclosure Topics of
FASB ASC, which prescribes a recognition threshold of more likely- than -not to be sustained
upon examination. Measurement of the tax uncertainty occurs if the recognition threshold has
not been met. This guidance also addresses derecognition, classification, interest and
penalties, disclosure, and transition. In the normal course of business, the Organization is
subject to examination by taxing authorities. The Organization's tax returns for years
subsequent to fiscal 2007 are open, by statute, for review by authorities. However, at present,
there are no ongoing income tax audits or unresolved disputes with the various tax authorities
that the Organization currently files or has filed with.
Fair Value of Financial Instruments The following methods and assumptions were used by
the Organization in estimating its fair value disclosures for financial instruments:
Cash and cash equivalents due in less than one year The carrying amounts reported in
the statement of assets and net assets approximate fair values because of the short
maturities of those investments.
NOTE 2 DESCRIPTION OF PROGRAM AND SUPPORTING SERVICES
The Organization is a non profit community arts collective that encourages self- expression
through theater, music and dance. It seeks to develop, engage, and challenge audiences and
volunteers through the expansion of theater education and performance for both artists and the
greater Carmel community.
NOTE 3 SUBSEQUENT EVENTS
In preparing these financial statements, the Organization has evaluated events and transactions
for potential recognition or disclosure through March 29, 2012, the date the financial statements
were available to be issued.
:H
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F' 6
EXHIBIT F
.i ne Company
Board of Trustees Carmel Repertory Theatre
Board meetings are the second Sunday of each month. Next Meeting on 22- July -2012
due to AACT Board Meeting
Chairman Larry Creviston Carmel
Vice Chairman Jonathan Horton Carmel
Secretary Janet Crenshaw Carmel
Treasurer Patricia Bigham Indianapolis
Trustee Susan Creviston Carmel
Trustee Rachael Whitlock Carmel
Trustee Rayford Crenshaw Carmel
Trustee Tammy Haney Carmel
Trustee Natalie Corey, O.D. Carmel
Trustee Dick Leap Carmel
Trustee Larry BoneBright Indianapolis
Trustee Luke McConnell Carmel
General Counsel Douglas Haney, Esq. Carmel
Board Consultant Dr. Robert Gregory Kansas City
Board Consultant Duwain Hunt Orlando Fl
Committee Meetings are held on the last Sunday of the month at 6:30. Next meeting
will be held 29- July -2012 at Studio 15.
AACTFest Meeting 5:30
Operations Committee 6:30 Jonathan Horton, Larry Creviston, Tammy Haney,
Tracy Paul.
VOUCHER NO. WARRANT NO.
ALLOWED 20
Carmel Repertory Theatre IN SUM OF
484 E. Carmel Drive
Carmel, IN 46032
ib5, OW. DO
ON ACCOUNT OF APPROPRIATION FOR
Fund 504 Support for the Arts
'O# Dept. INVOICE NO. ACCT #/TITLE AMOUNT
Board Members
504 5 0 4 _t6 4;'8 Ut O q hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
Mayor
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
/10/12 Grant Support for the Arts r
Agreement [R coo. co
hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance
vith IC 5- 11- 10 -1.6
,20
Clerk- Treasurer