Department of the Treasury Internal Revenue Service
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. See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
BOYS & GIRLS CLUB OF LA PLATA COUNTY INC
Employer identification number
20-5112759
Part I
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
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
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 III.)
10
11
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).
f
If the organization received a written determination from the IRS that it is a Type I, Type II, 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 (ii)
Yes
No
and (iii) below, the governing body of the supported organization?
................
11g(i)
(ii)
A family member of a person described in (i) above?
......................
11g(ii)
(iii)
A 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of monetary support
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in)
(a) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
216,552
251,235
270,807
341,736
456,396
1,536,726
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
4
Total. Add lines 1 through 3
216,552
251,235
270,807
341,736
456,396
1,536,726
5
The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included
on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
23,341
6
Public support. Subtract line 5 from line 4.
1,513,385
Section B. Total Support
Calendar year
(or fiscal year beginning in)
(a) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(f) Total
7
Amounts from line 4..
216,552
251,235
270,807
341,736
456,396
1,536,726
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
3,063
5,765
2,243
-1,281
3,975
13,765
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
22,484
22,484
10
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
1,399
1,399
11
Total support (Add lines 7 through 10).
1,574,374
12
Gross receipts from related activities, etc. (see instructions)
..................
12
116,734
13
First five years.
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here........................................
Section C. Computation of Public Support Percentage
14
Public support percentage for 2012 (line 6, column (f) divided by line 11, column (f))
.........
14
96.130 %
15
Public support percentage for 2011 Schedule A, Part II, line 14
...............
15
94.670 %
16a
33 1/3% support test—2012.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
.......................
b
33 1/3% support test—2011.
If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2012.
If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization
.....................................................
b
10%-facts-and-circumstances test—2011.
If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization
................................................
18
Private foundation.
If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions
.....................................................
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 3
Part III
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 to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in)
(a) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(f) Total
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 furnished 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.)
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(f) Total
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.)..
14
First five years.
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public support percentage for 2012 (line 8, column (f) divided by line 13, column (f))
.........
15
16
Public support percentage from 2011 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f))
......
17
18
Investment income percentage from 2011 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2012.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
........
b
33 1/3% support tests—2011.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
.....
20
Private foundation.
If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 4
Part IV
Supplemental Information.
Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Schedule A (Form 990 or 990-EZ) 2012
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
BOYS & GIRLS CLUB OF LA PLATA COUNTY INC
Employer identification number
20-5112759
Identifier
Return Reference
Explanation
EXPLANATION ON VOLUNTEERS AND TYPES OF SERVICES OR BENEFITS
FORM 990, PAGE 1, PART I, LINE 6
VOLUNTEERS PROVIDE PROGRAM AND ACTIVITY SUPPORT IN THE CLUB'S AFTER-SCHOOL AND SUMMER PROGRAM AS WELL AS GENERAL ADMINISTRATIVE, MAINTENANCE, ACCOUNTING, AND ORGANIZATIONAL SUPPORT THROUGH BOARD AND/OR COMMITTEE SERVICE.
FIRST ACCOMPLISHMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4A
ACTIVITIES: --A TOTAL OF 270 MEMBERS PARTICIPATED IN PROGRAMS TO PROMOTE GOOD CHARACTER AND CITIZENSHIP INCLUDING TORCH CLUB, KEYSTONE CLUB, JUNIOR TORCH CLUB, YOUTH OF THE MONTH, YOUTH OF THE YEAR, HIGH SCHOOL LEADERSHIP LA PLATA AND P.A.S.S SPORTS LEADERSHIP GROUP. THIS RESULTED IN 2,800 HOURS OF PARTICIPATION IN CHARACTER AND LEADERSHIP ACTIVITIES. --305 MEMBERS PARTICIPATED IN ACADEMIC SUCCESS PROGRAMS SUCH AS POWER HOUR HOMEWORK HELP PROGRAM (AVERAGE OF 35 YOUTH ATTENDED DAILY). 280 MEMBERS PARTICIPATED IN PROGRAMS SUCH AS PROJECT LEARN, POWER HOUR, KIDS COLLEGE, AND CLUB TECH. THIS RESULTED IN 3,360 HOURS OF HOMEWORK AND EDUCATIONAL ACTIVITIES. --A TOTAL OF 258 MEMBERS PARTICIPATED IN PROGRAMS TO PROMOTE HEALTHY LIFESTYLES INCLUDING: SPARK, SMART MOVES KIDS IN THE KITCHEN, AND GARDEN CLUB. THIS RESULTED IN 9,288 HOURS OF HEALTH AND FITNESS PROGRAMMING. OUTCOMES: THE END OF THE YEAR MEMBER SURVEY WAS COMPLETED BY ALL MEMBERS WHO ATTEND THE CLUB AT LEAST THREE TIMES PER WEEK. SOME SURVEY HIGHLIGHTS INCLUDED THE FOLLOWING: --98% REPORTED THAT THEY THINK IT IS IMPORTANT TO STAY IN SCHOOL; --75% REPORTED THAT THEY GAINED LEADERSHIP SKILLS AT THE BOYS & GIRLS CLUB; --93% REPORTED THAT SINCE COMING TO THE BOYS & GIRLS CLUB, THEY TREAT OTHERS WITH MORE RESPECT; --87% REPORTED THAT SINCE COMING TO THE BOYS & GIRLS CLUB, THEY EXERCISE FOR 30 MINUTES OR MORE EVERY DAY.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990
FORM 990, PAGE 6, PART VI, LINE 11B
THE CHIEF PROFESSIONAL OFFICER AND FINANCE COMMITTEE REVIEW THE FORM 990 PRIOR TO FILING. A COPY OF THE FORM 990 IS ALSO PROVIDED TO THE BOARD OF DIRECTORS VIA E-MAIL PRIOR TO FILING.
ENFORCEMENT OF CONFLICTS POLICY
FORM 990, PAGE 6, PART VI, LINE 12C
IN ADDITION TO REQUIRING BOARD MEMBERS, STAFF, AND REGULAR VOLUNTEERS TO PROACTIVELY NOTIFY THE FULL BOARD OF ANY CONFLICTS, ALL BOARD MEMBERS, STAFF, AND REGULAR VOLUNTEERS MUST SIGN AN ANNUAL FORM WHICH A) AFFIRMS THAT THEY HAVE RECEIVED A COPY OF THE POLICY; B) READ AND UNDERSTOOD IT; C) AGREED TO COMPLY WITH THE POLICY; D) UNDERSTOOD THAT BGCLPC IS A CHARITABLE ORGANIZATION AND MUST ENGAGE IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES; AND E) LIST ALL RELATIONSHIPS WITH BGCLPC VENDORS, SERVICE RECIPIENTS, FUNDERS, EMPLOYEES, AND CONTRACTORS. ALL POTENTIAL CONFLICTS ARE REVIEWED BY THE BOARD OF DIRECTORS WITHOUT THE PRESENCE OF THE INTERESTED PARTY.
COMPENSATION PROCESS FOR TOP OFFICIAL
FORM 990, PAGE 6, PART VI, LINE 15A
THE BOARD OF DIRECTORS REVIEWS AND APPROVES THE CHIEF PROFESSIONAL OFFICER'S ANNUAL SALARY, WITH NO PARTICIPATION BY THE CHIEF PROFESSIONAL OFFICER OR OTHER INTERESTED PERSONS. THE CHIEF PROFESSIONAL OFFICER'S SALARY IS ESTABLISHED USING COMPARABLE DATA FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILAR NONPROFITS; CONSIDERATION OF ROLES AND RESPONSIBILITIES OF THE CHIEF PROFESSIONAL OFFICER; AND COST OF LIVING DATA. COMPARABLE MARKET DATA IS OBTAINED FROM THE BOYS & GIRLS CLUBS OF AMERICA SALARY SURVEY. THE CHIEF PROFESSIONAL OFFICER ALSO RECEIVES REIMBURSEMENTS FOR ROUTINE, REASONABLE, AND DOCUMENTED EXPENSES INCURRED DURING THE YEAR. THE CHIEF PROFESSIONAL OFFICER TRAVELS THROUGHOUT OUR SERVICE AREA.
COMPENSATION PROCESS FOR OFFICERS
FORM 990, PAGE 6, PART VI, LINE 15B
A LINE ITEM BUDGET IS APPROVED BY THE BOARD OF DIRECTORS ANNUALLY. THE BOARD APPROVES THE OVERALL SALARIES AND BENEFITS EXPENSES. DISCUSSIONS AND DECISIONS REGARDING THE BUDGET ARE DOCUMENTED IN BOARD MEETING MINUTES. THE CHIEF PROFESSIONAL OFFICER REVIEWS AND APPROVES THE SALARIES OF OTHER OFFICERS OR KEY EMPLOYEES, WITH NO PARTICIPATION BY THE INTERESTED PERSONS, IN ACCORDANCE WITH THE ANNUAL BUDGET APPROVED BY THE BOARD. THE CHIEF PROFESSIONAL OFFICER ESTABLISHES SALARIES USING COMPARABLE DATA FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILAR NONPROFITS; CONSIDERATION OF ROLES AND RESPONSIBILITIES OF THE OFFICER OR KEY EMPLOYEE; AND COST OF LIVING DATA.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION
FORM 990, PAGE 6, PART VI, LINE 19
THE FINANCIAL STATEMENTS AND GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST.
RECONCILIATION OF CHANGES - OTHER
FORM 990, PART XI, LINE 9
SPECIAL EVENTS EXPENSES 6,073 SPECIAL EVENTS EXPENSES -6,073
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.